Auditory Verbal Therapy

Sharon Hodgson Excerpts

Tuesday 21st January 2025 Westminster Hall

[Mrs Sharon Hodgson (Washington and Gateshead South) (Lab)]

I beg to move,

That this House has considered the provision of auditory verbal therapy.

It is an honour to serve under your chairmanship this fine morning, Mr Western. I thank all hon. Members, especially the new Members, who have come along to speak in this all-important debate, which I have the privilege of opening. I thank the Minister for Care, my hon. Friend the Member for Aberafan Maesteg (Stephen Kinnock) and the shadow Minister, the hon. Member for Hinckley and Bosworth (Dr Evans) for attending.

I am delighted to see in the Gallery Sam and his parents, whom I met when I sponsored Auditory Verbal UK’s parliamentary drop-in back in October last year—how time flies! At that reception, I was talking to Sam and some of the other young people there, and I asked whether any deaf children had come along, only to be told that all the children I had been talking to were actually deaf, including Sam. That is the difference this therapy can make, and why I am so passionately supporting and making this case today.

Sam was diagnosed as being profoundly deaf at five weeks old. It was not until Auditory Verbal UK was recommended to Sam’s parents by a friend of a friend, by chance, that his fate changed forever. With the help of auditory verbal therapy, Sam learned to listen and talk just like his peers. Now 13 years old, Sam can speak and do anything he puts his mind to. He is doing really well at school, I am told, and will enjoy the same opportunities as his hearing friends.

For children like Sam, Auditory Verbal UK has been life-changing. Its specialist work and support provided to deaf children and their families is truly remarkable. I am therefore glad to also see representatives from AVUK here today. They will always have my support and should be very proud of the work they do.

Sam stands today as living proof that when deaf children and their families have access to early, effective support to develop language and communication, opportunities are transformed. If the Government, or anyone here or watching at home, need convincing of the clear, compelling and existing evidence of the benefits of auditory verbal therapy, they have only to look to children like Sam.

Although all deaf children would benefit extraordinarily from auditory verbal therapy, the truth is that they will not all be as lucky as Sam. The current reality is that more than 90% of deaf children under the age of five in the UK are unable to access auditory verbal therapy, because there is little to no provision through publicly funded services. Currently, there are a mere 33 certified auditory verbal therapists in the UK. It is clear that these wonderful therapists, who hold the potential to transform the lives of our deaf children, are sadly few and far between.

In the whole of the north-east, there are no qualified auditory verbal therapists. Deaf children in my constituency of Washington and Gateshead South, for example, are unable to access this support through publicly funded services. This postcode-lottery approach to healthcare is simply unacceptable. This is the situation in spite of public research that shows that a huge 83% of adults from the north-east believe that auditory verbal therapy should be available to all deaf children via publicly funded services. We know the therapy works and that there is public support for its roll-out throughout the country, so what are we waiting for?

Raising awareness that support is out there is just the first hurdle, because if impacted families are aware of the therapy but have no qualified therapists in their area, their challenges persist. Even Sam’s journey from discovering auditory verbal therapy to completing it was far from smooth sailing. With no access to the therapy via public services local to him, he and his family had to travel weekly to Oxfordshire from Eastbourne so that they could access this life-changing therapy. Not all deaf children and their families can afford the privilege of time or money to go to such lengths every week, as much as they may want to. Certainly, not all deaf children have the privilege of having a qualified therapist in their area, which is a clear problem. We absolutely need to address that inequality of access.

To extend access, we need to train more specialist practitioners in auditory verbal therapy. By equipping a small proportion of the speech and language therapists, audiologists and teachers of the deaf who are currently working in the public sector with additional skills in this approach, we can enable every family who wants their deaf child to learn to listen and talk to access auditory verbal therapy through publicly funded services close to where they live.

Training is already happening, with UK professionals already qualified and others on their training journey. This is possible only thanks to the fundraising efforts of the charity Auditory Verbal UK, including two teachers of the deaf in the north-east who remain in training. There is a clear route for professionals to become trained in auditory verbal therapy, as well as a cohort of public sector professionals who can then share their experience of training and how it has enhanced their practice. Research points towards the fact that as a result of pursuing the training and qualifying as listening and spoken language specialists, professionals recognise significant growth in their knowledge and skills, equipping them to train others who can then do the same—the “train the trainers” model.

There are around 50,000 deaf children in the UK, and 7,200 of them are under the age of five. They currently face the prospect of lower academic achievement and employment, and they are at a higher risk of poor mental health, bullying and social exclusion. Deaf children are almost twice as likely as all children to complete their first year of school without having achieved a good level of development in relation to the early years foundation. The statistics clearly highlight a stark difference between hearing and non-hearing peers in quality of life, educational attainment, employment rates and mental wellbeing.

If the moral argument is not convincing enough, surely no one can deny the huge economic returns. Economic analysis based on His Majesty’s Treasury guidelines shows that an investment of just £2 million per year for the next 10 years for training a proportion of the existing public sector workforce could deliver a whopping £152 million of economic benefit to the UK. That is a massive £11.7 billion over a 50-year period.

The economic savings are huge, including £3.4 billion through less need for one-to-one support throughout primary school; £1 billion of increased employment; £4 billion due to increased quality of life; a £7.5 million decrease in Government support; and £30.5 million saved through avoided injury. It is a small economic investment that will transform the lives of some of the most vulnerable children in this country, while also bringing us huge economic returns. Surely this is a no-brainer.

So long as the UK remains unconvinced, we are falling behind as other countries trailblaze the way. Auditory verbal therapy is already state-funded in countries including Australia, New Zealand and Denmark, and the success rates speak volumes. In 2022, following a successful Government-funded pilot in Denmark that showed that 84% of children acquired age-equivalent spoken language after just three years of AVT, compared with 30% previously, auditory verbal therapy became part of the standard healthcare system there. The irony is that here in the UK we are now training many Danish professionals in AV therapy to deliver it to children in Denmark, despite being unable to support our own workforce to enhance their skills to get those outcomes for children here in the UK. That cannot be right.

I thank the Minister for his time and leave him with three questions. First, what scope is there for the UK to implement a pilot scheme, in the same way that Denmark did, at least to prove the transformation potential of this therapy in a couple of areas, for those who remain unconvinced? Secondly, will he commit to supporting the need to increase access to auditory verbal therapy, and provide the investment needed when the funding allows? Thirdly, will he meet the deaf children and families charity Auditory Verbal UK, from which representatives are here today, to hear at first hand about the impact of early support, and the charity’s tangible plans to enable families to access the therapy wherever they live in the UK?

I thank the Minister in advance and look forward to hearing the other speakers. I look forward to the Minister’s response after he has listened to colleagues’ perspectives in this very important debate.

[Several hon. Members rose—]

--- Later in debate ---

[Stephen Kinnock]

My hon. Friend will know that one of the constant challenges in the system is getting the right balance between empowering those operating at the coalface—those who are close to the communities and know them best—to ensure they are delivering the best possible services, and ensuring consistency and coherence, both strategic and operational, across the entire system. It is safe to say that we are not always getting that balance right. One of the key objectives of the 10-year planning process that we are going through will be to address the so-called postcode lottery—variation between regions—across the whole range of health and care. Without that cross-cutting strategic look at the system, it will not be possible to get the balance right. I absolutely take the point, but one thing I will say is that we are crystal clear when we issue guidance to ICBs that they must take that guidance into account, and their performance is monitored on that basis.

[Mrs Hodgson]

Am I right in thinking, from what the Minister has just said, that he will issue revised guidance following today’s debate? Am I right that the Government, having given an extra £26 billion to local areas, will give them guidance that they should be looking to commission these services on a much bigger scale, so that we have more than 33 AVT therapists?

[Stephen Kinnock]

I can certainly tell my hon. Friend that this is a very dynamic situation. A system never stands still. For a system to work, we have to be constantly reviewing its performance and whether it is delivering to its objectives. I believe that the 10-year plan that we are producing will absolutely lead to a radical rewiring of the way our health and care system works. It will be driven by three big shifts: from hospital to community, from sickness to prevention, and from analogue to digital.

There is no doubt at all that where there are therapies and treatments that are working—that are clearly delivering big results, and value for money for the taxpayer—it is right that we give those priority in the way that we deliver. It is clear that AVT has huge potential, and it appears to have unexplored potential. I cannot pre-empt today how this is all going to pan out in terms of the system and the reforms that we are looking to push forward, but I can assure my hon. Friend that we are committed to innovating and to building a system that is fit for the future.

In 2019, with input from the National Deaf Children’s Society, NHS England produced a guide for commissioners and providers who support children and young people with hearing loss. The guide provides practical advice on ensuring that non-hearing children receive the support they need. Auditory verbal therapy is one type of therapy to support children with hearing loss, and it is important that local commissioners know their population and have the discretion to decide how best to meet its needs. When it comes to commissioning and providing services for children with hearing loss, we have been crystal clear with ICBs and NHS trusts that they must take the relevant guidelines into account.

We recognise the real need to improve access to therapies for all children who need them, including children with hearing loss. In recent years, in very difficult circumstances, the NHS has increased the number of speech and language therapists working in the service, but we know that more needs to be done. That is why the Government are committed to fixing the NHS and building a service that is fit for the future, with the workforce it needs to get patients seen on time.

--- Later in debate ---

[Mrs Hodgson]

I thank everyone who has taken the time to come along and made such excellent contributions on this vital issue. I thank the Minister, the hon. Member for Hinckley and Bosworth (Dr Evans), who spoke for the Opposition, and the hon. Member for North Shropshire (Helen Morgan), who spoke for the Lib Dems, for listening.

I was happy to hear that the Minister will meet AVUK and explore the potential of a pilot. That is great news. I hope that he might also get a chance to speak to Sam today—that would be wonderful. I also hope that, if NICE deems—as we all have—that this therapy is both clinically and economically valuable, he will update the guidance to ICBs. The Minister also mentioned the NHS 10-year plan. I hope he recognises that it has already been nine years since the guidance was updated and that the issue needs urgent attention, perhaps towards the start of the 10-year plan rather than the end of it; otherwise, we will be getting on for 20 years.

Today, we have the opportunity—the Minister especially—to change the fate of deaf children in this country. They deserve the same opportunities and outcomes as their hearing peers. That surely cannot be a controversial position. These children are the future. We must invest in them, not only because it is the right thing to do morally, but because any financial investment will produce economic returns in abundance. Mainly, we should invest in them because our children deserve it.

[Matt Western (in the Chair)]

I also thank Sam and his family for attending this morning.

Question put and agreed to.

Resolved,

That this House has considered the provision of auditory verbal therapy.