July 20, 2008
Bercow Review debate
John Bercow introduces his report into services for children and young people with speech, language and communication needs.
John Bercow (Buckingham) (Con): It is a pleasure to follow the Under-Secretary of State for Children, Schools and Families, the hon. Member for Cardiff, West (Kevin Brennan), and I am particularly grateful to him for his generous remarks this afternoon. I would like to take the opportunity to acknowledge and pay tribute to the Secretary of State for Health and the Secretary of State for Children, Schools and Families, who have been unstinting in their support and encouragement of me in this venture during the past 10 months.
A great many colleagues have engaged with the review, either by inviting me to visit a pre-school, primary school, secondary school or somewhere with post-16 provision, or by making a written submission. To each and every one of them, for their contribution to an important task, I am greatly indebted. Although it is invidious to single out an individual, I am moved to pay a special tribute to someone who has gone the extra mile‚Äîway beyond the call of duty‚Äîin submitting material to me and offering me personal support and encouragement throughout, and that is the right hon. Member for Sheffield, Brightside (Mr. Blunkett), whom I am delighted to see in his place.
The Under-Secretary referred to the process through which my colleagues on the review advisory group and I have gone in the past 10 months. We have sought evidence from four different sources. First, we launched an online consultation questionnaire in October, to which, on the due date of 18 January, we had received more than 2,000 replies, of which just over half were from parents, telling us what they thought, what worked, what did not work, and what was needed.
Secondly, we staged a series of focus or consultation groups around the country, calling on children, young people and their parents to offer their impressions of the state of services. In addition, we thought it justified and prudent to stage two particular focus groups on the thorny questions of augmentative and alternative communication under the auspices of Scope on the one hand, and of provision for young offenders, courtesy of the Prison Reform Trust, on the other.
Thirdly, as the Under-Secretary said, we went round the country, visiting pre-schools, primary schools, secondary schools and post-16 facilities. A plethora of different examples were presented to us. We wanted to see not only London and the south-east but the midlands, the north and the south-west, urban and rural areas, mixed communities, different social cohorts and so on, to get the widest possible representative picture of what currently is‚Äîand is not‚Äîon offer.
Finally, we thought it right to secure the services of some noted and distinguished academic researchers in speech, language and communication, a group of whom have engaged in a detailed project to look at service provision in six different areas, and seek to adduce evidence from their studies, the better to inform future policy making and the prospects of necessary and beneficial research.
We have formed some fairly clear and explicit conclusions, based on what we saw around the country. Without doubt, some excellent professionals and high-quality services are out there, but, on the whole, the current state of speech, language and communication provision is highly unsatisfactory. Access to information and services is often poor; the quality of services is very mixed; continuity across the age range is lacking; joint working between health and education professionals, which is so critical to achieving success, is rare, and the system is characterised by high variability and a lack of equity, the short-hand translation of which is that a postcode lottery currently exists throughout the country. Above all, the priority attached to communication is too low. In our judgment, that must change.
David Tredinnick (Bosworth) (Con): I congratulate my hon. Friend on the report. I wrote to him about specific problems in my constituency with the recognition and treatment of dyslexia. Will he say a word about his findings about the more difficult conditions of autism and Asperger’ syndrome, which appear increasingly to affect children nowadays?
John Bercow: I certainly will pick up on the theme that my hon. Friend has identified, because it is essential to cater for all the groups on the spectrum. I will say something more shortly about the need for a broad range of provision.
The Under-Secretary referred to the five themes around which the review’ recommendations have been formulated. Communication is crucial‚Äîit is the key life skill that enables children to learn, achieve, make friends and interact with the world around them. It is a vital part of the equipment of citizenship, yet all too often it has not enjoyed that priority in the minds of commissioners or policy makers. Sometimes an unwritten, unspoken and‚Äîdare I say it?‚Äîlazy assumption has been made that children will speak when they are ready, and other important aspects of the children’ development agenda have tended to elbow speech, language and communication out of the way.
That is why we have recommended the creation of a ministerial communication council upon which both the Department of Health and the Department for Children, Schools and Families would be prominently represented. We believe, too, that an identified individual with relevant expertise and commitment‚Äîa communication champion‚Äîshould be appointed to drive forward the process of implementation, to report to the communication council, to raise awareness and to disseminate best practice. The communication champion will, over time and after appropriate and due preparation, have responsibility for overseeing and running the national year of speech, language and communication.
As part of that process of investing in speech, language and communication services and making them a great priority, it is right that information at key ages and stages of a child’ development should be proactively made available, in a readily accessible form, to children, young people and, in particular, their parents, charting the normal course of communication development, indicating where a person should go if there is a difficulty and advising parents on how best they can assist in the process of bolstering their children’ speech, language and communication development. That concept‚Äîthat communication is crucial‚Äîaccompanied and reinforced by a series of specific recommendations, is very important.
The Minister rightly referred to early intervention. At the risk of being marginally pedantic, I would like to describe it as early identification and intervention. If we are to identify early, we need regular monitoring and surveillance of children’ speech, language and communication development at key ages and stages. We have not been over-prescriptive‚Äîthere is scope for differences of opinion on the exact point at which it is most appropriate to undertake the monitoring; indeed, there is also scope for local variation in what is judged to be right‚Äîbut the principle that monitoring and surveillance should be done, that it should be done regularly, and that it should be done with a view to securing a signpost to appropriate assistance if there is a problem, is important and, indeed, inviolable.
We all know that if we intervene early when there is a problem, the child has a better chance, other things being equal, of overcoming the difficulty, accessing the national curriculum and fulfilling his or her potential. The logical corollary of that is that if we do not intervene early, the problems mount: emotional and psychological difficulties, behavioural problems, lower educational attainment, poorer employment prospects, persistent communication impairment, challenges to mental health and, in extremis, even a descent into offending and reoffending. That is why it is so important that we intervene early, both through that monitoring and surveillance, and by making speech, language and communication a prime component‚Äîa centrepiece‚Äîof the work of all children’ centres.
Mr. David Blunkett (Sheffield, Brightside) (Lab): I thank the hon. Gentleman for his enormous generosity towards me. I also congratulate him on an excellent piece of work and on persuading the Government to have a year dedicated to bringing it alive and implementing its recommendations. I would like to pick up his point about early identification. Following my hon. Friend the Minister’ comment about point three of the five-point plan, may I suggest that in the identification process, we need to take account of the fact that for many children‚Äînot all, but many‚Äîthere will have been a problem in identifying speech, language and communication difficulties in their lives already, before they reach a statutory group or even before they are identified by Sure Start, and that it is very important to work with the family, not just the child, on bringing alive that child’ talent and capability?
John Bercow: The right hon. Gentleman could not have put it more powerfully if he had tried. That early intervention is incredibly important. Yes, it involves the child, but it is important to ensure that we have the benefit of the services of multidisciplinary teams. Precisely which representative will be relevant in a particular case will vary from one situation to another, but we need to have speech and language therapists, teachers, classroom assistants and special educational needs co-ordinators as part of the mix. Indeed, health visitors might be needed in certain circumstances, too. Some flexibility in that process is important.
Reference has already been made to the continuum of services, and I want to underline that we need to ensure that, through effective joint commissioning between education and health services, we commission services that are across the piece. They should be universal services that can be of benefit to all children and young people who need to have their capacity to communicate taught, honed and nurtured. We need targeted services for those who require a little additional help‚Äîsometimes only for a short period and sometimes for longer‚Äîand specialist services, which are often tailored for the benefit of those with acute and ongoing needs, who will realistically require extensive and specialist provision, including therapy, sometimes for long periods.
I simply say, in all courtesy, to the Government that I have made recommendations in respect of augmentative and assistive communication‚Äîthat is to say, for those who require communication aids‚Äîand in respect of the requirements of young offenders, about which there is still some anxiety and scepticism. My message to the Government is that in taking this process forward and securing what I hope will be the advantageous implementation of the report’ recommendations, we must be sure that we do more than just the easy stuff. We must cater more widely than just for those with relatively minor difficulties and those who need low-dosage intervention, of whom there are large numbers. They are incredibly important, and Ministers are right to highlight those cases. However, we also have a duty to do more‚Äîto do all that is necessary‚Äîto bring benefit to those whose needs are the most acute. A child or young person who requires an expensive piece of technological kit in order to have a voice is deeply needy. They might be non-verbal, and in such situations we must stop at nothing to ensure that the appropriate help is provided. We must not fight shy of knowing the scale and incidence of the challenge with which we are confronted.
In taking forward the pathfinders, we will learn a great deal. There will be five areas involved, and I am grateful to the Government for the fact that they will be funded by the Department for Children, Schools and Families or the Department of Health‚Äîthey can fight about that between themselves‚Äîand will have a responsibility to assess need, to devise services, to secure the appropriate skilled work force, to put the processes into effect, to monitor the outcomes and to report the results. That means having a work force, to boot, which is why we have recommended that speech, language and communication must be at the heart of all the qualifications leading to the integrated qualifications framework. Qualified teacher status must demand a greater knowledge of, and‚Äîto a degree‚Äîexpertise in, speech, language and communication. It is also right that speech, language and communication should be a core requirement and an elective module of the new master’ degree in teaching and learning, on whose introduction I congratulate the Secretary of State for Children, Schools and Families.
Joint working must be to the fore, but I am sorry to say that at the moment, that principle is honoured more often in the breach than in the observance, especially at the level of strategic planning and priority setting. That is why I have said that we should let each children’ trust designate an appointed person to drive forward the pursuit of improved speech, language and communication outcomes. I speak possibly as the voice of cynical experience when I say that I have a sense that if something is everybody’ responsibility, ultimately it is no one’ responsibility. If we name an individual and give him or her a task, set the benchmark, require the assessment and demand the performance, at least there will be a likelihood of a catalyst for improvement. Certainly, the public would have someone to whom they could properly direct their complaints or representations if success were not achieved.
Tackling postcode variations is critical. Local variation, local initiation, local social entrepreneurship, and local variety depending on the make-up of one area relative to another are of course valid and necessary. However, we need to make some sort of core offer to children and young people that they can depend upon. They need a certain level and type of service, irrespective of the part of the country in which they happen to live. In that regard, I perhaps risk upsetting the Opposition Front-Bench spokesman, my hon. Friend the Member for East Worthing and Shoreham (Tim Loughton), but I say that there is a compelling case for the continuation of early-years targets beyond 2011, and for working towards the development of a national indicator on speech, language and communication as the prelude to a public service agreement target post-2011.
Mr. Deputy Speaker, I have to say that engagement in this review has been the single most stimulating and rewarding endeavour of my 11-year parliamentary life. It is about two things. It is about helping needy, marginalised, vulnerable and sometimes frightened young people, because that is the right and decent thing to do. I have a child who is so affected, and I make no apology for trying to do my best to ensure that other children get the sort of excellent help that my son Oliver is receiving.
However, this issue is not just or even mainly about compassion or niceness or being decent; it is also about the authentic self-interest of Britain plc, because tackling these problems is relevant to the educational attainment agenda. It is relevant to the greater qualifications agenda, to the acquisition of vocational skills agenda, to the fight against antisocial behaviour agenda, to the improvement of public health agenda, and to the pursuit of the commercial advantage of UK plc in an age in which a job for life is a relic of the past and the premium placed on speech, language and communication in today’ knowledge economy is greater than ever. If in my small way, with the assistance of a fantastic advisory group and the support and engagement of parliamentarians throughout the House, I can broker an improvement in services for, and the life chances of, these vulnerable children and young people, I can say that I shall die a happier man‚Äîalthough not, I hope, just yet.