January 23, 2007

Disabled Children

During an Opposition Day debate on disabled children, John Bercow specifically highlights the needs of children whose disability is to suffer from a speech, language or communication impairment and the importance of early intervention.

John Bercow (Buckingham) (Con): I begin by declaring an interest as the father of a child who has significant, and probably long-term, special educational needs. It is a privilege to follow the hon. Member for Blackpool, North and Fleetwood (Mrs. Humble), because she speaks with integrity and authority on the issues that we are discussing. I also pay warm tribute to my hon. Friend the Member for South-West Surrey (Mr. Hunt), who offered the House both a forensic dissection of some of the failings of the system and a philosophical framework that will inform the policy of the next Conservative Government, and I congratulate him on that.

As chair of the all-party group on speech and language difficulties, I would like narrowly to focus my remarks on the 1.2 million children whose disability is to suffer from a speech, language or communication impairment. Each and every right hon. and hon. Member in the Chamber is familiar with, and probably signed up to, the doctrine and mantra of ensuring that there is earlier intervention to address such impairments. We all know the consequences of effective early intervention, and the dangers of its absence. Let us take a child with initial speech, language and communication impairments. If early intervention takes place and is focused and effective, a child with relatively moderate difficulties will be able to read, spell and communicate by the age of five and a half. However, the consequence of the failure of that early intervention, which is an essential prerequisite for recovery and progress, is bleak indeed. Some of the consequences for a child who does not get the benefits of that early intervention are, of course, obvious. Later interventions, because time has been lost, will probably have to be more intensive, and will necessarily entail a greater cost. It is likely, as others have pointed out, that the problem will deteriorate and the condition will worsen so that instead of suffering from a significant but transient condition, the child unfortunately suffers from an impairment that is significant, persistent and even insuperable.

I want to reflect on the consequences for children in such circumstances of the absence of early intervention. There are huge risks, both to the child and to the country. The risks to the child are well known, but they must be underlined so that they are at the forefront of ministerial and other minds in the discussion of public policy. There is a risk of emotional and psychological difficulties; of poor behaviour; of lower educational achievement; of a persistent handicap in communication; of deteriorating employment prospects; of serious challenges to the individual’ mental health; and, yes, there is a notable risk of descent into criminality, of which the individual denied services and the country as a whole are the hapless victims.

I said that there was a problem not just for the individual but for a society as a whole, and it can be viewed in economic terms. I calculate that the lifetime cost of denying effective assistance to the present primary school cohort with language and communication impairments is £26 billion. Without early intervention to address their disability and offer them hope and the prospect of progress, they suffer an economic loss in earnings potential and societal contribution which I CAN calculates to be worth £97,000 per person. In Milton Keynes, Buckinghamshire and Oxfordshire, 2,063 people fall into the so-called NIET category—not in education, employment or training—and 1,000 are in that position as a consequence of speech, language and communication impairments that have not been addressed, which is a very serious state of affairs indeed.

We must reflect on the public policy required to address the problem. I do not want large numbers of people to be consigned to unemployment, disability and continuing dependence, or to be deprived of opportunities and denied a chance to contribute effectively to the society of which they are part. They want to assert themselves, to achieve, to be independent, and to prove how much they have to offer, both for their own self-fulfilment and for the benefit of society as a whole.

I wish to identify, in as non-partisan a way as I can—and I think that the record shows that I generally do so—a number of issues that must be dealt with if we are to address the disabilities of those children and of others. First, may I tell Ministers that there is a fundamental weakness and conflict of interest at the heart of the special educational needs system? The local education authority, as my hon. Friend the Member for South-West Surrey said, has long been in a position of virtual omnipotence, which is an unsatisfactory and indefensible state of affairs. To put it simply, the LEA assesses, decides, pays for and, more often than not, provides the services to meet the assessed needs of the individual disabled child. That seems to me to be fundamentally wrong. It logically follows, as parents—including myself, know from our personal testimony and experience—that when we are seeking a statutory assessment, when we are successful in obtaining a statement of special educational needs, when we are arguing about the precise contents of that statement, or when we are fighting our corner to secure its effective implementation, we are up against an authority that has been in the driving seat throughout the process.

That is wrong, and it is not only my view—it is the view of an authoritative body, after considered reflection and detailed study of the available evidence. I refer, of course, to the Education and Skills Committee, so ably and independent-mindedly chaired by the hon. Member for Huddersfield (Mr. Sheerman). Its report was clear that that system needed to change. My own view—and I will not rehearse the detail or the intricacies of the system tonight—is that we need to move towards a system for the delivery of special educational needs, including the determination of eligibility for statements, which is independent of Government, of local education authorities, of the source of funding and of the means of supply. Unless and until we get to that point, there is a lacuna in the system, which I readily concede has applied under successive Governments. The fact that we as a country got it wrong in the past should not in any way cause us to shy away from the issue or abdicate our responsibility.

Mr. Tom Clarke: The hon. Gentleman is making an inspiring and extremely well informed speech. May I reassure him that when our review considered these matters, including the recommendation of the Select Committee, we unanimously endorsed that recommendation? I hope that he will find some comfort in that view.

John Bercow: I am extremely grateful to the right hon. Gentleman. That is consistent with the non-partisan spirit that ought, as far as is possible, to inform these debates, and has certainly characterised the discussions that I have had with the right hon. Gentleman over a period of nearly a decade. It was an incisive intervention which happened to help my cause, and I am grateful to him.

We talk, as I said, about early intervention. In very broad terms admitting of some oversimplification, one can categorise the debate in terms of deciding what is needed and then ensuring that it is available. On the subject of determination, I believe that we suffer continually in this country from a problem of late assessment, late identification and late diagnosis. I recognise, as the Under-Secretary of State for Work and Pensions, the hon. Member for Stirling (Mrs. McGuire) would argue if I did not, that in the case of a child there is a process involved, that development can proceed at different rates, and that it is legitimate to allow for periods in which changes in behaviour or performance can be achieved. However, I believe that sometimes those operating the system play precisely upon the hopes, as well as the more exaggerated fears, of some parents by saying, “Don’t worry. There’ plenty of time.” Of course, those who are articulating that message very often have a reason of financial self-interest for holding back the provision of what is needed. I say to the hon. Lady that there is a problem in that regard.

There are magnificent people working in the public service for disabled children. I think, for example, of health visitors, early years workers, teaching assistants and qualified teachers. Therefore, it might be politically incorrect to say what I am about to say, but, notwithstanding their experience and their dedication, they are not always remotely well trained or equipped specifically to identify the range of impairments from which children can suffer. We all know of stories from all parts of the House of people who had to wait two, three or four years to get the assessment that is needed. I know of a recent case that was highlighted to me by the National Autistic Society of a child whose diagnosis was incredibly late and who suffered grievously in consequence. We know that one in five schools does not possess a single teacher who has had more than a day’ training in the phenomenon of autism. That person is inevitably not well equipped to identify the difficulties, still less to offer a prescription.

I suggest a practical way forward. Let me ask the Under-Secretary of State for Health, the hon. Member for Bury, South (Mr. Lewis), who will respond on behalf of the Government, why not listen to the view of the Association for All Speech Impaired Children, of which I am fortunate recently to have become a patron? It made a submission to the Treasury review on services for disabled children. It suggested the development through specialist expertise of a particular screening test that would help at an early stage in a range of schools to identify who suffered from which impairment and how that child might best be helped. A speech and language therapist could develop such a test at a relatively modest cost, and the expertise could then be spread across the piece.

We must also take account of the problems that result from lack of capacity. I appreciate that the Government have invested significant resources—I respect that, applaud it and believe that some benefits can flow from it. However, a difficulty remains. If a child is integrated into mainstream education, with no additional provision or frills because the impairments are judged to be relatively modest, so be it, but we must still ensure that trained staff are readily accessible to deliver assistance of a quality, in a quantity and at a time required. That does not always happen.

Schools have language units attached to them that often provide for children with somewhat more pronounced difficulties. Again, I declare an interest because my son started school at such a facility last week, and I have high hopes of what might be achieved there. We need more of them and we must ensure that there is a quality team available, preferably in the school. I should like a speech and language therapist to be based in every primary and secondary school in the country. However, when that cannot happen, we need training for people and peripatetic provision of considerable intensity at regular intervals. We must define what we mean by “regular” for individual pupils.

At the severe end of the spectrum, we must ensure either that we have highly qualified local people who can deliver and develop capacity sufficiently to ensure that every child gets what is necessary or we have to go for something else. We must have regional centres of excellence and the use of expertise, the better to cater for such difficulties.

The Under-Secretary knows that in “Every Child Matters”, the word “specialist” is used no fewer than 32 times. In “Removing Barriers to Achievement”, it appears 68 times. He knows that in 2002 the Audit Commission deplored the shortfall in specialist provision and that the Government have said that there must be high quality, intensive, local provision available before a decision is made either to reduce places in a special school or to close whole institutions. I emphasise the importance of that in the context of dealing with low incidence, serious, persistent, complex and multifaceted impairments.

The Government have done some good work, but there are genuine weaknesses in the system that need to be tackled. In my judgment, too many children have suffered too much for too long. They get too little, too late and the recovery that then has to take place is an enormous challenge for them, their families and the educational system. Let us resolve to go forward, improve policy and ensure that every child gets the best deal that can be offered.

9.24 pm

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