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Column 31the LEA is expected to provide on the basis of the needs stipulated in the statement. The draft of the code before us puts a stronger emphasis on the role of the LEA in that respect. I hope that such disputes will not take place, and that the Government will be prepared to issue further advice and guidance if questions arise. The code has made great efforts to improve liaison between local education authorities, health authorities, health trusts and social services departments. Many of the problems of providing a statement in six months have often occurred with agencies over which the LEA has no control. The code attempts to ensure that everyone keeps in step in meeting the timings that are required ; nevertheless, I know that LEAs are still fearful that, especially at the final stage, there may not be sufficient time for them to properly complete the statement, and that therefore they could have recourse to the several provisions in paragraph 3.43 to enable them to take a little longer. I am especially worried about speech and language therapy, because I am not happy that, by the provisions in paragraphs 4.34 to 4.36 of the code on page 82, the Government have cleared up who should pay for that therapy and in what circumstances. I do not understand why the Government did not opt for the procedure that is followed in Scotland, where it would appear that the service is being provided in a way that is welcomed by health authorities, LEAs, parents and schools.
Better provision is made in the code for under-fives. Nevertheless, I believe that there is a case for improving such provision. There should be specific provision for special educational need co-ordinators to be provided in nursery schools or for local education authorities to make specific peripatetic provision to cover nursery schools, nursery classes and playgroups, in all of which there will be a need to ensure that the special educational needs of children are picked up as soon as possible.
I hope that the Government will consider provision beyond the age of 14 in more detail. They have instituted a system for children from the age of 14 onwards, which will be better for those children who previously had statements. Nevertheless, it leaves children with learning difficulties but without statements in a position where they will not necessarily get the help they require once they leave school. Will the Government consider extending the operation of the code to 19-year-olds ?
I have received many representations on the need to mention autism in the code of practice. I have spoken about that issue to people working in the health service and schools, and to parents. It is reckoned that some 30,000 children may be affected by difficulties associated with the autistic continuum. There is now strong evidence that autism is under-identified and therefore under-provided for by local education authorities.
The Departments for Education and for Health are undertaking research, with the good offices of Professor Elizabeth Newson, director of the child development research unit at Nottingham university. An interim report has been published, but I understand that a complete report expected last September has not yet been published. I hope that the Government will respond positively to that research if it becomes apparent that a stronger and more specific reference to autism needs to be made.
Column 32The "named person" is also a welcome improvement, but have the Government considered the difficulties that may arise for parents whose children have emotional or behavioural problems ? Over a wide spectrum of special needs, many voluntary organisations work in that area, but help may not be so forthcoming for emotional and behavioural problems. I should welcome a response from the Minister on that issue.
Have the Government compiled, or are they in the process of compiling, a list of lay members with expertise in special needs and local government to serve on the tribunals ?
Mr. Forth indicated assent .
Paragraph 6 :12 on page 100 refers to people who should attend the special annual review but makes no compulsion. A local education authority should be obliged to have a representative at the annual review, because, under the code of practice, schools now play a much greater role than previously. Schools should be properly resourced for that work.
My last specific point concerns a matter that appeared in the original document but does not appear in this draft--the requirement for schools to specify the special educational experience and qualifications of members of staff. While much is said about what schools must do in terms of providing information about training, nothing is said about the experience and qualifications of staff. Why were those matters dropped from the code ? It is valuable information, which parents should have.
On the framework in which the code will operate, a recent Court of Appeal decision will allow parents to sue local education authorities if they believe that the authorities have failed to provide appropriate special education for their children. It is important that the code of practice is seen to work properly.
Then there are the pressures on learning support services caused by other Government policies. There is much evidence that such services are under great pressure ; there must be concern about whether there will be enough support at the centre to ensure that schools have access to them in developing their own policies and practice, and identifying and meeting special educational needs.
A survey conducted by the British Association of Teachers of the Deaf, for example, reveals a decline in the number of such teachers. Let me give just one example : in the midlands region, between 1991 and 1993, there were 380 more children with hearing impairments, but 16 fewer teachers of the deaf to deal with them. In the same period, the number of vacancies for educational psychologists increased from 42 to 70. If the code is to work properly, however, extra responsibilities will be imposed on such people-- especially at stage 2--as they must help with preventive work in schools.
Another survey, carried out in a Merseyside authority, showed a loss of 28 special needs support teachers in 28 schools, at a time when the number of pupils with special needs had increased in more than 50 per cent. of those schools. I am worried about the ability of local education authorities to provide for schools.
In that context, too, the local government reforms pose a problem. My education authority, Mid Glamorgan, currently employs either three or four educational psychologists ; when the county is divided into four or even
Column 33five separate education authorities, there will not be enough psychologists even for one to be employed in each authority. Local authorities in both Wales and England must be brought together to ensure that they provide such services.
The problem is that the Government seem to see schools as self-sufficient units, to be judged principally on their examination results, and the meeting of special education needs is not considered as important as it should be. The increase in the number of exclusions is very worrying ; I know that the Government are trying to deal with the problem, but--although the code has tremendous possibilities and is very welcome--I am concerned about potential problems that could damage its implementation if they were not prepared to monitor it carefully and perhaps, in its third year of existence, conduct a major, far-reaching and independent review. 4.17 pm
Mr. Alan Howarth (Stratford-on-Avon) : I should, perhaps, declare my interests, as both the parent of a child with a statement and a parliamentary adviser--unpaid--to the National Association for Special Educational Needs.
I welcome the code of practice. I welcome it in principle : it offers an amplification of the Government's objectives and recommendations. It is not rigidly prescriptive in regard to method and leaves proper scope for professional judgment and discretion. At the same time, it has authority and legal standing derived from the Education Act 1993 and from the requirement for the tribunal to have regard to the code in forming its judgments. That authority is reinforced by the intention--mentioned in the foreword--for registered inspectors and the Office for Standards in Education to monitor the code's implementation.
I think that the Government have struck the right balance, leaving scope for independence of judgment while making it clear that they attach great importance to the implementation of best practice on the model set out in the code. I applaud the substance of the code. It strikes me as a fully considered, imaginative exposition, setting out and underpinning best practice in schools and local education authorities. I may differ from the Government over one or two points of detail in the code, but most of the document I find admirable. The document valuably clarifies the responsibilities of all concerned. In their document "Getting in on the Act", the Audit Commission and Her Majesty's inspectorate called for clearer definitions of objectives and responsibilities and for improved accountability. We could not possibly ask for those requirements to be better met than they have been in the code.
Promulgation of the code will also, I believe, mitigate some of the difficulties that I had feared would arise from the absence of a planning framework. I spoke about that during proceedings on the Education Bill last year, on 2 March. As my hon. Friend the Minister knows, with colleagues, I met the Secretary of State to pursue a discussion on that last summer. The code is a positive and constructive response in that regard.
For instance, I am interested in, and welcome, the proposal that there should be moderating groups, as set out in paragraph 4.7, although I should have liked the tone of that section to be rather less tentative. It is a good idea and it should be pursued vigorously. Similarly, I welcome the
Column 34recommendation that standard formats for record keeping should be used. Again, I should have liked paragraph 2.25 on this subject to be rather firmer in tone. Standard formats should be used nationally, not just within a local education authority. In that way, we can help to promote equity and to minimise discontinuity. The discrepancies and gaps between primary and secondary phases, between different schools in an authority's area and between different education authorities have been a justifiable source of discontent. I want pressure to be maintained in the direction of more equity and consistency of provision.
Some have said that consultation on the document was somewhat too restricted, but it seems clear to me from the revision that we are debating today that Ministers and officials have listened and have responded to proposals put to them in consultation. Certainly, they have significantly redrafted the document.
I greatly welcome the inclusion of the foreword. I was pleased to note that even the rather dauntingly legalistic notice to parents, which is fairly intractable material to make user-friendly, had been rewritten and is now fractionally less forbidding.
I know that the National Association for Special Educational Needs is grateful for the constructive consideration given to its representations. I also know that the British Dyslexia Association has welcomed the passage in the revised code on the criteria for achieving multi-professional assessments of dyslexia and the new section on resolving parental complaints at school level. I offer my hon. Friend the Member for Mid- Worcestershire (Mr. Forth) my warmest congratulations on his achievement. I believe that it marks a most valuable advance for parents, children, teachers and all practitioners in this field.
The time scale held out for implementation seems sensible and realistic. The foreword in which the regulations are explained makes it clear that it is not expected that the systems will instantly come into being and emerge fully fledged by 1 September. At the same time, it is made equally clear that schools and LEAs are expected to get down to their task and to develop systems to put them in a position to publish information on their special educational needs policies by 1 August 1995, and thereafter to keep them up to date and to make them clear in prospectuses and annual reports. That is reasonable. I do not underestimate the demands that the code will make on the teaching profession and indeed on all the relevant professions, but the right balance has been struck in the time scale that the Government envisage.
I welcome what the Minister said about his plans to explain the code and to encourage and to build confidence on the part of all who will have to operate it, by means of a series of conferences and training events. I am pleased that he welcomes the partnership with voluntary organisations and that he at least does not regard pressure groups as subversive of all that is best in our national life. It will not be enough just to distribute the document, although it is important to distribute it as rapidly as possible to all schools and voluntary organisations at local and national levels. We still need to overcome some apprehension and misapprehension among teachers. At the weekend, I spoke to an experienced and dedicated special educational needs teacher who was teaching seriously disabled children in a difficult inner-city area. She had not had the opportunity to read the draft code, which I do not think was distributed to all schools, and she was fearful of
Column 35what it might mean. She had heard about the five-stage model and she was worried that it was one more bureaucratic incubus from the Department. She was even apprehensive that teachers might boycott the code.
Teachers need not have any such fears. In paragraph 7 of the foreword, Ministers sensibly and helpfully explain that the detail of what schools decide to do
"may vary according to the size, organisation, location and pupil population of the school."
Paragraph 12 states :
"In practice, the precise definition of the stages and the number of stages adopted are matters for schools and LEAs to decide, consulting each other, in the light of the Code."
That is sensible and, when understood, should allay any fears. It will be important to explain and reassure as soon as possible. Implementation of the code will entail taking a clear view of resources. There is no question but that the proper implementation of the code will cost money, but no one should exaggerate what it will cost and no one should exploit the fact that it will place a new set of demands on the system. Everyone should seek best value for money. Some unavoidable costs will arise--for example, the appointment of the special educational needs co-ordinator, who should be properly rewarded for the demanding task that he or she will have to undertake. Other teachers may well have to take over some of the former responsibilities of the SENCO--the special educational needs co-ordinator. Consider the activities to be undertaken not only by the SENCO, but perhaps by all colleagues.
They will involve developing overall school procedures, assembling information about individual children, recording, consulting parents, ascertaining the wishes of the child, co-ordinating with other services, generating letters and holding meetings, assessing, planning and reviewing. That will involve far from insignificant resources in stages 1 and 2 and stage 3 will involve the cost of outside specialist services. Account has also to be taken of the cost of training, which, if properly done, could be the biggest cost. The identification of budgetary resources applied to special educational needs school by school will be essential in the interests of accountability and so that we can know whether resourcing will be adequate. It is natural for people to say that resources will not be sufficient--people will always say that schools do not have enough--but we should at least be clear what resources they have. I am glad that paragraph 2 :7 of the revised draft emphasises the obligation on the governing body to establish the appropriate funding arrangements. Paragraph 2 :11 places an obligation to include in the annual report information on
"how resources have been allocated to and amongst children with special educational needs over the year".
Local management of schools formulae have varied significantly in relation to special education needs across the country. I should be grateful if my hon. Friend the Minister would comment on the evolution that he foresees of the LMS methodology. It is important to ensure not only transparency but the maximum fairness and consistency between authorities. Arbitrary variations between one local education authority and another of resources applied to special needs have been a source of puzzlement, and all too often people have felt a sense of unfairness and disappointment.
Column 36In another place last year, my noble Friend Baroness Blatch, the Minister of State at the Department for Education, made a helpful and important comment. During proceedings on the Education Bill, Lady Faithfull, who knows a thing or two about local authorities, asked whether there might be a risk that a local authority treasurer might say that it was too expensive to provide a statement. My noble Friend said unequivocally :
"The child is diagnosed as having special educational needs. Those needs are set out in a statement and then the education provision consistent with those needs must be found. It is reasonable for the treasurer to say to those involved in making that professional judgment that they must look for the most cost-effective solution. But the cost-effective solution they come up with must be wholly consistent with the statement, whatever the cost."-- [ Official Report , House of Lords , 29 April 1993 ; Vol.545, c.562- 63.]
I do not know whether my noble Friend was then upbraided by my right hon. Friend the Chief Secretary to the Treasury, but I have not been able to find any such unequivocal and sonorous statement in the code. Perhaps the Minister will reaffirm that resources must be found to match the statement and that that will be put into the final code.
Mr. Forth : I shall try to answer that important question now in case we run out of time. There are two important aspects. One is in the interesting current variation in the number of statements provided by different local authorities--for example, fewer than 2 per cent. of pupils in some authorities to nearly 4 per cent. in others. That shows that most authorities can find the money if they can justify it and support the mechanism.
The other crucial new factor in the equation is that for the first time, the special educational needs tribunal will have powers to bind local education authorities on the statementing process and will do so quite impartially. Those two factors lead me to suppose that the money will be found where it is necessary under the constraints of the new standardised, but more rigorous, approach.
Mr. Howarth : I am grateful to my hon. Friend. I know that he well understands the great importance of this issue. If his intentions in the code are to be truly fulfilled, we must not slide back to resource-led statements with all the evasions, the frustrations, the sadness and the waste of children's potential that they have involved.
Mr. Win Griffiths : I welcome what the Minister has said, but why was it necessary in paragraph 2.15 on page 10 of the code to say : "Governing bodies and head teachers may need to give careful thought to the SEN co-ordinator's timetable in the light of this Code and in the context of resources available to the school" ? Surely the SEN co-ordinator's role should be developed and resources should be found to make sure that the co- ordinator is able to do his or her job properly.
Mr. Howarth : It is not for me to answer that question but I think that all hon. Members, and those on the Front Benches, agree that the necessary resources must be found. Of course that applies not only at school level but, as the hon. Member for Bridgend (Mr. Griffiths) suggested in his speech, what the noble Baroness Blatch said has an important bearing on LEA resourcing. There are legitimate concerns about the contraction of special educational needs support services in LEAs. If we are to make the code's aspirations a reality the support services at LEA level should be sufficiently resourced.
Column 37The principle of integration of children with special needs into mainstream education and the requirements of the code carry massive implications for initial teacher training, in-service education and training and for specialist training in the special educational needs field. Training is the ghost at the feast in the code. I note what is said in paragraph 2.26 and I noted what the Minister said. Although I welcome the Department's support for the development of distance learning packages, relatively little about training is explicit in the code, while there is much that is implicit. The code assumes a formidable range and depth of expertise. Every school will have a so-called responsible person. There are implications in the document for the training of heads and deputies and of governors, whose responsibilities will be enormous, special educational needs co-ordinators and all teachers in all schools.
Training will be the fountainhead of success or failure. The code rightly raises expectations and sets better standards. We understand, for example, that some 300,000 schoolchildren have dyslexia. The code has important and constructive points to make about their entitlement. Teachers in all schools will need to know how to identify and respond to specific learning difficulties. The development of that competence will need to be embedded in initial teacher training and reinforced in INSET--in-service training-- through the GEST--grants for education support and training--programme. I welcome the fact that GEST funding for special educational needs training is due to rise from £6.6 million in 1991-92 to £9.7 million in 1994-95. I am not sure how many schools the country has now but in my time in the Department, they were thought to number 27,000. On my reckoning, that amounts to £360 per school and the LEA must provide an additional 40 per cent. Given that standard spending assessments are tight, how confident is my hon. Friend the Minister that the necessary training will be sufficiently resourced ? There must be enough good training and sufficient resources must be provided. Training must draw on the latest and best practice in schools nationally and internationally.
I welcome the requirement that one member of the Teacher Training Agency should have knowledge of special educational needs. I hope more than one member will do so and that that experience and knowledge will be fully up to date.
I am concerned that the Government envisage that initial teacher training could be offered by schools without collaborating with higher education. Although some schools have highly developed expertise in special educational needs, all too many do not, and no school can reasonably be expected to keep absolutely up to date with latest developments.
How can the generality of schools, which have considerable leeway to make up, take responsibility for developing the content of training, to provide their own teachers and prospective teachers with the knowledge and skills demanded by the code ? My hon. Friend the Minister may say that the criteria for the accreditation of courses will provide a safeguard, but what if schools fail to satisfy those criteria ? Where will training come from then ?
I understand that my hon. Friend does not envisage schools running specialist training on their own without input from higher education, but the Education Bill does not preclude it either. Special education is, by definition, special. Teachers of children with special educational needs must provide teaching that is additional, to and
Column 38different from, ordinary education. Their training must correspondingly inculcate special knowledge and skills. I should be most concerned if training in special educational needs were cut off from access to national and international developments.
A recent conference on integration organised by the Organisation for Economic Co-operation and Development showed that special educational needs are a rapidly developing field in many countries. We must not deprive ourselves of the ability to learn from international experience. Rather, we should ensure that, where appropriate, it is rapidly translated into the practice in our schools. Schools alone cannot possibly achieve that.
There is a shortfall of available specialist teachers. The number completing courses in teaching pupils with severe learning difficulties fell from 200 in 1989 to 80 in 1993. The number of teachers of hearing- impaired children qualifying has fallen from 150 to 110. The British Association of Teachers of the Deaf reports an average age of more than 40 for new trainees and a serious fall-off in younger teachers. Special schools and support services are having difficulty in filling appointments with qualified people. If there is to be further doubt about the viability of specialist training courses in institutions of higher education, I fear that numbers will fall even further. Yet the code, for example, in paragraphs 3 :78 and 3 :79 on the assessment of children with hearing difficulties, makes assumptions and, indeed, explicit requirements that imply considerable specialist expertise.
We must ensure that we will the means as well as the ends. A great deal of training is needed. It must be adequately resourced, and the processes of training must not be cut off from the centres of expertise in higher education--for example, the university of London institute of education and the education department of the university of Manchester, which have a great deal to offer, as we all know. Therefore, I hope that my right hon. Friend the Secretary of State will be willing to ensure that the Education Bill will require training for special educational needs to be carried out in collaboration with institutions of higher education. I welcomed his undertaking on Second Reading, in response to an intervention from me, to reflect further on that. If we fail to ensure appropriate training, the volume of appeals will ineluctably soar and, after all, we do not want the tribunal to be busy. We must not see the aspirations of the code turn to bitter disappointment on account of failure in training.
The code and the legislation will be helpful in achieving better collaboration between services, but, like the hon. Member for Bridgend (Mr. Griffiths), I have some worries in that regard. I am concerned that delays in the processes of assessment and statementing might be generated from agencies other than local education authorities--particularly from health authorities.
I remain dissatisfied with paragraphs 4 :34 to 4 :36 on speech and language therapy, which simply recapitulate the existing unsatisfactory status quo at law. I would add that they look at the existing pattern of provision somewhat through rose-tinted spectacles. The availability of speech therapy remains deficient in too many health authorities. In the gap between what is described as
"educational and non-educational provision"
and what is referred to as "prime" and "ultimate"
Column 39responsibility, a great deal of time can be lost--precious, irrecoverable time--for children, whose development every week and month is crucial.
The case law has helped to clarify responsibilities, but as the wording of the code demonstrates, they are still not nearly clear-cut enough. I wrote to my hon. Friend the Under-Secretary of State for Schools last year asking him whether he would use the opportunity provided by the Education Bill to define beyond doubt where responsibility lay. I believe that the duty to provide speech and language therapy in schools should rest clearly and inescapably with the local education authority, which should buy in the professional services it needs from the health authority, or where ever. Will my hon. Friend therefore look for an opportunity to act on that and at least strengthen his expression of expectation in the code ? I want to end on a positive note. I believe that the tone and style of the code are exactly what are needed. It is written in plain English--it should be submitted for a prize for that. It is humane in spirit. It is undogmatic. It makes it clear that its provisions are not set in tablets of stone and that it will evolve as a living document. The emphasis on partnership--with both parents and children--to which my hon. Friend drew attention, is right and necessary. All that is humane and sensible.
Throughout the code, there is a sensitive recognition of the stress, anguish and even depression that parents of children with special needs can experience. In the past, the processes of assessment and statementing have, all too typically, been antagonistic and dragged out. I welcome, for example, the provision in paragraph 3 :11 for a "named person" to be a friend to parents when the assessment and statementing process is being carried forward. I welcome also the desire, expressed in paragraph 3 :12, to avoid confrontation. The code contains imaginative touches, such as the recommendation that the letter telling parents that a local education authority intends to undertake an assessment should be delivered personally. The code requires that parents should be treated with respect and dignity. They are entitled to receive all the reports and are encouraged to express their own preferences for the school at which their child should be placed. I was pleased to note that they were not discouraged from expressing a preference for a non-maintained special school.
The requirements for targets for progress and for time scales to be observed will be exceptionally valuable for children and their parents who, all too frequently in the past, had to face the prospect of almost endless struggle to achieve what they ought to have. I hope, however, that my hon. Friend can assure me that OFSTED and the Department will be vigilant to ensure that stages 1 to 3 do not become excessively prolonged as the stages preliminary to assessment and statement. I know that that is a concern of the British Dyslexia Association.
I welcome the tribunal. That was an idea that was under consideration during my time at the Department. I am very glad that my successors have carried it forward. It should mean an end to local education authorities being judge and jury in their own case on appeals and to the protracted and bitterly legalistic and antagonistic process of appeals to the Secretary of State.
Column 40If my right hon. Friend the Secretary of State and my hon. Friend the Under-Secretary of State can ensure sufficient resources and if we have sensible arrangements for training, with the code, the interests and prospects of children with special educational needs will be enormously enhanced.
Mr. Alfred Morris (Manchester, Wythenshawe) : When The Times made its recent appeal for donations to help AFASIC--the association that represents children and young people with speech and language impairments and their families--the outcome was not only one of much-needed financial help for a voluntary organisation whose achievements are held in admiration on both sides of the House : the appeal also made hundreds of thousands of people much better informed of the extent of unmet need for speech and language therapy among children and young people in this country.
It is about AFASIC's reaction to the code of practice that I want to speak in this debate. I do so, as my hon. Friend the Member for Bridgend (Mr. Griffiths) recalled, as the former Minister for the Disabled who, in the 1970s, was principally involved in the setting up of the Warnock committee. As the House knows, my interest in the debate arises also from my Chronically Sick and Disabled Persons Act 1970, the first ever statute specifically to legislate for children with dyslexia and autism, as well as those with the devastating dual handicap of blindness and deafness.
The hon. Member for Stratford-on-Avon (Mr. Howarth) said that he was ending his speech on a positive note. It is on a positive note that I begin my speech. Let me make it clear at once that AFASIC welcomes many aspects of the code, not least its recognition of the importance of early identification, assessment and provision. The association also welcomes the code's emphasis on partnership between schools, parents, the local education authority, other agencies and the children and young people themselves ; its clarity in establishing stages of assessment and provision and the identification of responsibilities at each stage ; and its time limits for the assessment and statementing process.
AFASIC's concerns about issues raised by the code of practice include the onerous responsibilities placed on the individual special needs co- ordinator within the school. The association is concerned also about whether special needs co-ordinators will be given training, more especially as there appears to be no money in the 1994-95 grants for education support and training--GEST--budget ; the need for a Government lead in regard to the training of teachers, therapists and other professionals in order to ensure effective implementation of the code ; and the worrying assumption that measures detailed in the code can be implemented with no adjustment to the level of resources available.
The issue of resources is made all the more important by wider public understanding now both of the extent of the need for speech and language therapy intervention in the school-age population and of the pace at which need is growing. Nearly a quarter of a million children today have some speech and language impairment or disorder. Of those, 6,000 or 7,000 have severe, long-term difficulties. Some 10 per cent. of all pre-school and school-age children have difficulties which could interfere with their
Column 41educational progress at some time ; and 5 per cent. of all children enter school with noticeable speech and language difficulties. In England and Wales, responsibility for ensuring that there is provision for speech and language therapy is currently divided between local education authorities and district health authorities, with the result that many children do not receive the therapy they need, or do so only as a result of strong parental persistence. Many parents, of course, are sadly in no position to exert such pressure. The code fails to clarify who is responsible for ensuring that therapy is purchased for those children--an issue of increasing concern to public representatives, voluntary groups like AFASIC, professionals and families. Again, the distinction in the code between "prime" and "ultimate" responsibility is of little help to purchasers, providers or parents.
The Council of Local Education Authorities--CLEA--recently compiled a dossier of evidence from LEAs of shortfall and confusion in the provision of speech and language therapy to children who are acknowledged to need this help in order to progress with their education. I give the House two sample quotations from that dossier. The first is :
"One of our health districts, covering a school population of approximately 20,000, provides no service to children in mainstream schools over the age of eight, whether statemented or not. Our special school for children with autism/communication disorders is underfunded to the tune of one full-time equivalent speech therapist. Our six moderate learning disorders--MLD-- schools require an additional two full-time equivalent speech therapists to meet the needs of children placed there. The provision of speech and language therapy is (apart from dyslexia) the issue which chronically prevents the LEA from developing reasonably harmonious relationships with parents." My second quotation is about differing levels of therapy services. It shows that, in effect, the level and availability of therapy services depend not on the urgency or extent of need, but on where one lives. I quote again from the dossier :
"We liaise with six different health authorities which offer widely varying levels of therapy services. Achieving coherent delivery of this service is therefore particularly difficult and has been further exacerbated by the developing purchaser/provider split in the health authorities themselves. Agreements with the purchasers do not necessarily hold with the provider . . . the DHA is placing children on ever-lengthening waiting lists and there is increasing evidence of disagreement over whether cases are educational or medical in origin. A recent joint LEA/DHA working group showed that a disproportionate amount of speech therapy time is devoted to adults."
That is the background, some might think sombre background, to the Minister's statement today that it has always been the Government's policy to match speech therapy provision for children to their needs.
Confusion over who is responsible for ensuring the purchase of speech and language therapy is exacerbated by shortages among the providers. Figures to demonstrate this shortfall are scarce. That is due in part, AFASIC believes, to fear on the part of purchasers and providers of identifying needs they are unable to meet. No such fear was shown, however, by the Greenwich healthcare speech and language therapy service. In a survey last June, it identified a shortfall of 5.8 full-time equivalent speech and language therapists for children in mainstream schools and a shortfall of 5.6 full-time equivalent speech and language therapists for children in special schools.
However, with regard to the point raised by the right hon. Member for Manchester, Wythenshawe (Mr. Morris), against the background of the general increase in the amount being spent on speech therapy over the past few years, I hope that he will acknowledge that, for the first time, in the Education Act 1993, we made provision for a much more explicit and formal co-operation and co-ordination between local education authorities and local health authorities. I hope that that will be helpful.
Later this year, my Department will have further discussions with AFASIC and others to determine the nature of any continuing and on-going problems and the best way to resolve them. We have not by any means seen or heard the last word on this matter. We will consider very carefully what the right hon. Gentleman has to say.
Mr. Morris : I am very grateful to the Minister. I wish him luck with the Treasury in securing more resources for the very needful children about whom we are concerned in this debate. I hope that the debate itself will arm the Minister with compelling arguments for more resources for these children.
I was referring to the Greenwich healthcare speech and language therapy service. Its disturbing findings were made at a time when there were also 417 pre-school children among the service's case load and a further 213 children awaiting an assessment.
In a survey carried out in September 1992, the Canterbury and Thanet service identified a shortfall of 4.1 full-time equivalent speech and language therapists for statemented children in mainstream schools. At the time of that survey, 288 children in Canterbury and Thanet mainstream schools had no speech and language therapy provision, despite demonstrating a need for it.
I turn now to the performance of health authorities in helping speech- impaired children and young people. Unlike education authorities, health authorities have only a general duty to provide services. They have no specific duty to individual children ; indeed, there is evidence that some health authorities, such as Stafford, are refusing to provide any speech and language therapy at all to children over the age of eight.
As the Minister knows, the "NHS Efficiency Index" encourages health authorities to spend on health care items which will most obviously demonstrate a return. That urges DHAs towards provision of acute services and discourages them from investing in community services such as paediatric speech and language therapy. Health authorities know that LEAs are the providers of last resort and thus have little incentive to provide services themselves. Fundholding general practitioners are also purchasers of speech and language therapy, a role for which many will have been inadequately prepared. AFASIC can find no other instance in which a health authority is responsible for meeting specified educational needs and, on the association's behalf, I now ask the Government to clarify beyond doubt who is responsible for ensuring the provision of speech and language therapy services to children of school age.
In Scotland the education authorities have been allocated funds in the local authority settlement to purchase therapy from the health boards. The Government
Column 43have indicated that this is working well and I believe that it could serve as a useful model for England and Wales. I suspect that the Minister, who has been very generous in responding to points that have been raised in the debate, is rather envious of the arrangements in Scotland and would like, as many of us would, to see them repeated here. I ask the Government also to commit themselves, first, to monitoring the implementation of the code of practice with particular reference to speech and language therapy ; and secondly, to revisit the code no later than 1996 to put into place any amendments which may have been shown by the monitoring process to be necessary. Not to give speech- impaired children the right help, in the right place and at the right time is to endanger their future. In some cases, it can lead to a lifetime of preventable handicap and dependency for children whose claim to the attention of the House ought not to need emphasising to Ministers. If they want to make certain that the code of practice succeeds in safeguarding such children, they can do no better than to keep in close and continuing rapport with AFASIC about its implementation and to respond positively now to the association's concerns.
Mrs. Angela Browning (Tiverton) : First, I thank my hon. Friend the Minister for introducing the code of practice. I do not want to reiterate everything that hon. Members have already said, but I hope that my hon. Friend will take it from me that I warmly welcome the code. I know that much consultation has gone into the document. As we are under pressure of time, I shall simply go quickly through one or two matters which are of concern to me and which I hope my hon. Friend will monitor as the code is implemented.
Many hon. Members mentioned the question of speech therapy. I shall repeat what a speech therapist in my constituency told me in my surgery : because of the introduction of care in the community, the peripatetic speech therapists who work primarily under the umbrella of health find that they are spending a lot more time travelling to people's homes to assist stroke victims who necessarily need help early after they are discharged from hospital. That is taking up a lot of their time--time which must often be shared with children who need speech therapy. Although I welcome the increased number of hours that speech therapists are giving nationally, I suspect that they are being asked to cover a much broader area. That area must be examined.
I certainly welcome the partnership with parents. I hope that my hon. Friend will monitor carefully circumstances where parents elect the person alongside them, especially at the appeal stage, perhaps to have knowledge of a particular disability. That has often been a problem. In the statementing process, there has often been a conflict between educational psychologists and clinical psychologists. Often, the clinical psychologist has a much greater knowledge of a specific disability, especially if it is clinically based. I hope that the presence of psychologists, if necessary, will be recognised when they stand alongside parents and represent them.
Many hon. Members mentioned resources, especially with regard to disabilities. As autism has been mentioned
Column 44by Labour Members, I should perhaps declare an interest as an unpaid special counsellor to the National Autistic Society. My hon. Friend the Minister knows that I have been in correspondence with him on several aspects of the subject.
When we consider resources and the anticipated number of children with special educational needs, including that segment of children who require statements of need, we are still working on the excellent report of Baroness Warnock in the 1970s, which was put into statute in the Education Act 1981. Although Baroness Warnock mentioned autism and dyslexia in her report--I have made this point to my hon. Friend before--those two disabilities were not in the final list at the back of the report where she identifies areas where statements of need may be necessary.
Hon. Members mentioned the figures relating to both disabilities. I do not think that resources have increased because there are more people with dyslexia or autism ; I simply think that our awareness of the two conditions is much more enhanced now than it was 10 or 20 years ago. In terms of resourcing and meeting the need, it is likely that Baroness Warnock's figures need reappraisal in the 1990s in terms of the scale of the problem.
I recognise that for local education authorities, the Government and even schools, it is something of a Pandora's box to take the lid off and say that the area of need is much greater than the figure on which we have been working since the 1970s. In aggregating statistics as a result of the much more strictly run statementing and special needs process, I hope that we will be able to identify the scale of need of all the categories of children.
Mr. Forth : I do not think that we should attempt to put things in boxes in that way at this stage--we have rightly resisted that temptation. However, I recognise the desire of people from specific needs groups to have their requirements identified and recognised. First, I simply ask my hon. Friend to accept that the Audit Commission, in its excellent report about two years ago, did not identify a shortfall of money ; it identified the fact that the money was not always efficiently used, and the code will be a major step forward in that direction. Secondly, we should recognise the variation in existing LEA practice and existing special needs provision. There is no indication that there is a lack of money ; there is an indication of an unacceptable variation in the way in which the money is brought to bear.
Mrs. Browning : I am grateful to my hon. Friend. I shall make two final points. The first relates to the money side. We must be careful when using the Warnock statistics, because LEAs which reach a 2 per cent. target of statementing of special needs feel that they have reached the target. I suggest that that is a somewhat artificial level and that other children below that 2 per cent. may need statementing. As the process is now being speeded up because of the six-month rule, there may be a tendency in some areas not to statement children who otherwise deserve it.
My final point relates to teacher training. Recently, I met many dyslexic children and I was horrified when they told me that teachers in their school referred to them as thick. When it comes to in-house training for existing teachers, I hope that my hon. Friend will understand that we have a long way to go in spreading throughout the