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John Bercow: I accept that the hon. Gentleman will wish to hold discussions on the issue and check my account against other accounts. However, I wish to put a point of principle to him. If I am right and the specialists are correct that the children benefiting from the unit cannot receive treatment of comparable quality elsewhere, does the hon. Gentleman agree that it is wrong for the trust to target the unit for closure for the saving of a relatively paltry sum, which accounts for 0.2 per cent. of the turnover of the trust?
In reply to the hon. Lady, may I say that local education authorities are democratically accountable. I know that the debate about inclusion has been widespread in many communities, including my own, Hodge Hill, where we are about to enjoy a new and integrated school. These are decisions that are ultimately for politicians to account for locally.
On the Nuffield speech and language unit, I appreciate why both professionals and parents are concerned about the future of the unit. I understand that there are currently 10 children at the unit, eight of whom are to leave in July 2006. The hon. Member for Buckingham made a number of important points about the way in which the service has been marketed. He knows rather a lot about the business of marketing, having served at board level in organisations that are world leaders in that activity. I want to explore the matter further, but the information that I have been given suggests that the pattern of demand for the trust is changing. LEAs referred 14 children in the academic year commencing in 2004.
It has been suggested to me that the trust is a health care organisation that is performing an educational role. In the context of the hon. Gentleman's remarks, I understand that there is a nuance or two to add to that argument. Across many London boroughs, education policy is changing so that education provision such as the unit's services are provided more and more locally. Hillingdon LEA, for example, which referred many of the children to the unit, has created two new speech and language units, resulting in a downturn in the referrals that it has made to the trust. I understand that many LEAs are trying to place children with special needs in mainstream schools. I take the hon. Lady's point, which was echoed by the hon. Gentleman, that for some children that may not be the appropriate solution.
The Minister is being very courteous and generous in giving way. Does he accept that so far, the early evidence appears to be that the Hillingdon services are not on a par in terms of quality with those provided at the Nuffield? Does he acknowledge what is an observable fact, and a harrowing onethat parents who want to get their child referred to the Nuffield have to fight the most heroic fight, which is extremely time-
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consuming, protracted and expensive? Even if they win, they do not get their costs. The LEA uses in-house lawyers, in-house specialists and in-house advisers and gets off virtually scot-free. It is a national scandal that parents can get through the process only if they have dosh or are prepared to impoverish themselves.
I turn to the process of consultation, which the hon. Gentleman rightly forecast. As a keen student of the Conservative manifesto, I think there has been agreement in all parts of the House that local health professionals are often in a stronger position to lead on consultations about the design of local health services. I differ slightly from him, as I think that PCTs and strategic health authorities, together with local authorities and other local organisations, are often in a much stronger position than I am, for example, to draw up the blueprint for the local delivery of services.
That is why it is right that the trust leads on the consultation. I will explore the arrangements that it has made to publicise the consultation, because it seems from what the hon. Gentleman said that some important questions need to be answered about the way that consultation has been conducted. It is not appropriate to hold all public consultation meetings on a working day when parents cannot attend, because consultation must be wider than that.
I will explore with the strategic health authority whether such services should be commissioned through specialist arrangements. My noble Friend Lord Warner is currently overseeing a review of specialised commissioning, and, from what the hon. Gentleman has said about the services currently offered at the Nuffield unit, I need to achieve a better understanding of the correct commissioning arrangements for such services.
Dr. Julian Lewis: I have attended many Adjournment debates in my time in this House, but this is the first time that I have seen a Minister who is open-minded and willing to listen to the arguments and refer back to the people who have advised himI congratulate the Minister on his approach. However, he has said that the local PCT is best placed to address such matters, but I remind him that we have been here before on an almost cyclical basis. My mind goes back to the controversies about the closure of mental health institutions. Today, nobody denies that it was right to include many more people in society than used to be included before the reform of mental health institutions, but most people also accept that the pendulum swung too far and that the minority of people for whom it was not right to be included more generally in society for their treatment and therapy suffered as a result. Does the Minister not see the doctrinal parallel, where a new idea, philosophy or doctrine gets a grip in the minds of some health professionals, so that they over-compensate for a trend which is praiseworthy in itself?
The hon. Gentleman has far more experience than me, and he has highlighted the importance of robust consultation procedures, which the Secretary of State has done a great deal to enshrine.
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Her leadership ensured that the recent social care and health White Paper was written as part of a unique public consultation event. I have replicated that consultation method in schools with young people. One is always struck by the intelligence, passion and analysis that so many people can bring to those debates, which is why this evening's debate is so important. There is a public consultation process, and it is important that not only health professionals, but hon. Members, members of the public, service users and local authorities have the opportunity to contribute to it.
John Bercow: A moment ago, the Minister concededI welcome this concessionthat it was not right for public consultation meetings simply to take place during the day at times that were obviously inconvenient for working parents. Will he accept that there is something rotten in the state of Denmark when, for example, the Royal College of Speech and Language Therapists, the Association of Speech and Language Therapists in Independent Practice and the association that looks at the interests of all children with speech and language impairments are not included in a consultation relating to this issue? Does he agree that that is simply wrong and that the situation must be corrected? If it is not corrected, the process will be legally flawed Mr. Way ought to be worried, ought he not?
I have said what I came to the House to say. I cannot stress strongly enough that the closure proposal is one of several options along with several others that are being put forward. There are two points for me to take away. First, I want better to understand whether a service of this degree of expertise and specialism could be rethought in the context of specialised commissioning arrangements in London; and secondly, I want to double-check the nature of the consultation arrangements that the trust put in place.
In the light of the arguments that I have presented and the widespread anxiety that exists on this subject, will the Minister agree to meet me and a delegation of speech and language therapists and parents to discuss it?
Mr. Byrne: I hope that the hon. Gentleman will permit me first to check whether the consultation process as it is set out in the Cabinet Office guidance will allow that to happen on this side of the consultation. In principle, I would very much welcome it, but I will observe Cabinet Office niceties if I may.
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