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21 July 2008 : Column 556

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’s speech, language and communication development at key ages and stages. We have not been over-prescriptive—there 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—but 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—a centrepiece—of the work of all children’s 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’s 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—not all, but many—there 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’s 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
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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—sometimes only for a short period and sometimes for longer—and 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—that is to say, for those who require communication aids—and 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’s 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—to do all that is necessary—to 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—they can fight about that between themselves—and 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—to a degree—expertise 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’s 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’s 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’s responsibility, ultimately it is no one’s responsibility. If we name an individual and give him or her a task, set the benchmark, require the assessment
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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’s 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—although not, I hope, just yet.

5.11 pm

Hilary Armstrong (North-West Durham) (Lab): I too congratulate the hon. Member for Buckingham (John Bercow) on his report, which will stimulate a great deal more thinking and many more ideas. In a sense, he finished where I want to begin, with the point that paying attention to this issue is absolutely critical for the future of this country.

An interesting report was published by the Institute for Public Policy Research last November, entitled, I believe, “Freedom’s Orphans”. It examined two cohorts of children—we are very good at longitudinal studies in this country—born on a particular day in different years and looked into the differences in their lives. What it showed, among many other things, was that the very skills that people need to get the jobs available these
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days—skills centred on basic good communication—are frequently not developed. It showed that too many children are growing up without the experience of really good interaction with adults, so they do not acquire the negotiating skills or the communication skills required for them to get what they want. For example, they often do not make eye contact or convey the sort of things that we often take for granted. That means that they are unable to get jobs in call centres or in the service industries—the sort of jobs available for them today.

That report stimulated my interest in this topic, and I have also had a lifelong interest in trying to improve education. I think that we have too often missed this crucial issue as we have sought to develop educational opportunity for all, trying to give everyone a fair chance in this world. I would have liked to deal with many issues in the Bercow report, but I am going to confine myself to two areas. The first, which is centred on the work force, I shall touch on only briefly.

The hon. Member for Buckingham is absolutely right to say that we must take far more seriously the point that the whole work force must have appropriate training and support in order to tackle these problems with all the children they work with; but we must also try to identify precisely and at an early stage when things are going wrong, and subsequently develop a series of strategies to intervene effectively.

I was in a primary school a couple of weeks ago, where the teacher identified to me—privately—two children in the class whom she was worried about. Both of them lacked effective communication and language skills. For one of them it was straightforward to see why; for the other it was much more difficult. The teacher was saying, “I don’t feel I have the knowledge or understanding to help these two children adequately.” I was horrified, because that simply should not happen today. Across the board, attention to the work force is absolutely critical.

It will not surprise the hon. Member for Buckingham to hear that the second issue that I want to speak about is early identification and intervention. I am absolutely convinced that that can be done much more systematically and rigorously than at present. As we have provided many more children’s centres, with access for every family, we must do more than just hope that children are identified: when it is clear that there will not be normal speech, language and communication development in families, we must rigorously ensure that those children are identified and worked with early.

I have told the House previously that I have taken up again with NCH—soon to change its name—and had the privilege of visiting some of the children’s centres in which it is involved in the Northumberland area, including the Ashington children’s centre. NCH’s briefing for Members highlights its work, which includes employing language development workers to identify at an early age children who have, or are at risk of, speech and language delay or disorder. It offers individual outreach support to families, who will be visited over a six to eight-week period. It is finding that addressing the problem early through such support to the family results in much less reporting to specialist speech and language workers later. By the time such children start school, they are at the same stage as every other child. That is the direction that we need to take.

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As the hon. Gentleman’s report says, those in prison have huge communication difficulties, and that is because we failed earlier. Failure in communication skills frequently leads children and young people into lifestyles that they did not start off wanting to get into, but they end up in the juvenile justice system and then in prisons. Once we know that we can do something about that, we have no excuse not to do it. We have programmes that deliver the rigour and sustained activity that will transform children’s lives and opportunities. We have no option but to use those intervention programmes to identify children early, and to address speech and language difficulties so that they do not become behavioural and other difficulties as the children grow older.

I thank the hon. Gentleman for his contribution, and I also thank my hon. Friend the Minister, because I believe that the Government will get hold of this issue and transform opportunities for millions of children in the future.

5.19 pm

Annette Brooke (Mid-Dorset and North Poole) (LD): I congratulate the hon. Member for Buckingham (John Bercow) not only on his review and his leadership, but on the persistence with which he has raised these issues since his election to Parliament, which has contributed to both the report and the Government’s positive response.

My eyes were first opened to the deficiency in this area more than 12 years ago, when I talked to parents whose children had just completed their schooling at a special school for those with mild learning difficulties. It became clear that if the children’s speech, language and communication needs had been addressed at an early stage, some of them might well have gained access to mainstream schools, and their educational outcomes at 16 would have been very different. The consequences of not dealing with such issues in an appropriate and timely way are lost time and, it could almost be said, lost lives. We should consider the behaviour of children who are frustrated when they cannot communicate as they wish to, underperformance, and involvement in the criminal justice system with all that that implies. I sincerely hope that no more time will be lost, and that none will be lost in implementing the report’s recommendations.

The report identifies five key themes. Although—like the right hon. Member for North-West Durham (Hilary Armstrong)—I shall focus on early identification and intervention, I think it important for all five of those themes to work together to bring about the outcomes that we desire. In the short time available, I shall concentrate on just a few of the issues that they raise.

First, it is important to remember that communication is a two-way process. While the needs of the child are central, we must take account of communication within the family, communication between nursery and teaching staff and the child, and communication in many other contexts. Sadly, features of today’s society are contributing to basic communication problems: the lack of conversation between adults and adults, adults and children, and children and children, in the home and in play. That in turn derives from the tendency towards TV meals and time spent with television, DVDs and computers in the bedroom.

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At the more severe end of the spectrum of needs is the importance of not just early identification but appropriate follow-up intervention, both of which require a skilled work force. I particularly welcome the report’s recommendations in those areas. Miscommunication is all too easy if, for example, a teacher interprets lack of eye contact as challenging behaviour, rather than picking up signals about special needs. We need a balance between specialist training and general special needs training. The latter is now belatedly being included in teacher training courses, but in my view it should have been tackled before we embarked on our main inclusion agenda.

There should be clarity about when a specialist speech therapist is needed, and when the more generic approach of training teachers and early-years workers in specific skills will be sufficient. Clear assessment and planning must take place to ensure that there are enough speech therapists. I am sure that all Members have been visited by parents who tell them that a son or daughter should be having speech therapy, but nothing has happened throughout the term.

It is all too easy to tick boxes, suggesting that a service is being provided, even when children are not being given the specialist therapy that they need for their particular conditions. I believe that all children with a given degree of speech impairment should have access to specialist nursery provision or to specialist services within mainstream provision, such as those provided by I CAN. Such services should be provided within reasonable travel distances, and consideration must be given to transport provision. Behavioural problems can so easily develop at an early age, threatening a child’s whole future.

I mentioned the two-way process of communication. Let me give a couple of examples to which I particularly relate. One involves sight-impaired children who do not have the appropriate text books in an appropriate format. Those need to be provided. How can such communication take place if there are no books in the appropriate format, particularly text books? On the hearing-impaired, I understand that some teaching assistants are not fully qualified in sign language. It is not just a question of having the technique of sign language; there needs to be an interpretation process as well. I am told that national vocational qualification level 2 in sign language is not sufficient for the interpretation of lessons. I emphasise the importance of this two-way communication process.

Sadly, from personal experience I can relate to the remarks in the review, and the comments made in evidence, about the ping-pong between health and education budgets. I have often heard it said, “No, that’s not up to us to provide; that has to come out of health money.”

I also relate to the issue of there being different boundaries. In my constituency, the boundaries between the children’s services and the primary care trusts are not coterminous, with the consequence that much is not considered.

The report makes important recommendations on commissioning, to get us out of these traps. I endorse—

Mr. Deputy Speaker (Sir Michael Lord): Order. I am afraid the hon. Lady has had her six minutes.

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