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Lord Clement-Jones: My Lords, is it not the case that since 1994 the Department of Health has had an opportunity to assess how many specialists are needed in this area? Perhaps I may refer him to the report entitled Good Allergy Practice, published in 1994 by the Royal College of Pathologists, with a foreword written by his noble friend Lord Turnberg. The document recommended,

Is not that the correct test here?

Lord Hunt of Kings Heath: My Lords, I am grateful to the noble Lord for referring to that report. I understand that currently 106 consultants in immunology are in post. That figure is expected to rise to 135 by 2006. I believe that we have seen an expansion in that field. We are also seeing increases in

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the numbers of dermatologists and gastroenterologists as well as in other specialties. I recognise that there are still issues surrounding waiting times for people to be seen at such clinics. It is clear that we shall need to redouble our efforts to ensure that we are aware of the demands being made on those services. I can assure the House that we shall be doing that.

Earl Baldwin of Bewdley: My Lords, is the noble Lord aware that there exists a large range of intolerances and sensitivities to foods, air and water which lie outside the classical definition of allergy, but which, similarly, appear to be on the increase and for which patients are not receiving the help they need within mainstream medicine? In particular, is the noble Lord aware of the allergy unit which has been doing good work at the Middlesex Hospital, but which is likely to close down on the retirement of the present incumbent?

Lord Hunt of Kings Heath: My Lords, it is my understanding that, as regards food intolerances, the Committee on Toxicity yesterday produced a report on adverse reactions to food and food ingredients which strongly recommended raising awareness of such problems in the food industry. I shall be happy to send a copy of the report to the noble Earl. As regards the general issues, we need to ensure that our research programme is comprehensive. I should be glad to discuss that programme with the noble Earl.

Lord Colwyn: My Lords, does the Minister recall the case of Mr Patrick Webster, the serial sneezer, who sneezed several hundred times a day for 35 years? He consulted more than 60 doctors, but it was not until he saw an allergist that his treatment was successful. It turned out that he was sensitive to oats. What steps are being taken by the Minister to ensure that general medical practitioners are made aware of the work undertaken by allergists?

Lord Hunt of Kings Heath: My Lords, this issue needs to be addressed on a number of levels within the health service. We already have in place 100 clinics, along with six regional specialty clinics which can provide the type of comprehensive service that is needed. However, I certainly accept the noble Lord's point that we need to redouble our efforts to ensure that those working in primary care--GPs and nurses--are able to deal with allergy issues. The Royal College of Physicians and the Royal College of Pathology have been involved in producing standards of care which will be of great assistance to the primary care sector.

Lord Geddes: My Lords, I should like to reinforce the point made by my noble friend Lord Colwyn. Can the Minister ensure that the maximum possible co-operation takes place between allergy specialists in the private sector and the NHS? I speak as one who was sceptical in the extreme until approximately six

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months ago when, on the advice of my noble friend Lord Colwyn, I visited an allergy specialist. I am now totally cured of the allergy from which I suffered.

Lord Hunt of Kings Heath: My Lords, I am very glad to hear that. Of course I believe that where the private sector has specialist services to offer, it is right that the NHS should look to see whether that is relevant. I also believe that, when seeking to ensure effective services, local health authorities, in producing health improvement programmes, need to ensure that they have considered the full range of services available for allergy sufferers.

The Countess of Mar: My Lords, does the Minister agree that the noble Lord opposite was not the only sceptic? Many working in the medical profession have been sceptics for years. For example, multiple sclerosis was regarded as the "idle man's disease". Following on from the question put by the noble Earl, Lord Baldwin, has the Minister considered the problem of multiple chemical sensitivities? Because this condition is now accepted in many states in America, can the Minister say what is being done in the United Kingdom to confirm that multiple chemical sensitivities exist and that they can be treated?

Lord Hunt of Kings Heath: My Lords, it is certainly the case that many explanations have been put forward for the rise in allergies in this country. We need to ensure that our research programme is sufficiently geared so that we are able to identify all the causes of allergies. So far as concerns the use of complementary and alternative therapies outwith the NHS, it is absolutely clear that where the NHS and individual clinicians feel that such therapies would provide the appropriate treatment, they are able to refer patients on to those services.

Special Needs Action Plan: Stammering

3.17 p.m.

Baroness Whitaker asked Her Majesty's Government:

    What account they will take of the needs of pupils who stammer in the new Special Needs Action Plan.

The Minister of State, Department of Education and Employment (Baroness Blackstone): My Lords, the existing code of practice gives guidance on policies and procedures aimed at enabling pupils with special educational needs to reach their full potential. In the SEN Programme of Action, we declared our intention to establish a working group to look into the provision made for children with communication difficulties, including stammering. That work is now almost finished and a report on speech and language services will be published in the autumn.

Baroness Whitaker: My Lords, I thank my noble friend for that Answer. Is she aware of the analysis made by the British Stammering Association--I

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declare an interest both as a member and as a long-term practitioner--which showed that 95 per cent of the teachers surveyed knew nothing about how to help a disfluent child at school? Can she ensure that the work of the British Stammering Association, which welcomes the initial interest shown by the department, is used to good effect in teaching?

Baroness Blackstone: My Lords, all newly qualified teachers must be able to demonstrate that they can identify pupils with special educational needs and then refer them on to appropriate services. They must also know how to give the positive and targeted support that such pupils need, and they have to be familiar with the code of practice. More specialist knowledge is provided through various forms of in-service training. The department is now spending some £26 million a year under the Standards Fund on such in-service training. However, we very much welcome the training resources that are being developed by the British Stammering Association. We shall do our best to publicise them.

Lord Rea: My Lords, bearing in mind that 95 per cent of teachers do not have the skills or training to cope with such speech or language problems, are the Government satisfied that there are enough trained practitioners for every secondary school, so that all children can receive the treatment that they need when they need it, if teachers can identify those with difficulties? If the Government are not satisfied, what is being done?

Baroness Blackstone: My Lords, my department and the Department of Health have been examining the issues surrounding the recruitment and retention of speech therapists. My right honourable friend the Secretary of State for Health has set up a review to examine the difficulties in recruiting and retaining such specialists. The review will report later this year.

Lord Ashley of Stoke: My Lords, I declare an interest as president of the Royal College of Speech and Language Therapists. There is an acute shortage of speech therapists. The reason for that is their abysmally low pay. Is there anything that the Government can do to help?

Baroness Blackstone: My Lords, I am sure that my right honourable friend the Secretary of State for Health is looking at issues of pay as well as other matters relating to terms and conditions of service and the recruitment of specialists in this area.

Lord Puttnam: My Lords, I wonder whether my noble friend can help me if I broaden the issue slightly. In the past two years I have visited a number of special educational needs schools and units. As well as being very impressed by the work that they do, I have been alarmed to note that decisions as to whether children should be excluded or included seem to be taken largely on an anecdotal and personal basis--one might even describe it as prejudiced. Can my noble friend

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assure me that sufficient resources will be made available over the next few years so that judgments can be made on a far more secure basis with regard to whether special educational needs children should be educated in special schools or in general schools?

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