Health and Social Care Bill

My Lords, I was hoping to speak in support of my noble friend Lord Northbourne, who introduced a whole cluster of amendments which had at their heart not just parenting but also the development of our children. I do not want to bore the House but my interest in this subject goes back to an occasion when I visited a young offender institution in Scotland. When I was walking round with the governor of the prison he said to me that if he had to get rid of all his staff, the last one out of the gate would be his speech and language therapist. I asked why and he said, ““Because none of the children can communicate, either with each other or with us, and unless they can communicate there is absolutely nothing that we can do with them, or for them, and that includes their education, their discipline, their healthcare and indeed their general well-being””. Therefore this group of amendments—Amendments 72A, 81A, 200A, 201ZA, 327B, 327C, 329A, 331C, 333B and 91A—is all to do with getting speech and language communication needs for our children, which is the most common disability shared by children and adults in this country, put properly into the context of the Bill. I think it is recognised that communication skills are the key life skill and the single most important factor in determining a child’s life chances. They are the means by which people form relationships and make choices and by which people access education, employment and society in general. Over the past few years—ever since I first became aware of this problem—I have been worried that nobody seems to be grasping the fact that every child’s communication ability must be assessed properly and as early as possible in life so that they can be given the best possible chance. Following that experience in the young offender institution I was responsible for a two-year pilot with speech and language therapists in two young offender institutions. This pilot proved conclusively that if an assessment had been carried out much earlier those offenders may well have not ended up in the institution and that a very large number of them would not have been excluded or evicted from education because they would have been able to engage with their teachers. I have therefore been trying to interject in various education and justice Bills over the past six years the need for such an assessment to be built in to the education of this country. It is interesting that Northern Ireland has listened—now every child there is assessed for their communication skills at the age of two. That might be very early but, on the other hand, it also identifies potential problems. The amelioration of those problems can then begin early enough for the children to be able to engage in education. Unfortunately, although that need has been accepted in education and justice Bills, nothing has happened because neither the education nor the justice department is responsible for funding those who have to make the assessment. Indeed, in 2005, when this pilot scheme came to an end, the Minister—Mr Paul Goggins—was invited to examine the funding of the possible provision of assessment. He could not work it out because neither the Ministry of Justice not the Department for Education was willing to fund. When it came down to it, we found that individual speech and language assessors were the responsibility of individual primary care trusts around the country. Some of them decided that the assessors were essential and some of them did not and, therefore, it became a postcode lottery. If we accept that communication difficulties severely limit an individual’s participation in education, in the world of work and in their family and community life then it stands to reason that unidentified speech and language problems can pose a secondary challenge, as they lead to diminished social skills, poor educational outcomes, anti-social behaviour, unemployment and mental health problems. In other words, all the factors that arise from a failure to assess communication skills and to enable people to communicate as well as possible can become a public health issue. I believe that it should be regarded as such, which is why these amendments mention the need for those who are responsible to have an integrated approach in order to ensure that all the relevant healthcare professionals liaise with each other and make certain that every child is given the proper start in life to enable them to engage with all the things that follow. This will require liaison with education and other authorities. I am not going to list all the various things that speech and language therapists can do, but one of the problems at the moment is that the assessment in many places is left, for example, to district nurses who have been trained by speech and language therapists. That is fine, except that we are told that the funding for speech and language therapists is to be cut and therefore it may be that their ability to train those who carry out these assessments will be inhibited. I ask the Minister to ensure that this issue is examined properly and that the various authorities should be instructed to make these assessments in order to make certain that all our children can access that vital education and the other factors that will make their lives either possible or a failure. I beg to move.