§ 10.0 p.m.
§ Mrs. Eirene White (Flint, East)
I beg to move,That an humble Address be presented to Her Majesty, praying that the Handicapped Pupils (Certificate) Regulations, 1961 (S.I., 1961, No. 476), dated 16th March, 1961, a copy of which was laid before this House on 23rd March, be annulled.The reason for our praying that this Statutory Instrument shall be annulled is not because we are seriously opposed to it. On the contrary, we think that it is a quite useful measure as far as it goes. However, it provides the occasion for us to ask some questions about the treatment of handicapped pupils, particularly about their ascertainment and the methods of ascertainment which are in force.
As I understand it, the chief point of the Regulations is that in certain circumstances children will have to submit to only one medical examination whereas at present sometimes they have to undergo two medical examinations. The other quite important reform contained in the proposed new Regulations is that in future parents will have a valuable right which, I understand, they have not possessed before. In the past, parents have been able to appeal to the Minister if they considered that their child had been wrongly ascertained and had been allocated to a special school or occupational centre. The parents had no statutory right to appeal if, in their view, their child required such special education but that education was not granted.
In so far as these new Regulations give parents an additional right, I think that they are to be very much welcomed. Nowadays, when the general attitude towards the training of handicapped children is much more rational than it used to be—it is all part of the general advance in the treatment of mental illness, defect, and so on—it is important that, if a parent feels that the opinion of the medical officer concerned was perhaps mistaken and that the child would benefit by some special form of education, the parent should have the right to ask for another opinion and to 1112 approach the Minister. From that point of view, we welcome the proposed new Regulations.
Before consenting to them completely, however, we ought to ask the Minister to give us some more information about precisely what happens to children who undergo the process of ascertainment with which we are concerned.
§ Mr. Roderic Bowen (Cardigan)
Why does the hon. Lady say that if a parent objects to a certificate he will have the right to take the matter up in order to bring about a different result?
§ Mrs. White
As I understand it, in the new certificate in the form contained in the Regulations before us the medical officer may give one of two opinions. He may state categorically that in his opinion the child is not suffering from any disability of the mind or body so as to require special educational treatment. That is a form of certificate which is different from the one previously used. By putting in this statement categorically it provides ground for a formal appeal by a parent against the decision of the examining officer. That ground was not formerly available. That is a change which is to be welcomed. One wants to ask the Minister questions about the whole subject of ascertainment.
Within the categories of handicapped pupils are ten groups. I do not propose to deal with them all tonight. A number of categories affect only those who are physically handicapped in one way or another. Difficult as it may be to provide adequate treatment for all these children, the main difficulty with parents mainly arises, not over those who are physically handicapped, in whom the handicap is generally obvious, but about those who are mentally handicapped. It is, therefore, primarily about them that I wish to speak tonight.
These children may be regarded as educationally subnormal, or they may be regarded as ineducable, which I consider to be a most unfortunate term.
§ The Parliamentary Secretary to the Ministry of Education (Mr. Kenneth Thompson)
We no longer use it.
§ Mrs. White
I am delighted to hear the Minister say that he no longer uses it, but the phrase has been official language in the past. If we get that cleared out of 1113 the way tonight so that the expression is no longer used by anybody, that in itself will be a step forward.
In recent years, there have been a great many discussions among those who take an interest in these children about the admission of children to special schools, and whether a statutory ascertainment is necessary or desirable or whether, if it could not be entirely dispensed with—that would hardly be practicable—it could at least fall to some extent into disuse and that voluntary admission to special schools should be very much encouraged.
I do not profess to speak with any specialist knowledge of the matter and, therefore, I must rely upon those who specialise in the education of children requiring special provision. I have been particularly interested in a survey that was carried out last year, of which, I am sure, the Minister is well aware, by the Guild of Teachers of Backward Children, the results of which I have no doubt that the hon. Gentleman has seen. It was interesting to find that a number of those who were consulted, including medical officers of health, directors of education and headmasters of special schools, felt that the voluntary admission of children to special schools should be very much encouraged and that much less reliance than heretofore should be placed on statutory ascertainment. It would be valuable to have the Minister's opinion on the matter.
There have also been discussions concerning the kind of examination which takes place and for which the certificate would be used, and whether it is not in many areas still unduly medical rather than educational in its emphasis. Again, inquiries have recently been made into the way in which the examination is conducted, how far it is done by a medical officer alone and to what extent an educational psychologist is brought in. In some areas, I believe that the main examination is undertaken by an educational psychologist rather than by a medical officer.
It would be interesting to know whether the Ministry considers that there should be provision for authorities with relatively small populations who are not likely to have an educational psychologist on their staff or within easy reach. I think, for example, as the hon. and learned Member 1114 for Cardigan (Mr. Bowen) will appreciate, of some of the rural counties in Wales which are a long way from a main centre of population and whose staffs would be unlikely to include somebody with special educational psychological expertise.
Has the Ministry considered the possibility of arranging for a consultant service for such authorities? Many of us are concerned with the position of the small number, although nevertheless important in their own individual worth, of handicapped children in these rural areas.
§ Mr. Sydney Irving (Dartford)
Is my hon. Friend aware that in certain areas the final decision is taken not only either by the medical officer or by the educational psychologist, but by a conference which includes the head teacher, the medical officer, the education officer, the welfare officer and all the people who are interested in the child's future? Is not this wholly desirable and a practice which should be extended throughout the country?
§ Mrs. White
I am delighted at that intervention by my hon. Friend who, I hope, will be able to develop that theme, because this question of moving from a simple statutory ascertainment towards the kind of joint consultation that he has suggested is obviously in line with modern thought. Again, I would like to know the attitude of the Ministry towards all this and what it is trying to do to encourage this more up to date attitude towards the problem.
§ Mr. Speaker
I am sorry to interrupt the hon. Lady, because I enjoyed the intervention of her hon. Friend as much as she did, but I am wondering about the scope of this debate, about which I have a duty. It appears to me, in my ignorance, that these are Regulations which make an alteration in the form of the certificate. I am afraid that I must confine the debate to matters relevant to that.
§ Mrs. White
This certificate, Mr. Speaker, is in itself something of great significance, because if the certificate is passed in the form proposed it means that a child on whose behalf it is made is then to be sent to a special educational establishment. It is therefore, surely extremely important to decide 1115 whether this is a proper form of certificate, and whether it is to be awarded in proper circumstances or not.
One has to decide, for example, whether a medical examination is sufficient. You will observe that the certificate concerns the name, date of birth and address of a child submitted for medical examination. One of my arguments is that a medical examination by itself is not necessarily sufficient, and that other considerations arise which are not, in the narrow sense of the word, medical.
§ Mr. Speaker
As the House knows. I do not want to be unduly restrictive, but this appears to be a set of Regulations which modify slightly—the phrase used is "slightly modify"—the form of the existing certificate, and what is at issue is the modification between the old and the new certificate.
§ Mrs. White
There are, with respect, various other matters which are so closely allied to this that we could not pass this form of certificate without being thoroughly satisfied that it was adequate in the light of present knowledge and practice. For example, before you returned to the Chair, I made the point that one of the specific alterations made in the form of certificates was to give a parent the right, which he did not have in the previous form, of appeal to the Minister if his child was not granted special educational provision.
I was suggesting that one of the reasons why this new attitude was praiseworthy was precisely because the whole context of this ascertainment is changing, and that if it is approached in the modern way, this right of the parent will be very valuable. I was also raising the question whether, in the view of some experts, such ascertainment provided for in the certificate is necessary. If it were not necessary, the certificate would not be required. I hope I carry you with me that far in my argument, because this whole question of ascertainment, which is not merely an ascertainment at first instance, can arise at other points in the career of a school child. There can be de-ascertainment as well as ascertainment.
This, again, raises the whole question of the context in which this process is 1116 carried out, and of whether a medical officer by himself is the right person to carry out that ascertainment, or any de-ascertainment that may come about later on. As I say, it is extremely important to know just what the term… disability of mind or body so as to require special educational treatmentinvolves. The House is entitled to know that.
I ask that for this reason, having looked at some of the figures of children about whom as a result of the use of the existing form of certificate which we are about to amend—as a result of the existing form of ascertainment—a most peculiar situation seems to have arisen. One finds that children who presumably even under the existing procedure are sent to special schools range according to the children to be found in those schools from those with intelligence quotients of 30 up to 115. I am quoting from the National Union of Teachers survey of educationally sub-normal pupils carried out very recently.
That seems an astonishingly wide range of intelligence for children who, I presume, were covered by the existing form of certificate. The Minister might give some idea why this astonishingly wide range of intelligence appears to have been covered by the certificate. If it were not so covered, perhaps he will explain why these children are nevertheless in schools for E.S.N. children.
I have some other figures which were obtained in the survey conducted by the Guild of Teachers of Backward Children. Although the figures are not quite so extreme, nevertheless they show that no fewer than 48 per cent. of the schools in that survey had children with I.Qs. of above 70. That, of course, is nothing like as high as the extreme figure which I quoted—and which astonished me—from the N.U.T. survey. In any case, that is a very high proportion.
It is perfectly clear that this form of ascertainment so far as children in the E.S.N. schools are covered—and the Parliamentary Secretary may explain how many are not covered by the certificate—shows a very wide range and a fairly large proportion of children of a rather higher intelligence quotient than one would expect to find in E.S.N. schools. I suspect the reason is that there is inadequate provision for such 1117 children in ordinary schools and they therefore find themselves in E.S.N. schools whereas there ought to be more provision in the ordinary schools. If there are too many in the E.S.N. schools, we can assume that a number in the E.S.N. schools are not getting the kind of education they should have in special schools because the places have been taken by rather more intelligent children who should be provided for in small classes in the ordinary schools.
I do not know whether the Parliamentary Secretary can tell us anything more about the proportions of children who are being dealt with under this ascertainment certificate which we are discussing. I think I am right in saying that the Minister's official calculation, on which he works, is that approximately 10 per cent. of the total school population is to be regarded as to some degree subnormal.
I think I am also correct in saying that 1.2 per cent. is the accepted official figure of the proportion which should be dealt with in special schools. I think the Parliamentary Secretary will agree that that proportion is contested by certain specialists. Dr. Whitmore recently suggested that it should be 1.5 per cent., and that agrees with earlier estimates by Sir Cyril Burt, the Scottish Council for Educational Research, and others.
I do not want to go beyond the Regulations we are discussing. All I would say is that although there is provision for a considerable increase in school places for the children who will be dealt with under these proposals, nevertheless, even when it reaches the 42,000 E.S.N. places in 1962, which is the Minister's estimate—and I shall be glad to know whether the Minister thinks this figure will be reached—it will provide for far less places than the probable number who ought to be in special schools. It is true that it is not very far short of the 32,000 plus the 12,000 waiting list given in the latest figures, but I repeat that that number is below the proportion which the experts say should be treated in some special educational way.
There are many other subjects which we would dearly like to raise, but I bow to your Ruling, Mr. Speaker. I have given the Minister a good deal on which 1118 he can give the House some useful information.
§ 10.21 p.m.
§ Mr. Roderic Bowen (Cardigan)
I intervene only in the hope of obtaining some clarification in relation to the position under these new Regulations if they come into force. One of the reasons which has prompted me to intervene is that I suspect that my hon. Friend the Member for Flint, East (Mrs. White) appeared to think that under these new Regulations parents of children in the category we are discussing, children who might require special educational treatment, will have additional rights, or some additional protection.
If that is so, I hope that the Minister will make it clear in what respect it is the case, because it appears to me, and I hope that I am wrong in this respect, that the Regulations will not in any way affect the rights or duties of the local education authority, the parents, or the Minister.
On the face of it, the Regulations appear to revoke the Regulations relating to the certificate at present in existence—these Regulations having been in force since 1953—and to provide for a new form of certificate in which there is not only a negative expression of opinion but a positive one as well. That is to say, the medical officer will say not only whether the child is suffering from a disability, but whether the child is not suffering from a disability.
I agree that that form of certificate is more satisfactory, particularly when it says that the child is not suffering from a disability, because in most cases that will be a source of gratification to the parents of the child involved. From that point of view this change in the form of certificate is to be welcomed.
Will this change bring about any alteration in the position of the parents in relation to the local education authority and the Minister? During the last few moments I have looked at Section 34 of the Education Act, 1944, and it is clear that whether the medical examination has resulted by reason of the intervention of the local education authority under subsection (1), or by reason of the request of the parents under subsection (2), at present a certificate to the effect that the child is suffering from a disability can be 1119 cancelled by the Minister by virtue of the powers given in subsection (6). If that certificate is cancelled, the child will cease to receive special educational treatment.
As I understand it, the opposite does not apply. That is to say, assuming that a certificate is issued by a medical officer to the effect that the child is not suffering from any disability of mind or body so as to require special educational treatment and the Minister cancels that certificate, it does not follow that, because the Minister has cancelled the certificate, the child will then receive special educational treatment by the local education authority
That is based on a certificate given by a medical officer of the authority involved, and the most that would be likely to happen as a result of cancellation of a certificate by the Minister would be that the authority would be asked to look at the matter again, and the question of another certificate being issued would then arise. If the second certificate were in the same terms as the first, what remedy would the parents have?
§ Mr. K. Thompson
It may help the hon. and learned Member if I ask him to consider in what circumstances my right hon. Friend would cancel the certificate, as he puts it. It would not be except upon the best medical advice he could obtain, and it would be with that medical advice in support that any correspondence he subsequently had with the local education authority would take place. I have no doubt that, the relationships between the Ministry and local authorities being what they are, most local authorities would take careful account of what that letter from my right hon. Friend said in conveying this information to them.
§ Mr. Bowen
The hon. Gentleman has still not dealt with this very important difference between where a certificate providing that a child is suffering from a disability is cancelled and where a certificate providing that there is no disability is cancelled. In the case of the first, subsection (6) comes into operation and there is legal force to it. In the second case, the most that can be said is that the Minister would use his influence with the authority and hope that his influence would produce 1120 the right result. The parent has no rights in the matter. That is why the position by this change in the certificate in relation to the legal rights of the parent will be precisely the same as it is at the moment and precisely the same as it has been since 1953.
The type of case I have in mind is where there is a dispute between the authority and the parent about whether a child needs special educational treatment. The dispute may well arise where the parents themselves have asked for a medical examination under Section 34 (2). The authority's medical officer would issue a certificate that the child was not suffering from a disability. The certificate would go to the Minister who would cancel it under subsection (6). The parents are then left in the position of having to rely entirely on the Minister being able to influence the authority to revise its opinion on a medical matter.
§ Mr. Ronald Bell (Buckinghamshire, South)
The position is that under the Education Act, 1944, the parents are entitled to the provision of a normal education for their child, there being no certificate in respect of it.
§ Mr. Bowen
Certainly, but I am dealing with a case where, the Minister having cancelled the certificate, the basis of the cancellation would be that the initial certificate was wrong and that the child was in fact in need of special educational treatment.
I do not want there to be any confusion about this. A parent asks for a medical examination under Section 34 (2), and a medical examination takes place and a certificate is issued by the local medical officer to the effect that the child is not suffering from any disability. Under subsection (6) that certificate can be cancelled by the Minister. There one has the position where the child has been examined, a certificate has been issued that the child is not suitable for special educational treatment and the Minister has cancelled the certificate. Obviously, the proper thing to be done is that the child should be re-examined in view of the Minister's cancellation and a different certificate issued.
All I am saying is that it is quite clear that parents' rights in the matter are totally unaffected by these Regulations and there is no difference between the position where a certificate has been 1121 issued saying that the child is suffering from a disability and the position where it is not suffering from a disability. I wanted to clear up that point.
I reinforce what my hon. Friend the Member for Flint, East said about the problem of sparsely populated rural areas where the number of cases dealt with under these provisions is very small indeed. I remind the House that the definition in the 1944 Act of a medical officer clearly envisages the invoking by local authorities of special assistance in this regard. The reason why I say that is that in the 1944 Act a medical officer is defined as a duly qualified medical practitioner employed or engaged, whether regularly or for the purpose of any particular case, by that authority.
With all respect to local medical officers, who carry out their work excellently, I should like local authorities to make greater use of specialist consultant services when they have really difficult cases to decide. There are ten categories in which children may be classified in this regard, and I should have thought that some of them required the assistance of a consultant or specialist to help the local education authority to arrive at a proper decision.
§ 10.33 p.m.
§ Mr. James Boyden (Bishop Auckland)
I wish to put a number of questions to the Parliamentary Secretary relating to the certificate.
First, does he expect the number of children ascertained and the number placed in special schools to be increased? The Ministry thinks that 15,000 children are without places, but in some quarters it is felt that the figure is probably 19,000. In any case, the present Minister's view on this is very conservative compared with pre-war surveys. Are these Regulations purely formal, or will they have a decisive effect on the number of children which the Ministry thinks ought to be in special schools?
To put it another way, do the Regulations foreshadow a new attitude on the part of the Ministry towards making better provision for E.S.N. and deaf children and a tendency towards generally making a more dynamic approach to the problem? In the Ministry's last report there are several references 1122 to the problem of deaf children. I do not want to go into the whole problem and will merely say that the Minister will be well aware of this very serious matter and must be far from satisfied with the provision which is being made. Is this certificate an attempt to make a more precise organisation of deaf schools? Is it associated with a recruiting drive to increase the number of teachers of the deaf? In my own region, for example, is greater provision to be made for this category of handicapped children?
I want to raise another point in relation to overcrowding. Do the Regulations affect the Ministry's definition of overcrowding in special schools, as laid down in 1953? Perhaps the figure has altered a little, but in the last Ministry report it was stated that there were 268 educationally subnormal classes—
§ Mr. Speaker
I am sorry, but I cannot follow the hon. Member's question as to whether the Regulations affect the Ministry's definition of overcrowding. If he can tell me why he is in order on this point I will listen to him, but if he cannot I hope that he will desist.
§ Mr. Boyden
The same Regulations seem to be concerned. The Handicapped Pupils (Certificate) Regulations, 1953, are revoked by these Regulations, and the Regulations affecting overcrowding are also No. 34/53. I wondered whether the two Regulations were connected.
§ Mr. Speaker
My knowledge is not enough for me to be definite, but I should be very surprised if the Handicapped Pupils (Certificate) Regulations defined overcrowding.
§ Mr. Boyden
The effect of the Regulations may be to cause overcrowding, in which case it would have a bearing on the situation.
§ Mr. Boyden
I hope that you will forgive my relative inexperience, Mr. Speaker. If the alteration of this certificate will cause a greater number of children to come forward, and the Ministry is thinking of taking up a more dynamic approach to the matter, will arrangements be made for the increased 1123 training of teachers of handicapped children? I have asked the Parliamentairy Secretary what is being done about this on several occasions. It seems that the present provisions for training are most inadequate. Has the Minister a more expansive programme for training these teachers? He knows that the birth rate continues to rise, and that the problem is bound to grow, in the natural course of events. Is the Ministry looking at this matter, and will the Minister seriously grapple with this problem in all its aspects?
§ 10.37 p.m.
§ Mr. John Dugdale (West Bromwich)
I want to say a word about deaf children rather than handicapped and mentally subnormal children. Will there be a sufficient number of auditory centres to ascertain whether full use is made by a child of its natural hearing? A child may often be sent to a school for deaf children at a time when, if it had been ascertained how it could use its residual hearing, it need not have been sent to such a school. That is still possible. There are some places, such as Birmingham and Glasgow, and, of course, London, which have these training centres and which can discover whether a child is suitable for a school for handicapped children. With enough training a child may be able to go to an ordinary school instead of a special school.
If the number of these centres can be increased it may be possible to decrease the number of special schools for deaf children. That would be of great assistance, because they are exceedingly costly. They do not cost as much as my right hon. Friend the Member for Huyton (Mr. H. Wilson) described the Admiralty schools at Manadon and Dartmouth as costing—where, we understand, there is one teacher for each pupil—but, for all that, they cost a good deal, because of the ratio of teachers to children, and if the children can be taught to use their residual hearing so that they do not have to go to these schools it would be of great assistance.
The thing that children need more than anything else is not so much accurate scientific testing as an untold amount of sympathy, and if they have that many may turn out not to be as deaf as they seem.
§ 10.40 p.m.
§ Dr. Horace King (Southampton, Itchen)
These Regulations deal with perhaps the most tragic and yet the most hopeful part of our education system. Every hon. Member, I am certain, has met mothers who have received one of these certificates, or its predecessor, and has taken pains to point out, as the Association of Parents of Backward Children points out, that there is no reflection on a parent in having a child who is backward for any reason; there may be sorrow but there is no disgrace. Healthy parents may produce handicapped children.
The Regulations ask the medical officer to do a very complex job. I do not think that it is beyond the capacity of any medical officer to ascertain a physical handicap and to decide that a child is blind or deaf or partially deaf and can go to a school for the blind or the deaf or to one of the wonderful new schools for the partially deaf. Once a certificate has been made out, it is practically certain that the blind ox deaf child or the partially deaf child will go to the right type of school, because such schools exist not only at primary and secondary level but also for various kinds of secondary education. One of the great achievements in educational development is the work which we have done for blind, deaf and partially deaf children in special schools under specially qualified teachers. I recall the work of our late friend, Edward Evans, in this great field of education.
But a different problem arises when a medical officer fills in Part 2 of the form if he is dealing with disabilities of the mind. He must decide whether the child is mentally retarded and whether the educational provision under these Regulations should be in a special class in an ordinary school—and it is interesting that we have long abandoned the idea that teaching backward children is for inferior teachers; it is now regarded as a highly specialised job, as is recognised by the Minister and by local authorities.
If the child's mental capacity is below this, or if there is emotional maladjustment, the medical officer is asked to recommend that the child should go to a special school. If the child is below this level and is intellectually or emotionally incapable of profiting by education 1125 at any school at all, he has to suggest possibly an occupation centre. I think that this diagnostic task is so complex as to be beyond the medical officer.
I know that he co-operates with the education authorities, and I take the opportunity to mention our experiment in Hampshire where we have set up a diagnostic school to which children about whom we are doubtful are sent for a short period during which they can be diagnosed, and the information which we want from this certificate can be more accurately obtained over a period of observation than by a single examination. Such diagnostic schools will, I hope, increase in number.
There is the fantastic problem of the spastic child who has no control over his muscular movements. There is a barrier between his brain and his muscular movements of his body. I remember speaking about this in the House some years ago. We are beginning to learn that behind that barrier which exists between the brain and muscular movement there may well be a very good brain, and it may be that many spastic children are merely physically handicapped in their motor faculties and that what we recorded previously by the known intelligence tests as lack of intelligence overlooks the fact that there may be a real intelligence which cannot get through and respond to such tests. This is a problem which must present great difficulties to the medical officer when he is trying to work out whether the spastic child is fit for any kind of special educational treatment.
But the biggest problem—and this is the question which I put to the Minister—is what to do with the certificates when we have them. If there is a form filled in by the medical officer certifying that the child is recommended for a certain kind of educational treatment, has the child a right to that treatment? Has the parent a right to insist on the Minister or the local authority providing such educational treatment, just as every parent has the right to demand that the Minister or the local authority should provide—
§ Mr. Speaker
Order. I am sorry to interrupt the hon. Member, but I am having difficulty in following him about this. The consequences of the procedure following the certificate do not 1126 seem to me to be relevant to the changes in the form of the certificate, which is what we are debating.
§ Dr. King
I realise that we can speak only about the certificate itself. Does the certificate—and did the previous certificate which it replaces—give to the parent the right to what is recommended by the medical officer in this form?
In the ordinary schools of England there are children whose parents have received such a form. There are parents who have had at home for two or three years children in respect of whom they hold certificates from a medical officer stating that they require one of the special forms of education which the medical officer is asked to enumerate. The gap between the certificate and the special education of handicapped children—between the dream and the reality—is still vast.
§ 10.45 p.m.
§ Mr. William Ainsley (Durham, Northwest)
The handicapped pupils' certificate, according to these Regulations must be signed by the medical officer for the local education authority and must state the disability of mind or body from which the child suffers. I should like the Parliamentary Secretary to the Ministry of Education to confirm that the medical officer's opinion does not stand for the whole of the child's educational career. Many parents are not aware that they can appeal to the Minister. It should be made more widely known that parents can appeal to the Minister even against the medical officer's decision.
When I was chairman of the local education authority in my area I had to deal with many of these cases. One case moved me tremendously. I approached the medical officer about it because, in my humble opinion as a layman, there was some semblance of intelligence in the child's mind, judging by the way it handled picture books and identified the pictures of different animals on coloured blocks. The medical officer, however, assured me that his certificate could not be challenged by anyone. I am glad that we are now moving a little away from that position, and I want all parents to know that they can appeal to the Minister. I should like to know whether when a medical officer makes a decision there is any 1127 means of obtaining a second or third medical or psychiatric opinion.
Two years ago I had the pleasure of being invited to see 150 of these handicapped boys and girls who had been brought into the City of Durham from all parts of the county. I was greatly moved by the sight, and recently I have been asked to accept the honour of being vice-chairman of an organisation which is doing very good work for these children. As a layman I feel when I see these boys and girls that a great deal could be done to make them into useful citizens. I should like an assurance from the Parliamentary Secretary that it is possible to make repeated application for further medical and psychiatric evidence bearing on their welfare.
§ 10.50 p.m.
§ Mr. Ronald Bell (Buckinghamshire, South)
I imagine that the changes introduced by this Statutory Instrument are of a rather formal character and that the point before us this evening is a narrow one. It occurs to me, however, that the general scope of the certificate may be a little wider in future than in the past, because the initial part of the certificate prescribed in the Schedule to the Regulations avoids any explicit reference to Section 34 of the 1944 Act, so that the certificate is made a rather more general comment upon the ability of the child in either a positive or negative sense than was the old certificate.
To that extent, it seems to be an advantage in that respect, as well as in the one which has already been commented upon, that the new form of certificate allows the medical officer to say not merely, if it be the case, that a child is suffering from defect of mind or body which requires special treatment, but also, if more fortunately it be the case, that the child is not suffering from such a defect; so that in many cases it will be the parents who ask for the child to be medically examined to see whether he can be normally educated. Under the earlier practice, what happened was either that a certificate was given saying that the child could not enjoy a normal education or that nothing was given. That is not altogether a satisfactory outcome.
If on the result of the examination a medical officer decides that a child is not 1128 suffering, to use the words of the new certificate,from any disability of mind or body so as to require special educational treatment—and that goes wider than merely Section 34 of the Act—that is a comforting reassurance for the parents to have. It may even strengthen their hand in insisting upon the education authority finding the child accommodation and instruction appropriate to his mental abilities.
Those who have taken an interest in this matter, on both sides of the House know that the real problem is so often to find accommodation and treatment for the child suitable to his possibilities, mental and physical. I was interested in the references which have been made to deaf children. I do not want to carry on the debate on the Regulations beyond its proper limit, but in view of the change between the new and the old certificate it can be said that this is a rather critical point in this difficult matter.
I have known some tragic cases, as, I dare say, other hon. Members have, of children whose difficulties were not correctly diagnosed in the early stage and who had completely normal minds behind the curtain of deafness which often produces symptoms easily confused with those of mental disability, and where a failure, because of something which may have been medical in origin but which often is not medical, to provide them with suitable accommodation and treatment for their defect has had the most unhappy results.
In most parts of the country, there are many deaf children who are not incapable—I cannot remember the exact statutory words—of profiting from education in school in any medical sense but who have not been able to obtain accommodation in any school. Sometimes that situation has gone on even up to the age of nearly 14. A child may have been shut off from any kind of help for his mind either because there was not a proper diagnosis on the original certificate or, much more often, because no suitable accommodation existed to look after him.
I do not know whether the new form of certificate will have this result, but I should think that it will have some effect in the direction of strengthening the hands of the parent whose child is either described by the certificate as not suffering from a defect or in the second paragraph, 1129 in which the defect is described, is defined as suffering from a defect of that character.
It will strengthen the hands of the parent in forcing the education authority to say, "We will, in accordance with the certificate, find this child accommodation at an ordinary school because he comes under the first part of paragraph 2 of the new certificate," or "We will find accommodation for him in a special school because he has a defect which is described in the second part of that paragraph."
I know that my hon. Friend the Parliamentary Secretary is sympathetic on this point. This new certificate is a real advance on the old one technically, and it will be helpful to the parent, but in addition to the narrow point, will he also bear in mind, from the tenor of this debate—even when it has strained against the bounds of order—that the opinion generally felt on both sides of the House is that there is also an unsolved general problem of accommodation for certain kinds of mentally retarded children, and, perhaps over and above all, for those who suffer the disadvantages of deafness?
§ 10.56 p.m.
§ The Parliamentary Secretary to the Ministry of Education (Mr. Kenneth Thompson)
May I offer first two remarks by way of preface? The first is that I am always flattered by the assumptions upon which the hon. Lady the Member for Flint, East (Mrs. White) bases her speeches. They seem to rest upon a firm, but I regret to say, unfounded belief, that I am in constant touch with anything produced by any authority on any aspect of any part of education. I must be a constant source of disappointment to her if I cannot comment on all the statistics which she supplies for our delectation.
§ Mrs. White
All I am doing is assuming that the hon. Gentleman has as wide a source of information as we on the Opposition benches have.
§ Mr. Sydney Irving
Does not the hon. Gentleman realise that there is such a variety of progress in this field, and such a range of opinions, that a much closer survey and a greater collation of 1130 opinions would be helpful both to the Ministry and to others interested in the problem?
§ Mr. Thompson
What I had intended to be a complimentary remark was cut off before I could complete it. I wanted to say that if, whenever she thought it a good thing to concentrate on any part of this great and complex matter, she prepared me beforehand, I could give her greater satisfaction.
My second point is that since so much of what has already been said strained, as my hon. Friend the Member for Buckinghamshire, South (Mr. Ronald Bell) said, the bounds of order, I hope, if I sin in attempting to reply, that you, Mr. Speaker, will allow your attention to contemplate some of the other failings of mankind while I am dealing with as much as I can.
The Regulations themselves cover a very narrow point and need not engage the attention of the House for very long. The change springs from the passing of the Mental Health Act, 1959, which amended, in part, the Education Acts of 1944 and 1948. We took the opportunity provided by this change to make it possible for a single medical examination of a child to be available to serve either one of two possible purposes.
The House will know that the procedure through which a child comes before a medical authority starts, as a rule, when his teacher begins to notice that he is not keeping pace with his fellows in a normal class. That is the origin of the process. The education authority is, as a rule, then informed by the head teacher of the school. At that stage, some education authorities will send a child to an educational psychologist if they have the services of one at their disposal. Others will send the child direct to a medical officer, the purpose being to find if it is a fact that the child is in some way mentally different from the ordinary children in the class and, if so, the extent of that difference and what should be done, following that kind of ascertainment.
If under the old Regulations it had been found that the child was—"ineducable" was the word the hon. Lady used, "unsuitable for education at school" is the phrase we use today—he or she would then become the responsibility of the local health authority and, 1131 prior to the issue of this form of certificate, another medical examination would have to be carried out. The simple purpose of this Regulation is that one medical examination shall be applicable to a child who reaches the medical officer either by way of the health authority or the education authority in order to save distress and embarrassment to the child, the parents and the school alike. I think that the House will commend that as meeting the convenience of everyone concerned.
The form has two other important changes embodied in it; important in the sense in which we have been speaking about this matter this evening. First, it gives the parents this certificate which says that the child is not suffering from a defect. This is not a new statutory right given to the parent, as the hon. and learned Member for Cardigan (Mr. Bowen) reminded the House. It does not give a new power into the hands of parents. The parents have a right of appeal to the Minister against the certificate issued under this section of the Act, but this is not a new right. What it does is to hand to the parents a certificate that says either that the child is suffering from a defect, which in itself is of value to the parent in certain circumstances, or the child is not suffering from a defect.
It is not always the parents who do not want their children to have a certificate issued against them who are involved in this process. There are many cases in which the certificate is asked for by a parent who wants it for another purpose. Where those parents go to the local authority for reasons of their own, which may or may not be good ones, and say, "It is our belief that our son"—or daughter—"is suffering from a defect of mind which makes him unsuitable for education in an ordinary school," the local authority will arrange for this inspection and the medical officer or educational psychologist may decide and certify that the child is not in fact suffering from such a defect. With that certificate in his possession the parent may then approach my right hon. Friend for that decision to be queried.
My right hon. Friend does not cancel the certificate. He does not say, "This is wrong". What he does is to carry out 1132 the kind of examination I suggested to the House in my earlier intervention and then use his influence—which is not without some force—with great delicacy—with the local education authority. Such is the harmony prevailing between the Minister and the education authorities, that there is not in his experience a great deal of difficulty in obtaining the right solution to the problem.
I hope that that deals with the presentation of the form itself. The House will have observed that we have taken away from the statutory part of the form the printing of the categories of disability. This is clearly a better use of this machinery since occasionally it becomes necessary to vary slightly the description of one or other of the categories. Had we made it part of the statutory form, that would have required re-submission of the Regulations from time to time and we think that it would meet the wishes of all concerned to arrange that without coming before the House.
A number of questions were asked which bore to a greater or lesser extent on the precise form of the certificate, and I hope that the House will allow me to deal with such of them as was not blatantly out of order, since I would not dream of endangering myself and meriting your condemnation, Mr. Speaker.
I do not propose to enter into a discussion about whether the figure is 1.2 per cent. or 1.5 per cent. I have no doubt that education experts can always find enough to argue about between these differences of interpretation and differences of emphasis. All I want the House to know is that this certificate will be used in circumstances which today have produced a situation where accommodation in suitable schools can be provided for most of the children suffering from most of the handicaps; with the principal exceptions of those who are either maladjusted or mentally defective in one degree or another. Most of the others, including the deaf children to whom one or two hon. Members referred, can be found places with very little or no waiting time involved.
I have seen, and taken an interest in, the provision that is today available for children who are known to be deaf. I share the deep concern which hon. Members have expressed about the provision 1133 made for these children, and about the urgency, particularly in the case of deaf children, of early and precise ascertainment; about the importance of using the abundance of new skills and highly-developed techniques available today for encouraging the use of those residuary powers that are possessed by some of the children; and about the need to use the other skills instead of hearing where that has completely gone. I pay great tribute to the patient and skilled work with these children in the schools that I have had the opportunity and privilege to visit.
I doubt whether there is very much more that I can say to the House in answering some of the questions put to me without embarking on an abuse of your patience, Mr. Speaker. I should like the House to believe that we are aware that there is still a long way to go before it will be possible for all the children who might need special education treatment as a result of some degree of mental deficiency to be ascertained under this certification process.
On previous occasions I have given the House the figures of the accomplishments of my Department during the last ten years or so. The hon. Member for Sunderland, North (Mr. Willey) chided me with failing to maintain the rate of progress. I think that he based his criticism on the fact that there still remained a figure which seems to be surprisingly constant. He must not deduce from that that no progress is being made. The area over which the net is cast today is becoming wider, understandably and rightly so, and the rate at which new provision is becoming available is not in any way to be derided because of that fact. We are providing new places for these kinds of children at the rate of rather more than 2,000 places each year.
This will still leave us with a difficult problem to face in the three years which follow the building programmes that I have announced to the House and which comprise about £2¼ million annually until the end of 1963. But in the years immediately following that period we expect the rate of provision to be even greater and I am very hopeful indeed that it will be possible to see the end of this problem before many years have passed after that, basing that rather 1134 imprecise forecast on what we know of the figures at present.
It is not possible to be more precise, because as we go on providing more and more places for these children in more and more schools with more and more teachers—and the figures were given in answer to a Question put by the hon. Lady yesterday—we will still have medical officers and local education authorities increasingly anxious to bring more children into this education process who are at present outside it. I hope that they will, because the methods now available for bringing these children to the fullest possible development of their talents are extraordinarily beneficial to the children.
I hope that the children, parents and local authorities will continue to realise that it is an advantage and not a handicap for a child to be brought into these schools and this system of education, where appropriate, and that they should make full use of all the provision there is. I hope that the House will now be good enough to approve these Regulations.
§ Mrs. White
Will the hon. Gentleman say something about the diagnosis and categories which I mentioned and the apparently extraordinarily wide range of intelligence of children in E.S.N. schools?
§ Mr. Thompson
That is one of the matters to which I obliquely referred at the beginning of my remarks. Clearly, there will be factors other than the measurement of I.Q. in the decision about what educational treatment a child should have. It is those other factors that probably cloud the validity of the I.Q.—particularly in the example of a high I.Q. cited by the hon. Lady. Another factor is that some authorities may have made more progress than others with their provision for E.S.N. children and may therefore be able to take in pupils with a slightly higher I.Q. Other authorities will hold to the view that these children should be not in special schools at all but in special classes in ordinary schools. We are bound to get a great variety of children going into the special schools for very different reasons. I hope that that goes some way in answering the hon. Lady.
§ 11.13 p.m.
§ Mr. Frederick Willey (Sunderland, North)
I am sure that the House need not apologise to itself for discussing these Regulations this evening. This is not an unimportant certificate which we have been discussing, but a certificate which is the badge of a humane and civilised society. I congratulate my hon. Friend the Member for Flint, East (Mrs. White) for having promoted the debate and—afflicted by the impartiality which besets me at this time of the evening—I thank the Parliamentary Secretary for his reply, which will be useful to those responsible for the administration of the Regulations.
I agree with the Parliamentary Secretary about the necessity for sympathetically administering the certification. I was very struck by what my hon. Friend the Member for Dartford (Mr. Sydney Irving) said, and we recognise his experience and knowledge of this subject, which was confirmed by what was said by the Parliamentary Secretary. I hope that in any advice given about the Regulations and the certificate it will be constantly emphasised that sympathetic consideration is vital and that the cooperation of parents should be obtained, for that co-operation is more essential than anything else.
I agree with what the Parliamentary Secretary said in reply to the hon. and learned Member for Cardigan (Mr. Bowen). There is no dispute about what the legal position is and I have no wish to challenge it. This is an occasion on which it is far better for the Minister to make representations to those who are responsible for certification. That, too, would fall within sympathetic and humane administration of the Regulations.
Having heard the discussion, I think that, in the light of the points made about the diagnosis itself, we ought to do more to see that we make this patently as clear and definite as we can, and we ought to call in aid all the ancillary services which could help to ensure that the diagnosis is right, and to convince those who are affected by it that it is right.
Finally, I just touch on the point which the Parliamentary Secretary apparently 1136 felt a little apprehensive about. He felt apparently that I had been chiding him unfairly. We are at cross-purposes. I would not deny for a moment that progress has been made and is being made. What I do not want to condone, and I am happy to conclude that it may not be so, is complacency. We are living in a new world so far as special schools are concerned. We recognise what is being done, but I am sure that the Parliamentary Secretary would join me in recognising that it is discouraging that the waiting list is not being reduced. I do not want to pursue this, because it may just be within the bounds of order, and I do not want to transgress. The fact is that the waiting list is what we have to pay attention to. It is a human problem that faces us.
§ Mr. Speaker
How on earth can a change in the form of a certificate be related to the numbers on the waiting list? I am sorry, but I have a duty to discharge.
§ Mr. Willey
I heard the Parliamentary Secretary chiding me on this. I do not wish to pursue it further. It was in reply to him that I called attention to the fact that this illustrates and demonstrates the problem we are trying to solve. As long as we have this facing us, we must feel a real anxiety about the adequacy of what we are doing.
So far as the Regulations themselves are concerned—to put myself painfully in order, Mr. Speaker—the debate has demonstrated that they are a marked improvement on the earlier ones. Many doubts that might have been felt about them have been removed during the debate, and in the light of this I am sure that my hon. Friend, the Member for Flint, East will be willing to ask leave to withdraw the Motion.
§ Motion, by leave, withdrawn.