§ 11.8 p.m.
§ Mr. Cecil Parkinson (Enfield, West)
We have heard a great deal this year about the problem of children handicapped as a result of their mothers taking thalidomide tablets. On the day of the great debate in this Chamber, I visited a school on the borders of my constituency which specialises in helping handicapped children. In the course of that visit, I came to realise that although there is and has been a great deal of discussion about the problems of the thalidomide children there is a gigantic army of handicapped children in our country many of whom have problems which compare in their horror with those of the thalidomide children but which do not get the same discussion, the same coverage, or the same attention.
I want to talk about the problem of the son of a constituent of mine, Christopher Capes. I want to talk about his problem in particular terms, and as an example of the large problem that exists in this country and with which we are not dealing in a very satisfactory manner.
Christopher Capes is now 11 years old. When he was 2½ his parents realised that he was retarded, and he was taken to hospital. In 1967, when he was 5, he was transferred to a selection unit and there a first doctor advised that a residential school was desirable and necessary.
A year later Mr. Capes received a notice under Section 34(4) of the Education Act informing him that his son had been classified as a member of category G and thatarrangements will therefore be made for the child's admission to a suitable residential school as soon as a vacancy arises.A later letter said that that vacancy was not likely to arise until Christopher was 7.
One year later, in 1969, Christopher was examined by a third doctor, Dr. Weiss of the Steiner School, who said that he was a suitable child for admission to a Steiner school and that he should be admitted as soon as there was a vacancy.
628 In March 1970, by which time Christopher was 8, he had to be admitted to hospital since he was causing great physical damage to himself by punching himself on his cheeks until they bled, and in other ways. This was two years after the parents had been informed that Christopher should be educated in a residential school. Again, a fourth doctor said that he must be admitted to a residential school as soon as possible.
In 1971 the parents had an interview with a representative of the chief education officer of Enfield, and after that there was an ominous silence.
In October 1972 Mr. Capes came to see me. The last correspondence that he had had from the chief education officer was pretty specific. In a letter dated 7th June 1971, the chief education officer simply said:… I have now heard from the Camphill-Rudolf Steiner-Schools that they cannot fore-see when a suitable vacancy for Christopher will arise. The situation appears to be that the class for Christopher's age group is overcrowded. There is, however, a chance that a parallel class in the age group might be started within the next two years".That class has not yet been formed.
Therefore, the position is that over a period of nine years four doctors have said that this child should have residential education and everyone is in agreement. Indeed, the chief education officer of Enfield classified him as being a person in category G. It was at that point that I was contacted by Christopher's parents.
I wrote to my right hon. Friend the Secretary of State for Education and to the chief education officer of Enfield, both of whom not only promised to look into the matter, but wrote conciliatory and would-be helpful letters. But the plain fact is that nearly a year after that Christopher is still at home, is still not receiving the education that everyone admits he needs, and is five years older than on the day that it was first admitted he needed this treatment.
The plight of Christopher and of his parents is tragic. One can imagine the chaos that his condition is causing in the home. Indeed, it is causing or is threatening to cause the breakdown of the family.
I have since taken an active interest in the problems and education of handicapped children. The subject of this debate is Christopher as a particular case 629 against the background of the general problem of special places for educating handicapped children—I make no apology for devoting quite a long time to this specific case—and if we examine his case we find that he is an extreme example of a problem about which our society knows very little indeed.
At present, there are 112,000 children in special classes, and it seems to be widely accepted that the number who should be receiving special treatment could be between 10 and 15 times that figure.
The situation is getting worse. In January 1969, there were 13,000 children waiting for places, of whom 5,650 had been waiting for more than a year. There are now 14,900 children waiting for places, of whom more than 6,000 have been waiting for more than a year. Of that total, a high proportion are in the category of educationally sub-normal—five out of six, approximately.
Immediately one starts to take an interest in the subject one runs into the fact that not very much is known about the size of the problem and also that it is very badly defined, and here we come to the heart of the matter. Mr. Segal, the President of the Guild of Teachers of Backward Children, said in a most interesting article in Where in May/June 1972:The problems are as yet insufficiently well defined to enable training objectives and processes to be firmly and confidently established.We are not sure of the size of the problem. We do not know how the problem should be defined. We are working on 10 categories of handicap which were defined in 1959 which have been overtaken by medical and scientific knowledge and by events.
The conclusion to which one is inevitably drawn is that what is needed is what the Conservative Party promised when we were in opposition, namely, a commission of inquiry into the whole problem. One fact which comes over very clearly as one studies the problem is that we do not have sufficient data and we do not know enough about how many children need help. The problem is not well defined, and therefore we do not know how to set about giving the help that is needed.
630 Other problems immediately spring to mind, but I do not want to go on about them. There is a complete lack of trained teachers, but that is hardly surprising. We do not know the size of the problem. and therefore it is not possible to make provision for an adequate supply of teachers. We know that local authorities are not seconding teachers to take the additional training that is necessary. In a recent survey of 31 local authorities. it was discovered that only 150 teachers a year were being seconded for special training—one teacher for every 184,000 pupils in those authorities—and yet we know that the number of children who need care is anything up to 10 per cent. of the number of children in schools.
There is a real and desperate need, and I hope that when my hon. Friend replies to the debate he will not deal only with the specific problem of Christopher Capes who is a very sad and very serious example of a national problem. If one considers the problem of Christopher Capes, and my own experience, over 18 months, of trying to help, one sees a pattern emerging. At first, there is an enthusiasm from my hon. Friend's Department and from the education department in Enfield, and one gets hopeful letters. Gradually one gets less hopeful letters, followed by silence, and then nothing happens.
I hope that my hon. Friend will examine the problem of Christopher Capes. His is a case in which specific help is needed now, but it is a warning to us of the huge problem that the country faces. It is a problem that we do not seem to be prepared to face, and one for which we are not making adequate provision.
I conclude with the cold medical note which the consultant psychiatrist sent to me. He said:The consultant paediatrician in charge of this child recommended over two years ago that residential schooling was required urgently. Since then nothing has been done and there is a cumulative deleterious effect on the child and the whole family.That letter could have been written about tens of thousands of families in our country. It is time we started to take action and to ensure that the Christopher Capes of this world get a fair chance to develop the very limited abilities with which they have been born.
§ 11.21 p.m.
§ The Under-Secretary of State for Education and Science (Mr. Norman St. John-Stevas)
I congratulate my hon. Friend the Member for Enfield, West (Mr. Parkinson) on raising this issue. He has a special reputation in the House as a zealous constituency Member, and the fact that he has taken the trouble to raise this individual case is typical of his concern for his constituents.
There are, of course, wider issues involved than that of one child, however important every child is. Special school populations contain many more children with multiple disabilities than was once the case. There are two reasons for this, both of which are creditable in their way. First, medical science is now ensuring the survival of some children with severe physical handicaps who would previously have died in infancy. Second, ordinary primary and secondary schools are managing to cope satisfactorily with more children whose handicaps are comparatively mild and straightforward.
The boy whose sad circumstances have so tellingly been brought to the attention of the House tonight by my hon. Friend obviously presents acutely difficult problems of diagnosis and placement. Between 1964 and 1970, Christopher Capes was seen by a paediatrician and at least three psychiatrists. From those reports which I have seen it appears that none of them was confident about a diagnosis and their provisional views varied. Amentia, psychotic disturbance and autistic symptoms were all mentioned.
It may be helpful if I say a word about autistic symptoms. The three most characteristic features in early childhood are usually considered to be a difficulty in forming relationships with other people, severe retardation in the development of language, and ritualistic and obsessive behaviour. Christopher has, I understand, exhibited all these traits. It will easily be understood how behaviour involving destructiveness and interference with almost every ordinary activity, resulting in a need for constant attention throughout the day and also at night, imposes a terrible strain upon the parents and, indeed, upon the whole life of the family. Mr. and Mrs. Capes, and their elder son, have carried an immensely heavy burden for the last 10 years.
632 What help have they received from the Enfield local education authority? The local child guidance clinic recommended as long ago as 1968 that Christopher should certainly be placed away from home. As my hon. Friend said, admission to a Rudolf Steiner school was sought, but it could not do more than place him as an urgent case on its waiting list. The LEA approached several other schools for mentally handicapped or maladjusted children in 1969 and 1970, but could not obtain a place for him. In the meantime, Christopher had in 1967 been transferred from a junior training centre under the local health authority to a so-called "selection unit", whose function is partly diagnostic but where some handicapped children stay for longer and receive skilled teaching. He is still at that unit.
Two of the few encouraging documents about the case which have been sent to us by the Enfield authority were most perceptive reports written by the teacher in charge of the selection unit in 1968 and 1972. These showed that, along with some very bizarre behaviour, Christopher could be happy and co-operative at times and respond with warmth and affection. The last report said that altogether he seemed a much happier child than he was 18 months previously.
I understand that the authority has arranged short-term care for Christopher during holidays, once or twice a year, to give the parents a much-needed break. The fact remains, however—and I am almost as aware of it as my hon. Friend —that five years after a strong recommendation was made that Christopher should be boarded away from home, he is still at home.
What is my Department's attiude to this situation? We do not provide any schools, nor do we control placement in special schools run by local education authorities or voluntary bodies. No one can guarantee a suitable school place for a particular handicapped child, but what we are always willing to do, when asked, is to suggest some schools which seem worth approaching to see whether they can offer a vacancy. In this instance the Enfield authority never took the initiative in asking for the help of my Department. It was only when, in December of last year, my hon. Friend the Member for Enfield. West, in pursuit of his duties as 633 a Member of Parliament, wrote to my right hon. Friend the Secretary of State about the case that we heard about it.
After obtaining medical and other reports from the authority, officials then wrote to the chief officer, in January 1973, suggesting eight schools which might conceivably take Christopher, though we were handicapped by the fact that the last report sent from the Enfield child guidance clinic was dated 1968. None of the schools could offer a place. It seemed pointless to make any further suggestions until an up-to-date medical report was available. The psychiatrist at the Enfield clinic agreed to see the boy and his parents for the purpose on 17th May, and I have seen his report this morning. The psychiatrist is now confident about a diagnosis of mental subnormality and recommends a boarding school for severely mentally handicapped children.
Now that we have this clear recommendation, we shall be glad to give all the advice and assistance we can, though there is a serious shortage of boarding places for the severely mentally handicapped. At least there are several options: boarding special schools, or independent schools, or hostels, run either by the education department or by the social services department of the local authority, where children can live while attending day special schools. Failing all else, there are hospitals, some of which have schools attached. If necessary, the co-operation of the social services department of the local authority must be sought in working out a residential solution.
My hon. Friend mentioned the question of an inquiry. We do not need a general inquiry because we have had a whole series of particular investigations into various aspects of this subject. But I am aware that it is not only the situation of one child that we are discussing. We are discussing something of much wider importance to the community. I appreciate the fact that the parents of Christopher have agreed to the exposition of what to them must be painful facts in public in order to assist others who find themselves in a like position.
I should like to put the facts about this whole situation in perspective. Governments of all complexions are frequently 634 criticised because of the length of the waiting list for special school places.
In January 1972, the latest date for which figures are available, it was 14,900. What is often not realised is that, since 1955 at least, this figure has not gone down very much despite a substantial growth in the number of special school places provided. In the 15 years between 1955 and 1970 there was an increase of 31,800 children attending special schools, but the waiting list went down by only 2,400. This shows that the waiting list represents only the tip of the iceberg of need. Local education authorities tend to stop identifying more children as requiring special school places when their waiting list reaches a certain length.
Now, however, the Government have announced in the White Paper "Education: A Framework for Expansion" accelerated building programmes for special schools between 1972–73 and 1976–77, which should substantially reduce what we believe to be the genuine, as opposed to the announced, waiting list. The programmes should mean an average increase of some 30 per cent. in the annuol provision of new places in the next five years compared with the three previous years. Handicapped children should also benefit from the expansion of nursery education which is another prominent feature of the White Paper. Educationally sub-normal (severe) children will enjoy a high priority in the enlarged special school building programmes, including those in hospitals; and we hope that some 5,000 new places for these children, in addition to the replacement of unsuitable premises, should be started out of the resources announced in the White Paper.
The contents of building programmes, however, depend on the nature of the proposals for new schools that LEAs submit. A remarkable proportion of the school places available for children with severe multiple handicaps are provided by voluntary bodies. We would welcome more proposals for special schools of this kind from LEAs. There are, of course, exceptional circumstances over provision for ESN(Severe) children. Until April 1971, when they were brought into the educational system, these children were the responsibility of the Department of Health and Social Security. LEAs naturally had to use the premises of the 635 former training centres for the new special schools that were created overnight. The transfer has gone very smoothly, and I should like to pay tribute to the deep interest taken by LEAs in this new group of handicapped children and their readiness to make generous provision for the education which is now the children's due.
It has inevitably taken some time to assess the adequacy of the facilities available and so far the only boarding project submitted by an LEA for inclusion in a building programme has been a 12-place hostel providing for both groups of ESN children—medium and severe. This has been included in the 1973–74 design list, which will be issued in a week or ten days' time and will allocate resources totalling £11.5 million.
I very much hope that more proposals for boarding places for ESN (Severe) children will reach the Department from LEAs for the next design list. Increasingly, too, we want boarding special schools to be planned to meet regional needs, instead of—as still too often happens—children being sent to the other end of the country because there is no suitable school with a vacancy nearer home. My right hon. Friend the Secretary of State said in the House in December 1972 that she was considering promoting a series of regional conferences at which LEAs would be invited to consider, with the voluntary bodies concerned, the needs for all types of handicap within their region. My right hon. 636 Friend added that the timing of such conferences would depend, amongst other things, on the progress of the local government reorganisation. I would expect these conferences to stimulate the regional planning of increased boarding provision for ESN (Severe) children.
These are long-term aspirations which, when translated into bricks and mortar, will in the years to come benefit many children in great need. But Christopher, of course, requires help immediately, and, as I have said, we now have an up-to-date medical report on him, which we have just received, with clear-cut recommendations. I pledge to my hon. Friend that we will do all we can to help the Enfield authority to find a suitable placement for him and so provide relief for his hard-pressed parents. I assure my hon. Friend of my personal concern in this case.
I thank my hon. Friend for having raised this case, which affects a particular family so intimately and profoundly. I thank him, also, for his action tonight, which has drawn the attention of the House to the plight of many children in a similar position to that of Christopher. This short debate will, I think, be a valuable contribution to improving the lot of those who suffer from such severe handicaps and need the help of the community in overcoming them.
§ Question put and agreed to.
§ Adjourned accordingly at twenty-four minutes to Twelve o'clock.