EDUCATION OF HANDICAPPED CHILDREN

HL Deb 06 April 1965 vol 265 cc50-68

4.45 p.m.

LORD GRENFELL rose to ask Her Majesty's Government what plans they have to assist the education of children suffering from the dual handicap of deafness and mental subnormality or spasticity. The noble Lord said My Lords, I have put down this Question in order to stress the vital importance of assisting children who suffer from the dual handicap of deafness and mental subnormality or spasticity. These children, in my opinion, will not reach the highest possible level of education within their ceiling of intelligence without the special deaf training, and hence will not have the best chance of living a normal life within the community.

I am including spastics in this Question, as the case of Muriel Rissen has been highlighted in the Sunday Express, and I sent a copy of the article to the noble Lord who is to answer this Question. Muriel Rissen is a spastic deaf mute whose mother and father have frequently moved house and jobs to try to find some school which will' take her as a pupil, so far as I know without success.

Some noble Lords may remember that on the Second Reading of the Mental Health Bill I spoke about my daughter, who is a deaf mongol of 15 years of age with very little speech, and she was making little progress at a special training school owing to her incapacity to hear what the teacher was saying. In spite of deaf aids, the noise set up by a class of mentally handicapped children causes a buzz in the ear-phone which inevitably cuts out the voice of the teacher, and the size of the class prevents individual attention to the deaf child and hence the lesson is lost.

About eighteen months ago, with the assistance of Dr. Wickley, the Medical Officer of Health of the then Middlesex County, and Dr. Scott of the then London County Council, my daughter was accepted into a deaf school at Brighton called the Hamilton Lodge School for the Deaf. There are very few deaf schools which will accept mentally handicapped children, as they consider that they will hold back the other children. Miss Taylor, the then headmistress, never refused any children until she had proved over a period of six months that either she could not help them or they were unhappy. She, unfortunately, died last year, but Mr. Jansen, the present headmaster, and his dedicated staff carry on her great work and have over 100 pupils in their care, two of whom are mongol children. During the period of my daughter's residence at this school her progress has been astonishing. Before entering the school she could not draw any consecutive lines on paper, but now she is writing out simple letters. Her speech has improved a little, her understanding has made spectacular strides and she is blissfully happy. She has integrated with the other pupils completely, and all are most kind to her.

There are a number of mentally subnormal deaf children in the country who are not getting the expert training which my daughter is getting, and by reason of their deafness are not able to assimulate fully the teaching at special training schools, which are not wired for sound, nor are the wachers trained in the expert art of teaching the deaf. These children will never rise to the full level of education within the ceiling of their intelligence, which they have a right to do. Hence, their chances in life are sadly curtailed.

I have not raised this Question before because I wished to be certain that children with a dual handicap could benefit from this training. I am now convinced that this is so, and I feel sure that all noble Lords will agree that every effort should be made to see that the best possible education is given to these children. I am also convinced that deafness is as great a handicap as, or an even greater handicap than, mental subnormality. In fact, there have been tragic cases of some children being diagnosed as mentally subnormal when actually they were only deaf. I fully realise that in the paying of fees adjustment has to be made owing to the so-called uneducable children being under the Ministry of Health while the deaf children are under the Ministry of Education. But this can be and is being dealt with.

I hope that Her Majesty's Government will inform local authorities and the schools for the deaf that it is the wish of the Government that these children should be placed in schools for the deaf, and that these schools should accept them for at least a trial period. In many cases it will mean the children becoming boarders owing to their living a long distance from the school. But many of the deaf though otherwise normal children are boarders, for the same reason, and there should be no difficulty here. I would stress that one day a week in a deaf clinic is of no value, as it is essential for these children to have continuous deaf teaching if the best results are to be obtained. My story is a success story, and I have put down this Question in the hope that other children in the same circumstances as my daughter may have an equal chance to enjoy the best possible education within the ceiling of their ability, and a chance to live happy and useful lives.

4.55 p.m.

THE EARL OF ARRAN

My Lords, the noble Lord, Lord Grenfell, has spoken wisely and movingly on that part of the Question which concerns deafness. May I say a special word on the subject of mentally subnormal spastics, which is also referred to, because of course, spasticity and mental subnormality often go together? I thought I might tell your Lordships what life is like in one of the places where they look after the children whom the noble Lord has in mind, and what their needs are, for it is a proud and, at the same time, an incomplete story. My experience is limited to Harperbury, in Hertfordshire—a special hospital which does special things and has a world-famous cerebral palsy unit. So far as I know, there is, no other such unit in the country.

Let us face it, these children, carrying a double burden of spasticity and mental subnormality, are very pitiful The behaviour of some of them its suck, as highly to tax one's faith in the Divine purpose. But there is comfort at Harperbury. It does not exist merely to accept them as painful facts. Things could not be worse, so they try to make them better. They start from nothing and they work upwards, and they are getting results. One doctor, a Czech, to whom the whole world in in debt, is taking on the worst cases of all—children whose brains have been damaged before, during or soon after birth. For such children there had seemed to be no hope; but he has shown that they can be vastly improved, mentally and physically—though of course never completely cured—especially if they are treated early, before the pattern of uncontrolled movements has been established. To take the simple indication referred to by the noble Lord, it has only recently been realised that many of these children are deaf and therefore remain dumb. A simple hearing aid often works wonders. But, of course, the rest is not quite so easy: it calls for endless patience and resolve, and the stuff of dedication.

That is all very fine. But what more do we need? Where do we go from here? First of all, this, as I say, almost unique cerebral palsyunit, now established at Harperbury over four years. needs to be repeated in other parts of the country. Harperbury caters for about 90 babies and children of this sort. An estimate of the total number in Britain is about 2,000. At present, so far as I know, the other babies are not getting the benefit of the new educational techniques and treatment. Have they not the right to this? Why should there not be similar units in the Provinces, within the framework of the Hospital Boards, or at any rate in some hospital setting? And if these things are too difficult, or too expensive, should there not at least be out-patient facilities for these children in every district enabling them to spend, say, a day at the hospital, learning—and this is for them education—such simple things as how to eat and how to keep themselves clean, if that can be done?

To return to Lord Grenfell's point, are there really adequate facilities outside London and the immediate regions for diagnosing deafness or inadequate hearing which is so often the cause of what is falsely regarded as mental defectiveness? I have thrown out these points shortly, and at short notice. Clearly, they are not entirely my points, though I go along with them wholeheartedly, for they seem to me to make sense. Perhaps Her Majesty's Government will have a look at them, and, to-day or later, will let the House know their intentions. There is a little job to be done here. It will be greatly to the Government's credit if they do it, and do it quickly.

5.0 p.m.

LORD BROCKWAY

My Lords, I am sure the whole House will want to thank the noble Lord, Lord Grenfell, for introducing this subject this afternoon. We were all deeply moved by his speech. If I may say so, it is characteristic of so many parents who are in his position that when they have a child who needs special care they make that child the inspiration for all children who suffer similarly. I should like also to express to the noble Earl, Lord Arran, our gratitude for what he has said. I am not sure if I am in order, but I would extend this appreciation to the noble Lord, Lord Hastings, who introduced the earlier debate, because these two debates seem to me to raise the deepest test as to whether a society is civilised and human, whether we all belong to the human family, and whether it is not our duty to help specially all those who are handicapped, whether physically and mentally, and those who are rejected.

I cannot help remembering to-day one of the most depressing experiences of my life when, a year after the defeat of Hitler in Germany, I went to a mental institution there. The greatest crime of Nazism was that it was not only racialist in rejecting the Jewish people and the coloured peoples from the human family, but that it rejected even those who physically or mentally were handicapped. As I entered the room where those patients were gathered, I could not remain there. They were just skeletons clothed with flesh, with feverish eyes; they had been starved for years. It was a form of genocide against those who were unfortunate. The great difference between that philosophy and the philosophy which expresses the Christian ethic—I say that, though I am a humanist rather than a Christian—is the greatest challenge as to whether a society can regard itself as civilised.

I have risen to-day because I have been associated with the National Society for Handicapped Children, and particularly with its branch in Slough, the constituency which I represented in another place. I want to endorse the appeal which has been made from the other side that much greater care should be taken to decide whether these children are educable or not. I know cases in my own experience where later it has been discovered that a child is not abnormal mentally but has given the appearance of it only by deafness. There ought to be a certainty in our society that there is sufficient provision to be able to diagnose the condition of every child who is like that. My colleague in the neighbouring constituency was Mr. Ronald Bell, with whom I differ on every issue on earth, except this issue. Together we once went to a group of children who had been rejected as uneducable. Mr. Bell pays special attention to this subject, and we took the view that three of those children were able to learn. It was Mr. Bell's efforts which secured that two were able to join ordinary schools and were able to become part of a child community in education.

I have often been to the parties of these children. In one way they are distressing occasions, but on the other hand they are occasions of great inspiration. One remembers the love of the parents for the children, the extraordinary sweetness of the children themselves at moments when they are touched and when they respond to what has been said or done, and also the inspiration of the voluntary workers who maintain these activities. I think again of Slough, where the Secretary of the Slough Society for Handicapped Children, Mrs. Barbara Mason, a member of the board of St. Bernard's Mental Institution, devotes her time to the children. They have done extraordinary things. By voluntary labour they have established one of the loveliest little halls, which is known, most appropriately, as "The Friendly Club". There, twice a week, they have classes for the children of nursery school age, with trained attendants, which provides a tremendous relief for the parents who otherwise are so tied down. In addition, they have parties for the elder children, teenagers, and even adults who do not seem to be much more than children.

This leads me to my first question to the Minister who is to reply. Tonight in that hall the club for the teenagers and the older sufferers will meet. I want to ask whether it is not possible to apply to youth clubs of that character the same grant which is given by the county educational authorities to other youth clubs. I urge that this should not just be left to the generosity of some county councils, but that the Ministry should use its influence to see that it is applied everywhere.

Secondly, I want to put this point of view. There is a danger that the special schools for these children will not be regarded as a first priority. I think of the school in Slough, where there is a trained, devoted teacher, but it is in one of the older buildings and is rather makeshift. If we are to develop the best for the children, they must have the brightest surroundings that can possibly be given to them. I am urging that in the programme of educational advance which the Ministry is now undertaking it shall give a special place to provision for these children.

The third point I want to ask him is this. In Slough we have the experimental centre for the National Society for Handicapped Children. We have there, in Ellerman Avenue, workshops which are for the teaching of the older children—and later as they become teenagers—in just normal, simple things, with a view to their advancing to a capacity which will enable them to take jobs in industry. It is a little pathetic how they begin—just learning to tell the difference between a penny coin and a halfpenny coin, going on learning for the first time to use a knife and fork, passing on from that to being able to use a telephone, and then to doing little, simple jobs which will even prepare them for engagement in industry. That experiment is coming to the end of its period of two years. I am asking the Minister whether his Department will have a very careful look at this experiment and, if necessary, take it over as a model and a pattern of what might be done for children of this kind.

Finally, my Lords, I want to press for much more research enabling earlier diagnosis of these cases. The instance of the deaf children who are misunderstood as being subnormal is an example of this problem. I would say, although I speak as a layman, that here is a great field for human discovery, which would not only make the children happier and give them greater opportunities, but would bring hope to their parents.

LORD GRENFELL

My Lords, before the noble Lord sits down, may I say that my understanding about the Slough project—and I think I am right—is that in time that will be handed over to the Buckinghamshire County Council. They will take it over and will run it for ever and keep it going.

LORD BROCKWAY

My Lords, I am very much hoping that that will be done. I was speaking to Slough this afternoon, and I am not sure that an absolute decision has yet been reached. But I hope that will be done, and that the Ministry will encourage it.

5.13 p.m.

LORD SEGAL

My Lords, I feel that I must express some apology for inflicting myself on the House twice in two successive discussions. But although I was partly suborned into taking part in the previous discussion on epileptics, I cannot refrain from adding my own few words in this discussion, because it concerns a subject about which I feel so much more deeply than on the question of epileptics.

Let us remember that epilepsy is a problem which can recur from time to time, and that long intervals—perhaps of months, or years—may elapse between an epileptic attack; but the problem of the mentally handicapped children is, like the poor, always with us. In fact, it is to-day with us very much more than the problem of the poor, because we like to pride ourselves on the fact that, thanks to our Welfare State, the whole problem of poverty has been largely eliminated. But our Welfare State has so far done very little indeed to tackle this vast and heartbreaking problem of the mentally handicapped child.

I am sure that we are all deeply grateful to the noble Lord, Lord Grenfell, for having initiated this discussion. He spoke very feelingly about his own daughter, and those of us who know of his work in the past, how he has given unsparingly of his time, both publicly and privately, on behalf of the cause of mentally handicapped children, are especially grateful to him to-day for having raised this subject. He has highlighted what is really one small aspect of a very much larger and most appalling problem. He himself, I think, is a shining example of the way so many parents, in the happiest of homes, who find themselves afflicted with this problem of having a mentally handicapped child, have not only shouldered the burden themselves through the long unceasing agony of the years of childhood, of adolescence, and even of adulthood, but have always, perhaps as a result of this, tried to help so many other parents who are similarly afflicted.

If I were to declare my own interest, it would be that I have a niece who was born a normal healthy child, but who at the age of about three-and-a-half years suffered from a very malignant type of meningitis. Her life was despaired of, and then, through the care and the constant attention which she received at the hands of surgeons and physicians in hospital, and after a succession of ventricular and cysternal punctures, her life was saved. But she was left with some mild degree of mental impairment, from which she will have to suffer for the rest of her life.

The problem is so extensive to-day that I believe there is scarcely a single home in this country which is not involved, either among its own relatives or among its friends and neighbours. Although we try to-day to draw a veil over this problem, it does exist; it exists to the knowledge of almost every citizen in the land. And I believe that it is high time not only that further publicity was given to this question, but that a deeper understanding was installed in the minds of all our citizens. I also believe that our Government should now be seen to take a far more active part in dealing with this problem, in helping the parents, in providing and assisting for the education of the children, and in seeing that the utmost is done to enable them to grow up to become useful citizens and members of our community.

My noble friend Lord Brockway has spoken about the problem as it existed in his constituency, and I am very proud of the fact that in Slough pioneer work has been done in the establishment of a hostel for the training of children, and for helping them to learn some useful and productive activity. He has spoken very feelingly of the love of these parents for their children, of the actual sweetness of the nature of these children themselves. It is so fundamentally a human problem that, as he rightly said, it is by our own attitude to this question that our present-day civilisation will be judged. This work that is carried on in Slough is pioneer work of its kind. The tragedy is that it remains an isolated instance. It should be multiplied in many other regions in the country.

There is also a vast problem where these children are so handicapped that they are admitted into hospitals; for, unfortunately, despite all the care and devotion that they receive in hospital, their stay there tends to be prolonged. So little is done in the way of helping them and treating them, and there, alas! in many instances they tend to remain. Perhaps what is more needed to-day is not the admission of so many of these children into hospitals, but the provision of hostels where they can spend the daytime under the care of trained, efficient and experienced workers, and perhaps be trained in some useful occupation and enabled to go to their homes in the evening. In that way, the burden of caring for them can be lifted from the shoulders of their parents, and the children can have an opportunity of creating some useful place for themselves in our society. Not only is the provision of hostels for these children needed. One would like to see a much greater extension of holiday homes, where these children can mix together as a community, taken away from their immediate surroundings and given the benefit of a healthy holiday period, if only for a few weeks of the year. I am sure the good will is there, but the amount of work ahead is enormous. It is enormous, not only in the scope that it affords for voluntary help; it is enormous also in the scope that it affords to the Government for taking an active interest in this work and helping effectively in so many directions in which only the Government can help.

The noble Lord, Lord Brockway, has spoken about the need for research. Earlier diagnosis and dealing with causation of mental illness are dependent upon research; and there, too, I feel this Government could do so much more through the hospitals, through our medical schools and through our universities in stimulating fundamental research into the causation of this mental illness, so that the problem in all its present-day dimensions can perhaps be prevented from becoming unduly large in the future.

The tragedy of these mentally handicapped children is that the extent and scope of the problem is relatively little understood. One of the first cares of our Welfare State is for the welfare of the blind. We have our blind register and we have our register of partially sighted, but so little is known of the extent of the problem of our mentally-handicapped children. Figures are given variously as between 80,000 and 100,000 or 150,000; 'but, surely, there is scope, with the initiative taken by the Government, to institute a register of our mentally-handicapped children, so that some idea could be given to the community as a whole of the dimensions of this problem. Because I believe that, by our treatment of these problems of our mentally-handicapped children, our Welfare State will ultimately be judged, and that by this test will our Government be enabled to justify their record of service to the community.

5.24 p.m.

LORD ROWALLAN

My Lords, I had not intended to intervene in the debate this afternoon, but I should like to express my gratitude to the noble Lord, Lord Grenfell, for raising this matter. As I listened to the eloquent and moving stories which were told by those who followed him, my mind went back two or three years to a little school in Tasmania. There they claimed with pride, and I think with justice too, that in its equipment it was the most up-to-date school in the world. They had gone to endless trouble in collecting and adapting to their needs visual and acoustic aids for bringing these children back into the community. The result that we were able to see before we left, two and a half years after it was founded, fully justified the faith of those who started the school and the devotion of those who taught in it. We still receive letters from those children, and only the other day one of the girls, who seemed a very difficult case indeed and most unpromising, wrote a letter to my wife saying that she had just passed a national examination in typewriting—a tremendous achievement, not only for the girl herself and her parents but also for those who had made that possible.

My Lords, I feel quite sure that work that is done among these children is not only work for them but work for the whole community, in providing an inspiring example of what can be done with good will, determination and faith. My wife is very proud indeed that that school bears her name, and we shall always look back with pride on the very sketchy association that we had with it during those two and a half years and realise that, in however small a way, we were in at the beginning of something which was a big experiment for a very small country, and well justified by the results.

5.27 p.m.

THE MINISTER OF STATE FOR EDUCATION AND SCIENCE (LORD BOWDEN)

My Lords, I am sure that I speak for everyone when I say that we greatly appreciate the opportunity that the noble Lord, Lord Grenfell, has given us to discuss this most distressing problem. The personal tragedies of these children have been brought before us very clearly by several speakers who have first-hand experience of what they mean; and particularly, of course, we have all been very moved by the account given by the noble Lord, Lord Grenfell, of his own daughter. I am sure that this debate will inspire us all to realise that much can be done for these people and that much more must be done in the future.

I should like, if I may, to describe briefly the present statutory position. Local education authorities have a duty to make sure that education is provided for all children who have any disability of mind or body, unless, in the case of the mentally handicapped, the disability is so great as to render the child unsuitable for education at school. This statutory requirement applies whether a mentally handicapped child has normal hearing or whether he is deaf, or has some other physical handicap.

The Department of Education and Science has for many years believed that no child should be excluded from the education system without a very careful assessment of his potentialities, if necessary over a long period, unless his mental impairment is so great as to leave the matter in no doubt. This is a view which Her Majesty's Government believe very strongly to be right; and we will take it fully into account in our plans for the further development of the various services.

It is in fact remarkable that a generation ago children who were short-sighted were sometimes mistakenly diagnosed as mentally-handicapped because they were unable to read what was written on the blackboard. To-day one finds that people who are unable to hear are sometimes similarly diagnosed as having some mental defect. It is very tragic that these things should still happen; but, none the less, very much greater care is taken these days than used to be the case, and the work of such of the schools for the deaf as I myself have seen is obviously based on the belief that most of these defects can be identified and that appropriate treatment can be given. It is extremely important, both for the mentally handicapped and the other children, that a distinction should be made between those children who can obtain benefit from education and those for whom some other type of provision is much more suitable.

At present, there are two maintained boarding schools which cater specially for children with hearing defects who are also educationally subnormal. There are many other special schools for the deaf and partially deaf, which provide to a greater or lesser degree for children with severe learning difficulties. A new boarding school is being built by the Royal National Institute for the Deaf, with the aid of a grant from the Department of Education and Science. It is intended both for deaf and partially hearing pupils who are emotionally unstable and are psychologically disturbed. In addition there are several independent schools which are able to accept deaf children suffering from a disability of mind, and local education authorities send pupils to these. The Department of Education and Science is at present considering the adequacy of this range of provision. If further facilities are shown to be needed, discussions will be arranged with the local education authorities and special schools concerned with a view to making provision as soon as possible if they appear necessary.

In cases where it has been established beyond doubt that a deaf child is also mentally handicapped to the extent that he is unsuitable for education at school, responsibility for the child's training and any other facilities which it needs becomes the responsibility of the National Health Service, either through local health authorities or through hospitals. Hospital specialists can also help in the very difficult task of assessment before this important decision is taken.

The number of children who have this severe degree of mental subnormality and are also deaf or hard of hearing is small. We have no reason at present to think that it is much in excess of the general incidence of deafness in the population as a whole, which is about one per thousand or one per two thousand for profound deafness. But when the defects of deafness and mental subnormality are found together in one child, the problems are extremely severe, and the difficulties of training such a child arc very great. It has been suggested that special hospital units and residential training centres should be established to give such children, or other mentally subnormal children who do not use speech as a means of communication, the benefit of specialised treatment and training in methods of communication.

In order to assess the possible demand for such facilities, the Ministry of Health is at present collecting information from hospitals and local health authorities about the number of such children known to them, and about any further defects from which they are suffering, such as blindness, cerebral palsy or congenital malformations of any sort. When the results of this inquiry are available they will be carefully studied and, if it seems desirable and practicable, encouragement will be given to the provision of specialised units, which inevitably would have to be residential because of the small number of children in any one area.

In the meantime, mentally subnormal children who attend local health authority training centres and are capable of benefiting from a hearing aid are provided with one. If the mental subnormality is very severe, or if the deafness is very severe, the child may not be able to use a hearing aid to the best advantage; but those who can do so, use them. Children who cannot use hearing aids are not at such adisadvantage compared with the other children as a deaf child might be in an ordinary school, as much of the training of severely subnormal children is always done through visual communication and manual practice. Nevertheless, in such circumstances the children would not receive special training designed to help them to make the most of such hearing as they have or to develop their speech; and it is for this reason that the Ministry of Health are investigating the extent of the problem and the practicability of establishing special centres.

I have looked into the case of Muriel Rissen, who was referred to by the noble Lord, Lord Grenfell, and it seems that she has so many handicaps that it is very difficult to provide satisfactorily for her education because her parents move around the country. But I feel that the article in the Sunday Express to which the noble Lord referred was in some ways misleading. Muriel Rissen has been under careful medical supervision since her birth. At the age of 4½years she was admitted to the nursery class of the Tottenham School for the Deaf and was later transferred, when she was six years old, to a day school for physically handicapped pupils which contained a unit for deaf children. Her departure from this school after four years was prompted not so much by educational considerations as by a change in her home circumstances, which made it necessary for her mother to seek employment and to move out of reasonable daily travelling distance of the school.

This was at the end of 1963. From the time she left Middlesex the girl's mother has moved through the area of four different local education authorities, each of which has made every effort to find a suitable school, but, except in the case of the authority now responsible for the child, each has had to relinquish the case before a vacancy could he found. It is not the case that the mother and the girl's stepfather have moved from place to place in search of a suitable school. They appear to have done so in the course of their employment. The nature of their employment, which involves their moving about, suggests that a residential school place is clearly desirable, but unfortunately the accommodation, especially the residential accommodation of boarding schools for the deaf, is mostly unsuited to the needs of children with a severe physical handicap.

I am glad to say that the Headmaster of the Royal School for Deaf Children, Margate, has now accepted Muriel as a day pupil for mornings only, at first, and the Kent local education authority are providing transport for her to and from school. She started school again on 19th March, some two weeks ago. At present she is living at a private boarding house in Ramsgate under arrangementsmade on behalf of the parents by the Spastics Society. The local education authority are aware that if this arrangement could not continue for any reason, an alternative would be needed to enable her to continue to live within daily travelling distance of the school.

My Lords, Muriel Rissen's case has presented peculiar difficulty, not only because of the lack of suitable accommodation in schools for the deaf for a child with her physical disabilities, but also because of the severity of her hearing loss, which was caused by meningitis and is much greater than that normally associated with spasticity. There are about 2,500 spastics in day and boarding special schools, excluding hospital schools, approved by the Department. It is not known exactly how many of these are additionally handicapped by deafness, but the number is not more than 100 to 150. Very few of the children in these schools are so severely handicapped by deafness as Muriel Rissen.

Special provision is made in a number of day schools for physically handicapped children in London, Middlesex, Essex. Bristol, and other heavily populated areas, for spastics who are also partially hearing. Special units are also being provided within new schools for the physically handicapped being built in West Ham and Manchester. There are one or two partially hearing children in a number of the special schools for physically handicapped children throughout the country. With the use of hearing aids provided under the National Health Service they are usually able to cope adequately with the ordinary curriculum of the school.

In addition to the above children there are also some 300 spastics in the independent boarding schools run by the Spastics Society. Two of these schools have special units for partially hearing children, but not for deaf children: they are the Wilfred Pickles School, Rutland, and the Ingfield Manor School, Sussex.

A survey recently carried out of physically handicapped children awaiting places in residential schools confirmed the Department's view that there is no evidence of any real need for more school places for children with this dual handicap. If evidence were forthcoming, provision could be made available without great difficulty in the new schools which are due to be built over the next few years for physically handicapped children, as well as in existing non-maintained boarding schools for spastics where there are vacancies, or where there are likely to be difficulties in filling all the places in the next few years. I am most conscious, as we all must be, of the great burden which a severely handicapped child places on its parents. It is important to remember that this is a handicap for the family, and not merely for the individual child. This is true whether the handicap is physical or mental, and it is greater still when the poor child has multiple handicaps. As several noble Lords have said, it is in large measure a test of the attitude of society that some effort is made to help people to cope with what can be an intolerable burden.

It is true to say that facilities for helping children and their families are now much better than they have ever been in the past. There are now many more day and boarding schools for the physically handicapped, and many more training centres for the mentally subnormal, which not only succeed in training children, but also in relieving the parents of caring for them part of the time, at least during the day. This is of enormous importance, because otherwise the burden can become quite intolerable. Most parents are devoted to these children and wish to keep them at home, but they need relief to enable them, for example, to take a family holiday without the necessity of being burdened by the child. It is now a recognised function of the local health authorities to arrange for residential care for mentally subnormal children and for adults, both for holidays and at times of domestic stress—for example, when the mother is ill. Voluntary organisations do a great deal of this work, both for mentally and physically handicapped children.

All in all, though most difficult problems remain, the parents of mentally handicapped children have at their disposal to-day a much wider range of facilities and services than was the case even twenty years ago. I am sure that your Lordships will be glad to know that there are prospects of even further improvement. In the last five years, the Medical Research Council have doubled their expenditure on research into mental illness, and I hope that this will lead to further results, so that more and more can be done for successive generations of handicapped children.

My noble friend Lord Brockway asked me about the club in Slough. I am afraid that I cannot tell him the answer to his question, which is rather technical, but I undertake to look into it and write to him. The noble Earl, Lord Arran, referred to the most remarkable work which is being done at Harperbury Hospital, near St. Albans, by Dr. and Mrs. Bobath. This is a hospital for the subnormal, and many of the patients are both spastic and deaf. Dr. Bobath is a psychiatrist and Mrs. Bobath is a physiotherapist, and they are working together in a cerebral palsy unit within the hospital. The technique which they have developed can be used for children as well as for adults, and Dr. Bobath has offered to train other doctors to use the methods he has developed. I understand that the Regional Hospital Board are arranging for other doctors to join the unit in order to learn Dr. Bobath's techniques.

THE EARL OF ARRAN

My Lords, does that mean that there is a possibility of cerebral palsy units being set up in regions other than the London and North Western Region?

LORD BOWDEN

I hope so, my Lords, but it depends on the success which Dr. Bobath has in finding suitable disciples who can take his techniques elsewhere.

As many of your Lordships have said, we are discussing to-day some of the most tragic of all the problems which can beset human beings, both as individuals and as members of families. I am glad that we have had an opportunity of discussing these problems, and that I have been able to describe to your Lordships at least some of the provision which is being made for such children, both in schools and in hospitals. It is a part of our social services about which, often, little is known. People are distressed by these things and often try to pretend that they do not exist. The work involves doctors, teachers and many voluntary workers. It is remarkable how much of the work is being done by people who, like the noble Lord, Lord Grenfell, have for many years devoted themselves to the alleviation of some of the worst consequences of these tragedies, the nature of which is still obscure to us.

Once more I would thank the noble Lord for all he said, and other noble Lords for the way in which they have helped to make this debate so memorable. I can assure your Lordships that all that has been said to-day will be of great help to the Government in framing policy.