Speech and Language Therapy (Hansard, 8 May 2003)

§ Baroness Andrews
My Lords, we have increased the number of speech and language therapists employed in the National Health Service by 17 per cent since 1997, and the number of people in training for those professions by 21 per cent since 1999–2000. We are encouraging service redesign by improving and developing joint working between health and education, and by developing the roles of support staff in order to make the best use of professional skills.

§ Lord Quirk
My Lords, in declaring an interest as a past president of the Royal College, I thank the Minister for that very encouraging reply. Would she agree that early assessment and intervention are important for anyone suffering from language impairment, but especially so for children and vitally so for pre-school children?
Has the Minister seen the recent report by Maria Luscombe, which shows that a child of three will wait somewhere between six months and two years before therapy can even start? Two years is a long time when you are three, is it not, when you know that your peak period of language development is slipping away and when your anxious parents know that also slipping away is the chance of a decent education?

§ Baroness Andrews
My Lords, I quite agree with the noble Lord; I could not disagree with anything that he said. Obviously, delay with such young children is crucial. Having recruited an additional 810 new speech and language therapists, we hope that we will be able to make an impact on the figures. Part of the challenge is that, because so many initiatives have been put in place, such as Sure Start, which depend on hacking-up contact with children and families with such provisions as speech and language therapies, we have more speech and language therapists but a steady vacancy rate. That is a challenge, and that is why we are glad to see an increase in training places.

§ Lord Clement-Jones
My Lords, we should bear in mind the fact that the Sure Start scheme is run by the Department for Education and Skills. The SEN code of practice says that, since communication is so fundamental in learning and progression, addressing speech and language impairment should normally be recorded as educational provision unless there are exceptional reasons for not doing so". Clearly, there are unacceptable waiting times for those services. To achieve joined-up provision, is it not time that provision of and responsibility for those services was handed over to the DfES?

§ Baroness Andrews
My Lords, the noble Lord raises complex, sensitive and indeed historic issues. The 1233 Department of Health and the DfES are working closely and collaboratively to develop a plan to facilitate more joint working. We very much look forward to the outcome of that. Speech and language therapy is very fertile ground for joint working. There is no excuse why the workforce confederations and the local education authorities should not be working more closely together. Children's trusts, for example, will create opportunities for such work. We have some extremely good practice. Mansfield District PCT, for example, has an early intervention programme, and Amber Valley has a jointly funded speech and language therapy post. I shall write to the noble Lord—and anyone else who is interested—and give some examples of that good practice. It is such an important programme and direction in which we should go.

Lord Campbell of Croy
My Lords, as the patients include people recovering from strokes and severe head injuries, does the noble Baroness agree that this therapy is much needed to help them resume life in the community?

§ Baroness Andrews
My Lords, I entirely agree with the noble Lord. The National Service Framework for Older People draws attention to the need for better and more extensive therapy services for stroke victims. Just as it is important to intervene promptly with children, it is extremely important to intervene promptly and build up the confidence of the stroke victim who has lost his capacity for speech.

§ Lord Ashley of Stoke
My Lords, I also declare an interest as a past president of the Royal College of Speech and Language Therapists. When I was there, I learned that the need for speech therapy for children and for adults arose from many different causes. As a consequence, responsibility was divided between Health, Education and Social Services—with inevitable confusion, some overlap and many misunderstandings, all of which contributed to the delay mentioned by the noble Lord, Lord Quirk. So far as I can see, the joint working to which the Minister referred has not been outstandingly successful. The efforts so far at co-operation, co-ordination and unification also have not been dazzling. Will the Government therefore come up with different initiatives from the ones that we have had so far?

§ Baroness Andrews
My Lords, we shall certainly be looking at good practice where it exists to see how we can universalise it and encourage other local areas to adopt it. The noble Lord is quite right. The need for joint working was a theme running throughout the report from the Audit Commission last November on special needs. Clearly we want to take more effective action.

§ Lord Clinton-Davis
My Lords, I declare an interest as someone who has suffered two strokes. In undertaking the invaluable work that my noble friend 1234 has indicated, will she look at the practice of the Royal Free Hospital in Hampstead where there is absolutely no waiting time at all? Does she agree that although the issue which has been raised is extremely patchy, the best is not necessarily the enemy of the good?

§ Baroness Andrews
My Lords, I am delighted to hear of the noble Lord's positive experience. In overcoming his own difficulties he is an example to many of us. I think that he is an inspiration to all of us. I certainly take the point about the Royal Free and how much we can learn from best practice. The NHS is a learning organisation and we want to learn across the whole organisation.

§ Baroness Billingham
My Lords, if I may, I should like to press the Minister further and refer back to the points on children made by the noble Lord. Lord Quirk. He is perfectly right that three year-olds have a very short time in which to have this remedial work, which will affect not only their educational but possibly their behavioural performance when they get into school. It is such a crucial issue. The Minister talked about what is happening in the future. What hope for the next two years can she offer parents whose children are currently being diagnosed with problems in order to redress the problems that are here and now?

§ Baroness Andrews
My Lords, in the past three years the number of people in training has increased from 457 to 553. Next year we are expecting even bigger increases, to almost 600. People want to become speech therapists. It is our responsibility to enable them to do so and to ensure that we cut down the delays.