Speech and Language Therapy

16:30:00

I beg to move, That this House has considered e-petition 657935 relating to speech and language therapy. May I say what a pleasure it is to lead this debate with you in the Chair, Mr Vickers? Before I turn to e-petition 657935, I beg your indulgence to mention that today is International Holocaust Memorial Day and the 80th anniversary of the liberation of Auschwitz-Birkenau. Given that it is possibly the last significant anniversary on which many of the survivors will be with us, it is really important that we mark today, because we must never, ever forget the crimes that were committed in the early part of the last century. I stand four-square behind the work of the International Holocaust Remembrance Alliance in making sure that we never forget and that we can turn darkness into light. Today I am introducing a debate on a topic that we so often take for granted, particularly those of us who have the opportunity to contribute to the debate. Communication, and our ability to speak and to put our views on the record, is fundamental. It is fundamental to Members of Parliament because of the job that we do, but it is also fundamental to everybody across this country and, in fact, across the globe. The power of communication is in our ability to speak and to express our thoughts, our feelings, our hopes, our needs and our politics. In its simplest definition, it is how we connect with each other. For some people, however, it is not so simple. The words, feelings and thoughts are there, but they cannot quite find how to get their words out. That is so difficult for many people, and we should never overlook it, because every single human being has the ability to communicate and a need to connect with people. Supporting people to make sure that they can always find the words, and that they can always communicate and reach out to others, is something that I am sure everybody would support. That is where speech and language therapy steps in—not just as a treatment, but as a lifeline and a way to help people to find the words. It is about helping people to find their voice and to overcome the barriers that keep them from being heard. If we cannot communicate, we can feel invisible and alone, which is a huge challenge in itself. Speech and language therapy is more than just a clinical service; it is absolutely vital to a huge number of people across this great country. It is the bridge between silence and expression, and between isolation and inclusion. Speech and language therapists are the unsung heroes who help people to rediscover their ability to speak, to listen and to engage with the world, regardless of whether they are a child who struggles to form words, an adult recovering from a stroke, or someone with a lifelong condition that affects communication. Last week, I had the great privilege of speaking to Mikey, who created this fantastic petition. One thing that struck me in that meeting was not just how thoughtful, well prepared, well read and on top of every single part of the issue he was, but his determination that this debate should not just be about him. It is not about Mikey’s treatment or his journey, although he is very able and willing to discuss them with people; it is about Mikey standing up for people who find themselves in a similar situation to him. When we meet somebody who is a true campaigner, and who is willing to spend their time and effort supporting people across their community, we should applaud them. I place on the record my thanks to him for his work. When I spoke to Mikey, he told me that he is actually one of the lucky ones. A year and a half after he was diagnosed with apraxia, he was offered an hour of speech therapy a week. That was a huge boon to Mikey’s ability to take part, develop and just be part of the world. He feels lucky for that one hour, because the ability to access speech and language therapists is a postcode lottery, but it should not be a matter of luck. Getting help for something so important should be a minimum; in fact, the Royal College of Speech and Language Therapists recommends four sessions a week for Mikey’s condition. Mikey raised that not because he did not feel supported, but as an example of the fact that current provision and support do not meet the need, even for people like Mikey, who, in his own words, is lucky to have the support that he has had. Just over 23,500 adults and more than 67,000 children and young people are on a waiting list for speech and language therapy. Every one of those lives can be touched and immeasurably improved by ensuring that they have the treatment they need to rebuild the confidence that they may have lost. Mikey told me that, after his treatment, his confidence has grown, he is less anxious, he is able to speak publicly with strangers and friends, and he has been able to get a job and catch up in education. That is all down to the speech and language therapists who have supported him to reach his goals. Not everything is down to the therapists, obviously—Mikey is responsible for a huge amount of what he has done—but his ability to express himself, and to show the world where he is coming from and what he does, is down to the language therapists who have supported him. I met representatives of the Royal College of Speech and Language Therapists and Speech and Language UK last year, and the most striking thing that came out of those meetings was how important it is to look at this issue through the lens of social justice. The most striking piece of data that they shared is that 25% of all children, when they go to primary school, have some form of diagnosed or undiagnosed speech, language and communications need. If one looks at the most deprived areas of the country, that percentage rises to 50%. On top of that, more than 60% of children in young offender institutions have communication difficulties. That information—that reality—is too stark to be an accident; something could be driving that. Reaching out and ensuring that people can express themselves and engage with the world at large, whether that is school, friends or family, can support them to access the world and prevent them from going down a path that could end with them making some difficult decisions and finding themselves incarcerated. However, it is not just about young people; it is also about adults who develop conditions such as dementia, Parkinson’s, which is close to my heart, or long covid, which we will be talking about a lot over the coming years in the post-pandemic world. The speech and language difficulties that can come with long covid have driven demand since the pandemic, although there was significant demand for speech and language therapists before that. I will touch briefly on Parkinson’s, because a close family member—my mum—suffers with it. Mam learned English to go to school, as her family spoke Welsh at home, and since she moved to England, where she brought up me and my brothers, she has spent her whole adult life communicating in her second language. Mam was also fluent in French. Seeing where she has gone with her Parkinson’s—just not being able to find the words—is a real challenge for all of us who know her. Helping her to find that word and communicate is something that I think everybody who knows her would support, and I am sure that anybody with a relative in a similar position would also be eager to support them with that. Parkinson’s UK did an audit of its members in 2022 and, of the people it spoke to, just 40% had access to speech and language therapy. Only 15.5% were referred to therapists at the diagnosis stage and only 8% were seen. That is one example—I beg the House’s forgiveness for raising one of such significance to me; I picked it because that is where I have a lot of direct experience—but there are many, many conditions that can be supported through speech and language therapy. Returning to the postcode lottery that I mentioned, there are areas of this country where integrated care boards are spending less than £1 per person receiving therapy—I think 58p was the smallest number that I saw. In the best-funded area for speech and language therapy, the ICB was spending £16.35 per child who was receiving therapy, which is a vast difference. Now, I am not going to say that ICBs are not doing their job; we are all aware that there are regional disparities and that ICBs have to cut their cloth according to the funding available. When we see such a significant disparity, however, with around 30 or 32 times the amount being spent in one area compared with another, it highlights that for far too many people, it is a real fight to get the support that they need because the funding is not there. In the Minister’s response, I am interested to hear whether anything can be done in the long-term 10-year health plan for the NHS to set minimum standards or whether the Government intend to level the playing field between different areas. Many people, especially those from disadvantaged communities, live in areas where services are scarce and where waiting times are long. That can exacerbate some of the issues faced by those communities, as well as by the individuals affected. We know that it is not always about just funding or putting more money into the system. Where money is needed, it should be there, but recruiting and retaining speech and language therapists is vital. No amount of funding in the world can replace a human being actually doing that role, or the skills, training and care that they provide for the people they are supporting. There is a shortage of therapists in our system, and many are leaving the profession due to burnout, insufficient support and unsustainable workloads. When I spoke to the royal college, it was absolutely clear that recruitment is one side of the coin, but retention is the other. It is not just an operational necessity, but how we increase the number of speech and language therapists available and make sure that the more experienced people can train, support and mentor people who are less experienced to get through those grades, from grade 5 to grade 6 and so on. A survey by the royal college found that 17% of speech and language therapy roles are currently vacant. That is a huge number: almost one in five. Ensuring that we have the right number of people to support the vital care that people need would have a profound effect across the country. The biggest shortages are in bands 6 and 7 in the NHS, which are the more specialist roles. Across the board, therapists are saying that they want to do the job. Nobody goes into healthcare for the money, but because it is a vocation and they want to support their community and support people where they need it. To support them, however, we have to do something about caseloads to ensure that they can devote enough time to each person they see. I am proud that the Government will bring forward a 10-year plan to offer a vision of a healthier, more resilient NHS. However, given how well supported this petition has been and how important speech and language therapy is for people who need it, I am very eager to hear that the Government are taking the issue seriously and making sure that speech and language therapy is fully integrated into that 10-year plan, so that we can look much more at preventive care, get community services to deliver support where it is most needed, and prevent those acute issues developing. I am very glad to see so many hon. Members from both sides of the House in the Chamber. Ultimately, this debate is an opportunity for us to talk about speech and language therapy, and to make sure that it has the place that it deserves at the heart of our health system. I am sure that there is much more that other hon. Members will want to say, and I look forward to the contribution from the hon. Member for Meriden and Solihull East (Saqib Bhatti).

I remind hon. Members that they should bob—as indeed they are doing—if they wished to be called to speak.

16:44:00

It is a great privilege to serve under your chairmanship, Mr Vickers. I pay tribute to the hon. Member for Lichfield (Dave Robertson). He gave an excellent speech, and I cannot think of a single thing that I disagreed with—although I might wait to read the Hansard to double-check that. He spoke passionately about his own mum and the situation with Parkinson’s. As for many Members across this House, issues of special educational needs, and speech and language therapy are not new to me or to my inbox, so I think this is a timely and important debate. It is particularly important because of the hard work of one of my constituents, Mikey Akers, who is in the Public Gallery today, along with his mother and friends, whom I will also mention. He was the instigator of the petition, which is very much the reason why we are here. Mikey first came to see me on 13 January 2022. Little did I know at that point that this young man would be such a giant when it came to standing up for children and adults everywhere who have been affected by speech and language conditions. In many ways, this young man has given voice to so many up and down the country who, through no fault of their own, do not have their voice. Mikey’s ask of me was really simple. He looked at me and said, “Will you help me to raise awareness of verbal dyspraxia?” I am not afraid to admit that I had no idea what verbal dyspraxia was at that moment, but of course I said yes, because for us as Members, one of the easiest things that we can commit to is using our platform to raise awareness of issues that particularly affect not only our constituents, but others across the country. I went away to investigate verbal dyspraxia and see how widespread it was. I found out that there is a huge lack of awareness of verbal dyspraxia, and yet there were friends of mine, parliamentarians in the previous Parliament, who suffered from various forms of dyspraxia, as I found out when I raised Mikey’s issue at Prime Minister’s questions. Parliamentarians came to speak to me about them having some form of it, or said that they knew someone who did. Simply, for those who do not know, verbal dyspraxia is when a child has difficulties in being able to make and co-ordinate the movements needed to produce speech that is clear and easy to understand. Like the hon. Member for Lichfield, I then set about meeting the Royal College of Speech and Language Therapists, the Dyspraxia Foundation, and many other expert organisations and practitioners. I draw attention to Gillian Rudd, who is in the Public Gallery and is a senior lecturer at Birmingham City University. She is training future speech and language therapists—I will also touch on the workforce. She contributed to the “Bercow: Ten Years On” report, and her petition—back in 2018, garnering 11,000 signatures at the time—led to a Westminster Hall debate on the topic. Gillian came to see me in 2020, and I am so pleased that I have been able to at least highlight her work and to support her in all the work she has been doing. Since my first meeting with Mikey, I have been able to raise the issue of speech and language therapy and verbal dyspraxia in the House on a number of occasions, including at PMQs. I am pleased that in conjunction with Mikey, the Royal College of Speech and Language Therapists, and Chris Kamara—who, as you may be aware, Mr Vickers, is a well-known footballer and commentator—we were able to hold an event in the previous Parliament calling on the Government to do more to support speech and language therapists. I have talked about verbal dyspraxia, so I will say that Chris—I hope he will not mind me saying this, as he has spoken about it in public—suffered during lockdown from apraxia. In his role, voice and speech matter so much, with the intonations and being able to get thoughts out. I will not try to copy his most famous lines, but those things matter so much. He was so brave in the way he spoke about it. Kammy and Mikey were kind enough to invite me on to their documentary, “Lost for Words”, which is on the ITV player. The documentary is illuminating for anyone who wants to get an understanding of some of the challenges families face across the country and of the trials and tribulations that parents and children go through to get the support that they need. Georgia Leckie, who was on it, is also in the Gallery. This issue has affected so many of us in this Parliament and in previous Parliaments. Under the previous Government, the Department for Education committed £8 billion to special educational needs in the 2021-22 financial year. In the financial year ’22-23, that was increased by £1 billion to more than £9.1 billion, and at the 2021 spending review, the Government announced £2.6 billion, over the spending review period to 2025, to create more than 30,000 new high-quality school places for children with special educational needs and disabilities —more than tripling the previous capital funding levels to over £900 million to ’24-25. That was a transformational investment, which I was proud of, and it supported local authorities to deliver new places in mainstream and special schools, as well as other specialist settings. It would also have been used to improve the suitability and accessibility of existing buildings. Of course, none of that is to say that there was not more that needed to be done, or that needs to be done. A £2.6 billion capital investment in high-needs provision was announced in October 2021. That was to deliver up to 60 new special and alternative provision free schools, and was in addition to the 48 special free schools already in the pipeline and the more than 90 that were already open. In fact, a number have opened in the borough of Solihull, which I represent, and one opened recently in the constituency of my hon. Friend the Member for Solihull West and Shirley (Dr Shastri-Hurst). In March 2022, the Government announced high-needs provision capital allocations amounting to over £1.4 billion-worth of new investment, which was focused on the academic years ’23-24 and ’24-25. Of course, there has been a change of Government and a change of priorities, so will the Minister set out whether that funding will be increasing and what his intentions are in that regard? In March, the previous Government published their SEND and AP improvement plan. The plan set out what the Government would do to establish a single national system to deliver for every child and young person with special needs and disabilities from birth to age 25, so that they could enjoy their childhood, achieve good outcomes and be well prepared for their next step, whether that was employment, higher education or adult services. Has that plan continued, or has it informed current Government strategy and how the Government intend to take the previous Government’s ambitions forward? It is no secret that councils are under great strain, so I hope that the Minister can highlight how, in the coming years, the Government intend to support local councils to alleviate that strain, especially when it comes to SLT and integrated care boards. The hon. Member for Lichfield mentioned the demand on the workforce, which has been a perennial issue—the RCSLT briefing for this debate also highlighted it. How do the Government intend to alleviate pressures in this area? Do they intend to fund more places, especially at the university level? These are complex issues, and highly skilled people are needed. I also want to ask a few questions that Mikey had. One of the key things that he has raised with me from the first day I met him is the lack of awareness in the teaching profession and among GPs when it comes to identifying cases of verbal dyspraxia. The Minister might not be able to answer on the education side, but he might be able to say how the Government intend to ensure that health professionals are prepared to identify some of these serious issues. Of course, I have to ask whether the Minister will agree to meet me, Mikey, RCSLT and—given the cross-party nature of this debate—the hon. Member for Lichfield. Can the Minister also describe the timeframe for any increases in spending? The hon. Member for Lichfield mentioned the retention of the workforce, so what are the Minister’s thoughts on ensuring that we keep more of the people who enter this profession? The metrics that we use to assess policies are key, so can the Minister describe the metrics for a successful policy around speech and language therapy? That would ensure that Members can assess the policy going forward. I hope that the answer to this question is yes, but do the Government recognise the economic benefits of getting people, young people and those who are young at heart to have better speech and language therapy and to contribute to the economy? I will finish where I started: by encouraging people such as Mikey, as well as those he inspires, to continue to campaign on this issue. There is always more to be done. I have met Mikey a number of times, and he really is a legend. I thank him for allowing me to support him on his journey. I will end with some of his words: “I raise awareness of verbal Dyspraxia/Apraxia so those who share my diagnosis, now and in the future, never feel the loneliness I felt growing up.”

16:54:00

It is a pleasure to serve under your chairmanship, Mr Vickers. I thank my hon. Friend the Member for Lichfield (Dave Robertson) for securing this important debate. I also thank Mikey Akers, all campaigners and the Royal College of Speech and Language Therapists for their tireless efforts in bringing this critical issue to the forefront and getting it the priority that it needs. I heard, remarkably, that when Mikey started the petition on the Parliament website back in March 2024, something like over 10,000 signatures were secured in just 16 days. However, I am not surprised, because communication is at the heart of who we are. It is how we connect, learn, work and build relationships. It is a fundamental human right. Just as vital is the ability to eat and drink safely when swallowing becomes difficult. For deaf people, who already face enormous barriers, access to timely and appropriate support is even more crucial. In September 2024, more than 64,000 children in England were waiting for speech and language therapy. In my Wolverhampton North East constituency, children and families are facing unacceptable delays and limited access. Behind each number is a child struggling to communicate in the classroom, a young adult trying to rebuild their life after a brain injury, or a stroke survivor who feels isolated because their voice has been taken away. I would like to share the story of Samantha, one of my constituents who knows that struggle all too well. Samantha is a former modern foreign languages teacher in Wolverhampton. After a stroke during the pandemic, her ability to speak four languages and her independence were severely impacted. Samantha is mobile—her disability is hidden, but you would know after speaking with her. Yet accessing the specialist speech and language therapy she needed was an uphill battle. Samantha’s story is not unique. It is a reality for far too many people across the country. Let us not forget the workforce challenges. Speech and language therapists are invaluable, yet there simply are not enough of them to meet the growing demand. Despite efforts such as the speech and language degree apprenticeship, we are still falling short. Private therapy is out of reach for most families, leaving NHS services overwhelmed. The current system is underfunded, overstretched and unprepared for the future. Meanwhile, adults in the Black Country integrated care board are waiting far too long, with over 1,000 people on waiting lists in November 2024. What do we need to move forward? First, we need to increase funding to meet growing demand. Secondly, we need a robust workforce plan so that we have enough skilled therapists to support everyone in need. Thirdly, we need equitable access to therapy across the health, education and criminal justice sectors, no matter where someone lives. Investing in speech and language therapy not only changes lives; it saves money. Early intervention can reduce the need for more costly services down the line in health, education and criminal justice. I urge the Minister and my colleagues to listen to the voices of campaigners such as Mikey, the Royal College of Speech and Language Therapists and people like Samantha. Their message is clear: we must work at pace to tackle the crisis in speech and language therapy. Let us make sure that no one in Wolverhampton North East or anywhere in this country is left without a voice or the support that they need to thrive.

16:59:00

It is a pleasure to serve under your chairmanship, Mr Vickers. Not being able to articulate one’s thoughts verbally is, I suspect, not something that many of my parliamentary colleagues suffer with, but unfortunately it is the truth for hundreds of thousands of people in this country. Speech therapy is not limited to children, as was mentioned by the hon. Member for Lichfield (Dave Robertson), who I am grateful to for bringing this debate to the Chamber. There are countless adults in need of speech therapy services. Those include stroke survivors who are relearning how to speak—which is why it is such a pleasure to speak with Chris, who is here in the Public Gallery and is a true hero in the footballing world—as well as people with cleft conditions or those living with dementia. I thank the hon. Member for Lichfield for spotlighting long covid, because that is an issue that will be with us for many years to come. The need in the adult sector is significant, but today I will focus on children because they represent our future, and without intervention at a critical stage the challenge they face will only grow. I have not had the pleasure of meeting Mikey, but I would like to know if this resonates with him. Imagine a child starting school for the first time: friendship and bonds are made, and classmates are eagerly raising their hands, making friends and joining in chatter in the playground, but the child remains silent—not because they do not want to speak, but because they cannot. Their words are locked away and their thoughts are trapped. Thousands of children face that challenge daily and they are getting left behind, not because they lack potential but simply because they lack support. That is the silent struggle of thousands of children in our country. Speech, language and communication difficulties are not just a health issue but a life one—they affect mental health, academic success, employment, and relationships. They are a barrier to participating fully in our society. Over 369,000 pupils in England were identified as having speech, language and communication needs in 2023-24. That is a staggering 64% increase since 2015, and yet, as of November 2024, more than 65,000 children were waiting for speech and language therapy, with nearly half waiting for over 12 weeks. The impact of that delay cannot be overstated. Worryingly, in socially deprived areas, upwards of 50% of children start school with impoverished speech, language or communication. Those delays snowball, creating challenges in literacy, learning, and most importantly, social integration. It is concerning that research shows that more than 60% of young offenders have difficulties with speech. Is that the postcode lottery that the hon. Member for Lichfield talked about? The cycle of disadvantage starts with communication barriers, and it can end in exclusion, isolation or even worse. It is now a crisis. Speech and language therapists are overstretched, underfunded and working in systems that fail to meet the demand of local needs. However, there is a solution within reach. Speech and language therapy changes lives. It is not about helping children speak clearly; it is about unlocking their potential. It gives them tools to learn, connect and thrive. It breaks down barriers to education and opportunity, and with timely intervention children can overcome those difficulties and go on to succeed in school, work and life. In 2015, the Royal College of Speech and Language Therapists commissioned research to estimate the benefits of speech and language therapy compared to the cost of not doing it. The results showed that for every £1 spent on speech and language therapy, £2.30 in healthcare savings was delivered. Speech therapy is not a cost; it is an investment in the future of our society. We need urgent action. First, we need increased investment to reduce waiting times and to ensure every child, no matter their background, gets the support they need. Secondly, we need improved workforce planning that addresses the shortages of speech and language therapists across all sectors—health, education, social care and justice. Thirdly, we need universal proactive provision, so that support is fully preventive, rather than reactive and limited. Those changes align with the Government’s stated priorities. Communication is fundamental to all areas of public policy—it touches economic growth, an NHS fit for the future, safer streets and breaking down barriers to opportunity. This is the moment to decide whether we will act. Will we allow those children to struggle in silence, or will we give them a voice? Lastly, I urge the Government to meet with Mikey Akers and the Royal College of Speech and Language Therapists to discuss workforce retention and development. Let us invest in our future and ensure that every child has a chance to be heard, to succeed and to thrive.

17:04:00

It is a privilege to serve under your chairmanship, Mr Vickers. I thank my hon. Friend the Member for Lichfield (Dave Robertson) for opening the debate, and I pay tribute to Mikey. I have been privileged to work with young people for many years, putting them at the heart of leading change, and it is always brilliant to see that happening. I congratulate Mikey, and hope that he will start to see actual results. We have heard that he has been working on this for a long time, and is perhaps frustrated that he has not seen change happen more quickly. It is not an exaggeration to say that high-quality speech and language services can transform lives because supporting a person to communicate can open a whole new world of opportunity for them. As we have heard, communication is an essential aspect of life for all ages, including for adults who have experienced major setbacks due to medical events. However, I will focus my comments on the need for excellent speech and language provision for children and young people. A vital part of this Government’s mission is to break down barriers to opportunity for all children, and to help ensure that a record number of children start school ready to learn. A key component of our approach will be better identification of those children who may need additional support with their language and speech development. Speech and Language UK has found that 1.9 million children struggle with talking and understanding words, which demonstrates the scale and importance of this issue. I hope that the investments that this Government are making into increasing the availability and standard of pre-school childcare and into family hubs will lead to more opportunities to support young children with their early language development, at an earlier stage. However, many of those children will need access to high-quality speech and language therapy to help them progress, and their families need support to know how best to encourage and aid their child’s development. I recognise that, often, parents feel left out in the cold and unclear on how they can best support their children when they face challenges. That support will be crucial to ensuring that no child is left behind in their educational progression because we know that language skills are the foundation for literacy development and further learning. I was delighted to see at first hand, in schools that I have worked with, the impact of the decision already taken by the Secretary of State for Education to fund a further year of the Nuffield Early Language Intervention programme. I hope that the Education team will continue to support that as one means to tackle this bigger issue. I ask the Minister, how are the Government further working alongside education colleagues? We know that it is by working together that we can enable children who need formal speech and language therapy to access it without the horrifically long waiting times that they currently experience. There are specific challenges within the north-west, and it is no surprise that the majority of constituencies with a high level of signatories to the petition are in that region. In the north-west, in November, around 45% of children and young people who were waiting for speech and language therapy had been waiting for over 12 weeks, compared with 28% of those on the waiting list in the east of England. The latest available figures show that 2,672 children and young people in the Lancashire and South Cumbria integrated care board area were waiting for speech and language therapy. That is a damning statement on the inheritance that we received from the Opposition, and that inheritance is further demonstrated by their Benches being almost empty for this debate. Earlier today, we heard the shadow Secretary of State for Education, the right hon. Member for Sevenoaks (Laura Trott), make a big noise in the Chamber, but she did not take seriously the challenges that the Opposition have left us and how we can tackle them. The regional disparity is adding another level of disadvantage to children growing up in my constituency of Hyndburn. Like all children, they deserve to be supported to learn. It is important that we are careful, when we speak about children with special educational needs and disabilities, not to suggest that their educational performances or communication skills are due to some internal difference or lack of ability: it is the systems and structures around them that we must fix to make sure that every child and young person has the same access to opportunities to fulfil their potential. It is important that we provide wraparound support for families so that the Government can make better use of standard two-year check-ups to unlock pathways to support. Time and again, I hear of children and families in my constituency who are on pathways for not just weeks or months but years, without access to the education, health and care plan that they might need or the wraparound services intervention required to make sure that a child has the best possible chance in life. It is welcome that the Government’s mission to build a health service fit for the future will look to design a system that meets the changing needs of our changing population, but can the Minister share more about how speech and language services will feature in the current national conversation on the 10-year strategy? Effective speech and language interventions can reduce the need for more intensive and costly healthcare services down the line, and as hon. Members have mentioned they have a significant positive return on investment in the long term. Investing in early screening and diagnostic services will help identify speech and language issues at a young age and allow for more effective interventions. Effective intervention does not just help young people to access language and communication skills but helps with their confidence and the ability to make friends and start school with their best foot forward. I know that Ministers across Government appreciate that there is a crisis affecting the SEND education system. We have had a 140% increase in the number of children and young people with EHCPs, but outcomes have stagnated. More money has been put in, but we are not seeing better results for the children impacted. That is why I welcome the commitment that this is not just about investment but the right reforms. I would like to ask the Minister about closer working relationships with education professionals—not just how it happens at the top of Government but on the ground. Is there an opportunity with the schools rebuilding programme to look at the co-location of education, health services and therapy and make sure that they are built into the design right from the start? The headteacher leading on the rebuilding of Hyndburn Academy is open and keen for this thinking, so it would be great to hear the Minister’s views as to how that will be rolled out nationally. There are many wonderful examples of inclusive schools, but many parents have felt forced to seek an EHCP for more specialised speech and language support. Has the Minister made an assessment of how a focus on speech and language specialised support as well as inclusion in schools could create a system where parents do not always have to go through a formal written process to secure the resources they need? That might tackle the huge challenges we face in that part of the system. We cannot solve the problems in the SEND system without increasing support for children struggling with speech and understanding words. My comments have focused a lot on language development and formal education, but I have had the immense privilege of knowing children who are non-verbal but wonderful and profound communicators. Communication comes in many forms. That is why I spoke about the systems and structures we facilitate around our children to ensure that every child and young person is given the opportunity to thrive. No child should be held back from the strong social participation, relationships, learning and wellbeing that can be forged with the right support.

17:12:00

I echo the congratulations to my hon. Friend the Member for Lichfield (Dave Robertson) on introducing this important debate, and to all the campaigners who work tirelessly on this issue. I thank everyone who signed the petition, especially the 124 people in my constituency of Altrincham and Sale West: we contributed more signatures than any other constituency. That reflects the great number of conversations that I have had on this issue with local residents since being elected. Other Members have spoken powerfully about the fundamental nature of communication to human life. It is clear that speech and language therapy can be transformational for those who experience it— approximately 76% of people who have had therapy say that it has materially improved their life—but it is a service that is far too hard to access. NHS England figures show that in September last year, over 64,000 children were on a waiting list for speech and language therapy, and 41% of them were waiting more than 18 weeks. In my local NHS trust, there are about 154 speech and language therapists working full time. If we speak to any family with a relative affected by a communication or language difficulty, they will tell us that that simply is not enough. I have spoken to many school leaders locally, especially primary leaders, who are having to make stretched budgets stretch even further to fill in the gaps. The picture we face is stark and reflects the huge crises in our national health service and our special educational needs system. In 2023, a report by the Royal College of Speech and Language Therapists identified significant failings over many years in planning for the speech and language workforce. Alongside significant cuts to early intervention services under the previous Government, those failings were reported as driving factors behind the waiting lists for therapy, which in turn piled pressure on other parts of the system and ultimately resulted in a demoralised workforce leaving the job they love and in the public going without the support they need. Ofsted, the Education Committee and the Care Quality Commission have all published similar reports, which should frankly have set alarm bells ringing in Government, but the truth is that not enough has been done. Neither funding nor the numbers of speech and language therapists have kept up with the 64% increase in the number of children identified as having communication needs since 2015. Tragically, with adults, we have seen a steady decline in the amount of speech and language therapy received after a stroke, and effectively no dedicated adult service for those with long-term speech conditions. The challenge for this Government is that we must reverse these trends, not just because it is absolutely the right thing to do, but because improving access to speech and language therapy is essential to this Government’s missions for change, as my hon. Friend the Member for Hyndburn (Sarah Smith) outlined. Whether that is breaking down barriers to opportunity in education or getting the NHS back on its feet, giving people the support to communicate effectively is critical. Given the impact that speech and language therapy can have on giving people the ability to return to work, it is hugely important to our national effort to boost economic growth. I know that some important steps have been taken, and taken quickly, by this Government, not least the record funding increases set out for the national health service in the Budget. I know that there is no ringfenced central funding for speech and language therapy and that service delivery is in the hands of the integrated care boards, but I would like to know from the Minister, if possible, what work the Government are doing with ICBs to ensure that that extra funding feeds through the system and is being felt by individuals affected by communication and speech issues. If possible, I would also like the Minister to address how the Government will improve the planning for the whole speech and language therapy workforce and what provision there is for that in the NHS workforce plan, which I know the Department of Health and Social Care is currently looking to update. That is desperately needed across our national health service. Finally, I will be extremely grateful if the Minister sets out the progress in delivering early language support for every child pathfinder project, so education settings can increase their ability materially to support speech, language and communication development. These are big challenges for the Government to address, but that is why Labour Members like me have been sent here. We were elected on a mandate of changing and rebuilding our public services, so that they can be there for those who need them. We should never lose sight of the role that restoring speech and language therapy provision must play in the driving missions of this Government.

17:19:00

Thank you for your chairmanship, Mr Vickers. It is a pleasure to speak in this debate, which my hon. Friend the Member for Lichfield (Dave Robertson) introduced on behalf of the Petitions Committee. I thank Mikey for campaigning to bring this really important matter to this place. I cannot miss the opportunity to say that I am delighted to see Chris Kamara in the Public Gallery. I am a Stoke MP, and my twin sister is a massive Stoke City fan, so she will be most envious that she is not in Westminster Hall today. I want to emphasise the importance of speech and language therapy in delivering on our Government’s ambition for childhood development and in supporting children with special educational needs. Ten per cent of all children and young people have a diagnosed long-term speech, language and communication need. We must invest in such services so that those young people are not held back in school and can communicate confidently with their peers. Early language development promotes positive outcomes later in life, but in disadvantaged areas such as my constituency, about half of children start school with delayed language skills or diagnosed speech, language and communication needs. Speech and language therapists provide vital support in clinical settings to children with diagnosed complex needs and SEND. They also deliver universal programmes in early years settings, but sadly those programmes have been decimated by funding cuts in recent years. Across Stoke-on-Trent and Kidsgrove, our local team at the Midlands Partnership University NHS foundation trust and organisations such as Stoke Speaks Out and Thrive at Five work incredibly hard to support our children, but sadly I have heard repeated concerns from local service providers about insufficient funding, rising demand and difficulties with recruitment and retention. Investment has simply not kept pace with the increase in the number of children with increasingly complex needs and SEND. I was surprised to learn that in Stoke-on-Trent an average of 269 children are allocated to a single therapist’s caseload at any point in time. That is simply not acceptable. Our children and young people deserve to be able to access clinical services when they need them, but too often that is not the case. In 2024, 41% waited longer than 18 weeks for therapy—the longest waiting list across paediatric services. Under-investment has impacted accessibility and waiting times for clinical services and has hollowed out our local preventive services. Scarce resources are being used to meet statutory requirements and deliver specialist services, and we have seen significant cuts to universal programmes that support children in early years settings to meet their developmental milestones. We know that universal programmes have a very positive impact on children’s outcomes. Early intervention can prevent children from developing more complex needs and can reduce the need for referrals to more specialist services in the future. That is why we need more programmes such as Every Child a Talker, Thrive at Five and Stoke Speaks Out, which have delivered excellent support to our families across Stoke-on-Trent and Staffordshire. I am delighted that our Government have committed to a new target. We want 75% of our children to achieve a good level of development at five. The first three years of a child’s development are critical to their brain development. I stress the importance of investment in speech and language therapy to deliver on that mission, and our plans to reform the SEND system. I urge the Minister to listen to the calls for investment to tackle the long waiting lists faced by people in my constituency, and the calls to invest in preventive services.

17:23:00

It is a pleasure to see you in the Chair, Mr Vickers. I thank the Petitions Committee for securing this important debate and my hon. Friend the Member for Lichfield (Dave Robertson) for introducing it; I associate myself with his words on Holocaust Memorial Day. I also congratulate Mikey on starting the petition and on his impactful campaign. Speech and language therapy is a vital service that supports children and adults with the development of speech and assists those who have difficulties in eating, drinking or swallowing. As Chair of the Education Committee, I will focus my remarks on access to speech and language therapy for children and young people. Speech and language are vital building blocks of communication. Children who face barriers to developing speech and language early in life, for a wide range of reasons, can face significant difficulties. Poor communication skills reduce participation in education and can lead to frustration and challenging behaviour or withdrawal and school avoidance. For children whose needs relate to a difficulty in eating, drinking or swallowing, good and timely speech and language therapy can make the difference between being able to attend school or nursery safely or not. I know the difference that speech and language therapy makes in my own family. When my oldest daughter started to learn to speak, it became apparent that she was really struggling to say particular sounds and that her inability to differentiate between sounds, because of her difficulty in pronouncing some of them, was having a consequential impact on her ability to read. We were able to seek advice from an open access speech and language therapy clinic at our local health centre, which provided a wealth of advice and some helpful exercises that we could support our daughter to do at home. The clinic was available to us whenever we needed it, and my daughter was able very quickly to overcome the challenges that she faced. I am pleased to report that she is now a 19-year-old who is nothing but forthright in her ability to communicate with everybody. Open-access services such as the clinic that we were able to access are now extremely hard to find. There is a shortage of speech and language therapists. Children who need speech and language support face long waiting lists in many parts of the country. That is a huge problem, because accessing timely support has a significant bearing on the impact that a speech and language difficulty can have in the long term. Issues that can be quickly addressed in very young children, for example, can become much more challenging to overcome with the passage of time. Early intervention saves money and delivers better educational outcomes. Speech and language therapy sits at the junction of several parts of the public sector. Needs are often identified in nurseries or schools; local authorities have a statutory responsibility for special educational needs and disability support; speech and language therapy is an allied health profession commissioned often by the NHS, but sometimes by local authorities and schools directly, and is often based in community settings. This complexity and the lack of a clear single pathway of commissioning services are among the contributory factors to the current shortage and the geographical disparities in the availability of speech and language services. I welcome the Government’s recognition of the importance of speech and language development in children and the commitment from the Department for Education to roll out the evidence-based NELI—Nuffield Early Language Intervention—programme in reception classes across the country. Expanding the availability of targeted support to help people who have speech and language difficulties to catch up will undoubtedly make a difference, but we know that the earlier a speech and language difficulty is identified, the better, not least because sometimes a speech difficulty is the first indication of wider special educational needs. The earlier a problem is identified, the easier it can be to address it. The Government recognise this, but there is currently no clear plan to expand the availability of speech and language therapy in early years and community settings. The early years sector is diverse and disparate. There is a need for clarity on expectations, commissioning pathways and professional development to ensure that very young children can access speech and language therapy as soon as a need is identified. The fact that it is not compulsory for children to be in a formal setting until the age of five underlines the importance of community-based support in children’s centres, family hubs and health centres, so that parents and carers can access support readily when they need it. Adjusting the workforce challenges within speech and language therapy will also require intervention from the Government to make more training places available and to encourage those who have left the profession to return. I hope that the Government will produce a workforce plan for all the professions related to SEND support, so that professional expertise and support will be there for children and families who need it. More widely, we have a SEND system that is failing children and their families across the country, with far too many children unable to access SEND support in school, waiting far too long for an EHCP and often finding that, when they get an EHCP, it cannot be fully delivered. Since the Minister for Care is responding to this debate today, I take the opportunity to highlight that when I speak with parents, teachers, local authority officers and others who are responsible for delivering SEND support, they very often say that, “within the EHCP, the H is too often absent”. They struggle to get the NHS to the table and there is very weak accountability in the levers that can force it to do so. I ask the Minister to look in detail at the issue, and to work with his colleagues in the Department for Education to ensure better collaboration between Health and Social Care and Education, in the best interests of children with special educational needs and disabilities. Finally, I take the opportunity to plug the Education Committee’s recently launched inquiry on special educational needs and disabilities. As a Committee, we recognise the vital role of speech and language therapy within the wider network of services that contribute to effective SEND support. Our call for evidence on SEND is open until 6 February. I encourage all right hon. and hon. Members who have an interest in SEND services or challenges within their constituencies to encourage their constituents to submit evidence to our inquiry, including those who have experience of speech and language therapy, so that we can hear the widest possible range of evidence and make recommendations to the Government that can deliver a transformation in SEND services across the country.

17:31:00

It is a pleasure to serve under your chairmanship, Mr Vickers. I thank Mikey for being here today and for all his hard work to get to the point of having a debate. It takes a lot of campaigning to get as many people involved in a petition as he has done, and that is a fantastic tribute to him. I also thank the hon. Member for Lichfield (Dave Robertson) for introducing the debate. I was struck by his comment that speech therapy is not just a treatment, but a lifeline. That was certainly brought home to me recently. In Winchester last year, I visited an aphasia support group. Its members meet every couple of weeks and they all have speech issues caused by various types of brain damage, which could be caused by a brain injury, a stroke, a brain tumour or dementia. They told me that aphasia affects about 350,000 people in the UK. Jez Hodgkinson, who is part of the group, said: “Learning to live with aphasia takes hard work, luck and lots of support—and this isn’t helped by the lack of knowledge of the condition. I’d never actually heard of aphasia until I had a stroke so hence it’s so important to share our stories both inside the group and with the wider public—including those with a voice in parliament.” I also have personal experience of living with my father who had a series of mini-strokes and then dementia, and really struggled to communicate. He knew what words he wanted to say but he could not reach for them. It made communication difficult, and especially did not help a very independent farmer who had quite a hot temper at the best of times. All people who have difficulty communicating, whether it is the result of a hearing impairment, special educational needs or conditions such as strokes and Parkinson’s, have the right to participate in society fully and independently. Too often, those rights are not fully recognised. Everyone has talked about how fundamental it is for us to be able to communicate, because we are a social species; we function because we can communicate. Even with my veterinary background, I understand how fundamental that need is. Puppies communicate primarily by body language; when they have had their ears cut off or their tails docked, they lose that ability to communicate and cannot socialise—they get psychological issues or behavioural problems that last for their entire lives. And the issue is so much more important for humans who need to communicate with friends and family, access services and interact with strangers on a regular basis to be able to work and get an education. Everyone deserves independence and the opportunity to flourish, with them and their families supported so that they can express themselves and communicate with ease in the most comfortable way for them. Speech and language therapy can make a life-changing difference to the people it supports. It is a vital and overstretched service. In recent years, demand has risen at a faster rate than the number of therapists or the support they can offer. That desperately needs to be addressed. By improving outcomes, speech and language therapy can help to deliver better care, and actually save money for other parts of the NHS. We heard about supporting people who are unable to swallow properly; that can have a significant impact on reducing repeat chest infections. The hon. Member for Leicester South (Shockat Adam) mentioned how every £1 spent on speech therapy can save £2.30 of NHS costs. When people ask how we can afford to do this, we have to ask, “How can we afford not to do this?” Children and adults are waiting far too long for the speech and language therapy they need. As the hon. Member for Lichfield has already said, it is a postcode lottery; there are huge differences in outcomes depending on where someone lives. Helping people to swallow, eat and communicate is an essential service, and everyone should be able to expect that support if and when they need it. We, the Liberal Democrats, are pressing for the NHS 10-year plan to address specifically the inadequate access to these speech and language therapies, and how that will be improved. We want the Government to develop a workforce strategy to end the chronic shortage of speech and language therapists, so that everyone can get the support that they need. As a slight aside, but on a related note, we have also long campaigned for more support for those communicating through British Sign Language. We have campaigned for it to have equal official status to the UK’s other languages, and we are campaigning for free access to sign language lessons for parents of deaf children. I visited St Peter’s primary school in Winchester recently. The headteacher was discussing how, since the covid pandemic, they had noticed a sharp rise in pupils struggling to communicate, as their speech and language had not developed as quickly as it did before the pandemic. We need to remember that it is not just people’s educational needs that are affected—both by covid and by speech and language challenges—but their entire social development and friendship groups as well. We are really pleased that this issue has been highlighted, and that we have had this debate today. I urge the Minister to push forward on this issue as fast as possible.

17:37:00

It is a pleasure to serve under your chairmanship today, Mr Vickers. I congratulate the hon. Member for Lichfield (Dave Robertson) on his introduction to today’s debate. I also particularly congratulate Mikey Akers, who I understand introduced this petition, for the work that he has done in raising awareness of verbal apraxia—work that will no doubt help people right across the country. I know that he has been working with my hon. Friend the Member for Meriden and Solihull East (Saqib Bhatti) on this issue too, and no doubt that will also be helping people. I also welcome Chris Kamara to the Gallery. He is doing great work on raising awareness too. The more awareness we raise, the better it will be for everybody, and the easier it will be for people to be treated for the conditions they have. As we have heard today, speech and language therapists have a wide range of skills for people of all ages. The issue is much bigger than speech itself. It also includes swallowing, from newborns with developmental delay to the elderly, who may be struggling to swallow after a stroke. It is about communication, feeding issues, and specific sound delays—a stammer. Speech and language therapists are involved in a huge amount of work. I have seen in my own family the work that speech and language therapists do, with one child unable to say “s”, and having speech therapy to try and encourage her to do so—one of her younger siblings, having spent much time attending these appointments, consequently learned to say “s” about 18 months earlier than she was supposed to. I also had a child with a stammer who was treated successfully. I learned from that that the whole family needs to be involved in treating the child, and I am grateful for the support that I got from the NHS speech and language therapists for my family. When I went along, particularly with the child with the stammer, I learned that the parent, and indeed the whole family, had to play games every day. I had to learn to play with my child without asking her any questions, which is a lot harder than it looks. I learned about the importance of sleep and that early therapy is better. I remember the speech and language therapist likening the condition to a record getting stuck in a groove on a record player. If someone got stuck in a particular groove, the more times the disc went round the deeper it got and the harder it was to jump out, so it is important to ensure that speech and language therapy is instituted as early as possible to make it easier to treat the patient. I want to ask the Minister about parent resources. If early is better, special guidance on aspects of treatment and management even before the patient sees a speech and language therapist would be helpful. I saw that Hereford and Worcestershire health and care NHS trust had some very good online resources for parents and what they can do to help their child with a speech or language condition. The priority of reducing overall waiting times for community services was reflected in NHS England’s operational planning guidance for 2024-25. Local systems across England were asked to develop the comprehensive plan by June 2024 to reduce the overall waiting times for community services, including reducing waits over 52 weeks for children’s community services. The waiting lists have reduced from roughly 76,000 last July to 63,000 at the end of last year, which is still too long. Will the Government focus on trying to reduce the waiting lists still further? And does the Minister have a target in mind for next year to see how far he would consider it successful to have reduced those waiting lists? What is also clear and has been reflected in many hon. Members’ speeches is that the demand for speech and language therapy has gone up. According to Department for Education data, in 2023-24 370,000 pupils had a speech, language and communication need in England—an increase of over 64%, from 225,000 in 2015-16. That is not related to an overall increase in the number of school-age children, so why is that the case? One could perhaps consider that more people are aware of the conditions, thanks to active campaigns. That is a good thing because people are getting referred earlier and treated earlier. But it also would appear that the number of children affected by speech and language conditions has gone up. The Minister and his Government have talked a lot about prevention being better than cure, and I agree with that. So what work has he done to look at the causes of the rise in speech and language difficulties? As I was researching causes, I came across the issue of screen time. What is the effect of screen time? It reduces imagination, peer-to-peer speaking and verbal problem solving. It is also a solitary rather than truly social activity. We know that children are spending more and more of their time online, particularly young children. Families are smaller. Does that mean that people have less time to interact with other children? We have an increase in the number of bilingual children. Although that in itself does not cause speech and language problems, it can cause temporary language mixing at younger ages, and in some cases slower vocabulary acquisition in early years. What is the Minister doing to find the cause of the rapid increase in the number of children with speech and language difficulties so that we can prevent them rather than waiting for them to occur and then treating them? I also want to talk about the Nuffield Early Language Intervention, known as NELI, which was mentioned earlier. It is a teaching assistant-delivered programme that has been accessed by over 11,000 schools since the pandemic. It is known to improve the speech and language communication of the children who go through the programme by three months; the improvement is much greater for more disadvantaged children. Can the Minister commit to continuing to ensure that children have access to the NELI programme? Pre-election, the Department of Health and Social Care worked with the Department for Education to ensure that young people with special educational needs and disabilities received the right support. The collaboration included working together to implement the SEND and alternative provision improvement plan, published on 2 March 2023. Those two Departments also worked together on SEND workforce planning and established a steering group to oversee the work, with a view to completing it by 2025. Will the Minister provide an update on the steering group’s work and what plans there are to commission research into supply and demand for speech and language therapy? In 2023 the Department for Education launched the two-year early language and support for every child pathfinder project with NHS England to improve access to speech and language therapy. Funding for that is due to run out this year, so can the Minister confirm whether it will be renewed to allow the project to continue? The Government are also due to refresh the NHS long-term workforce plan this year. Back in 2023, that plan set out an ambition to increase allied health professional training places by 25% by 2031-32. However, the Royal College of Speech and Language Therapists and others have highlighted that that is likely to cover only speech and language therapists in the NHS workforce, and the Minister also needs to address shortages in educational and criminal justice settings. Can he confirm what work he is doing with his colleagues across Government to ensure that is the case? Many speeches today have been focused on the social speech and language needs of children, which is understandable, but in the Minister’s wrapping up, will he talk about what work he is doing to support adults with speech and language difficulties or swallowing needs? Finally, we understand from the newspapers that many aspects of care across the NHS are now to be deprioritised, and Ministers are to focus on one specific target. While I would not expect the Minister to comment on any leaks, can he confirm that speech and language therapy will not see a reduction in real-terms resources?

17:45:00

It is a pleasure to serve under your chairship, Mr Vickers. I congratulate my hon. Friend the Member for Lichfield (Dave Robertson) on introducing this important debate, and on the passionate, moving and powerful way in which he spoke, particularly about his mother. I would really like to thank him for sharing those personal experiences. I also thank every Member who has spoken today. We have heard really compelling accounts about access to speech and language therapy for both children and adults.

I thank my hon. Friend the Minister for giving way, and my apologies, Mr Vickers; I had to leave earlier for a ministerial appointment. In 2018 my father suffered a stroke, and the staff at my local hospital, the George Eliot, could not do enough for him—they were absolutely fantastic. I know that my father stayed in hospital longer than he needed because that was the only way in which he could access the speech and language therapy that he needed, as well as the help to enable him to swallow. It was fantastic to see him recovering that speech because of their intervention. As he had served for nearly 50 years as a volunteer magistrate, it is wonderful to see him now being able to challenge my ideas and give his comments on my contributions in this House. Last week, I held a consultation event in my constituency where a dietician told me that she felt there was not enough ability for her and her team, as well as speech and language therapists, to give help in the community. She was quite excited about our ideas for virtual wards and asked me, on her behalf, to plead with the Minister to ensure that we give recognition to putting more speech and language therapy in the community. I know that my dad would have been very pleased to receive that.

Order. Interventions should be brief— I was very generous.

I thank my hon. Friend for that wonderful example of the personal experience that so many Members on all sides of the House have of this service, which can be life-changing for so many people. I pay tribute to her father for coming through in the way that he has, and I also pay tribute to all those in the community care services. The care that he received was obviously vital and life-changing for him, and that is wonderful to hear. My hon. Friend raises an interesting point on virtual wards. It is absolutely right that we build on the innovation and opportunities that they offer. Later in my speech I will say a word or two on the three big shifts that we will put at the heart of our 10-year plan: from hospital to community, from sickness to prevention and from analogue to digital. I think the virtual wards are a great illustration of how we can bring those three seismic shifts together to transform our health and care system. I can tell my hon. Friend that the 10-year plan is the right forum and opportunity for that, and I encourage her and all Members to get involved in that plan, which can be accessed at change.nhs.uk. Hon. Members may also wish to organise roundtables and discussion fora in their constituencies to talk exactly about the kind of innovations that we are looking to bring to the fore. It would be remiss of me not to pay tribute to Mikey Akers; he is an outstanding young man and truly an example to us all. Of course, I also pay tribute to Chris Kamara and the whole team campaigning with such vigour and verve on this vital issue. I would of course be delighted to meet Mikey, Chris and the team at a mutually convenient time to discuss the project and how to take it forward. As our debate today has shown, speech and language therapists work with people of all ages, providing specialist care and support. Their work takes place across a range of different settings in health, care and education. It responds to a wide range of communication needs, from those of children whose speech is slow to develop to those of older people whose ability to speak has been impaired by illness or injury, for example as a result of Alzheimer’s, a stroke or head injury. Speech and language therapists also support patients who have difficulties with eating, drinking and swallowing. The variety of support that speech and language therapists provide means that they play a key role in a wide range of care pathways. A speech and language therapist is a core part of the multidisciplinary stroke rehabilitation team, providing long-term rehab for stroke patients. It is not just patients they support—a speech and language therapist also works with a patient’s family or carers on how best to facilitate communication and support the patient, sharing their expertise to upskill the support network of the person they are caring for. Another example of the work of speech and language therapists is the role they play in supporting autistic people. They can offer interventions to improve communication skills where needed. For individuals who are unable to speak, speech and language therapists can design alternative communication systems. Moreover, as part of a wider multidisciplinary team, speech and language therapists also contribute to a young person’s education, health and care plan. A therapist will carry out a detailed assessment of an individual’s speech, language and communication abilities, which will help to determine the additional support they may need to access education. However, it is the key role that speech and language therapy plays in care and support pathways that creates complexity in funding and commissioning models for it. In some cases, full care pathways are commissioned as opposed to individual services within a particular pathway, while in some areas community health services are commissioned using block contracts. Both these things create challenges in clearly identifying specific funding streams for specific services. Speech and language therapy is generally commissioned locally by integrated care boards and in some cases by local authorities. Funding is allocated to ICBs by NHS England. The allocations process uses a statistical formula to make geographical distribution fair and objective, so that it more clearly reflects local healthcare needs and helps to reduce health inequalities. This process is independent of Government, and NHS England takes advice on the underlying formula from the independent Advisory Committee on Resource Allocation. NHS England is also continuing to work with ICBs to develop their financial plans. NHS planning guidance sets priorities for systems, and the Secretary of State has confirmed that this key document will be published in due course—indeed, imminently. Each ICB will then commission the services they need for their local area, taking into account their annual budget, planning guidance and the wider needs of the population they cover. Local commissioners are responsible for ensuring that their offer is tailored to the local population and that their communities are able to access the specific support they need. NHS England continues to work with ICBs to develop their financial plans, to ensure that communities can access the healthcare support they need when they need it. A complex patchwork quilt of systems and processes needs to be gone through by the people who know best about what is required in their community—those at the coalface—to deliver the care that is needed. That said, I reassure hon. Members that the Government are committed to funding the NHS properly. We recently provided a £26 billion boost for health and social care at the Budget through the policies and choices that the Chancellor laid out. We have been clear that funding must go hand in hand with reform, and we will ensure that every penny of extra investment in the NHS is well spent. The community health services data plan, published by NHS England last year, goes some way to improving data about community health services. The plan sets out how the NHS aims to improve the quality and relevance of data, and the timeliness of its publication. It will improve our understanding of demand and capacity across community health services, including speech and language therapy, with high-quality data to generate helpful insight to shape interventions and improvements to services. Data and clear funding lines are not the only challenge facing speech and language services. Our children and young people are stuck on waiting lists, some for more than two years. More than 65,000 children and young people were on a waiting list for speech and language therapy in November 2024. We know that more than 23,000 have been on those waiting lists for longer than 18 weeks. That is simply too long. Waiting times for adults are not as bad as those for children and young people, but there were more than 23,000 adults on waiting lists for speech and language therapy in November 2024. We hear a lot about the increasing demand for speech and language therapy, and about the fact that our existing workforce are struggling to meet the increase in referrals—pretty much every hon. Member said that in the debate. The reason for the increase in waiting times is multifaceted. Although services are still recovering from the pandemic, there has also been an increase in demand, and analysis from the Royal College of Speech and Language Therapists shows that demand is increasing faster than the workforce are growing. Speech and language therapy covers a broad spectrum of support. Therapists are often dealing with complex long-term cases, requiring a resource-intensive approach to supporting their patients, and referral pathways are often complex. Those referral pathways, and the services offered, also vary regionally. As my hon. Friends pointed out, we are coming off the back of 14 years of failure, which have led to serious workforce challenges, and the reality is that we have a mountain to climb on recruitment and retention. The speech and language degree apprenticeship is now in its third year of delivery and offers an alternative pathway to the traditional degree route into a successful career as a speech and language therapist. We think that that has had a positive impact on recruitment, but much more needs to be done. We want to remove the barriers to training in clinical roles, which is why eligible students get a non-repayable grant of £5,000 a year. Further financial support is also available for childcare, dual accommodation costs and travel, but we know that that does not go far enough. The training and retention of our talented NHS staff are absolutely key to our mission of rebuilding a health service that is fit for the future. A central part of the 10-year plan concerns our workforce and how we ensure that we train and provide the staff, technology and infrastructure that the NHS needs to care for patients across our communities. This summer, we will publish a refreshed long-term workforce plan to deliver the transformed health service that we will build over the next decade and that will treat patients within the 18-week constitutional standard once again. We will ensure that the NHS has the right people in the right places, with the right skills to deliver the care that patients need when they need it. We must acknowledge that tackling this will take time, but we are committed to training the staff we need to ensure that patients are cared for by the right professionals and in a timely manner. Community health services, and speech and language therapies in particular, speak to the three seismic shifts that will drive our 10-year plan: shifting healthcare from hospitals to communities, focusing on prevention, and embracing digital care. Effective, user-centred services are invariably delivered by multidisciplinary teams that are based in the communities they serve. The early language and support for every child—ELSEC—programme provides an example of different professions coming together to support children and young people, with local authorities, schools and the health and care system working together in the community. In our view, that is a potential building block for how our neighbourhood health service should work. Nine regional pathfinder partnerships are trialling new ways of working to better identify and support children in early years settings and primary schools. We have asked the pathfinders to consider how to make the model sustainable after the project period. The therapy assistant roles have the potential to attract individuals to train to become speech and language therapists through the apprenticeship route. The ELSEC workforce model focuses on recruiting pre-qualification speech and language therapy support workers into the workforce to improve the capacity and knowledge of staff who support children with emerging or mild to moderate speech, language and communication needs in early years and school settings. That will be important, because we hear a lot about the challenges our workforce face in meeting the increasing demand for speech and language therapy. Across all community health services, increasing demand and workforce availability are frequently cited as the main reasons that systems are struggling to reduce waiting times and get on top of the demand. The interim programme evaluation is due to be published in February, at which point we can explore insights into the effectiveness of ELSEC delivery at a local level. Reporting data shows that therapy support teams have supported around 13,000 children so far, and just over 1,000 staff in settings have been upskilled in delivering interventions. That is an encouraging set of achievements, and I will continue to work with my ministerial colleagues and officials across my Department and the Department for Education to support this important programme. I referred earlier to our ambition to build a neighbourhood health service. We are firmly committed to moving towards our vision for such a service, and community health services will be an essential building block of it—keeping people healthy at home and in their communities, and providing more preventive, proactive and personalised care. Later this year, we are going to trial neighbourhood health centres, which will bring together a range of services and will ensure that healthcare is closer to home and that patients receive the care they deserve. We have heard about the importance of adequate funding and timely access to speech and language therapy services for children and adults with communication and swallowing needs. The importance of such services is not in doubt, nor is the life-changing impact that timely access to high-quality services can have, from helping a child to develop the right skills to engage with education to supporting adults to regain their ability to speak. Speech and language services are facing challenges, but sustainable, accessible and high-quality community health services are vital, and I will continue to work closely with NHS England, the Department of Health and Social Care and the Department for Education on this critical issue.

18:04:00

I place on record my thanks to all the hon. Members who have contributed to the debate, starting with the hon. Member for Meriden and Solihull East (Saqib Bhatti), who made an excellent contribution, as I think we would all expect. I congratulate him on his campaigning on this important issue. I thank my hon. Friend the Member for Wolverhampton North East (Mrs Brackenridge) for raising the story of her constituent Samantha, who I am sure will be watching the debate closely. I thank the hon. Member for Leicester South (Shockat Adam) and my hon. Friend the Member for Hyndburn (Sarah Smith) for reminding us of the importance of supporting the next generation and all those who come after. I thank my hon. Friend the Member for Altrincham and Sale West (Mr Rand) for raising the issue of unacceptably long wait times for speech and language therapy. I thank my hon. Friend the Member for Stoke-on-Trent North (David Williams) for highlighting the caseload faced by speech and language therapists in Stoke-on-Trent and the great county of Staffordshire. I also thank my hon. Friend the Member for Dulwich and West Norwood (Helen Hayes) for discussing the need for early intervention and the remarkable impact that it can have. I thank my hon. Friend the Member for North Warwickshire and Bedworth (Rachel Taylor) for the story of her father’s experience in speech and language therapy. I thank the Liberal Democrat spokesperson, the hon. Member for Winchester (Dr Chambers), for his excellent contribution on the need to raise awareness around aphasia, which does not necessarily get spoken about enough in the community. I thank the hon. Member for Sleaford and North Hykeham (Dr Johnson), on behalf of His Majesty’s official Opposition, for her considered remarks and for avoiding making the issue a political football. It is really important to highlight where we do agree, because there is often more agreement than people realise in this place. By working together, we can achieve those goals. I especially thank the Minister for Care, my hon. Friend the Member for Aberafan Maesteg (Stephen Kinnock)—did I get that right?

Not bad.

Mam never quite got round to teaching me the Welsh that she speaks. I thank the Minister for his kind words about her and for outlining the complicated funding scenario that currently exists for speech and language therapy, along with the Government’s desires for the future of this therapy as an example of the three shifts that the Government will introduce in the NHS, and the need for people to engage thoroughly with the NHS 10-year plan consultation as a vehicle to securing those changes. I thank the Petitions Committee for allowing me to lead the debate. It has been a real pleasure, not least because my constituency was the fourth most supportive of the petition. Finally, on behalf of all hon. Members who have been able to contribute today, I say an enormous thanks to Mikey, without whose campaigning we would not be here discussing this issue. Question put and agreed to. Resolved, That this House has considered e-petition 657935 relating to speech and language therapy.

18:07:00