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Communication is a fundamental right

Norbert Lieckfeldt | 01.09.2008

The Bercow Review final report sees communication as a core life skill and a human right. Norbert Lieckfeldt, BSA's chief executive who was on the Review's Advisory Group, reports.

Ed Balls and John BercowIn September 2007, the Secretaries of State for Health, Alan Johnson MP, and for Children, Schools and Families, Ed Balls MP, asked John Bercow, Conservative MP for Buckingham, to conduct a review into the services for all children with speech, language and communication needs (SLCN), including of course stammering.

The Review brought together experts from charities, including BSA, with specialists from the National Health Service, the Education Service and officials from the Department of Health and the Department for Children, Schools and Families. It undertook a huge consultation exercise - parents were queuing up to tell us about their experiences. In addition, researchers looked into the provision of services in six different areas in England.

The results were illuminating and reflected BSA's experience over the years. While pockets of excellent service exist, in the main there is huge variability; parents find it difficult to get problems identified and taken seriously; and, once a problem has been identified, there is often a ping-pong argument between education and health about who should fund the extra support. There is insufficient understanding of SLCN and the impact they can have on a child's life and development, and therefore insufficient priority is given to addressing these needs.

BSA's concerns

BSA's concerns are well known - in terms of stammering, we know that early intervention can have an excellent chance of completely overcoming stammering, so that the child grows up unencumbered by what still is a serious communication impairment. However, there are two obstacles to this -

  •  there is public ignorance about early stammering and as a result parents are often given the wrong, harmful advice when they notice their child is starting to stammer
  •  NHS speech therapy services vary greatly from place to place; this 'post-code lottery' means that many children, even when they are being identified, miss out on the opportunity to receive the early intervention which is their best chance of recovery.

For those who continue to stammer beyond pre-school years, they will have to live with this communication impairment for the rest of their lives. Now, it is clear that the impact this has on people's lives can vary greatly. But as a population, people with communication problems and disabilities are far too often overlooked - it is the last hidden disability. As a result, government policy or service providers do not take into account the needs of children with SLCN - not because they consider and dismiss these needs, but because it simply does not occur to them that there might be any.

It's been 9 months of meetings, of visits, of responding to consultation documents, of arguing and pleading. The final Report was launched on July 8th 2008, by both Alan Johnson and Ed Balls, sharing a platform with John Bercow.

The final report

Five key themes have been highlighted in the report

  • Communication is crucial. No child can succeed in life, can access the Curriculum and can fulfil the five criteria of the Government's Every Child Matters strategy (be healthy, stay safe, enjoy and achieve, make a positive contribution and achieve economic well-being) when they cannot communicate. That's why the Report calls communication a 'core life skill' and, for the first time, clearly states that communication is a human right.
  • Early Identification and Intervention are essential.
  • We need a continuum of services designed around the family. For example, it's not helpful if the service for school-age children simply ceases outside term time, and the service should be seamless in transition, from pre-school, to school-age, to secondary school and beyond.
  • Joint working, mainly between teachers and speech and language therapists, between local authorities and NHS, is critical.
  • Under the current system access to and quality of services can be very different in parts of the country.

The Review makes 40 recommendations to government. In terms of BSA's desired outcomes: we have got the creation of a Communications Council, set up jointly by the Departments for Health and for Children, Schools and Families to ensure that speech and language needs are considered at the highest level of government; we are advocating the creation of a Communications Champion, whose task it is to ensure that the recommendations accepted by Government will be implemented; and we are looking for a national campaign called the Year of Speech, Language and Communication so that we can address the lack of public awareness about conditions like stammering with official support from the Government.

In addition, the report recommends that all children's speech development should be monitored at crucial points in their development so that problems can be identified early. This used to happen with regular health visitor checks and we are hoping that something similar will be re-instated. The Review is calling for training of all staff supporting children in communication and - one important snippet in the light of the current trend in the NHS to abolish posts of speech therapy managers in favour of Therapy Service Managers who do not need any clinical skills - recommends that "the Department of Health supports the development of appropriately skilled and experienced clinical leaders who can interpret policy and research to support the delivery of evidence-based practice for children and young people with SLCN."

Response

The Government has stated that they are minded to accept the recommendations in principle - but we will have to wait until the autumn to see the details. Ed Balls announced funding of a £40m programme called Every Child a Talker, looking at developing general communication skills in pre-school children, and a further £12m for work in six pathfinder areas across England to identify models of best practice of collaboration between local Primary Care Trusts and their speech therapy departments and local authorities and their schools.

I think BSA can be very happy with this outcome. Not only have we got a strong emphasis on public awareness of communication needs, we also have a commitment that speech and language should be at the heart of the Government's policies. We also have a strong commitment to early identification of all children with SLCN, something for which, in respect of stammering, we have been working for more than ten years now. And BSA has shown it can operate well and hold its own at the heart of policy-making - quite a learning curve for a small organisation like ours.

What next? Well, the final recommendation of the Report states that "we recommend that progress on implementing the recommendations of this review is assessed through an independent progress check conducted in 18 months' time." This has been accepted by Ed Balls. John Bercow, whose personal commitment to this process and to the whole issue of SLCN is without doubt, will be having another look. It would be good to hear from BSA members whether they can see any discernible difference that flows from the publication of this Report.

What about adults? Preliminary work with other charities is starting on putting forward, perhaps as early as next year, the case for a Review of services for adults with SLCN. BSA is determined to ensure that the needs of adults who stammer are represented, too.

From the Autumn 2008 issue of Speaking Out, pages 12-13.