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1773 6 JUNE 2013 Augmentative and Alternative 1774
Communication Services
Augmentative and Alternative
Communication Services
Motion made, and Question proposed, That this House
do now adjourn.—(Mr Syms.)
5pm
Paul Maynard (Blackpool North and Cleveleys) (Con):
It is a pleasure to speak in this debate on this very
important issue. I mean no disrespect to you, Mr Deputy
Speaker, but it is a shame that Mr Speaker is not in the
Chair, because he has been a great champion of speech,
language and communication needs down the years. It
is worth quoting his key comment from the Bercow
report:
“’Communication is crucial. Recognising that is right in terms
of equity for those in need and right in the national interest as we
all wish to cut the costs of failure”.
Nowhere is that clearer than with augmentative and
assistive communication. As that is rather a mouthful,
I shall refer to it as AAC.
AAC is a series of aids, some complex and some not
so complex, that assist those with neurological conditions
that make it hard for them to express themselves. I was
delighted when I received a commitment from the Prime
Minister during Prime Minister’s questions in March
that, as a result of the new commissioning landscape in
the NHS, it would be available to more children and
adults. I welcome that, and my aim is to ensure that it
can actually happen.
I have a personal interest in this subject; it is not
something I acquired when I was elected. I attended
Hebden Green special school at the age of just three or
four, and many of my fellow pupils would have benefited
from these complex aids. It gives me real pleasure that
one of my pupils, Alexis Egerton, recently gained a
PhD thanks to utilising a complex powered aid—an
example of how AAC can change people’s lives.
I am grateful to the Minister for the time he was able
to spend yesterday meeting me and representatives from
Communication Matters and the ACE Centre. I apologise
for detaining him further today with a variation on the
same theme. It is worth focusing on how the users of
the aids feel about how the system currently works.
Toby Hewson is an AAC user. He said:
“I cannot express adequately how frustrating it is for people
with disabilities to have to battle with the system in the way we are
forced to do...like a game of pass-the-parcel, people like me are
sidelined and marginalised until we are exhausted.”
That is just an indication of the frustration so many
people, and their families, feel about a system that has
not yet worked properly for them.
I would be misleading the House and unfair to the
Government if I did not make it clear that a great deal
of progress has been made, not least through the Bercow
report, the work of communication champion Jean
Gross and the decision to ensure that most of the
commissioning will occur at a national level. I hope that
the Minister can act like a statin in the arteries of NHS
England to allow what is good to occur, and for policy
to be implemented in the way that I am sure everybody
in the Department of Health wants it to be implemented.
However, I would also be misleading the House if I
did not express some of the concerns about how policy
is being implemented. The issue can be as fundamental
as the funding mechanism deployed. I am sure that we
would all agree that NHS England has to start from
somewhere in deciding how much money it will allocate
to this type of provision. I am reminded of the farmer
leaning over a fence who is asked by a walker, “How do
I get to Blackpool?” He replies, “Well, I wouldn’t start
from here.” I would not start from where NHS England
is starting, because it intends to use historical budgets,
which might sound perfectly sensible—perfectly obvious
perhaps—but if all that involves is ringing up a local
hospital manager and asking how much he spends on
AAC, when he might not even know what AAC is, I do
not think it a particularly satisfactory starting point.
It is more frustrating still given the work done on
levels of need by the communication champion—available
to NHS England—and further reports since from the
University of Manchester. We know the level of provision
and unmet need: 0.014% of the population currently
use a powered aid, but total need is 0.05%. I am sure
that the Minister can do the maths. It is about 3.5 times
what is currently being funded. I am not making the
predictable everyday point that more must be spent—far
from it—but I want NHS England to begin from a
sensible starting point when making its decisions.
Mr Gordon Marsden (Blackpool South) (Lab): I am
grateful to the hon. Gentleman, my constituency neighbour,
for giving way. I warmly commend his work to bring
this matter to public attention. He and I have constituents
at Highfurlong school and other special schools in
Blackpool where these issues are very important. I have
had correspondence from two constituents involved
with the school. I know that Governments are not
always keen on ring-fenced budgets. Does he agree,
however, that NHS England should take account of the
technology to come, rather than relying on past practice?
Paul Maynard: Indeed. We disagree on many things,
but on that issue the hon. Gentleman and I can agree. In
Highfurlong, we have an excellent provider of specialist
communication provision, so I hope he shares my concern
at the proposals, which look to be coming from the
local council, that could result in Highfurlong being
shut. It causes me great concern, as it does many
parents in his constituency and mine, so I hope he will
join me in ensuring that Highfurlong is not threatened
in the way it might be.
The funding decisions being made have consequences
for the proposed hub-and-spoke model. I would welcome
a commitment from the Minister that clinical
commissioning groups should not interpret the existence
of specialist hubs as a justification for winding down
their investment in local spokes. That, to me, is crucial,
if only because of the issue of complexity. The hon.
Member for Blackpool South (Mr Marsden) alluded to
that.
Dr Sarah Wollaston (Totnes) (Con): Does my hon.
Friend agree with me and my constituents with children
using these important assisted technologies that what
matters is not just providing the equipment, but the cost
of providing training and support, without which children
and adults cannot benefit fully from these important
technologies?
Paul Maynard: I thank my hon. Friend for that
perceptive contribution. The concern is that NHS England’s
budget for AAC will not be sufficient for training. The