Speech and Language Therapy

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.

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.

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.

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 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 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.

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.

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.

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.