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