Westminster Hall debate on Special Educational Needs and Children’s Mental Health Services - Feb 9

Laura Farris (Newbury) (Con)

I beg to move,

That this House has considered special educational needs and children’s mental health services.

It is a pleasure to serve under your chairwomanship, Ms Fovargue. It is timely to be holding this debate in Children’s Mental Health Week. Today I want to focus on one aspect of mental health—specifically, the conditions that fall under the wider banner of special educational needs.

The difficulty that families in West Berkshire experience in seeking a diagnosis has been raised with me since I was first elected, but it was not until I conducted a constituency-wide survey last summer that I understood the extent of its prevalence and urgency. For many people in West Berkshire, accessing CAMHS—child and adolescent mental health services—for diagnosis of a potential learning difficulty is an extraordinary uphill battle. Waiting times regularly exceed two years for an autism diagnosis and can be substantially longer. I know that this problem also exists in other parts of the country.

When I was preparing for this debate, I asked affected families to get in touch with me, and was overwhelmed by responses, which came from everyone from mums and dads through to headteachers and GPs. The Minister whom I expected to respond to the debate, the Minister for Care and Mental Health, my hon. Friend the Member for Chichester (Gillian Keegan), is not in her place, but I had a word with the Under-Secretary of State for Health and Social Care, my hon. Friend the Member for Lewes (Maria Caulfield), in advance. The issue as it affects West Berkshire is less about a lack of funding—the Berkshire West clinical commissioning group has received additional investment for this—and more about accountability and the adequacy of the service. I have had too many letters and emails to refer to them all, but I would like to tell hon. Members about three of my constituents, whose stories capture the issue more widely.

The first is Steffi Whelan, who told me about her 11-year-old son. He has been waiting more than two years for a CAMHS appointment. His problems began seriously in year 4. What began as outbursts of screaming in class evolved into something more disruptive. Sometimes he would tear up work or behave in a way that was completely unsustainable for the teacher. In time, he was moved from that primary school to another, and his parents have been told that he will not be emotionally able to move on to an ordinary secondary school. He is now nearing the end of year 6, and despite all of that, the family are still waiting for their first appointment.

Melanie Fenemore told me about her nine-year-old son, Archie, who was strongly suspected to have autism. Melanie was first referred to CAMHS in October 2018. She filled out a load of complicated forms, and in January 2019 was told that her son was on the waiting list and to expect a 20-month delay. In fact, she waited 27 months before he was seen in April last year. At the time of the assessment, the view was formed that he probably did not have autism spectrum disorder but had something more equivalent to attention deficit hyperactivity disorder, and he was referred to the ADHD team. Again, Melanie was sent a bunch of forms, which she described as “pretty much identical” to the previous ones, and her son was sent back to the bottom of a waiting list. The family have been told to expect a 36-month wait. If that projection is correct, Archie will have been on a waiting list for six years, from the age of six to 12, by the time he receives his first appointment. During this time, Archie’s mum tells me, he has

“expressed a desire not to be alive.”

He has a tendency towards violence, born out of frustration. She says:

“I am sometimes at the receiving end of Archie’s violent outbursts which hurt more as he gets older.”

The Buller family’s young daughter, Daisy, has been waiting more than two years for an autism diagnosis. By the time her mum contacted me last July, her daughter was self-harming and barely attending school, even though she was in the crucial year 10. Her mum wrote to me:

“This is 5 years since we first started struggling and we are no closer to helping my daughter. Simply one question Laura, in today’s age, how is this Ok.”

One headteacher of a primary school described the waiting times as “absolutely awful”, with another saying that the situation has got worse in recent years. Valiant efforts are made by West Berkshire Council to offer support through its Emotional Health Academy, but that is not a substitute for a clear diagnosis. A head at a primary told me that until they get a CAMHS diagnosis,

“The child may be excluded or at risk of exclusion, their anxiety will often worsen and they don’t attend school, the school can try but it cannot put in the support that it is required until there is an Educational Health Care Plan in place and CAMHS diagnoses are critical to this.”

The headteacher of Kennet School in Thatcham said,

“While schools will have an indication of what a pupils needs may be, a diagnosis through CAMHS leads to targeted work and accessing additional services to further support the child and their family. A huge part of a SEND diagnosis is the support”.

It enables the young person to

“understand themselves. Where a diagnosis is not yet given, this delays the essential step for the young person, causing more erratic behaviours and often fall-out at home as well as at school.”

The short point is that a timely CAMHS diagnosis is often crucial for life chances. It hardly needs to be said that a child who is repeatedly excluded can easily end up in a pupil referral unit. People with neurodiverse conditions are significantly over-represented in the prison estate and the youth estate. Their employment opportunities are often compromised, anyway—it is said that only one in five people with autism sustain full-time employment—and in teenagers there is a significant correlation with depression and self-harm. Timely diagnosis and the correct support is crucial for addressing that.

I want to focus on the Government response so that my speech does not sound like a barrage of criticism. I know that the Government attach significant importance to improving outcomes for those who are neurodiverse. The SEND review, to be published soon, is a testament to that, as is the work being done to ensure that children with autism will have a designated key worker within the next year or so. Hundreds of millions of pounds of additional funding was made available for CAMHS in the spending review, and I have to concede that West Berkshire is one of the first 25 areas that will pilot the schools-based mental health support teams.

I said at the start of my speech that Berkshire West CAMHS received significant investment from the Government last year—£1.6 million in April 2021. In fact, when I spoke to the service a few months ago, it said that funding was no longer the problem. The money will enable it to recruit another 27 members of staff that it so badly needs, although so far it has managed to recruit only 12.

Despite a detailed local transformation plan published last September, in which some laudable ambitions were set out, including a goal of reducing waiting times for diagnoses to just a year by next month, when I spoke to Berkshire West CAMHS, it conceded that there is in fact no fixed deadline for reaching that target, so it is not really a target at all; it is nothing more than a general ambition. There is no consequence if the service fails to reduce waiting times. I regret to say that that is not good enough.

The overall impression of Berkshire West’s child and adolescent mental health service is that there is a serious lack of urgency or accountability. Dr James Cave, the well-respected medical director of the Downland Practice in my constituency, wrote to me:

“I think it is important that you understand the depths of despair GPs feel about the local CAMHS service. Remote, unresponsive, closed, uncommunicative sums them up. It feels as if they are always looking for a way NOT to have to see a child. They demand detailed referral forms from us…and then find reasons not to see a child. If they do accept a referral the wait is forever and then often the intervention is a fixed predetermined intervention that does not take”

into account

“the needs of a child.”

I am not seeking to humiliate anyone, but families in West Berkshire are being failed, and it is my role and my responsibility to fight for them.

The Health Secretary has said time and again that the Health and Care Bill currently making its way through the House will deliver better accountability. Speaking in the debate in July, he stated:

“The third theme of the Bill is greater accountability.”—[Official Report, 14 July 2021; Vol. 699, c. 430.]

He said that people have the right to expect “clear lines of accountability” for how every priority is delivered. So my plea—a cri de coeur—from the many families in West Berkshire is that the Department demands better accountability from CAMHS in West Berkshire and across the country. We want details of how that £1.6 million will be spent, and firm commitments to reduce waiting lists, with consequences if managers fail to deliver.

The issue is not confined to West Berkshire, but it is stark within it, and I therefore speak today for the families that I represent and all those families across the country who are experiencing the same struggle.

Yvonne Fovargue (in the Chair)

As there is considerable interest in the debate, I will set a formal time limit of four minutes for speeches.

9.39am
Olivia Blake (Sheffield, Hallam) (Lab)

I thank the hon. Member for Newbury (Laura Farris) for securing this important debate. I was not expecting to be called quite so early.

I will focus my remarks on my own personal experience of having ADHD, dyslexia and dyspraxia, none of which were recognised during my schooling. I want to highlight this because it is a journey of things going wrong and children not being fully supported.

By the age of 12, the average child with ADHD has received 20,000 more negative comments about their behaviour than their peers. “Lazy,” “distracted,” “too chatty,” “fidgety,” “failing to meet potential,” “disorganised” and “in disarray”: those were all comments that were levelled at me as a child, and they stick in my brain to this day and make me consider all my actions daily. This has led to huge feelings of anxiety and depression—a feeling that I am always doing something wrong. My ADHD was diagnosed only last year, and I have only just started taking medication, which has been life-changing.

There are two sides to the coin on this issue. When children and young people are supported at home and in school with the love and understanding that they deserve and need, they can flourish, as I feel I have flourished. I thank my family for the support that they showed me throughout my education to enable me to get to where I am today.

However, I meet too many children whose stories are still the same: their needs are not recognised or are not severe enough to merit critical help, and they are stuck in the middle, reaching their potential in some subjects and failing in others. They also feel that they are not listened to, that they cannot access support and that there is something critically wrong with them. They internalise negative comments about themselves, which is really damaging in the long term.

There are also lots of huge positives to being neurodivergent. Neurodivergent people are more likely to be entrepreneurs, and to take the risk of setting up businesses. However, the dark side is that they are more likely to try illicit drugs and to get involved in crime. There really are bright and dark sides. To any young person who is struggling at school, I say: “Don’t worry. There is always something else for you to strive towards. You just need to find what you are good at, and you will relish that opportunity.” No one should be held back because they have a diagnosis of ADHD, autism, dyslexia or dyspraxia. All children should be supported to get the best out of themselves.

However, far too often our education system is one-size-fits-all. I am really proud to chair the all-party parliamentary group for special educational needs and disabilities. It is so important that we change the classroom and home environment for these children, so that their behaviours are understood, and they can fully experience school and get to where they need to be.

So many things have gone wrong during the pandemic. Some children with autism have flourished through online learning, but others have found themselves isolated from their friends, peers, teachers and support. Several organisations are yet to start providing the therapeutic interventions that they are meant to provide under children’s education, health and care plans, and this is causing huge disruption to the ability of those children to thrive. Three quarters of disabled children have seen progress in managing their conditions and overall development regress in the pandemic. This is urgent and critical. Those who receive a diagnosis of dyslexia should also be screened for ADHD or other neurodivergent conditions, because the crossover is huge. We are letting our young people down by not helping them to get the tools they need to understand themselves—first and foremost—and how they fit in with the world.

I hope that the Minister will think more about how we can intervene as early as possible to avoid young people becoming incredibly depressed and anxious about just who they are—because they are round pegs trying to fit into square holes. It is critical that we support young people to thrive and give back to our society and economy by being the great pioneers and entrepreneurs that we all want to see.

I also have the privilege of having someone with autism in my family—

Yvonne Fovargue (in the Chair)

Order. I call Aaron Bell.

9.44am
Aaron Bell (Newcastle-under-Lyme) (Con)

It is a pleasure to serve under your chairmanship, Ms Fovargue, and a real pleasure to follow the hon. Member for Sheffield, Hallam (Olivia Blake), who made a powerful speech. Sharing her personal experience in this place is a brave thing to do. It has informed our debate, and I am sure that the Minister will refer to that when she sums up.

I congratulate my hon. Friend the Member for Newbury (Laura Farris) on securing the debate. Like her, I have been contacted by so many distressed parents of children with special educational needs. Their experiences of trying to get support for their children are summed up in exactly the word she used: a battle—it is really a battle. EHCPs are the entry ticket to specialist support, but the whole application and appeal processes seem designed to be difficult and time-consuming. As my hon. Friend said, too many times people have to repeat things that they have already said again and again. We must ensure that we have a tell-it-once approach to such things, however long the waiting list might be—she spoke movingly about that as well.

My constituent Samantha King’s four-year-old, for example, was receiving one-to-one nursery support in Wales before they moved to Newcastle-under-Lyme. She supplied extensive documentary evidence of the child’s need when they moved, yet she described having her child’s application refused on the basis that she had not included the reports that she had in fact submitted. That is all too common—things get lost and people have to fill in almost exactly the same form again or for another authority. It is extremely tedious and it breaks people down, and that is why this is such a battle.

Parents then find that they have to appeal to SENDIST, the special educational needs and disability tribunal, as the main route to access an EHCP. We need to analyse the proportion of successful appeals. If local authorities are turning down applications that are successful on appeal, those at the top of that league table need to think about why that is the case. They need to consider applications more carefully in the first place.

Even when someone gets an EHCP, the battle continues. Parents in my constituency report annual reviews not taking place, or the plans not being updated for months following review, severely impacting on a child’s progress through education. A lot of things go wrong in the transitions between stages of education or into work.

Sir Robert Buckland (South Swindon) (Con)

I am grateful to my hon. Friend for mentioning transition, because it is there that a condition such as autism or ADHD can turn into a mental health condition. Does he agree that one of the key issues for the Government to consider is the training and availability of clinicians? Funding is now much better than it was, but we still do not have the trained clinicians who could cut through the waiting lists, which are causing so much frustration to far too many families.

Aaron Bell

My right hon. and learned Friend is absolutely correct about the availability of clinicians. His intervention also speaks to the point made by the hon. Member for Sheffield, Hallam that if these conditions are not treated at school, they can lead to severely negative mental health outcomes later in life.

My constituent Mr Winkle has fought for many years to obtain suitable educational and therapeutic support for his son. Following a tribunal decision last month, he was sent a revised EHCP that still contained a number of inaccuracies, including out-of-date details about his son’s residential placement. I want to talk a little about residential placements, which have not been raised much so far, because the lack of suitable placements causes distress to many families.

One constituent described how the 14-year-old in her care only receives an hour’s at-home tuition a day, because a suitable therapeutic placement with a small and consistent staff team cannot be found. Alternatively, children are given residential educational provision that is unsuitable, which can cause them to regress and even, in one case, to self-harm.

Another common complaint is that social workers change too regularly, so the social worker does not truly know the child. Parents may not be told who the new social worker is and many have described the difficulty they experience when trying to get in touch with professionals, as telephone calls are not returned.

Despite parents being the ones with the most knowledge of the child or young person they are caring for, they struggle to be heard. Should they then complain, they describe encountering a complaints process that is frankly not fit for purpose: timescales are not followed; complaints sometimes seem to be ignored completely; and it is only possible to complain to the ombudsman with a final response, but that often never seems to arrive, and even when they do complain, it will take months for the ombudsman to reply. Furthermore, adults involved in the care of children can become fearful of complaining, in case there are reprisals in the form of their contact with the child being blocked.

Added to that is the struggle to obtain adequate mental health treatment. One constituent of mine was told that the priority waiting list for CAMHS—not the list to which my hon. Friend the Member for Newbury was referring earlier—is 11 months in Staffordshire. That is the priority list. Only this week, a constituent described how she is desperate for respite provision, having accepted a child back into her care on the basis that the local authority would support her.

The local authority has been good at keeping in touch, but its hands have been tied by what it says is a lack of resources. As well as struggling to find an educational placement for the young person, it has only just found an agency to take him on outings twice a week. After five and a half months of caring 24/7, my constituent is exhausted and in the terrible position of considering having to say that she can no longer look after the young man. She has been let down by a breach of implied trust—the local authority told her that it would support her, but it has not been able to.

As Members of Parliament, we inevitably hear the failures, rather than the success stories, but I welcome any support that can be given to improve the experience of so many. As my constituent Mr Winkle said:

“In this journey I have communicated with many regulatory bodies each claiming to have the child’s interests wishes and safety at the forefront of their agenda...but as I have experienced this is certainly not so...my assumption is that it’s a closed circle and these entities do not know how to facilitate or co-ordinate any kind of solution and just want it to ‘Go Away’.”

I am sure that is not the full truth of it, but that is the experience that people are having out there.

I welcome the imminent Green Paper and the additional funding, but too many people have been failed for far too long. I hope the Minister will be able to address that when she responds.

9.50am
Kerry McCarthy (Bristol East) (Lab)

It is, as always, a pleasure to see you in the Chair, Ms Fovargue. I congratulate the hon. Member for Newbury (Laura Farris) on securing the debate. I also pay tribute to my hon. Friend the Member for Sheffield, Hallam (Olivia Blake). I have a friend who was diagnosed with ADHD in his 50s. He is a very talented musician but he really struggled at school and with the basic things in life. He, too, says that the medication has made a huge difference.

As we have heard, life is a never-ending battle for many parents of children with SEND. They have to deal with their child’s physical and mental health needs, trying to get the right diagnosis and all sorts of things on top of that: hospital appointments, physiotherapy, daily meds, vulnerability to viruses, communication issues, issues with trying to get their child to eat properly, and behavioural problems. They face all those things at home, and then they have to battle with bureaucracy, and they often feel that they are at war with the very people who are meant to be there to help them. They feel that the system is stacked against them and that sometimes people would rather they went away and stopped being such a nuisance—what the hon. Member for Newbury said about CAMHS in that context very much resonated with me.

The first battle that parents often face is to get the right diagnosis for their child. Then there is a battle to get the EHCPs. Then the councils say they do not really have the power to enforce them. If a child develops mental health problems, it is often a battle to get support from CAMHS, and parents of neurodivergent children, in particular, sometimes find that they are being bounced around between CAMHS and SEND provision, with nobody stepping in to help them.

In 2019, it was estimated that 6.8% of children in Bristol had special educational needs or disabilities, and it is true that Bristol City Council has struggled to meet the needs of those children—as we have heard, that seems to be case with many councils. We had a pretty damning Ofsted report in 2019, and the council says it is now absolutely committed to trying to do better with its Belonging strategy and a three-year, £6.1 million education transformation programme. There are concerns about getting schools to buy into that, and some parents have said that a significant number of schools are batting away struggling pupils even though they have a legal duty to meet the needs of SEND children.

Children should never be put in the “too difficult” box, but I have heard many examples of children being out of school without any support or just having part-time schooling or perhaps hospital school tutoring—if a child has to go into hospital because of their underlying physical disabilities or illness, they will have education there, but not when they are at home. Parents complain about schools having a one-size-fits-all approach to dealing with children with additional needs, while there are complaints from schools that they can no longer afford teaching assistants, who are so valuable in providing children with the one-to-one attention they need.

Delay can make a huge difference to children’s wellbeing and future attainment, as we have heard. We know that half of all mental health problems are established by the age of 14. Tragically, in some cases, young lives will be lost if we do not intervene early. In 2017, suicide was the most common cause of death for both boys and girls aged between five and 19.

I would like the Minister to commit to provide mental health support in every school, early interventions so that we can spot the signs—otherwise, problems will increase in severity—and respect for a child’s individuality. I know that that costs more and needs more resources, but the problem with these pathways—the hon. Member for Newbury talked about fixed, predetermined interventions—is that it does not help to refer a child with autism for counselling based on cognitive behavioural therapy, because their minds just do not work like that. Finally, we also need better in-patient services, because sending children hundreds of miles away from home, when they need intensive support, is absolutely unconscionable.

9.54am
James Sunderland (Bracknell) (Con)

It is a pleasure to serve before you, Ms Fovargue. I commend my constituency neighbour in Berkshire, my hon. Friend the Member for Newbury (Laura Farris), for securing the debate. I also pass on the best wishes of our right hon. Friend the Member for Maidenhead (Mrs May), who regrets that she cannot be here today. She asked me to point out that she fully supports every effort to increase the provision of mental health support for children in Berkshire and beyond. Finally, I want to welcome Dr Priya Singh, who is the new chief executive of the Frimley integrated care system and who I met yesterday to discuss this issue.

Time is short but, in brief, local NHS CCGs spent £12 billion in 2020-21 on mental health support. NHS England spent a further £2 billion, making a total of just over £14 billion. That is great, but I was horrified to learn that CCGs spent 14 times more on adult mental health support than on services for children. We need to invest much more heavily in that area.

East Berkshire, where I reside, has £2.6 million in funding for children’s mental health, including £1.4 million for CAMHS and £200,000 for eating disorders. That is not enough, which is my opening contention to the Minister. The Berkshire Healthcare NHS Foundation Trust, based in Bracknell, does a fantastic job, but the demand for mental health assessment in children has gone up by 60% in the past five years. Since the pandemic, it has gone up by a further 27%. We have a problem. A constituent wrote to me only yesterday to tell me that the current wait for a child to be seen by CAMHS is 30 months; prior to the pandemic it was 18 months. Families are being left unsupported at this time.

As politicians, we spend lots of time admiring the problem, but perhaps not enough time thinking about the solution. What do we need to do? The first thing I would say to the Minister is that the SEND review is still awaited. It was promised last year and has failed to materialise. Will she please ensure that we get it as soon as possible? We also need to invest in our children with SEND as never before. That requires money, patience, determination and a much clearer Government strategy.

Why might that work? By providing the right care in the right settings we can give our children the focus they need to be productive, employable, law-abiding and responsible citizens. Prisons are sadly full of people who have made the wrong decisions or acted impulsively, perhaps because they were not diagnosed at an early age. Let us invest in more specialist educational settings, so that people’s needs can be addressed. Yes, that is expensive and resource-heavy, but the cost of not doing so will always be greater, and this is non-discretionary spending.

I would like to see every local authority in the UK comprehensively reviewing its SEND provision, so that it becomes available in every area. Specialist and dedicated settings are the way forward for those who need them. We need to give our teachers better training with education, health and care plans. Those should not become a magic bullet—a passport for the lucky few—but a rightful passport for every child to get the support they need.

Lastly, CAMHS across the UK need 20,000 volts put straight through them. For families to wait two and a half years for a consultation is not only immoral but frankly inept. The irony will not have escaped anybody here that a GP cannot prescribe medication for ASD, ADHD, oppositional defiant disorder, Asperger’s or any other mental health condition, without a diagnosis from CAMHS. We have to focus on CAMHS right now.

To conclude, let us please get spending, diagnosing and treating, and let us give all our children, not least in Berkshire, the future they deserve.

9.58am
Layla Moran (Oxford West and Abingdon) (LD)

It is a pleasure to serve under your chairmanship, Ms Fovargue. I congratulate the hon. Member for Newbury (Laura Farris) on securing this timely debate in Children’s Mental Health Week.

Over the past year—frankly, five years—the number of parents writing to me about their children and the lack of support has grown exponentially. I was a teacher before I was an MP, and I commend the speech made by the hon. Member for Sheffield, Hallam (Olivia Blake), because she is right that this is about allowing young people to be themselves. The word “special” is the right one: just look at the number of Nobel prize winners with neurodiversity in their make-up. When I taught maths and physics, these children were often the brightest, most interesting people in the room. They should never be seen as a burden.

The way the system treats families and children who are neurodiverse makes it so difficult for them that it is understandable how that goes on to affect their mental health. One family contacted me about Poppy—I have changed her name—who is 12. As previously described, there was violent behaviour in the household, and the family was incredibly worried. It took months to even get the GP to refer to CAMHS. The mother said to me:

“Mrs Moran, to be honest, you are my last hope. I am suffering with both my physical and mental health and quite honestly I do not have the energy left to continue fighting the system.”

We are also in a perverse situation where even more professionals are writing to me. I would be curious to know if that is the same for other hon. Members. This is new. GPs are also writing to me, as are educational psychologists, because they all recognise that CAMHS is broken. I had one psychologist write to me saying that he no longer refers to CAMHS. He said that social services and CAMHS are so broken that the only thing he can do is keep children on his books because he worries that if he loses contact with them they will not get anything at all. How is this system not failing our young people? It absolutely is.

My first question to the Minister is on the lack of educational psychologists in this country. My local county council is doing its very best; it is one of the F40 councils and is twelfth-lowest in the country when it comes to the high needs block. I said, “If you had a magic wand and could ask for anything from the Minister, what would it be?” and the council said, “More educational psychologists.” We currently fund only 200 training places in the country. There is only one educational psychologist for every 5,000 young people, which is nowhere near enough. Tackling that issue would go a huge way towards immediately helping to alleviate the backlog.

In the interim, there are amazing third-party groups that are helping. There is Shift, which is an informal parent group in Abingdon, set up by Sally and Andy Foulsham. They run it, provide support and help families navigate the system. There is also The Abingdon Bridge, which is the only wellbeing and mental health charity for young people in Vale of White Horse. It focuses on 18 to 25-year-olds. It is particularly worried about the 16 to 18-year olds that it finds because, if they are referred to CAMHS, the waiting lists are so long that they then drop off that cliff edge. Strangely, the charity cannot access funding from the CCG because of the way that the funding works. Could the Minister help me help The Abingdon Bridge to access more funding?

To conclude where I started, we absolutely must appreciate that these children deserve the best, and deserve more, but the current system is failing them. There is a perverse disincentive in the system, where a school must basically pay the first £6,000 of the funding. We need a national SEND strategy that solves the problem once and for all. Without that, we risk failing our children and our country in the future.

10.02am
Nickie Aiken (Cities of London and Westminster) (Con)

It is a pleasure to serve under your chairmanship, Ms Fovargue. I thank my hon. Friend the Member for Newbury (Laura Farris) for bringing forward this important debate.

I do not think we realise the crisis that our children face on mental health. It is hard growing up—we all remember growing up—but our young people face an even more traumatic time following the pandemic. I truly believe that our children and young people have been badly affected by the pandemic and also by social media—we did not have social media, growing up, with that extra, 24/7 pressure.

On educational attainment, I have a 17-year-old daughter going through A-levels and a 15-year-old son going through GCSEs, and I can speak with authority about just how much pressure they are under. However, I cannot imagine how families cope with all the extra pressure when that is compounded by a special educational need.

I want to speak about people’s actual experiences in schools. I recently spoke to the head of a Westminster secondary school, who is a very experienced teacher. She said that she has never, in her 20-plus years as a teacher, known such a crisis in the mental health of young people and particularly teenagers. The pandemic has obviously compounded that, but we are now seeing far more anxiety, self-harming and suicidal thoughts. That is what she explained to me. The pressure that that head and her staff are under—to help and support the young people going through these things—has created even more of a burden for them. They are taking advantage of the Mind counsellors and the extra help that the Government are providing, but it simply is not enough.

There seems to be a disconnect between the Department for Education and the Department of Health and Social Care, because there is no one Minister taking control, and I ask the Minister to really consider that point. We cannot just leave it to schools to try to navigate special educational needs and support for families. We must make sure that there is one place for teachers to go for that support. There is such pressure on budgets now in schools. The head I spoke to told me how much they were now spending on extra support for pupils, which comes out of the general budget. I plead with the Minister to try to secure more funding for this issue from the Department for Education.

In Children’s Mental Health Week, I pay tribute to the local authorities in my constituency. This week, Westminster launched a trial of a keyring, which will reach 4,000 young people. They simply scan a QR code to take them to a special hub, which will give them the advice and support they need. That is the kind of practical help we need to give our children, but this is also about getting the funding that our schools need, to ensure that our young people have the future they deserve.

10.06am
Florence Eshalomi (Vauxhall) (Lab/Co-op)

It is a pleasure to serve under your chairship, Ms Fovargue. I pay tribute to the hon. Member for Newbury (Laura Farris) for calling this important and timely debate. It is always a pleasure to follow the hon. Member for Cities of London and Westminster (Nickie Aiken). I agree with everything she said. Our young people are facing a mental health crisis. They need vital support and funding in our schools.

For my Vauxhall residents, the mental health impacts of measures to tackle covid-19 have been some of the hardest of the seismic effect of the pandemic. Since March 2020, people have had severe restrictions on who they can meet and where they can go. We have seen park benches taped up. As a mother of two young children, that was difficult for me as well. People have seen their friendship groups shrink. They have had to deal with being shut at home, not going out and not seeing loved ones. They have missed loved ones for many months. In some cases, they have missed those vital last minutes. That situation has taken a toll on all of us but, most importantly, it has taken a toll on our young people.

Schools develop vital skills in subjects such as maths and English, but for our young people they are also a place to make friends, solve conflicts and develop vital interpersonal skills that help us all to navigate our lives. Those skills are vital in developing mental health resilience in our young people.

The Health and Social Care Committee has found that 1.5 million children and young people under 18 will need new or additional mental health support after the pandemic. That places a tremendous strain on already stretched mental health provision. Although extra funding has been promised, too few children are getting the treatment they need.

Several hon. Members have highlighted the many difficulties that parents, carers and, most importantly, young people face in accessing SEND provision. I am sure the Minister is aware of the data on the disparity and the barriers that black and minority ethnic children and their families face in accessing that provision.

I went to visit Lansdowne School in my constituency last December. Lansdowne is a specialist school for young people with autism, communication difficulties and speech and language delay. On my visit, I spoke to the headteacher about the fantastic work teachers and carers did during lockdown, providing vital support for children with challenging needs. I also spoke to the head boy and head girl and said that, in return for their giving me a tour round their school, I would give them a tour round my workplace, here in Parliament. They had such smiles on their faces; they beamed with joy. I saw a mural that students have worked on with local artists. With the right support and funding, our young people with special educational needs will flourish. We have to believe in them.

For many young people with special educational needs, finding the right support is vital. I am proud that the National Autistic Society decided to open another school in my constituency, on Kennington Road—the Vanguard School. Unfortunately, because of the many lockdowns, we have not been able to have the official opening, which has been postponed three times. I hope that when that opening finally takes place, the Minister will come to visit this excellent school, which provides state-of-the-art services for young people with additional needs.

As chair of the all-party parliamentary group on knife crime and violence reduction, and through my work on youth violence, I see the effects of youth violence and mental health trauma faced by our young people. If we fail to tackle the mental health crisis among them, we will continue to see them develop lifelong problems and not have access to vital SEN provision. Most importantly, we may see some of those young people taken too soon. I urge the Minister to look at providing vital support in this area now.

10.10am
Robbie Moore (Keighley) (Con)

It is a pleasure to serve under your chairmanship, Ms Fovargue. I pay tribute to my hon. Friend the Member for Newbury (Laura Farris) for securing this debate, which, as many hon. Members have identified, is important for all present.

Identifying special educational needs and early diagnosis is a particular problem given the complexities surrounding this issue. Early diagnosis is absolutely key. I have heard from constituents many harrowing stories of people trying every channel and route possible, including schools and local GP services, to identify special educational needs at an early stage.

Children’s mental health and special educational needs are complex. Their conditions can often be misdiagnosed or not even identified at an early stage. The signs of autism, for example, can be put down to a child experiencing a dislike for something such as going to school. Of course, the recent challenges of the pandemic have not made things easier.

Early diagnosis is key, but the process of getting a formal diagnosis is far too inaccessible and long-winded for many of my constituents. One constituent told me that there was no point in even entertaining the process, because they would have to wait three or four years for their child to receive a diagnosis. That is completely unacceptable. Likewise, private companies that offer such services are currently working their way through a huge backlog that accumulated during the pandemic. Too many of my constituents also find themselves priced out of any private offering.

In spite of those difficulties, there are a number of fantastic groups across Keighley and Ilkley that support young people with special educational needs and mental health issues. Take Margaret Nash, Helen Millar and the rest of the team at AWARE—Airedale and Wharfedale Autism Resource—which provides support to families with children and young adults on the autistic spectrum, with no formal diagnosis required. My thanks also go to Lesley Brook and everyone at the Nebula Girls Group, a Keighley-based organisation that helps young girls in Keighley who suffer with special educational needs.

I want to emphasise the issues of appointments and referrals. Battling their way through the bureaucracy and red tape, parents and young children find that the challenges of navigating a complex diagnosis system are not easy at all. As many hon. Members have identified, the transition from primary to secondary school—and then into the job sector—is extremely difficult, whether or not a person has been diagnosed.

That is where I would like more emphasis from the Government. Emphasis should be put on not only funding and providing targeted support, but providing businesses with the support they need to help people with special educational needs beyond the education system and into the work environment.

I appreciate that this issue is not being ducked by the Government, and I recognise that the Department for Education will continue to increase funding for children and young people with the most complex needs. However, we cannot stop there. All hon. Members present have recognised that CAMHS is not fit for purpose—we must ensure that it is. Like my hon. Friend the Member for Newbury, I call on the Minister to make sure that the SEND review is released at the earliest possibility so that we can try to get better mechanisms in place. There are some fantastic efforts being made at a local level, but we cannot rely on voluntary groups to sort this issue out. The Government, local authorities and CAMHS have got to do the utmost to make the whole process fit for purpose.

10.14am
Jim Shannon (Strangford) (DUP)

Thank you, Ms Fovargue. I apologise to the hon. Member for Newbury (Laura Farris) for not being here earlier—I was at the launch of an inquiry that I chair. I spoke to you, Ms Fovargue, to ask for permission and I thank all hon. Members for the opportunity to make a contribution.

Special needs education is a key issue. When the news of lockdown for schools came, my initial concern was for those going through exams. My next train of thought was for those special needs children whose parents simply could not take them on. They were difficult times, as everyone present knows, and the hon. Member for Newbury knows that better than most.

We had parents ringing our diverted phones crying because they literally could not settle their special needs child who was waiting on their school bus and could not understand the concept of lockdown and what it meant. For special needs children, it is important to have a routine and a simplified version of life, so that they can try to cope with it. It is not an exaggeration to say that children with special needs were distraught, and it quickly became clear that the impact on them was large. I was thankful for the Tor Bank School, the special needs school in my area, which kept its doors open for its own pupils and took a small number of students from other schools that were unable to open. Our office referred one pupil whose mother was distraught, and they took the child in until their own school reopened. These schools took special steps to enable things to happen, and we are in debt to them for that.

My thanks go to Peter Weir MLA, the former Education Minister, for allocating specific funding to special needs schools for tailored catch-up programmes and mental health support, as well as to mainstream schools for the wellbeing of pupils. Recognising the impact of isolation on individual children, and on children as class groups, is an essential part of helping them process and deal appropriately with the remnants of isolation. I am thankful that Ministers have rightly acknowledged the difficulty of lockdown for our children and that it is our duty to do our utmost to repair it.

The briefing that I received from Parentkind merely underscored my opinion of the damage done to all schoolchildren, but particularly children with special educational needs. I want to quote from it because it illustrates the problem. I know people say there are lies, damned lies and statistics, but I tell you what: these statistics tell a story. I hope nobody else has stated them already.

Some 55% of children with special educational needs experience homework-related stress, as opposed to 37% of children without SEN. Anxiety affects 55% of children with SEN, as opposed to 34% of ordinary children. Other figures include 46% versus 32% for exam stress; 45% versus 27% for bullying; 34% versus 16% for pressure to constantly engage with social media; 38% versus 11% for depression; 35% versus 11% for cyber-bullying and online abuse; 30% versus 6% for self-harm; 28% versus 5% for eating disorders; 25% versus 4% for sexual harassment; and 23% versus 3% for substance misuse.

Those statistics clearly illustrate the impact on those with special needs. These figures underscore the greater vulnerability and the higher risk facing children from less advantaged backgrounds or with additional needs or disabilities. The data shows that they were more susceptible to mental health impacts and social challenges in their peer group. It is clear, as this debate shows, that there is a problem, and we in this House need to ensure that the solution is available and is long term.

It is good to see the Minister in her place. We have a special friendship, and she does extremely well when it comes to answering these issues. We look to her to address the impact on England. This issue is not her responsibility when it comes to Northern Ireland, but it is always good to bring a Northern Ireland perspective to these debates, as well as to illustrate to the hon. Member for Newbury that we in Northern Ireland have similar pressures.

10.18am
James Daly (Bury North) (Con)

It is a pleasure to speak in this debate. I thank my hon. Friend the Member for Newbury (Laura Farris) for bringing this important issue forward. I hope that Members will forgive me because, based on the contributions that have already been made, I am going to give a completely different speech from the one I had intended to make.

I certainly do not like doing this, but I feel that I have to bring my personal experiences to the debate. My son is on the autistic spectrum.

Jim Shannon

Will the hon. Gentleman give way?

James Daly

It is fine. My wife and I waited many, many months for a diagnosis. When we had the diagnosis, it was a relief, but when it happened we were told, “Well, nothing changes. Just carry on as normal.” We were not referred to services—we have not been referred to services throughout the whole of my son’s time in education. We have been given a diagnosis and essentially asked to carry on as normal. My son is a beautiful boy, and he is in mainstream schooling. He has challenges, but he does not have the complex needs that other families have, and that was it.

I can tell Members from personal experience that the length of time people have to wait for a diagnosis is a disgrace, but in many cases nothing happens afterwards. To help, aid and support my son, we are reliant on the special educational needs co-ordinator at his school. SENCOs are brilliant people, but they often do not have the expertise we would hope them to have in these situations. If the levelling-up agenda is to mean anything—and I fully believe in our Government’s levelling-up agenda—we have to find ways to ensure that those people with challenges in their lives are able to achieve and maximise their potential. I have not raised the issue of my son for any other reason than this: I do not believe that the support that he has received, and that other children are receiving at this moment in time, allows that to happen.

I was in a debate yesterday with many Members who are in this Chamber today. The issue of funding is a very legitimate concern to raise, but my borough in Bury has spent £40 million over the past financial year on special educational needs and mental health. We have to go beyond just saying, “Give more money”. We have to have local accountability, strategies and bespoke support services for each individual child in our country to allow them to achieve their potential.

I support one of the things that the Labour party said yesterday, and I support what the Government are doing. We have many family hubs, which I support, and they provide fantastic support for this agenda. The shadow Minister, the hon. Member for Dulwich and West Norwood (Helen Hayes), talked yesterday about mental health hubs. We can call them anything we want, but every town in our country needs a bespoke, 24/7 support service that schools, individuals and families can turn to in the knowledge that they are not just a statistic—they are human beings—and so that local services can respond to the individual needs of each individual child, who we must cherish.

10.22am
Steve Brine (Winchester) (Con)

It is an honour to follow my hon. Friend the Member for Bury North (James Daly).

In a few months, I will have been in this place for 12 years, but we are still having the same debate and saying the same things, so I want to give voice to a few constituents who have been in touch with me. One wrote that

“my son (6 in April) is diagnosed autistic…I had to fight to get an appointment with a paediatrician…I cannot express to you how stressful this was and for two years we didn’t get any support…We did find some support once he started school but…I am now paying for this privately…at £70ph…There is no one place to work out what support is out there. It is all piece meal. I’ve learnt far more from speaking to other parents of autistic children about available support than through official channels…if support was given beforehand, so many of these mental health difficulties could be prevented. The majority of parents I know of autistic children are burnt out and stressed—even when they have money to provide private help”.

Another constituent wrote:

“It was apparent at pre-school that he was experiencing difficulties, he was seen briefly by a speech therapist…He transitioned into primary school, where I still remember that fateful day where he just crumbled. Due to a lack of external help we sought the advice of a child psychiatrist…This cost us thousands. Eventually we received, with primary school SENCO help, admittance onto the CAMHS pathway for autism assessment. After many years of waiting we were discharged…We were then dropped from any further care and given a leaflet with web links for information…Any request for help that we have made has been firmly shut down…to navigate the system requires an MSc level of education, legal knowledge, money (we are on benefits!) and time. All at an emotional cost to one’s self.”

Another constituent wrote:

“We only get one childhood and it is proven that it has an impact on the rest of a person's life. I hear so many times of people being turned away from CAMHS and struggling to get support, even when their child is suicidal”,

and another said:

“SEN parents are really stretched to the limit. I cannot begin to tell you what a battle it is and how a more global approach would be of benefit...rather than the fragmented system of try the school, try the GP, try CAMHS etc.”

Another constituent wrote:

“Our experience of CAMHS? Well there isn’t much as we haven’t been able access any treatment for him!…My husband and I referred our son on the CAMHS online referral form in November last year. I wrote on the form that he was using the palm of his hand to slap his forehead out of frustration to get the compulsive thoughts out of his head…We didn’t hear anything so I sent an email asking them to confirm that they had received our referral form. The confirming email asks parents not to inquire about waiting list times...A member of the School Welfare Team phoned me to say that there is a waiting list of 18 months…As a family we are frazzled and I feel like I’m hanging by a thread. Where do we go from here?”

Another one wrote that

“the situation is abysmal. My family have been ripped apart by my daughter’s mental health and she is just SIX years old.”

Finally, another constituent wrote:

“Last night my nine-year-old son said, ‘I would rather have no life than this life’.”

None of those emails makes for easy reading. I have had so many emails, and the key thread I take from them is that, as many have said, early diagnosis is what is missing. As a result, children fall further down. They are helped later, and the help they need is consequently significantly more acute. Covid has been a disaster for children and young people’s mental health, so let us not compound that now by this constant asymptomatic testing.

“Don’t ask us how long the wait is.” I would love the Minister to explain how that message fits with the physical waiting list on My Planned Care, which was launched this week. Where is the parity? I have been really moved by what I have received this week. My constituents do not care about six people being shuffled around the same jobs in Government. They care about the services that they are paying a lot of money for and are not getting. One constituent said to me:

“Childhood is short but it also lasts a lifetime.”

We cannot have this debate for the next 12 years.

10.27am
Dr Lisa Cameron (East Kilbride, Strathaven and Lesmahagow) (SNP)

It is a pleasure to serve under your chairmanship, Ms Fovargue, and to speak in this debate on behalf of the Scottish National party and also as chair of the all-party parliamentary group for disability, a role that I have been proud to champion in my six or seven years of being in Parliament.

We must thank the hon. Member for Newbury (Laura Farris) for realising how vital this debate is and for securing it. She spoke eloquently of her concerns, which were reinforced in just about every speech. Her questionnaire asking constituents about services is a fantastic initiative, getting to the frontline and the heart of what is happening.

When I visit local services in my area, they often give me statistics and tell me how things are improving, but it is not until I speak to people and ask about their experiences that I see whether it has translated into changes for the children who need the services. The hon. Lady emphasised that a timely CAMHS diagnosis is absolutely necessary for someone’s chances in life. That is the key message from today.

The hon. Member for Sheffield, Hallam (Olivia Blake) spoke from her heart about her personal experience. That is a very powerful thing to do in this House. She is a real champion for the screening of neurodivergent conditions. Because of her own struggles, she has been a role model for so many. It is important that she uses her voice, as she has done so powerfully today.

The hon. Member for Newcastle-under-Lyme (Aaron Bell) spoke of the battle faced by parents in his constituency and of the lack of staffing. It is not just about money; it is about training and staffing and making sure that there is an appropriate workforce plan. I hope that the Minister will address that point.

The hon. Member for Bristol East (Kerry McCarthy) eloquently said that the system as it stands is stacked against parents. From what we have heard, I think that is so true. There has to be mental health support in every school, and it has to be at a local level. We cannot expect families and children who are already extremely vulnerable to travel a huge distance for the care that they need.

The hon. Member for Bracknell (James Sunderland) said that 14 times more money is spent on adult services than on children’s services. I worked in psychology prior to coming to this House, and children’s services were always seen as a Cinderella service—entirely wrongly, in my opinion. Investing in our children is investing in our society for the future, and we really need to understand that.

The hon. Member for Oxford West and Abingdon (Layla Moran) described what many of us experience: that people come to us and say that their MP is the last hope for their family. That is how we feel, because that is what people tell us: “You are my last hope; I have tried everything.” It is unacceptable that families have to battle the system to that extent. The Disabled Children’s Partnership contacted me prior to the debate and said that 60% of families with disabled children have sought mental health support for themselves, which shows just how desperate the situation is.

The hon. Lady mentioned another really important issue, which the British Psychological Society has also raised with me: the lack of educational psychologists in the UK. There is only one for every 5,000 young people. That is a really crucial issue that the Minister should take forward. To make a difference, we must have the correct professionals in place to undertake the required diagnoses.

The hon. Member for Cities of London and Westminster (Nickie Aiken) spoke really well about the trauma experienced by children in the pandemic. We must not underestimate that. Their childhood has been different from that of every other generation: the trauma that that cohort has experienced, the loss that many have experienced, the loss of their daily structure and the loss of contact with their loved ones, which was snatched away at a critical time. We need to improve services not just generally but very specifically for the most vulnerable children with special needs.

The hon. Lady also spoke about the impact of social media. I have heard so many negative things about online algorithms and the impact of constant social media use on children and young people’s mental health. That has such a negative impact that we should look at taxing social media companies specifically to raise money to increase mental health support. That must be addressed in the Online Safety Bill.

The hon. Member for Vauxhall (Florence Eshalomi) spoke about her excellent work helping those from diverse backgrounds in her constituency and the important issue of knife crime. She said that, when people are failed in childhood, they can go on to engage in antisocial behaviours; they are steered down that path because the system has failed them. We must ensure that we avoid that at a much earlier stage.

The hon. Member for Keighley (Robbie Moore) spoke about the importance of early diagnosis and the battle against bureaucracy, and the hon. Member for Strangford (Jim Shannon) about the impact of the pandemic and the lack of structure on children with special needs, which has been severe. In my own constituency, we are still struggling to get services back up and running at the level that they were before the pandemic. Parents are continually contacting me, worried that the pandemic may be used as a rationale to reduce services. That must never happen; we are here to champion those parents and to make sure that that does not happen. The hon. Member for Strangford also underlined all of the very bleak statistics that show the greater impact of the pandemic on children with special needs.

The hon. Member for Bury North (James Daly) spoke emotionally and powerfully about his son. The hon. Gentleman came here to listen, but decided to give us the benefit of his own experience. That is one of the bravest and most important things we can do when we come here to raise our voices for others. That personal experience resonates with everybody more than statistics or anything else that the rest of us have to say.

The hon. Member for Winchester (Steve Brine) said that he has been a Member of Parliament for almost 12 years and has been talking about these issues for 12 years. Clearly, these issues have to be taken forward. What I will say—this is slightly different from the speech that I prepared—is that having worked in the services, it is very clear to me that CAMHS cannot manage diagnosis and assessment for children with special needs, as well as the overwhelming number of children who are there for mental health issues. There has to be a streamlined diagnostic service that is available locally, at local authority level, where children can have that intervention, that assessment, because one year in a child’s life is a huge amount of time. The six years that we heard about is almost one third of their childhood. The developmental milestones that have gone by can never be caught up on, so early diagnosis is crucial. There has to be the development of a streamlined service with specialist practitioners who can do the diagnosis and also, from the diagnosis, provide intervention. Why wait six years for a diagnosis only to be told, “You’ve got your diagnosis, but nothing follows it”? That is totally unacceptable.

The all-party parliamentary group for disability would be keen to engage with the Minister, who I know wants to do her very best on these issues, and the Department to look at, where possible, streamlining services for diagnosis and treatment for those children with special needs who deeply require it—we have all said the same thing today—and to learn from best practice right across the UK. There are things that we are doing well in Scotland, and there are things that we can learn from as well. At the heart of this are children, and we must do our best for those children. I want to work collaboratively to try to ensure that we do, together, across this House.

10.36am
Helen Hayes (Dulwich and West Norwood) (Lab)

It is a pleasure to see you in the Chair, Ms Fovargue. I congratulate the hon. Member for Newbury (Laura Farris) on securing this very important debate during Children’s Mental Health Week. She has been a powerful advocate for her constituents who are struggling to access the support that they need for their children. I thank all the hon. Members who have spoken this morning. We have heard many powerful and distressing examples of the impact that the combination of the pandemic and the underlying gaps in support for disabled children is having on their mental health and the mental health of their families.

My hon. Friend the Member for Sheffield, Hallam (Olivia Blake) spoke movingly about her own experience and the impact that a lack of access to diagnosis can have, even into adulthood. The hon. Members for Newcastle-under-Lyme (Aaron Bell) and for Keighley (Robbie Moore) spoke about the battles that families in their constituencies face and about the need for a “tell it once” approach when dealing with services. My hon. Friend the Member for Bristol East (Kerry McCarthy) and the hon. Member for Cities of London and Westminster (Nickie Aiken) made a really important point about the lack of co-ordination among health, education and social care services, which leaves so many families being passed from pillar to post and without the support that they need.

My hon. Friend the Member for Vauxhall (Florence Eshalomi) paid tribute to the brilliant work of Lansdowne School, which is also attended by many children in my constituency, who progress to Lansdowne from Turney Primary School in my constituency. Both schools provide a brilliant education for their children.

It was very moving to hear the hon. Member for Bury North (James Daly) speak about his own experience and the battle that his family have faced and continue to face on behalf of his precious son. It is so important that the hon. Member has brought here today the insights into the system as a whole that that personal experience has provided. I do hope that his son is able to access the support that he needs in order to enable him to continue to flourish in the future.

The hon. Member for Winchester (Steve Brine) made a really important point—there is far too much distraction at the top of Government just now. The disgraceful reality of that is illustrated no more powerfully than by the plight of disabled children, up and down the country, who are struggling to access the support that they need.

From listening to those accounts and looking at the evidence on disabled children’s mental health, it is impossible not to draw the conclusion that the most vulnerable children are being profoundly failed by this Government. According to research by the Disabled Children’s Partnership, nine out of 10 disabled children have been socially isolated during the pandemic, with 72% of parents and carers reporting that their child was often unhappy, downhearted or tearful. The impact of the withdrawal of vital support services, both in and out of school, has been devastating. The situation is of course complex, because many disabled children have physical health vulnerabilities that increased their risk in relation to covid-19 and it was important that protections were put in place.

I pay tribute to the staff working in SEND education and support, who adapted their services very quickly to provide online learning and undertake home visits. I recently visited Cherry Garden School in Southwark, a brilliant primary school for children with special educational needs. I heard from staff about the rapid action they took to develop an online curriculum and the learning packs that were delivered to children via home visits. I know that those visits were a lifeline for many families.

Despite the undoubted commitment of professionals, there was no systematic approach. The necessary precautions that were taken to reduce the risk of covid infection were, all too often, not supplemented with any additional support. At the start of the pandemic, 76% of families surveyed by the Disabled Children’s Partnership said that the vital care and support they relied on had stopped altogether, leaving parents and siblings taking on all care responsibilities around the clock. The support has been very slow to come back. As late as June 2021, more than 70% of disabled children were still unable to access pre-pandemic levels of therapies and health services. The pandemic has been challenging for everyone. It has been particularly gruelling and exhausting for far too many families with disabled children.

However, we know that the challenges facing disabled children and their families are not only a consequence of the pandemic. Some 60% of families with disabled children have sought NHS mental health support due to the stresses of fighting for basic services. That is the story, again and again and again. Every Member of this House will know constituents who are battling with a system that simply does not work as it should, with thresholds for support that are getting higher and higher, and have been doing so for a decade. Parents battle for assessment and diagnosis, they battle for EHCPs, they battle for the right support or the right school place, and in many cases they battle for housing that is suitable for their children’s needs.

I have mentioned many times in this House my constituent Matthew Garnett. I am pleased to say that Matthew is now thriving as a young adult in supported housing, pursuing the things he loves, including his project to visit every football ground in the country. Matthew, who has autism and a learning disability, first came to my attention when he was, like far too many children, in a secure hospital, held under the Mental Health Act 1983.

I supported Matthew’s parents in their battle to get him out of hospital. As part of that battle, the then Mental Health Minister commissioned a review of Matthew’s care. The review made devastating reading. It documented, year by year, his parents’ struggle, over more than a decade, to get their son the support he needed. The consequence of the system failure they encountered was that Matthew, like far too many autistic children and children with learning disabilities, ended up in a secure hospital, far away from his loved ones, with his health deteriorating week by week.

According to the Disabled Children’s Partnership, only 4% of parents and carers of disabled children feel they get the right support to care safely for their disabled children; 53% have had to give up work to care for their child; and 40% have experienced relationship breakdown since their child was diagnosed.

The Minister will, I am sure, mention the £30 million of funding for short breaks for families with disabled children. That is very welcome, but short breaks should be genuine respite. They should not be respite from a system of support that breaks people. It is not enough to substitute for a system that is failing in its entirety the promise of access to a short break every now and again.

The SEND review was originally promised in September 2019. It is now shamefully overdue. The pandemic is simply not an adequate excuse for the lack of urgency in that work, given the impact that the pandemic itself has had on disabled children. It sends its own message about the level of priority the Government place on families with disabled children. I hope the Minister will set out today a firm date for its publication. We need the review to set out clearly the gaps in current provision and in resourcing, so that the Government can set out a clear plan for ensuring that every disabled child in the country is able to access the support they need.

The current system is failing far too many families, and the impacts are being felt in devastating consequences for their mental health. This cannot go on, and I hope the Minister will set out a plan for change today.

10.44am
The Parliamentary Under-Secretary of State for Health and Social Care (Maria Caulfield)

It is a pleasure to serve under your chairmanship, Ms Fovargue. I thank my hon. Friend the Member for Newbury (Laura Farris) for securing this important debate on special educational needs and children’s mental health services. As we can see by the number of Members who have attended the debate, this is clearly a significant issue across many parts of the country. Unfortunately, the Minister for Care and Mental Health, my hon. Friend the Member for Chichester (Gillian Keegan), is unable to be here today because she is self-isolating, so I will do my best to answer hon. Members’ questions. I am sure we can follow up on anything that I am not able to cover in my remarks.

I thank the hon. Member for Sheffield, Hallam (Olivia Blake) for sharing her personal experience, which illustrates some of the struggles that people face. She outlined the positives and negatives in her remarks. I also thank my hon. Friend the Member for Bury North (James Daly) for sharing his son’s experience, which is unfortunately not uncommon.

My own postbag reflects many of the comments that have been made in the debate. Children are often not getting the help and support they need at the early stages, which often leads to more difficult interventions later that could have been avoided if the support was in place. The collaboration locally between health and education is often not where it should be. I am here not to deny any of the remarks made in debate, but to set out what is being done to address these issues, which have been in place for many years. I agree with my hon. Friend the Member for Bury North that funding is not necessarily the only factor here; it is also about how services are brought together. As my hon. Friend the Member for Newbury said, it is about accountability for how those services are delivered.

In March last year, we published the covid mental health and wellbeing recovery action plan, which includes £31 million to improve autism and learning disability services. There is £42 million to continue funding projects to support young people and families with special educational needs. There are funding pots available, but we are hearing that they are not making it to the families who need them or to the services being provided. In the short time that I have, I hope to be able to set out how we aim to resolve some of those issues.

The demand for services has increased. There is no doubt that the demand for CAMHS, ADHD assessments, autism assessments and diagnosis has increased over time, but waiting times are also dismally short of where they should be. According to the National Institute for Health and Care Excellence, which provides evidence-based guidance on many of these areas, children and young people who are referred for an autism diagnosis should have a diagnostic assessment within 13 weeks. We have heard from many colleagues, including my hon. Friend the Member for Newbury, that it takes around two years. My hon. Friend the Member for Bracknell (James Sunderland) cited three years. Of course, my hon. Friend the Member for Bury North cited his son’s experience, and the hon. Member for Vauxhall (Florence Eshalomi) also spoke about this issue. We can see that it is a problem across the country.

For ADHD diagnosis, NICE guidelines do not recommend a specific waiting time, but they set out recommendations for how services should support and manage children who need a diagnosis and their families, for how such children should be supported through education, and for general support as well. We want every area of the country to meet NICE guidelines but, sadly, that is not happening in many places. To make sure that we get on top of the situation and reduce the delays, we want to work towards providing an assessment within the recommended 13 weeks in order to deliver a timely diagnosis—not just so that they get a diagnosis, but so that the interventions are there to help and support young people and their families.

There are three key areas where I think we can improve things. The SEND review, which was touched on a couple of times in the debate, is a joint collaboration between the Department for Education and the Department of Health and Social Care. It is in progress, and we expect its findings to be announced fairly soon—I am talking about weeks, rather than months. Following the recommendations from that, a Green Paper will be published. It will follow a 12-week period in which I encourage all Members to take part in the process and to highlight many of the experiences that we have heard today. We have talked about the funding that is being announced, but often that goes to health and does not get into schools. I met representatives from one of my schools only last week, and the joined-up working locally between education and health just is not happening. That reflects the point made by my hon. Friend the Member for Newbury that accountability for who is responsible for doing what, and the joint working, is currently not happening.

Layla Moran

Will the Minister comment on access to funding for third-sector organisations, which are often more expert at offering advice and support that families need?

Maria Caulfield

Absolutely. Services are commissioned locally. Part of the issue is that there is no accountability for when services are not commissioned. The funding that is put forward needs to look at all service providers, and the third sector is often well placed to provide those services.

To touch on long waits, NHS England is working to ensure that CAMHS have embedded diagnostic pathways for autism and ADHD as a core part of their work. A sum of £13 million is going in to improve those pathways and identify those at risk of crisis; £2.5 million of that funding will test different approaches to diagnostic pathways and ensure that they are backed by research and are evidence-based. In addition, NHS England wants to develop a single point of access to ensure that referrals are triaged, and that individuals do not stay on lengthy waiting lists. We have heard today of the difficulties caused by not having a single point of access. I have met families in my constituency. As the hon. Member for Oxford West and Abingdon (Layla Moran) said, we are the last refuge and point of contact when they cannot get anywhere else.

We know that school settings can provide an invaluable opportunity to identify autistic children early in life. We are investing £600,000 in significantly expanding an autism early diagnosis pilot in Bradford. That will test at least 100 schools over the next three years to assess whether new approaches to achieving a faster diagnosis can be rolled out across the country. The early findings from that pilot are positive. Education staff report that they are better able to identify children and put in place the support they need to thrive in education. Local areas will look to upskill mainstream staff to better identify children’s needs. In Manchester, a project to support early identification and diagnosis in young children involves health visitors identifying those who show signs associated with autism and fast-tracking their assessment, with additional post-diagnostic support for families.

The issue for many years has been the lack of a national strategy, but that is changing. What we want, when pilot studies show good initial results, is to roll them out across the country. In the next year, on top of the £1.5 billion spent in the past two years, we are providing an additional £1 billion of high-needs funding for the education of children with more complex needs. The aim of that funding is to reduce waiting lists and variations in practice, make navigation pathways less complex, and improve the speed and quality of diagnosis.

Those points tackle some of the issues around waiting lists, but accountability was the main thread of the introductory remarks of my hon. Friend the Member for Newbury. At the moment, no one is held accountable locally if services are not commissioned. The integrated care system will be put on a statutory footing from 1 July, if the Health and Care Bill goes through on time, and ICS boards will be the accountable bodies for commissioning services. Their chief executive officer will be the accountable officer for the NHS locally and will be responsible for bringing those services together and will be accountable if that is not happening.

Since November 2019, NHS Digital has reported on waiting times for autism assessments, trying to ensure transparency in how services are delivered and highlighting areas where improvements are needed. It is incredible that, up until now, we have not had the data to hold people’s feet to the fire when services are not provided.

Steve Brine

On accountability, can the Minister shed any light on the issue of CAMHS in Hampshire telling parents not to ask how long, or will she take it away? It means that they cannot plan, for instance, decide to sell the car. Those are the choices that people are facing. They cannot plan for what is next. Does that sound right to her, that people have been told not to ask?

Maria Caulfield

No, that does not sound right. That is exactly why we want to bring some accountability to local services, so that when such statements are made, we can look at what the problems and the blocks in the system are to try to overcome them.

Local authorities also need to be held to account for how they support schools, because schools do a huge amount of work, going above and beyond in most cases to support children with special educational needs. That is why we continue to work with Ofsted and the Care Quality Commission to develop a new area of SEND inspections, which will look at how services and support are delivered in practice on the ground. That will hold local areas to account, so that there is no gap in oversight before full implementation of any new reforms resulting from the SEND review. It also recognises the importance of inspections in SEND services by highlighting areas of good practice and areas to improve on.

I reassure colleagues across the Chamber that that is an area of high priority. The SEND review will be published shortly, and the Green Paper will follow swiftly on from that. I encourage all colleagues to share their powerful experiences in that process, as they have today, so that we can improve services for the children and their families who at the moment are not getting the service that they deserve.

10.56am
Laura Farris

I thank every Member and colleague who spoke in the debate, from five different political parties, revealing the power and privilege of being a Member of Parliament. We can represent the concerns of families at their most acute, with all the detail and desperation in the emails and letters that we have all received.

My time is limited—I am not sure how limited—so if I do not mention every single Member who spoke, they must not think that I am not grateful for what they said. I pay particular tribute to my hon. Friends the Members for Bracknell (James Sunderland), for Winchester (Steve Brine) and for Bury North (James Daly), all of whom have children with special educational needs. My hon. Friend for Bury North showed absolutely directly what the emotional effect on the family means and how much that consumes the thoughts and all the deepest concerns of the parents about the outcomes wanted for their child.

I also pay tribute to the hon. Member for Sheffield, Hallam (Olivia Blake). One of the things that she said, which was reflected in so many of the emails that I got, was that when someone has a child considered to have autism, ADHD or something equivalent, often there is a period in the child’s school life when they are being told that they are a failure or disruptive. Headteachers told me that one of the things that happens is that not only is the child sometimes not popular, missing out on sleepovers, play dates out and so on, but the parents are not popular, because the other parents think that they have this difficult child. They cannot do anything about it.

One Member present today shone the light on what I am trying to achieve with the debate, and that was my right hon. and learned Friend the Member for South Swindon (Sir Robert Buckland). When he was Justice Secretary, he had a direct interest in neurodiversity, and he was appalled by the correlation between neurodiversity and autism, and the prison estate. We can all agree that it is never the responsibility of the Justice Secretary—from whichever party—to deal with that, but as a society we have failed if that is the end destination of people with autism.

We can draw a few strands together. I think that everyone present agrees that the need for intervention is urgent and that most of the problems could be identified at primary school, but there is much greater need for accountability. Where the Government have commendably made money available to commission locally, those services need to set out what is achievable and then to deliver them, with consequences for not doing so.

The Minister talked about integrating services and about improvement, all of which was music to my ears—joined-up working between education and health services. It must be the case that families in all the constituencies that we represent can have reasonable expectations. When their child is considered possibly to have a learning difficulty, the families should expect a diagnosis in a timely way and that some form of educational support will be made available. Almost—not all, but almost—every family who receives adequate educational support has seen a transformational impact on the life of their child.

Question put and agreed to.

Resolved,

That this House has considered special educational needs and children’s mental health services.