Baroness Whitaker (Lab)

My Lords, I first apologise for not having been able to speak at Second Reading; I would have welcomed the Bill. In speaking to Amendments 2, 49, 52, 60, 112, 114, 118, 119 and 126 in my name, I declare my interests as honorary vice president of the Royal College of Speech and Language Therapists, as a former member of the Tavistock and Portman NHS Foundation Trust board, as a patron of the British Stammering Association, and as a stammerer myself. I thank the Royal College for its briefing and my noble friend Lord Bradley and the noble Lord, Lord Patel, for their support. I also warmly support Amendment 1 in the name of the noble Baroness, Lady Tyler. I shall add amendments consistent with it in a later group. My amendments, which are supported by 49 professional, charitable and training organisations, are all based on the premise that speech and communication difficulties are an insufficiently recognised component of a very great number of mental ill-health symptoms and that professional speech and language therapy could—and should—enable more successful treatment. One study found that 80% of people accessing mental health services had a difficulty with language and 60% with communication or discourse. Especially in the case of children and young people, those with a mental health disorder report having five times more speech or language problems than those without. One study found that 81% of children with social, emotional and mental health needs had significant unidentified language deficits. One of the problems with the lack of specialised staff to help such children is the demoralisation or challenging behaviour that comes from frustration with unmet communication needs, quite apart from the impediments to treatment. I could quote many examples of this, as well as some success stories—for instance, where speech and language therapy effected a sizeable reduction in the use of restraint in a secure children’s home, or enabled psychological treatment to work and give the inestimable benefit of the ability to cope. I must emphasise that most of us take the ability to communicate for granted, perhaps without realising how essential it is to our lives. It is when it is lacking that you notice what it means. I am therefore sure that it must underpin the principles of this excellent Bill. Amendment 2 does that. Without a rider of that kind to the principles, we will not have effective treatment in very many cases of acute distress and challenging behaviour. Amendment 49 puts the speech and language therapist squarely in the frame of responsible clinician, so that where communication difficulties are the key problem, that can be tackled. Amendment 52 does the same for treatment decisions and Amendment 60 for care and treatment plans. Amendment 112 provides the same safeguard for detained patients who need to complain and Amendment 114 is to make sure that patients can understand their information on discharge, which is surely essential. Amendments 118, 119 and 126 have a similar function: to make sure that advance choice documents are properly understood and properly made.