Contribution
I thank my hon. Friend for her intervention. She brings a breadth of experience to this place on these issues, both as a member of the Health and Social Care Committee and as a registered nurse. I agree that we do need to take urgent action to rebuild the numbers of allied health professionals and health visitors. The Committee has heard that there has been a halving of the number of health visitors in the past 10 years, which has had an almost catastrophic impact on their ability to deliver the vital role that they play in identifying early need in childhood, particularly in the early years, supporting families where there is an additional need for support and signposting people to other mechanisms, such as Best Start family hubs, to ensure there is that proportionate universalism that is so key to ensuring that those who need help get it in a timely way. I very much agree with my hon. Friend that urgent action needs to be taken to address this, which we will hopefully see in the upcoming NHS workforce plan.
That ties into my earlier point. There are 77,500 children and young people who have been on a community care waiting list for more than a year in England, which is a sixfold rise since the start of 2023. For comparison, only around 1% of adults wait for more than a year for community care, compared with around 25% of children. Thinking about equity in healthcare, a year for a child could be an entire lifetime, which is not the case for an adult.
We also know that there is a really rapid development window in the early years, particularly in the first 1,001 days, where we have the ability to make an impact on the life chances of a child, when all that quick-fire development is happening mentally, physically, socially and emotionally. It is absolutely crucial to get in at the onset and arrest conditions before they become more serious and make a real impact on the life chances of a child through to schooling, employment and beyond.
However, there is a crisis across the allied health professions, particularly in early years. I want to highlight a few areas where this is really bearing fruit. According to the Royal College of Occupational Therapists, four fifths of occupational therapists are unable to meet local demand. The workforce remains focused on secondary care, which limits capacity for prevention and early intervention in communities. Workforce pressure does translate into rising waiting lists; in February 2026, nearly 18,000 children and young people were waiting to see an occupational therapist. This has a huge impact on the life of a young person. Quite often occupational therapist interventions are not costly, but the inference and reference of an expert or specialist is needed to be able to direct people in how best to carry them out. The fact that 18,000 children are waiting to see an OT is really shocking. These delays will have a real impact on professionals being able to act at the very earliest opportunity to turn children’s life chances around.
Speech and language therapy is another area that is experiencing a crisis in both recruitment and retention. According to Speech and Language UK, more than 2 million children in the UK have struggled to speak or understand words and an estimated 1.3 million have a developmental language disorder. The Government must train and recruit enough speech and language therapists to ensure that the trend of a reduction in the profession is arrested. Currently, 16% of NHS speech and language therapy posts in England are vacant, and the vacancy rate for NHS speech and language therapy posts supporting people with a learning disability is even more stark, at 25%. The Royal College of Speech and Language Therapists reports that 96% of children’s speech and language therapy services say that recruitment is more or much more challenging than at any time in the past three years.
What that translates to is those in these crucial professions spending the vast majority of their time carrying out assessment work when things have reached a point of crisis or acute care need. They are not getting to see people and intervene at the earliest opportunity, and they are not getting to help families. That is driving the retention crisis, as professionals find themselves unable to perform the role for which they trained and about which they are, by and large, incredibly passionate. Instead, they are spending their time carrying out assessments and recommending therapeutic care that they know is very unlikely to materialise.
The real crisis in the paediatric allied healthcare professions could have a huge knock-on effect on a major part of Government policy found in the education White Paper. I know that the Minister is here to speak for the Department of Health and Social Care, but the Health and Social Care Committee has continually found that there is a real gap in the role of healthcare when it comes to education, health and care plans, and in the special educational needs and disabilities system as a whole.
The White Paper places huge demand on having “experts at hand”—a locally trained workforce who are able to provide specialist support. It names professions such as occupational therapy, physiotherapy and speech and language therapy, which fall entirely within the allied health professional workforce, which it is in the gift of the Department of Health and Social Care to provide. However, we know that these occupations are at crisis point; time and again, when we talk to our local integrated care boards, they say that they do not have the people available to fulfil that “expert at hand” role. It is such an important part of the education White Paper that if it fails, I am afraid the entire White Paper is at risk of failure. The crux of it is early and timely intervention, and support for families, school staff and children, in order to make an impact at the earliest possible opportunity. Without this workforce, it cannot and will not succeed.
I ask the Minister: what plans will there be in the upcoming workforce strategy to address the decline in paediatric allied healthcare professionals? What plans are there for training, recruitment and retention, not just to support this important part of the education White Paper, but to address the real health inequality in paediatrics? It is fair to say that the impact on children is so much worse than that on adults receiving healthcare, because they can spend such a significant chunk of their life on a waiting list.
Most importantly, what action is being taken to ensure that these professionals, particularly those in the paediatric workforce, feel valued and know that their contribution really counts towards the delivery of both the current healthcare system and the Government’s wider reform agenda? How can we ensure that the life chances of children are best improved and encouraged through the recruitment, retention and valuing of allied healthcare professionals?