Alternative and Augmentative Communication
Order. Members should not cross the well of the chamber.
The final item of business is a members' business debate on motion S3M-1660, in the name of Nanette Milne, on alternative and augmentative communication. The debate will be concluded without any question being put.
Motion debated,
That the Parliament expresses concern following the findings by the Royal College of Speech and Language Therapists, Capability Scotland and Augmentative Communication in Practice whose recent survey of alternative and augmentative communication (AAC) equipment and speech and language therapy support provision in Scotland revealed that eight out of 15 NHS boards, including NHS Grampian, are providing a poor service; notes that only 16% of potential beneficiaries are accessing specialist AAC services in Scotland and that AAC provision is a postcode, age, advocacy and impairment lottery, and considers that an AAC strategy for Scotland should be developed and implemented to provide for a national standard of specialist speech and language therapy provision.
The inability to communicate leads to perhaps one of the most desperate feelings of frustration that a human being can have. Sadly, in 21st century Scotland, a significant number of our fellow citizens daily experience such desperation and frustration.
The device that I have just used to open my speech is a modern and sophisticated talking machine. It is one of a range of alternative and augmentative communication aids that includes simple picture boards and sign and even personal body languages. The aids can be used either to augment speech or as an alternative to speech and writing for people who have difficulties with communication.
While I used the machine to highlight the debate, I had hoped that there would be some people in the public gallery for whom AAC is the difference between complete isolation and the ability to make meaningful contact with their families, friends and the outside world. Unfortunately, those people could not make it this evening, but I am delighted that a number of specialist speech and language therapists have come to hear the debate. I know that all members in the chamber will welcome their presence.
Earlier today, I was privileged to meet several younger AAC users from Crossford primary school, who came along to show that difficulties with communication can affect all age groups.
I was very happy to lodge the motion on behalf of the Royal College of Speech and Language Therapists. In partnership with Capability Scotland and the augmentative communication in practice group, the RCSLT has been leading a campaign called give us our right to communicate. I am grateful to the 43 MSPs who supported the motion.
There are an estimated 2,500 potential AAC users in Scotland. They range from pre-school children to elderly people, and they suffer from a wide variety of conditions, such as learning difficulties, cerebral palsy, autism, multiple sclerosis, motor neurone disease, Parkinson's disease, stroke, Alzheimer's disease or head injury or are post-laryngectomy because of head or neck cancers. For all those people, AAC can make a huge difference to their quality of life, and allow them to express themselves, to have more control over their lives and to take part in activities at school and in their communities.
For AAC to work effectively, its users need two things—appropriate communication aids, and specialist and on-going speech and language therapy. The communication aids must match the user's communication support needs, which can change over time—for instance, as a child grows up or as a degenerative condition such as motor neurone disease gets worse.
With a limited number of potential users, the cost of equipment is not massive in public sector terms. Low-technology aids such as picture boards cost only the time that the therapist spends designing and making them, and the high-technology talking aids cost from £100 up to around £6,000 for the one that I have here, plus the on-going cost of insurance and maintenance.
On top of that, specialist speech and language therapists are required to assess communication needs, to identify the best aid for the individual, to design and produce simple aids, and to programme the high-tech aids with the language that the user needs to cope with education, work and social situations. Of course, users and the carers, teachers, employers and others who are involved in their lives need support to get the most benefit out of the equipment.
Unfortunately, at present, only around one person in six who could benefit from alternative and augmentative communication aids can access specialist AAC services in Scotland. Even when an aid is provided, there is often an unacceptably long wait between assessment and provision. Health boards throughout Scotland have recently had their AAC services rated according to funding procedures; budgets to loan, purchase, insure and maintain communication aids; the availability of dedicated local speech and language therapy; and contracts with specialist AAC centres. Eight out of the 15 health boards—including NHS Tayside and NHS Grampian, the two in my region—have been found wanting and are rated as poor. In such areas, people can wait months or years for assessment and the aid and support that they require. In other areas, there is no wait at all between assessment and provision. Once again, Scotland has a postcode lottery of provision.
Services for children tend to be better than those for adults, but provision can fall short when the children move on from school and lose funding from the education budget. Funding tends to be erratic: sometimes it comes from the education authority, sometimes from the national health service and sometimes from a combination of both. Budgets are small, and money for the purchase of new aids often comes from ad hoc, competitive streams such as end-of-year money at the end of the financial year, so a patient is more likely to get their aid if their need is identified in January rather than September. Provision also varies according to disability and advocacy, with charities and a diverse range of statutory providers giving different degrees of support, hence the campaign to develop and implement a Scotland-wide AAC strategy to achieve a national standard of specialist provision.
The right to communicate is an equal opportunities issue; it is a recognised human right. That point has been stressed vehemently by the Commissioner for Children and Young People in Scotland, Kathleen Marshall, who has been highly supportive of the efforts that are being made to improve AAC provision throughout Scotland.
I am hopeful that the campaign will bear fruit, because the Scottish National Party Government has accepted the recommendation of the disability working group—which the previous Executive set up—that there is a need for adequate support and equipment to access education. That is backed up by the tenor of some of the comments in "Better Health, Better Care". Also, following a recent report by the Scottish Executive social research unit on communication support needs and its recommendations for further research into the problems that people with such needs, including AAC users, face, the Government said that it hoped to respond this spring with plans to address the issues that have been raised.
I hope that the debate has come at an opportune time. The campaigners, including a young AAC user from Dumfries and Galloway, are looking forward to their meeting with the minister to discuss AAC provision next week. I congratulate all the people who have worked hard to raise the profile of AAC, which is highly important for a small but significant number of our fellow citizens. I look forward to the minister's response, which I hope will be sympathetic.
I congratulate Nanette Milne on securing the debate.
How awful it must be for someone to know that they could communicate with others but that the means to do so is not available to them. Some people use AAC, as Nanette Milne has explained, to communicate; others use it to help them understand what is being said. A few weeks ago, I had a members' business debate about the lack of proper wheelchair provision. Having read up on the subject for this debate, I feel as if I have been flipped back a couple of months, as I am finding the same sorts of problem. We have the knowledge, and we could provide what is necessary, but we do not. Why not? As with the debate on wheelchair users, it seems that the louder people shout and harass, the better chance they have of success. The give us our right to communicate campaign states:
"Communication … allows us to interact socially, to learn, to develop, to have control in our own lives and to express our needs, hopes and fears for the future."
As Nanette Milne has said, AAC is used by many people, including people who were born with learning difficulties and older people who have had a stroke or brain injury. Some people need to use it for a short time; others need it for all of their lives. Why should that provision be a postcode, age, advocacy or impairment lottery? Why are eight out of 15 health boards classed as poor in their provision? Is it because the AAC budget line is easy to cut?
Financial considerations should not be the key issue. Providing the right equipment and adaptations needs to be viewed in the context of social justice and social inclusion. The equipment can have a significant impact on people's lives and on those of their carers. The right equipment can mean the possibility of employment, education, and social and recreational opportunities. The provision of equipment and adaptations addresses inequality issues. Equality of opportunity means that everyone should have the possibility to increase their potential and to have more control over their lives. To have those opportunities, people need to be able to communicate.
What of the process that is required to access communication devices? I know from the experience of constituents that it can be difficult, but it should be easy: people should be able to get local information, advice and support. There should be a joined-up approach: a single assessment, the provision of quality products—I referred to that in the wheelchair debate—and an holistic approach to the person, their environment, their care needs and their carers' needs.
The European convention on human rights covers fundamental rights, including the prohibition of degrading treatment. As I said, we have the knowledge, but we are not providing the equipment that is needed. That is degrading treatment that stops young people and older people from communicating with the people around them.
Corseford school is in my constituency, and I visited it earlier this year. I sat in a class where the pupils were making up satchels to send to Africa. They were putting in pencils, pens and notepaper. They were delighted to tell me, through their AAC systems, that they were sending them to kids in schools in Africa who did not have the same opportunities that they did. Some children used the devices like Nanette Milne did, with their hands and fingers; others used them with the side of their head. The pupils were absolutely delighted that they were able to send the satchels to Africa, because they knew that the children there were not getting the same opportunities for social interaction and education that they were getting as a result of being able to communicate.
I will finish by quoting from a letter that I received from Steven Sweeney, who is a constituent of mine:
"I have a DynaVox. If people don't understand my gestures then it helps me to communicate with them. I can join in with assemblies and plays. I was the ‘sound guy' for our school musical, ‘Beauty and the Beast'. I can use it for environmental control so I can open doors and special windows and work my DVD player and TV. The most important thing is that I can speak. All people who need this help should get it, I think."
I think so too, Steven. I hope that the eight health boards that were rated as poor in their provision of communication systems—they include Greater Glasgow and Clyde NHS Board—are listening, and that they think so, too. The ball is in their court, and in the minister's.
I add my congratulations to Nanette Milne not only on securing the debate but on her thought-provoking opening speech.
I am pleased that the health board that covers most of my constituency—Ayrshire and Arran NHS Board—is rated as very good. I hope that many lessons can be learned from its work.
The augmentative and alternative communication resource provides an area-wide service to the communication-impaired population of Ayrshire and Arran who require to be assessed for and use high-tech methods of augmentative or alternative communication. The resource is staffed by only 0.5 of a whole-time equivalent speech and language therapist. That individual—or half an individual—is responsible for leading that specialist service throughout the entire health board area. Nevertheless, training is provided and there is support for clients, carers, speech and language therapists, and others in all aspects of AAC systems.
Interestingly, AAC devices are not always expensive. The cost ranges from around £100 to, in some cases, in excess of £6,000. For a relatively limited amount, a significant number of people can be helped. As we have heard, only about 2,500 people in Scotland really require AAC devices.
In the past year, there have been 41 loans of AAC equipment to people in Ayrshire and Arran. The equipment has been provided to people ranging from pre-school children to the elderly, and whose diagnoses include, among many others, cancer, learning difficulties, head injuries and cerebral palsy. The service maintains a large bank of AAC equipment that is provided on loan to individuals during the assessment period. As a result, there is little waiting time for adults or children. Over the years, a catalogue of frequently used equipment has been built up.
Once an appropriate voice output device has been identified for an individual, the equipment is provided on a long-term loan basis. NHS Ayrshire and Arran is responsible for the maintenance costs for the equipment, which is carefully tracked and well maintained.
There is an opportunity for other health boards to learn from the health boards that are doing well. Best practice is extremely important. I hope that Ayrshire and Arran NHS Board will be one of the boards from which others learn.
Of course, that does not mean that everything in the garden is rosy in Ayrshire and Arran. At present, the budget for AAC systems in the area is small and, as we know, there are always competing priorities. Much of the budget is taken up with renewing warranties for devices and paying for repairs. Additions to the loan bank are often made by making one-off requests for equipment to a range of committees and bidding for money at the end of the financial year.
Accommodation for delivering the service is also an issue. Currently, the AAC resource is in an area of Ayrshire Central hospital in which it is not suitable to see clients. We have already heard that some people would have liked to come to the debate but were unable to do so. The situation is the same for people who try to get assessed. In Ayrshire Central hospital, the AAC resource is on the first floor, with no lift access. The area is cramped and there is no room in which to meet clients, even if they could get to the office. That is unacceptable, given the needs of many people who use the service.
Given that my assistant James Stewart suffers from severe stammering, I should mention that for people who suffer from stammering, which is another communication problem, there is a piece of technology called SpeechEasy, which is expensive. James has looked into it and advises me that the technology is available only in private clinics and costs up to £5,000. That would not help him, but it would help a number of other people who have severe stammering problems. We need to allow people who suffer from stammering to communicate more, fluently and with confidence, so that they can play their full role in society.
I thank Nanette Milne for her excellent introduction and for securing this important debate.
I, too, congratulate Nanette Milne on securing the debate and on the innovative way in which she commenced the debate, which was a first in the Parliament and which brought home to us all just how important the issue is. As politicians, we are so used to being able to say our piece and have people hear us—regardless of whether they take account of everything that we say—that it takes something such as what Nanette Milne did to bring home just how important the subject is and how important it is to harness the use of technology to give people who would otherwise have no voice a way of expressing themselves and communicating.
Nanette Milne told us about the recent survey carried out by the Royal College of Speech and Language Therapists. The survey shows the disparity in service provision across Scotland, which was mentioned by Kenny Gibson and Trish Godman.
It is good news that some health boards have an overall rating that is perhaps good, but it is clearly a cause for concern that a number of health boards provide a disappointing level of service. NHS Ayrshire and Arran, in my own area, came out of the survey with one of the most positive overall ratings. However, although I welcome the very good practice that Kenny Gibson highlighted, even in that health board area there is still evidence of a disparity in the services available to people across Ayrshire. For example, the education contract with the communication aids for language and learning centre is available only in East Ayrshire. I will pursue that issue with the health board, as I am sure will other members.
The Royal College of Speech and Language Therapists, Capability Scotland and augmentative communication in practice are campaigning on two key areas for action. First, they want a national strategy that is based on need and minimum standards of service. They also want to ensure that the strategy covers closer co-ordination of health services with local education authorities and social work services and any other partners that need to be involved to deliver the high standards of service that everyone needs. Secondly, they want increased provision of specialist speech and language therapy equipment. We have heard about how important that aim is in ending the postcode lottery of access to specialist communications equipment. I am sure that we will hear more about that.
I cannot put the case any more eloquently than a young constituent of mine did. Daniel Montgomery, from Coylton in South Ayrshire, wrote to me when the motion was lodged. He told me, in his own words, what his communication aid meant to him and the difference that it made at school. I promised Daniel that I would read out his letter when the motion was debated. He states:
"I've had my Dynavox for 4 years and it really helps me speak to people. I use it in class for all my subjects and for chatting around school. I've also done presentations to important visitors. I enjoy telling my news and showing people my photos and playing the MP3 player. I really like Take That!
I love having my Dynavox and have had lots of practice with my Speech Therapist to learn to use it for all these things. I think people who need them should get them—they're cool."
I might not agree with him about Take That, and I am not sure that I would use the phrase "they're cool", but that is how Daniel sees his aid. It has been very important to him, to the other young people with whom he communicates and to the adults who work with him. I hope that today we will get a positive response from the minister as we take the matter forward.
This is a timely debate and I join other members in congratulating Nanette Milne on securing it. With her medical background she is well placed to put the case for the various groups of people with such communication difficulties. I have no such expertise but, like other members, I have had the opportunity over the years, as a member of the Scottish Parliament and previously, to meet individuals and families with such problems in their schools or homes.
Such a problem does not usually come alone; it is often one of a number of difficulties, disabilities or challenges. Like others, I can imagine few things more frustrating than being unable to communicate with other people, including our parents and carers, peer group and the miscellany of people whom we meet daily and with whom we normally take communication for granted. That is the central point. As Trish Godman said, we should view the issue not from a medical perspective but from a social perspective. People with communication difficulties need to be put, as far as possible, in the same position as the rest of us so that they can be facilitated, in this age of marvellous modern communications—devices such as the one that Nanette Milne demonstrated are marvellous modern forms of communication—to live lives that are as normal as possible and as full of opportunity as they can be.
The picture revealed in the survey is tragic. Indeed, it is a tragedy that is multiplied by 2,100, given the estimated 2,100 individuals who were not accessing specialist AAC services in Scotland when the 2004 survey was conducted. Whatever the reasons, explanations, policies, strategies or financial pressures, the situation is not satisfactory and I hope that when the minister replies she can be specific about what can be done.
In the two areas in which I have a constituency interest, Greater Glasgow and Lanarkshire, it is disturbing that, as Trish Godman said, the health boards are marked as being poor. The Royal College of Speech and Language Therapists tells me that the main problem is funding for communication aids and support in using the aids. In addition, however, there is no pan-Glasgow specific AAC or specialist speech and language therapy service.
Talking aids can be expensive, as we heard earlier. However, when we are told that some children have their aid equipment removed when they go home at night or when they leave school and become someone else's responsibility, we can be pretty sure that the challenges are organisational and systemic as well as financial. Transition points are always an issue—I know that from my previous experience in the Education Department—and there is often a significant disjunction when the young people about whom we are talking leave school, in terms of the support that they get.
A situation has been brought to light that is not tolerable in modern Scotland, and I hope that the survey and today's debate can act as a wake-up call for all of us with any influence in these areas.
I congratulate Nanette Milne on securing the debate and on finding a graphic way of highlighting the function of communication aids.
In the first session of the Scottish Parliament, we passed the Adults with Incapacity (Scotland) Act 2000, which was a landmark bill. It was heralded in Europe—although not in Scotland, because, at the time, there was a huge debate about irrelevant issues—as a massive advance. Debates on the bill concentrated quite considerably on the question of communication, and dealt with the fact that people who cannot communicate are often perceived as being unintelligent or unable to formulate thoughts. That is simply not the case. The problem of stigma has not been referred to much in today's debate, but there is a need for a campaign—like those that are designed to deal with stigma in other areas—that helps people to understand that people who use communication aids are often very intelligent and are perfectly able to communicate, if they are given the tools to do so.
The question of price really should not enter the issue. Others have talked about that issue, so I will not go into it. We hear about the postcode lottery in relation to many services—the best service is good, and the worst service is poor, and whether someone gets the service that they need depends on where they live. Undoubtedly, that needs to be addressed. Trish Godman was right when she said that, in this debate, one gets a sense of déjà vu, as the wheelchair debate dealt with a similar situation.
Over the years, I—like, I am sure, Nanette Milne—had considerable experience of patients with communication difficulties. The difference that the application of technology made over the 40-odd years that I was in practice is absolutely enormous. Forty years ago, it could not be said that we had the means to help people communicate. Now that we have the means, we must have the will to deliver aid to everybody who needs that help. If we do not, we will allow children to grow up without the ability to meet their aspirations because of a lack of relatively inexpensive equipment, because of a lack of training on the equipment, or because they have the wrong equipment. We need a skilled and specialised service if we are to ensure that the right equipment is delivered and the proper training is provided.
We have another good news story in Scotland. Our 30-day-and-beyond stroke survival rate has increased substantially, and will continue to increase due to the specialist stroke and rehabilitation services that we have put in place. However, people who have suffered from a stroke are in a situation in which their ability to manipulate their environment and communicate can be affected. That loss of control and independence can have a devastating psychological effect. If that devastation can be prevented by the provision of a piece of appropriate equipment, we owe it to those individuals to ensure that they have access to such equipment at the appropriate time.
The challenge to the Government is to update the survey of need; establish standards in order to eliminate the postcode lottery; provide entitlement to a maximum waiting time, because people in these circumstances cannot and should not be made to wait; and provide funding for the service that will end the charitable lottery on which people in some areas are forced to depend, as well as the lottery that arises as a result of the fact that some conditions are eligible for charitable support and some are not. We need a clear strategy and additional funding in order to solve the problem.
I apologise for having to leave before the minister sums up; I will read the Official Report. I congratulate my colleague Nanette Milne on securing the debate and on her interest over many years in the issue. Her use of the DynaVox was moving and was probably the best way to hit home on what we are talking about.
As Cathy Jamieson said, there is no doubt that we all take for granted the ability to speak. A document that the Royal College of Speech and Language Therapists provided contained touching quotations from AAC system users. A young child who had been given the ability to engage with classmates said:
"I can take part in school activities and discussions".
How simple is that? A 46-year-old said:
"My communication aid gives me a voice."
Those statements are simple, but they hit home.
It is unfortunate that such comments can come from only 16 per cent of potential AAC system users. As Nanette Milne and others said, we have a postcode lottery. The briefing paper surveys current service provision. The overall rating of NHS Highland's service is good. It has a funding procedure in place and a defined budget for AAC services. That is wonderful. However, the service in the neighbouring Western Isles has an overall rating of poor—that area has no funding procedure in place and no defined budget for AAC services. Constituents who live in those areas receive a vastly different service and experience a different quality of life as a result.
As Nanette Milne said, an AAC strategy for Scotland would be a positive way forward to ensure consistency and to set minimum standards for the service. The strategy could cover pooling of budgets from local authority education and social work departments and health services. That would not only maximise resources and streamline delivery but prevent potential users from being denied an AAC system because, for example, as they are close to the school-leaving age, the education budget will not give them funding.
Mobility issues can entitle people to a wheelchair, as Trish Godman said, or to a walking stick, but people have no such entitlement to assistance for communication problems. As Richard Simpson said, it is tragic that although we have the technology to aid communication, as we have seen, only 16 per cent of those who could benefit do so.
We must move away from the current situation in which the AAC provision that a person receives is determined by the health board area in which they live or by other factors, such as their age, their medical problem or their ability to pay, which Kenny Gibson mentioned. In some areas, users must fund their communication aids, whereas other users choose to do that because of the time that statutory agencies take to make decisions. That situation must not continue.
I hope that Nanette Milne's voice will be listened to and I commend her for raising the issue in the Parliament and for all her hard work to ensure that people without a voice are heard.
I, too, congratulate Nanette Milne on securing the debate and on her groundbreaking use of a communication aid in the chamber. Not all communication aids are as high-tech as the DynaVox. Widespread use is made of picture boards, for example. I am still undecided about whether it might be preferable for some of our colleagues—present company excepted, of course—to use such aids to enliven and augment their speeches. Broadcasting and official report staff might also appreciate such innovations more often.
Today, I was delighted to join other MSPs in meeting pupils from Crossford primary school, some of whom are lucky enough to use such special communication aids. As Nanette Milne said, the pupils were also joined by Scotland's Commissioner for Children and Young People, Kathleen Marshall, who is a powerful advocate of fair services for children. She talked enthusiastically about the right of every child to have a voice—their own voice.
As a member of the Equal Opportunities Committee, I believe that everyone should have the opportunity to lead as full a life as possible. However, that means different things to different people. The promotion of equal opportunities is a founding principle of our Parliament, and we are rightly proud of the progress that has been made across all the equality strands in Scotland. However, we should consider the statistics that have been provided by the Royal College of Speech and Language Therapists. It seems to me from those figures that equality of opportunities must seem an empty-sounding concept. None of us can accept that meeting the needs of only 16 per cent of people is remotely adequate. I am therefore pleased to join the cross-party call for a framework and a national standard of specialist speech and language therapy provision. Wherever people live in Scotland, they need to have access to adequate, properly funded and timely provision.
I welcome the minister's intention to meet the campaign group, but I also urge that action be taken Scotland-wide to end the postcode lottery of services. Services should not depend merely on where a person happens to live or on how old they are. Young people are assessed at school and, under the Education (Additional Support for Learning) (Scotland) Act 2004, they ought to have a co-ordinated support plan that includes provision for communication. That plan should be in place for pupils in schools, but I worry that, with the national priorities action fund being rolled up in the general settlement, there will be no specific money for additional support for learning. I hope that the minister will address that point in summing up.
I remember being delighted as a support for learning teacher by the input of a speech and language therapist who was engaged for a pupil with particular communication difficulties. The therapist made a wonderful difference not only for that pupil but for the whole peer group that was included in the group work. Indeed, the therapist's input was motivational for teachers and classroom assistants alike.
We need to renew the focus on basic skills for all children, including communication, in order to provide the building-blocks to assist every child to get the best start in their education. I am pleased that the Labour Party's consultation on children regards that as a key principle.
It is probable that all of us have direct knowledge of older people who have had communication difficulties following a stroke or because of a debilitating disease. Their needs must also be met and not dismissed on the ground of age.
We should not rely solely on charitable funding, welcome though it is. Groups such as the Parkinson's Disease Society provide huge support for sufferers and their carers, but we are planning for a great change in the demographics of Scotland. That is another aspect that must be addressed, and I look forward to what the minister says about that.
People have the right to communicate and the right to a voice—their own voice—wherever they live and whatever their age. Members must join together to ensure that we are strong advocates of their cause.
I am minded to accept a motion without notice to extend the debate for 10 minutes in order to complete our business.
Motion moved,
That, under Rule 8.14.3, the debate be extended until 5.53pm.—[Nanette Milne.]
Motion agreed to.
I congratulate Nanette Milne on securing the debate and on her campaigning work on alternative and augmentative communication over a period of years. I also congratulate and welcome to the gallery members of the alternative and augmentative communication campaign. I commend their central demand for a strategy that is based on need; that sets out minimum standards of service; that delivers better-quality and equitable provision throughout Scotland; and that leads to the co-ordination or pooling of local education, social work and health budgets. I was pleased to see from the survey that was carried out that Lothian NHS Board—which is the board that covers my area—is doing better than some other boards in that regard. However, it is clear that we cannot regard as satisfactory a situation in which eight NHS boards are judged to provide poor services.
Of course, as the suggestion to pool resources indicates, alternative and augmentative communication is not just a health matter. It affects a wide range of services, including education, social care, justice and other services.
I was pleased to commission research on communication support needs in 2006 when I was the Minister for Communities. The first part of that research, entitled "Communication Support Needs: A Review of the Literature", was published in 2007. The research found, among other things, that people with communication support needs are more likely to experience negative social interactions in education, health care, criminal justice and other services. It also found that people with communication support needs have difficulty in accessing the information that is required to utilise services. A key recommendation was that there should be further research, central to which was the recommendation that research should be carried out that engaged directly with people with communication support needs. That was the most important of several recommendations that the report made.
In January, I asked a parliamentary question about the report. I was told:
"The Scottish Government very much welcomes the findings of the research report … The review concluded with recommendations for three further research studies and we are considering the options carefully. We hope to respond in the spring with our plans for addressing the issues raised."—[Official Report, Written Answers, 31 January 2008; S3W-8595.]
As we can all see the sun shining into the chamber, we know that spring has now passed. I therefore look forward to the minister's response.
I thank Nanette Milne for securing this important debate and for making a strong point at the start of her speech. I also thank her for giving me the opportunity to comment on the concerns of service users and alternative and augmentative communication professionals about the current provision of AAC services, which impinge on social and education services as well as health services.
I am grateful for being allowed access to the findings of the survey that was undertaken by the Royal College of Speech and Language Therapists, Capability Scotland and augmentative communication in practice. I welcome the speech and language therapists who are in the public gallery tonight. The survey indicates good practice in Lothian, Fife, Highland and Ayrshire and Arran, as Kenny Gibson noted. I would welcome other NHS boards reaching similar levels of good practice in collaboration with local authorities. It is for NHS boards, working together with local authority services, to ensure that alternative and augmentative communication aids are available that best meet the needs of their local communities. That also requires appropriately trained staff who are able to provide the service to all those who need that level of support.
The Scottish Government is committed to equality of opportunity for all, and our work on disability equality is inclusive of all conditions and impairments. We are currently funding the communication forum Scotland to deliver a project that aims to improve and support civic participation among people with communication support needs in Scotland. A key product of the project is a toolkit that provides practical advice, guidance and resources to policy makers at all levels of government and across all public and other sector agencies, supporting effective engagement with people with communication support needs in Scotland. The toolkit was formally launched yesterday at a communication forum Scotland event, "Talk for Scotland", and was centrally funded from the £60,000 that was given by the Government to the civic partnership network.
Although I acknowledge that there may be room for improvement, I will outline some examples of the good work that is currently being delivered in NHS Scotland. NHS Scotland provides a range of AAC services, including the communication aids for language and learning centre, which is known as the CALL centre. The CALL centre is a national service that was set up for children and which is funded centrally by the education and training branch of the Scottish Government. NHS Scotland also provides the Scottish centre of technology for the communication impaired, which is based in the Southern general hospital in Glasgow and works to an outreach model.
With the exception of NHS Fife, NHS Lothian, NHS Orkney and NHS Shetland, NHS boards contribute to the Glasgow centre and the boards contract into the services that are provided from Glasgow. NHS Orkney and NHS Shetland have contracts for children with the CALL centre. NHS Lothian and NHS Fife both have successful integrated models of service delivery in place. NHS Lothian has a service for all ages that is jointly funded by health, education and social care services. It provides joint assessment and the loan of communication aids to service users, sourcing equipment for permanent use when required. The Fife assessment centre for communication through technology has AAC policies for all schools in the area and the service is jointly funded by health, education and social care services. In Grampian, the city of Aberdeen has a service that supports pupils in schools, which is funded by the local authority's education department. That includes part-time speech therapy provision for children who require communication aids. In Ayrshire and Arran, speech therapy services are provided by NHS Scotland to cover AAC needs. There is a lot of good practice out there, but we need that good practice to be provided elsewhere.
I know that the Scottish Government no longer ring fences local authority funding, but what is its position on ring fencing health board funding? Given that this situation seems to be exactly the same as the one that we discussed a few weeks ago, in that money is not being made available, will the Government consider ring fencing money for AAC provision?
I will come to potential solutions in a moment.
In 2004, the previous Administration launched the sensory impairment action plan, which was targeted primarily at local authorities and contained recommendations on the community care needs of adults with a sensory impairment. The action plan was produced in consultation with voluntary organisations. Under the action plan, there has been joint working between voluntary organisations that represent those with a sensory impairment and the Scottish Government. I want that partnership working to continue, with the aim of further improving services to this client group.
In April last year, guidance was issued to Scottish local authorities to raise awareness of the services available and to provide for a more person-centred approach. Provision was made for the need to assess and meet any sensory impairment requirements, including any particular communication requirements. Communication training for front-line community care staff is included in the action plan, and training material has been developed and piloted.
The work of the sensory impairment action plan steering group will shortly come to an end, but members of the group and Scottish Government officials will continue to work together to help to deliver services to those who have a sensory impairment.
In "Better Health, Better Care", the Scottish Government committed itself to providing more responsive and better-quality care for people with disabilities, with a particular focus on improving access, communication and respect for individuals. Fair for all—disability has also published national guidance on improving access and removing the barriers that face people who access NHS services.
The Scottish Government supports the principle of independent living and wants to see action to deliver that. On that point, I can advise that we will shortly announce our plans to take that work forward. In doing so, we will of course work closely with disabled people and their representative organisations.
On where we go from here, I have a meeting next week—as Nanette Milne mentioned—with the Royal College of Speech and Language Therapists. In advance of that meeting, I will look at the DVD outlining the royal college's concerns, some of which are also contained in the briefing. At that meeting, I want to set out a course of action on how we can begin to address some of the shortcomings. In my discussions with the royal college, I intend to include many of the suggestions that have been made in the course of this evening's debate. I assure members that we will look at how we take forward the many important issues that have been raised this evening. I will be happy to give Parliament an update on progress in due course.
Meeting closed at 17:53.