Cerebral Palsy

– in the House of Commons at 11:10 pm on 12th January 1988.

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Motion made, and Question proposed, That this House do now adjourn.—[Mr. Lightbown.]

Photo of Tony Baldry Tony Baldry , Banbury 11:22 pm, 12th January 1988

I am sure that whenever a child is born a parent's deepest wish is, "Pray God they be healthy." Alas, through no one's fault, some children do not enjoy full health, and some suffer from cerebral palsy. At present, hundreds of children with grave impairment of their motor co-ordination are destined to remain bedridden or in wheelchairs, unable to sit, stand, walk or achieve even a modest measure of independence.

I started to learn about cerebral palsy only by parents coming to see me to tell me about their hopes for their children's future. Several families in my constituency have children afflicted with cerebral palsy. One extremely courageous mother has three children who are so afflicted.

They came to see me not to whinge but with a message of hope that their children could one day walk and live more independent lives because they had either been to or were going to the Peto Institute in Budapest. Some five families from north Oxfordslaire have been to Budapest. They wanted to make sure that I understood the potential of conductive education and the outstanding achievements that are being made at the Peto Institute.

Many hon. Members have had a far closer involvement than I in trying to ensure the maximum opportunities for children suffering from cerebral palsy. The right hon. Member for Stoke-on-Trent, South (Mr. Ashley) has always been tireless in his efforts on behalf of the disabled and has led an all-party parliamentary campaign to promote conductive education.

My hon. Friend the Member for Wyre Forest (M r. Coombs), before entering the House, was a Birmingham city councillor and was largely responsible for helping to set up the Foundation for Conductive Education in Birmingham. My right hon. and learned Friend the Chancellor of the Duchy of Lancaster and Minister of Trade and Industry visited the Peto Institute when he was Minister for Health. The Institute was similarly visited by my hon. and learned Friend the Minister of State, Foreign and Commonwealth Office on behalf of the Foreign Office, and in a personal capacity by Lady Howe, the wife of my right hon. and learned Friend the Secretary of State for Foreign and Commonwealth Affairs.

Many hon. Members have first-hand experience of helping to raise money for the Foundation for Conductive Education in Birmingham. They include the hon. Members for Walsall, South (Mr. George) and for Coventry, South-East (Mr. IN ellist) and the Parliamentary Under-Secretary of State for Trade and Industry, my hon. Friend the Member for Coventry, South-West (Mr. Butcher). I simply seek to add my voice because I have been so greatly impressed by the courage of those constituents of mine who have children afflicted with cerebral palsy, and impressed by the evidence of my own eyes of what has clearly been achieved in Budapest.

When, for example, little Richard Shakespeare was first brought to see me by his parents, I never in my wildest dreams believed that this little boy, who could barely raise his own head unaided, could within a matter of months stand on his own two feet. But the truth is that Richard Shakespeare can now stand on his own two feet with confidence and move his arms naturally, thanks to the training that he has received at the Peto. Institute. I know that there are many children like Richard who have improved beyond their parents' greatest hopes. Credit, in Richard's case, must go to Oxfordshire county council for being prepared to pay Richard's fees in Budapest and for helping with some of the travel costs.

As the House will know, conductive education has been developed in Hungary and is used there as the main basis for the early education of physically handicapped children. The emphasis of the movement is on establishing sufficient control for the individual child to take part in everyday life without the use of artificial aids. Children are allocated to one particular teacher known as the conductor, who takes them through the whole process of education as they grow older.

Conductive education is hard work; it is intensive, with children being taught from the time they wake up in the morning until they go to bed at night. This approach clearly has great success. I understand that the Hungarians estimate that it could help 70 per cent. of all children afflicted with cerebral palsy, across the whole spectrum of the disability range, to achieve self auto-function; in other words, to reach a position where they can live as independently as children of a similar age and can walk with confidence and be able to go to school.

This is a fantastic achievement. There is, of course, the evidence of the experience of those who have been to Budapest and the evidence of our own eyes as to what has been achieved out there. It is clearly good news that the Peto Institute is collaborating with the Foundation for Conductive Education which, as the House knows, is a national charity formed to establish the Hungarian system of conductive education in Britain and collaborating to set up an integrated programme to train conductors and to establish working conductive groups of children. The Peto Institute has undertaken to train British conductors to the same high standard as its own and will co-operate to ensure that conductive education is established and working properly here in Britain. We all have good cause to be grateful to the Peto Institute.

I also have little doubt that what has been achieved by mutual understanding has come about in large part because of the efforts and energy of the staff of the British embassy in Budapest and the Hungarian embassy in London. I understand that a British-Hungarian cultural exchange agreement is to be negotiated in the next few months. It is hoped that it will include a provision that will enable this invaluable co-operation to continue and to expand.

It is also extremely encouraging that the Government have provided a grant of £326,000 to enable Birmingham university to carry out a research evaluation of the Foundation for Conductive Education project over a five-year period. My hon. Friend the Under-Secretary of State for Health and Social Security and her colleagues in the Department of Health and Social Security and the Department of Education and Science, with the help that they have received from Ministers within the Foreign Office, are to be congratulated on the initiatives that they have taken so far. Clearly it is right and proper to ensure that conductive education is evaluated in this country before being more widely available. However, as yet there is no conductive education in this country to evaluate.

This project should not be a matter of five years of research, with us then standing back and seeing what has been learned and deciding what to do next. Such an approach could result in the loss of valuable time and momentum and, most important, could affect Britain's relationship with the Peto Institute, and I believe we are the only country with such a close involvement.

The international pressures on the Peto Institute are such that, if we are to maintain the closeness of our involvement, we must have clear commitment. Unless a strong reason appears to question the validity of conductive education, there should be a clear commitment on the part of the Government, in co-operation with others—individuals, charities and local authorities—to secure the future of the Birmingham centre within the next five years and to expand conductive education throughout Britain. That can be done by people from this country being trained in Budapest and, in turn, returning to train to the same high standard further conductors here. Then, by that cascade effect, conductive education could be available throughout the country.

Britain is at present the only country that is involved so closely with the Peto Institute. We thus have a wonderful opportunity to ensure that good conductive education may become established here. It would be a tragedy if we lost that opportunity and the momentum that has been established with the Peto Institute.

It is difficult for a fit person to imagine how frustrating it must be for a child to be confined to a wheelchair and to have difficulty moving about. While conductive education cannot help all children afflicted by cerebral palsy, it is clear that it can help many. It is difficult to calculate the costs of the special educational requirements of children who are confined to wheelchairs or who have severe difficulty in moving about. Those costs must, however, be far greater in the long term than any short-term costs involved in those children being given the benefit of conductive education here in Britain.

The Government have demonstrated their willingness to support conductive education. Let us make clear our determination to make conductive education available throughout Britain as soon as possible so that children like Richard Shakespeare may also get up and stand and walk on their own two feet. I ask for nothing more and nothing less than a commitment to make the introduction here of conductive education a firm policy objective.

Photo of Mrs Edwina Currie Mrs Edwina Currie , South Derbyshire 11:32 pm, 12th January 1988

I congratulate my hon. Friend the Member for Banbury (Mr. Baldry) on his success in the ballot and on raising the question of the valuable treatment known as conductive education which is being undertaken at the Peto Institute in Budapest.

As my hon. Friend pointed out, we have received a number of favourable reports about the Peto Institute from Members in all parts of the House. He referred to the visit made to the institute by the Chancellor of the Duchy of Lancaster in November 1984 when he was Minister for Health. I am also aware of the favourable comments made by the Minister of State, Foreign and Commonwealth Office, my hon. and learned Friend the Member for Putney (Mr. Mellor), when he visited the institute in the autumn of last year with Lady Howe, the wife of the Foreign Secretary. Other Members have also visited the Peto Institute or taken an interest in the development of conductive education in this country, and my hon. Friend the Member for Banbury referred in his speech to several of them.

We are aware that about 70 families with children now attend the Peto Institute and are currently living in Budapest. Of those, we think that about 40 are British, the rest coming from other countries. The total school roll is about 750 children and 250 adults. It is sometimes forgotten that much of the work of the institute is with adults who have motor impairment, perhaps as the result of an accident, and I am also interested in aspects of that work.

I am sure that my hon. Friend will join me in paying tribute to the tremendous efforts of Her Majesty's ambassador in Budapest, and his wife, Mr. and Mrs. Appleyard, in providing help and comfort to the United Kingdom families there. I understand in particular that Mrs. Appleyard has regular weekly lunches to enable the families to meet together, and I wish to put on record our appreciation to her for her efforts.

It has to be recognised that the extent to which it is possible to help United Kingdom nationals who voluntarily leave this country to seek treatment abroad is constrained by the statutes laid down by this House. Perhaps it will do no harm, and some good, if I remind families that, except in the most restricted and extreme circumstances, Ministers in this Department have no power to pay for treatment of this kind in most other countries. My colleagues in the Department of the Environment have no powers to pay for accommodation, nor do their own local authorities. My colleagues in the Department of Education and Science are similarly constrained.

According to a letter that was sent recently to the Oxfordshire local education authority by Mr. Sawtell from the Department of Education and Science, there may even be some difficulty if the local education authorities pay, since the definition of "school" under the current legislation seems to apply only to schools in this country. However, some local education authorities make such payments. I recognise that the local education authorities take their own legal advice and that some, such as Oxfordshire, have decided to proceed.

We are therefore doing a kindness by warning families that, if they choose to go to Hungary or, indeed, anywhere else, we have no power to assist them; nor do the Hungarian authorities have any obligation to remit fees, to find or pay for accommodation or transport, or anything else. Before families commit themselves to spending a year or more in another country with a very different culture and language, however kind people are to them while they are there, we hope that they will give careful thought to these points.

Some United Kingdom social security benefits may continue, if the beneficiary goes abroad specifically for medical treatment—for example, attendance allowance, mobility allowance and invalidity benefit. There should be no problem concerning child benefit in respect of any child attending the institute, provided that there is a responsible adult in the United Kingdom to whom the benefit can be paid. However, child benefit in respect of other children accompanying a disabled child to Budapest can only be paid for up to eight weeks.

Some parents have reported difficulty over renewing benefits while abroad, since more than one office must be contacted. To help to simplify matters, we have introduced some common rules and we shall do what we can to help them, but again we are somewhat constrained by the different statutes that cover the various benefits concerned.

I am very concerned about the appalling pressure on families in these circumstances and on the family members, including children, who have to stay behind. There have been divorces. The price that some people have to pay has been very high indeed. Nevertheless, I should like to put on record our thanks to the Peto Institute for the kindness that it has shown to the families and children concerned, and also our appreciation to the Hungarian authorities. We shall bear my hon. Friend's remarks in mind as we renegotiate regularly the various agreements that we have with the authorities in Hungary.

The technique of conductive education as practised at the Peto Institute is the main system of early education for physically handicapped children in Hungary, where it is regarded as a necessity that a child should be able to walk to school if he or she wishes to receive normal education with able-bodied children. No such rule exists here, and disabled children are readily integrated into normal schools, following the Warnock reforms earlier in the 1980s. The technique is quite intensive and can require a child to be resident in the institute.

The work goes on throughout working hours, so it is hardly surprising if some children show considerable improvement. The institute can be highly selective, and it is probably right that it should be selective. We do not . expect any one technique to be universally successful for all conditions. We have no reason to doubt its success rate, as claimed, of about 70 per cent. of children being able o attend normal schools after treatment, but there are quite a number of questions that we should wish to have answered relating to the techniques that are used at the Peto Institute.

For example, to what extent does the technique concentrate on certain aspects of disability — for example, motor development, or incontinence — at the expense of something that we would regard as important, which is all-round social development? What does the institute do about the more severely or multiple handicapped children? If there is no chance of a child ever walking again, or if the treatment fails, are children then regarded as ineducable — as, for example, Down's syndrome children were regarded in this country until quite recently?

What is the procedure? Is there an alternative procedure if the child has difficulty in communicating or understanding the commands of the conductor? What long-term follow-up arrangements are provided in the community? What happens if a child, for example, has a condition that is subject to a relapse, or if he has a degenerative problem? In other words, we need to know whether the effect is lasting.

We also need to know why the institute excludes epileptics. We need to know to what extent the high degree of concentrated service input at the institute contributes to the success of the type of education that is provided. We need to know what is the role of the parents. Other schemes—for example, the Philadelphia system — rely very heavily on parents and helpers. It may be that we should need to take on board messages and lessons from more than one scheme.

Given those two main concerns, there are many unanswered questions. We are concerned about families who feel obliged to go abroad. I feel very sympathetic to what my hon. Friend has said about doing the work here. Recently, with my hon. Friend the Member for Wyre Forest (Mr. Coombs), a junior Minister at the Department of Education and Science, I met some of the families concerned in the campaign to bring conductive education to this country. On behalf of both Departments I say that we do not wish to stand in the way of any techniques that would assist disabled people, including children with cerebral palsy, spina bifida or any condition that would benefit from improved techniques.

When the BBC television programmes were broadcast, therapists in this country, for example, in Preston, protested that the techniques were available here and were being used to benefit people. In that respect, therefore, it seemed wise to take the following approach. The Government have involved themselves in two studies. My hon. Friend has already referred to the Birmingham project. He is probably aware that I am acquainted with a large number of the people who are interested in that project. I am delighted to join him in the tribute he paid to my hon. Friend the Member for Wyre Forest (Mr. Coombs), who was my fellow councillor in Birmingham for a number of years, for his efforts to get something set up.

The research project arose out of the Anglo-Hungarian cultural agreement, which was signed in Budapest on 21 March 1986 under the auspices of the British Council, involving Birmingham university and the Teachers' Training and Education Institute for the Motor Disabled in Hungary. Because of the need to approach the development of conductive education in a systematic way, it was decided that the Government could best assist the four-year research project being undertaken by Birmingham university to train conductors in the Peto method of conductive education by funding the evaluation of the project.

As my hon. Friend has said, the Government therefore provided some £326,000 over five years for the evaluation. I understand that the first batch of 10 teachers selected for the research project either have gone or will shortly be going to Budapest for part of their training. We hope that some valuable information comes out of the study. I share my hon. Friend's view that if we get good news more quickly than five years, we should be able to act on it.

Apart from this, the DHSS and the DES have jointly funded a survey by the Spastics Society into the extent to which aspects of conductive education are being practised in the United Kingdom. Findings are expected to be available later this year.

I hope that the approach I have outlined shows what progress has been made in the past 12 months or so in the United Kingdom. We look forward with interest, enthusiasm and great sympathy to the results of the studies and to hearing more from families who have benefited from the work at Peto and perhaps from those who have not had the opportunity to benefit, despite having had their children assessed there. It is also helpful to know about the failures because that helps us better to understand the successes.

I am most grateful to my hon. Friend for raising this important issue and giving us a chance to put on record our policy as it stands at the moment.

Question put and agreed to.

Adjourned accordingly at eighteen minutes to Twelve o'clock.