Pupils are being wrongly diagnosed with special needs (Image: PA)
Former health secretary Sir Jeremy Hunt has backed a new study that warns huge numbers of children are being wrongly diagnosed with mental illness or special needs when many are simply feeling sad or misbehaving. One in five school pupils is now classed as having special educational needs (SEND).
Half of all schools' spending since 2015 has gone on SEND, with costs hitting ￡11billion a year in 2024-25. More than ￡1.1billion will be spent on taxis alone for SEND students by 2030. Sir Jeremy said: “As a society, we seem to have lost sight of the fundamental reality that child development is a messy and uneven process.
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"Our laudable desire to ensure young people are happy and well-supported is at times manifesting in excessive impulses to medicalise and diagnose the routine, in a manner that can undercut grit and resilience."
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He made the comments in a foreword to a report published by think tank Policy Exchange, which warns that overdiagnosis has stretched the state to breaking point – and calls for radical reform of the SEND system, including reinventing Education, Health and Care (EHC) Plans which currently give children a legal entitlement to support.
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The Department for Education is set to announce changes to SEND in the autumn. This is likely to include making it harder to obtain an EHC plan, a prospect that has already sparked opposition from parents. Ministers insist that every child will still receive the help they need.
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The report’s authors – who include Jean-Andre Prager, senior adviser to three prime ministers on welfare and disabilities – conclude that the current SEND system and the policies that underpin it should be scrapped: the Children and Families Act 2014 and 2015 SEND Code of Practice should be repealed and replaced with a new statutory regime.
They say that over-diagnosis has contributed to overwhelmed systems in mental health, SEND and welfare designed to support children and young people.
“Concept creep” and public anxiety about supporting mental health in children has led to a “new normal”, where misbehaving, feeling sad or being a late bloomer is resulting in medical diagnoses, often with shaky or unreliable evidence, the report warns. In extreme cases, this has set more children on a medical pathway, with the number of boys receiving ADHD medication rising fourfold and girls ninefold between 2000 and 2018.
The SEND, child disability and mental health systems designed to support small numbers of acute cases among vulnerable young people have been overwhelmed, as families chase the support that a diagnosis can unlock. For example, Education, Health and Care Plans can give a child unlimited financial support for school travel, teaching assistants and specialist therapy.
Sir Jeremy said: “Mental ill-health and neurodiversity now accounts for more than half of the post-pandemic increase we have seen in claimants of disability benefit. Spending on SEND provision has skyrocketed and risks the financial sustainability of Local Government.
“Rather than assuming that more money or ‘more of the same’ is the answer, we need to ask more fundamental questions. Is a cash transfer – or a label that means young people are treated and come to see themselves as different – the right way to help them? What about the importance of good work, physical activity, social connection?”
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Mr Prager, senior fellow in welfare at Policy Exchange and co-author of the report, said: ”Our health and disability benefit system needs to be fundamentally reformed, and this includes not just working-age benefits but also how we support children.
"Child Disability Living Allowance is from a bygone era, and our understanding of disability has fundamentally changed in the intervening more than 30 years. We need to reconsider the assessment and eligibility criteria of this benefit and create a more robust process.
“We need to have a more open and honest debate about the incentives in our health, welfare and education system and consider first principled questions to make sure support is aligned correctly.”
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