I’ve written; deleted and rewritten this post as I know it’s likely going to raise a few eyebrows however today I wanted to open the discussion on public funded versus privately funded Speech & Language Therapists.

Whether your SLT is paid by the NHS; Local Authority; a Charity; schools directly or parents they are all equally qualified and will have attended a degree or masters accredited by the Royal College of Speech & Language Therapists (RCSLT) and as such are entitled to use the legally protected title “Speech & Language Therapist”.

Despite this what I have personally come across is the fact that all Speech & Language Therapists are equal however some are more equal than others.

Most SLTs begin their careers in the NHS where they cut their teeth working a variety of roles and gaining valuable experience and skills that can be transferred across caseloads and age groups for the rest of their careers.

The vast majority of SLTs continue working for public services for the entire careers whilst some choose to work independently either directly for schools / colleges as employees or set-up on their own and work wholly independently with families and schools / hospitals etc.

I find the key difference between public and private SLTs is the flexibility to work in a particular location; with a specific client group and in a way that some desperately cut down public services can’t.

I’ve worked independently for eleven years now and in a past life founded and grew the (then) UK’s largest independent Speech and Language Therapy team of 35 full-time employed SLTs – which dwarfed a lot of NHS SLT teams.

Over my time working independently I’ve learnt to grow a thick skin. When you meet someone and they ask you what you do and you say you’re a Speech Therapist quite often their eyes light up with interest. When the subsequent question “and who do you work for?” is asked I always take a big gulp so as to prepare for the look of disappointment and the subsequent underhand “oh you must love money…you must charge parents lots for something they can get for free” remarks when they find out I work privately.

As an independent SLT I have no sick pay; no holiday pay; I have to pay for a admin support / a PA; a bookkeeper and accountant to keep the business above board and I have to pay thousands a year for 3-4 types of insurance; therapy and assessment resources. Whilst I’m personally lucky to rarely have quiet periods I have zero guarantee whatsoever of my income and whether I’ll be paid for the work I do. Despite this I wouldn’t change it for the world!

On the flip side my public service colleagues receive a minimum of 28 days fully paid annual leave; sick leave; compassionate leave; should COVID-19 lead to 14 days of self isolation they’ll be paid in full; a training budget; an annual increment; a gold plated pension plan and a competitive salary.

We all make choices and I choose to work independently and with that I accept the pros and cons that come with it. Conversely others choose to work for the NHS / LA / etc and likewise accept the pros and cons.

The UK NEEDS the NHS and it’s SLT services. The NHS needs significantly more funding and, in my humble opinion, a root and branch change to how Speech & Language Therapy services are provided in paediatrics.

In my line of work, as a SLT working primarily in SEN Tribunals as an expert witness, I often have to call into question recommendations provided by NHS / LA SLTs and (following evidence based practise) present alternative recommendations and justify these in front of an expert panel.

I have no qualms with highlighting when any SLT has recommended solely what their service can provide as opposed to what a particular child NEEDS, and what evidence based practise recommends, however this is often portrayed as being anti-NHS. I’m most certainly not anti-NHS and have the upmost respect for my NHS colleagues. I will call out any SLT who I perceive as providing poor practise and I would expect the same should my clinical skills be brought into question.

The issue for me is the level of blind defensiveness I come across when questioning the practise of a publicly funded SLT (whereby you can be chastised for suggesting the status quo is inappropriate) and the degree of ‘Saviour Syndrome’ attached to and by some publicly funded SLTs solely down to who employs them.

Yes the NHS fundamentally needs protecting but believing that someone who is compensated healthily for this work is in some way a saint is ludicrous.

ALL Speech & Language Therapists are equal AND NONE are more equal than others.