Lord Hunt of Kings Heath
To ask Her Majesty’s Government whether they will introduce uniform standards and a national tariff payment in order to achieve high-quality outcomes for wheelchair users.
The Parliamentary Under-Secretary of State, Department of Health (Lord Prior of Brampton) (Con)
My Lords, NHS England is developing a national dataset to ensure transparency about the quality of services in order to drive improvement. NHS England and NHS Improvement are actively working with the sector to define the currencies and reference costs that will enable national tariffs to be set.
Lord Hunt of Kings Heath (Lab)
My Lords, the noble Lord will know that the wheelchair alliance, chaired by the noble Baroness, Lady Grey-Thompson, has shown that we have, essentially, a set of dysfunctional local wheelchair services with variations in access, standards and waiting times. The noble Lord has referred to a national specification but the reality is that, unless he can ensure that it is mandated at local level we will not get high-quality, consistent services. Will Ministers be prepared to meet the wheelchair alliance to discuss how we can get uniform, high-quality standards at local level?
Lord Prior of Brampton
The noble Lord is right: the variation in wheelchair standards around the country is wholly unacceptable. The truth is that we do not know the level of this variation because we have never collected the data before. The data are now collected and, of course, I can answer yes to his question. In fact, my honourable friend in the other place is making an announcement on 18 May, I think, about the support we are going to provide to local CCGs over wheelchair provision. I am sure that I can speak for him and say that he will be delighted to meet the wheelchair alliance.
Baroness Gardner of Parkes (Con)
My Lords, is the Minister aware of problems encountered with London buses? I declare an interest in that my daughter has used a wheelchair for many years, although just recently she has made a marvellous improvement after being given an electric impulse and has been able to walk for the first time for 30 years. Bus ramps have been broken by wheelchairs that are too heavy. She has done a lot of work to ensure that wheelchair manufacturers produce wheelchairs with a marked vehicle weight that will not damage buses. Therefore, there is a need for more uniformity in higher standards.
Lord Prior of Brampton
I totally agree with my noble friend that there is an absolute need for greater uniformity and standardisation. The level of variation around the country is wholly unacceptable.
Baroness Brinton (LD)
My Lords, the NHS guidance on the website to people seeking a powered wheelchair says:
“Each service will have a strict criteria of eligibility. Usually the NHS services do not provide powered wheelchairs … for outdoor use only”.
Some areas, including mine, say that this means you get one only if you need to use it inside your own house. This does not mean independent living. When will the criteria be changed to ensure that if a powered wheelchair is needed for work purposes it will be provided?
Lord Prior of Brampton
As the noble Baroness knows, the criteria are local at the moment. The point of collecting the data and developing a tariff, which takes into account assessment, the equipment and repair and maintenance, is to have local commissioning against the national standard.
Baroness Grey-Thompson (CB)
My Lords, I declare an interest as chair of the national Wheelchair Leadership Alliance. Does the Minister recognise that not getting this service right is increasing the burden on the NHS? The cost of fixing a pressure sore alone is about £150,000, whereas providing the right cushion costs £400, so by improving wheelchair services we can save the NHS money rather than costing it money.
Lord Prior of Brampton
The noble Baroness is absolutely right. Getting the wheelchairs fitted properly and making the right assessments can save the NHS a fortune. It is outrageous that we have not tackled this before. The tragedy of the NHS is that if you do not have a tariff or target, you do not get the money. We are developing a tariff. The charter developed last year by the wheelchair alliance is an outstanding document.
Lord Faulkner of Worcester (Lab)
My Lords, can the Minister indicate how much progress his honourable friend the Minister for Disabled People has made in persuading Britain’s sports governing bodies, particularly the football authorities, to make sure that all their stadia comply with the accessibility guidelines, which are of course of particular importance to wheelchair users? I declare an interest as a vice-president of the Level Playing Field charity.
Lord Prior of Brampton
My Lords, I am afraid that I cannot answer that question as I do not know the answer. If it is all right to do so, I will write to the noble Lord and place the answer in the Library.
Baroness Masham of Ilton (CB)
My Lords, I declare an interest as president of the Spinal Injuries Association. Is the Minister aware of the very complex needs of some people who break their necks, are completely paralysed and operate a wheelchair by pushing the back of their head or by their mouth? Will he assure the House that the specialist hospital units are able to advise CCGs on this issue?
Lord Prior of Brampton
The noble Baroness raises a very important point. I will do what I can to ensure that we retain that specialist knowledge that can be provided to local CCGs.