(5 years, 1 month ago)
Commons ChamberI suppose I should probably have declared an interest in this issue, because I am severely asthmatic and I do not get free prescriptions, but then again I do not think I should. There is a prescription exemption system designed specifically to assist people who are most likely to need support in paying for prescriptions: people on low incomes or in full-time education; the over-60s; people living with many long-term conditions; and people with an increased risk of illness, such as pregnant women. That is why 89% of prescriptions are dispensed without charge.
Cancer survival rates are, thankfully, at a record high. Last year, the NHS carried out 53 million diagnostic tests, which is 53% higher than the number carried out in 2010, but we need to do more. Our aim is to diagnose three quarters of all cancers early, so that 55,000 more people each year survive cancer for another five years. To achieve that, we are radically overhauling screening programmes to improve access and uptake, investing £200 million in diagnostic equipment and accelerating the adoption of the most innovative cancer treatments.
(5 years, 2 months ago)
Commons ChamberLike Members on both sides of the House, my family and I rely on our national health service, and it has always been there when we needed it most. It was there when my two children were born in local hospitals, caring for them when they were at their most vulnerable and looking after my wife through complications and immediately after their births. Then, at the start of 2017, the NHS was there for me when I unexpectedly became ill very quickly and developed severe septic shock.
Sepsis is a nasty condition. It is fast, devastating and indiscriminate. It affects people irrespective of wealth, gender, or age. In my case, I came back to Parliament after the Christmas recess with a cold, an experience with which most Members will be familiar, and the cold developed into a sore throat. Within days, I was at Russells Hall Hospital A&E and then in intensive care. Within a few hours, I was in an induced coma, where I would remain for the next 11 days.
I received incredible treatment and care from our national health service, from doctors, from nurses, from ancillary staff, from every single member of team, and I will always owe them everything. I was also incredibly lucky. At one point when I was unconscious, the doctors had called in my parents to explain that I probably had about a 10% chance of waking up. Even with the incredible skills and dedication of the hospital staff, there was also a huge amount of luck involved in my pulling through.
Of course, not everyone is as lucky. Of the 250,000 cases of sepsis in the United Kingdom each year, at least 52,000 people lose their lives—a little more than are killed by breast cancer, bowel cancer and prostate cancer combined. It amounts to about 80 deaths in each of our constituencies. Indeed, 13 people somewhere in the United Kingdom have probably lost their lives to sepsis since the start of this debate. Each year tens of thousands more people suffer permanent and life-changing after effects that may leave them with permanent disabilities or health conditions.
A report presented to the European Society of Intensive Care Medicine last year found that sepsis mortality rates in Britain had not fallen as quickly as those in some other countries between 1985 and 2015, and there are many possible contributory factors. Some of it may be down to genuine differences in how sepsis is diagnosed and how causes of death recorded in the United Kingdom. On top of the roll-out of the second generation of the national early warning score system, I urge the Minister to consider a national registry to measure the extent of sepsis so that we can properly rate how effective we are in tackling the causes. Some of the differences may also be down to some clinicians being slow to follow the new systems and procedures. We have seen that in my local hospital, where I was treated so well, because CQC reports have made it clear that cultural resistance to change has been a problem, so we need better commissioning levers to incentivise best practice.
I am delighted to see measures in this Queen’s Speech that will we hope address one of the big causes of avoidable deaths: human error. The Health Service Safety Investigations Bill will help to discover the truth rather than to apportion blame. It will provide for the world’s first independent body that will investigate patient safety concerns to ensure that we do not have repeated mistakes that can cause further unnecessary deaths.
(5 years, 5 months ago)
Commons ChamberUrgent Questions are proposed each morning by backbench MPs, and up to two may be selected each day by the Speaker. Chosen Urgent Questions are announced 30 minutes before Parliament sits each day.
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We are determined to improve treatments for people living with rare diseases. As the hon. Gentleman pointed out, they have to be treated differently because fewer people are affected by them. We have the rare diseases strategy, and we are trying to use genomics better to diagnose and treat diseases. We are trying to be the first health service to put genomics into day-to-day health delivery, which will enable us to diagnose and treat diseases such as Batten more quickly. We have care co-ordinators for patients with rare diseases and we are trying to ensure that those who live to adulthood are cared for better, but what the hon. Gentleman said about having an international approach is valid.
The Minister rightly speaks about NICE’s important role in eliminating postcode lotteries. Does she agree that NICE’s independence is vital to ensuring availability to patients once an agreement is reached with BioMarin, wherever those patients are from, whether Penwortham in her constituency or Pensnett in mine?
(5 years, 7 months ago)
Commons ChamberI will certainly consider it and I look forward to talking to the hon. Gentleman about the idea more next week. Dialogue in this area is critical, but we should not only have dialogue; we also need concrete legislative action, but I am grateful for what he has said about the work that has been done. I am glad that he is also working in this area, and I look forward to discussing it with him more.
Three million of the four million videos taken down by YouTube in the last six months were identified and removed by artificial intelligence. What greater role does the Secretary of State see for technological development in helping to reduce online harm and keep people safe online?
Artificial intelligence clearly has a role in identifying material that needs to be removed in the same way that it is now being used to remove terrorist content. We are talking to companies that may be able to do this, but we also need to identify what material should be taken down and what should be left up. Defining that boundary is critical to training artificial intelligence to do its job, hence the importance of the decision to ask the Samaritans to do the work of identifying the boundary so that we can train artificial intelligence to identify what needs to be taken down.
(5 years, 9 months ago)
Commons ChamberI am proud to be a vice-chair of the all-party parliamentary group on autism and to have served as a governor at a special school in Dudley that had a particular focus on autism and Asperger’s. Ten years have passed since my right hon. Friend the Member for Chesham and Amersham (Dame Cheryl Gillan) steered the Autism Act 2009 through this House as a private member’s Bill, so it is a good time to reflect on not only all that has been achieved, but all that still needs to be done truly to deliver on the promises of that legislation to improve support and services for people with autism and their families.
In the time available to me, however, I will focus on issues that relate to children with autism. As the hon. Member for Liverpool, West Derby (Stephen Twigg) said, nearly five years after the Children and Families Act 2014 became law, progress on implementing the new SEND system is still patchy at best. According to the National Autism Society, 42% of families are being refused education health and care assessments when they are first requested and more than 70% are waiting longer than six months for support at school.
As of January 2018, there were 825 pupils in Dudley’s special schools. That compares with, according to the Department for Education, 119,910 pupils with autistic spectrum disorder in state-funded schools in England. Of those, more than 70% were being educated in mainstream schools, and that has huge implications for teachers and teacher training. That is why it is so important that, since 2016, the new teacher training framework has made supporting children with special educational needs, but particularly autistic children, a core part of the initial teacher training. That training and support needs to be stepped up, so that everybody can be confident that every teacher in every school up and down the country is competent and confident working with children with autism. If teachers do not currently have a child with autism in their class, they will at some point, probably very soon in their career.
The issues of working with, supporting and educating autistic children are very real. As my hon. Friend the Member for Bexhill and Battle (Huw Merriman) suggested, the behaviour of children with autism can be perceived incorrectly. Children on the autistic spectrum can often find themselves being chastised for not behaving in exactly the same way as other pupils. By not behaving in the way that teachers would expect, they can be punished in a way that may be appropriate for the class as a whole, but completely inappropriate given the special educational needs and medical condition of such children.
Government figures show that autistic pupils are four times more likely to be excluded from school compared with pupils who have no special educational needs. Clearly, there is an ongoing debate about the impact of exclusions, but there can be no doubt that the fact that autistic pupils are far more likely to be excluded has a severe impact on the life chances of children whose life chances are already impacted by their medical condition. That effect is most obvious in opportunities for future work and for training.
In many cases, the Government are making good progress on the target of getting a million more disabled people into work. However, the employment gap for people with autism is far wider. Just 16% of autistic adults are in full-time work, so it is essential that Jobcentre Plus staff and work coaches properly understand autism and that employers have the full range of support and advice they need to employ autistic people confidently.
I will conclude as I have done in similar debates by reflecting on the words of Natalie, who was one of the parent-governors at the school where I was a governor. Natalie said of her son Will, who attended that school:
“Autism is only a small fraction of our son. It is not everything he is. Will is so much more than the label society has given him. We want him to be accepted, and for him to be accepted equally as a citizen of this country as his peers are.”
That is what all parents want for their children. In this 10th anniversary year of the Autism Act, we have a responsibility to do all that we can to make that wish a reality.
(5 years, 11 months ago)
Commons ChamberThe hon. Gentleman will know that the draft withdrawal agreement hopefully sets us on a relationship with the EMA, but the UK’s strategy for rare diseases, which was published in 2013, sets out our commitment to improve the diagnosis and treatment of patients with rare diseases and to end the diagnostic odyssey that has been referred to throughout the past few years.
Autism and learning disabilities are clinical priorities in the NHS long-term plan. We are committed to improving the quality of care provided to people with a learning disability or autism and to addressing the persistent health inequalities they face.
I congratulate my hon. Friend on his active involvement in the all-party parliamentary groups on learning disability and on autism. Over the next three years, we will be testing and implementing the most effective ways to reduce waiting times for specialist services. We are developing guidance to support commissioners to develop the necessary services to support all autistic people, and we have launched a review of our autism strategy.
(6 years, 2 months ago)
Westminster HallWestminster Hall is an alternative Chamber for MPs to hold debates, named after the adjoining Westminster Hall.
Each debate is chaired by an MP from the Panel of Chairs, rather than the Speaker or Deputy Speaker. A Government Minister will give the final speech, and no votes may be called on the debate topic.
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It is a particular pleasure to serve under your chairmanship this evening, Dame Cheryl; we are debating an issue on which you have done much, not only to raise awareness, but to transform the legislative framework in which we operate. I thank the Petitions Committee for ensuring that time was made available for the debate, and congratulate the hon. Member for Cambridge (Daniel Zeichner) on his opening speech. I pay tribute to Oliver’s family in particular, and to the many other families who have done so much and worked so hard, exhausting reserves of energy and emotion that I am not sure many of us could have found, to ensure that some public benefit can come from their individual personal tragedies.
I have rather less direct personal experience of autism than many of the Members who will contribute today, but as a former governor at a special needs school that had a particular focus on autism I am familiar with many of the issues that Members have raised. As of last week I am a proud officer of the all-party parliamentary group on autism. I am fortunate to benefit from the fact that many constituents contact me to give me advice and tell me of their and their families’ experience in the healthcare system. I also benefit from the advice and experience of my former colleagues, the staff and governors at the school, and the National Autistic Society, which does much important work to push forward the agenda.
As has already been said, there are clear healthcare inequalities between people who have autism and the general population. That is clearly recognised by the Government. It was recognised in their mandate to NHS England and, of course, as one of four clinical priorities in the 10-year plan published last month. Those inequalities clearly have many causes. There are many co-factors more likely to affect people who have autism, such as issues to do with unemployment, mental health and poverty; but one of the most obvious ones, which is referred to in the petition, is the interaction between the national health service and healthcare professionals, and people with autism.
For many of us it can be hard to decipher what medical professionals tell us, particularly when we are very ill and perhaps not thinking as straight as we might. For people with learning disabilities and communication difficulties, the difficulty is on an entirely different scale. For many people with autism it is a question of heightened difficulty not only in understanding what they are being told, but also, of course, in communicating how they feel physically, emotionally and mentally. It is therefore essential that understanding of autism becomes part of the mandatory training for healthcare professionals, just as it is finally becoming a core part of initial teacher training.
Like other hon. Members, I am pleased to see that the new core skills education and training framework finally sets out proposals for a tiered approach and levels of training depending on levels of contact that can be expected for people with autism. There are half a million people in England—more than 1% of the population—who we already know have autism, so there can be barely any part of the healthcare system in which any worker is unlikely to have regular contact with patients with autism and their families. So it is a core part of their job and responsibilities to be able to respond, and to make necessary adaptations in the way they behave. That is a core part of being a healthcare professional.
There are throughout society people with varying skills, disabilities or learning difficulties, so do not we need to bring that right into medical and nursing school, and try to have a philosophy that counters what we see in society? That, frankly, is attacking the “other”. We have had so much of the politics of “other”, and attacking the “other” socially, and we need to try to get rid of that when people are at school and in medical and nursing school—not just when they have qualified.
There are two important and slightly distinct points there. For mainstream education it is vital that an understanding of autism and other learning disabilities is part of personal, social, health and economic education—I do not know whether we still call it that—for precisely the reasons that the hon. Lady describes. Of course, in medical or nursing school it is vital that there is a core level of understanding of the issues for autism and other learning disabilities and of the impact they have on how people need to do their job once they have qualified and are practising and in work. That needs to be embedded from day one, but just as importantly, it must be reinforced and built on with continuing professional development.
Although there is clear evidence of inequality in many health outcomes, there is little concrete evidence yet known about how the wellness of people with autism compares with that of the general population. I hope the new framework will explicitly cover primary and community health as well as acute healthcare. Primary and community health is where much of the early interaction with patients and the wider population takes place. It could not be more important that our GPs and community healthcare staff understand the particular issues faced by patients with autism and their families, and how they should respond to them.
However, I hope the framework will go slightly further than that. I am sure that you, Dame Cheryl, might have wished to raise this issue were you not chairing the debate: the need for a GP autism register, as recommended by the National Institute for Health and Care Excellence, with a relatively easy and simple code so that people’s progression through primary healthcare pathways and on to an acute healthcare or a mental health setting can be tracked and we can have a better understanding of the impact of autism and learning disability on wellness and the particular challenges and experiences of people with autism.
The hon. Gentleman touched on poverty earlier. The learning disability employment gap is over 90%; if we actually want to look at the wellness of people with learning or communication difficulties, we as a society must include them, rather than parking them on the side and wasting their talents.
The hon. Lady is right, and if I may give a quick plug, the all-party parliamentary group has done some important work with the National Autistic Society on precisely the issue of autism, employment and education. I understand it will be published shortly and I hope it provides a focus for a future debate.
Following on from that point, does the hon. Gentleman agree that people with autism and additional support needs have a huge contribution to make to our economy and society? As someone who has had a number of people on work experience, they have helped me to see the world in a different way. I am sure the hon. Gentleman will have seen “The Curious Incident of the Dog in the Night-Time”; when I went to see that in the west end, it was a turning point for me in understanding the world and a little window into how people with autism see it.
The hon. Lady is absolutely right. That enormous employment gap is a tragedy in terms of not only the lost opportunities for those people directly affected, but the wasted opportunities for the many employers who could be benefiting from the skills of people with autism and other learning disabilities, and for wider society, which is losing the contributions that they can make.
Finally, I will touch quickly on the issue of mental health. Autism is not a mental illness, but we know that people with autism are much more likely to be affected by many mental illnesses, particularly anxiety-related illnesses, than the general population. We need to ensure that the new framework is properly embedded across mental healthcare as well as physical healthcare, so that our mental health services can ensure that people with autism get the proper services they need. Far too often, people with autism find not only that their condition means their mental health problems are not properly diagnosed at an early stage, but that, if diagnosed, their condition can interfere with their receiving the appropriate treatment in a way that might be expected elsewhere.
We must ensure that autism is one of the four clinical priorities right across the healthcare system and that the training our healthcare professionals receive reflects that. Only then can we start to address the healthcare inequalities that we see in this country and, hopefully, try to ensure that there are fewer repeats of the terrible stories we have heard this afternoon.
Before I call the next speaker, I think that, without compromising the objectivity of the Chair, I should probably have put on record at the beginning of this sitting that I currently chair the all-party parliamentary group on autism, in case people have not gathered that by this stage. Secondly, I apologise for the temperature in this room, which is below what I would consider comfortable standards. We have made inquiries and unfortunately we cannot adjust the temperature unless the room is vacated and the engineers come in to look at the equipment. I apologise for that, but, unusually, if anybody wants to put on their coats, they are welcome to. I understand that some people are feeling very cold in this environment and I can only apologise.
(6 years, 8 months ago)
Commons ChamberThe hon. Lady is absolutely right. Not every council needs a child psychologist who is an expert in the identification of autism, but it would be great if there were one or two across the north-east, in my region, whom we knew we could always tap into. There have not been for years. The situation is getting better, but it is not good enough. We need to think more intelligently about how we provide that resource for families.
I want to talk in more detail about interventions. It is so exciting that the teacher training module will come into the system from September. Before I talk about that, I want to read from a letter sent to me by one of my constituents, a lady called Skye. I have not met her; I have knocked on her door, but there has never been anyone in. She wrote to me about her son, who is four years old and has complex needs. He attends our special school in Berwick. She says:
“Every day so many simple things in life that we all take for granted become a moment of stress, worry and concern”.
She says that could give a vast list of examples of the stresses her child undergoes every day. My heart goes out to her; I was there some 15 years ago, too. She highlights one particular issue:
“Shopping trolleys with child seats are designed for toddlers. My little/big man squeezes into this trolley with pain and distress. I have to lift him above my head because I am only a 5ft mummy.”
Those are the sort of practical things that day-to-day life can throw at mums who are having to deal with this. She goes on to say that
“many younger autism sufferers…have no boundaries, no understanding of the consequence of their actions, and if they have a crisis moment could injure themselves”
by falling out of the trolley or running away. I lost James once in a supermarket, and it was possibly the worst half-hour of my life. She says:
“Being confined to a safe space (trolley seat) is safer for them. It provides an object reference”,
as well as security, as a pram does for a much smaller child. That is a really interesting challenge to us, to think about how we might encourage the tools that can help a family in those public spaces where we go every week.
I almost never took James shopping until recently, as part of our plastics challenge, which I am sure the Minister will join us in. We went shopping and I said, “I’m not buying plastics.” He wanted a particular cheese that only came wrapped in plastic, so he had to buy it himself. There is a lesson for an 18-year-old boy who has never been shopping before: he gets taken shopping, and his mother then makes him do his own shopping.
The reality is that the tools to help people get over the crisis points are vital. I really hope that as the autism module rolls out, teachers are given those tools. James had an amazing teacher when he was six years old. He was not diagnosed, but she could see his meltdowns coming. She told me to bring a beanbag into school, which she put behind her desk. She said to James that whenever it all got too much for him—which was quite often, when somebody was prodding him, he was sitting in the wrong place or he could not see or hear—he was allowed to get up and leave his desk or wherever he was and go and sit in the beanbag behind the desk. The teacher knew where he was, because that is where he always went. The other children did not know or care; they carried on with their school activities. It gave him a safe place that was invisible to everybody else, but they knew he was safe, and then the moment passed.
This is a child who got three A-levels last year and is going to Newcastle to read zoology in September, but when he was seven or eight years old and undiagnosed, nobody thought he would be mainstreamed. He was mainstreamed because teachers thought about how they might give him the tools to get around those moments. We need the teacher training framework to think about the practicalities. These children are simply different, and we have to understand what not being neurotypical means. It is hard for those of us who are neurotypical to understand it.
We must give teachers the opportunity to ask questions. For many teachers in busy classrooms, if one or two children are struggling, the exclusion line is the one that is followed. The behavioural problem kicks in because the child is under a great deal of stress, entirely unnecessarily, and we find those children suffering huge long-term educational failure as a result of the teacher’s inability to intervene early on with something quite simple that can give the child time to recover.
My hon. Friend is absolutely right. It is fantastic news that special educational needs and autism are finally part of initial teacher training. Does she agree that, to make a really big difference, we need to ensure that autism training is a core part of continuing professional development for teachers, so that we can get it into all classrooms?
I completely agree with my hon. Friend. That is exactly the challenge. If we can embed understanding that these children simply see the world and react to it in a different way and that those different ways of looking at a classroom space can be all that is required, we can ensure that we get the very best out of every child.
As I often say, if we look at some of our great inventors, we see that the autistic mind is wired differently and therefore sees the world differently. They are an incredibly valuable part of our society’s intellectual value. Without them, we all think the same way. Group-think and moving in a single direction are not where the great stages of improvements come from. We need minds that look at the world in a completely different way. It does not make any sense to me half the time, but that is fantastic, because it throws in something completely different. They can direct change in a way that very few of us who are neurotypical will ever do, and to lose that by allowing these children to fall out of the education system early on is a great loss to society and to our intellectual value as a nation. I hope very much that the Minister will feed that back.
I reiterate that not being able to access support and a diagnosis is a continuing pressure for families that we should not be allowing to go on. When a doctor says, “I can tell you what it is with your child that you haven’t understood: it’s that they’re on the autistic spectrum,” it is like having a weight lifted off your shoulders. At that point, the world makes sense. As the hon. Member for Huddersfield said, you start to understand and be able to educate yourself as a family and bring others in. You still have to shout at people, because not everybody understands yet, but that is okay. You are empowered as a family member, and as grannies and grandpas, because you can understand why this child is not quite like others in the family. You can then move forwards and value them, and really give them the tools, so that they can be the great success that we know they can be.
(6 years, 10 months ago)
Commons ChamberI support the Bill today. Like my hon. Friend the Member for Shipley (Philip Davies), I am not entirely comfortable with the principle of the state taking control of bodies without express permission, but I think that that option is far less bad than the situation whereby hundreds of lives are unnecessarily lost every year effectively through inertia. We know that action could be taken that most people would agree with. The hon. Member for Coventry North West (Mr Robinson) referred to the massive gap between the number of people who agree with donation and would be willing to be donors and the far smaller number of people who actually register as donors.
None the less, a number of points have been raised with me by constituents that I hope the hon. Gentleman and the Minister will consider during the passage of the Bill to strengthen it further. First, we should strengthen the safeguards—I was reassured by the hon. Gentleman’s comments on this—to make sure that hospitals are absolutely sure whether people are on the register. It must not be a question of, if systems are down, hospitals taking a chance and operating anyway. If people have actively opted out, we need to have belt and braces to make sure that their choices are respected. Secondly, we need to strengthen the existing law in other areas to make sure that in no circumstances can organs be harvested to be sold, which would clearly be outside the scope and the intention of this Bill.
This is a very worthwhile and important Bill. My constituent Sam emailed me this morning to say:
“This important change in legislation will prevent the needless waste of usable healthy organs being sent for cremation when they could instead change many thousands of lives.”
(6 years, 10 months ago)
Commons ChamberIt is a great pleasure to follow the hon. Member for Great Grimsby (Melanie Onn), who made a very thoughtful and engaging speech on this important issue. I am very glad that so many Members are in the Chamber to take part in the debate.
I particularly congratulate my right hon. Friend the Member for Harlow (Robert Halfon) on steadfastly championing this issue in Parliament for many years. He is much admired across the House for taking up issues that not everybody chooses to champion, but his work on such issues so often makes the lives of the people he and I represent much better, so I thank him for it. Indeed, I was inspired by his efforts in this area when, before I became an MP, I campaigned in my constituency of Telford on the whole issue of parking charges after they went up by 75% at our Princess Royal Hospital, creating a great deal of local upset.
My constituents, like my right hon. Friend’s, raise their concerns about this issue frequently. During the time I have campaigned on it, I have received over 5,000 letters —letters, not emails—on this specific issue. In Telford, we really care about this, and that is why I am here today. I was supposed to giving a speech at Thomas Telford School’s ethical debating society but, unfortunately, I have had to cancel at short notice so that I can be here, because this matters so much. I apologise to the students at Thomas Telford School.
I was told by my hospital trust in 2014 that it was not possible to change the existing arrangement because of the long-term nature of the trust’s legally binding contract with CP Plus, a parking contractor. Even poorly negotiated long-term contracts eventually expire, so we must look forward to what we will put in place when they do. It is not acceptable for those who can effect change simply to stand back and wait for onerous contracts with parking contractors to be renewed.
As my hon. Friend says, part of the problem is that so many hospital trusts are locked into long-term PFI contracts. Many of them were negotiated in the late 1990s or early 2000s and will shortly be coming up for renewal or expiry. Does she agree that now is the time to look at what provisions we can put in place to ensure that, as the contracts are renewed, they do not contain exploitative provisions that allow hospital trusts to take patients, as well as their families and visitors, for mugs by overcharging them for parking?
My hon. Friend eloquently makes a very important point, and I am very glad that he has raised it. The debate is timely, and it is important for us to be here to make this case.
Sadly, my local hospital trust has continued to increase hospital parking charges in a way that some feel thoughtless and has been described to me as cavalier. Following the rises in 2017, it is cheaper to park in Southwater shopping centre in Telford than to go to hospital to visit a sick relative. There is clearly something wrong with a model that operates in that way, because, as many hon. Members have said, no one chooses to go to hospital.
Telford is a new town, much like the constituency of my right hon. Friend the Member for Harlow. There are problems to do with the way in which many new towns were designed because, rightly or wrongly, they are all about road users. Major roads and roundabout systems are much loved in Telford. Everything is focused on the car, and it was never intended that the pedestrian should be able to walk from A to B. That is one of the problems that makes this such an important issue locally.
We do not have good public transport. We cannot just hop on a bus, jump on a tube or walk to the local hospital, as people might in other areas; instead, we have to take buses, changing a few times. Many people are therefore driven, or drive, to hospital, and they have to pay. My trust gave several reasons why its charges increased, one of which was that they were lower than those elsewhere in the country. That argument does not have a lot of teeth to it, because London is very different from Telford, in terms of income and accessibility of transport. Trusts need to consider local factors when setting charges.
It is good if concessions are offered, and there are concessions at the Princess Royal in Telford, but they are complicated to administer and operate. People have to prove that they are on benefits, that they have had an appointment and that they have paid their charges. Healthcare staff have to administer that system. They have to cancel charges and give out refunds and concessions, but that is not what they are there for. It is no good saying that if there was more money for hospitals, they would not need to charge for parking, because we all know what happens in many cases. In my local hospital, 50% of the revenue goes to CP Plus, the parking contractor, which has to be wrong.
Another argument that we have heard today is that if there were no parking charges, there would be nowhere for people to park, because anyone who wished to could use the hospital car park. It is argued that charges are a disincentive to parking. My local hospital trust says that without charges, people might stay all day in the hospital cafés, having refreshments, rather than leaving the site. Clearly that is complete nonsense, because even with incredibly high charges, there is nowhere to park. All the spaces—and the grass and concrete—are filled. The argument that everyone is sitting in a café is simply beyond my comprehension. This issue needs to be addressed with careful thought, rather than charges being seen as an instant panacea to a problem, when they clearly are not.
Bizarrely, my hospital trust tried to justify the increase by talking to residents about the number of nurses whom the parking revenue has paid for. I do not like that argument, because nurses are paid for by taxpayers through Government funding, not by parking charges. The increase that it implemented was in the contractual agreement, and nothing whatever to do with the number of nurses whom it employed.
I worry when hospital managers think that the charge is not that big a deal because parking is cheaper than somewhere else; that transport is not really their problem; and that if people are spending too long in cafés, managers need to move them on by putting up the charges. That shows that they probably do not understand the people whom they serve as well as they should.
If we dig a little deeper, we see the reason why it is not possible to park at the Princess Royal is that there has been a huge increase in the number of staff working on the site and therefore parking in the car park. We need to look at ways of helping staff to reduce car park use, as that would free up many spaces for patients to use throughout the day. We need to think imaginatively about how that might be done. Perhaps park and ride schemes specifically tailored to shift times might help. It is a surprise to find that hospitals are not looking at that.
We have heard today that this is a tax on the sick. Most taxes take account of people’s ability to pay, as is absolutely right, yet hospital managers and porters pay the same to park at work. It is always the least well-off who are hit the hardest. If the aim is to tax people and then give half the tax revenue to a car parking company—that is a bit senseless in any event—do it through pay-as-you-earn, and do not get nurses and other healthcare staff involved in the enforcement. It is completely inefficient to operate the system in this way.
Others have touched on the rigmarole that goes with paying for parking. Whether that means people paying with coins, typing in their number plate, or being videoed as they go in or come out, there is a punitive element. When a person is rushing to see someone who is extremely ill, or if they are waiting for an appointment and the consultant is running over time, it all adds to the anxiety, and in this context, it is completely inappropriate.
No one really wants to own this issue, so we all end up accepting it rather than solving it. Too many people say, “It is not our problem, it is too difficult to fix and actually, it is not really that important, because it is only £8 a day.” Too often, people in power look at the world through their own eyes and not through the eyes of those whom they serve.
There is little appetite among hospital management to deal with this. It is not a big-ticket issue. It is not exciting. It is not a shiny new hospital. It does not cost £300 million—in Telford, we spend a lot of time talking about our new emergency unit—so that is why I am here today. I want the Government and hospital managers to sit up and take notice. Do not brush this off as a non-issue—it is not. Try to see it through the eyes of others and tackle the issue that is facing everyday users of our hospitals. It can be fixed and it will make a difference to the lives of those who most need hospital services. For that reason, we should all care about it.
My right hon. Friend the Member for Harlow does a great service to his constituents. I thank him for securing this debate and I support him entirely.