Princess Alexandra Hospital, Harlow

Robert Halfon Excerpts

Tuesday 5th June 2018 Commons Chamber

[Robert Halfon (Harlow) (Con)]

It is a pleasure to see you in the Chair, Madam Deputy Speaker. I thank you for your support for a new hospital in Harlow, as my constituency neighbour.

I want to update the House on the desperate need for a new hospital in Harlow that is fit for the 21st century. The hospital would bring together A&E services, GP provision, social care, physiotherapy and a new ambulance hub in state-of-the-art, purpose-built facilities. Success in securing the capital funding, for which there is already a bid in place, could make this a reality for Princess Alexandra staff and patients in Harlow and across the region.

When I debated Harlow’s hospital last October in Westminster Hall, it was in special measures. In March, following the Care Quality Commission inspection, we heard the amazing news that the Princess Alexandra had left special measures. In fact, two thirds of services were on their way to a good or an outstanding rating. I said it then and I will say it again: this is a testament to the extraordinary hard work of all Princess Alexandra Hospital staff, including the cleaners, porters, nurses, doctors, kitchen staff, support staff and, of course, the leadership and management. I would like to give a particular mention to Nancy Fontaine, head of nursing and one of the most remarkable NHS workers I have ever met. Nancy will soon be leaving the Princess Alexandra to help another hospital, but I take this opportunity to thank her for her work. It is people like her who make the NHS what it is.

The Health Secretary congratulated PAH staff in a video—a sentiment seconded by the Prime Minister. In his message, the Health Secretary not only noted the impressive CQC report and the outstanding work in the neonatal department, but made it clear that it is the staff who make a hospital and that good care is the result of their instinct to do the right thing for patients. The Health Secretary and the former Hospitals Minister, my hon. Friend the Member for Ludlow (Mr Dunne), have both visited the Princess Alexandra a number of times, speaking to the staff and the leadership there. I know that the Health Secretary and the current Hospitals Minister—to whom I am hugely grateful for engaging with me regularly on this issue—are aware of the capital funding bid in place.

The leadership team, headed by chief executive Lance McCarthy, have been developing their case for capital funding since the Health Secretary made the request in autumn 2016. The team are due to resubmit the final plans next month. I understand that the trust is one of seven schemes requiring more than £100 million of capital and that funding for some schemes will be announced in the autumn. I ask the Minister, when will we learn of the progress of these capital funding bids?

[Mr Charles Walker (Broxbourne) (Con)]

Does my right hon. Friend agree that Princess Alexandra Hospital has a great future if it is allowed to have that future?

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[Robert Halfon]

I thank my hon. Friend for being a huge supporter, along with other colleagues here today—my hon. Friends the Members for Hertford and Stortford (Mr Prisk) and for Saffron Walden (Mrs Badenoch). They understand that this is not just an issue for Harlow, because a new hospital will benefit the entire—

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[Robert Halfon]

My hon. Friends understand that this is not just an issue for Harlow but for the surrounding areas of Essex and Hertfordshire. My hon. Friend the Member for Broxbourne (Mr Walker) is exactly right—for our hospital to have a future, we need a new hospital.

[Mr Mark Prisk (Hertford and Stortford) (Con)]

I commend my right hon. Friend for his championing of this important cause. He is right to point out that while this facility is important for the people of Harlow, it is just as important for the people of Bishop’s Stortford, Hertford, Ware and other towns represented here today. It matters to the whole region. I hope that he will emphasise that point and that the Minister will take it on board in his remarks.

[Robert Halfon]

I am very proud that my hon. Friend and I share a constituency office and work together on an enormous range of issues. His support and backing is recognised by his constituents because they understand, as he does, that a new hospital in Harlow will benefit not just Harlow but all the surrounding areas and residents.

The hospital’s infrastructure is deteriorating. As my hon. Friend the Minister stated in response to my question on 8 May 2018, the Government

“recognise that the Princess Alexandra Hospital…is in a poor condition.—[Official Report, 8 May 2018; Vol. 640, c. 537.]

While the hospital leadership has been proactive in seeking out funding—last year, the trust secured £2 million to redesign the emergency department—long-term under- investment means that the estate is extremely fragile. A survey in 2013 said that 56% of the hospital’s estate was rated as “unacceptable or below” for its quality and physical condition.

Not only is the hospital falling apart, but the layout is unco-ordinated and problematic. To use a horrible euphemism, there are “sub-optimal clinical adjacencies”, in the words of the previous Minister. Urgent care is spread across the site due to the sporadic development of temporary structures, making it very difficult for patients seeking care to find their way around and for the hospital staff caring for them.

[Mrs Kemi Badenoch (Saffron Walden) (Con)]

Does my right hon. Friend agree that short-term investment is only a bandage and a fresh overhaul is needed due to the permanently declining facilities? Does he also agree that given how many of my constituents use the Princess Alexandra, the three new garden communities that are being planned mean that we need a huge influx of investment for infrastructure in our area?

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[Robert Halfon]

I am hugely grateful for the support of my new neighbour, who is a brilliant representative of her area. She is exactly right. We cannot just carry on with Elastoplast solutions, however welcome, because that cannot sustain the hospital in the long term. She also makes the crucial point that we are going to have thousands more houses in Harlow and the surrounding areas, and we need a hospital that is fit for purpose—fit for the 21st century. I think that the Minister will hear the views of my neighbours and realise that this is not just a Harlow issue but something that is very important to Essex and Hertfordshire.

[Jim Shannon (Strangford) (DUP)]

Obviously, I am not one of the right hon. Gentleman’s neighbours, but I am always here to support him on the issues that he brings forward. One of the things that comes to my attention back home, but I am sure that he will have the same issue, is that healthcare needs to be accessible to all people. We can jump in a car and go to the hospital, but other people may have to depend on a bus or a train, or on someone giving them a lift. Does he agree that local trusts need to have accessibility as a precursor to providing care? If someone has accessibility, they can get there; if they do not, it does not matter where the hospital is.

[Robert Halfon]

The hon. Gentleman says we are not neighbours, but we are kind of neighbours in the make-up of the current Parliament. He is absolutely right, and he makes the wider point about the support needed for the NHS.

The hospital also experiences issues in recruiting and retaining staff. Harlow’s hospital now has 27 more doctors and 35 more nurses than in 2010, and the leadership has made great efforts to improve staff retention and staff stability at the PAH. It is now among the best in the sustainability and transformation partnership. However, the trust still runs an 11% vacancy rate, with a key deficit in nursing recruitment and retention. The vacancy rate and recruitment are a perpetual worry, and the reasons for that appear to be twofold. The first is proximity to London, which makes pay weighting a serious factor. The second is perhaps more significant. The hospital leadership has told me that opportunities for career development, or the lack thereof, are off-putting for potential recruits. The hospital must compete with Barts and UCL in specialist training and career development. Last year, the retention support programme established career clinics and clear career pathways, but there is only so much the hospital can do to compete with the huge investment and top-class facilities at London hospitals.

There is unbearable and increasing pressure on A&E services at the Princess Alexandra due to the downgrading of other local healthcare facilities, including Chase Farm Hospital and the Queen Elizabeth II. The population of Harlow and the surrounding area is growing, and the additional influx of patients has led to occupancy levels at the hospital consistently running higher than 98%. The A&E department sees 200 to 300 patients per day—that is 10% higher than the national average. This is a small hospital in a medium-sized town. The Care Quality Commission agreed in its most recent report that that makes it difficult for staff to tend to patients in a timely manner.

While the hospital is working incredibly hard to make improvements and has successfully upped the four-hour emergency care standard record, the chief executive and management have told me that the estate and infrastructure are simply undermining the staff’s ability to carry out their roles well and negatively impacting on the hospital’s overall performance. It is clear from the occupancy level statistics that the Princess Alexandra is fundamental to the health and wellbeing of the population of Harlow and the wider area, including parts of Hertfordshire and Essex, as my colleagues and I have stated today.

In the light of that, I wrote to the Secretary of State for Health last week along with seven colleagues representing neighbouring constituencies: my hon. Friends the Members for Broxbourne, for Hertford and Stortford, for Saffron Walden, for Brentwood and Ongar (Alex Burghart) and for Braintree (James Cleverly), and my right hon. Friends the Members for Epping Forest (Mrs Laing) and for Witham (Priti Patel). We wanted to make it clear that the development of a new hospital health campus is fundamental to the vitality of the community and the economy of the entire region. We asked the Health Secretary for his support for the hospital’s capital funding bid, and I hope to receive his positive response soon.

It is clear that there are a number of complex and interlinked issues at the Princess Alexandra. Those problems make it very difficult for the hard-working staff to provide sufficient healthcare to Harlow residents and those living in my colleagues’ constituencies. The development of a new purpose-built hospital health campus would answer each and every one of those problems. First, it would allow high-quality and state-of-the-art facilities to be developed in a carefully planned manner. The staff would no longer be working in temporary structures, and patients and visitors would be able to find their way around the site easily.

Secondly, the investment in new facilities would draw nurses, healthcare assistants and auxiliary staff to the hospital and provide a welcoming working environment in which they could see out a long career in the NHS. Thirdly, the new hospital health campus would redevelop the emergency care services at the PAH. That would create a working environment in which staff truly had the capacity to meet the needs of the many patients seeking help, without the fear of a bed not being available.

While regeneration of the current site has been considered, it is widely accepted that building a new hospital health campus on a different greenfield site would be most affordable and provide the greatest benefit to the patients served by the PAH. The hospital’s current location in the town centre may partly explain the very high A&E use, and it makes further expansion of the hospital incredibly difficult. A new greenfield site on the outskirts of the town would mitigate these problems and allow the town-centre land to be redeveloped into much-needed housing for Harlow’s growing population. Additionally, developing a new hospital on the current disjointed site would require the existing set-up to be demolished before starting work on the new health campus. This would lead to huge disruption for patients seeking help and for staff who would need to carry on working for a number of years.

As I have previously mentioned, the hospital is vital for the economy of the entire region. Developing a new hospital health campus could act as a centre for degree apprenticeships. I know that the Minister, like me, is passionate about improving skills and apprenticeships in the health service. The hospital health campus could build on the existing hospital’s strong links with Harlow College and the new Anglia Ruskin MedTech innovation centre. It would bring specialist training to the eastern region, and it would send the message that Harlow is a place to start and develop an amazing and long-term career in the national health service. The hospital health campus would allow so many hundreds of my constituents, and those of my hon. Friends, to climb the ladder of opportunity. The degree apprenticeships and training opportunities would help people across the east of England to get the education, skills and training they deserve and to achieve the jobs, security and prosperity that they and our country need.

Finally, I want to explain that this debate is only part of an ongoing and wide-reaching campaign for a new hospital health campus in Harlow. As I have mentioned, I had a debate on this subject last year, and I have tabled 10 early-day motions, asked 40 written questions and kept in regular contact with Health Ministers. As I have said, I am hugely grateful to my hon. Friend the Minister for his regular dialogue with me. In fact, may I ask him now whether he will definitely meet me and the hospital’s chief executive, Lance McCarthy, to discuss the hospital health campus proposals further, and will he actually join us at the hospital in Harlow so that he can see the current site at first hand?

I am here today because of the desperate need for a new hospital campus in Harlow. This is probably the most pressing issue that our town will face for a generation. The new hospital proposal is backed by ten local councils—including Harlow Council, Epping Forest District Council, Essex County Council and the Greater London Authority—and by the West Essex clinical commissioning group and the Hertfordshire and West Essex sustainability and transformation partnership, which brings together 13 local bodies and hospital trusts. It is also backed by the seven neighbouring MPs I have mentioned, some of whom are in the Chamber.

The people I represent, and those represented by my colleagues and constituency neighbours, deserve better. Patients deserve to be treated in a safe environment, without the threat of their operation being cancelled due to sewage—I repeat, sewage—flowing through the operating theatres. Visitors should be able to find their poorly relatives easily, without snaking their way through a muddled and confusing hospital estate, wasting valuable time that they could have spent with their loved ones. The hard-working staff should have top-class and purpose-built facilities so they can tap into their instincts and provide the very best care they can. They should be able to progress their careers at the hospital and to build a community around their working lives—building an even better Harlow and protecting our NHS as they do so. Training opportunities should be provided so that our young people or those who wish to retrain can gain skills and climb the ladder of opportunity, flexibly and close to home. I am here this evening to show the Government that the Princess Alexandra bid for capital funding is not just about the materials from which the hospital is built; it is more important than that. It is time that healthcare in Harlow was brought into the 21st century.

Education (Student Support)

Robert Halfon Excerpts

Wednesday 9th May 2018 Commons Chamber

[The Minister for Health (Stephen Barclay)]

I join the hon. Member for Ashton-under-Lyne (Angela Rayner) in welcoming the opportunity to discuss the increase in the number of postgraduate places that will be unlocked as a consequence of the statutory instrument. She ended her speech by saying that there was an “urgent need” to recruit more. The central premise of her opposition to a change that will remove the arbitrary cap imposed by the bursary, and hence unlock additional places for postgraduate students, seems a strange one on which to base her speech, given that we are ensuring that we can continue to increase the number of nurses that the Government have delivered through the postgraduate route, as we have through the undergraduate route.

At present, about 2,500 students gain access to nursing, midwifery and allied healthcare professions through the postgraduate route, a number that is constrained by the cap. The policy that we are discussing has already been applied to the much larger population of about 28,000 undergraduates studying the same subject. The statutory instrument will ensure consistency in the approach to both populations, while enabling both to increase their number by 25%.

This is part of a much wider package of Government measures. We are, for instance, increasing the number of apprenticeships. I know that my right hon. Friend the Member for Harlow (Robert Halfon), as Chair of the Education Committee, has repeatedly championed their importance as a route into nursing for those who do not want to go to university. Similarly, my hon. Friend the Member for Chelmsford (Vicky Ford) has campaigned repeatedly in respect of medical school places. There are five new medical schools and 1,500 new medical places, again as part of the increase in the number of nurses. We have made a commitment through “Agenda for Change”, working with the trade unions, to deliver pay increases and we have programmes such as the return to work programme, which has seen more than 4,000 former nursing staff applying to return to the profession.

[Robert Halfon (Harlow) (Con)]

I will be supporting my hon. Friend this evening. I welcome what he said about apprentices. I think this squares the circle. We need to rocket-boost apprenticeship programmes in the NHS. I intend to say more about that in my speech, but may I ask whether he is committed to that today?

[Stephen Barclay]

I was just taking inspiration. Let me explain the route into nursing through apprenticeships. A four-year package will enable people who do not want to go to university—this is a point that my right hon. Friend has repeatedly made in the Education Committee—to progress to nursing roles by means of what he has often referred to as a ladder. Healthcare assistants tend to feel trapped in roles that do not give them an opportunity to progress. This is at the heart of what the Government stand for: giving people an opportunity to progress at different stages in their lives through the apprenticeship route.

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[Robert Halfon (Harlow) (Con)]

To achieve social justice and deal with the skills deficit, we need a skills revolution. In many sectors, we have a real skills shortage, particularly at level 4 and above. Young people are pushed towards traditional degrees, but only 52% are getting jobs after graduation that require a degree, according to the Chartered Institute of Personnel and Development. On the flipside, degree apprenticeships are just not growing fast enough, and we need to invest more in further education and skills provision.

I welcome what the Minister has said today, and I thank him for meeting me to discuss this issue. We must go further on nursing apprenticeships, which I believe are the answer to this whole problem. We can square the circle and support nurses by rapidly expanding the apprenticeship programme. Hon. Members will know that I am a passionate advocate of apprenticeships, and I therefore support the introduction of new routes into nursing, through degree apprenticeships and the creation of the nursing associate role.

Nursing degree apprentices will not have to pay anything themselves, as my hon. Friend the Member for Lewes (Maria Caulfield), a brilliant former nurse, explained. They will be able to become degree-registered nurses in four years. Similarly, the new nursing associate role will provide extra capacity in the workforce, and many of those who train as nursing associates may decide to continue to degree-level nursing.

The twin themes of the Education Committee in this Parliament are social justice and productivity. Nursing degree apprenticeships are key to both. They offer an attractive route both for mature students and for those with children, ensuring that all those who wish to train as nurses have the opportunity to do so. I am not suggesting that people should not have the choice of a three-year undergraduate course, but we must maximise the opportunities provided by degree apprenticeships. Doing so would mean that we have a sufficient nursing workforce and that aspiring nurses have options for training.

I have real worries about the fact only 30 people began training as a nurse through the nursing apprenticeship schemes this year, and we need to rapidly improve the number of people doing degree apprenticeships. There needs to be a taskforce involving the Minister for Apprenticeships and Skills, the Minister for Universities, Science, Research and Innovation, Health Ministers, the Institute for Apprenticeships and others to drive this forward and to encourage people with a proper advertising campaign, using the £200 million levy. Thirty is just not enough; we need many thousands of people. If people in my constituency and across the country knew about the schemes, they would want to take them up.

[Dr Murrison]

Does my right hon. Friend agree that part of the way we might expand the numbers taking the apprenticeship route is to unleash the power of the further education sector? The sector now has degree-awarding powers and would be very attractive to a large number of people not just in the big urban centres but in the smaller regions, too.

[Robert Halfon]

Like me, my hon. Friend is a big champion of further education and understands it completely. This could be an incredible moment for our further education colleges because, along with some very good private providers, they could be leading the way in providing degree apprenticeships.

[Julian Knight (Solihull) (Con)]

My wife was a renal nurse for 15 years, and she says that one of the key changes that happened in her time as a nurse was the university-fication of the nursing profession. Does my right hon. Friend agree that having this diverse route is a much better way to do things and brings in people from all backgrounds?

[Robert Halfon]

My hon. Friend is right. My hope is that, rather than 50% of all students just going to university, one day 50% of all students will be doing degree apprenticeships in all subjects, but especially in the subjects we need, particularly in coding, healthcare, science, engineering and nursing.

[Dr Wollaston]

I welcome my right hon. Friend’s work as Chair of the Select Committee on Education. Does he agree that we are losing too many healthcare assistants because in the past there have not been the opportunities for them to progress? These regulations are an important way to retain such a valued part of our workforce.

[Robert Halfon]

As so often, my hon. Friend is a mind reader. I will address her point, but of course she is right.

These jobs should not be limited to degree level; we should ensure there are apprenticeships in healthcare professions from level 3. We must have sufficient progression for those already working in the sector. The nursing associate role is a positive step that will provide opportunities for healthcare assistants to progress within the sector. From there, they could train to become registered nurses, if they wish.

[Bambos Charalambous (Enfield, Southgate) (Lab)]

Will the right hon. Gentleman give way?

[Robert Halfon]

This is the last intervention because I am conscious that other people want to speak.

[Bambos Charalambous]

In the light of the poor recruitment to the apprenticeship schemes, does the right hon. Gentleman agree it is best to keep both routes open—the bursaries and the apprenticeship schemes—to maximise the number of people coming into the system?

[Robert Halfon]

I thought that initially, but I have listened to my hon. Friend the Minister’s arguments. There was previously a cap, and not everybody was able to get into the system. If we can encourage people down the apprenticeship route, they earn while they learn, there is no debt and they get a lot more than they would get if they had a bursary.

[Michelle Donelan (Chippenham) (Con)]

Will my right hon. Friend give way?

[Robert Halfon]

This is genuinely the last time I give way. It is impossible to say no to my fellow member of the Education Committee.

[Michelle Donelan]

Further to the intervention made by my hon. Friend the Member for South West Wiltshire (Dr Murrison), my constituency neighbour, I, too, met Wiltshire College last week, and it is eager to take on nursing apprenticeships. The college shows we can get past the few roadblocks, because it is already affiliated with universities in offering degrees. That is one way in which we can look positively at increasing the number of apprenticeships, rather than looking at it negatively, as we hear from the Opposition.

[Robert Halfon]

My hon. Friend is a remarkable member of our Committee and she is right in what she says. It is good that the Minister for Health, the Minister for School Standards, the Minister for Universities, Science, Research and Innovation and the Minister for Apprenticeships and Skills are here, because we need to unblock the roadblocks and bureaucracy and really make these things happen, so that thousands of people are doing this, not just 30.

We need to ensure that we are making the progression as smooth as possible. Our Committee is concluding its inquiries on value for money in higher education and the quality of apprenticeships and skills training. Nursing bursaries are relevant to both, so we decided last week to hold a one-off evidence session on the subject in the next few weeks. I hope that the Minister for Health will accept our invitation to discuss the matter in greater detail then. I urge him to carry on championing nursing apprenticeships for other healthcare professionals and to set out in detail, at a later date, what the Government will do on apprenticeships. Let us make that culture change, so that apprenticeships are not seen as the inferior option to traditional courses. The change must start in Whitehall, and only when it happens will we see nursing apprenticeships used to their full potential, contributing effectively to tackling the skills deficit and helping the most disadvantaged to have the careers that they and our country need.

Oral Answers to Questions

Robert Halfon Excerpts

Tuesday 8th May 2018 Commons Chamber

[Stephen Barclay]

We have a debate involving postgraduate nursing tomorrow, but the intention is to increase the number of such nurses by removing the current cap, which means that many who want to apply for postgraduate courses cannot find the clinical places to do so. That is the nature of tomorrow’s debate, and I look forward to seeing the hon. Gentleman in the Chamber.

[Robert Halfon (Harlow) (Con)]

Will my hon. Friend, on top of the degree nursing apprenticeships, rapidly increase the nursing apprenticeship programme so nurses can earn while they learn, have no debt and get a skill that they and our country need?

[Stephen Barclay]

My right hon. Friend is absolutely right to signpost this as one of a suite of ways to increase the number of nurses in the profession. As he alludes to, there will be 5,000 nursing apprenticeships this year, and we are expanding the programme, with 7,500 starting next year.

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[Mr Hunt]

Yes, I can.

[Robert Halfon (Harlow) (Con)]

T2. The Secretary of State has visited Princess Alexandra Hospital in Harlow on a number of occasions and he will recognise that, despite excellent staff, the hospital is not fit for purpose. Will he confirm that Harlow is at the top of the list for capital funding, and that we will get the new hospital our town desperately needs?

[The Minister for Health (Stephen Barclay)]

We recognise that the Princess Alexandra Hospital estate is in a poor condition. NHS Improvement is working with the trust to develop an estate and capital strategy by summer 2018 to be assessed, with other schemes put forward, for the next capital announcement for sustainability and transformation partnerships. I am very happy to meet my right hon. Friend to have further discussions about it.

Autism

Robert Halfon Excerpts

Thursday 29th March 2018 Commons Chamber

[Dame Cheryl Gillan]

The hon. Gentleman anticipates another bit of my speech. That is really important, because people with autism are disproportionately not being taken off the unemployment register. In fact only yesterday, with the all-party group for disability, I had a joint meeting with the Minister for Apprenticeships and Skills to look at the problems and consider how, working with employers’ organisations and the Government, we can try to improve the situation.

More councils now include autism in their joint strategic needs assessment, and almost every local area has a diagnostic pathway—those that do not will know who they are, but all but three are covered. That is really significant progress, but let us face it there is not a person in the House who does not know that we need to make more progress in this area, so I do not say that with any sense of complacency whatsoever.

I want to touch on a few areas, but I have only limited time. I have been very impressed by the number of Members on both sides of the House who have put in to speak, and it is really important that I hear from them.

I will start by talking briefly about education. My hon. Friends the Members for Bexhill and Battle (Huw Merriman) and for Lewes (Maria Caulfield) recently chaired an inquiry into autism and education under the umbrella of the APPG. They did some fantastic work, looking at how the education system in England currently works for children. The inquiry involved evidence sessions and surveys, and took additional evidence from more than 3,000 parents, professionals and people on the autism spectrum. It found that children are being held back from achieving their full potential because they are autistic. In our surveys, nearly 70% of parents told us that they had waited for more than six months for support at school, and 50% had waited for more than a year.

[Robert Halfon (Harlow) (Con)]

I congratulate my right hon. Friend on leading this debate. As a distinguished former Cabinet Minister, she could be drinking piña coladas in her garden in Amersham, yet she dedicates her life to helping with autism. Is she aware that autistic children are four times more likely to be permanently excluded than other children?

[Dame Cheryl Gillan]

My right hon. Friend, who chairs the Education Committee with distinction, is absolutely right. That is why I am so pleased that this year, for the first time, the Government are putting a compulsory autism module into initial teacher training. That is significant, and I hope that my right hon. Friend’s Committee might look into that provision.

The inquiry of my hon. Friends the Members for Bexhill and Battle and for Lewes also found that four in 10 families were initially turned away when asking for the extra help that their child needs. To address these challenges, we have recommended that the Department for Education develops an autism strategy. That call has been enthusiastically taken up by the National Autistic Society and Ambitious about Autism, which launched the Held Back campaign to support the report’s recommendations.

More than 20,000 people, including 70 Members of this House and the House of Lords, have signed an open letter to the Secretary of State for Education calling for the report’s recommendations to be implemented. It is really important that Lord Agnew, the Under-Secretary of State for the school system, comes forward with the Department’s response, as it has confirmed that it will respond to the inquiry. It will be good to hear what it is doing to make improvements in this area.

I turn to the autism employment gap, which is a major problem.

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[Robert Halfon (Harlow) (Con)]

I am hugely grateful for the opportunity to speak in this important debate, and I again congratulate my right hon. Friend the Member for Chesham and Amersham (Dame Cheryl Gillan) on her work in this area. I particularly want to pay tribute to the work of organisations that support autistic people, such as PACT for Autism in my constituency of Harlow. It started off as a small charity, but has now become a national one, and it has done so much to educate me about autism and to support families with autistic children across my constituency and elsewhere.

Ensuring that all children are able to access supportive, high-quality education and post-16 opportunities is essential for their life chances and for enabling them to climb the education ladder of opportunity. Our Education Committee is currently holding an inquiry into alternative provision, and we are likely to do an inquiry in the future into the role of special needs in education.

Children in alternative provision are the most vulnerable children. Compared to their peers, they are seven times more likely to have a special educational need, 10 times more likely to have a recognised mental health problem and, as I said to my right hon. Friend earlier, four times more likely to be permanently excluded from school than any other child. We have a real problem with the number of exclusions in our country. We are excluding a classroom-plus—35 children—from school every day.

[John Howell (Henley) (Con)]

Is my right hon. Friend aware that schools deliberately exclude children with autism when they know that an Ofsted inspection is coming?

[Robert Halfon]

We have heard all sorts of stories about exclusions in schools, and I think there is a wild west of exclusions out there. This is why our Committee is looking into it and undertaking an inquiry, and we have heard what my hon. Friend has said.

[Martin Whitfield (East Lothian) (Lab)]

Does the right hon. Gentleman share my frustration at the fact that, while the strategies for making life as easy and pleasant as possible for such children in schools are available to everyone, the dissemination of that knowledge and its take-up by schools and authorities are so lacking?

[Robert Halfon]

The hon. Gentleman makes an important point. I will mention this later, but when my right hon. Friend the Member for Chesham and Amersham opened the debate, she talked about the increased training that is taking place, and the Government are doing a fair bit to try to change this situation.

As I have said, our Committee has heard that the number of exclusions is rising and that increasing numbers of children are being educated in alternative provision, but in some cases this is not the most appropriate place for children to be educated. We have heard that children with special educational needs and disability may have unrecognised or unmet needs early on in their school career—possibly speech, language and communication needs or, indeed, autism.

These children do not engage with their learning, and their struggle to engage and their unmet needs affect their behaviour and they get caught up in the school’s disciplinary procedures. Earlier intervention and support may well enable the children to continue to learn with their peers, or to be moved to more specialist provision, without the need for exclusion and the distress and disruption that this creates for the child and their family.

As the hon. Member for East Lothian (Martin Whitfield) pointed out, teachers need to be supported and trained to identify where pupils have additional needs and require extra support in the classroom. According to the National Autistic Society, only one in four teachers say that they received any autism training when completing their teaching qualification. Nearly eight in 10 say that they have received some autism training since qualifying, but fewer than half say they feel confident about supporting a child on the autism spectrum in their class. That is why projects such as The Difference, which aims to train school leaders to support pupils with mental health issues and autism, and reduce exclusion from school, are important. Such leadership is essential.

Our Committee heard from Drew Povey, headteacher of Harrop Fold school. He said that they consider education to be about preparing a pupil for life, and that

“as a result of that, we shifted our mindset to move from ‘we cannot exclude young people’, to, ‘we do not exclude’”.

Indeed, that school excludes no one. Drew Povey went on:

“That was extremely powerful for us as a school, and we are proud to say that we have not excluded a student, fixed term or permanently, now for over 10 years.”

What a remarkable school and remarkable headteacher.

We need to get post-16 opportunities right for young people so that they can continue to climb the ladder of opportunity when they leave school. I served alongside the Minister in one of her previous roles, and she is passionate about apprenticeships. Autistic young people should be able to benefit properly from opportunities such as apprenticeships, and I urge the Government to come up with specific proposals. They are doing a lot for people with disabilities, and to attract more women and people from the black and minority ethnic community, but we need a specific programme to help and encourage businesses to employ apprentices who have autism. I think that a levy would be a good financial incentive, and we should set aside money to create a specific apprenticeship social justice fund to support organisations such as the Prince’s Trust that bridge the gap between school and apprenticeships, and help vulnerable people.

These are issues of social justice, and all members of the Education Committee are committed to helping children and young people climb that educational ladder of opportunity. All children should have equal life chances, and be able to learn in schools that meet their needs and support them to thrive. However, being able to climb that ladder of opportunity is not sufficient if young people are not then able to move into the world of work. I welcome the Government’s commitment to approving alternative provision for young people, and I am heartened that a review of exclusion is being led by the brilliant former Minister, Ed Timpson. There must be more focus on ensuring that those children do not drop off the cliff edge of support when they leave school.

NHS Staff Pay

Robert Halfon Excerpts

Wednesday 21st March 2018 Commons Chamber

[Mr Hunt]

I cannot agree that this is a drop in the ocean. If the hon. Lady does not want to hear it from me, let me point out what was said by the Unison head of health, Sara Gorton, who is also the head negotiator for the NHS unions. She said that the deal

“would go a long way towards making dedicated health staff feel more valued, lift flagging morale, and help turn the tide on employers’ staffing problems.”

That is not a drop in the ocean.

[Robert Halfon (Harlow) (Con)]

I strongly welcome the measures that my right hon. Friend has announced. He will have heard my question to the Prime Minister earlier, and he will acknowledge that Harlow Hospital is out of special measures and that this pay award is much deserved by staff. In the future, will he look at the particular problem we face—we are just outside London, and a lot of staff work in London, which makes it harder for Harlow Hospital to recruit—and perhaps think again about the pay scales?

[Mr Hunt]

I am happy to do that and to congratulate the staff at my right hon. Friend’s hospital, which he has long championed and whose pressures and needs he has highlighted assiduously. To come out of special measures is a huge achievement. I have recorded a video message, but I am happy to say in the House how proud we all are of what the staff have achieved. I also recognise the capital issues at the hospital and the fact that the building is not fit for purpose.

NHS Winter Crisis

Robert Halfon Excerpts

Monday 5th February 2018 Commons Chamber

[Stephen Barclay]

Again, the hon. Gentleman is ignoring the increase in the number of doctors. There are now 14,900 more doctors and 14,200 more nurses in the system. As I alluded to earlier, it is not just the number of beds; it is also how we manage those beds. It is how we manage the fact that 5% of the patient population is occupying 43% of beds that will best address bed occupancy rates.

[Robert Halfon (Harlow) (Con)]

I strongly welcome the extra investment in Essex and Harlow in terms of the winter crisis in the national health service, and I very much hope we get a 10-year plan, as suggested by the Secretary of State. Is my hon. Friend aware of the difficulties that Harlow Hospital faces, in that we have among the highest A&E figures per head in England and a hospital that is literally falling down and not fit for purpose, as recognised by the Department? Will he visit the hospital to see what can be done to help us in our campaign for a brand-new hospital for Harlow?

Hospital Car Parking Charges

Robert Halfon Excerpts

Thursday 1st February 2018 Commons Chamber

[Robert Halfon (Harlow) (Con)]

I beg to move,

That this House calls on the Government to undertake a consultation to identify the most efficient means of abolishing car parking charges at NHS hospitals in England for patients, staff and visitors and to provide the timescale for its implementation.

I thank the Backbench Business Committee for accepting the application for this vital debate. I especially thank my colleagues who have supported me in securing it, particularly my hon. Friend the Member for Telford (Lucy Allan), the hon. Member for Kingston upon Hull West and Hessle (Emma Hardy), my hon. Friend the Member for Cleethorpes (Martin Vickers), my right hon. Friend the Member for Hemel Hempstead (Sir Mike Penning) and the hon. Member for Colne Valley (Thelma Walker). I also thank the various charities and organisations that have actively supported the campaign through their own research and on social media, such as CLIC Sargent, Bliss and Scope, and organisations representing drivers, such as FairFuelUK and the RAC. Those are just a few of the bodies offering their help and support to bring an end to the extortionate car parking charges found at many hospitals in England.

We all know that being a patient or visitor can be a stressful time. The last thing that anyone should be worried about is whether they have change for a car park or whether they can afford the rates that are charged. I started this campaign for free hospital car parking in 2014, after finding out that hospitals in England were charging staff and visitors up to £500 a week to use on-site parking facilities. As a result, in the same year, the Government published guidance urging hospitals to cut their parking fees. They said:

“Concessions, including free or reduced charges or caps should be available for staff working unsociable shifts, blue badge holders and visitors of gravely ill relatives.”

Although some weekly charges have fallen since 2014, I was shocked to discover last year when we carried out further research that 47% of hospitals have increased the hourly parking charges and nearly half of hospitals charge blue badge holders to park. The average cost to park for a week at a hospital in England is £53.41 and people pay on average £1.98 for one hour stay.

[Sir Edward Davey (Kingston and Surbiton) (LD)]

The right hon. Gentleman is a fantastic campaigner on such issues and I congratulate him on bringing the issue to the House of Commons. In my constituency, Kingston Hospital just announced with no consultation that it will impose parking charges on blue badge holders, citing that people are doing it everywhere else in the NHS and that it is an NHS-wide issue. Does he therefore not agree with me that it is up to the Government to give a clear lead and, at the very least, get rid of parking charges for blue badge holders?

[Robert Halfon]

The right hon. Gentleman is exactly right. Too often, these charges are imposed without any consultation, or without fair consultation, and they hit the most vulnerable. He will hear later in my remarks that I completely agree with him.

[Mr Jim Cunningham (Coventry South) (Lab)]

Will the right hon. Gentleman give way?

--- Later in debate ---

[Robert Halfon]

I will not take too many interventions, but I would be honoured to take one from the hon. Gentleman.

[Mr Cunningham]

I agree with the right hon. Member for Kingston and Surbiton (Sir Edward Davey). A lot of the hospital charges are part of private finance initiatives, and he is right that the Secretary of State or the Minister responsible should now be looking at eliminating those charges. We could argue that they are a tax on illness.

[Robert Halfon]

That is the sad thing. Many private companies are making profits from the taxpayer and the most vulnerable people in our society. That must stop. The PFI things that have happened under Governments of both main parties have caused huge amounts of problems to many people, particularly when they park at hospitals up and down the country.

There is still a postcode lottery on car parking charges; different hospital trusts set wildly different fees. The core principle of the NHS is to provide free healthcare for all at the point of access but the charges are a stealth tax on drivers using the health service. The parking charges are the bane of people’s lives. No one goes to hospital out of choice; they go because they have to. No one chooses to be ill, and we rely on our doctors and nurses to look after us. I urge the Health Secretary and the Minister to take urgent action to end this social injustice once and for all, and to introduce substantive legislation to ensure hospitals scrap their parking charges.

[Julian Knight (Solihull) (Con)]

rose—

[Robert Halfon]

Mindful of the advice from the Chair, I shall give way one last time.

[Julian Knight]

My right hon. Friend is being most generous. I should declare that I am the joint chair of the all-party parliamentary group for fair fuel for UK motorists and UK hauliers. I have tremendous sympathy with my right hon. Friend in this respect and have campaigned hard on hospital parking charges in my own constituency. However, one difficulty I have in squaring the circle is the fact that my hospital is located right in the town centre and, if it is free, people use it as a base to go off shopping. That has happened in the past. Does my right hon. Friend have any solutions or ideas to deal with that?

[Robert Halfon]

I am very proud to have worked with my hon. Friend on the FairFuelUK campaign to keep fuel duty low. The point he has just made is very broad, so if he could wait a few minutes, I hope to be able to address the concerns that he has expressed.

I mentioned earlier that, in 2014, the Government had offered guidelines on concessions for patients and visitors. I welcomed that, as it was a sign that the Government were aware of the extortionate costs facing hospital users, but the problem with the guidance is that none of it is mandatory. In fact, the guidance encourages the postcode lottery. The guidelines state that charges should be reasonable for the area. Trusts are free to set their own fees, which means that patients and staff living in London and the south-east are charged the most. I have asked the Government on a number of occasions what constitutes a reasonable charge, and I consistently receive responses along the following lines: first, that hospital car parking charges are a matter for individual NHS trusts; secondly, that local NHS trusts are expected to follow the published guidance; and thirdly, that the Department of Health and Social Care has not discussed car parking charges with local NHS trusts.

[Sandy Martin (Ipswich) (Lab)]

Will the right hon. Gentleman give way?

[Robert Halfon]

I will give way one last time, as I want to be fair to Mr Deputy Speaker who spoke to me before the debate started.

[Sandy Martin]

Does the right hon. Gentleman accept that the national health service is not best placed for administering car parks, and that if we take car parking charges away from it we should also take away the whole provision of car parking from it and ensure that it does not lose out financially as a result?

[Robert Halfon]

The hon. Gentleman raises an important point. The crucial thing is that the NHS does not lose out financially. I think that that is the substance of what he is saying.

Sadly, the guidance is superficial. I have been unable to work out what constitutes a reasonable charge. The Government are not able or willing to keep local trusts in check. Since 2013, the campaign to scrap hospital car parking charges has gained speed, with more and more leading UK charities and associations representing drivers carrying out research into the negative effects of the charges on different groups of patients and drivers.

The sick and vulnerable are disproportionately hit by the charges, particularly those with long-term or severe illnesses who require repeated or lengthy stays in hospital. Research has shown that cancer patients and parents of premature babies face the greatest financial consequences. CLIC Sargent, a wonderful charity supporting young people with cancer, found that families were paying an average of £37 in car parking charges every month, with some families paying up to £10 per day. It also says that more than one in four parents of a child with cancer—29%—are not offered a reduction in parking costs by their NHS trust.

Macmillan Cancer Support mirrors that sentiment, saying that cancer patients in England are paying extortionate hospital car parking charges. Bliss is another very special charity for families with premature babies. Although some babies stay in the neonatal unit only for a few days, some parents will have to pay more than £250 if their baby stays in the neonatal unit for eight weeks. The charity says that many parents cannot even afford to go to see their premature baby because of the cost of hospital car parking.

I have a quote from the charity, Headway, which really sums up the whole debate. Headway does an incredible amount of work with brain injury. This is what it said:

“Recently, we supported a family who had spent more than £1,500 in parking charges in only 15 weeks. They needed to be at the bedside of their son who was fighting for his life after sustaining brain injury. What parent wouldn’t want to be there, day and night? Yet they were faced with a huge bill. These charges are driving families into debt and despair at a time when they already have more than enough to cope with.”

Kidney Care, another charity, told me that dialysis patients have to go to hospital three times a week, and each appointment takes four hours, with the average cost of four hours of parking estimated to be £3.28. Members can imagine how the costs stack up. The right hon. Member for Kingston and Surbiton (Sir Edward Davey) mentioned disabled car parking. It is extraordinary that, despite the Government guidance, almost half of hospitals inexplicably charge disabled drivers. They do not go to hospital out of choice. It is harder for them to use public transport, yet they have to pay significant charges. Even the hospitals that allow free parking attach a lot of conditions to that provision. Scope, the charity supporting disabled people, shares the sentiment, widely noting that disabled people

“have on average £108,000 fewer savings and assets than non-disabled people”.

It is not just charities that do valuable work. The RAC and FairFuelUK have also supported the campaign to scrap hospital car parking charges. I have worked with Howard Cox at FairFuelUK for a number of years in order to freeze fuel duty. The organisation held a poll last year with almost 9,000 respondents, 95.5% of whom wanted hospital parking scrapped or set at a maximum of £1. The RAC carried out a serious survey of more than 1,000 motorists. Two thirds of them named hospitals as the location where they most disliked having to pay for parking, and 41% said that the Government should scrap hospital parking charges immediately. It is clear that support is growing for the campaign to scrap hospital car parking charges, not only from the charities representing the most vulnerable—often with long-term and life-threatening illnesses—but from the two major organisations representing millions of motorists in the United Kingdom.

The support for an end to hospital car parking for patients and their visitors is clear, but we must not forget our incredibly hard-working NHS staff, some of whom are charged to go to work. Other public sector workers such as police officers and teachers are, for the most part, rightly able to park for free on their work premises, whether at a police station or a school. The Government guidance suggests that concessions should be available to all hospital staff—nurses, porters, cleaners, occupational therapists and doctors—working shifts that make public transport use difficult, but so much of the hospital workforce cannot rely on public transport to get to work.

Let us take the example of a hospital worker living in Pocklington in Yorkshire. He or she would either have to make the 15-mile drive to work at York Hospital and pay £2 to park during the shift, or spend more than an hour on two buses to get to work. If staff are working shifts at unsociable hours—as, of course, many do in the health service—they have no choice but to use hospital car parks.

Although all hospitals seem to offer a discounted parking scheme based on pay band or salary, or by allocating a limited number of discounted staff spaces, NHS staff are charged to work unsociable hours. The hon. Member for Kingston upon Hull West and Hessle (Emma Hardy) was told by hospital staff that they cannot afford the charges at hospital car parks, so they have to park on unlit nearby streets, which leaves them vulnerable when leaving the workplace at night.

Interestingly, staff car parking charges are a nuisance not just for hard-working NHS staff, but for residents too. I was recently contacted by a resident of Scarborough. This person was delighted to hear of the campaign, but came from a rather different angle. Staff park in the residential roads around Scarborough General Hospital to avoid being charged to go to work. The influx of cars every day means that driveways are blocked, there is more traffic on the road and residents are unable to go about their daily business.

I realise that hospital parking charges can be a source of income for hospitals. They are certainly a goldmine for some private companies, but the Government have previously stated:

“Providing free car parking at NHS hospitals would result in some £200 million per year being taken from clinical care budgets to make up the shortfall.”

I have a number of things to say about that. When considered in the content of the £120 billion-plus to be spent on running the NHS, the figure of £200 million is put into perspective. Going on the assumption that free hospital car parking would cost £200 million a year, I think that there are a number of funding options that would not leave hospitals out of pocket or affect clinical care budgets. The Government themselves have published a report saying that better procurement in national health service hospitals would bring in more than £1 billion a year. I am just asking for £200 million to scrap hospital car parking charges.

The Department of Health financial accounts for 2016-17 suggest that the Department underspent its revenue budget by £563 million, which is about 0.5% of the total budget. Could some of this money not go towards covering the parking costs of patients and hospital staff? It might also be time to look at other areas of government where we spend a significant amount of money and look at reallocating the very small amount of that money—£200 million—that it would take to scrap hospital car parking charges.

Another concern, raised by my hon. Friend the Member for Solihull (Julian Knight), is that free parking at hospitals would be exploited by shoppers. However, this could easily be solved by using parking tokens validated by ward staff. Some NHS hospitals in England do the right thing and provide free parking, including Northamptonshire Healthcare NHS Foundation Trust and Leicestershire Partnership NHS Trust. That shows that it is possible to deliver free parking for patients, visitors and staff while discouraging abuse of the system with tokens or barriers. Having contacted hospitals in Scotland and Wales directly, I know that there are numerous parking solutions to ensure that free parking is not exploited. Alongside the abolition of hospital car parking charges, a system could be introduced whereby a ticket or token is presented to ward staff at the beginning of the visit and validated at the end.

It is time to end the hospital car parking rip-off once and for all. The NHS is supposed to be free at point of access. It was never envisaged that people with cars would have to pay on top of their taxation for the national health service, yet patients and visitors are charged for access to vital services. That causes a huge amount of stress to many. It affects the most vulnerable: parents with sick children, patients suffering from long- term illnesses, and staff without access to public transport. These charges are a cause of major social injustice. Clearly, the Government guidance is not working. I urge the Government to look into the most efficient way to scrap hospital car parking charges and bring an end to this stealth tax on drivers once and for all.

[Several hon. Members rose—]

--- Later in debate ---

[Dr Lisa Cameron (East Kilbride, Strathaven and Lesmahagow) (SNP)]

It is an honour to speak in this debate, and indeed in any debate in which the NHS is at the heart of what is being discussed. I particularly thank the right hon. Member for Harlow (Robert Halfon) for bringing the debate to the House. As has been discussed, the matter is extremely important to patients, charities, emergency workers, volunteers, carers and NHS staff, so it is a credit to him that he secured this debate. He set out his case most eloquently and comprehensively.

The SNP Scottish Government scrapped hospital car parking charges approximately 10 years ago in all car parks that are owned by the NHS. I urge the UK Government to follow both this principle and policy.

As an NHS employee for more than 20 years, I must declare an interest. I was part of the campaign, all those many years ago, as a Unite rep, to scrap NHS parking charges. I was so pleased when we succeeded, because that has made a great difference to many people, and has saved some of the most vulnerable who are already facing so many financial difficulties from spending money on parking.

[Robert Halfon]

The hon. Lady has been very generous in giving way, and I thank her for her kind remarks. Given that, for the most part, hospital parking charges have been scrapped in Scotland, she must have heard about how the problem of people perhaps misusing the car parks to go shopping or whatever was dealt with.

[Dr Cameron]

Indeed. Where there is a will there is a way. It can happen; it can be done. Basically, it is a matter of prioritisation and making things happen. That issue can be raised with the Minister today.

Hospital car parking charges hit the most vulnerable people in our society: disabled people; those who are chronically and even terminally ill; families caring for terminally ill children; and those who require repeat appointments and lengthy hospital stays. Before the change in Scotland, I heard about families and couples who had had their cars impounded because their partner was giving birth in the maternity unit and things did not go quite to time, as happens so often in these cases, and they were unable to feed their meter. At a time of utmost importance for the family, that is one of the last things that we would want to have on our mind.

NHS staff, particularly those on community-based shifts, are also penalised. They often have no choice but to use their cars to travel from the hospital to make community visits, so they cannot travel by public transport to their hospital base. There is something fundamentally wrong with charging our valued NHS staff to get to their work of saving lives when their pay has already been affected for so many years by caps.

The SNP is clear that the founding principle of the NHS is services that are free for everyone—services that are not out for profit. We have heard today from hon. Members that it is sometimes cheaper to park in town centres than to park at hospitals. That just cannot be right. By 2015, getting rid of hospital car parking charges had saved patients and staff in Scotland more than £25 million. Parking charges are basically a tax on NHS treatment, and that cannot be allowed to go on. As chair of the all-party group for disability, I am particularly concerned that people with disabilities, who we know are more likely to experience poverty, are being doubly financially penalised if they require medical treatment, as in England they have to pay for hospital parking—should they have retained their Motability vehicles of course.

The right hon. Member for Harlow is right that there are pragmatic ways to address the issue. The things that are said to prevent change from coming about can be overcome. He discussed tokens and other pragmatic ideas that can be put in place and that can work. We have made this work—we made it a success—so it can happen. With the will, there is the way.

I will take a brief moment to extend the issue from hospital parking charges by addressing parking for NHS staff in health centres. I believe that all health centres in my constituency have free parking, aside from the new Hunter Community Health Centre multi-storey car park. I have been in a somewhat intransigent negotiation with NHS Lanarkshire for more than a year, as only a limited amount of permit parking has been made available for staff. This has unfortunately meant that some staff—often those in lower pay bands, such as admin staff—face extortionate weekly charges for getting to work. That is unprincipled and unfair. Why should we penalise only staff who work in a particular health centre?

On Fridays, I have taken to monitoring the free spaces in the car park. I can assure the House that it is half empty every single Friday, which is usually an extremely busy day for car parks elsewhere, so there are enough spaces for the staff. I once again urge NHS Lanarkshire’s chief executive, Calum Campbell, to reverse this decision and ensure that permits for staff, as requested, are restored and that this principled step is taken. I will be writing to him after the debate, which I am sure he will look forward to, as he always does. I will let him know that he has been mentioned in the House of Commons once again.

I thank hon. Members from all parties who have taken part in this debate: the hon. Members for Great Grimsby (Melanie Onn), for Telford (Lucy Allan), for Kingston upon Hull West and Hessle (Emma Hardy), for Colne Valley (Thelma Walker), for Slough (Mr Dhesi), for Batley and Spen (Tracy Brabin) and for Enfield, Southgate (Bambos Charalambous); the hon. Member for Cleethorpes (Martin Vickers), who raised an important point about people in rural areas being badly affected; the right hon. Member for Hemel Hempstead (Sir Mike Penning), who made an extremely pertinent point about volunteer drivers; and the hon. Member for Heywood and Middleton (Liz McInnes), who worked for the NHS as fellow Unite rep in my time, and who has done great work for the NHS.

Everyone who has spoken has urged the Government to act. We do not need any superficial rhetoric, but we do need action. I ask the Minister and the Government to act by putting NHS patients, staff, carers, relatives, volunteers, emergency workers and those who care about the NHS first. We are all requesting change. This request must be taken forward, and I trust that the Minister will do so.

[Julie Cooper (Burnley) (Lab)]

I am pleased to have the opportunity to respond to this debate on a very important subject. I am grateful to the right hon. Member for Harlow (Robert Halfon) for bringing this subject forward. He and I agree on most aspects of the issue, and he has campaigned passionately on it for so many years.

[Robert Halfon]

As you have.

[Julie Cooper]

I thank the right hon. Gentleman for that comment.

I am grateful to Members on both sides of the House because it seems that there is much agreement on the matter. It is heartening to hear Members mentioning—and fully understanding—its impact on patients, visitors, carers and NHS staff. My hon. Friend the Member for Great Grimsby (Melanie Onn) mentioned the effect on the greater transportation system.

The hon. Members for Telford (Lucy Allan) and for Cleethorpes (Martin Vickers), and my hon. Friend the Member for Kingston upon Hull West and Hessle (Emma Hardy) made powerful speeches, as did my hon. Friend the Member for Colne Valley (Thelma Walker), who accused the system of profiteering. My hon. Friend the Member for Heywood and Middleton (Liz McInnes) made an important point on behalf of staff. The right hon. Member for Hemel Hempstead (Sir Mike Penning) referred to the burden of having to pay to go to work. My hon. Friends the Members for Batley and Spen (Tracy Brabin) and for Enfield, Southgate (Bambos Charalambous) mentioned personal family issues when people are taken away from a sick family member’s bed to replenish parking meters.

No one likes to pay to park, but to pay to park at a hospital really does add insult to injury. We are not talking about a luxury experience, a shopping trip or a fun night out; we are talking about paying to visit a hospital. People are not queuing up to go to the hospital café, as the hon. Member for Telford pointed out. No one goes to hospital because they want to. People go because they are sick. They go for treatment, for surgery, for chemotherapy and for kidney dialysis, and they go to visit loved ones. In short, hospitals are not destinations of choice: people go because they must. I am quite shocked that it is free to park at Trafford shopping centre yet I must pay to park at my local hospital.

During the past three years, I have spent hours and hours visiting my mother in hospital. I have often gone backwards and forwards two or three times a day, juggling hospital visiting around work and other commitments. I have to say that it has all been very distressing. As I leave the hospital each night worried, wondering what tomorrow will bring, the last thing I want to do is to stand outside in the cold queuing to pay for my parking. This burden is, of course, in addition to the actual cost.

Some hospital car parks demand payment in advance, as we have heard. This brings its own set of problems, because patients and visitors have to judge how long each hospital visit will last, and then often have to leave the ward or treatment room to feed the ever-hungry parking machine. Of course, running to and fro between the car park and the hospital is impossible for someone hooked up to a dialysis machine. Many dialysis patients suffer with multiple conditions and are unable to work, so paying to park three times a week for dialysis sessions that each last four to five hours is a real financial burden for them and their carers.

Paula in my constituency relies on the weekly £62.70 carer’s allowance she has received since she was forced to give up work to provide round-the-clock care for her husband, who suffered a severe stroke. He has been in hospital for the past month. She has visited every day, often staying for two to three hours to support and comfort him. This costs her more than £20 a week. By the time she has paid for her petrol, half her carer’s allowance is gone.

We have a national health service that was set up to be free at the point of delivery. It was established in 1948 to make healthcare a right for all, but that is not what is happening. Even though hospital car parking is free in Scotland and Wales, here in England, hospital users are forced to pay often extortionate rates, with charges varying from £1.50 an hour to £4 an hour. We are charging the chronically ill, the terminally ill, and their carers and visitors. More than half of all people over 76 have conditions that require regular hospital appointments, and hospital car parking charges are an extra burden for them and their families. The Alzheimer’s Society reports that patients with dementia stay five to seven times longer in hospital than other patients aged over 65. Hospitals can be frightening places for people with that condition. They rely on family and carers visiting them to give support. Parking charges are an extra burden that these families could well do without.

The Patients Association has commented:

“For patients, parking charges amount to an extra charge for being ill…Hospital appointments are often delayed or last longer than expected, so even if you pay for parking you could end up being fined if your ticket runs out. Visiting a hospital can be stressful enough without the added concern of whether you need to top up the parking.”

Macmillan Cancer Support says:

“The core principle of the NHS is to provide free healthcare for all at the point of access. But sadly some cancer patients in England are paying extortionate hospital car parking charges in order to access treatment for a life-threatening illness.”

Bliss, the charity for babies born prematurely or sick, says in its “It’s not a game: the very real costs of having a premature or sick baby” report that these charges can contribute to the financial burden that many families face when their babies need neonatal care.

In the midst of all this misery, the average hospital trust is making £1 million of profit from car parking charges, and several hospitals the length and breadth of the country report profits of over £3 million. Last year, NHS hospitals made a record £174 million from charging patients, visitors and staff. In addition, 40 trusts report additional income from parking fines.

Some people point out that public transport is an option that avoids parking charges. Public transport provision has been reduced in response to funding cuts, but even where it exists, there are many for whom it is not an option. Some patients are too unwell or too frail to travel on a bus. Others, including cancer patients attending for chemotherapy, have reduced immunity and must avoid contact with the general public.

--- Later in debate ---

[The Minister of State, Department of Health and Social Care (Stephen Barclay)]

May I begin by commending my right hon. Friend the Member for Harlow (Robert Halfon) for securing the debate? Members across the House recognise that he has campaigned assiduously on this issue for some time, as he has on many campaigns, and he has already had some success, as reflected in the Government guidelines issued in 2014. However, it is right, in the light of the concerns raised across the House, that the issue is revisited. This has been a very constructive debate, granted by the Backbench Business Committee, and I commend all Members who have contributed and informed the House of what is happening in their constituencies.

I do not think anyone in the House has any issue with the desirability of scrapping car parking charges. As English Members of Parliament—it is different for our Scottish National party colleagues—we all pay these charges, as the hon. Member for Great Grimsby (Melanie Onn) said in a constructive way. We all know that they are unpopular with our constituents and are a concern for staff working hard within the NHS.

As my right hon. Friend the Member for Hemel Hempstead (Sir Mike Penning) highlighted, the charges predate this Government. This issue has long been debated in the House, by parties on both sides. The issue is not the desirability of what is sought by my right hon. Friend the Member for Harlow. The issue is the execution and how it would be done in a way that does not have unintended consequences, and how those might be mitigated. I think we got a flavour of some of those unintended consequences in the constructive contributions made by Members on both sides of the House.

Implicit in the motion is the suggestion that car parking charges apply in all NHS hospitals. It is not in the specific wording, but the impression from the debate has been that they apply across the NHS as a whole. However, as hon. Members will be well aware, 67% of NHS sites do not charge at all at present. We are talking about a subset of the NHS where charges apply, albeit that the subset is particularly concentrated in the acute sector, from which many of the examples we have heard come. For example, mental health patients, who are often among the most vulnerable of our constituents seeking the support of the NHS, do not on the whole face charges because those parking facilities are not charged for. This tends to be an issue in the acute sector.

[Robert Halfon]

I thank my hon. Friend for his kind words, but I must say that I disagree with what he has said. Hospital car parking charges in England are widespread, and we just have to go from one hospital to another to see that. As I said, nearly 50% of hospitals are charging the disabled, for example.

[Stephen Barclay]

With respect to my right hon. Friend, it is a statement of fact, as confirmed by my officials—I am very happy to correspond with him further about it—that 67% of NHS sites do not charge. If one wants to get into the definition of a hospital, it actually covers more than acute services. I do not want to get distracted by that point. The one I was seeking to make is to recognise that this issue is particularly concentrated on acute hospitals, and that is the issue before us.

The hon. Member for Great Grimsby recognised that there is considerable room for flexibility within trusts. One of the key issues in this debate is the distinction between charges covering the maintenance of car parks, and how a reduction in charges may lead to a reduction in the number of spaces and the quality of the facilities—we heard, for example, about the state of the car parks in north Manchester—and those involving profiteering, with charges going beyond of the cost of maintenance. The hon. Lady is concerned about that, and the interplay with the current guidance. The hon. Member for Colne Valley (Thelma Walker) also mentioned that when she highlighted the distinction between the charges at her hospital and those of the local authority, and raised the issue of transparency.

The right hon. Member for Kingston and Surbiton (Sir Edward Davey) expressed concerns about transparency in relation to blue badge holders. They are not means-tested, so an affluent blue badge holder could be spared a charge while a less affluent visitor to a hospital is charged. Transparency about how the guidance is applied is therefore a factor, as has been recognised.

[Stephen Barclay]

Absolutely. As my right hon. Friend will be aware, the guidance speaks to that. My hon. Friend the Member for Cleethorpes (Martin Vickers) mentioned the 64 pages of guidance. I am very happy to take away and look at why there are 64 pages of it. Blue badges are part of the conversation that my right hon. Friend the Member for Harlow began in 2014.

[Robert Halfon]

I have huge respect for my hon. Friend, but the fact is that the guidelines in relation to blue badges are not working. According to the FOI request—this is backed by charities such as CLIC Sargent—up to 50% of hospitals are still charging disabled people to park. There is no point talking about the guidelines if people with disabilities are still being forced to pay to park at hospitals in England.

[Stephen Barclay]

I am very happy to look at such cases and to speak to those trusts to understand this better, but I was making a point about the complexity of the issue and how to manage reducing the charges. For example, as the hon. Member for East Kilbride, Strathaven and Lesmahagow (Dr Cameron) will no doubt be aware, there were local media reports over the summer about a hospital car park in Inverness being used by those going to the airport; there was displacement there. We do not want a solution that constrains capacity for those using the hospital and makes access more difficult.

Some of these issues have a very local flavour. That was recognised in the debate: the hon. Member for Heywood and Middleton (Liz McInnes) said that shoppers do not seek to use the car park at the north Manchester site, whereas my hon. Friend the Member for Solihull (Julian Knight) was concerned that simply removing charges would cause displacement at his hospital. The point is that there are local factors, just as there are with legacy PFI contracts, including in Scotland and Wales, where charges are still made under contracts going back to 2008.

--- Later in debate ---

[Robert Halfon]

I thank the hon. Members who have spoken from both sides of the House. The Minister has heard about the madness of the guidelines not working, the problems with public transport, parking being given over to football club supporters, as my right hon. Friend the Member for Hemel Hempstead (Sir Mike Penning) said, and the moving stories of families and the problems that people with severe illness have had to face.

I have to say, I am incredibly disappointed with the Minister’s response. I gave him my speech in advance because I wanted him to look at this seriously, but a lot of what he read is very much what we might think would come from officials. It is a great disappointment. He opened his speech by saying that he believes in the desirability of this, but then gave no indication of how. Many hospitals have hospital car parking charges, as figures show. It is not beyond the wit of man to develop a number plate recognition system to deal with the problems of people misusing hospital car parking.

The Minister said that we will just try to make sure the guidelines work. Well, even if the guidelines were working, they would still mean that many hospitals charge millions of patients and visitors. On both sides of the House, we constantly talk about the billions being spent on the NHS and whether they should be. Most members of the public find that hard to understand, but this is real and it affects millions of people who go to hospital regularly—as has been said again and again today, not out of choice, but because they have to. This is real and substantive, and a solution would not cost a huge amount of money in terms of the overall NHS budget. There are different solutions to pay for it, so that the NHS is not harmed.

I strongly urge the Minister to look again at this issue and realise that there is cross-party consensus in the House. Many Government Members want the situation changed. When this issue comes up again, I urge him to come back with a more substantive solution to scrap hospital parking charges. That is why I moved the motion today.

Question put and agreed to.

Resolved,

That this House calls on the Government to undertake a consultation to identify the most efficient means of abolishing car parking charges at NHS hospitals in England for patients, staff and visitors and to provide the timescale for its implementation.

NHS Winter Crisis

Robert Halfon Excerpts

Monday 8th January 2018 Commons Chamber

[Mr Dunne]

I have to say that I am disappointed with the right hon. Gentleman. He was a Minister in the previous Labour Government, and in each quarter for which I have the figures, which go back to 2000, between 10,000 and 20-something thousand procedures were deferred or cancelled. This problem has affected this country’s health service every year, going back to the beginning of recorded data.

[Robert Halfon (Harlow) (Con)]

My hon. Friend will be aware that Harlow’s Princess Alexandra Hospital has among the highest rates of A&E use in England. That has been exacerbated by the winter crisis, which has caused significant pressures on the ambulance services, resulting in a constituent having to wait 10 hours for an ambulance over Christmas. Will my hon. Friend redouble his efforts to do everything possible to have a new hospital in Harlow, to help us with the infrastructure and ensure that Harlow has a hospital that is fit for purpose for the 21st century?

[Mr Dunne]

My right hon. Friend is another consistent campaigner in favour of improving the infrastructure and estate of his hospital. He has invited me to visit; I have seen it and I am well aware that the hospital trust has put in an application for a significant rebuild, which will be considered in the allocation of the next phase of sustainability and transformation plan funding.

Capital Funding: New Hospital in Harlow

Robert Halfon Excerpts

Wednesday 18th October 2017 Westminster Hall

[Robert Halfon (Harlow) (Con)]

I beg to move,

That this House has considered capital funding for a new hospital in Harlow.

It is a pleasure to serve under your chairmanship, Mr Howarth, and I am grateful to Mr Speaker for allowing this debate. The Princess Alexandra Hospital was completed in 1966 to provide acute hospital and specialist services for around 350,000 people living in Harlow and the surrounding areas. Alongside others, I have been working hard for Harlow residents to improve healthcare services, so that they are fit for the 21st century. I have worked to secure extra funding and more doctors and nurses for our hospital, and the new leadership team work tirelessly to do everything possible to improve performance.

However, only so much can be done at the hospital as it stands. The infrastructure is deteriorating. The accident and emergency services are overstretched and staff retention remains a serious problem. It is for these reasons that I am putting forward the case for capital funding for a new health campus in Harlow, bringing together accident and emergency services, GP provision, social care, physiotherapy and a new ambulance hub—bringing healthcare in Harlow into the 21st century.

The Princess Alexandra Hospital is in special measures. It was judged as inadequate overall by the Care Quality Commission in 2016. It is important to note, however, that maternity and gynaecology were rated outstanding at the inspection. Day in, day out, a huge amount of remarkable work is done by the hospital leadership, the hospital’s chief executive Lance McCarthy, and above all the doctors, nurses and auxiliary staff, to provide the very best care they can.

I take this opportunity to thank and praise the health trade unions, led by people such as Councillor Tony Durcan from the nurses’ union, and Councillor Waida Forman and Daniella Pritchard from Unison, whose only aim, whatever our occasional political differences, is to improve the quality of hospital care and the services for their members. Much of this improvement work has been noted by the CQC. Its report, however, outlined various remaining concerns, from staff shortages to deteriorating mortuary fridges, some of which were no longer fit for purpose and were ordered to be repaired during the inspection.

This leads me to my first and most pressing concern. The Princess Alexandra Hospital is not fit for purpose. It is unable to provide healthcare fit for the 21st century and Harlow and the wider area. According to the CQC report in 2016:

“The environment was one of the top risks for the trust. The estate was aged and in need of repairs costing tens of millions”.

Much of the hospital is original and therefore over 50 years old. It has exceeded its useful life and much of the infrastructure is in a state of permanent decline. In addition to the original hospital built in the 1960s, a number of temporary structures have been added, many of which have now surpassed their 10 to 15-year lifespan. That creates a complicated design, with urgent care spread across the site.

A 2013 survey rated 56% of the hospital’s estate as unacceptable or below for its quality and physical condition, which puts the capacity of the hospital to care for those in need at serious risk. That becomes strikingly clear when we read and hear reports of sewage and rainwater flowing into the operating theatres.

The doctors, nurses, management team and support staff at the Princess Alexandra Hospital work so hard, every single day, but their working lives are made so much harder by the hospital’s deteriorating facilities. In addition to the ageing infrastructure, the services are under increasing pressure to provide care to residents in Harlow and the surrounding area. Changes to other local facilities have placed additional pressures on the trust’s capacity, resulting in occupancy levels running higher than 96%. That means that the Princess Alexandra is not only fundamental to the health and wellbeing of the growing Harlow population, but to a wider area, including parts of Hertfordshire and Epping Forest—it is very good to have my hon. Friend the Member for Hertford and Stortford (Mr Prisk) in the Chamber to ensure we get good health services in our area.

[Mr Mark Prisk (Hertford and Stortford) (Con)]

I congratulate my right hon. Friend and parliamentary neighbour on securing this important debate. Does he agree with me that in my constituency and his, ever since the previous Labour Government scrapped their plans for a new hospital at Hatfield, there has been a sense locally that somehow our area has been ignored for capital investment, and that is why his proposal is so sensible?

[Robert Halfon]

As usual, my hon. Friend makes a powerful point. I will come on to how changes in nearby hospitals have had a significant effect on the Princess Alexandra Hospital.

The emergency department in particular suffers. As the CQC reported last year:

“Long waits in the emergency department and capacity issues in the wards meant that patients were not always seen in a timely manner, with many patients in the emergency department breaching four hour and 12-hour targets.”

As I understand it, we have the highest A&E use of any hospital in England. The department struggles to deliver the national four-hour standard, achieving 72% for 2016-17. Having said that, the A&E department saw 10,628 more people in less than four hours last year than it did in 2009-10. This improvement is astonishing when considered against the changes to the nearby emergency departments and with attendance rates at the Princess Alexandra Hospital being 10% higher than the national average, at around 200 to 300 visitors per day.

Chase Farm Hospital near Enfield became an urgent care centre in 2013. The same happened at the Queen Elizabeth II Hospital near Welwyn Garden City in 2014. Urgent care centres only deal with minor injuries, while the Princess Alexandra Hospital deals with those plus major injuries, including life-threatening chest pains and head injuries. All major injuries and illnesses have been dispersed to surrounding emergency departments, and attendance at the Princess Alexandra Hospital has risen consistently.

[Lucy Allan (Telford) (Con)]

My right hon. Friend is making an excellent and passionate speech about the needs of his community—a new town, just like mine. He is setting out the problems of decaying infrastructure against a backdrop of increasing population. Does he agree that, as new town MPs, we should be championing our hospitals at all times? They are the centre of our communities and cement our identity. Hospitals are something people are deeply attached to and they form so much of what the town is, whether it is the Princess Alexandra or the Princess Royal in Telford.

[Robert Halfon]

My hon. Friend has set up the all-party parliamentary group on new towns, of which she is the chair and I am pleased to be vice-chairman. We set it up because we have many of the same problems. Our towns were built at the same time and we have the same issues, whether it is to do with our hospitals or regenerating housing and our high streets. I thank her for the work she does on this and the way she represents her new town and her constituents in Telford.

As I was about to say, the hospital secured £1.95 million of emergency department capital funding in April this year, allowing significant building works to support the department’s work, including the expansion of the medical assessments base. That is coupled with an A&E-focused recruitment drive to take advantage of the new facilities.

That leads me on to staff recruitment and retention. While Harlow hospital now has 27 more doctors and 35 more nurses than in 2010, the vacancy rate in recruitment is a perpetual worry. The nurse vacancy rate for September stood at 25%. Staff vacancy rates were picked up in the CQC report in 2016, in which inspectors found that

“staff shortages meant that wards were struggling to cope with the numbers of patients and that staff were moved from one ward to cover staff shortages on others.”

The proximity of Princess Alexandra Hospital to London plays a major role and, although pay weighting is a factor, I have been told by the hospital leadership and Harlow Council’s chief executive, Malcolm Morley, who is in Parliament today, that career development is significant. Princess Alexandra Hospital must compete with Barts and University College Hospital in specialist training and career development. The retention support programme established career clinics and clear career pathways, but there is only so much that the hospital can do to compete with the huge investment and facilities at London hospitals. Harlow needs to be able recruit and retain staff. Recruitment is related partly to the future of the hospital itself and partly to the staff’s ability to develop their careers in Harlow. Of course, both factors relate to the hospital’s infrastructure.

I have tried to make sure that our NHS in Harlow is a top priority for the Government, and I have had many meetings with the Health Secretary and the hospitals Minister. I am pleased to say that they have visited our hospital a number of times, most recently in May, when the Health Secretary visited the Princess Alexandra Hospital to speak to the hospital leadership team about Harlow’s case for a new hospital. He spoke of

“the exciting proposals which are coming together to invest capital in upgrading these facilities, including the option of a brand new hospital.”

He also stated:

“These proposals are at an early stage but upgrading services on this important site will be a priority for a Conservative government”.

Following capital funding announcements for sustainability and transformation partnerships in July, I was informed that

“Princess Alexandra Hospital is still a real priority”

for the Department of Health

“and work is ongoing to take it forward”,

and that the Government are “on hand” to carry on helping to get the Princess Alexandra bid together. Given that the Health Secretary said that Princess Alexandra Hospital is a priority case, will the Minister say what the current budget is for capital funding and how it will be allocated to new hospitals, such as Harlow?

In autumn 2016, the Secretary of State requested that the PAH board, the local clinical commissioning group and local authority partners progress a strategic outline case. After considering a number of options,

“the SOC concluded that a new hospital on a green field site, potentially as part of a broader health campus, to be the most affordable solution for the local system”—

note the expression “most affordable”—

“and the solution that would deliver most benefit to our population.”

The health campus would bring together all the services required to ensure that healthcare in Harlow is fit for the 21st century: emergency and GP services, physio, social care, a new ambulance hub, a centre for nursing and healthcare training.

Having recently met the chief executive of the East of England Ambulance Service, I know that there has been a significant increase in the number of calls from critical patients who need a fast response. Harlow has four new ambulances but the development of a top-class ambulance hub would allow huge improvements in that area. The health campus could also act as a centre for degree apprenticeships in nursing and healthcare, bringing specialist training to the eastern region. It could build on strong links between the Princess Alexandra Hospital and Harlow College and capitalise on the new Anglia Ruskin MedTech innovation centre at the Harlow enterprise zone.

The health campus proposal has been supported by West Essex CCG, the East and North Hertfordshire CCG and the Hertfordshire and West Essex STP, which brings together 13 local bodies and hospital trusts. A joint letter has been signed by more than 10 councils, including Harlow Council, Epping Forest District Council, Essex County Council and the Greater London Authority.

Despite recognition from local authorities and Ministers alike, some NHS England officials—I stress the word “some”—suggest that a refurbishment would be more fitting than the development of a brand-new hospital, due to capital funding constraints. That solution is the equivalent of an Elastoplast—a short-term option that will do nothing to solve real, long-term problems.

Given the support from the Government and key organisations, we need to be sure that plans for a new hospital are not obstructed. Will the Minister give an assurance that NHS England and NHS Improvement will work positively with public, private and voluntary sector partners to progress the plans? A rapid strategic solution is needed, rather than a short-term fix.

The cost of the new campus model would be between £280 million and £490 million, depending on the type and preferred method of funding. The hospital leadership is looking at all the options to maximise public sector investment and bring together the public, private and voluntary sectors. Private investment will not involve any kind of private finance initiative contract. Instead, the leadership will focus on how the private sector works with the NHS and how the development can generate revenue flows through social care, for example. The development also raises the potential development of housing as a source of income and private investment. These are decisions for the future. When the PAH leadership looks at private investment, it will consider supported housing and similar options.

Moreover, Public Health England’s move to Harlow will create a world-class health science hub. Without exaggeration, once Public Health England has completed its move, Harlow will be the health science capital of the world, Atlanta aside. We must ensure that the Princess Alexandra Hospital is an important partner that benefits from and adds to that success. The creation of a health campus is vital not only for Harlow but for the surrounding area. The infrastructure of the campus would be fundamental to the vitality of the community and the economy of the entire region that the Princess Alexandra serves.

I have visited the Princess Alexandra Hospital many times. I defy the Minister to find more professional and dedicated staff, doctors and nurses. They work day and night to look after the people of Harlow and the surrounding area. I have seen the incredible work in A&E, intensive care and the maternity and children’s units. That is why I know that PAH staff are second to none. However, their professionalism and hard work will go to waste unless our hospital is fit for purpose. I know that the Secretary of State recognises that, given his numerous visits to the hospital and what he has said since. I know that the Minister himself recognises that, given his visit to the hospital this time last year. I know that all the key local authorities, neighbouring MPs and trusts are supportive. I urge the Minister to do everything possible to ensure that Harlow has a hospital that is fit for the 21st century.

[Mr George Howarth (in the Chair)]

Before I call Mark Prisk, he needs to be aware that adequate time must be allowed for the Minister to respond. If he does not appear to be finishing his speech in a timely manner, as I am sure he will, I will intervene to bring in the Minister.

Autism Diagnosis

Robert Halfon Excerpts

Wednesday 13th September 2017 Westminster Hall

[Robert Halfon (Harlow) (Con)]

It is a pleasure to serve under your chairmanship, Mr Howarth, and I congratulate the hon. Member for Enfield, Southgate (Bambos Charalambous) on securing the debate. I also congratulate the new Minister.

I have learned a lot about this issue from my local and national charity in Harlow, PACT for Autism, which does remarkable work for families. It has been made clear to me that, although there is help out there, as described today, the diagnosis process is incredibly complicated and goes on for years. A case in Harlow sums up everything that has been described:

“My son is 7 and we are going through the very slow and frustrating process of getting a diagnosis for ASD. We are a year into the process and…we have had 1 appointment with a paediatrician who confirmed he had High Functioning ASD and told us that she would see us in a few months to complete the background and then he would be diagnosed. She then backtracked and he has been put on a waiting list (9-12 months) for CDAC—I don’t even know what this is and I’m assuming that after this we will be put on a waiting list for ADOS which we have been told is a minimum of a year. My husband spoke to her yesterday because we have been waiting for over a month for the outcome letter from our appointment. She told my husband that we would be better getting a private diagnosis and then the NHS would rubber stamp it. I am feeling a bit lost—there seems to be no clear process and I am not sure what I need to be asking the NHS for.”

The average waiting time for an autism diagnosis has been described as being between 2.5 and 3.5 years for children and 2.5 years for adults, which is far too long. It hurts parents, who are incredibly anxious to support their children; it hurts schools, which will not be receiving the funding they need to help their students reach full potential; and it hurts the children themselves, whose struggle to understand themselves and their autism may lead to mental health difficulties.

We need to recognise that some individuals with autism do not get a diagnosis until they are adults. I understand from PACT for Autism that it is seeing an increase in contact from adults seeking support because local GPs seem unaware of the diagnostic pathway for adults and are “reluctant” to refer patients. It is also important to consider the support and guidance available to individuals and families during and after diagnosis. The diagnosis process can be complicated, sometimes with no follow-ups from the NHS.

On a positive note, however, in Harlow we are lucky to have some fantastic support in schools such as Milwards primary and Passmores secondary, which have specialist autism units. Recently, I went to the opening of the renewed Milwards autism hub: what is being done there is extraordinary. I pay tribute to head teacher Katherine Henson.

I ask the Government what resources are being put in place to implement and enforce fair waiting times for autism diagnosis, and what guidelines can be put in place to ensure that individuals with autism and their families receive the support they need during and after the diagnosis process. Furthermore, I urge the Minister to visit PACT for Autism in Harlow.