Allied Health Professionals Debate
Full Debate: Read Full DebateJen Craft
Main Page: Jen Craft (Labour - Thurrock)Department Debates - View all Jen Craft's debates with the Department of Health and Social Care
(1 day, 12 hours ago)
Commons Chamber
Jen Craft (Thurrock) (Lab)
I beg to move,
That his House has considered the contribution of allied health professionals.
I am very grateful to be able to introduce this debate today, and I would like to begin by congratulating my hon. Friend the Member for Dudley (Sonia Kumar) on her hard work in securing it.
Allied health professionals, such as occupational therapists, physiotherapists, dieticians, music therapists and so many more, are a vital part of our NHS. They will be crucial to delivering the three shifts in healthcare—in particular, treatment to prevention and hospital to community—that the Secretary of State set out as key to delivering the 10-year health plan and securing the future of the NHS for generations to come. They help people to recover from illness or injury, prevent the onset and development of conditions such as frailty, help people to adjust to new or existing realities of disability, and are vital in enabling and empowering people to take control of their health.
My hon. Friend the Member for Dudley brings considerable professional experience to this place as a trained physiotherapist. I believe she plans to speak to the importance of those professionals to adult healthcare—indeed, she is best placed to do so—so I will focus primarily on the vital role of allied health professionals in paediatric care.
As a parent with experience of paediatric allied health professionals, I can speak to their completely invaluable contribution to a child’s wellbeing. They not only support the child who is the patient in their care, but the entire family. It can be a real lifeline to have a trusted professional helping you to come to terms with your child’s diagnosis, or perhaps with a shift in reality. I also know, from friends and constituents who have children living with life-limiting conditions, that allied health professionals such as music therapists and drama therapists can be the lifeline that provides moments of joy, as well as extending the lifespan and the time that people get to spend with their children who have very severe and limiting conditions.
I want to put on record that paediatric allied health professionals in particular are not just a “nice to have” or an add-on to the health profession. It is quite easy to overlook the contribution and impact that people such as music therapists—I will give an excellent example—can have on a child’s life. If Members can imagine a child who is non-verbal and potentially has behavioural and communication difficulties and no real form of self-expression, an art therapist, a music therapist or a drama therapist can help to unlock something that traditional healthcare workers perhaps cannot. They can make a real difference to how that child’s care progresses and how their life chances pan out.
Paediatric allied health professionals are also able to reduce the pressure and the intensity on the acute system. Excellent work has been done with music therapists, art therapists and play therapists, who do not currently come under the auspices of allied health professionals but perhaps one day may do, to reduce sometimes even the need for general anaesthetic, MRI scans or CT scans for particular children with complex needs, as they help them to navigate their pathway through the system.
They are also crucial in helping children who perhaps have had a traumatic early start to life to engage with the healthcare system and the wider healthcare system at large. Children who are recovering from, or going through treatment for, cancer or other severe diseases and illnesses, are supported by these professionals to come to terms and to grips with what they are going through and to express themselves. Professions such as occupational therapists, physiotherapists, and speech and language therapists play a vital role in childhood, enabling children who have an additional need in those areas to be able to perform at the same level as their peers and to be the best version of themselves.
The Health and Social Care Committee, of which I am a member, has taken considerable evidence on the crisis in the allied healthcare professions, in particular in paediatrics and early years. We have discussed at length with various organisations such as the Royal College of Occupational Therapists, the Royal College of Speech and Language Therapists, Speech and Language UK, the Disabled Children’s Partnership and Contact the impact this is having on children, on families and on the professionals themselves.
There are currently 77,500 children who have been on community waiting lists—quite often the way that people access allied health professional care—for over a year.
My hon. Friend is making some fantastic points, especially those highlighting the findings of the Health and Social Care Committee. Allied health professionals are absolutely vital to what we do in the health service. As with health visitors, their numbers seem to be going down at the moment, and nothing is really being done to build them back up. Does my hon. Friend agree that we need to build the numbers of allied health professionals back up?
Jen Craft
I thank my hon. Friend for her intervention. She brings a breadth of experience to this place on these issues, both as a member of the Health and Social Care Committee and as a registered nurse. I agree that we do need to take urgent action to rebuild the numbers of allied health professionals and health visitors. The Committee has heard that there has been a halving of the number of health visitors in the past 10 years, which has had an almost catastrophic impact on their ability to deliver the vital role that they play in identifying early need in childhood, particularly in the early years, supporting families where there is an additional need for support and signposting people to other mechanisms, such as Best Start family hubs, to ensure there is that proportionate universalism that is so key to ensuring that those who need help get it in a timely way. I very much agree with my hon. Friend that urgent action needs to be taken to address this, which we will hopefully see in the upcoming NHS workforce plan.
That ties into my earlier point. There are 77,500 children and young people who have been on a community care waiting list for more than a year in England, which is a sixfold rise since the start of 2023. For comparison, only around 1% of adults wait for more than a year for community care, compared with around 25% of children. Thinking about equity in healthcare, a year for a child could be an entire lifetime, which is not the case for an adult.
We also know that there is a really rapid development window in the early years, particularly in the first 1,001 days, where we have the ability to make an impact on the life chances of a child, when all that quick-fire development is happening mentally, physically, socially and emotionally. It is absolutely crucial to get in at the onset and arrest conditions before they become more serious and make a real impact on the life chances of a child through to schooling, employment and beyond.
However, there is a crisis across the allied health professions, particularly in early years. I want to highlight a few areas where this is really bearing fruit. According to the Royal College of Occupational Therapists, four fifths of occupational therapists are unable to meet local demand. The workforce remains focused on secondary care, which limits capacity for prevention and early intervention in communities. Workforce pressure does translate into rising waiting lists; in February 2026, nearly 18,000 children and young people were waiting to see an occupational therapist. This has a huge impact on the life of a young person. Quite often occupational therapist interventions are not costly, but the inference and reference of an expert or specialist is needed to be able to direct people in how best to carry them out. The fact that 18,000 children are waiting to see an OT is really shocking. These delays will have a real impact on professionals being able to act at the very earliest opportunity to turn children’s life chances around.
Speech and language therapy is another area that is experiencing a crisis in both recruitment and retention. According to Speech and Language UK, more than 2 million children in the UK have struggled to speak or understand words and an estimated 1.3 million have a developmental language disorder. The Government must train and recruit enough speech and language therapists to ensure that the trend of a reduction in the profession is arrested. Currently, 16% of NHS speech and language therapy posts in England are vacant, and the vacancy rate for NHS speech and language therapy posts supporting people with a learning disability is even more stark, at 25%. The Royal College of Speech and Language Therapists reports that 96% of children’s speech and language therapy services say that recruitment is more or much more challenging than at any time in the past three years.
What that translates to is those in these crucial professions spending the vast majority of their time carrying out assessment work when things have reached a point of crisis or acute care need. They are not getting to see people and intervene at the earliest opportunity, and they are not getting to help families. That is driving the retention crisis, as professionals find themselves unable to perform the role for which they trained and about which they are, by and large, incredibly passionate. Instead, they are spending their time carrying out assessments and recommending therapeutic care that they know is very unlikely to materialise.
The real crisis in the paediatric allied healthcare professions could have a huge knock-on effect on a major part of Government policy found in the education White Paper. I know that the Minister is here to speak for the Department of Health and Social Care, but the Health and Social Care Committee has continually found that there is a real gap in the role of healthcare when it comes to education, health and care plans, and in the special educational needs and disabilities system as a whole.
The White Paper places huge demand on having “experts at hand”—a locally trained workforce who are able to provide specialist support. It names professions such as occupational therapy, physiotherapy and speech and language therapy, which fall entirely within the allied health professional workforce, which it is in the gift of the Department of Health and Social Care to provide. However, we know that these occupations are at crisis point; time and again, when we talk to our local integrated care boards, they say that they do not have the people available to fulfil that “expert at hand” role. It is such an important part of the education White Paper that if it fails, I am afraid the entire White Paper is at risk of failure. The crux of it is early and timely intervention, and support for families, school staff and children, in order to make an impact at the earliest possible opportunity. Without this workforce, it cannot and will not succeed.
I ask the Minister: what plans will there be in the upcoming workforce strategy to address the decline in paediatric allied healthcare professionals? What plans are there for training, recruitment and retention, not just to support this important part of the education White Paper, but to address the real health inequality in paediatrics? It is fair to say that the impact on children is so much worse than that on adults receiving healthcare, because they can spend such a significant chunk of their life on a waiting list.
Most importantly, what action is being taken to ensure that these professionals, particularly those in the paediatric workforce, feel valued and know that their contribution really counts towards the delivery of both the current healthcare system and the Government’s wider reform agenda? How can we ensure that the life chances of children are best improved and encouraged through the recruitment, retention and valuing of allied healthcare professionals?
Gregory Stafford (Farnham and Bordon) (Con)
May I wish you a very happy St George’s day, Madam Deputy Speaker?
It is a privilege to respond to this debate on behalf of His Majesty’s most loyal Opposition and to recognise the invaluable contribution of allied health professionals, especially those living and working in my Farnham and Bordon constituency. Having spent much of my career in the healthcare sector, including time working for the College of Occupational Therapists—before it was granted its royal title, which shows how old I am—I have seen at first hand the critical role those professionals play across health and social care, often without the recognition they deserve.
I congratulate the hon. Member for Thurrock (Jen Craft) on leading today’s debate, and the hon. Member for Dudley (Sonia Kumar) , a physiotherapist herself, for her work in securing it. The House is right to give time to those who do so much, often without fanfare. I want also to mention the hon. Member for North Durham (Luke Akehurst), whose experience of care by allied health professionals was both extraordinarily moving and amusing. I have taken to heart his recommendation of a diet of red meat and cheese.
If this debate is to mean anything, we must address the central issue, which is workforce. Without a clear and credible workforce plan, warm words about allied health professionals will not translate into better care for patients. The Government’s still-awaited NHS workforce plan, due this spring, will be crucial. It is meant to set out how the ambitions of the 10-year health plan will be delivered. Without it, there remains real uncertainty about how workforce shortages and rising demands will be addressed, as the hon. Member for Thurrock highlighted so powerfully when she summed up the situation as “a crisis”. That matters, because allied health professionals are already helping to unlock capacity across the system. We see that clearly in the expansion of independent prescribing, which we as Conservatives support. By enabling allied health professionals to take on those responsibilities, pressure is reduced on GPs and specialists, and patients receive faster, more efficient care. It is a practical reform that improves outcomes, but one that depends on proper planning and support in order to scale it.
The challenge does not stop in the NHS; it extends directly into education and special educational needs and disabilities provision. As the vice-chair of the all-party parliamentary group for SEND, I see the growing reliance on an expanded workforce of therapists and specialists to support children with additional needs. From experience of working alongside occupational therapists early in my career, I know just how critical that support can be in helping children to access education and achieve their potential.
However, the pipeline simply does not match the ambition. Training an educational psychologist can take up to eight years and other key roles, such as speech and language therapists or occupational therapists, take many years to develop. Without a clear and actionable workforce plan, local authorities are left trying to bridge that gap themselves, often without the certainty or the funding required to do so effectively. I saw that at first hand in Hampshire, as I am sure you have, Madam Deputy Speaker. Proposed changes to therapy provision raised real concerns among professionals in my constituency, but through consultation, the council listened, protected staff and expanded the specialist roles. That is the difference that practical, locally informed decision making can make, protecting services while improving provision.
Unfortunately, by contrast, there is a growing concern that the Government’s approach risks creating uncertainty, rather than clarity. That is particularly striking when we consider the progress that had begun under the previous Conservative Government, rightly outlined by my hon. Friend the Member for South West Devon (Rebecca Smith) in her superb speech. Through the AHP strategy and the long-term workforce plan, clear steps were set out to expand the workforce, increase training places and grow apprenticeship routes into these vital professions. It was not perfect, but it was a plan.
What we see now, however, are drifts: no published workforce plan, no clear assessment of the impact of recruitment challenges, and decisions that risk weakening the very structures needed to support AHPs. The requirement for integrated care boards to reduce their budgets has already raised serious concerns. The Chartered Society of Physiotherapy has warned about the impact on leadership roles, and we are already seeing a reduction in senior AHP positions across the system. That is not strengthening the workforce but undermining it.
Jen Craft
I welcome the hon. Member’s comments on supporting the SEND White Paper through an allied health professional workforce plan. However, there is something of an amnesiac recollection from Conservative Members when it comes to looking at a decline in numbers of healthcare professionals, and allied health professionals are not unique in that. Would he like to say what happened to the figures for allied health professionals over the 14 years when the Conservative Government were in office?
Gregory Stafford
The hon. Lady, with whom I serve on the Health and Social Care Committee, always raises important points. What the last Government were trying to do—certainly by the end—with their workforce plan, which was the first of its kind, was to ensure that the workforce began to expand again. That is what all of us across the House are hoping that this Government will build on.
The Government have confirmed that they have no plans to extend the job guarantee to allied health professionals, and have made no assessments of the impact of recruitment delays on patient care. For a Government who often speak about the importance of the NHS, it is difficult to understand why the very professionals who play such a central role in recovery, rehabilitation and patient flow are being overlooked, as the hon. Member for Stourbridge (Cat Eccles) passionately highlighted. If we are serious about reducing waiting lists, improving outcomes and supporting patients across both health and education, allied health professionals are not optional but essential—and essential services require serious planning.
In conclusion, I will ask the Minister three simple questions. First, when will the NHS workforce plan be published and how will it specifically address the shortages in allied health professionals? Secondly, will the Government reconsider their decision not to include AHPs in the job guarantee, given the clear need to support and retain this workforce? Thirdly, what steps will be taken to ensure that NHS organisations and local services can recruit and retain the AHPs they need, particularly in under-resourced areas?
Without clear answers to those questions the risk is clear: we will continue to ask more of allied health professionals while giving them less support to deliver. From what I have seen throughout my career, including in my work with occupational therapists, that is not a position that any of us should accept for the workforce or the patients who depend on them
I add my thanks to my hon. Friend the Member for Thurrock (Jen Craft) for introducing the debate and to my hon. Friend the Member for Dudley (Sonia Kumar) for bringing it forward and setting out her role as a physiotherapist.
I am grateful for the opportunity to set out the practical contribution of AHPs to delivering this Government’s priorities for health and care. I agree with many hon. Members who have spoken that the 10-year health plan, “Fit for the Future”, and the forthcoming 10-year workforce plan, due in the spring—we are now in the spring, so hopefully very soon—provide a real opportunity to optimise the AHP contribution for the years ahead, including by supporting AHPs to work at the top of their skills. As a Department, we are clear that the three shifts that patients and the public need—more care in the community, a stronger focus on prevention and better use of digital and data—must be delivered in day-to-day services. AHPs will be central to making that happen.
As we have heard, AHPs make up the third largest workforce in the NHS. They include physiotherapists, occupational therapists, radiographers, speech and language therapists, paramedics, dietitians, podiatrists, and arts therapists, among others. They work across hospital, community, primary care, mental health and education settings, bringing regulated, evidence-based practice that supports faster access, better outcomes and better value for the taxpayer.
The contribution of AHPs is not confined to any single service line. AHPs assess, diagnose, treat and rehabilitate. They support self-management and they work in multidisciplinary teams spanning health, social care and education. That combination—clinical autonomy alongside team-based working—is exactly what we need to redesign services around neighbourhoods and around people’s day-to-day lives.
First, on the shift to community, AHPs work across neighbourhoods, primary care and community services, including in people’s homes. They prevent avoidable admissions and they help people leave hospital sooner and recover well. Physiotherapists, occupational therapists and speech and language therapists support rehabilitation and independent living. Paramedics are increasingly part of urgent community response and neighbourhood teams, helping people get the right care, first time, closer to home.
Secondly, on the shift to prevention, prevention is fundamental to AHP practice, as we have heard. AHPs support earlier intervention for long-term conditions. They play a key role in falls prevention, respiratory disease and musculoskeletal health, and in improving population wellbeing. That work helps people stay well and independent, and it reduces pressure on urgent and emergency care and on hospital waiting lists. That contribution aligns directly with the Government’s work and health agenda.
By providing early intervention and rehabilitation, AHPs help people with long-term conditions, disability or injury to remain in, return to and thrive in work. We heard no better example of the role that they play than in the very moving speech by my hon. Friend the Member for North Durham (Luke Akehurst). I thank him for sharing his experience and I hope he is still enjoying playing with his son. It is good to have him in the Chamber being able to articulate that experience, which is not easy to do. Whether supporting recovery after illness, managing pain and fatigue, or enabling reasonable adjustments and independence, AHPs reduce avoidable time away from employment and help more people to remain economically active, benefiting individuals, employers and the wider economy.
Thirdly, on the shift to digital, AHPs are helping to lead the adoption of digital tools to improve access and continuity. That ranges from imaging and diagnostic technologies led by radiographers, to virtual rehabilitation, remote monitoring and data-enabled triage. Alongside shared care records, these approaches can support safer, more efficient and more personalised care. Remote consultations should be used where appropriate.
Across each of those shifts, AHPs also make an important contribution to mental health and wider wellbeing. Occupational therapists support recovery and independence, speech and language therapists help to address communication needs that can affect engagement, and arts therapies, which we heard about, including art, music and drama therapy, offer clinically led support. As was well articulated by many, including by my hon. Friend the Member for Cannock Chase (Josh Newbury), those skills in neighbourhood teams can help to provide earlier, more joined-up care, including for children and young people.
I place particular emphasis on children and young people, as my hon. Friend the Member for Thurrock did so ably, including those with special educational needs and disabilities. AHPs play a vital role in early identification, assessment and intervention, supporting communication, mobility, sensory needs, mental wellbeing and participation in education and community life. Speech and language therapists, occupational therapists, physios and others work alongside families and schools so that children can develop, learn and thrive, meeting their needs before they escalate.
For children with SEND, timely access to AHP support is fundamental. Delays affect speech and language development, social interaction and educational attainment, and they can place additional pressure on families and carers. That is why work is already in train with the Department for Education, NHS England, integrated care boards and partners in local government to strengthen community speech and language therapy and other AHP provision. Our aim is earlier support closer to home and better, joined-up services.
I recognise that many hon. Members will understandably focus on the current access and waiting times, particularly for speech and language therapy. We as constituency MPs all recognise that. As my hon. Friend the Member for Thurrock said, that is critical to achieving the Government’s ambition.
More broadly, in neighbourhoods, AHPs support people of all ages to avoid deterioration and to recover well through rapid assessment, rehabilitation and support management. That point was well made by the hon. Members for South West Devon (Rebecca Smith) and for Mid Dorset and North Poole (Vikki Slade). Working alongside GPs, community nursing, social care, mental health services and the voluntary sector, they help prevent complications, reduce frailty and improve long-term condition management, easing pressure on acute services, as my hon. Friend the Member for North Warwickshire and Bedworth (Rachel Taylor) rightly said. I thank her for her support for George Eliot hospital as it improves its services for her constituents.
Delivering those shifts depends on having the right AHP workforce in the right place. That includes those smaller AHP professions such as podiatry, orthoptics, and prosthetics and orthotics whose specialist skills are essential to prevention, independence and quality of life. Through our work with system leaders and professional bodies, we will continue to support education and training routes to improve retention and enable new ways of working across systems so that people can access specialist expertise when they need it.
As part of enabling AHPs to work at the top of their skills—that is what we want—we are also taking forward work to increase their ability to prescribe medicines where it is safe and appropriate to do so. That point was well made by the hon. Member for Richmond Park (Sarah Olney); others noted that duplication issue. I confirm to my hon. Friend the Member for Stourbridge (Cat Eccles)—I thank her for her expertise in operating department practitioners—that that does include ODPs.
We must also address variation in access, including in rural and underserved areas. Neighbourhood delivery models, stronger integration with local authorities and the voluntary sector, and sensible use of digital services can all help broaden reach while maintaining safe, personalised care for those who need face-to-face support.
AHPs bring the clinical skills and professional leadership to redesign pathways, strengthen neighbourhood teams and intervene earlier so that people receive effective care in the right place at the right time. My focus as the lead Minister for the workforce plan in the Department of Health and Social Care is to support systems to deliver those priorities. As part of that, I work closely with the chief allied health professions officer—it was news both to her and to me that there is concern about her ongoing role—and will continue to do so. I thank her for her help so far—indeed, including in preparing for this debate.
The 10-year plan set the direction to rebuild the NHS, but it absolutely depends on all our staff to deliver it. The long-term workforce plan produced by the previous Government essentially looked at supply, but it did not look at future service models, it did not look at the role of technology, it did not ensure sustainability for the future and it did not base itself on future workforce models. That is some of the reason why we have problems with, for example, bottlenecks and frustration—particularly for young people coming out of their training—in not being able to get into the right roles in the right places. That is part of the problem that we need to address with the workforce plan, which we will bringing forward in the spring, so that we ensure patients and the public have the services they deserve, and particularly so that young people and children get the best start in life. I look forward to bringing forward those plans.
I have been asked again for several meetings—it is always nice to be popular for meetings—and I look forward to working with people as we bring forward that plan. We are working closely with all representatives of the sector—I know that there is a lot of interest in this work—and I very much look forward to working with hon. Members in the House as we go forward with delivering the plan.
Jen Craft
I really appreciate the Minister giving way—I know that she was concluding her speech. She obviously cannot reveal the contents of the workforce plan before it is published, but particularly on paediatric care, can I ask specifically for reassurance that there is something in mind for the plan when it comes to servicing the SEND Experts at Hand provision? That will be key to delivering the White Paper aims and key to young people’s life chances. We hope to be able to see that soon.
I was literally on my last words, so let me go back. My hon. Friend tempts me to reveal more about the workforce plan. As I said, we are not waiting for the plan to work with our colleagues across the Department for Education, NHS England, locally in ICBs and so on to ensure that we deliver on that ambition. We will of course set out the overarching plan and where we want to have people in the future. I look forward to working with her and others on how that will work. We certainly want to engage with colleagues across the piece.
As my hon. Friend knows, the SEND White Paper—we all know this through our constituency work—is central to that and to the Government’s wider ambitions. We are due to publish the plan in the spring; I look forward to doing so very soon. I look forward to working with hon. Members on that, and I thank them for the debate and their contributions this afternoon.
Jen Craft
I thank everyone who has contributed to the debate. As my hon. Friend the Member for Dudley (Sonia Kumar) said, this is the first time a debate about the contribution of allied health professionals has happened in this place. It is really important to acknowledge the contribution they make to our health services and to healthcare in general. Particular thanks go to my hon. Friend the Member for North Durham (Luke Akehurst) for sharing his personal story about the contribution of so many different allied health professionals in bringing him back to health—basically bringing him back to life—which summed up perfectly the crucial role these many different professions play and the impact they can have.
I also thank my hon. Friend the Member for Stourbridge (Cat Eccles) both for her contribution and for her work as an allied health professional. As someone who has had two C-sections, I know that the entire operating theatre staff were crucial to making that a much better experience than anyone could have anticipated.
I thank the Minister very much for her comments, and particularly for being gracious in accepting my intervention at the last minute. I make a final plea for her to ensure that this vital part of our NHS, which is crucial to delivering those two strands—from sickness to prevention and from hospital to community—is not overlooked in the forthcoming workforce plan, and that its contribution is both valued and given due prominence.
Question put and agreed to.
Resolved,
That his House has considered the contribution of allied health professionals.
On a point of order, Madam Deputy Speaker. The Government placed a written ministerial statement on today’s Order Paper to update the House on the much-troubled Ajax armoured fighting vehicle programme. However, the media have reported within the last two hours that, according to urgent briefing from the Ministry of Defence, the statement will now be delayed until later next week due to the need to seek further interdepartmental approval across Whitehall. Given that the strategic defence review was published months late, the defence investment plan, including vital new equipment programmes, is still unpublished nine months on, and now the MOD is putting out WMSs on the Order Paper and then refusing to publish them, the Department is clearly in a state of chaos. Can you advise me on how we can force the MOD to clarify this utterly confusing situation later today, or on Monday at the very latest?