Services for Adults with Learning Difficulties: Hillingdon

John McDonnell Excerpts

Friday 4th July 2025 Commons Chamber

[Danny Beales (Uxbridge and South Ruislip) (Lab)]

I rise to discuss services for adults with learning difficulties and disabilities in Hillingdon. Approximately 1.3 million people in England have a learning disability. If we include those with learning difficulties, that figure is even higher. Yet too often our services, education system, NHS, workplaces and society as a whole are not inclusive of their needs, and they are often seen as an afterthought.

I was motivated to bring forward this Adjournment debate having recently had the privilege of meeting many adults with learning disabilities and difficulties and their families in the borough of Hillingdon. They expressed to me that, again, they feel like an afterthought, as they were appalled by the council’s recent decision to close another vital service for adults; many other services have been closed, moved or cut in recent years.

Before turning to the specific important services that have been lost or are under threat, it is important to note that, of course, many good organisations are working hard in challenging circumstances to provide support. In the NHS, the Hillingdon community team for people with learning disabilities provides specialist support for adults with learning disabilities in the community and across primary and secondary care. Those services, however, are largely around diagnosis and access to medical support—just one aspect of an adult’s needs.

DASH, a voluntary sector group, offers a range of sporting and recreational activities for people with a disability, all focused on encouraging people to socialise, but it too has struggled with decreasing funding in recent years. Hillingdon Autistic Care and Support provides an autism hub, advice and social activities for adults in the London borough of Hillingdon, but the slashing of its budget in 2023 led to the closure of the popular tea rooms—a café open to the public that offered training and work support to adults with autism. Unfortunately, that was a sign of even more damaging cuts to come. Following those proposals, an e-petition signed by 3,330 people called on the council not to withdraw the funding for the tea rooms. Despite that, the council pressed ahead, claiming that 20 people benefiting from training and support was not good value for money—a disappointing sign of things to come, with a council knowing the price of everything, but the value of nothing.

More broadly in the area of education, the Park View centre, part of the Orchard Hill college group near Uxbridge, has a range of on-site vocational opportunities. The college does excellent work in challenging facilities that were not purpose-built. I recently had the privilege of meeting a number of their learners and staff, and they showed me at first hand how much they have to offer our community and workplaces. As well as insisting I attend their next disco, their overwhelming message was that they love their job coach Holly, but unfortunately, there was only one Holly in the whole of the college. They wanted more work coaches, placements, internships and job coach support. Yes, learning is vital, but they wanted it to lead somewhere in adult life. They wanted real workplace experience and, ideally, a full-time or part-time role.

The Government’s commitment to invest more than £1 billion into workplace support for those with disabilities is a welcome step forward. I hope that the Department of Health and Social Care and the Department for Work and Pensions will work together to ensure that this investment is also targeted to help adults with learning difficulties get the support they desperately need.

Data suggests that the employment gap for people with a learning disability is still far too wide. Of the people accessing long-term social care, only 5% of those with a learning disability are in paid work, which is a shame on our society. Charities have previously called on the Government to set a new ambitious target for reducing the disability employment gap with strategic actions behind it. A previous Secretary of State for Work and Pensions said in March 2023 that he would set a new disability employment goal, but progress has been slow, and I hope the two Departments can work together to progress that. Such a gap is why supporting work placements, centres for training and volunteering is vital.

Following the closure of the Hillingdon tea rooms, another such facility is now under threat. There is a strong community-led campaign to save the Rural Activities Garden Centre, which provides employment opportunities, skills, lifelong relationships and a connection to our community for adults with learning difficulties across west London. Conservative-led Hillingdon council took the decision just last week to slash that vital service.

I have been shocked and saddened to see how the voices of adults with learning difficulties and their families have been silenced in this discussion, not even being allowed to speak or question the decision at the civic centre. We are now in this Chamber, and we can ensure that their voices and stories are heard; a number of them are in the Gallery with their families.

George is 28. He was separated from his parents at birth due to their inability to care for him at that time. He has spent years unable to eat without a feeding tube and has battled self-harm throughout his life. After decades of struggle for specialist support, four years ago George found something precious: a community at the Rural Activities Garden Centre, where he feels valued and understood. Since the announcement, and as a result of the fear that that vital support system may be stripped away, George’s challenges have again become overwhelming.

Oliver has been attending the RAGC for 10 years and has complex health needs. He is partially sighted and has severe learning difficulties and chronic kidney disease. More recently, he has suffered from post-traumatic stress disorder. Oliver’s battle with mental health impacted on his ability to do day-to-day tasks and the usual activities that brought him joy, but one comfort remained: the RAGC.

There is also Doug, who I have had the pleasure to meet. He is an adult with learning disabilities that impact on his ability to read, write and count. Where the private sector was unable to provide support to Doug with his additional needs, the RAGC saw past what he could not do and nurtured what he could. It watched him transform from a shy young man into a confident 32-year-old with purpose. After the closure meeting, Doug asked a simple but heartbreaking question: “Where do the staff go? What happens to me and my mates?”

I was also told of Georgia’s story. Before joining RAGC, she struggled with anxiety and undiagnosed autism, leaving her imprisoned in her own home. The garden centre helped her to develop skills and build confidence, and she even went on to compete in a wreath-making competition. It was the service now under threat that transformed her from someone who could not leave the house to someone who could confidently serve customers—what a transformation. She fears the closure will reignite those same issues that she has worked so hard to manage.

The difficulties of day-to-day life are often felt more acutely by adults with learning difficulties. It is the sanctuary that places such as the RAGC provide that makes it imperative we continue to fight for their survival. The Rural Activities Garden Centre makes employment opportunities, personal development and skills curation accessible for those who are often isolated. I have met so many people from right across the community who have volunteered there, gained skills and even moved into permanent jobs as a result. Families feel that their loved ones are cared for, safe and nurtured in this space, and it has given carers and families their own ability to have respite and time to care for themselves.

[John McDonnell (Hayes and Harlington) (Ind)]

I congratulate the hon. Member on securing this debate. He will know that the garden centre also provides an essential service to my constituents. I have visited the place for either 20 or 30 years—I am not clear—and it was commended by the former Conservative leader of Hillingdon council, who called it a jewel in the crown. That is why it has come as such a shock that this Conservative administration is now willing to close it with such brutality. Does the hon. Member agree that the council should, even at this late stage, think again and consult properly—including all those volunteers and parents as well as the people who use the centre—to look at a wider range of options? This does not have to happen now: the council just needs to listen to us.

[Danny Beales]

I concur completely with my right hon. Friend. We have both met those affected, their loved ones and their families, and we can really hear and see the value. Unfortunately, that value was not considered in the rushed decision made by the councillors—I will turn to the lack of consultation very soon, and I completely agree with him about that. It is not too late and, like him, I hope that the council thinks again.

The Rural Activities Garden Centre is another in a long list of closures at the hands of the local council. Following years of financial mismanagement by the leadership, the modus operandi has become to cut through its crisis. While the council’s cabinet sees nothing more than a line on a spreadsheet, behind this move are adults with learning difficulties, whose lives have been transformed by this service and who risk losing it all as a result of the council’s decision. By its own admission, it views the decision of the closure through the lens of profit. Failure to turn a profit means inevitable closure to Hillingdon council. That was the reason quoted at the recent decision-making meeting, but should social services have to make a profit to survive? To me, it defeats the objective of those services. By that logic, one wonders what will be cut next by Hillingdon council? What other social services or schools will it have in its sights?

This heartless approach to community services aside, Hillingdon council’s binary decision making in relation to profit is economically flawed. These services are not costs; they are investments in the future. The National Audit Office calculated that supporting someone with moderate learning disabilities in residential care costs £4.7 million over their lifetime. With proper community support such as the RAGC, that drops by £1 million. We save money while giving people the dignity, purpose and independence they deserve.

Perhaps the council’s inability to understand this basic economic principle of investment and returns sheds some light on why it is about to go bankrupt, receiving damning reports from its own chief financial officers. Still, Hillingdon council dismisses the RAGC as merely a “retail service”. Tell that to George, Doug, Oliver or Georgia. Tell the families who have watched their loved ones transform from isolation to independence that this is a “retail service”.

I recognise that there are similar stories across the country, unfortunately, scattering services, breaking up communities and destroying what works for short-term savings that create long-term costs, with our most vulnerable communities always the first to feel the brunt. The Rural Activities Garden Centre works. Its clients thrive. Their families are supported. The evidence is overwhelming, but evidence means nothing without political will, and political will means nothing without adequate funding.

We are not asking for the impossible. We are asking the council and this Government to back choice and independence for adults with learning difficulties and care packages and to recognise that supported employment is not a luxury to be cut when times are tough; it is a vital investment that pays dividends in human dignity and economic returns for national and local government.

The Rural Activities Garden Centre must be saved. Services like it across England must be protected. The people who depend on them deserve nothing less than our absolute commitment to their dignity, their potential and their right to belong. I appreciate the Minister giving up her time to be here today, with so many pressing issues across the health and care system. There are some specific issues I hope she will take away for further consideration.

First, I and local families would like to welcome the Minister to Hillingdon to meet disabled adults and those with learning difficulties, to hear their experience of a fragmented system and a council and NHS not working together as well as they could and should, which I hope could inform the broader review of social care taking place nationally.

Secondly, the Women and Equalities Committee report in 2023 on inequalities for people with learning disabilities outlined clearly that people with a learning disability, and those who care for them, are the real experts when it comes to their health and care needs. However, aside from the occasional opportunity to feed into consultations, far too often their voices are missing when it comes to decision making at both a local and national level. Their lived experience should be better reflected in efforts to reduce health inequalities and improve outcomes.

I hope the Government will look at how they can embed co-production and meaningful engagement in decision making on care packages and services and ensure that those with care packages and support are genuinely consulted and engaged in any service changes. There must also be clearer guidance for providers and commissioners of services about consultations and full equality impact assessments being conducted before services are changed, which has been woefully lacking in this case.

Thirdly, the NHS 10-year plan, launched yesterday, included welcome announcements about supporting people with health budgets, giving people personal health plans and a shift to prevention and community-based working for the NHS. Will the Minister address whether we can and should expect the same principles to lead work on adult social care support, too?

Fourthly, on enabling joint working, the Public Accounts Committee report in 2017, “Local support for people with a learning disability”, found that people with a learning disability who live in the community have patchy access to healthcare and limited opportunities to participate in the community—for example, by having a job. While the Department has the policy lead for people with a learning disability and care plans, responsibility for their support spans across Government. We even found that to be the case when discussing which Department should respond to this debate. Responsibilities cross the Department of Health and Social Care, the Department for Education, the Department for Work and Pensions and the Ministry of Housing, Communities and Local Government.

In its report, the Public Accounts Committee recommended that Government should

“set out a cross-government strategy for improving access to health care and opportunities”

for adults with learning disabilities to

“participate in the community, including employment, as well as how it will measure the effectiveness of this strategy.”

I hope we can return to this in future, because clearly all these Departments bear some oversight and responsibility for this important group of the population.

Lastly, I hope the Minister will join me in thanking Oliver, Doug, George and Georgia, as well as all the service users and their families, for building this project from scratch, many decades ago, planting the first trees, building the first planters, volunteering to keep it going in difficult times and creating this amazing life-changing project, and now also for their campaign to fight for its survival. I hope that Hillingdon council will think again, take the time to genuinely listen and get the decision right, working with the community. In the absence of that, I hope the Government will prioritise adults with learning difficulties in services like this one.

We were elected a year ago today on a manifesto of change, investing in people, transforming life chances and providing everyone with opportunity. These are the things that the Rural Activities Garden Centre, and so many other services in Hillingdon, have done, and can continue to do, for countless people in the borough of Hillingdon.

[The Parliamentary Under-Secretary of State for Health and Social Care (Ashley Dalton)]

I thank my hon. Friend the Member for Uxbridge and South Ruislip (Danny Beales) for securing this debate around services in the community for people with a learning difficulty in Hillingdon, and for championing the rights of people with learning difficulties in his area. I welcome those in the Gallery who are here to demonstrate how important services for people with learning difficulties in Hillingdon are to them. I join my hon. Friend in paying particular tribute to Oliver, Doug, George and Georgia for all their work in this area.

I am aware that, as a member of the Health and Social Care Committee, my hon. Friend has a keen interest in health and social care matters. He will therefore be pleased to know that the Government have today published their response to the Health and Social Care Committee report “Adult Social Care Reform: the cost of inaction”. I am sorry to hear that Hillingdon council has decided to close the Rural Activities Garden Centre, but as Members know, decisions on local services are for councils to make since they are best placed to understand and meet the needs of their local populations.

[John McDonnell]

I fully appreciate the point that the Minister makes, but will she take advice from colleagues in other Departments on the following specific point? My hon. Friend the Member for Uxbridge and South Ruislip (Danny Beales) and I have been working with different groups and we have sought to register, under relevant legislation, the Rural Activities Garden Centre as a community asset, which would force the local authority to properly consult with us and to engage with the wider community. The council is going ahead with the decision to sell or close in advance of even considering whether it should be a community asset. Will she help us by taking advice, from whichever Department is relevant, about whether or not there is anything we can do, as a Government, to ensure that Hillingdon council abides by the legislation that was passed to protect community assets such as this one?

[Ashley Dalton]

I will ensure that that issue is raised with the relevant Department. I will say a little more about some of the expectations we place on local authorities to shape their care markets to meet the diverse needs of all local people, as required under the Care Act 2014.

This Government recognise the vital importance of co-production and working with people who draw on care and support. To ensure local authorities are meeting these duties, the Care Quality Commission are assessing local adult social care services by publishing a full report and overall performance rating for each local authority. Hillingdon has been rated as “Good” in the CQC’s recent assessment, but the report also includes feedback on areas where the CQC concluded that Hillingdon could improve.

It is great to be having this discussion today, on the last day of Co-production Week, an important annual awareness campaign to recognise the benefits of working in equal partnership with people using health and social care provision. Local councils should absolutely involve, engage and consult adults with learning difficulties on their care plans, as well as on wider decisions that affect their care and support, and their lives in general. We are committed to encouraging genuine co-production between social care professionals, local authorities, policymakers and, crucially, people who draw on care and support, to design a system that works better for everyone—one that is fair, inclusive and puts people first.

The Government recognise that investment in local services in the community is vital. That is why we have made available over £69 billion for local government this financial year, increasing core spending power by up to 6.8% in cash terms on last year. For Hillingdon, that means a total of £266.3 million in its core spending power for this year, an increase of 6.2% on 2024-25.

We strongly encourage councils to apply elements of good market-shaping practice involving providers. My hon. Friend the Member for Uxbridge and South Ruislip talked about how people with learning disabilities should be worked with across the Government, but actually that applies to all Government, because we seek to serve the people and that includes people with learning disabilities.

Yesterday, we published our 10-year plan. I am delighted that social care will, for some people, be a key part of the neighbourhood health services we discussed, but the adult social care system is in need of wider reform. We have already begun that journey, including legislating for a fair pay agreement and the independent commission into social care. Over time, the neighbourhood health service and the national care service will work hand-in-hand with each other to help people stay well and live independently.

To conclude, I note my hon. Friend’s invitation to visit Hillingdon and I will ensure that that invitation is extended to the relevant Minister. I once again thank him for bringing forward this important debate, and every Member who has contributed. I hope that Hillingdon council takes notice of this debate.

Question put and agreed to.

Covid: Fifth Anniversary

John McDonnell Excerpts

Thursday 12th June 2025 Commons Chamber

[John McDonnell (Hayes and Harlington) (Ind)]

I will follow on from my hon. Friends the Members for Edinburgh South West (Dr Arthur) and for Paisley and Renfrewshire South (Johanna Baxter). I have been meeting a group of clinicians who approached me, led by Dr Rae Duncan, a consultant cardiologist and long-covid physician and researcher at Newcastle hospital. She has provided me with a detailed briefing note; the two-minute limit will not allow me to do any justice to it, so I will circulate it to hon. Members, but its message is very straightforward. The team want to get across the message that covid is not over. It is not seasonal, and it is not just a cold. It is a long-term, substantial and chronic burden.

[Lloyd Hatton]

I will be brief. This is Diabetes Week, and we are rightly looking at the impact that diabetes has on children. Does the right hon. Member agree that a similar approach must be taken for long covid? We must look at the unique impact it has on children and young people, so that we can better understand it.

[Madam Deputy Speaker (Ms Nusrat Ghani)]

Order. I think the right hon. Member for Hayes and Harlington (John McDonnell) needs to respond to the first intervention. I appreciate what is happening, though, and he may wish to take the second intervention shortly afterwards.

[John McDonnell]

I have never seen an intervention on an intervention. I will follow on from that point. The clinicians are trying to get across to me that, as others have said, covid doubles the risk of a heart attack. We have seen heart attacks, strokes, pulmonary embolisms and deep-vein thrombosis. In addition, the team is trying to get across the message that long covid is not simply fatigue. It is an umbrella term for a range of chronic, multi-system pathologies that have an effect.

There is one issue that affects children in particular. The work of Dr Danielle Beckman has shown that covid breaches the blood-brain barrier. As a result, it infects the neurons and causes persistent brain inflammation, thereby imposing cognitive impediments.

[Lillian Jones]

My right hon. Friend is speaking about children. Does he agree that the covid pandemic really affected children who were going through school? All of a sudden, they could not see their friends for many, many weeks. I worked in the NHS. When we are living in the moment, we do not think of these things, but when we reflect, we think, “Oh God, what a time we lived through.” That struck me when I was with my niece, who was running through the park, and she saw her friend—she was 10 years old. They ran and hugged. It was fantastic to see. They had not seen each other for so long. That act of kindness, friendship and coming together of spirit really lifted me, because even children of that age were feeling something huge that they had never felt before. That was an inspirational point for me during covid, and the same point hit me when carrying out my NHS role.

[John McDonnell]

The intervention on an intervention was definitely worth it.

I will briefly raise another issue. One of the messages the clinicians wanted me to get across was exactly that: children have not been spared. Some of the research they have done, for example, indicates that covid doubles the risk of cardiovascular disease and diabetes in children as well. A recent study in America indicates that up to 20% of children at the moment are endangered and experiencing long covid symptoms.

One of the other issues that came out of my discussions with the clinicians is that repeat infections are cumulative and dangerous, resulting in long covid that increases the risk of cardiovascular, neurological, gastrointestinal and endocrine diseases. These clinicians are trying to get across how challenging the situation is. The problem we have at the moment is that the Office for National Statistics’ covid infection survey has been shut down. I can understand the argument for doing so at the time, but the figure coming out of the recent GPs’ survey is that 3.2 million people are experiencing long covid at the moment—again, a staggering figure.

A number of recommendations have been made, one of which is to restore national infection surveillance as quickly as possible. Exactly as my hon. Friend the Member for Edinburgh South West has said, we should fund research and clinical services for long covid. We should implement public health mitigations to reduce infection, particularly in places such as hospitals, classrooms and so on. We benefit from air circulation in this building; others should as well. Finally, as my hon. Friend said, we should protect vulnerable populations—including children—from the chronic disability that covid can impose.

I will circulate the briefing paper to all Members, and we can have another discussion at another time. I was hoping no one would turn up today and I would have longer for my speech.

[Madam Deputy Speaker (Ms Nusrat Ghani)]

I call the Liberal Democrat spokesperson.

Brain Tumours: Research and Treatment

John McDonnell Excerpts

Thursday 8th May 2025 Commons Chamber

[John McDonnell (Hayes and Harlington) (Ind)]

I pay tribute to my hon. Friend the Member for Mitcham and Morden (Dame Siobhain McDonagh) for the way she has pursued this issue seriously and with such emotion. I knew her sister Margaret. She was a Labour party organiser and I knew her for 45 years. She terrified me, to be honest, over the years, but I always admired her commitment to the Labour party and the wider community. I think Margaret would be proud of her sister for the speech she made today and the work that she has done.

I congratulate the Milan group, a women’s group in my constituency—they call themselves a ladies group. It is a group of Asian ladies who came together when one lost their daughter to a brain tumour. They come together every year, including last weekend, when they raised £2,500 for the Brain Tumour Charity. Each year, they get me to do something. This year, I sang in Punjabi, and they had to lock the doors. The previous year, I danced to bhangra music—I tried to purchase the video off them because it was going viral at one point. That raised a large amount of money and shows the commitment in the wider community, as people become more aware of the situation and of the impact of brain tumours, particularly among children. People realise that something must be done.

I want to make a particular point to reinforce what my hon. Friend the Member for Mitcham and Morden has said. There is a desperate need to look at the mechanisms by which new drugs are brought forward and trialled and people can access those trials. I am a member of the all-party parliamentary group on brain tumours, and we met one family who were desperate to get on to a trial of a particular drug, but the drug was being delayed through the mechanisms we have at the moment. I completely understand the processes we have to go through to ensure that a drug is safe and does not cause harm, but there is frustration at how long that takes and the fact that some people who have no other option are not being allowed to access those trials quickly or effectively enough. On that one occasion, we met the drug company, and as an all-party group, I think we did have a beneficial effect in bringing forward the trials and enabling some of the sufferers to access those trials, which we hope will be successful.

One of the most important points my hon. Friend made is that the system just is not working at the moment. It is producing an element of frustration and a lack of confidence in the NHS, which is disappointing. That is because the treatments are not being brought forward quickly enough, the access to the trials is tortuous to say the least, and there does not seem to be any mechanism by which we are co-ordinating better with the pharmaceutical industry and trying to set priorities for it. My hon. Friend mentioned why the industry concentrates on other cancers—because that is where the big profits are—but there has to be some way in which we can incentivise these companies to focus on this range of conditions.

The problem is that there are so many types of brain tumour, and it is difficult to see a company investing a large amount of money when there might be only a limited impact on a small group of patients. However, that is where Government come in. The resourcing of the experimentation, research and trials is so important, and that falls to the state. My hon. Friend has made the point in previous debates and in meetings of our all-party group that, even where the money is there to enable that to happen, it is not getting out there. We have gone through the different organisational structures to investigate what the issue is. I think it is a lack of leadership, and that needs to come from Government.

One of the suggestions I put to the Minister is that there needs to be a conference—it might be a one-off—where we bring everybody together again. The Government have put forward their proposals in the cancer strategy, and they have looked at the pathways, but a new element of zest is needed. We need to bring the pharmaceutical companies in and have an honest discussion about whether the existing structures are working well enough and whether there needs to be some rationalisation, to ensure that we are more effective and speedy in our actions and to investigate what the pharmaceutical companies need in order for research to be undertaken speedily, more effectively and with greater patient access.

As the hon. Member for Edinburgh West (Christine Jardine) said, there is an issue with the funding of individual drugs. If there is to be a rationing process, it is better to be open and transparent about how rational the implementation is across England, Scotland and Wales. At the moment, there seems to be a bit of a postcode lottery in people’s ability to access these individual drugs, in particular when they are being developed for trial.

We need a fresh initiative. I am sure the Government will commit to doing all they can in the coming period, and I hope that more resources will be applied, but unless we get the structures right, the application of those resources will be as frustrating as it is at the moment. As I think the Minister can understand, there has been an expression of frustration at each of our all-party group’s meetings, because the structures are not implementing what the Government themselves want: the wise investment of resources and a more effective link-up with private sector pharmaceutical companies. We need some form of breakthrough event to enable us to move forward more effectively and more rapidly.

Finally, I pay tribute to the various charities, including the Brain Tumour Charity, that are doing such hard work to raise funds and to give hope and comfort to people as their families go through this appalling experience. I thank them for all the support they have given us in the all-party group.

--- Later in debate ---

[John McDonnell]

I pay tribute to Mr and Mrs Atwal in my constituency, who lost their daughter and have been doing fundraising. One of the most effective things they have been doing is ensuring that at local community events there is a stall that provides information about how to access a diagnosis. That has proved to be incredibly effective, as a range of other professionals have picked up on the information. I pay tribute to Mr and Mrs Atwal for their creativity.

[Shockat Adam]

This is about awareness campaigns. People should be aware that 39%—I think—of children unfortunately diagnosed with a brain tumour experience some kind of sight loss or vision changes, and one in three people diagnosed report a problem with their vision that converts into a brain tumour. An eye test cannot detect all brain tumours, but it is a really valuable tool.

Over 112,000 people have signed a petition demanding that brain tumour research is no longer left behind. These are not just signatures; as we have heard from today’s powerful testimonies, they are families, and they are stories of lives cut short and missed chances. We cannot allow that to continue any longer.

Eating Disorder Awareness

John McDonnell Excerpts

Tuesday 1st April 2025 Westminster Hall

[John McDonnell (Hayes and Harlington) (Ind)]

I do not know how to follow that speech. I just want to thank the hon. Member for Camborne and Redruth (Perran Moon). I can understand how tough it was. I also put on record that we all agree that the hon. Member for Bath (Wera Hobhouse) is a star, who has been working on this throughout, and so are Hope Virgo and Dr Agnes Ayton and all the others behind the scenes.

Just to give some hope to hon. Members, we now have a Minister in place with a record of understanding these issues, and with some of the sharpest elbows in Government to get the resources, so I am confident that there will be a move forward. He is aware of the strategy. It is straightforward. There must be input into training not only for health workers, but for teaching staff and education psychologists. We had school nurses come forward with a package that was incredibly effective in raising awareness on the issues, including online safety.

We need community level support services, specialist units and family support. One of the issues raised in the briefings we have circulated from the all-party parliamentary group is the lack of family support. As has been exemplified, when a family member becomes a sufferer of these conditions, the family feel completely isolated and lack support in some of the most challenging situations any family can face. During the discussions around this strategy, there is a need to go into the detail of family support, including the professional advice and community support they can access, to ensure that they do not become isolated.

There is also the issue of financial support. I ask the Minister to look at the consultation on disability benefits and support for people with long-term sickness conditions that is taking place now. Again, it is important that we do everything we possibly can to ensure that sufferers do not lose their benefits as a result of this review. The Government are undertaking consultations, but not on the criteria for the personal independence payment, the points-awarded system. I would be grateful if the Minister could look at that and liaise with Ministers in the Department for Work and Pensions, so that sufferers do not lose the benefits support that they have. Also, some families who are receiving carer’s allowance as a result of the award of PIP to an eating disorder sufferer may be at risk of losing that benefit, but they should not be. We are not even sure what the numbers are, so we would all be extremely grateful to the Minister if he could pay attention to that issue.

Finally, the principle of the all-party group’s work has been to seek a process in Government for co-production of the strategy, in a timetabled way and with funding allocated over the life of this Government. That way, by the time we get to the next election, we can be confident that the strategy has been implemented based on the expertise of those who really know what needs to be done—the sufferers themselves and the families who support them. That process of co-production is as important even as the scale of funding that we need to achieve. Otherwise we will be wasting resources, rather than investing them effectively on the basis of what will work.

--- Later in debate ---

[Stephen Kinnock]

National funding has increased over the years, as the hon. Lady will know. The question is whether that funding channels through to ICBs. The Government’s view is that ICBs are best placed to make decisions as close as possible to the communities that they serve and to target and, if necessary, reallocate funding accordingly. As a Government, we are constantly trying to get the balance right between setting frameworks and targets and ensuring that those are being met, while also ensuring that ICBs are not being micromanaged from the centre. We do not think it is right that people sitting in Whitehall or Westminster micromanage what is going on at a local level. We are absolutely clear that every ICB must meet its targets, while also being clear that it is up to the ICB to take decisions as close as possible to the communities that they serve.

Sadly, we have seen the prevalence of eating disorders in children and young people sharply increase since 2017. In 2023, NHS England published follow-up results to its survey on the mental health of children and young people. The report found that the prevalence of eating disorders in 17 to 19-year-olds rose from 0.8% in 2017 to 12.5% in 2023. Unfortunately, we are also seeing the prevalence of eating disorders rising among adults. The 2019 health survey for England showed that 16% of adults over 16 screened positive for a possible eating disorder. The figures do not mean that the individual had a confirmed eating disorder, but they present a worrying situation that we must address by continuing to promote both awareness and early intervention.

The surge in demand has inevitably made meeting our waiting time targets more challenging. However, our services and clinicians, backed by new funding, are supporting more people than ever before. These services are changing and saving lives. As hon. Members will know, we have kept in place the access and waiting time standard for children and young people who are referred with eating disorder issues. This sets a 95% target for children with urgent cases to begin treatment within one week, and for children with routine cases to start treatment within four weeks.

Figures released last month show that although the number of referrals and demand for services has begun to stabilise during the past year, the number of children entering treatment reached a record high of 2,954 last quarter. This shows that the extra funding is enabling services to begin to meet the extra pressures caused by the pandemic. Similarly, the number of children entering treatment within the target time has reached a record high. Of the 2,954 children entering treatment last quarter, 2,414 were able to access that treatment within the one-week urgent target or the four-week routine target—a rate 81.7%. That is the highest figure recorded since NHS England began collecting that data in 2021.

However, we recognise that there is still far more to be done to ensure that patients with eating disorders can access treatment at the right time. The hon. Member for Bath rightly focused the debate on the importance of awareness. Raising awareness of eating disorders is the first step towards early intervention to prevent the devastating impacts that eating disorders can have on people’s lives. To support this, NHS England is currently refreshing guidance on children and young people’s eating disorders.

The refreshed guidance will highlight the importance of awareness and early recognition of eating disorders in schools, colleges, primary care and broader children and young people’s mental health services. A number of colleagues asked when that guidance will be published; my officials are working hard with specialists on that, and it will be published later this year.

The existing mental health support teams, supplemented by the specialist mental health professionals that we will be providing access to in every school in England, will support school staff to raise awareness and identify children and young people showing potential early signs of an eating disorder. Through these interventions, children and young people can be given early support and help to address problems before they escalate.

Community-based early support hubs for children and young people aged 11 to 25 also play a key role in providing early support for young people’s mental health and wellbeing. Early support hubs provide open-access drop-in mental health services that assist children and young people with a range of issues, such as eating disorders, at an early stage without the need for a referral or doctor’s appointment.

I am pleased to say that this year, thousands more young people will receive support with their mental health, thanks to £7 million of new funding for 24 existing community-based early support hubs to expand their current offer. That funding will deliver 10,000 more interventions such as group sessions, counselling therapies and specialist support over the next 12 months. Looking forward, we are also committed to rolling out open-access young futures hubs in communities. This national network is expected to bring local services together and deliver support for young people facing mental health challenges, including support for those with eating disorders.

We should also be concerned about the widespread availability of harmful online material that promotes eating disorders, suicide and self-harm, which can easily be accessed by people who may be vulnerable. We have been clear that the Government’s priority is the effective implementation of the Online Safety Act, so that those who use social media, especially children, can benefit from its wide-reaching protections as soon as possible. Our focus is on keeping young people safe while they benefit from the latest technology. By the summer, robust new protections for children will be enforced through the Act to protect them from harmful content and ensure that they have an age-appropriate experience online.

It is right to focus on awareness and early intervention, but we know that some people simply need access to high-quality treatment in order to get better. A key priority of this Government is therefore to expand community-based services to treat eating disorders, so that people can be treated earlier and closer to home. NHS England is working to increase the capacity of community-based eating disorder services. By improving care in the community, the NHS can improve outcomes and recovery, reduce rates of relapse, prevent children’s eating disorders continuing into adulthood and, if admission is required as a last resort, reduce the length of time that people have to stay in hospital.

I am pleased to say that funding for children and young people’s eating disorder services has increased, rising from £46.7 million in 2017-18 to a planned £101 million in 2024-25. With this extra funding, we can focus on enhancing the capacity of community eating disorder teams across the country. We are also committed to providing an extra 8,500 new mental health workers across child and adult mental health services to cut waiting times and ensure that people can access treatment and support earlier. Through the 10-year health plan, this Government will overhaul the NHS and ensure that those with mental health needs, including those living with eating disorders, are given the support that they need.

I share the concern of the hon. Member for Bath about accurate recording of deaths to understand the extent to which eating disorders and other factors have caused or contributed to deaths. This matter is being explored with the national medical examiner for England and Wales, the Office for National Statistics and the Coroners’ Society of England and Wales.

Hon. Members also raised concerns about BMI. It is not right that any individual is being refused treatment based on their weight or BMI alone. National guidance from the National Institute for Health and Care Excellence is clear that single measures such as BMI or duration of illness should not be used to determine whether to offer treatment for an eating disorder. I am ready to receive any representations from colleagues who have evidence that that is happening, and I would be happy to raise that with the appropriate channels.

[John McDonnell]

I raised with the Minister the reform of disability benefits, which will have implications for sufferers and their carers. My understanding is that the universal credit health element is to be denied to those under the age of 22. In addition, it will be halved and then frozen, and the PIP criteria are changing. As I said, I simply want the Minister to check with his colleagues in the Department for Work and Pensions what the implications are for sufferers of these conditions and their carers. We need specific action to protect them in the consultation; otherwise, people who are already suffering financially as a result of such conditions—particularly when the whole family supports the sufferer—will be further harmed.

[Stephen Kinnock]

I will follow up on those points and write to the right hon. Gentleman. As he knows, the Green Paper is out for consultation. Although the Government have made decisions about some measures, we are consulting and engaging on a number of others. It is very important that we see all the issues that he raises in the round, and I will follow them up with colleagues, particularly in the DWP, and write to him.

I again thank the hon. Member for Bath for raising this important issue and for her tireless efforts in this House to raise awareness of eating disorders. I thank all hon. Members for their thoughtful and moving contributions on behalf of their constituents and, in some cases, their loved ones. One person afflicted by an eating disorder is one too many, so the Government will strain every sinew to combat this profoundly debilitating condition.

Infected Blood Inquiry

John McDonnell Excerpts

Tuesday 19th November 2024 Commons Chamber

[John McDonnell (Hayes and Harlington) (Ind)]

On a point of order, Madam Deputy Speaker. I apologise for raising a point of order out of sequence, and I will explain why I am doing so. It relates to the case of Mr Alaa Abd el-Fattah and a point of order that I raised over a week ago. Some Members may recall that he is a British citizen who was imprisoned for his human rights campaigning in Egypt. He has served his sentence of five years and should have been released in September, but was not. His mother, a well-known academic at Cairo University, has been on hunger strike for 50 days. Anyone who has had any experience of hunger strikes knows that this is a critical period.

A number of us wrote to the Foreign Secretary over 10 days ago about this case, urging him to make further representations to the Egyptian Administration to secure Mr el-Fattah’s release. As of close of play today, we have not received a response. Through you, Madam Deputy Speaker, could I urge the Foreign Secretary to respond and, more importantly, take action? I am now fearful for the life of Laila, Mr el-Fattah’s mother, because as I said, the hunger strike has entered its 50th day.

[Madam Deputy Speaker (Judith Cummins)]

The very serious matter raised by the right hon. Member is not one for the Chair, but he has placed his concerns on the record in the hearing of the Foreign Office.

Children’s Hospices: Funding

John McDonnell Excerpts

Wednesday 30th October 2024 Westminster Hall

[John McDonnell (Hayes and Harlington) (Ind)]

I congratulate my hon. Friend the Member for Liverpool West Derby (Ian Byrne) not just on securing the debate, but on his work over the past couple of months or so on raising the funds for Zoe’s Place. He rounded up every Scouser he knew, including those of us who live in exile, and asked them to contribute in some way.

My contribution, to which my hon. Friend made reference, was to do a rendition of “You’ll Never Walk Alone” on the trombone—[Interruption.] “Oh dear”, I agree, but let us be charitable about this. The video was used to say, “If you don’t pay the money, we will keep on playing it.” My brother Brian, an ardent Liverpool supporter, contacted me to ask, “Why were you playing ‘Three Blind Mice’?” This man, my hon. Friend, has nearly raised the money, but I want the message to get out there: we are not yet over the line, and we need it for such a valuable resource.

I also congratulate my hon. Friend the Member for Mitcham and Morden (Dame Siobhain McDonagh) for her work in the all-party group for children who need palliative care. She and Lord Balfe met the Minister, and I believe it was a helpful ministerial meeting. I reiterate the requests that she made of the Minister: the idea of at least extending the £25 million is key, and ensuring that it is ringfenced. It is not that we do not trust the ICBs—eventually they will get into action and will be geared up—but if the money goes directly to them, this will be compete against their other priorities and it is difficult to see how it could be maintained and secure for the future.

Another petition has been raised as well, by Corin Dalby, who wrote to me, calling for £100 million of the money that is raised in fines by the Financial Conduct Authority to be transferred to hospice funding. I think that is worth looking at to fill a short-term gap in the coming period, but the long-term issue is exactly as my hon. Friend the Member for Mitcham and Morden said: we need a comprehensive plan. We accept that that could be a 10-year plan, but people want security over time. I want to see that money integrated into Government funding. Of course, charities raise funds, but additional funds—overall, I think it has to be core funding.

I want to make one final point. I chair a group of unpaid carers, and have done so for the past two years. For someone who is an unpaid carer in this country at the moment, whether they are looking after someone who is sick or a child with a terminal diagnosis, they have almost certainly been thrust to the edge of poverty, because the carer’s allowance is so little. That causes untold worry and stress for those parents, which is unnecessary.

We will see what happens in the Budget today, but I put in a plea and hope that the Government will address the carer’s allowance. It needs a dramatic uplift, which would help to alleviate some of the stress and pressures placed on parents looking after children with a terminal diagnosis.