Disability Equipment Provision
Debate between Luke Evans and Zubir Ahmed(1 week, 2 days ago)
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Dr Ahmed
I am grateful to the right hon. Gentleman, and to those who raised this matter earlier in the debate. It does trouble me deeply that we have a situation in which equipment is going unused when there is that need in another part of the system. I actually feel that quite acutely. Hon. Members may know that I am a vascular surgeon; at times, unfortunately, some of my job involves having to amputate people’s limbs for end-stage vascular disease. I see for myself that transition from someone being able-bodied to needing assistance, and, where that assistance is not available, the impact that has, especially when people know there is this lack of productive exchange of equipment in the system highlighted by hon. Members today. I am therefore very happy to take the issue forward with my officials to see what can be done further to marry the demand and the supply together in the country.
Regarding wheelchair provision, NHS England has developed policy guidance and legislation to support ICBs to commission effective, efficient and personalised wheelchair services. I again nod to the remarks from the hon. Member for Aberdeenshire North and Moray East on making sure we get better, more efficient and personalised service provision.
In April 2025, NHS England published the wheelchair quality framework, developed in collaboration with the NHS England national wheelchair advisory group. The framework is designed to assist ICBs and NHS wheelchair service providers in delivering high-quality provision that offers improved access, outcomes and experience. NHS England introduced personal wheelchair budgets, including legal rights, in 2019, providing a clear framework for ICBs to commission personalised wheelchair services that are outcomes-focused and integrated. Those budgets give people greater choice over the wheelchairs that they are provided with. Additionally, the model service specification for wheelchairs sets out that wheelchair assessments should take place in the most suitable environment based on the needs of that individual.
NHS England is aware, as am I, that several complaints have been made about the quality of services commissioned by some ICBs. NHS England is working through the appropriate regional teams to gain intelligence from those ICBs on quality concerns and contracting arrangements, to fully understand the issues being raised.
Dr Ahmed
Well, I have not got time. I will write more fully regarding his correspondence. I am genuinely disappointed, if it is true, that he has not been responded to since September.
In addition, the 10-year plan makes a commitment to reviewing the complaints regulations. NHS England and the Department are developing those together to achieve better accountability. The Government are also taking wider action to support disabled people through the 10-year health plan. On neighbourhood health, the neighbourhood health service will support disabled people to have choice and control over their care. That includes increasing the uptake of personal health budgets, which provide individuals with that greater choice and control over how their health is assessed and their wellbeing needs are met.
One aim is to have a neighbourhood health centre in each community, bringing the NHS, local authority and voluntary sectors together to create a holistic offer that meets people’s needs in the place that they are. We expect these services to be designed in a way that reflects the specific needs of disabled people, with a focus on personalised, co-ordinated care. I particularly think that this is an opportunity, as we move care from hospital to the community, to address some of the concerns raised in the debate today.
On social care, the Government are also driving forward improvements for disabled people. We are enabling people to have more choice and control over their care—through greater use of direct payments, for example. We are also expanding care options to boost independent living at home and have recently confirmed £723 million for the disabled facilities grant in 2026-27. The total DFG budget across 2025-26 and 2026-27 is £150 million more than the total budget across the previous two years. That represents an 11% increase and will support more disabled people to get the vital home adaptations that they might need.
The Better Care Fund, which took effect in April 2025, is a framework for ICBs and local authorities to make joint plans and pool budgets to deliver better joined-up care. That can include the provision of assistive technology and equipment, such as wheelchairs. This financial year, ICBs and local authorities plan to spend £440 million on assistive technology and equipment, and we have introduced care technology standards to help them to choose the right support. In addition, as we move from hospital to community, commissioners can, if they wish, think about better co-commissioning, transcending traditional boundaries between local authorities, social care and the NHS.
I am grateful to the hon. Member for Aberdeenshire North and Moray East for securing this important debate and I want to respond to a question he asked. Whether we call it a strategy or a framework, there is a real opportunity at this time of change in the NHS—including the development of a national quality board at NHS England, which will come into the Department of Health and Social Care once NHS England is abolished —to genuinely think about how we define “quality” for disabled people and about the equipment and the spaces that they use. Again, I will be very happy to discuss that with my colleagues in charge of the quality board. I will write to the hon. Gentleman with specifics that we can perhaps tease out after this debate today.
We recognise the life-changing impact that having timely access to suitable disability equipment can have on the lives of disabled people across the United Kingdom, in every nation. The Government are dedicated to ensuring that all disabled people have access to the services and support that they need to live a fulfilling life; the presence of disability Ministers in each Department is certainly progress in that regard. Our work to reform health and social care, alongside the new plan for disability, will also help us to achieve that.
Pharmacy First: Withholding Payments
Debate between Luke Evans and Zubir Ahmed(1 month, 1 week ago)
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Dr Luke Evans (Hinckley and Bosworth) (Con)
(Urgent Question): To ask the Secretary of State for Health and Social Care if he will make a statement on the withholding of Pharmacy First payments to pharmacies.
The Parliamentary Under-Secretary of State for Health and Social Care (Dr Zubir Ahmed)
It is a pleasure to take the traditional Department of Health and Social Care urgent question before recess—I would not miss it for the world.
Since coming into office, we have reversed the decade of cuts to community pharmacy with the biggest uplift for the sector in years and frozen prescription charges to help our constituents with the cost of living, and women can now get the morning-after pill free of charge across the country. Earlier this week, I spoke to the National Pharmacy Association’s winter reception to pay tribute to its members for their work and to assure them that I have their back, as does the Minister for Care.
The hon. Member for Hinckley and Bosworth (Dr Evans) raises the important issue of payments made via Pharmacy First. As he knows, pharmacy contractors receive a monthly fixed payment if they meet certain requirements. We agreed to reduce the claim window, in conjunction with Community Pharmacy England, as part of our deal for 2025-26 to introduce a new Pharmacy First fixed first payment of £500. That has supported a broader range of pharmacies and has meant that more pharmacies have become eligible for payments. We are in discussions with Community Pharmacy England to consider where improvements to the claiming process can be made, address concerns raised by contractors and aim for a more consistent approach to remuneration. We will also consult with Community Pharmacy England shortly on the contractual framework for next year.
There are issues relating to contractors being suspended from providing Pharmacy First that are for separate consideration. When concerns are raised, NHS England can suspend individual contractors from providing the service pending a full investigation. There are a number of reasons why that might be necessary, but the measures are there, first and foremost, as the House will appreciate, to protect patient safety. I am a clinician, as is the hon. Member for Hinckley and Bosworth, and I am sure that he will agree that patient safety should be at the forefront of everything we do.
Finally, funding for the core community pharmacy contractual framework has been increased to over £3 billion—the largest uplift of any part of the NHS in the last two years. As part of this year’s contractual framework, we have agreed to keep the current cost control mechanism linked to Pharmacy First that we inherited from the previous Government to ensure that the money is spent within that envelope. I thank the hon. Gentleman for his question.
Dr Evans
It is a regret that I have had to summon the Minister here to answer questions, and surprise, surprise—
Dr Evans
I of course withdraw that remark, Mr Speaker, and I thank you for summoning the Minister on my behalf. It seems to have had the desired effect, because the outstanding parliamentary questions have, strangely enough, been answered this morning. I hope to get some clarity as this is really important.
The issue has been explained simply by the chair of the National Pharmacy Association:
“The work was done. Patients were treated. The NHS benefited. Yet payments are being withheld on a technicality.”
What makes that worse is that many pharmacies do not even realise that some of the money is missing. He goes on:
“Statements appear ‘successful’, yet Pharmacy First payments are absent. Contractors are only discovering the issue long after the window has closed, when it’s already too late.”
Will the Minister tell the House how many pharmacies the Government think are impacted? What is the total value of the outstanding payments? What steps are the Government taking to rectify this, and would they consider a late payment mechanism to help solve the issue?
There is a wider concern. Payments are administered by the NHS Business Services Authority. The chair of the NPA labelled the behaviour of NHSBSA “outrageous”. That already follows repeat concerns about NHSBSA’s performance, including multiple serious delays in NHS pension processing and several urgent questions on the Floor of the House. Does the Minister still retain confidence in NHSBSA? Given the ongoing concerns from multiple fields, will he commission a review of the operational performance of the entire NHSBSA?
Community pharmacies are already under intense pressure from this Government, with tax rises on employment and business rates and with increases in costs, and now they appear not to be being paid for work already done. I hope the Minister will act quickly to put this right.
Dr Ahmed
As the hon. Gentleman will know—or should know—the current remuneration method was agreed in conjunction with the sector. The adjustment was agreed with the sector’s representative body, Community Pharmacy England. Advance notice of the change was provided to those contractors by letter and in an article published by the NHS Business Services Authority in May 2025. In addition, Community Pharmacy England knows that, should this be a priority issue for it to negotiate in the next contract, we will take that on board and use it as an option.
There are of course always extenuating circumstances, such as IT not working. Officials have reassured me that, following discussions with Community Pharmacy England, we have introduced specific provisions in the drug tariff that will allow pharmacy contractors to receive payment for claims that were delayed due to IT issues outside of its control.
I can appreciate why the hon. Gentleman wants to expand the remit of the urgent question across primary care—well, let me tell him. I know he had neck surgery recently; I did not realise they put a brass neck in him as well when they did it. He knows what kind of NHS decline and decay over which he and his Government presided over the past 15 years: primary care where people are left wandering around asking for GPs, and the Conservatives left GPs on the scrapheap, unemployed. This Government ensured, when they came into office, that—
ADHD Diagnosis
Debate between Luke Evans and Zubir Ahmed(2 months ago)
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The Parliamentary Under-Secretary of State for Health and Social Care (Dr Zubir Ahmed)
It is a pleasure to serve under your chairship, Ms Vaz. I thank my hon. Friend the Member for Sefton Central (Bill Esterson) for securing what is, by all acknowledgement, an important debate on ADHD. I thank other hon. Members for their valuable contributions today, particularly my hon. Friends the Members for Hertford and Stortford (Josh Dean), for Sheffield Hallam (Olivia Blake) and for Warrington South (Sarah Hall), and the hon. Member for Yeovil (Adam Dance) for sharing personal experience that has been invaluable to this House. In this debate, we have heard moving testimonies and I want to thank all hon. Members who have shared personal and family experiences. I personally express my welcome and my deepest sympathies to Christine and Richard, the parents of Matthew Lock. I thank them for being in the Public Gallery for this debate, and thank them for all the invaluable work that they have done with the Department and with NHS England to raise awareness of the issues surrounding ADHD and suicide through the charity that they set up in Matthew’s memory.
We have learned, through this debate, the intersection between ADHD, other mental health conditions and suicide risk. Every suicide is a profound tragedy that leaves families, friends and communities devastated. That is why, in addition to our approach to ADHD, mental health and autism, we are committed to delivering the suicide prevention strategy for England, which aims to address the risk factors contributing to suicide to ensure that fewer lives are lost. We will work across Government to improve support to those who are suffering, and those who have been bereaved by suicide.
We know that people with ADHD have co-occurring neurodevelopmental conditions. We must not only intervene early but assess people with suspected neurodevelopmental conditions—about which I will say more later—and ensure that, following diagnosis, people have the right support to meet their needs, including their mental health needs. The Government have already taken significant steps to stabilise and improve NHS mental health services but, of course, there is so much more to do. Transforming the system always takes time but we are committed to delivering a new approach to mental health.
The 10-year health plan sets out the ambitious reform that we wish to undertake to make the system fit for the future. In line with that, we will go further to ensure that NHS mental health services deliver the care that people deserve and rightly expect. The publication of the “Staying safe from suicide” guidance in 2025 means that all mental health practitioners must now follow the latest advice in understanding and managing suicide. Associated training is now available to all NHS and non-NHS mental health staff.
Following the tragic loss of their son Matthew, Richard and Christine have been keen to ensure that other families are made aware of the increased risks of addiction and suicide that are associated with ADHD. NHS England has worked closely with Richard and Christine to revise content on the nhs.uk website, and has included separate, tailored content on ADHD for adults, children and young people. The website also specifically highlights the increased risks of suicide and addiction in those with ADHD, it signposts anyone who might be struggling to find urgent help and support, and has updated wording to reflect lived and clinical experience. I extend my thanks again to Richard and Christine for all their input to that work. I invite them into the Department to meet me alongside my colleague, the mental health Minister, to see how we can go further faster.
We know that too many patients are facing long waits to access services including ADHD assessments and support. I know that such issues are affecting our constituents up and down the country, as has been reflected in this debate, and I understand the devastating impact that that has on individuals and families. Lord Darzi’s report laid bare the growth in demand for ADHD assessments nationally. That has been so significant in recent years that it risks completely overwhelming the resource available. I thank everyone who has taken part in sharing evidence for Lord Darzi’s report, and with the subsequent ADHD taskforce established by NHS England. We know, from the taskforce’s report, that there are quality concerns with assessments. There has been rapid growth in remote assessments and in use of the independent sector. We are urgently looking into those concerns. That is why work is currently underway to improve ADHD services in both the short and long term to meet the needs of those waiting for an assessment, or those needing treatment for a diagnosis.
Dr Ahmed
I have met the chair of the taskforce: we discussed the outcomes, and the need—as the hon. Member mentioned in his remarks—for work on those outcomes to dovetail with the prevalence review. I think that would be the most appropriate way to provide a holistic response. We, of course, respect the findings of the report, which is an excellent scientific piece of work looking at the data underpinning the diagnoses.
Dr Ahmed
At present, the hon. Gentleman will have to ask my colleague the mental health Minister about the specifics, but my understanding is that the prevalence review will be a wider piece of work that will be partly informed by the ADHD taskforce report. It would be better to respond to them as a combination rather than as individual reports.
The House will know that on 4 December 2025 the Secretary of State announced the launch of the independent review into prevalence and support for mental health conditions, ADHD and autism. It will bring together the most respected researchers, clinicians and voluntary organisations in the country, alongside, crucially, people with lived experience, who will be directly engaged to scrutinise the evidence and support the development of recommendations. Part of that will be about how we address and label reporting, and I would expect that we come up with a better definition and a better way of reporting than we have at the moment.
The Government’s 10-year plan sets out the core principle of early intervention and support, and will make the NHS fit for the future. Through the NHS medium-term planning framework, published in October 2025, NHS England has set an expectation that local ICBs and trusts improve access, experience and outcomes for ADHD services over the next three years.
I heard the call from hon. Members for much more integration between community mental health services, GPs and other healthcare bodies. It is our expectation that through the NHS reform Bill and the disbanding of NHS England, as well the production of independent health authorities and strategic commissioning, the health service will be better able to serve the needs of children requiring assessment for mental health conditions and ADHD. We will end up having a helicopter view, which is currently not possible.
Terminal Illness: Mental Health Support
Debate between Luke Evans and Zubir Ahmed(3 months, 2 weeks ago)
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The Parliamentary Under-Secretary of State for Health and Social Care (Dr Zubir Ahmed)
It is a pleasure to serve under your chairmanship, Sir Jeremy, and I start by sincerely thanking my hon. Friend the Member for Altrincham and Sale West (Mr Rand) for securing this debate. I also welcome Mike and his family to the Public Gallery, and pay tribute to Mike for all his efforts.
My hon. Friend raises an important issue that can affect so many people—all people perhaps, at some point—about ensuring that when someone is diagnosed with a terminal illness, they can receive the mental and emotional support that they need in the place that they need it. We want to be a society where every person receives high-quality, compassionate and personalised care from diagnosis through to the end of life. The Government are determined to shift more healthcare out of hospitals into the community to ensure that patients receive personalised care in the most appropriate setting.
Palliative care and end-of-life care services, including those provided by hospices, have a big role to play in that shift. Palliative care services are included in the list of services that an integrated care board must commission, promoting a more consistent national approach and supporting commissioners to prioritise palliative care and end-of-life care. To support that process, NHS England has published statutory guidance stating that ICBs must work to ensure that there is sufficient provision of care services to meet the needs of their local population. It also includes references to mental health, wellbeing and support for those with palliative care and end-of-life care needs.
Of course, there are many examples of voluntary initiatives, such as grief or bereavement cafés, or the Good Grief community, which aims to support people at the end of their life and their families through a programme of events and courses, and the provision of resources that often include pre-bereavement advice and support.
I know that my hon. Friend the Member for Altrincham and Sale West feels passionately about mental health support for those with palliative care and end-of-life care needs, and that he has been supporting Mike’s campaign for improved mental health services and support. I offer him my deep appreciation, as well as a meeting with the Minister for Care and end-of-life care officials, so that we can engage him around the palliative care and end-of-life care modern service framework that was recently announced, which we hope to publish in the spring.
The Government are also transforming the current mental health system, ensuring that people get access to the right care at the right time in the right place. That is why we are increasing our investment in mental health support by £688 million in cash terms.
The hon. Member for Hinckley and Bosworth (Dr Evans), who spoke for the official Opposition, talked about impact assessments. I gently say to him, in the context of this convivial and constructive debate, that when we came into office we had an impact assessment by virtue of the Darzi review, which highlighted in stark terms the difficulties that the NHS in its totality is under after 14 years—the difficulties that we inherited. I also point out that our real-terms investment of £26 billion is an increase to the NHS budget that will translate into, among many other things, a new national cancer plan. That will examine not only the process of getting the best treatments to patients, but improving communication, improving pathways, and instilling better and more bespoke mental wellbeing support into some of those pathways.
Dr Evans
The Minister is indeed right to say that there was an injection of cash, but the proportion of funding being spent on mental health was actually cut. The written ministerial statement is very clear that that proportion went from 8.78% to 8.71%, which the royal college said was about £300 million of investment. Can he confirm from the Dispatch Box—if he cannot, he can write to me later—whether the Government are still committed to the mental health investment standard, or is that commitment going to change? Currently, it is unclear whether they are still committed.
Dr Ahmed
The mental health investment standard is something that we expect ICBs to meet. I will gently push back on what the hon. Gentleman is saying because, as we have been so succinctly reminded in this debate, investing in mental wellbeing is about more than just headline figures. For instance, we need psychology in oncology, in children’s health, and in other forms of cancer care. The provision of such services is not always recorded in the way that the hon. Gentleman would wish it to be recorded, but there are still formats and sub-types of mental health support.
The Government are also keen to press ahead with our 10-year plan, and we are setting out ambitious plans to boost mental health support across the country while delivering the shift from hospital to community. As part of that process, we wish to open around 85 mental health emergency departments, reducing pressure on busy A&E services, which are the last places that people with mental health needs should be, and ensuring that people have the right support they need in a calm, compassionate environment.
We will also use new integrated health organisations to break down barriers between services, which I also think is really important in the context of this debate, and to ensure integrated and holistic care, addressing both physical and mental healthcare needs, with more freedom to determine how best to meet the needs of those local populations. That will build on the work that has already begun to bring down waiting lists. As I said, we are investing an extra £688 million this year to transform mental health services. On staffing, I am pleased to say that almost 7,000 extra mental health workers have been recruited since July 2024, against our target of 8,500 by the end of this Parliament.
We are also expanding talking therapies, and we have committed to continuing that expansion over the coming years. More adults already benefit from better access to those therapies, and the aim is for over 900,000 people to complete a course of treatment with improved effectiveness and quality of services by March 2029. Anyone who develops a common mental health condition, such as anxiety or depression, in any context, including terminal illness, can self-refer to talking therapies. [Interruption.]
Ageing and End-of-life Care
Debate between Luke Evans and Zubir Ahmed(4 months, 2 weeks ago)
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Dr Ahmed
I am very concerned to hear what my hon. Friend has reported to the House. Clearly, coercion is unacceptable in all forms. Safeguarding is taken very seriously by the national health service and by the Department of Health and Social Care, and as the Minister with responsibility for patient safety, I am very happy to look into that further and to take it up with him after the debate.
As set out in the 10-year health plan, we are going to shift more care out of hospitals and into communities, and make care more personalised. If there is anywhere where that is most important it is palliative care and end-of-life care. Palliative care and end-of-life care, including hospices, have a big role to play in that shift, and they were highlighted in the 10-year plan as an integral component of neighbourhood health teams.
In England, integrated care boards are responsible for the commissioning of palliative care and end-of-life care to meet the needs of the local population. To support ICBs in this duty, NHS England has produced statutory guidance. That includes the need for 24/7 access to palliative care and advice, and a palliative care and end-of-life care dashboard that brings together all relevant data in one place. The dashboard helps commissioners understand the palliative care needs of the local population. Of course, the majority of palliative care and end-of-life care is provided by NHS staff and NHS services, and that has benefited from the record funding in the NHS that the Chancellor delivered in the last Budget.
I will not be able to address all the points made by the hon. Member for Hinckley and Bosworth (Dr Evans), as he was in a typically verbose mood, but if he wills the ends, he must will the means, and if he does not agree with the means, he must present his thesis as to the alternative model of funding that he wishes to see. Otherwise, it is a case of cutting services.
However, we recognise the vital part that voluntary sector organisations, including hospices, play in providing support to people at the end of their lives and to their loved ones. In recognition of that, £100 million of capital funding has been made available to hospices in England to ensure that they have the best physical environment for caring. That includes helping hospices to provide the best end-of-life care to patients and their families in a supportive and dignified environment. It includes funding to deliver IT systems and provide refurbishments and facilities for patients and visitors, so that they can see their family members at the end of their lives in a dignified environment—much more than just a lick of paint.
Dr Evans
Given the recent National Audit Office report and the fact that the tax increase to national insurance contributions has had the biggest impact on the voluntary sector, has an impact assessment been carried out into how much the cost has gone up for hospices in England to provide their services? If not, will the Minister consider it?
Dr Ahmed
The hon. Gentleman knows that the NAO report covers a period both when his party was in government and beyond. I go back to the point about NICs. If he wills the end, he must understand the means. I am very happy to have that conversation with him at length after the debate, respecting the confines of the time that I have—I do not want to test your patience, Madam Deputy Speaker.
I am delighted that the first £25 million of the £100 million fund has been passed to Hospice UK and has been spent on capital projects already. The Minister for Care, my hon. Friend the Member for Aberafan Maesteg (Stephen Kinnock), visited Katharine House hospice earlier this year, Wigan and Leigh hospice in July, and Noah’s Ark children’s hospice earlier this month to see directly for himself how that record investment is making a meaningful impact on the ground. We can confirm that the Department of Health and Social Care has now transferred the rest of the £75 million to Hospice UK for onward spending in 2025-26. We are also providing £26 million of revenue funding to support children and young people’s hospices. This is a continuation of the funding that, up until recently, was known as the children’s hospice grant. That funding will see circa £26 million allocated to children and young people’s hospices in England each year via local integrated care boards on behalf of NHS England. This amounts in total to £80 million of hospice funding over the next three years.
For many of us who are in good health, managing complexity and ageing seems a distant idea. The Government recognise that the number of people with palliative care and ageing needs is projected to rise significantly over the next quarter of a century. That is why we are shifting more healthcare out of hospital and into communities through our plan for change. That is why we are investing, through the National Institute for Health and Care Research, over £3 million in a policy research unit in palliative and end-of-life care. The unit launched in January 2024 and is building the evidence base on palliative care and end-of-life care.
Earlier this year the Minister of State for Care and, more recently, the Secretary of State met key palliative care and end-of-life care and hospice stakeholders at dedicated roundtables, and focused that discussion on long-term sector sustainability within the context of the 10-year plan. Following the recent publication of the plan, the Minister of State for Care tasked officials to work at speed to generate proposals to improve the access, quality and sustainability of all-age palliative care and end-of-life care as we start to implement the plan.
In closing, I hope that those measures assure the hon. Member for Strangford of the Government’s seriousness to build a sustainable palliative care and end-of-life care sector for the long term.
Dr Ahmed
I will not, in the interests of time.
I reiterate my thanks to the hon. Member for Strangford for bringing forward this vital issue, and I thank all hon. Members who have spoken today. He can be assured that he has raised the voice of those who deserve dignity at the end of their lives, and that his call has been well and truly heard by the Government.