Autism

Martin Vickers Excerpts

Thursday 29th March 2018 Commons Chamber

[Martin Vickers (Cleethorpes) (Con)]

Like many colleagues, I suspect, I started to take a particular interest in how we as a society deal with those who have autism as a result of parents coming to my constituency surgery to describe the challenges that they face, and the obstacles that they must overcome to ensure that their children receive what we all want for our children: a good education, healthcare and so on. What struck me was the strength and determination of those parents. They felt that they had to be strong, determined and sometimes—I am sure that they will not mind me saying this—downright difficult to get the best for their children. We need to ensure that they do not have to be downright difficult to get what their children need, and that we provide for their needs—not necessarily without question, but certainly not in a way that appears obstructive.

Meeting these parents encouraged me to bring forward my ten-minute rule Bill in November 2016. As the motion said, it was a Bill

“to make provision about the access to education, school admissions and support for special educational needs, with particular reference to children diagnosed with autism”.

I noted in my speech that the Equality Act 2010 exists to protect people of all ages from discrimination. It should prevent disabled people from being treated unfairly because of their disability, but in some respects, sadly, there is still a long way to go. I went on to note what an irony it was that the Equality Act was being used to discriminate against children with autism. The National Autistic Society told me at the time that it believed that too many schools did not fully understand their duties towards children and young people with the condition. The law requires them to make reasonable adjustments for disabled and special educational needs pupils so that they may achieve their full potential. “Reasonable adjustments” mean ensuring that a disabled child or one with special needs can do what their non-disabled peers do, and it is important to recognise that while children with autism may behave in a manner that looks like bad behaviour, it is often an expression of anxiety. Unfortunately, as has been said, not all teachers have received specialist training that would enable them to identify it as such.

I had made a note that Department for Education figures show that autistic children are three times more likely to be excluded than children who do not have special educational needs, but the Chair of the Education Committee, my right hon. Friend the Member for Harlow (Robert Halfon), said earlier that they were four times more likely to be excluded. I suspect he is even better informed than the report from which I obtained my figure.

After presenting my Bill, I had a meeting with the then Minister, Edward Timpson, who launched a consultation on whether changes to the guidelines were needed. It would be nice to think that whatever changes resulted have cured the problem, and things might have improved, but cases in my Cleethorpes constituency indicate that it is not clear that that has indeed happened.

In that speech that I made 16 months ago, I said:

“There appears to be a loophole in the law that does not consider challenging behaviour linked to a child’s disability as an impairment. If their disability could result in aggressive behaviour towards others in the school, the law on disability discrimination does not help them, and some governing bodies use ‘tendency to physical abuse of others’ as a reason not to meet the needs of an autistic child”.—[Official Report, 1 November 2016; Vol. 616, c. 810.]

Sadly, it is then much easier to exclude such children. Of course governors have a duty to others in the school, but exclusion is sometimes the easy option.

This week I received letter from a constituent, who wrote:

“my daughter has been banned from the end of school Prom because she has ‘physically assaulted teachers and students’, no offer of being chaperoned was offered. I feel that the school has let her down by restricting her studies and as a result she is only taking four GCSE’s whereas prior to the school’s action she could have potentially got 5 pass grades.”

As I said, I received that letter only this week, so I have not yet had an opportunity to take the matter up with the school, but the fact that a parent felt it necessary to contact their MP about it rather than discussing it as part of the normal processes does not bode well.

A recent article in my local newspaper, the Grimsby Telegraph, set out the problems faced by parents of autistic children. It reported:

“Parents have…hit out at what they perceive as local services blaming them for the condition of their children, often being told that they are just poorly behaved, with the parents being told that they would have to go on a parenting course before they could get an autism assessment”.

That is unacceptable. The report continued:

“The main criticism has been levied against CAMHs, the national service commissioned by North East Lincolnshire Council that is meant to provide an autism pathway to help support children…Parents feel that while this service is meant to be available, they have had numerous troubles in trying to access it…Cora Leeson”—

a constituent of mine—

“has been campaigning for better autism services in the area for a number of years, and believes that a recent freedom of information request she has received a response to shows that there has been a very low number of people in the area actually receiving a diagnosis of being on the autism spectrum.

Her figures showed that from September 1, 2016, to May 31, 2017, there were 36 assessments…carried out by CAMHS…Only seven of these resulted in a diagnosis of autism.”

My aim is not to be critical of North East Lincolnshire Council or the local clinical commissioning group. Improvements have been made, many people are working hard to deliver a better service, and I recognise that there are resource implications. Moreover, society has moved a long way in improving the lives of those with disabilities or special needs. Nevertheless, in my constituency and elsewhere, there is clearly more to be done. A system that is designed—as it has to be—to provide for a vast range of people and needs must have enough flexibility to enable the needs of all to be dealt with. I welcome the opportunity to highlight once again the needs of those with autism.

Acute and Community Health

Martin Vickers Excerpts

Thursday 8th February 2018 Commons Chamber

[Stephen Barclay]

I am happy to reassure the hon. Gentleman, but he has raised an important point. The question of people moving within the United Kingdom is not the only issue; another potential issue is the question of people moving to a charity or a private company that is providing services for the NHS, or taking up other roles in the healthcare landscape.

[Martin Vickers (Cleethorpes) (Con)]

May I press the Minister a little further on his worrying suggestion that revolving doors are often facilitated by those who are tasked with regulating them? Will he also look at democratic accountability not just in the appointments of officials, but more widely in the NHS?

[Stephen Barclay]

I referred earlier to my desire to work on these issues with members of the Health Committee, who include my hon. Friend, and I shall be happy to look into the points that he has raised. The previous statement was about the culture in the House of Commons. I think that what goes to the heart of my hon. Friend’s question and the matters that we are discussing is that issue of culture, and the need for the culture in pockets of the NHS to change. My right hon. Friend the Secretary of State has done a great deal to bring about such change, particularly in respect of patient safety, but I shall be happy to work with my hon. Friend to take that further.

Oral Answers to Questions

Martin Vickers Excerpts

Tuesday 6th February 2018 Commons Chamber

[Stephen Barclay]

I think the hon. Lady prepared her follow-up before hearing the answer. There is an improvement board established within the trust, chaired by NHS Improvement, that is tasked with reducing waiting times and ensuring that the standard is improved. Currently, the average time waited is 11 weeks for out-patients and seven weeks for in-patients.

[Martin Vickers (Cleethorpes) (Con)]

Will the Minister give an assurance that the support that NHS Improvement is giving to the trust will continue? He will know that this is the second time that the trust has been in special measures, and clearly we need continuing support. Will he also assure us that he will visit the trust—a promise that was made by his predecessor?

[Stephen Barclay]

My hon. Friend is right to point out the need to give support to this trust. That is why a wider package of £1.6 billion of funding has been given to the NHS to improve accident and emergency and elective care performance. Alongside that, we have specific work through NHS Improvement to address some of the particular issues that he alluded to in his trust.

Hospital Car Parking Charges

Martin Vickers Excerpts

Thursday 1st February 2018 Commons Chamber

[Martin Vickers (Cleethorpes) (Con)]

It is a pleasure to follow the hon. Member for Kingston upon Hull West and Hessle (Emma Hardy), who represents the other side of the Humber bridge, and it is a particular pleasure to support my right hon. Friend the Member for Harlow (Robert Halfon). He was an asset to the Front Bench, but he has also shown his campaigning skills when dealing with issues such as this on the Back Benches. We are very pleased that he is once more among us. Let us hope that we can be as successful with this campaign as we have been with one or two in the past. It is also a pleasure to follow the hon. Member for Great Grimsby (Melanie Onn), whom I will call my hon. Friend. On this occasion, I agree with every word that my Member of Parliament has said. That does not always happen.

As with so many financial matters, it is a question of getting the balance right. Should we place an additional burden on patients and their families, especially at a time when they are particularly stressed and perhaps in great distress, or should we place the burden on the very limited NHS resources that our hospital trusts are having to manage? As has already been pointed out, some patients and their families can afford to pay, but if they are visiting, for instance, a parent who is coming to the end of his or her life, they will suffer just as much distress regardless of their financial circumstances.

In 2017, the trust that serves Diana, Princess of Wales Hospital in my constituency had an income of £2.28 million from car parking charges. It tells me that there was a surplus of three quarters of a million pounds which was spent on patient care. That is good news in the sense that that is three quarters of a million pounds that it desperately needs, but it has come out of the pockets of people who are visiting the hospital or patients at particularly difficult times. As the hon. Member for Great Grimsby mentioned, we live in an area with many low-paid jobs and this is a real burden on many hard-working families.

I am not going to detain the House for too long, but I would detain it for a great deal of time if I were to read the 64-page guidance the local trust produces for parking on its hospital sites. It is an appalling burden that we place on organisations, be they in the public or private sector, when they have to go to such trouble as to produce guidance of that length on how they operate their car park. It is complete madness.

I also draw attention to the fact that patients in my constituency and the neighbouring areas in many cases have to travel much further than others for their treatment, specifically across the river to Hull. That is an additional cost; they have the burden of the petrol or of bus fares, although public transport is almost non-existent for many of the rural villages in my constituency and the wider area served by Grimsby’s hospital.

[Sir Greg Knight (East Yorkshire) (Con)]

My hon. Friend is making a good point: the cost falls disproportionately on those who live in rural areas.

[Martin Vickers]

I thank my right hon. Friend for emphasising the point I am making. Many patients have to travel for perhaps 15 or 20 miles to get to the hospital, and that is an additional burden that they can well do without.

The hon. Member for Great Grimsby mentioned the fact that there is a problem with management, and she mentioned parking in neighbouring streets. I will add the names of a few more of them: Cragston Avenue, St Helens Avenue, Charles Avenue. We know them very well; when I was a councillor for that area people used to complain about cars blocking their streets, and I am sure they complain to their Member of Parliament today.

That is a problem I recognise, and there is also a problem with commuter parking, which has to be dealt with. Tokens have been mentioned, and simple time limits of two or three hours before charges kick in might be another alternative, as well as the flat charge that my hon. Friend the Member for Southampton, Itchen (Royston Smith) mentioned.

I urge the Government to tackle this; it needs Government action to resolve it. It is unreasonable to expect trusts—particularly those like Northern Lincolnshire and Goole, which are in special measures and have major challenges of their own—to do so. An extra burden such as this is something they could well do without. As has been said, savings can be made through better procurement procedures, and that is one possible route. I am sure every Member in the House today could identify one particular saving to meet the £200 million-plus the NHS would have to find. But this is a major problem and a burden on our constituents and it could easily be resolved, and I urge the Government to get on with resolving it quickly.

Patient Transport Services: Northern Lincolnshire

Martin Vickers Excerpts

Tuesday 16th January 2018 Commons Chamber

[Andrew Percy]

I could not disagree with a word the hon. Lady said. She has stolen my thunder—[Interruption.] No, it is good! I was going to come on to the company’s treatment of volunteer drivers. Not only has it said that it will not pay them for mileage unless a patient is in the vehicle, but at three months’ notice it told them that if their vehicles were more than five years old, they could no longer be volunteer drivers. Despite that having been its policy for a considerable time, a company cannot give volunteers three months’ notice like that—say, effectively, “Change your vehicle or give up on the service.” Through its own actions, the company has made an already struggling service much worse. It has absolutely brought the situation on itself.

I have dealt with the issue of volunteer drivers, and I thank the hon. Member for Great Grimsby (Melanie Onn) for raising it. I want to give a couple of examples from my constituency to demonstrate how poor the service has been. One of my constituents in Brigg was given short notice that their transport was to be cancelled because there were no ambulances. That meant that this person, who suffers from mobility issues, had to cancel an important scan. It is impossible for them to get in or out of vehicles unless they have been specially arranged.

The mother of another constituent from Crowle on the Isle of Axholme is 87 years old; she suffers from dementia, is partially sighted and has been repeatedly left stranded following appointments arranged way in advance. My constituent has completely lost trust in the service and family members have had to take time off work to ensure that the lady gets to hospital. The service is there to ensure that that does not have to happen. The situation is completely unacceptable.

Another constituent from the Isle of Axholme has repeatedly been left stranded and unable to book an ambulance. They have been forced to use expensive taxis, which meant that the trip doubled in length. On one occasion the service failed to fulfil a pick-up arranged in advance, and that again required them to use a taxi. The service is totally unacceptable.

[Martin Vickers (Cleethorpes) (Con)]

rose—

[Andrew Percy]

I give way to my north Lincolnshire colleague.

[Martin Vickers]

Like the Opposition Members and my hon. Friend, I have a long list of complaints from constituents, but I want to highlight a particularly bad case. On two occasions—once at Scunthorpe Hospital and once at Grimsby Hospital—a 91-year-old gentleman in Barton-upon-Humber had to wait for four hours before transport was provided to get him home. On one occasion, he did not get home until past midnight. The situation is extremely serious.

[Andrew Percy]

Absolutely. As my hon. Friend has highlighted again in this debate, we are not talking about one or two cases: Members of Parliament across our area have multiple cases. I want to highlight another one. Another constituent of mine, this time from Burton-upon-Stather, has to attend Castle Hill Hospital for chemotherapy every single day. His experience is of ambulances frequently being late, of other patients missing their appointments and of late collection for following treatment. As he has pointed out, receiving chemotherapy means that he is already very ill and weakened, but not just once but regularly he has had to wait up to three hours for an ambulance to collect him. He has also had issues with the booking system and trying to get a place at all.

My final example is of another constituent living just outside Burton-upon-Stather: 82 years old, suffering from Alzheimer’s, in a wheelchair and with very poor mobility, he is totally dependent on the assistance of others to get to and from hospital. Again, his experience is of frequently waiting for the service to collect him from Scunthorpe Hospital. Not so long ago, during snowy, freezing weather, he was left for over three hours in a hospital doorway, waiting for a lift. In the end, hospital staff intervened and brought him inside to warm up, but yet again the experience of the complaints process was that Thames Ambulance Service was wholly unresponsive in dealing with complaints.

--- Later in debate ---

[Andrew Percy]

It is incredible that what is judged to be a failing trust has a failing transport patient service that is making it even more difficult for it to get out of special measures. That is another reason I brought this matter to the House today.

Following on from the intervention of the hon. Member for Scunthorpe (Nic Dakin), one of my requests is to the Department for Transport—so not directly in the gift of the Minister in the Department of Health and Social Care—which is currently undertaking a transport accessibility consultation. It might be sensible if the issue of patient transport were to be wound up as part of that. That is one of my asks. I know that the Minister cannot respond, as it is not her Department, but it would be useful if she could pursue it interdepartmentally.



I want to give the Minister enough time to respond, so I will not say much more, but the concerns that I have described are shared by the clinical commissioning group, which has raised these issues with North Lincolnshire Council’s health scrutiny panel on a number of occasions and has told the panel that there will be further sanctions if the service does not improve. Sadly, that was said at the end of October, and, as other Members’ interventions have made clear, there has been no turnaround since then.

[Martin Vickers]

I agree with my hon. Friend that action needs to be taken. Does he agree that the service has had long enough to get its act together, and that the Minister ought to be consulting the local health trust and the CCG with a view to terminating the contract?

[Andrew Percy]

I think that that is absolutely true. The chairman of the scrutiny panel, Holly Mumby-Croft, who is a councillor for the Broughton and Appleby ward in my constituency, has said that the “volume of people” who have contacted the panel directly is “very unusual”. It is for people to go directly to a scrutiny panel; not many are aware of the position of the council. That alone suggests that the problem cannot be solved through the usual channels. After the most recent appearance of Thames Ambulance Service before the panel, the chairman said:

“I have seen actually no improvement. None at all. It is worse.”

There is something seriously failing here, and it is putting the performance of our local hospitals at risk. More important, it is having a huge impact on our constituents.

I realise that the Government did not commission the service, and that it was commissioned by the CCG, which is responsible for the performance of the contract. However, I have some asks of the Minister.

Could the whole issue of patient transport be considered as part of the consultation that is currently being undertaken by the Department for Transport? Will the Minister and the Department look at the performance of Thames Ambulance Service in north Lincolnshire, and perhaps also in Hull, to see whether anything can be done directly by the Department to improve its performance? Will they, if necessary, look into what powers are available to establish whether or not this is a business that should be operating within the health service at all? If it is routinely leaving people with three and a half to four hours to get home, surely we need to ask, whether through NHS England or locally, whether this organisation should be allowed to provide transport services.

I accept that responsibility lies directly with the commissioners. I therefore urge the Minister to engage with the north Lincolnshire CCG and put maximum pressure on it to ensure that the powers made available in the contract tender to impose fines or even terminate the contract are used if there are not serious improvements very quickly. I have no confidence that the service will improve. I think it is time that the contract was terminated, and that either the local authority or the local ambulance service has another opportunity to tender. All of us in our area want the same thing. We want a patient transport service that does what it is meant to do: take people to hospital and get them home in a timely manner.

I look forward to the Minister’s response.

Oral Answers to Questions

Martin Vickers Excerpts

Tuesday 19th December 2017 Commons Chamber

[Mr Hunt]

I have a great deal of sympathy with what the hon. Gentleman has said. We are putting a lot of effort into patient safety and staff safety in mental health trusts, and we are discovering that there is a wide variation between practices. The hon. Gentleman has made an important point, and, if I may, I will write to him to inform him of our progress.

[Martin Vickers (Cleethorpes) (Con)]

The patient transport service in northern Lincolnshire is contracted to Thames Ambulance Service Ltd, which is failing miserably to perform to an adequate standard. Will the Minister meet me, along with my hon. Friend the Member for Brigg and Goole (Andrew Percy) and other neighbouring Members, to discuss what influence the Department can bring to bear?

[Mr Dunne]

I should be happy to do so.

Oral Answers to Questions

Martin Vickers Excerpts

Tuesday 10th October 2017 Commons Chamber

[Mr Dunne]

As the hon. Lady will know, we have inserted payment for extra activity into the contract for community pharmacists because we want more activities to take place in community pharmacies. For example, many flu vaccinations throughout the country are now being carried out by pharmacists.

[Martin Vickers (Cleethorpes) (Con)]

I thank the Minister for the recent meeting that he had with me and other colleagues about Grimsby Hospital, which is in special measures. It was clear from a recent meeting I had with the chief executive that staff vacancies are one of the biggest problems preventing the hospital from getting out of special measures. What additional support can the Department offer in order to get the hospital back on track?

[Mr Dunne]

I was pleased to welcome my hon. Friend to a meeting a few days ago to discuss the situation, together with his Opposition constituency neighbours. One of the things that we will be looking at in the coming weeks is the allocation of the new doctor training places. As part of the criteria, we will be looking to ensure that some of those places are allocated to areas where it is difficult to recruit, such as rural and coastal areas.

Oral Answers to Questions

Martin Vickers Excerpts

Tuesday 4th July 2017 Commons Chamber

[Mr Hunt]

Like all clinical commissioning groups, Coventry and Rugby CCG is under a great deal of pressure, but our view is that, given the recent funding increases, it should be entirely possible for it to be sustainable.

[Martin Vickers (Cleethorpes) (Con)]

May I return the Minister’s attention to the issues facing Northern Lincolnshire and Goole NHS Foundation Trust? My constituents are worried that both Grimsby and Scunthorpe hospitals are in special measures for the second time in as many years. Will he meet me and neighbouring MPs to discuss the situation?

[Mr Hunt]

I am more than happy to meet my hon. Friend, but he should be confident that we have put in place a substantial support package, including a buddy relationship with another trust and special teams from NHS Improvement, to turn the situation around.

Community Pharmacy in 2016-17 and Beyond

Martin Vickers Excerpts

1st reading: House of Commons
Thursday 20th October 2016 Commons Chamber

[David Mowat]

I thank my hon. Friend for that comment, and I reinforce what I said earlier: NHS England plans to have this rolled out nationally by April 2018.

[Martin Vickers (Cleethorpes) (Con)]

I recognise the difficult decisions the Minister has had to make, but rural pharmacies are going to be particularly hit. He has attempted to sweeten the pill with his access scheme, but it is only a two-year scheme. What support will be forthcoming beyond that?

[David Mowat]

This is the first time ever that we have given pharmacies a two-year planning horizon; usually, these negotiations relate to a one-year period. After the completion of this period, there will be further negotiations, at which point we will take forward what is right to do.

Cities and Local Government Devolution Bill [Lords]

Martin Vickers Excerpts

Monday 7th December 2015 Commons Chamber

[Martin Vickers (Cleethorpes) (Con)]

I shall speak to amendment 56 and the Government manuscript amendment to it. Although I added my name to the amendment, the original proposal came from my hon. Friend the Member for Carlisle (John Stevenson), who apologises for not being present in the Chamber today. As the House will appreciate, his constituency has been very badly affected by the weekend floods.

I wish to make a few points on my hon. Friend’s behalf. Amendment 56 provides for a very modest change that would give greater flexibility both to the Government and to local communities. Where there is a clear wish for change, a county could achieve it in a much more efficient manner and without too much delay. The amendment seeks to build on existing legislation in relation to changes to boundaries. I am talking about not radical change, but easier changes that both Government and local people support.

My hon. Friend hopes that these changes can be applied to his own county of Cumbria, where they are badly needed and widely supported, as they would improve local government and lead to cost savings. I note that the hon. Member for Nottingham North (Mr Allen) spoke in favour of this amendment. I hope that that sentiment will also be expressed by the Opposition Front Bench and that we can proceed on this matter with consensus. With that, I hope that the House will support this amendment.

[Mr Jacob Rees-Mogg (North East Somerset) (Con)]

I wish to support some of the amendments tabled by my hon. Friend the Member for Hazel Grove (William Wragg) and to try to give more information to the hon. Member for Glasgow Central (Alison Thewliss) to explain why I am in favour of first past the post.

Briefly, let me talk about referendums and why I have attached my name to amendment 2. It seems that there is a slowly developing theory of referendums in this country that fits in with a parliamentary democracy. It is that those of us who sit in this House, who admire this House and who approve of how our constitution works, have a great affection for the understanding that we are representatives and not delegates, and that we are here to exercise sovereignty on behalf of the people for a five-year period before returning it to them in toto at the end of that period. That is the well-established constitutional position. Against that, and in sympathy with that, there is a developing view of where referendums are useful, and moving from useful to becoming essential; and that is to do with the structures of government. The reason for that is that there is a permanency in the structures of government that outweighs the normal level of legislation with which we deal.

It is quite right that Scotland had referendums on its decisions on independence and on establishing a Parliament in the first place, because those are effectively permanent decisions, irreversible and unchangeable without the consent of the Scottish people. Likewise in Wales, the Welsh have had referendums on their Assembly, as has Northern Ireland, too. With regard to local councils and changes, if the structures are to work they need to go with the grain of popular consent. Authority, when it is used, needs to have a legitimacy that is based in democratic consent. When that consent was not given in the Local Government Act 1972, there was a great deal of hostility to what was done because it did not meet the requirements of local people. Against that evolving doctrine of referendums there is, inevitably, the Government’s view of referendums, which I characterise, perhaps unfairly, as being, “We will have referendums when we think we will win them, but if we think we won’t win them, it is a bit too dangerous, so we won’t take the risk.” It is a pity that the Government have not taken the risk with these new structures. Let us take the Mayor of London as an example. The Mayor of London has enormous popular consent, even when it was Ken Livingstone, let alone now that it is the great man, my hon. Friend the Member for Uxbridge and South Ruislip (Boris Johnson).