Augmentative and Alternative Communication Services

Debate between Paul Maynard and Cathy Jamieson

Thursday 6th June 2013 Commons Chamber

[Paul Maynard]

I thank my hon. Friend for that perceptive contribution. The concern is that NHS England’s budget for AAC will not be sufficient for training. The only way that the hub-and-spoke model can work effectively is if the hub can train up more people in the spokes to deliver the more complex tools. Complexity is at the heart of the problem in the structure. AAC is one of five areas for which complex disability equipment is to be commissioned nationally—incidentally, another is artificial eyes, the national centre for which is based in my constituency. It would be remiss of me not to congratulate that centre during an Adjournment debate on a parallel issue. As I was saying, though, complexity is the key: it determines whether a patient is treated at the hub or at the spoke.

A stroke patient will receive a relatively straightforward medical diagnosis—it might be a devastating incident in their personal life, but its medical nature is relatively simple. None the less, what will restore the power of communication to someone who has lost it will be a complex piece of kit, yet under the current rules, as I understand them, it would be commissioned in the spoke. If the skills are not there to utilise that piece of equipment, that stroke patient will not benefit, so complexity of need has to be balanced by the complexity of the product being supplied. That is crucial.

The other issue on which I want to draw out the Minister is the concerns of worried providers in the voluntary sector about their ability to bid for commissions from NHS England. There has been a long-running battle over whether AAC should be based in the education or the health sector. It is now clear that it will be based in the health sector, but one of the key elements of what NHS England seeks to commission is an educational component in a multi-disciplinary team. That component is most often found in organisations such as the ACE Centre, the Dame Hannah Rogers Trust, near the constituency of my hon. Friend the Member for Totnes (Dr Wollaston), or the Percy Hedley school, up in the constituency of the hon. Member for Blaydon (Mr Anderson). They all have immense expertise, yet they greatly fear that the mood music emanating from NHS England suggests that they will be unable to bid for such provision, because of an understanding that it must be supplied by an NHS provider. That seems strange, given all that the Government have said down the years about trying to ensure a broader spectrum of provision—that more civil society organisations can provide such services. I hope the Minister can provide some reassurance on that.

I would also like a commitment from the Minister—this is another fundamental aspect—that this really is a health issue and no longer just an education issue. I hear far too many heartbreaking stories of children who are equipped with complex equipment when in school but, because it is funded by the Department for Education, lose it when they leave. It is not just a piece of kit they are losing; it is their ability to express themselves as fully formed adults. That is why it is so important that this becomes a health issue, not just an education issue.

My final query is rather technical—I beg the Minister’s forgiveness, but this goes back to acting like a statin in NHS England. A clinical reference group has been set up, but it has yet to meet—it is in a form of limbo, as it were. There is yet greater uncertainty, not merely because it has not met, but because the gentleman who chairs it, one Dr Thursfield, is shortly to retire from his academic post at the University of Birmingham. There is grave concern that his uncertain status in the clinical reference group is imperilling its ability to meet, take decisions and do its job. Alexis Egerton—the gentleman I mentioned earlier—was disappointed not to be appointed as a patient representative on the clinical reference group. I have known Alexis since my youngest days. He did his PhD on the funding of AAC provision, and it would be immensely valuable to the Government and the nation as a whole if we could find a way to allow him to play a role in that.

Finally—I want to ensure that the Minister has time to respond fully—will he bear in mind that the right to have a voice is a fundamental human right? We have an opportunity in this place to represent our constituents. If, in doing so, we give a voice to some who hitherto did not have one, we will have spent a useful half-hour in this debate. I look forward to hearing the Minister’s response.

[Cathy Jamieson (Kilmarnock and Loudoun) (Lab/Co-op)]

On a point of order, Mr Deputy Speaker. I apologise to hon. Members for having to raise this point of order at the end of a passionate speech in an important debate. I seek your guidance, Mr Deputy Speaker. Today I had a telephone call from someone in the press asking me to comment on a parliamentary question I had asked and for which they had the answer. Unfortunately I was not party to that answer, as it had not been delivered to me. When I contacted the Table Office, it could not elucidate either. I was, however, able to obtain a scanned copy from the press. Would you agree, Mr Deputy Speaker, that this is not the way to conduct business and ensure that Members are appropriately briefed?

Savings Accounts and Health in Pregnancy Grant Bill

Debate between Paul Maynard and Cathy Jamieson

Monday 22nd November 2010 Commons Chamber

[Paul Maynard]

I thank the right hon. Gentleman for that effort to bring clarity. None the less, I regret the use of the word “trivialise”, if only because I have spoken to many families in my constituency with disabled children. When speaking just a fortnight ago to one family who had benefited from the family fund and had their first holiday in five years, the mother broke down in tears.

I raise the matter not to have a go at the shadow Minister, but to highlight one of the wider issues that was illuminated in Committee: the difference between the accessibility of an asset that is locked away until the young person is aged 18, and the changing needs of families with disabled children—and of looked-after children, for that matter. If we are seeking to target the child trust fund at those in the community who are the most vulnerable, who have the most chaotic lives, who are subject to the most pressures, to whom unexpected things occur, is it truly sensible to tie them into something that can be delivered only when the individual reaches the age of 18?

[Cathy Jamieson]

Does the hon. Gentleman agree that the situation should not be an either/or? We should be able to give day-to-day help and support to the most vulnerable, at the same time as allowing people—for example, looked-after children and people who have disabled children—to build a capital asset that will be available to them when they enter adulthood.

[Paul Maynard]

I agree entirely, and I wish that during the evidence taking in Committee and in the debate, we had had an either/or discussion, rather than an “and, and, and, and yet another idea” discussion. We had far too many shopping lists and not enough recognition that hard choices had to be made. It is important to recognise, as Marc Bush from Scope did when he gave evidence to us, that delivering an asset at age 18 is not the solution to the problems faced by families engaging in the transition of their child from childhood to adulthood, when faced with a complex disability. That starts at age 14 and can continue to age 30. The hon. Member for Stretford and Urmston (Kate Green) recognised that when I intervened on her, and that was a useful move forward.

When we are discussing the future of child ISAs, I hope it is taken into account that families who are particularly vulnerable may need access before the age of 18. Locking the ISA away until age 18 is not always the best solution.

Savings Accounts and Health in Pregnancy Grant Bill

Debate between Paul Maynard and Cathy Jamieson

Tuesday 26th October 2010 Commons Chamber

[Paul Maynard]

Thank you for that advice, Mr Deputy Speaker.

There are other ways in which we can and do help looked-after children. In particular, for example, there is a high correlation between looked-after children and poverty. That stands to reason, particularly in terms of their geographical location, but the pupil premium, which we announced recently, will go a long way to helping those children who are in education to make it as far as university in the first place. Finally, on the child trust fund, I welcome the notion of a children’s ISA. I hope that I hear about it in a future announcement or Budget.

I should now like to apply my two tests to the health in pregnancy grant. It is what it says it is: it is about health in pregnancy. The former Prime Minister, when Chancellor, introduced the policy, saying that the Government had received “powerful representations” regarding the importance of good nutrition during the final stages of pregnancy. The grant was clearly designed to promote health in pregnancy, but, when the measure was going through its Delegated Legislation Committee, the then Health Minister, the right hon. Member for Exeter (Mr Bradshaw), accepted that the bulk of health improvements occur when changes in behaviour occur earlier in pregnancy. Waiting until the seventh month is rather like shutting the stable door after the horse has bolted; it certainly does not encourage a behavioural change.

[Cathy Jamieson (Kilmarnock and Loudoun) (Lab/Co-op)]

By that very logic, would it not therefore make sense for the hon. Gentleman’s party to propose an earlier payment of the grant?

[Paul Maynard]

I could well ask why you did not think of that when you introduced the scheme in the first place. It is a bit late now—