NHS and Social Care Funding

Debate between Philippa Whitford and Toby Perkins

Wednesday 11th January 2017 Commons Chamber

[Toby Perkins]

The hon. Lady is right to say that we have an ageing population but that is predictable. Does she think it is also significant that in 2008 the UK was spending about the same as all the major EU nations, whereas the OECD now says that we are spending considerably less than most of the other major nations? Is that not actually causing this problem?

[Dr Whitford]

Money is not the only problem. I accept that part of it is about how things are done. The Secretary of State talks about variations and many hospitals performing well, but, as I said, only one trust is meeting the target and only nine are at over 90%, so it is not that the majority are doing well and a few are failing.

The ability to look at how we deliver the NHS is crucial, but change costs money. We must therefore invest in our alternatives so that our community services and primary care services can step up and step down to take the pressure off. One of the concerns about the STPs is that because people do not have enough money, a lot of them start by thinking that they will shut an A&E, shut a couple of wards, or shut community beds—even though those are what we need more of—to fund change in primary and social care. Then the system will fall over. We need to have double running and develop our alternatives and then we will gradually be able to send the patients there.

Accessible Toilet Availability

Debate between Philippa Whitford and Toby Perkins

Wednesday 21st October 2015 Westminster Hall

[Toby Perkins]

I am very glad that the hon. Lady was able to pay that tribute. She is absolutely right to say that the contribution that Loretto made is gratefully reflected on by people right across the country, and we all mourn her passing.

Let me remind the House of the number of people affected: there are 250,000 such people in the UK, and if we take into account their family members, too, that number rises to 1 million people. There also around 900,000 children—most of whom would not be included in the original figures—who are diagnosed as having continence problems, many of whom would not be considered disabled, but none the less require appropriate space for changing. What those numbers tell us, apart from simply the scale of the problem and the health-related cost implications, is the huge potential tourism market available to venues that are accessible to disabled people—not to mention the moral obligation that we have as a civilised society to disabled people and their families. The case for having Changing Places toilet provision as widely available as possible is utterly compelling.

Before I go on to talk about what more can be done to further the case for Changing Places toilet provision, it is worth reflecting for a moment on the successes that campaigners have already achieved in Britain.

[Dr Philippa Whitford (Central Ayrshire) (SNP)]

I briefly mention that even ordinary toilets are under threat within local government areas. With an ageing population and more people with stomas and other problems of urinary or faecal support, I think the numbers that would be affected by high-quality toilets are even greater.

[Toby Perkins]

The hon. Lady makes an incredibly important point. The impact of local authority budget cuts on this and a huge number of other areas is something we return to time and again within the political arena. I thank her for making that point.

As I was saying, it is worth reflecting for a moment on the successes. Britain leads the world in provision of this sort; in no other country is the scale of provision of this kind of facility as advanced as it is here. The Prime Minister spoke today of the pride that we should feel in what we do for disabled people in this country. Although in some areas, that is questionable, huge strides have been made in our country, with legislative victories such as the Disability Discrimination Act 1995 and subsequently the Equality Act 2010. The progress on Changing Places means that we can justifiably argue that Britain is the leading disability-friendly holiday destination in the world.

We now have 770 Changing Places toilets in Britain, including 18 in Derbyshire. I would like to take a moment to highlight the work of Accessible Derbyshire, a ground-breaking charity with a mission to make Derbyshire the most disability-friendly county in Britain. It works with local tourist hotspots to advise them on what more they can do to make their offer more accessible and it promotes those organisations on its website, which means that any families with disabled people can learn more about what Derbyshire has to offer.

In Derbyshire, we are of course spoilt for great tourist destinations, from the world-famous Crooked Spire church in Chesterfield—where, among other things, I was married—to Chatsworth house, which is one of the most visited tourist destinations outside London. We have other great country houses like Hardwick hall and Bolsover castle, and, of course, the majesty of the Peak district on our doorsteps. However, even a county not so naturally blessed as we are in Derbyshire must be able to see the huge potential that exists.

The more arithmetically talented Members will have observed that with 770 different Changing Places toilets, there is an average of just over one toilet per parliamentary constituency. I am proud to say that in Chesterfield we have four Changing Places toilets—at the Queen’s Park sports centre, the Chesterfield Royal hospital, the new Chesterfield market hall and the Proact stadium, home to Chesterfield FC. Chesterfield football club may not currently be topping the league one table, but they are one of just six football clubs—alongside Arsenal, Liverpool, Brighton and Hove Albion, Tranmere Rovers and Preston North End—to have Changing Places toilets at their grounds, and Chesterfield’s community hub is an exemplar in catering for disabled football fans. There is positive progress, therefore, but just imagine for a moment that I was standing here saying that there was only one public toilet in a constituency. There would be an outcry, yet practically, for some of our citizens, that is precisely the case.

I come to what can be done. In part M of the Building Regulations 2010, section 5.6 states:

“In large building developments, separate facilities for baby changing and an enlarged unisex toilet incorporating an adult changing table are desirable.”

I would like to see Changing Places toilet provision move to being mandatory in all new large public buildings, rather than desirable as it is today. The cost of a Changing Places toilet is on average around £12,000 to £15,000, and it seems to me incongruous that in an era when we have the Equality Act, which is designed to ensure that disabled people are able to live in a fair and equal society, we can tolerate a situation where 1 million people have their choices so restricted by access to something as basic as toileting.

I would also like the Government, through the Minister’s Department, to make available grant funding to support new and existing building developers to install Changing Places toilets. It would not necessarily need to cover all the cost, but I feel that any support would enable more installations to happen. For example, a grant fund that provided perhaps up to half the cost of Changing Places provision, up to a maximum of a £10,000 grant, would make a real difference to the number of Changing Places toilets available. I also commend the work that the Government are doing with the Changing Places consortium on a new website, which I believe will be launched on World Toilet Day—who knew?—on 19 November. It will provide a detailed map highlighting all the Changing Places toilets currently available.

May I ask the Minister to confirm whether there are any plans to consider amending the building regulations to make Changing Places toilets mandatory in large public buildings? Will he investigate setting up a fund to support part of the cost of Changing Places toilets for developers and local authorities who include them in their design? Will he also advise what current sources of funding might be available to organisations that are considering making Changing Places toilets available in their premises?

Will the Minister say more about what the Government are doing to promote the importance of Changing Places toilets and make awareness of them more easy to access for families planning their trips? Finally, will he say a bit more about the steps that his Department are taking to market Britain as an accessible tourist destination? What opportunities does he envisage could be created to promote more effectively the steps that Britain takes to make our tourist destinations accessible to disabled visitors?

In closing, I should say that, to me, this is one of the really important civil rights issues of our time. It may be an unfashionable cause, but it is about justice and equality of access—a principle that I hope all of us would recognise. If there were five Changing Places toilets in every constituency, there would be reasonable access to appropriate toilet facilities for these families wherever they were. That should be our target in the coming years, and the measures I have outlined would help us to achieve that. One day, the misery that this issue has brought to families of disabled adults and children will be at an end. Why not let that time be now?