Musculoskeletal Conditions

Debate between Sonia Kumar and Jim Shannon

Tuesday 17th December 2024 Westminster Hall

[Sonia Kumar (Dudley) (Lab)]

I beg to move,

That this House has considered the diagnosis and management of musculoskeletal conditions.

I am grateful for the opportunity to have this debate. As chair of the all-party parliamentary group on osteoporosis and bone health, and as an advanced practice physiotherapist and first-contact practitioner, musculoskeletal health is my speciality. I am here to discuss the provisions needed to improve the diagnosis and management of MSK conditions.

My experience as an advanced practice physiotherapist is very much autonomous. I do not think many people know that physiotherapists work from paediatrics all the way to elderly care—from nursery all the way to palliative care. Most people do not know the work of a first-contact practitioner, which is a new service in which physiotherapists work with GPs to diagnose, assess and refer to secondary care, if needed. I was part of that vital service at Dudley Group hospitals, so I declare my interest as working on the bank there.

MSK physiotherapists work not only across hospitals and primary care but also in tertiary care. They work in fracture clinics, rheumatology, pain management and A&E. Not many people realise what we do. MSK physiotherapists are the specialists and experts in musculoskeletal diagnosis. That could include referring people for X-rays to look for suspicion of fractures or for MRI scans to look for sinister pathology, a differential diagnosis, masqueraders that look like Pancoast tumours, metastases or spinal or multi-joint cysts. Along with ultrasounds, guiding injections and prescribing, the scope of physiotherapists has expanded year on year, to a point where they are now specialising and moving their practice on to do simple surgeries, such as carpal tunnel releases.

I look not only from a diagnostic point of view but at the importance of managing MSK conditions, including in respect of rehabilitation.

[Jim Shannon (Strangford) (DUP)]

I commend the hon. Lady for securing this debate. There have been some worrying trends in the press in the last six months, in relation to children as young as 11. Does she agree that the NHS plan for change over the next five years is necessary, given that children as young as 11 are being diagnosed with arthritis? We need help and guidance for those whose lives might be impaired from an early age right through to older life, and who need coping mechanisms. The importance of this debate cannot be underlined enough.

[Sonia Kumar]

I agree with the hon. Gentleman. I have worked in paediatrics where many patients get diagnosed late and suffer with late onset. That affects their whole life from the beginning, including their ability to get involved with physical activity and to build relationships, or their mental health and sleeping patterns. Getting an early diagnosis is one of the solutions I want to put forward. I would like the Minister to consider involving physiotherapists from early on, at nursery stage, to find out why we are not picking up MSK conditions from a really young age so that we can provide health and wellbeing from day one.

Childcare: Black Country

Debate between Sonia Kumar and Jim Shannon

Wednesday 30th October 2024 Westminster Hall

[Sonia Kumar (Dudley) (Lab)]

I beg to move,

That this House has considered the quality and availability of childcare in the Black Country.

It is a pleasure to serve under your chairmanship, Mr Twigg. It is an honour to introduce this debate. I want to talk about the importance of high-quality and accessible childcare in the Black Country, a region that is rich in history, resilience and community spirit.

The Black Country, with areas such as Dudley at its heart, has always been a place where working families thrive, and where communities are built with hard work and strong values. For those families to thrive they need support, and childcare is a crucial part of the network for that. This is not just a family issue; it is also about children’s future in Dudley, our community strength and the local economy. Good affordable childcare supports parents in the workforce, boosts child development and helps build the foundation for a stronger society.

As of June 2024, Dudley has 45 registered childcare providers offering about 1,126 places for children under eight. Despite those numbers, much of the Black Country, including Dudley, is classified as a childcare desert. Families in the Black Country have long supported each other through community efforts but now face a lack of critical childcare options, with only 17 places per 100 children in Dudley. Those figures fall far below the national average of 25 per 100. Can Members imagine if every time they needed childcare, three out of every four doors they tried were shut? That lack of access leaves parents with fewer options and waiting longer, forcing them to make tough decisions about work and family care. The Black Country early years education sector faces unique challenges, especially for children with special educational needs and disabilities. The YMCA reports that over a third of children in its Black Country settings—34%—need additional support. That is significantly higher than the 13% in the most affluent areas of the UK, yet there is a shortage of resources, SEND assessments and funding, which limits vital one-on-one and specialist care. Without those early interventions, many children risk falling behind, underscoring the need for more targeted support in our community.

[Jim Shannon (Strangford) (DUP)]

I commend the hon. Lady for securing this debate and directly underlining the issues pertinent to her constituency. There are also other important issues to consider, including autistic children, children who need speech therapy and the one-to-one support needed in nurseries and childcare. Does she agree that a special priority needs to be given in circumstances where children need care early? By getting care early, they can get to a stage where they can do their schooling and are set up for their future life.

[Sonia Kumar]

I agree with the hon. Gentleman. Intervention is so necessary at early ages. If we catch children early, we can help their future development as they move from early years into schools, and if we help their development we can make sure that they succeed in the future.

It is about not just the availability of care, but the quality of care. Quality is just as critical as availability. Among 28 local providers inspected by Ofsted, only 7% received an outstanding rating, compared with the national average of 14%. Although most providers were rated good, Dudley still lags behind the national quality standards. Since 2022, rising costs have strained early years funding, making it difficult for childcare providers to maintain higher standards. Labour’s commitment to increase funding and expand access to vital services is essential for families that deserve and need them.

Rising poverty and inequality make those childcare challenges even tougher. In Dudley, child poverty rose from 22% in 2014 to 32% in 2023, while, across the UK, the rate rose from 15% to 20% over the same period. For local families under financial pressures, finding affordable childcare is significantly challenging. Department for Education data from 2023 shows that although 72% of mothers are working, nearly half of non-working mothers say that they would work if they had access to convenient and affordable childcare. For families with children under four, that number rises to 54%. With limited childcare options, many parents, particularly mothers, are forced to stay outside work, adding to family stresses and limiting the local economy.

Labour pledges to offer free quality childcare for children aged two to four, which will help parents to manage costs and allow more people to return to work. I welcome Labour’s promise to open 300 more nurseries within the year and use empty school classrooms to meet the demand for more childcare spaces, which are very much needed in places such as Dudley and the Black Country. By covering up to 80% of childcare costs for qualifying families, Labour’s plan to offer meaningful relief for working parents will help to build a foundation of support for children in the future.

Investing in early years education benefits not just families, but the entire economy. Studies show that universal childcare brings more parents, especially mothers, into the workforce, generating tax revenues that can help to cover programme costs. The Centre for Progressive Policy estimates that inadequate childcare access costs the UK about 1% of GDP a year. Imagine the positive effect that this would have in places such as Dudley if more parents could work with affordable, reliable childcare in place. Research from Ofsted highlights the significant role that early years education plays in lifelong learning and development. Its “Best start in life” report outlines four critical areas—literacy, mathematics, understanding the world and expressive arts and design—that provide young children with the foundation for academic and personal success.

As we look to the future, I urge the Minister to prioritise childcare reform and ensure that it matches local need. I have the following asks. How will the Government address the persistent childcare deserts in areas such as Dudley, where places fall below the average? With child poverty rising, what specific measures will the Government put in place to ensure that families in financial hardship can access childcare, especially in places such as Dudley? How will the Government support childcare providers who face inflation-driven costs that continue to rise and that are a burden on the provision of good-quality care? Will the Minister visit the constituency of Dudley to see what the childcare provisions are and the areas where improvement could be made?

We need a childcare system that strengthens our communities, supports our economy and ensures that every child has the chance to succeed. Quality depends on not just childcare, but its accessibility for families—not only for those who can afford it, but for those who need it most. By investing in early years education, we are investing in a stronger and more resilient future for the Black Country and my constituency of Dudley. Let us work together to make quality childcare a reality for every family, giving each child the foundation that they need to thrive and each parent the support that they deserve.