Contribution
I thank the hon. Member for Bexleyheath and Crayford (Daniel Francis). He is becoming a regular in these Westminster Hall debates, rivalled only by the hon. Member for Strangford (Jim Shannon). It seems that there is a competition to be the one who makes the most representations.
On a serious note, last month in the debate on disability equipment provision the hon. Member for Bexleyheath and Crayford spoke passionately and movingly about his personal experiences. We should treasure so much, in this House, people bringing their experience to try to make things better for their constituents, their family and the nation. The hon. Member deserves a lot of credit and I thank him for securing this debate. I also thank the all-party parliamentary group for wheelchair users for its work to ensure that wheelchair users are heard, and I thank the Wheelchair Alliance and others who continue to hold this House, Ministers and the Opposition to account on these issues.
There is little disagreement in the debate about the nature of the problem. The Government themselves acknowledged last month, in the debate on disability equipment provision, that too many wheelchair users wait too long for the equipment they need, with knock-on consequences for their independence, health and ability to participate fully in daily life. That admission is welcome, but recognition alone is not enough. The question before us is how responsibility, accountability and improvement are to be delivered in practice. On that point, the picture is far less clear. Ministers have been explicit that they do not intend to publish a national strategy for wheelchair services. At the same time, the Government are embarking on a major restructure of the NHS in England. Understandably, that combination raises concerns about where national oversight will sit in the future, how consistency will be ensured and who will ultimately be accountable when services fall short.
During last month’s debate on disability equipment, the Minister acknowledged the uncertainty created by the changes, noting that seemingly small gaps in practice or responsibility can have disproportionate impacts on the quality of life of disabled people. That is precisely why clarity matters. As the NHS is reshaped, wheelchair users and their families need to know who is responsible for setting expectations nationally, who is responsible for commissioning locally and who steps in when the system is not working. Without that clarity, there is real risk that the responsibility becomes fragmented and that unacceptable variation goes unchecked. Ministers often rightly point to the role of integrated care boards in commissioning wheelchair services for their local populations, but ICBs are being asked to do a great deal at once—to meet 18-week standards for community services, adopt the best practices set out in the wheelchair quality framework, and now to do so while operating with up to 50% reductions in headcounts and constrained budgets. So it is fair to ask whether those competing pressures risk pushing wheelchair provision further down the list of priorities rather than elevating it to where it should be. Going forward, who will be responsible for overseeing the wheelchair quality framework itself, and how are the Government assessing whether that is genuinely improving outcomes on the ground rather than simply setting aspirations?
There are also practical questions that remain unanswered. The Under-Secretary of State for Health and Social Care, the hon. Member for Glasgow South West (Dr Ahmed), previously undertook to look at the reuse and return of disability equipment, which could have real benefits for patients and for public value. Many will be keen to hear what progress has been made on that work and whether it will form part of a more coherent approach in provision.
Finally, I raise the issue of innovation. In my constituency of Hinckley and Bosworth, local businesses have shown how responsive, user-focused solutions can make a real, tangible difference. I mentioned Mounts and More as a primary example last time. As the national structure evolves, innovation like that must be supported rather than stifled.
As the Minister responds this morning, wheelchair users and their families are listening carefully. They will want assurances that, amid the structural change, accountability will not be diluted, responsibility will not pass around the system, and there will be clear leadership to ensure faster, fairer access to the equipment that is so fundamental to independent living. I have three questions to the Minister on that basis.
First, as NHS England is abolished through an NHS service modernisation Bill, can the Minister set out clearly which body will hold national responsibility for wheelchair service standards and oversight, and how Ministers will be held accountable when or should services for wheelchair users fail across different parts of the country? Secondly, who will be responsible going forward for overseeing and enforcing the wheelchair quality framework? What assessment have the Government made to date as to whether that is making a difference, and how we can have improvements?
Thirdly—I touched on this in my intervention—many wheelchair users will have had provision from NRS Healthcare. Given the size and scale of the impact of NRS collapsing, there is real concern about servicing their contracts and making sure their wheelchairs are maintained. What have the Government done and what do they have to say on that topic?