Health Bill

Daniel Francis Excerpts

Report stage
Monday 7th September 2026 Commons Chamber

[Helen Morgan]

Crumbling estates are a big part of the problem across the whole NHS and in maternity, and my hon. Friend is right to highlight the state of his own local hospital and advocate for its quick remediation. Amendment 10, which I am sure my hon. Friend the Member for Winchester (Dr Chambers) will outline in more detail, would reintroduce the mental health investment standard. That is a crucial investment to avoid failures further down the line if interventions are not made for patients early on.

Nowhere is the cost of failure more obvious than in maternity—a devastating scandal which, despite many recent reviews, still deserves far more attention. Our amendments to make our maternity services finally safe for mothers and babies will therefore be the main focus of my remarks today. I thank the Minister for her constructive engagement with me on new clause 1, and the commitment that she made at the Dispatch Box today to table relevant amendments when the Bill reaches the other place, and to put that maternity commissioner in place. I am grateful to her for the discussions we have had, and the constructive approach she has taken both with me and with the many campaigners on the issue beyond this place. In the light of that, I will not be pushing new clause 1 to a vote.

I have seen up close the human costs of failures in our maternity system. Four years ago the Ockenden review found that over 200 babies and nine mothers in my community had died needlessly in Shrewsbury and Telford due to failures in maternity care. That has been devastating for my community, and we have heard since then that the situation was not isolated. There have been terrible stories from families around the country, most recently following the review into services in Nottingham. New clause 6 would introduce a scheme to ensure that every maternity unit in the country is rated “good” or “outstanding” by the Care Quality Commission. That new clause is essential if we are to meaningfully address the crisis in our maternity services and show families that lessons have been learned not just locally but nationally.

The Liberal Democrat maternity rescue package would require an estimated £600 million a year to bring safety in maternity units up to standard, investing in safe staffing and listening to mothers. The Government already spend £1.3 billion a year—more than double the cost of the package—on maternity negligence payments, so introducing that reset is a no-brainer. Rather than spending a fortune compensating for failure and heartbreak, the NHS should be getting it right in the first place. Recently we have seen the consequences of safety failures, with lack of staffing causing North Devon’s maternity unit to close, forcing women to take a 50 mile trip if they go into labour. My hon. Friend the Member for North Devon (Ian Roome), whose constituency has been hit hard by that news, has tabled new clause 66 to guarantee safe staffing levels and access to a maternity unit within 45 minutes.

While on women’s health, I also want to highlight new clauses 11 and 12. Earlier this year I wrote to the Equality and Human Rights Commission to highlight the stark inequality in research and investment in women’s health, with a huge gap in investment, governance and reporting mechanisms between women’s and men’s health strategies. The new clauses would set up an inquiry into women’s health outcomes, and ensure that average waiting times for women’s health conditions do not exceed the average waiting times for wider elective treatments.

The crisis in our maternity care is a national shame and reveals a systemic neglect of the safety of women and their babies over many years. However, that is indicative of even wider concerns for patient safety, which I urge the Secretary of State to address in the Bill, and which we will discuss in more detail tomorrow. If the Government are serious about using the Bill to improve our NHS, they must invest time and money in the front and back doors of the NHS rather than structural reorganisations. The safety of staff and patients must be at the centre of those changes, and I urge the Minister to consider the amendments tabled by me and my Liberal Democrat colleagues, which would improve the Bill to achieve just that.

[Daniel Francis (Bexleyheath and Crayford) (Lab)]

I rise to speak to amendment 32 and new clause 39 tabled in my name, which seek to address the problems facing community equipment and wheelchair services across the country. I declare my interest as chair of the all-party parliamentary groups for wheelchair users and for access to disability equipment. As the parent of a wheelchair user, I know just how important getting such services right is for disabled people and their families, and the consequences and long-term impacts when it goes wrong.

Evidence gathered for an inquiry by the APPG for access to disability equipment last year found that one in three equipment users who responded to our inquiry are waiting a significant time for equipment, with one in five waiting over two months, and 55% stating that they do not have the equipment they need for their long-term needs. At a time when we are rightly focused on reducing waiting lists and improving patient flow, it makes little sense for somebody to remain in a hospital bed simply because the equipment they need to return home has not arrived. Some 74% of professionals and equipment providers report that patients experienced delayed hospital discharge because essential equipment was not available at home, increasing pressure on hospital beds and placing further strain on services. The current system is fragmented, inconsistent and lacks sufficient accountability and national oversight.

My amendments would introduce two things that the system lacks: a clear expectation of how long people would wait, with clear, set timelines and accountability when things go wrong, and they would ensure that patients have a clear pathway for hospital discharge. Amendment 32 would require ICBs to provide community equipment and wheelchair services within 18 weeks of the date that a person is assessed. I know from experience of my daughter’s case when she was eight that the 18-week deadline was missed on two occasions, and she was without an adequate wheelchair for 21 months. These issues simply shunt costs to elsewhere in the NHS. The APPG for wheelchair users heard evidence from consultants within the NHS about the quality of assessment, interventions and aftercare. We heard that delays led to children receiving a wheelchair that was no longer fit for purpose by the time they received it. The following are quotes that we heard:

“There is the additional care to consider as well. Poor equipment provision leads to pressure sores, increasing scoliosis, all of which have a wider impact on the sector.”

“In terms of inequity of care, when asked for information it is always the same eight or 10 ICBs who respond. The ones who don’t, are probably the ones we should worry about.”

“There is a level of bureaucracy in the NHS that stops things happening. Disability is not considered as important as other things in health parameters.”

The data available shows that the wheelchair deadline is being missed by many ICBs, and 29% of ICBs are not meeting the target of providing over 25% of wheelchairs in 18 weeks.

[Danny Beales (Uxbridge and South Ruislip) (Lab)]

I thank my hon. Friend for his work on the all-party parliamentary group; he is a real champion of this cause. AJM Healthcare, the contractor in my constituency, has a similar level of failure. People are left for months—sometimes six months—without a wheelchair, bed-bound and unable to get out of the house. Does he agree that ICBs seem completely at sea on this issue, and are totally unaccountable? Does he agree that we need much tougher measures, such as those he suggests, to hold them to account?

[Daniel Francis]

I completely agree with my hon. Friend. As I will come on to, there is an inconsistent set of data across the country. This inconsistency is not just between ICBs but, in the case of my constituency and that of my hon. Friend the Member for Eltham and Chislehurst (Clive Efford), between neighbouring London boroughs, which may have the same ICB but different frameworks.

I also welcome the support for the amendment from the Children’s Commissioner, who has said:

“Across the country, children wait far too long for the right equipment that is essential for daily life. In recent research on children experiencing delayed discharge from hospital, the office was told that delays in getting equipment, and having equipment serviced, had led to children being stuck in hospital, away from family, friends and school.”

This postcode lottery is not just cross-country—I know of a number of ICBs in which there are significant issues—but within ICBs. In my part of south-east London, one patient can be discharged, while another, in the same hospital with the same condition, living on the opposite side of the road, cannot be discharged. That difference arises because a borough boundary runs down the road. There are different contractual arrangements between different London boroughs in the same ICB. I know at first hand that pupils in the same school class, and in the same ICB, can have completely different service standards for their wheelchairs because one lives in one London borough while another lives in the neighbouring borough.

I will speak briefly to new clause 85, tabled by my hon. Friend the Member for Thurrock (Jen Craft). Like me, she is the parent of a disabled child. We have fought these issues for many years, both as parents and on behalf of our constituents. In my case, I know that when Ofsted found that there were systemic failings in our SEND provision, we could hold our local authority to account, but we could not properly hold our ICB to account. The judgment was issued against the council, not the ICB.

[Josh Fenton-Glynn (Calder Valley) (Lab)]

I thank my hon. Friend for his powerful speech, and for bringing his personal experience to the Chamber. I am sure that he will agree with me that the ‘H’ in EHCP stands for health; we need to see the health service doing its part. Does he agree?

--- Later in debate ---

[Daniel Francis]

I absolutely agree, and I was a Labour councillor and leader of the council’s Labour opposition back then. I was also married to a special educational needs co-ordinator who was employed by the local authority. I was employing my own professionals to get through this process and ensure that the health aspects of the EHCP were upheld. The situation is absolutely abhorrent. Many parents who do not have the opportunity and insight that my wife and I had cannot ensure that accountability for their child. When my borough received that judgment of systemic failings, that issue really came to the fore.

I would be grateful if the Minister or Secretary of State could outline how the Government intend to address the issues addressed by my amendment and the new clause tabled by my hon. Friend the Member for Thurrock. My amendment intends to ensure that we deliver basic objectives, set clear expectations for how long disabled people should wait, set consistent standards, and ensure meaningful accountability for ICBs when services fall short.

[Sir Jeremy Hunt (Godalming and Ash) (Con)]

I want to start by thanking the Minister for the emphasis that the Bill places on a single patient record. Despite many problems in NHS care, that is an area where the NHS is a world leader, but putting a single patient record on the right legal footing, making it possible to share data with proper governance, gives the NHS an opportunity to become a world leader in artificial intelligence, and it creates the opportunity to transform care for patients, so that has my full support.

I speak in support of new clause 25. The biggest structural reform in this Bill is the abolition of NHS England, but my worry is that there are other structural reforms that are not in the Bill that would have a much bigger impact on patient care. New clause 25 is about continuity of care, particularly in general practice and maternity. It is now very clear to many people that the abolition of the old GP list system in the 2004 contract changes was a huge mistake. In fact, restoring the system so that GPs have their own patients was part of the Labour manifesto, so that is an issue that the Government understand, but it is not in the Bill.

A study in Norway, published in the British Journal of General Practice in 2022, of over 4 million patients showed that patients who have their own doctor for more than 15 years are 30% less likely to need out-of-hours care, 28% less likely to need hospital care and 25% less likely to die. Why is that? Because GPs who know their patients are less likely to make mistakes, more likely to give an accurate diagnosis and will better calibrate risk, as they will have situational awareness of a patient and their family. The experience of a patient is infinitely better when they are dealing with a GP whom they know.

Instead of that, we have moved to a system in which many GP surgeries effectively operate like call centres. People will contact a GP and they may never see that GP again. It is exactly the same when someone calls 111, if you get put through to a clinician. Contacting a GP in the NHS should never be like calling an Uber driver who will never be seen again.

Lobular Breast Cancer: Moon Shot Project

Daniel Francis Excerpts

Thursday 9th July 2026 Westminster Hall

[The Minister for Care (Stephen Kinnock)]

It is a pleasure to serve under your chairship, Mrs Hobhouse. I thank the hon. Member for Horsham (John Milne) for securing this vital debate. I also thank the hon. Member for Maidstone and Malling (Helen Grant) for campaigning on this topic, following her own diagnosis of lobular breast cancer.

I add my tribute to Dr Susan Michaelis, as today marks one year since she passed away from lobular breast cancer. As a founder of the Lobular Moon Shot Project, she campaigned tirelessly on behalf of women diagnosed with lobular breast cancer and raised awareness for the condition. I also pay tribute to members of the Lobular Moon Shot Project, including Susan’s husband, Tristan Loraine, for picking up the mantle, continuing the important work of the project and carrying Susan’s torch forward.

I recognise the number of charities that carry out important work in this area, such as Lobular Breast Cancer UK, Breast Cancer Now and Cancer Research UK, and all the right hon. and hon. Members who continue to provide support, many of whom we have heard from today.

Lobular breast cancer accounts for 15% of breast cancer cases. However, as we have heard, this form of cancer sadly goes undetected in too many women. We are determined to transform diagnosis and outcomes for patients. Earlier this year, the Minister for Public Health and Prevention, who is the lead DHSC Minister on this issue—I am standing in for her today—and Lord Vallance, the Minister for Science, Innovation, Research and Nuclear at the Department for Science, Innovation and Technology, met representatives of the Lobular Moon Shoot Project. Alongside Government research funders, they discussed the Lobular Moon Shot’s work, listened to the experiences of lobular breast cancer from those who attended, and discussed how to advance research in this vital area.

Following that meeting, last month Lord Vallance hosted a scientific roundtable that brought together a range of researchers, clinicians and industry representatives to identify opportunities to advance research and innovation. At that meeting, attendees agreed that one of the next steps should be to encourage collaborative research and funding applications across multiple existing schemes, including for basic discovery science. I would like to emphasise that Government research funders stand ready to support that work as it progresses.

We acknowledge and share the Lobular Moon Shoot Project’s ambition for researchers to take a collaborative and interdisciplinary approach to addressing the unique challenges of lobular breast cancer. Government responsibility for delivering cancer research is shared between the Department of Health and Social Care, with research delivered by the National Institute for Health and Care Research, and the Department for Science, Innovation and Technology, with research delivered via UK Research and Innovation.

The Medical Research Council primarily supports the discovery sciences and fundamental biological research, which is the focus of the Lobular Moon Shot campaign. Through MRC, UKRI has emphasised its commitment to supporting interdisciplinary team-based research across its funding schemes and highlighted support for collaborative activities to provide a platform on which to build a portfolio of research in this important area. NIHR’s research is complementary to the MRC’s focus, supporting the translation of discovery science into patient benefit.

Through the MRC and NIHR, we are already funding research into lobular breast cancer. For example, a breast cancer screening study is investigating whether a new, faster MRI scan could detect breast cancers earlier. The FAST—first post-contrast subtracted—MRI is a new type of scan that aims to detect cancers, including lobular breast cancer, that may not be routinely picked up by mammograms during a first screening visit. The £1.36 million study is jointly funded by the MRC and the NIHR. Furthermore, with a total investment of £32 million, the Institute of Cancer Research and the Royal Marsden’s NIHR Biomedical Research Centre support lobular breast cancer by combining translational research, precision diagnostics and targeted clinical trials to develop and test tailored treatments.

Promising discoveries are being made. Scientists at the Breast Cancer Now Toby Robins Research Centre at the Institute of Cancer Research have recently discovered a drug, currently being tested in clinical trials for a rare blood cancer, that could also be used to treat lobular breast cancer. Researchers now hope to progress the drug to clinical trials for lobular breast cancer. More widely, we are supporting world-leading research and development to enable the prevention of cancer and to improve diagnosis, treatment and care for people affected by the conditions. Cancer is a major area of NIHR spending. Reflecting its high priority, the institute spent £141.6 million on it in 2024-25. Alongside that, UKRI invested £198 million in cancer research in the same year.

We are investing in the best science, which explores lobular breast cancer both in isolation and in conjunction with other cancers, to maximise the opportunity to share learning and identify possible breakthroughs. Historically, the breast cancer research community has categorised the field around signalling, pathway and molecular presentation on tumours. Rather than naming a particular cancer sub-type, therefore, grants within the MRC portfolio focus on the understanding of molecular mechanisms common to both lobular breast cancer and invasive breast cancer.

We know that more research is needed. That is why both the MRC and NIHR are committed to continuing to support the development of high-quality, fundable research proposals. There are a range of existing opportunities across funders that support this developing portfolio. The NIHR is actively encouraging high-quality, ambitious research proposals on lobular breast cancer, having launched a highlight notice in late 2025 to signal to researchers our interest in funding research into this area.

[Daniel Francis (Bexleyheath and Crayford) (Lab)]

rose—

[Helen Maguire]

rose—

[Stephen Kinnock]

I think my hon. Friend the Member for Bexleyheath and Crayford (Daniel Francis) was first.

[Daniel Francis]

I thank the hon. Member for Horsham (John Milne) for securing the debate. I have supported my constituent Emma Hunwick and her campaigning on this issue. It is the third time I have attended a debate on this subject in the two years I have been an MP. I hear what the Minister says about research, but I think what supporters want is assurance that we will not be having a similar conversation again next year. They want confidence that we will have made some progress in the next 12 months.

[Stephen Kinnock]

In a nutshell, what I am trying to lay out is that it is not an either/or question. There is a tremendous amount of work going on to research cancer, including lobular breast cancer, which is a vital subset of that work.

The challenge for us is the idea of ringfencing £20 million, because ringfencing is not the standard process. The standard process is to have applications that are subject to peer review and judged in open competition, with awards made on the basis of the importance of the topic to the public and health and care services, value for money and scientific quality. If there is a difference of view in the Chamber today, it is whether we have an ecosystem of cutting-edge research, applications and competitive process, based on the principles I have just outlined, or a ringfenced fund.

I have to be absolutely clear and straight with my hon. Friend that currently the Government are not of the view that a ringfencing approach is the right way to go. The worry is that that approach could potentially cut across the ecosystem-based approach that we are seeking to nurture and foster, which we believe will deliver better outcomes in the end.

Nottingham Maternity and Neonatal Services

Daniel Francis Excerpts

Wednesday 24th June 2026 Commons Chamber

[James Murray]

My hon. Friend is right to emphasise quite how shocking it is that people in senior leadership positions refused to take part in Donna Ockenden’s review. I cannot understand how they could make that decision and think it acceptable. That is exactly why the law needs to change. It shows why the Hillsborough law is so important and why it was important to put it on the statute book, and also why it was important for us to decide now to apply that duty of candour to future reviews of the failures of maternity services so that never again can NHS staff, current or past, decide not to take part in the search for justice and accountability that it is so crucial for us to deliver.

[Daniel Francis (Bexleyheath and Crayford) (Lab)]

I pay tribute to my hon. Friend the Member for Sherwood Forest (Michelle Welsh) for all her work. My heart goes out to those families in Nottinghamshire, and I pay tribute to their work as well. I cannot imagine what it is like to lose a child in those circumstances, but I do know what it is like to see your own child suffer a brain injury at birth. I work very closely with other families with children who have cerebral palsy or hemiplegia, because of what they have been through and what my own family have been through.

The reasons why such things happen are often connected with negligence, but they are often a result of other circumstances. In our circumstance, our children were born at 31 weeks, as twins. In other families, it is the fact that this woman is black or that woman is disabled that has caused those issues and that negligence. Will my right hon. Friend act on the recommendations of the Ockenden review and the review that is being undertaken by Baroness Amos, and work to ensure that those disparities are overcome when mothers have a greater risk of these things happening to them?

[James Murray]

I thank my hon. Friend for sharing with us his experience of brain injury in his own family, and for reminding us how some of the issues that we are discussing today touch the lives of many people in the House and across the country. We all have a responsibility to act on the basis of the recommendations of today’s report, and I assure my hon. Friend that those recommendations, along with those in Baroness Amos’s report, will enable the taskforce to produce a comprehensive action plan. A key element of that work—this concerns his direct point—will be ensuring that when people are at greater risk of harm, greater risk of being ignored, greater risk of being discriminated against, lied to or not being given the care that they need, that inequality will be addressed.

Health Bill

Daniel Francis Excerpts

2nd reading
Monday 1st June 2026 Commons Chamber

[Daniel Francis (Bexleyheath and Crayford) (Lab)]

At the outset, I echo the comments of my hon. Friend the Member for Thurrock (Jen Craft). As fellow SEND parents, we both call for the measures that she has pressed for.

I declare my interest as chair of the all-party parliamentary groups for access to disability equipment and for wheelchair users. I wish to speak about some of those issues, predominantly as they relate to clauses 15 and 16 of the Bill and how ICB commissioning needs to be considered in relation to carers and disabled people. Last October, the APPG for access to disability equipment published a report entitled “Barriers to Accessing Lifesaving Disability Equipment”, which made recommendations that I believe need to be considered as the Bill progresses. Its main recommendation was that there be a national strategy for community equipment, ensuring consistent national standards and accountability at every level.

Disparities exist not just across ICB areas, but within them. In my part of south-east London, there are different contracts in Bexley, Greenwich and Bromley—three neighbouring boroughs within the same ICB, where people receive completely different service levels. My daughter is a wheelchair user. She is in a school class with children from the neighbouring boroughs that, despite being in the same ICB, have completely different commissioning contracts and different levels of service. That postcode lottery, both across ICBs and within them, is something we really need to look at.

Getting the commissioning of disability equipment right is crucial if we are to streamline processes, reduce delays and prevent unnecessary hospital stays. For instance, there is no timescale for equipment when it comes to hospital discharges. A timescale of 18 weeks for wheelchairs is set out in the national strategy, but not for disability equipment. That leads to delayed discharges, but also to operations that in many respects are unnecessary, such as for people with cerebral palsy who do not have the equipment they require. There is clear evidence, as we will see again in the months ahead, that providers of disability equipment and wheelchairs bid lowest for contracts, creating cash flow issues for them. They then have to slow down the ordering and provision of equipment, which has great knock-on effects on both operations and discharges for the NHS. That is why our APPG has called for a streamlining of communication channels between local authorities, health bodies and Government Departments to ensure a more joined-up approach.

I have very little time, but I want to mention the recycling of equipment. Often, one ICB will have the equipment that a patient in a neighbouring ICB requires, because it has recycled it, but it cannot pass that equipment on because the contracts are different. We saw that issue to a great extent last year in the area of disability equipment when the NRS Healthcare contract collapsed. I welcome the Bill, but I believe it can be strengthened to better address the needs of carers and the disabled.

Wheelchair Provision: Independent Review Body

Daniel Francis Excerpts

Tuesday 21st April 2026 Westminster Hall

[Daniel Francis (Bexleyheath and Crayford) (Lab) [R]]

I beg to move,

That this House has considered the potential merits of establishing an independent national review body overseeing wheelchair provision.

It is a pleasure to serve under your chairship, Dr Murrison, and I thank the Backbench Business Committee for agreeing to this morning’s debate. I declare an interest as co-chair of the all-party parliamentary group for wheelchair users, alongside Baroness Tanni Grey-Thompson; as the chair for the all-party parliamentary group for access to disability equipment; and as the parent of a wheelchair user.

Through the APPG’s work, we have heard directly from stakeholders and service users about the unacceptable delays that wheelchair users face in accessing suitable equipment, often with reduced health outcomes as a result. Too often we also hear that service users are confined to using completely inappropriate wheelchairs as that is, frankly, their only option. The issues I will discuss today in patients accessing disability equipment are also all too evident to me as chair of the APPG for access to disability equipment. I pay tribute to the Wheelchair Alliance and Whizz Kidz for their dedication in their advocacy for wheelchair users across the UK and for their support in preparing for today’s debate. I am grateful to have secured the debate and, as Members know, I am the parent of a wheelchair user and have lived and breathed the issues that so many wheelchair users face in accessing wheelchair provision.

The wheelchair quality framework, published in April 2025, outlines that wheelchairs provide

“a significant gateway to independence, wellbeing and quality of life for thousands of adults and children. They play a substantial role in facilitating social inclusion and improving life chances through work, education and activities that many people who do not need wheelchairs take for granted.”

While I welcome the framework for introducing some minimum standards and expectations, in my experience—and I will come to that later—it is the case that the user deals with the contractor, not the integrated care board. The ICB appears to have little or no idea, quite often, what the actual experience for users is when dealing with the contractor.

[Danny Beales (Uxbridge and South Ruislip) (Lab)]

I thank my hon. Friend for securing this very important debate. I know this is a subject on which he has much knowledge, experience and passion. ShopMobility, a group of volunteers who provide mobility aids at the shopping centre to get people out and about in the town centre, have recently reported to me that many of their customers are coming to them waiting for wheelchair provision from the contractor, sometimes for more than six months. I have also had young people with cerebral palsy and other conditions unable to get basic repairs to their existing equipment. Does he agree with me that these are simply unacceptable levels of services for what is vital equipment, not optional extras? Is that not exactly why, as he says, we need an independent review body to scrutinise the poor performance of the contractors and commissioners?

[Daniel Francis]

Absolutely; I completely agree. I will refer later to the position that we now know of, how ombudsman complaints have risen exponentially in recent years, and to the experience of many people, including that of my own daughter, who has quadriplegic cerebral palsy, in the kind of delays that my hon. Friend has outlined.

In the 2024-25 financial year, there were 630,000 wheelchair users registered in England, with 70,600 of them under 18 according to NHS data. However, that figure does not include those who have purchased their wheelchairs privately, or those unable to obtain the right equipment through the NHS. In 2018-19, the Wheelchair Alliance estimated there were a total of 780,000 users. That was an estimate due to lack of robust evidence to back those assumptions. There is no set location on NHS health records to identify whether someone is a wheelchair user. With many users purchasing their wheelchairs privately, or being provided a wheelchair through a charity, NHS data does not provide an accurate picture and we remain in the dark about the true number of wheelchair users in England. Unfortunately across the country we are seeing countless examples of wheelchair users being systematically failed by their service providers, and I am sure we will continue to hear horror stories throughout this debate. Wheelchair users face long waiting times, poor fitting and unsuitable equipment, and complex and fragmented access pathways, with reports of a postcode lottery in accessing wheelchair provision.

[Olivia Blake (Sheffield Hallam) (Lab)]

Alongside the postcode lottery my hon. Friend outlines, the impact on young people accessing education has huge implications. Not being able to view that data also impacts our understanding of why children might not be attending school. Does he agree that that is why data is so important for under-18s?

[Daniel Francis]

My hon. Friend is completely right. Last year I helped launch a report commissioned by Whizz Kidz about children who are wheelchair users accessing education, which highlights the issues my hon. Friend has brought to our attention.

The Parliamentary and Health Service Ombudsman has received a significant increase in complaints about wheelchair services, from four in 2018 to 76 in 2025, mainly about long delays in receiving equipment and poor communication. I would like to highlight the Wheelchair Alliance’s 2022 report, “An economic assessment of wheelchair provision in England”, which I will refer to throughout the debate. The report highlighted three areas of concern: wheelchair services in England do not consistently work for service users; NHS-provided wheelchair services should be subjected to more rigorous and mandated regulation; and the true scale of demand is not known.

Despite that report being published three and a half years ago, the findings are still relevant. Wheelchair users’ experiences have, if anything, deteriorated further. The report concluded that wheelchair users may be exploited due to a lack of clear regulation, independent review body or information about who to approach regarding repairs, complaints or suggestions for service improvements.

I am grateful to the Chamber engagement team for its support in preparing for today’s debate and for sharing the experiences of the 653 people who contributed to its survey on disability equipment. One respondent said:

“My husband has a basic wheelchair that is the wrong size and broken. It causes pain and pressure sores. He can’t self-propel more than 50 metres in it, making any kind of independence impossible. He is exhausted and in severe pain all the time.”

Another said:

“I had to put off starting university for a year because I couldn’t access a wheelchair in time. I spent a year at home unable to go out and see friends or access education or to even just go to the shop on my own.”

Wheelchair users already face everyday accessibility issues, from transport to housing and work. Having an unsuitable wheelchair adds not just an extra complication but often a debilitating and painful experience, and needs to be resolved. The current system is not working. Wheelchair providers need to work in cohesion rather than compete for contracts and undercut other providers.

National leadership and accountability of the service is necessary to ensure that service providers are held to account. Funding reform is needed to give wheelchair users the right piece of equipment, rather than the cheapest. The better, more appropriate yet expensive piece of equipment can often be the cheapest later down the line, with savings in health care and users better able to contribute economically. I will refer to that later in my personal experience.

Better and more conclusive data is needed. We are still not sure exactly how many adult and child wheelchair users there are in this country. We cannot, therefore, accurately access the current need or where gaps lie. To improve services, we need wheelchair users to be involved from the start in co-production, service design and commissioning. To get the service right and address the individual needs of wheelchair users, we need to hear directly from them. Ultimately, a national review body overseeing wheelchair provision is required to ensure that the service provided is of a good standard. As a result, wheelchair users will receive better quality care and outcomes.

I have five asks from recommendations to put to the Minister. First, it is clear that national leadership and accountability are needed. Service providers need to be held to account, as we have heard and will surely hear more during the debate. There are far too many examples of the service failing wheelchair users, leading to poor health outcomes. The Wheelchair Alliance’s 2022 report, “An economic assessment of wheelchair provision in England”, highlighted that NHS-provided wheelchair services should be subject to more rigorous and mandated regulation. Addressing the current inconsistent and fragmented service will improve outcomes for users, as forms of provision are held to account effectively.

The report suggests that mandatory regulation of wheelchair services could, for instance, be the responsibility of the Care Quality Commission, to address the gaps in accountability, guarantee a minimum standard of quality and, therefore, reduce the current postcode lottery in support. That could also cover private sector providers and additional regulations for private retailers, to give wheelchair users greater confidence and more oversight of the services they receive. Across the country, 45% of wheelchair services are not run directly by NHS trusts and are often commissioned to private companies. I would be grateful if the Minister could outline whether the Department has considered appointing a national lead or regulator to oversee the provision of wheelchair services to hold providers to account and ensure that wheelchair users in England are no longer at the mercy of a postcode lottery determining the quality of the service that they receive.

The second issue is budget. Increasing baseline funding in line with current needs and inflation would not only be beneficial for wheelchair users but would likely result in future long-term savings for the NHS. The Wheelchair Alliance’s 23 December report, “The Value of a Wheelchair”, showed that a £22 million per year increase in equipment spending to the average level among ICBs that currently report average levels of per patient spending would represent an estimated 14% increase in the current total annual NHS spending on wheelchair services. That would make a meaningful difference to the total equipment budgets in half of ICBs—and a big difference to wheelchair users. The research shows that this could reap £60 million—along with £315 million in wider societal and economic benefits—in NHS savings.

Budget should also be flexible and innovative, including in individual personalised wheelchair budgets, where users have found gaps in the funding, including not covering additional costs such as shipping or repair and maintenance, resulting in a need for users to self-fund for elements of care. The 2023 report outlines that some users felt the availability of support and funding was inflexible and not always optimally allocated. Whizz Kidz’ research has found that 22% of wheelchair users were offered a wheelchair budget as an option. Many more individuals had to fundraise and source charity support to allow them to get the right wheelchair. Reports from Frontier Economics show that, on average, the NHS spends £125 per wheelchair user per year, covering all types of equipment, staff, service, insurance and maintenance. Establishing an independent national review body to oversee wheelchair provision would help show where the gaps lie in the current funding and provide more efficient budget management, and where this can be improved. Could the Minister therefore outline whether steps have been taken to review current funding and whether consideration has been made of the benefits of introducing baseline funding in line with other complex and individual needs of wheelchair users?

The third recommendation was about data and transparency. To further improve wheelchair services, data collection needs to be vastly improved. As I have touched on, we do not know the number of wheelchair users in the country and while there is the national wheelchair data collection quarterly publication, it is essential that the available data also includes outsourced providers to ensure that they have a full picture of service provision across the UK. An independent national review body with oversight of all wheelchair services, including the NHS as well as private providers, would help to provide a greater understanding of the current provision, along with more accurate data to help identify gaps—whether in funding or in a postcode lottery of service users having different experiences based on where they live.

Wheelchair users and patients should also have a role. Their feedback and suggestions would illustrate the reality of the current provision and the impact that it is having on their lives. Currently, there are limited avenues for users to provide feedback on the quality of service received, resulting in reduced mechanisms for providers of care and ICBs to identify gaps in the service provided. The Wheelchair Alliance has found communication issues across multiple aspects of wheelchair provision, with users not being provided with an explanation for delays and a lack of communication between providers of care, resulting in users undergoing multiple unnecessary assessments. Giving users the opportunity to report those experiences to one body with national oversight would allow for greater improvements sector wide. Without an accurate national dataset and consistent reporting, unmet need and poor performance are not being addressed and continue to remain prevalent. Will the Minister therefore commit to improving the current collection of data on wheelchair users and their experience in accessing wheelchair provision and services?

The fourth ask regards procurement and value. Currently, many wheelchair users find that they are not given the most suitable wheelchair and are instead given the most cost-effective option. For example, in evidence provided to the APPG for wheelchair users by Charlie Fairhurst—and I declare an interest in that he is my daughter’s consultant at the Evelina—in his role as a consultant for 20 years and as the national lead for children’s neuroscience for the past eight, he outlined that in his experience, poor equipment provision leads to pressure sores and increasing scoliosis, all of which have a wider impact on the sector. Hip dislocation rates—which is a big issue for people, particularly children, with cerebral palsy—are increasing in both adult and child wheelchair users due to the wrong equipment being provided. My own daughter had to have her hip broken as a result and may need to have that done again because of those posture issues. Charlie described clearly to our APPG the issues for wheelchair users if they do not have the right equipment: they have to continue having the same operations to put their posture right again.

Another issue users encounter is the wheelchair they require not being suitable for their housing. One respondent to the survey said that the

“wheelchair I was offered weighed nearly 20kg and stopped me from moving around my very small home. Due to the size and weight of the chair, I spent almost four months not leaving the house.”

The NHS would experience cost savings as a result of improved provision, including providing patients with suitable wheelchairs from the beginning. I would therefore welcome the Minister’s comments on those issues.

The fifth recommendation relates to children. Currently, children aged three to five often miss out on receiving an appropriate wheelchair. The strict eligibility and issuing criteria that the NHS uses mean that young children are often deemed ineligible, despite their need not necessarily being any less than that of an adult or young person.

[Mr Gregory Campbell (East Londonderry) (DUP)]

I congratulate the hon. Member on securing the debate. On the issue of children getting access to wheelchairs, does he agree that sometimes the provision itself is fine, but parents subsequently establish that the wheelchair is not suitable and there can be difficulties in getting the best and most appropriate wheelchair for the child as they develop and age?

[Daniel Francis]

I absolutely agree. The hon. Member will hear my own personal horror story on that very matter in a moment. It is a big issue. Children grow, and the delays often mean that when the wheelchair finally arrives, the child is a very different size from when they were measured for it.

Instead of a wheelchair, younger children are offered a standard buggy, which often does not meet their clinical or social needs. It also impacts their social integration at a crucial age and limits their independence and participation at home, in school and at playtime. I would therefore be grateful if the Minister considered extending NHS wheelchair provision to children aged three to five so that they can get the right equipment.

The situation does not necessarily get any better for older children. In 2024, the national wheelchair data collection outlined that 80.9% of children under 18 received their wheelchair within the 18-week timescale, meaning that nearly one in five children are waiting over 18 weeks to receive their wheelchair. That figure unfortunately increases for children with more complex needs. In 2023-24, 29% of children assessed as having a specialist need waited over 18 weeks, and the figures for October to December 2025 showed that 1,563 children waited more than 18 weeks after a referral to NHS wheelchair services. A further 1,685 children were assessed with no equipment provided. That is despite the NHS England model service specification requiring services to have developed improvement plans by 2019 to ensure that all children who require a wheelchair receive one within 18 weeks.

My family and I have direct experience of that with our contractor in the London borough of Bexley. Back in October 2021, when my daughter—who, as I said, has quadriplegic cerebral palsy—was eight years old, it was agreed that she required a new wheelchair. The appointment to measure her for it was held three months later in January 2022, and the wheelchair arrived six months later in July 2022—nine months after the referral. Despite recommendations on the postural support that she required given that she has quadriplegic cerebral palsy, a standard wheelchair had been ordered, which then had to be repaired or have adjustments made to it on five occasions in the next four months. Despite those adaptations, it was still not fit for purpose.

After my wife and I got the ICB involved—how many parents out there know what the ICB is and how to get it involved?—a new fit-for-purpose wheelchair was ordered in January 2023. It arrived in April 2023, but no one advised us that it had arrived. I really believe our contractor rations appointments to manage its workload. When we chased the position in June 2023, we were advised that the wheelchair had been in stock for two months. An appointment was made in July 2023. Twenty-one months after the initial referral, my daughter received a wheelchair that was fit for her needs. That meant that the contractor had missed its 18-week deadline twice in an 18-month period in one patient’s case.

Importantly, as I have said, children grow and delays like that cause more work, given that the child will clearly be taller than they were when the referral was made. At such a crucial time in a child’s life, their mobility and independence matter. It is critical that children are given the necessary equipment to engage with their peers and participate in school. Having an independent national review body would help to give children and their families a voice and more ownership over their care and, in doing so, drive down waiting lists and improve patient outcomes. I look forward to hearing contributions from colleagues, and the Minister’s comments on the points I have made.

--- Later in debate ---

[Daniel Francis]

I thank all hon. Members who contributed to the debate. It was a great honour, though deeply disturbing, to hear of people’s lived experience as wheelchair users. To be brief, we heard good examples from my hon. Friend the Member for Uxbridge and South Ruislip (Danny Beales) of mobility providers, and from the hon. Member for East Londonderry (Mr Campbell) of the growing needs of users. We heard from my hon. Friend the Member for Sheffield Hallam (Olivia Blake) about access to school. I urge all hon. Members to look at the Whizz Kidz report on that issue.

There was an interesting comment from the hon. Member for Upper Bann (Carla Lockhart) on all-terrain wheelchairs, which is something we looked at in a recent event across the road. The hon. Member for Strangford (Jim Shannon) is always here for these debates. It is good to hear about the position in Northern Ireland and, in particular, about veterans’ use of wheelchairs, which also featured at that event.

We heard about AJM Healthcare from my hon. Friends the Members for Scarborough and Whitby (Alison Hume), for Lichfield (Dave Robertson) and for Stoke-on-Trent South (Dr Gardner). I accept that it is the largest provider in the market—it was the provider I was referring to in my comments—but clearly there have been issues with delays across the country. I will come back to those, and to individual ICBs’ awareness of what was going on.

I was really sorry to hear from my hon. Friend the Member for Bassetlaw (Jo White) about the suitability and parts issues experienced by her constituent. I know those issues at first hand. My hon. Friend the Member for Stoke-on-Trent South talked about discharge delays. I would say that they are sad but, quite frankly, they are just disgraceful. I welcome the pressure to improve standards from the Lib Dem spokesperson, the hon. Member for Mid Sussex (Alison Bennett), and from the shadow Minister, the hon. Member for Hinckley and Bosworth (Dr Evans), who also rightly brought up the point about NRS. I have met with officials from the Department of Health and Social Care in recent months on that and the overall framework for where the responsibility lies.

To my good friend the Minister, I will say that I will continue this pressure, as will other hon. Members. I accept that what happened during covid was very difficult. I was attending wheelchair appointments during that period and it was difficult—of course, delays were caused—but we have ended up in a position where there are far more ombudsman complaints now than before covid. I will not prejudge matters, but I think the ombudsman may have something to say about this later this year. Lots of wheelchair users have ended up having to go to the ombudsman because it is a complex system. That goes back to the framework and what I said earlier. How many people out there know what their ICB is and how to go to their ICB?

The wheelchair contract where I live is about to be tendered across three London boroughs: Bexley, Bromley and Greenwich. At the moment, those three boroughs have individual providers. It looks like they will have one provider going forward. When the consultation meetings were held around the new framework and the new contract, the provider, AJM Healthcare, was asked to advertise them. Did it tell any of the users? No, it did not, because if it had, they would have come to the meetings and told their horror stories.

I found out by accident because I am the Member of Parliament, and guess what? I was the only person who attended the meeting because none of the users had been informed that it was happening. That is my concern about ICBs monitoring those contracts and being able to say what is happening. It appeared to me in that meeting that, from my experience as a parent and from talking to other parents, I knew more about the problems in the system than the people commissioning the contract within my ICB. That is why we need continued monitoring and some kind of framework.

I absolutely welcome the Minister’s comments. There has been movement, but I will continue the pressure, along with other Members, in the months and years ahead.

Question put and agreed to.

Resolved,

That this House has considered the potential merits of establishing an independent national review body overseeing wheelchair provision.

Oral Answers to Questions

Daniel Francis Excerpts

Tuesday 14th April 2026 Commons Chamber

[Wes Streeting]

Yes; as part of our national cancer plan, we absolutely want to see survival rates improve in the way the hon. Gentleman describes. I welcome the new Minister working on this—the Under-Secretary of State for Health and Social Care, my hon. Friend the Member for Washington and Gateshead South (Mrs Hodgson)—to her place, and thank my hon. Friend the Member for West Lancashire (Ashley Dalton) for all her leadership in this area, too.

[Daniel Francis (Bexleyheath and Crayford) (Lab)]

My constituent Harley Harris is 15. He has spondylocarpotarsal synostosis syndrome, which has caused his spine to curve 120° and damaged his lungs, leaving him with significantly reduced lung function and in continual pain. Harley needs lifesaving surgery, but his family have been unable to get a referral to have it performed in the UK. Will the Minister commit to urgently reviewing Harley’s case to ascertain what support can be provided to him and his family?

[The Parliamentary Under-Secretary of State for Health and Social Care (Mrs Sharon Hodgson)]

I am very sorry to hear about Harley’s condition, and my thoughts are with him and his family. I am sure my hon. Friend understands that neither the Department nor NHS England can comment on the clinical appropriateness of suggested treatments for an individual. I understand that Harley and his family have already been in touch with the Department, and would suggest that my hon. Friend continues to raise this case with NHS England. We are committed to improving the lives of those living with rare diseases, including Harley’s condition of SCTS.

Meningitis Outbreak

Daniel Francis Excerpts

Tuesday 17th March 2026 Commons Chamber

[Wes Streeting]

Following the right hon. Member’s question, I will ask whether expansion to Tonbridge would be a sensible thing to do, given the number of people who may have been in Club Chemistry on the relevant dates. I take his point about some people not being willing or able to travel to the four sites that have been made available in Broadstairs and Canterbury. None the less, and not least because some students have left university for the Easter break, we are making sure that GPs are able to prescribe antibiotics through the NHS. I know he is talking about different cases—they will not be students—but we will make sure that people can get access to antibiotics via their GP. If I have not fully answered his question—he is shaking his head—I will catch him after this session to make sure that I do.

[Daniel Francis (Bexleyheath and Crayford) (Lab)]

May I share my condolences with the friends and families of the two young people who have very sadly lost their lives? Nine years ago, I saw my own daughter have a 42-minute seizure. Thanks to the work of the NHS and the drugs, she recovered from meningitis B, but I know exactly how terrifying that situation can be. For lots of families around the country, their children are currently at university and are hundreds of miles away. What advice can the Secretary of State give families about the conversations they should have with their young people in Canterbury about the health advice that they should seek and the symptoms that they should look for?

[Wes Streeting]

I thank my hon. Friend for sharing his awful experience, and for once again emphasising the importance of good public health information and advice, including for parents whose students will still be in Canterbury and who may therefore be particularly worried. UKHSA is now advising anyone who visited Club Chemistry on 5, 6 or 7 March to come forward for preventive antibiotic treatment as a precautionary measure; it can be collected from four sites. If they or people they know develop symptoms of meningitis or septicaemia, they should urgently seek medical help by going to the nearest accident and emergency department or dialling 999. If it is not an emergency but people are concerned, they can contact their GP or NHS 111.

Symptoms of meningitis and septicaemia can include a rash that does not fade when pressed with a glass; a sudden onset of high fever; a severe and worsening headache; a stiff neck; vomiting and diarrhoea; joint and muscle pain; a dislike of bright lights; very cold hands and feet; seizures; confusion or delirium; and extreme sleepiness or difficulty waking. I want to underscore that the general risk of transmission is low and that it takes place through close, direct and prolonged personal contact through things like kissing or sharing vapes and drinks. We need to get the balance right between promoting awareness—people thinking about their own situation and whether any of these factors apply to them—and not spreading unnecessary anxiety, because most people, including the overwhelming majority of students at the universities and people in Canterbury, will not be at risk.

Disability Equipment Provision

Daniel Francis Excerpts

Wednesday 11th March 2026 Westminster Hall

[Daniel Francis (Bexleyheath and Crayford) (Lab)]

It is a pleasure to serve under your chairship, Mr Betts. I declare an interest as chair of the all-party parliamentary groups for access to disability equipment and for wheelchair users. It is also well known that one of my children has cerebral palsy and uses a wide range of equipment, from a wheelchair to postural seating for eating and for bathing and so on, so I have become a bit of an expert in some of these matters over the years. I pay tribute to the hon. Member for Aberdeenshire North and Moray East (Seamus Logan) for securing the debate. There will be a separate debate later this year, through the Backbench Business Committee, on wheelchair provision, which I will be sponsoring.

On the point made by the hon. Member for West Dorset (Edward Morello), the collapse of NRS Healthcare last summer has caused real issues across the country. My Bexleyheath and Crayford constituency borders Kent and I know that there have been issues there, as there have been for other local authorities, and I have been working with organisations to try to reduce them. However, recycling continues to be an issue, and it is addressed in the recommendations of the APPG’s report.

As chair of the APPG for access to disability equipment, I am delighted to contribute to this debate, and I pay tribute to Newlife, the charity for disabled children, and the British Healthcare Trades Association for their dedication and hard work in advocating for users of disability equipment. As has been said, our first report, “Barriers to Accessing Lifesaving Disability Equipment”, was published in October. The report resulted from our inquiry—our first inquiry, in fact—into the systemic barriers that prevent millions of disabled children and adults across the UK from accessing the medical and community equipment that they need to live safely and independently.

I want to highlight some of the evidence that we heard. We found that 71% of people feel that the system providing hoists, grab rails and other essential medical equipment is not currently meeting their needs, and our first key recommendation was the implementation of a national strategy. Currently, there is no cohesive national strategy for community equipment and care provision, which has resulted in inconsistent experiences across the country. The APPG recommended that a national strategy should be overseen by a Minister, who would ensure that a national directive is issued to local authorities to clarify whose responsibility it is to provide equipment. That would ensure consistency and reduce confusion.

The APPG heard evidence that the system responsible for delivering essential community equipment is fragmented, inconsistent and too often failing the people it exists to support. Responsibility is split between local authorities and integrated care boards, but in practice that joint responsibility—I know this at first hand—frequently leads to unclear accountability, variation in provision and what many families and professionals describe as a postcode lottery. Often, delays are such that families order equipment and then wait a year or two, by which time it is obsolete. We heard that in the feedback we received for the report.

The report highlighted the consistently long waits for assessments and equipment, which worsen conditions and increase costs. In fact, 74% of professionals and equipment providers said that they are aware of patients who have experienced delayed hospital discharge because essential equipment was unavailable at home. Not only do those delays increase the financial strain on the NHS and pressures on hospital beds and staff time, but they slow down elective care and place further strain on the social care system.

One of the report’s key recommendations is to implement a co-ordinated national plan that includes clear targets, workforce investment and the streamlining of processes to reduce delays and prevent unnecessary hospital stays. Maximum service timeframes should be aligned with the wheelchair service standard of 18 weeks to ensure consistent, accountable delivery. Equipment providers from across the country said that every authority works differently, with little alignment between local areas and very limited national oversight of how services are delivered. Our inquiry found that 33% of equipment users are still waiting to receive approved equipment, with one in five waiting more than two months. That highlights the real consequences these failures have for the people who rely on the support. Despite the scale and importance of this sector, there is no single Minister with clear responsibility for ensuring that services are working effectively for patients.

It is clear that the system needs change, and I would be grateful if the Minister would consider the APPG’s recommendations to introduce a national strategy for community equipment and wheelchair services in order to eliminate the postcode lottery in provision and provide proper national oversight and monitoring of services, and to introduce of a co-ordinated national plan to reduce delays in the provision of community equipment. The APPG will be meeting on 26 March, and the Minister and all other Members will be welcome, if they can find time in their busy diaries, to join us.

Adult Cerebral Palsy: National Service Specification

Daniel Francis Excerpts

Tuesday 10th March 2026 Westminster Hall

[Daniel Francis (Bexleyheath and Crayford) (Lab)]

I beg to move,

That this House has considered the national service specification for adult cerebral palsy in the NHS.

It is a pleasure to serve under your chairship, Ms Jardine. I am grateful to secure this debate. Approximately 130,000 adults in the UK have cerebral palsy. Although the NHS now officially categorises it as a lifelong condition, there is clear evidence that specialist support stops at the age of 18. A national service specification for adult cerebral palsy in the NHS would ensure that the transition from childhood to adulthood is supported by relevant healthcare services and the necessary support. It would ensure that support continues to be provided throughout adulthood. I pay tribute to Up—the Adult Cerebral Palsy Movement, and Action Cerebral Palsy, for their dedicated advocacy for people with cerebral palsy throughout the UK, their campaigning on this issue and their support in preparing for this debate.

I will start by talking about my experience. As hon. Members will be aware, one of my daughters has cerebral palsy. Although she is still a child, I remain concerned about the level of support that will be provided to her when she reaches adulthood—a concern that I am sure many parents of children with cerebral palsy will relate to. During childhood, layers of support are provided, ranging from paediatricians to services that often are supplied at school and through the NHS such as physiotherapy, speech and language support, and occupational therapy. Parents are rightly concerned about what the transition at 18 looks like and whether wraparound healthcare remains. Sadly, the reality for many people with cerebral palsy is that after the transition, they are left with little support for their health needs and to help them function in life, including for day-to-day activities such as work.

Throughout this debate I will refer to the 2022 report of the all-party parliamentary group on cerebral palsy, “Barriers for adults with Cerebral Palsy on achieving full life participation: access to healthcare services and progressing at work”. Although the APPG is now disbanded, the key recommendations remain relevant. I pay tribute to my hon. Friend the Member for City of Durham (Mary Kelly Foy) and the former Member for Blackpool North and Cleveleys, Paul Maynard, for their work to commission the report.

For many adults with cerebral palsy, their experience is similar: they receive care and support through paediatric services before reaching adulthood, then find themselves facing a cliff edge. In essence, they are left without the support that they received for the first 18 years of their life. Cerebral palsy affects about one in every 400 children in the UK, but the severity of each child’s cerebral palsy varies greatly, and many have more complex issues, with one in two having a learning disability and one in four having a severe learning disability.

The first recommendation in the APPG report outlines that NHS England and social care, education and employment specialists must agree a national service specification for adult cerebral palsy, to be commissioned based on the needs of local populations within the 42 integrated care boards across England. Furthermore, in the 10-year health plan, the Government made the commitment that 95% of people with complex needs should have an agreed personal care plan by 2027. Many adults with cerebral palsy have complex needs and, with that, elevated health risks. They are 14 times more likely to die from respiratory disease and three times more likely to die from cardiovascular disease. In 2023, a review of 69 studies to assess the prevalence and incidence of chronic conditions among adults with cerebral palsy showed that 21% had depression, 21% had anxiety, 24% had asthma, 28% had epilepsy, 32%8 had incontinence and 38% had malnutrition.

I would welcome the Minister’s response outlining how the commitment in the 10-year health plan can be achieved for adults with cerebral palsy. I would also welcome the Minister considering how a national service specification for adult cerebral palsy could be implemented within the 42 ICBs, including by encouraging ICBs to implement the NHS framework for the commissioning of services for children and young people with cerebral palsy as a blueprint for adult cerebral palsy commissioning and provision.

In March 2021, the then APPG on cerebral palsy published its first report, entitled “Early identification, intervention and pathways of care of infants and young children with cerebral palsy: the case for reform and investment”. One of the report’s key recommendations was that all health authorities should be required to implement NICE—National Institute for Health and Care Excellence—guidelines. Dr Charlie Fairhurst, head of children’s neurosciences at the Evelina London children’s hospital and chair of the committee for NICE guidelines on cerebral palsy, accepted those recommendations, which have been implemented in the NICE guidelines for children. It is therefore disappointing that the recommendations for adults outlined in the 2022 report, including the full implementation of NICE guidelines, have not been implemented for adult cerebral palsy in the NHS.

In May 2025, NHS England published the commissioning framework for children and young people with cerebral palsy. The framework aims to simplify and summarise the existing guidance available. It also highlights best-practice care pathways that could be replicated by other systems and enables systems to identify population need through data. Over the past year, eight ICBs have been piloting that framework for children, which involves undertaking a baselining exercise to understand existing service provision and to identify service gaps for children with cerebral palsy. However, as we know—and as the 2022 APPG report highlighted—the needs of local populations differ across the country, and the results from just eight ICBs are not enough to provide an accurate representation of the effectiveness of the framework.

The existing postcode lottery of specialist support constrains the lives of adults with cerebral palsy and results in worse health outcomes, not to mention lower education and employment participation for individuals, with the subsequent substantial economic loss. Analysis from the Northern Ireland cerebral palsy register has shown that the prevalence of cerebral palsy in adults is comparable to that of multiple sclerosis or Parkinson’s disease.

[Jim Shannon (Strangford) (DUP)]

I congratulate the hon. Gentleman for securing this debate, and I thank him for sharing his personal story. That personal knowledge adds to the debate.

Studies by Queen’s University Belfast indicates that adults with cerebral palsy often struggle to navigate adult health and rehabilitation services after moving on from paediatric services. That can limit their access to physiotherapy, occupational therapy, speech and language therapy, orthopaedics and neurology. Does he agree that the best way to navigate this issue is to establish a clear, co-ordinated transition pathway from paediatric to adult services, with dedicated case management so that nobody is left behind when it comes to their care?

[Daniel Francis]

I absolutely agree. Between the APPG’s 2022 recommendations and the example the hon. Member gave of the analysis in Northern Ireland, it is clear that the evidence is there, and hopefully we will hear from the Minister about how we can continue to progress some of those matters.

I would welcome a commitment from ICBs across the country to implement the framework as a blueprint for adult cerebral palsy commissioning and provision, as the hon. Member outlined.

The 2022 report’s second recommendation highlighted the need to support GPs in identifying adults with cerebral palsy by extending the UK-wide quality and outcomes framework to incorporate the creation of general practice-level cerebral palsy registers along the lines of the expansion of the QOF to learning disabilities. That would make a profound difference in the health outcomes of children with cerebral palsy when they transition into adulthood care pathways. Would the Minister look to extend the quality and outcomes framework to incorporate the creation of general practice-level cerebral palsy registers, similar to the expansion of the quality and outcomes framework to learning disabilities?

The third recommendation aims to ease the transition into adult care pathways through a national service specification for adults with cerebral palsy in the NHS, which must include training covering adults with cerebral palsy for those working in general medicine, general practice and nursing from entry level. For many adults with cerebral palsy, their primary co-ordinator of care is their GP, who, despite their best efforts, often does not have the specialist knowledge or training to support their patients.

Written evidence submitted to the APPG as part of the report highlighted that medical undergraduate students do not receive training about cerebral palsy in adults. One way to support GPs in identifying adults with cerebral palsy is to extend the UK-wide quality and outcomes framework to incorporate the creation of general practice-level cerebral palsy registers along the lines of the expansion of the quality and outcomes framework to learning disabilities. That would make a profound difference in the health outcomes of children with cerebral palsy when they transition into adulthood care pathways. Would the Minister outline how the current NHS staffing guidelines could be amended to include the incorporation of training for those in general medicine, general practice and nursing from an entry level to cover adults with cerebral palsy?

The report’s fourth recommendation outlined that each ICB should be required to undertake a gap analysis of existing cerebral palsy services for adults against NICE guidance and use the results to inform and guide their local commissioning decisions. This must include investment in services to support and address associated conditions. The results should then be used to establish regional multidisciplinary cerebral palsy clinics for adults, providing access to a range of psychological, physical and complementary therapies. The recommendation highlights that disability access co-ordinators appointed in both acute and primary centres would be able to provide referrals to the clinics and ensure that reasonable adjustments are made.

The report also highlighted that the provision of a neurologist during the transition from childhood to adulthood is an essential component of adult cerebral palsy care to ensure that, when a patient is discharged from their paediatrician, they do not face that cliff edge in support. Will the Minister agree to investigate how ICBs can undertake a gap analysis of existing cerebral palsy services for adults against current NICE guidance, and how they can include adults with cerebral palsy in their integrated needs assessments?

The report’s fifth recommendation suggests that, to ensure the provision of specialist services, the Department of Health and Social Care should provide ringfenced funding to ICBs to enable them to develop the much-needed specialist services at a local level. Will the Minister agree to look at ringfencing funding for the 42 ICBs so that they can develop specialist cerebral palsy services?

Finally, I want to demonstrate why national service specification is so needed. Emma Livingstone, the co-founder and chief executive officer of UP, The Adult Cerebral Palsy Movement, is in the Public Gallery, and her lived experience perfectly encapsulates why national service specification for adults with cerebral palsy is needed. Emma was diagnosed with cerebral palsy at two years old. At 16, she was discharged from medical services after being told that she was the best that she would ever be.

Unfortunately, without any integrated care during Emma’s adulthood, she experienced a significant decline in mobility in her late 30s. That led to Emma having multiple surgeries, and unfortunately having to give up her work as a speech and language therapist. In Emma’s own words,

“In my late thirties, my mobility declined rapidly. I needed hip surgery, then more surgeries, and eventually had to give up work. What shocked me wasn’t the physical deterioration—it was the silence. The coordinated care I’d received as a child simply vanished when I turned 18.”

Emma is sadly not alone in experiencing that. The APPG report found that

“the transition into adolescence and adulthood is often accompanied by a decline in physical function,”

with up to 50%

“of people with Cerebral Palsy experiencing deterioration in walking function between 20 and 40 years of age.”

That statistic alone is reason enough to show why national service specification for adult cerebral palsy in the NHS is so greatly needed.

I would welcome the Minister’s response to the five recommendations from the APPG report that I have highlighted today.

Hughes Report: Second Anniversary

Daniel Francis Excerpts

Wednesday 11th February 2026 Westminster Hall

[Daniel Francis (Bexleyheath and Crayford) (Lab)]

It is a pleasure to serve under your chairship, Dr Allin-Khan. I thank the hon. Member for Chesham and Amersham (Sarah Green) for securing the debate.

I spoke in last year’s debate to raise the experience of my constituents Paula and Gillian, who had experienced the impact of having pelvic mesh fitted. Unfortunately, not much has changed since then, and Paula tells me she is still living with the devastation that pelvic mesh has caused in her life. She had the mesh implanted in 2012, and between 2020 and 2023 she experienced painful bladder stones that were linked to the mesh. She finally had surgery last year to remove a 3 cm bladder stone, which revealed that the mesh had completely eroded into her bladder. She will need further surgery to remove the remainder of the mesh, and will need to undergo a further recovery period. That story is like many others we have heard.

As I did when I spoke about valproate last year, I would like to thank Emma, Janet and the campaigners who are here today, who do so much in this area. With regard to the Hughes report, the Epilepsy Research Institute continues to ask the Government to allocate dedicated ringfenced funding for research into epilepsy drugs and to ensure that regulatory bodies act swiftly on safety concerns, and that pregnant women with epilepsy have access to the best possible information and care.

I will take us down a slightly different path now because, as some Members know, my wife and one of my daughters have epilepsy. When my wife and I tried to conceive, I saw at first hand the issues women have when they have to come off valproate. My wife was seizure-free for 12 years, and her life was turned upside down when she started having seizures again. Those resulted in her falling all the way down the stairs; falling into a bathroom cabinet and trapping her head—I had to try to disengage her; having a seizure in the bath, after which I had to resuscitate her on the bathroom floor; and having to surrender her driving licence. At one stage, she thought she would never go back to her teaching job, although she has now successfully gone back to it. She will be three years seizure-free this year, mainly because she has gone back on to valproate.

Those many years when she had seizures and other issues show why research is desperately needed for drugs to control epilepsy. Unfortunately, for many people, valproate is the only drug that allows them to lead a normal life. I have seen that; the rules are there for a good reason, but my daughter, who is 12 and who, as Members may know, has no mental capacity, has had to come off valproate because of the rules. We need to understand these issues and that wider issue, because for many people valproate is the drug they need to support them. That is not to disrespect Emma and Janet for the work they do to support those, including their children and families, who have been so desperately impacted by valproate.

I welcome the noises we have heard recently about forthcoming updates from the Department, but I also say, on behalf of my constituents and the wider community, that we need concrete measures for the implementation of financial and non-financial redress, and I would welcome the Minister’s comments on that.