Wheelchair Provision: Independent Review Body Debate
Full Debate: Read Full DebateLuke Evans
Main Page: Luke Evans (Conservative - Hinckley and Bosworth)Department Debates - View all Luke Evans's debates with the Department of Health and Social Care
(1 day, 7 hours ago)
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I thank my hon. Friend for her intervention; she underlines the point. I was going to give the example of a young fella from Newtownards. He lives in Dundonald, but he is more seen in Newtownards. He has severe, complex mobility needs, but he is the brightest wee boy you ever met in all your life, and he always encourages and lifts me when I meet him. He is a Chelsea supporter, so he needs some help at the minute, because they are not doing too good. I am a Leicester City supporter, and we are not doing too good either, so we have something in common.
There was just no way in the world that the NHS could give him the wheelchair that he needed for his special needs—similarly to the example that my hon. Friend mentioned in respect of those who have served in the forces. The only way that wee boy could obtain the wheelchair that he needed was through fundraising. Dessie Coffey in Newtownards has been fantastic. He raises money for all charities, but he did so especially for this wee boy. Over a period of time, we raised about £6,000 to help him with his wheelchair, and today that wee boy has some independence.
I wrote to one of the Manchester United stars—my mind just went blank and I cannot remember who it was, but he no longer plays for them—and he sent me a signed autograph, so I gave it to the wee boy and he sold it for £100. Again, if it was not for individual fundraisers, he just would not have had the money. I very much believe that we need an independent national review body to oversee wheelchair provision, and I support the hon. Member for Bexleyheath and Crayford in his call for one.
Some might ask why we need another body in an already complex system. The answer is quite simple: because the current system is failing the very people it was built to serve. Northern Ireland has the longest health waiting lists in the United Kingdom. People are waiting years for orthopaedic surgery, and while they wait, their mobility needs change, often without the system keeping pace. Just last year, we saw the collapse of NRS Healthcare, which was the main provider of repairs for our regional service. The Business Services Organisation stepped in to steady the ship, but that moment of crisis exposed the fundamental truth that out wheelchair services are fragile.
The NRS case is so important. I am keen to understand how the Government are ensuring the ongoing provision and servicing of wheelchairs, given that NRS has gone bust. I have been contacted by constituents who worked at high levels in NRS, and who are concerned that those contracts will not be followed up. Is the hon. Member concerned about that, too?
I certainly am. The shadow Minister always speaks with great knowledge on such matters, and I look forward to his speech. Hopefully, the Minister will respond positively to his point. Although waiting lists do not fall under the Minister’s responsibility, the fact is that they are of such length all over the country that mobility is declining, and support is needed more than ever.
One of the greatest merits of having an independent review body would be the death of the data desert. Currently, we do not have a full, transparent picture of the true demand for wheelchairs in the United Kingdom. An independent body would mandate high-quality, comparable data, forcing the Department of Health to confront the true scale of the backlog. The issue of data comes up during almost every debate we have on health. How can we know how to respond if we do not have the data and information? Perhaps the Minister could tell us how we can quantify the demand through data, which clearly needs to be collected.
We also need accountability that has teeth. Currently, when things go wrong, users are often left to navigate a complaints maze with their trust. An independent body would act as an impartial watchdog, ensuring that the wheelchair equality framework is not just a document on a shelf in Belfast or elsewhere, but a standard to which every service user can hold their trust. I gave the example of the wee boy—his name is Reuben Walls—and how fundraising got him what he wanted, but we need a system to help those who cannot fundraise and do not have the finances.
Every day that a child waits for a wheelchair or an adult sits in an ill-fitting seat that causes pressure sores, the cost to the health and social care system grows. Research shows that the right wheelchair can deliver a societal return worth triple its cost. Having an independent body would ensure that we treat wheelchair provision not as an optional extra, but as a vital investment in our economy and health. We need a national body that listens to the Wheelchair Collective, champions the user voice and ensures that the promise of
“the right chair, at the right time, right now”
is kept for every citizen in this United Kingdom of Great Britain and Northern Ireland. I look to the Minister and the Government to ensure and provide that, and I think all of us here today wish to see the same thing.
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?
The Parliamentary Under-Secretary of State for Health and Social Care (Dr Zubir Ahmed)
It is a pleasure to serve under your chairmanship, Dr Murrison. I congratulate my hon. Friend the Member for Bexleyheath and Crayford (Daniel Francis) on securing this important debate and also on challenging us, born of his lived experience, to make the lives of disabled people better and better lived across our country. We are grateful for his presence in this House and this place, every single day. I am also grateful to my hon. Friend for the work he has done to champion this interest more generally in his capacity as co-chair of the all-party parliamentary group for wheelchair users.
In recent months wheelchair services have received considerable attention, both within Parliament and more widely. As has been highlighted, last month I participated in a debate on the provision of disability equipment, brought forward by the hon. Member for Aberdeenshire North and Moray East (Seamus Logan). I have been struck by the compelling testimonies shared during those discussions and the ones today, highlighting the profound impact that timely access to appropriate disability equipment can have on people’s lives.
This is a matter clearly deserving of much more attention. Since the previous debate on this topic, I have written to the national quality board to request that disabled people and the equipment they use are considered as part of the board’s ongoing work to improve quality and reduce inequality across health and care services. I am pleased to update that the board has confirmed it will take this forward.
This Government remain steadfast in their commitment to ensuring that disabled people can access the services and support they need. Through our reforms to health and social care, we are dedicated to delivering meaningful change that will make that vision a reality. Integrated care boards, as has been highlighted, are responsible for commissioning local wheelchair services. Responsibility for providing disability equipment lies with local authorities or the NHS, depending on the person’s needs.
For adults and children with long-term complex needs, services are typically provided by NHS wheelchair services. There is a range of NHS wheelchair providers across England, as we have heard. I acknowledge the concerns that the hon. Member for Hinckley and Bosworth (Dr Evans) raises about NRS. My hon. Friend the Minister for Care and I will be having discussions about that, and it would be appropriate to write the hon. Member an urgent letter to update him, as I know that he is genuinely concerned about the topic. ICBs are expected to monitor service provision and effectively manage contracts with their commissioned providers.
Although the latest data from NHS England shows a reduction in wheelchair waiting times for adults, I recognise that far too many people of all ages, as we have heard today, experience unacceptable delays for appropriate equipment. The covid pandemic had a significant impact on wheelchair services, from which we are still suffering in terms of supply chain disruption. That has meant that waiting times for both adults and children have fluctuated unnecessarily—well, unacceptably—as services have worked to recover. Those with more complex needs can also experience delays due to the lead-in time for supply of more bespoke equipment.
I understand that there have been complaints about the quality of services commissioned by some ICBs. Some of these are being dealt with on an individual basis by the Parliamentary and Health Service Ombudsman, following escalation by individual patients. As part of its oversight of ICBs, NHS England is also gathering intelligence through regional teams to understand fully the issues being raised.
It is important that local commissioners have the discretion to decide how best to meet the needs of their local population, and we are giving systems control and flexibility over how that is done. None the less, the Government are taking action to support local systems in delivering effective wheelchair services. Although there are no plans at the moment to establish a national review body to oversee wheelchair provision, the medium-term planning framework, published in October, requires that from this year all ICBs and community health services should actively manage and reduce waits over 18 weeks and develop a plan to eliminate all 52-week waits. The framework also states that in 2026-27, ICBs are required to
“increase community health service capacity”—
including wheelchair services—
“to meet growth in demand, expected to be approximately 3% nationally per year”.
Dr Ahmed
Ultimately, ICBs are responsible for delivering the framework. The Government are held accountable in the manner being seen today, and I have no doubt that in the new structures that we propose there will be further accountability, because in many ways the middleman will be removed and we will have more direct oversight as to what is going on with wheelchair services and other services up and down the country.
I take the hon. Member’s point on data as well. I am the Minister responsible for data, health innovation and innovation in general, and I think this moment of restructuring, whether in relation to wheelchair services or other parts of the system, is a moment for us to really get into the 21st century with our capabilities for monitoring data for operational and capacity planning. I am very happy to share with him some of my thoughts about that over a cup of tea later, if he is interested.
The community health services situation report will be used to monitor ICB performance against waiting time targets in 2026-27. Those targets will guide systems to reduce the longest waits. In addition, the 10-year plan makes a commitment to reviewing the complaints regulations, and NHSE and the Department of Health and Social Care are developing plans to achieve that.
NHS England has developed policy, guidance and legislation to support ICBs to reduce delays and unacceptable regional variation in the quality and provision of wheelchair services. In April 2025 NHS England published the wheelchair quality framework, in collaboration with the wheelchair advisory group, which I understand includes the Wheelchair Alliance and Whizz Kidz, both of which were recognised by hon. Members in the debate today.
That framework is designed to assist ICBs and NHS wheelchair service providers in delivering high-quality provision that offers improved access, outcomes and experiences. The framework sets out quality standards relevant to all suppliers and aligns with the Care Quality Commission assessment framework that applies to providers, local authorities and integrated care systems. Those quality standards should be used to develop local service specifications and to benchmark current commissioning and provision.
Other measures taken by NHS England include the establishment of a national dataset on wheelchair waiting times to increase transparency and to enable targeted action if improvement is required, and the introduction of the legal right to a personal wheelchair budget in 2019. Personal wheelchair budgets provide a clear framework for ICBs to commission personalised wheelchair services that are outcomes-focused and integrated with other aspects of care.