Daniel Francis
MP for Bexleyheath and Crayford · Labour · United Kingdom
“As the Minister said, we were friends for many years in London local government prior to being elected to this place. I want to make two points. First, there is the issue of the Changing Places that have been provided in recent years and the amount of information out there about them.”
“As the Minister knows, I will hold her to account on this issue and continue to pursue it. I thank her very much for the commitments that she has given today that we can continue to pursue. I thank the hon. Members for Chester South and Eddisbury (Aphra Brandreth), for Bath (Wera Hobhouse) and for Strangford (Jim Shannon), my hon.”
“An expansion of capital funding for Changing Places toilets would lead to people with profound disabilities accessing more opportunities and more families and individuals contributing to our hospitality businesses, theme parks, leisure facilities and sports grounds—the list goes on. There was, of course, a previous fund.”
“I turn now to the importance of maintaining Changing Places toilets. I mentioned last year that, in Bexleyheath town centre, we had to close a Changing Places toilet because of the vandalism it was receiving, with people living in it and dealing drugs in it.”
“Although I acknowledge that changes to building regulations ensure that facilities continue to be installed in new buildings, I retain concerns that older buildings would greatly benefit from having a Changing Places toilet installed.”
“One said: “Without access to an appropriate facility, I am left with impossible choices: ending outings early, avoiding certain venues altogether, or changing my daughter on the floor of an accessible toilet, which is neither hygienic, safe nor dignified.” I have read through the responses to the survey, and there was a lot of appreciatio…”
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“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.”
“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.”
“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.”
“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.”
“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.”
“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.”
“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.”
“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.”
“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 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.”
“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?”
“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.”
“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.”
“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.”
“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.”
“I thank my right hon. Friend for her comments and support and echo what she has said about the situation in the middle east. The charity Shelter has long campaigned for people with no fixed address to be able to access bank accounts, including without ID. Which groups of people might benefit the most from the leadership shown by the Labour Government and from banks on this issue?”
“In addition to the situation on the ground in Hong Kong, there remains evidence of transnational repression against Hong Kong nationals living overseas, including here in the United Kingdom. Will the Minister update us on the work being done on that issue across Government Departments, and on the measures that she is pursuing to end the deliberate targeting of opposition voices in the UK?”
“Can the Minister commit that, through the consultation and legislative process, we will continue to hear those voices to get the package right? I know at first hand that the system is broken, and we have to get it right for these families.”
“I declare my usual interest, as my wife is a special needs co-ordinator and one of our children has an EHCP. I thank the hon. Member for Dorking and Horley (Chris Coghlan) for bringing forward this debate. My constituents have seen our London borough of Bexley council have a safety valve agreement and an Ofsted inspection of systemic failings, which we are hopefully about to come out of. I have seen those things as a councillor and as a parent. I am the parent of twins, and I can tell the House that despite having an EHCP, the transfer for my daughter with an EHCP was so much more stressful than it was for my other daughter. I welcome the changes, as the Minister knows. There are still a few things we need to iron out in these conversations about transition, support for schools and the role of ICBs.”
“If we had time, I would read out the case studies of Jessica, James, Gurkamal and Stuart, and also the comments from parents, such as Adebimpe, Emma and Nicola, outlining the experiences of their children, whose loans are growing and who, unlike those of us who had plan 1 loans, are having to pay huge amounts in interest, rather than paying off the loan itself. I thank my hon. Friend the Member for Ilford South (Jas Athwal) for securing this debate. I echo what he said about the key things that we need to hear from the Minister today: about the level of interest, the thresholds and how we can resolve the 9% repayment rates, and about how we can make the system closer to what I experienced and fairer for those studying today, those considering studying or those who have just been through the system.”
“It is a pleasure to serve under your chairship, Ms Lewell. As has been said, this is an issue of generational unfairness. My wife and I had plan 1 loans. At that stage, in our early 30s, having paid off our loan, we felt we could start career progression, work our way up the housing ladder and have a family. However, what I have seen in my postbag is correspondence from constituents across Bexleyheath and Crayford who do not feel that that is the case for them and feel that the system now works against them.”
“My constituent Steve Bainbridge is a dual UK-Greek national. He has raised his experience of a delay in receiving his UK passport forcing him to have to use his Greek passport to attend his daughter’s wedding in the UK. He also highlighted bureaucratic issues faced by women travelling from Greece, such as with their maiden name having to be displayed in their passport and Greek documents using a different alphabet from British ones. Will the Minister outline how, if someone’s UK passport is delayed, they can avoid having to pay several hundred pounds and facing the bureaucratic issues that Steve has highlighted?”
“I declare an interest, as my wife is special educational needs co-ordinator and one of our children has an EHCP. As the parent of twins, I have had to fight for virtually none of the education of one of my children, but for every single aspect of my other child’s education because she is disabled. What I say, and what I have heard clearly from my constituents, is that we must get right aspects such as holding ICBs to account—we heard about that from my hon. Friend the Member for Thurrock (Jen Craft)—and the transition stages at both primary and secondary school, and the end of secondary. I welcome the proposals, but will the Secretary of State assure the House that during the consultation we will hear those voices and get this right for the families I represent?”
“Last month, my Conservative-controlled council in the London borough of Bexley issued a press release stating that DFT data showed that it has the seventh best roads in England. Will the Secretary of State confirm that the data shows that it has an amber rating and does not say that it has the seventh best roads in England?”
“This coming Monday, I will be honoured to join my long-standing friend Tom Jones, who also happens to be my eldest constituent, for his 108th birthday celebration. Tom joined the Labour party under the leadership of Sir Clement Attlee, and has supported our party under every subsequent leader. This year, he will complete 92 continuous years of service with Unite the Union. Will the Leader of the House join me in wishing Tom a very happy 108th birthday, and thank him for his lifetime of service to our community in the London borough of Bexley?”
“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.”
“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.”
“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.”
“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.”
“I thank my hon. Friend for securing the debate. Like her, I have received a litany of complaints in recent weeks from constituents—including Antoni, Catherine, Christopher, Kevin, Mike and Robert—with similar heartbreaking stories. Does she agree that it is important we take urgent action to ensure that consistent and timely pension payments are made for all these scheme members in our constituencies?”
“Does the shadow Minister accept that in recent years, when Transport for London was negotiating its fare settlements, the previous Government dictated the level of fares that should be charged not just for the congestion charge, but for passenger rail services? The Conservative Secretary of State and Government were doing that very thing in negotiations with Transport for London for rail passenger services in London.”
“Amendment 62 causes some concern with its reference to fares being “one third lower” because in many cases that would represent a fare increase for wheelchair users and blind passengers.”
“I will briefly respond to some of the comments that have been made. First, the Greater London Authority Act 1999 does not have many of these components. Yet the Mayor of London allows a number of discounts, including for veterans, care leavers, apprentices and people who are unemployed and seeking work. They are not on the face of that legislation, but those exemptions do exist, including for veterans, and I am sure the Minister will cover those points in due course. However, there is other legislation where that is the case. At no point in their 14 years did the previous Government attempt to amend that Act to provide that exemption for veterans, so that is the position that remains. I remind Members of my interest as chair of the all-party parliamentary group for wheelchair users.”
“That provision is not included in the Bill, yet the Opposition thought it was more important to table an amendment to introduce a discount for 26 to 30-year-olds than to table one on a discount for the carer of a wheelchair user or blind or visually impaired passenger. I anticipate that the Government will confirm that the discount remains for carers and companions, and in my mind that does not need to be included in the Bill. I certainly do not support amendment 62, as it would undo the current, more generous discount arrangements for wheelchair users and blind or visually impaired passengers, and cause an increase in their fare.”
“I again declare my interest as chair of the all-party parliamentary group for wheelchair users. Amendment 62 appears to refer not to railcards but to all ticketing. As I have said, it would result in an increase for many tickets for wheelchair users and blind and visually impaired people. As the parent of a child who is a wheelchair user, I know that the discount on a ticket for wheelchair users is 75%, and it is the same for an adult day return. For blind and visually impaired users the discount on an adult day return is 50%. Some discounts also apply to the carer or companion of the wheelchair user or blind or visually impaired passenger.”
“I did this work as a member of a board for four years, and chaired many meetings of sub-committees looking at some of that work, and, in the work of a watchdog, these issues are there, they are referred to the organisation and they are in the reports that are presented on behalf of all passengers.”
“It is a pleasure to serve under your chairship, Mrs Hobhouse. I hear what was said about amendment 63, and I will wait to hear what the Minister says. I have sat on a passenger watchdog, although not this one, and worked in that role alongside Passenger Focus, as it was back then—it is now Transport Focus. I served as a member of the board of London TravelWatch, which is referred to as the London Transport Users Committee in the legislation, for four years, although that was a long time ago now. Many of the provisions we will see in later clauses are inherent in the aims and work of such organisations. Investigations, reports, representations and referrals come to the attention of the organisation from all passengers. The amendment is not necessary.”
“I fully support the need to look at the issues for disabled passengers who come to the council’s door, and I will hear what the Minister has to say, but I believe that how things are investigated and brought to the organisation’s attention are set out in the legislation, just as they are, in many regards, for Transport Focus and for the London Transport Users Committee. I do not believe that the amendment is necessary.”
“If the hon. Gentleman looks at the clauses in the group, he will see that there are significant issues that the passengers’ council needs to take into account for all passengers, which come to the door and—as I know, having sat on a watchdog for four years—come in the form of casework and meetings. I am sure that I will talk later about why nationalisation, and having trains, signals and rolling stock under one operator, is much better for a passengers’ council, but those issues come to the organisation’s attention anyway.”
“There will be reports that are really to say to the operator, “You need to look at this specific issue.” We do not need to make it mandatory that all those reports are tabled in this House, with the bureaucracy that brings.”
“London TravelWatch is a large organisation, and I used to chair some of its casework committees. It deals with and reports on a huge range of issues and, like Passenger Focus, it deals not just with trains but with other modes of transport. I made recommendations on a range of issues. I remember making recommendations to Eurostar about issues regarding disabled passengers. I remember making recommendations regarding changes to timetables. There were some significant issues that one would want to issue a report on. There was an issue back then for South Western about how Network Rail and the train operator were integrating, and a report had to be commissioned.”
“I do not think this provision needs to be on the face of the Bill. These issues already exist; there are examples where the passenger watchdog and the Transport Committee would be looking at the same matter. There would be examples with other Departments where an ombudsman would also be looking at something in a similar vein to a Select Committee. My view is that it would be an overly bureaucratic system. Passenger watchdogs issue many reports, and some are on very serious matters, but sometimes they need to issue a report that is not at that level, and I do not believe these amendments are necessary.”
“I thank the hon. Member, who is advocating for her constituents. Within London, Transport for London operates at least four lines—the Elizabeth, Central, Lioness and Metropolitan lines—all of which leave the London boundary. They would therefore potentially enter the boundaries of strategic authorities. If the amendment were passed, which would Great British Railways need to have regard to: the mayor’s transport strategy or the strategic authority’s transport strategy?”
“Those things do not need to be set out in the Bill; we already have examples of them with Southeastern and others, who are providing the facilities here and now.”
“We have seen that roll-out from Southeastern at Margate through what was Network Rail at London Bridge and Waterloo, and very soon we will see it at Charing Cross. I accept that disabled passengers still have poor experiences on many parts of the network, and we need to improve that. However, as I say, we already have, through Transport for London, an app that leads the way. I had a terrible experience last year in Paris, when there was no live information and a lift was not working. I had to carry my child up a set of escalators, while my wife carried the wheelchair behind us. Information about those kinds of things does not need to be on the face of the Bill, but, as we have already seen with TfL, we can lead on that provision, and I believe that Great British Railways should lead in due course.”
“It would be show people which stations were accessible, live information about which lifts were working, and where there were accessible toilets. For my constituents in Bexley and Crayford, we have a nationalised railway, in the main, through Southeastern, although we also have Thameslink at Slade Green. We already have an exceptional service for disabled passengers. Sometimes, passengers will need to book, but I could give the Committee a list of stations that are staffed constantly and that provide a very good service for disabled passengers. Equally, we continue to see the roll-out of changing places toilets. Toilets are a key issue for many disabled people, including my child, who cannot use a standard toilet.”
“It is a pleasure to serve under your chairship, Mrs Hobhouse. I will briefly speak to clause 18 stand part. At the outset, I remind Members that I am the chair of the all-party parliamentary group on wheelchair users, and one of my children is a wheelchair user. I do not believe that some of these details need to be set out in the Bill. I am a London MP. The details of how Transport for London operates on accessibility issues are not set out in the Greater London Authority Act 1989, yet, in my mind, TfL leads the way, particularly with its TfL Go app, on the accessibility of the information that it provides to disabled passengers. As the Minister and other colleagues know, I constantly say that I would like to see that kind of app being rolled out for Great British Railways.”
“Last Sunday, I joined the congregation at St Augustine’s church in Slade Green to celebrate the retirement of Rev. Jim Bennett. Jim has been a long-standing pillar of our community in Bexleyheath and Crayford, having worked for Greenwich and Bexley community hospice for 16 years, starting as a fundraising co-ordinator and eventually becoming its chief executive. Following his retirement from that post, he took on a new career later in life. Following his ordination, he spent over six years as the priest at St Augustine’s church in Slade Green. Will the Leader of the House join me in paying tribute to Jim for his work in supporting my constituents across Bexleyheath and Crayford, and wish him all the very best for his retirement?”
“Too many young people with education, health and care plans are being kept on them until they are 25 years old due to the complexities involved in offering them the specialist support required to place them into apprenticeships or work placements. Will the Secretary of State therefore provide an update on the work being undertaken across Government Departments to support these young people into career paths so that they can commence their working lives?”
“It is a pleasure to serve under your chairship, Mrs Hobhouse. For my constituents, in the period since the railways were privatised they have twice needed to be brought back under public ownership: once in 2003, when Connex failed, and again in 2021, when Southeastern failed. However, on both occasions, there was no impact on passenger numbers; rather, the factors that my hon. Friend is describing correlated and led to those passenger numbers. Does he agree that over the last 30 years, whether the service has been under national or private ownership has had no impact on the passenger numbers on trains in my constituency?”