Danny Beales
MP for Uxbridge and South Ruislip · Labour · United Kingdom
“Several of my constituents have been failed by Capita; with the support of my team, they have been battling to get the pensions that they are owed and deserve. Frustratingly, for some the June milestone has come and gone. Just last Friday I met Barbara, whose husband passed away in January.”
“I thank my hon. Friend the Member for Vauxhall and Camberwell Green (Florence Eshalomi) and the members of her Committee for their excellent pre-legislative scrutiny work, which we have heard about today.”
“As the Chair of the Select Committee has mentioned, leaseholders overwhelmingly responded to the survey that they want to see this change, and the Property Institute, RICS and even the managing directors of FirstPort and Rendall & Rittner are all supportive of the need for more effective regulation and a regulator of managing agents.”
“I understand that the Government are willing to move on mandatory qualifications for managing agents—again, that is welcome —but I am concerned that, without an independent regulator to enforce codes of conduct and ensure we can reap the benefits of those qualifications, that will be of little benefit to many leaseholders.”
“As Members have said, there are countless examples of service failure from managing agents. I welcome the Minister’s actions to date, and the proposals in the draft Bill to cap exploitative ground rents, which will save thousands of pounds over the lifetime of leases, pushing for service charge reform and transparency, and pushing for com…”
“There are significant costs and financial waste in the current system, and the leasehold brand has been exceptionally damaged by the poor behaviour of managing agents. A regulator has the chance to restore confidence in leasehold and commonhold in the future.”
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“My hon. Friend the Member for Rugby rightly talked about our flag, which is for all of us—it is my flag, your flag and the flag of everyone in our community. Unfortunately, however, the flag has been increasingly weaponised by certain segments of our community, who do not share the view that it is everyone’s flag. They believe that it is only a particular sort of person’s flag and do not appeal to unity, but to division and hatred. I have been contacted recently by many local residents who are concerned about the continued presence of flags on our streets. I was particularly struck by a piece of correspondence from a gentleman who contacted me to say, “I am a combat veteran with 20 years’ experience, including in Afghanistan, and I know the value of pride in one’s nation and our flag, having served under it.”
“We have a duty to call out these abhorrent instances of hatred; to act; to choose our words carefully and wisely; to seek to work with others in our community and across different divides in this place; to promote cohesion and unity; and to appeal to the common threads that we often see throughout those in public life and those in our community groups. Locally, we also have a duty and a responsibility to promote cohesion. Local councils, which are key institutions in this country, should have a responsibility to promote community cohesion and to produce plans locally to do that. Unfortunately, in my community, our local authority is falling short of meeting that responsibility. We have seen little action, if any, from it to address some of the issues on our streets. To be frank, in some instances, there is denial about these problems.”
“I have councillors who are British being told to go back home. I have residents telling me how they are abused in the street. Police are attacked at apparently peaceful protests. Just last week, the doctors surgery in Otterfield emailed me to say that doctors at the surgery face countless instances of racial abuse every week. Even now, the GP surgery has been vandalised and attacked. That is clearly unacceptable and needs addressing. So how do we address the problem of social cohesion? I will briefly touch on three key areas of action. The first is leadership. We have heard that, nationally, we all have a responsibility in this place and across our institutions to show leadership.”
“It is a pleasure to serve under your chairmanship, Dr Murrison. I thank my hon. Friend the Member for Rugby (John Slinger) for securing this important and timely debate. Social cohesion can feel like quite an abstract, nebulous term, but we all know, and have heard today, that the practice of social cohesion and how it is lived are vital for healthy, dynamic and thriving communities where people feel that they want to stay, live, socialise, invest and start and grow businesses. When we have the opposite of social cohesion, we have discord and division. Unfortunately, we are increasingly seeing that in many of our communities. We have heard countless examples of how that is lived out. We very much see the opposite of social cohesion present in my community in Hillingdon. We see instances of hate crime.”
“I welcome the statement, and the Government’s response in the Green Paper, particularly the commitment to 11,500 branches—branches will be focused on high streets—and the focus on accessibility. In the light of that, does the Minister agree that it is ridiculous that the Uxbridge post office branch is set to close in May? Today, we found out that TG Jones, the current operator, has withdrawn from the contract for a future branch, and has ended its search for a replacement. Will he join me in urging Hillingdon council to pull its finger out, stop blaming others, and do all that it can to secure a new site, using its own assets if necessary, and in urging the Post Office to ensure that we maintain a post office in Uxbridge town centre?”
“My predecessor, Boris Johnson, promised much that never seemed to materialise, locally as well as nationally. My hon. Friend is right in his assertion that we have seen significant economic impacts. Pharmaceutical companies in my constituency talk about double administration and double testing of the exports of drugs now, with the need to go through both the European and UK medicines agencies for approvals. They say that has directly harmed investment and jobs in the UK. Does my hon. Friend share my concern about that?”
“The post office in Uxbridge provides vital services to my constituents. It gives access to banking services, to Government forms for applying for passports or driving licences, and to general postal services. That is why residents were horrified to hear that the post office will close at the end of May, with no replacement in sight, and that when the council approved the redevelopment of the building, it made no provision for a new post office, and placed no conditions on the developer to find a new site for a post office in the town centre. Does the Leader of the House agree that this simply is not good enough, and will he make time for a debate in this place about the vital role of community postal services?”
“The hon. Member is very generous with his time. I always have a lot of time for him. He is talking about our constituents in Hillingdon. Is it not the case that the financial settlement of the previous Tory Government, which also included council tax, had a 7% cut to core spending power for our constituents in Hillingdon? This spending settlement has almost a 40% increase in core spending power for our constituents. [ Interruption. ] hon. Member seems rather depressed about this announcement. Surely that is fantastic news for our constituents. Does he not agree with me that thank God we have a Labour Government for Hillingdon?”
“My hon. Friend makes an excellent point. Rightly, this Government are putting more money back into local government for the first time in many years. That is long overdue, but that money has to be well spent. Unfortunately, what he describes in Harrow is quite similar to the experience of my residents in Hillingdon. The independent auditors are quite damning about the council’s budgeting approach. Millions of pounds have been misallocated, and there were no opening and closing balances, well into the financial year. It was recently reported by the press that the council, in a secret deal, had written off a former Tory councillor’s debt, all while applying for exceptional financial support from this Government, so I completely agree with him. Do we not need more independent oversight and audit of local government finance?”
“I am an MP with a Conservative council, and a colleague from the Conservative Croydon council area— [Interruption.] Conservative Members cheer; unfortunately, it is a bankrupt Tory council, but luckily this Government are stepping in, have followed the deprivation and the need, and are properly funding that council, regardless of its political colour.”
“I have been contacted by over 400 of my constituents who are calling for greater regulation of social media and young people’s use of it. There is disagreement about whether there should be a full or partial ban, and the exact age at which it should be introduced. Regardless of where the Government’s consultation leads, there will be a cliff edge, and young people will, at some point, start to engage with the digital world. With that in mind, what engagement is the Department having with the Department for Education’s curriculum review to give young people the skills, information and support they need to identify online harms and misinformation?”
“My hon. Friend is making an excellent speech about an issue that is important to many of us. He talks about masked thieves. Councils have the power to ban face coverings, particularly in town centres, by introducing public space protection orders. Does he agree that councils should work with the police to do that where appropriate? Is he as shocked as I am that Hillingdon council is refusing to ban face coverings in the town centre, despite the community and the police asking it to do so for exactly the sorts of reasons that he mentions?”
“I was recently contacted by a constituent whose daughter was the victim of an abusive and violent relationship for many years. There were continual delays in the case coming to court, and then again at the sentencing stage, including a five-month delay in sentencing due to mental health assessments being delayed, as well as barrister annual leave and other issues with staff availability. That led to the repeated cancellation of sentencing dates, which meant that the victim constantly had to relive deeply traumatic events over and over again. What steps is the Minister taking to address those preventable issues, which are causing delays and misery for victims such as my constituent?”
“I welcome the Government’s announcements about new sanctions on individuals responsible for the brutal treatment of protesters and the vile murder of 30,000 people, but human rights abuses on this scale are never the responsibility of a handful of individuals. They are systemic; they are state-wide actions. That is why I would like to press the Minister again about the decision to proscribe the Islamic Revolutionary Guard Corps. I know that the legislation would need to be drawn up carefully, but this House rapidly passed emergency legislation to save British Steel and, more recently, to update medical training regulations. Can the Minister confirm that we are moving at pace to introduce emergency legislation that fully proscribes the IRGC? Can he also update us about the UK’s efforts to bring this matter to the UN Security Council?”
“Friend agree that we need to accelerate things such as the health visitor pilot for delivering vaccinations? We heard positive things about that in the Committee, but progress has been slow. Does she agree that we need to accelerate those actions already in train? Does she agree that we should restore the World Health Organisation target of 95% vaccination uptake nationally? Finally, does she accept that the last Government’s vaccination strategy, developed in 2023, has clearly failed, considering where we are today? Does she think that the Government need to look again at a new national vaccination strategy so that we can get back to where we once were and then make more progress, ensuring that every child has the vaccination they need to protect them and to live a healthy and fulfilling life?”
“I thank my hon. Friend for today’s statement and for her excellent work in chairing the Committee’s important inquiry. It is much appreciated. There is much to welcome in this report. Colleagues have already touched on a number of the measures, so I will focus in particular on vaccination. The state of vaccination rates in this country shocked me during the inquiry. I think we all came to accept the success, the prevalence and the uptake of vaccinations, but now, for a number of reasons—including disinformation, some of which comes from elements in this Chamber—vaccination rates have been declining across the board for many years. This week, the UK lost its measles elimination status, which is shameful and an indictment of the situation in which we have got ourselves. In the light of that, does my hon.”
“Today’s news is welcome for leaseholders in my constituency, whose ground rents—often of £400 or £500—escalate throughout their leases. The measures will save them thousands of pounds throughout their leases. In my time as an MP, I have been shocked by the behaviour of managing agents. There is strong support in this place and the other place for Lord Best’s recommendation for a proper regulator of managing agents. Will the Minister outline what steps will be taken, and what the timeline is, for action on managing agents?”
“I am sure that they will continue to serve our national health service with dedication and commitment, and I am sure that the whole of this House is thankful for their service. As we have heard, however, it is absurd that thousands of British doctors trained by our NHS at great expense, funded by the British taxpayer, are currently unable to find jobs in the NHS after graduation. In a time of crisis for the NHS, we do not have a penny to spare, and every pound needs to go even further. It is a great waste of talent and capacity, and it is not fair to young doctors in the system, who are being beaten to entry-level NHS positions by doctors from overseas with decades of experience.”
“Member for Oxford West and Abingdon (Layla Moran), and others who have spoken—we often hear about the need for a proper workforce plan to address the NHS’s long-term issues with training and development, which frankly have failed staff and patients. It is important to reflect on, as others have, the important and vital contribution that doctors and nurses from around the world have made. That is the case in my constituency at Hillingdon hospital, and in GP and community-based health services. My mum recently had a stroke and, fortunately, recovered from it at University College London hospital in central London. As ever, it was doctors, nurses, speech therapists and allied healthcare professionals from almost every country around the world who helped and supported her to recover.”
“I thank the Secretary of State and the Minister for the Bill, which delivers on the promises made previously in this place in response to the proposed industrial action a couple of months ago. It is welcome to see the pace with which the Government have moved in progressing these important changes. It shows their commitment to backing doctors and medical professionals in this country. There is a lot to welcome in the Bill’s provisions. Members have talked at length and with a lot of personal and professional expertise about the challenges of the medical training system. As a member of the Health Committee—alongside the Chair, the hon.”
“I also ask that officials have discussions with Maltese counterparts about our important and ongoing strategic relationship in health and other key areas. To conclude, there is much to welcome in this Bill. I know that medical colleges and societies strongly support many of the provisions. I hope that they will be the start of a broader process of a comprehensive workforce plan that will address the many challenges in workforce planning, training and development and the numbers of bottlenecks that exist throughout the workforce system so that we have a training and development system for medical professionals in this country that delivers both positive results for patients and better and fairer outcomes for those applying to study, learn and train.”
“However, if the Bill’s current wording is interpreted strictly geographically instead of institutionally, it would mean that she is categorised as an international medical graduate, despite being a British citizen, studying a British medical degree at a British university. I ask the Secretary of State to take away this point and, with officials, to look at this specific issue in greater detail and at modelling and sharing the number of UK citizens projected to be affected this academic year by those changes. If, as has been suggested by Queen Mary University, this is a matter of 40 or 50 individuals, I ask the Secretary of State to look at whether further changes could be made to ameliorate the impact on UK citizens, at least in a transitional way, that would not bind us in future academic years.”
“When she enrolled last year, she was given a guarantee by the university that she would face no disadvantage compared with students on the London campus. We have heard that there can never be any guarantees; that there is not a legal contract that this Government make with individuals; and that this House is sovereign, and can make different decisions. But I think there are issues of fairness around the retrospective applications of decisions that we make that can affect people’s lives, particularly at crucial points, such as when studying or getting a job—decisions that have major impacts on someone’s future life chances. Alisha studies a British curriculum and she will be awarded the same degree qualification as her peers on the London campus.”
“Member for Mid Dorset and North Poole (Vikki Slade) raised, I will press the Secretary of State—and the Minister for Secondary Care, who is now in place—on the specific language of the Bill, which seeks to prioritise graduates from medical schools in the United Kingdom, rather than UK citizens who are medical graduates. Like other Members, I have been contacted by a number of my constituents who will be affected by these provisions. That includes Alisha, a British citizen who was schooled and grew up here; her family live in Ickenham in my constituency, and she is a first-year medical student at Queen Mary University of London’s campus in Malta, which my hon. Friend the Member for Stevenage (Kevin Bonavia) mentioned earlier.”
“I am about to turn to a specific issue about British citizens, so I hope I will pick up on the hon. Member’s points. More generally, there is nothing progressive about a system that promotes a brain drain from some of the most deprived and underdeveloped communities in the world, with significant health needs. To have doctors and nurses come from those systems on an industrial scale, and to take away the resources spent in those systems on education and training for our benefit in a western, developed country, is not progressive. It is important to welcome the provisions in the Bill that address those challenges. As the hon.”
“I hope the Minister will confirm that the new housing that is delivered will also be given as first preference to military and former military personnel. Our cadets, reservists, and armed forces personnel and their families are absolutely vital to our national security. I strongly support the progress of the Bill, so that we honour our commitment to them that they will have the pay, conditions, homes and equipment that they need to continue to perform their vital role.”
“We saw that change start to bear fruit towards the end of last year, and I was pleased to welcome the Secretary of State to view 100 properties being modernised in my constituency, with new doors, windows, decoration, kitchens and other improvements. It was an absolute privilege to see that work take effect. I hope that the new housing service will have a broader remit than just bricks and mortar; I hope it will also be about investing in the places where these homes exist, in play facilities for children and in utilities, such as fibre-optic broadband, which are often missing in our defence personnel housing. I welcome the Bill and the improvement to existing homes, as well as the commitment to better use under-utilised land to generate capital receipts to reinvest and provide much-needed homes for local people.”
“Although there is light at the end of the tunnel for military families living in forces accommodation, it is deeply shameful that we ever got to this place. The Conservatives left defence housing in an absolute mess. In 2023, satisfaction with service family accommodation hit a record low, with one in five service personnel satisfied with repairs and maintenance. Only now, under a Labour Government and with a deal negotiated in the first six months of office, have nearly 36 forces family homes been bought back into public ownership and we are rightly improving their condition. As a result, nine in 10 military homes will be modernised and upgraded with new higher standards, lifting the living standards of hundreds of families in my constituency.”
“In Uxbridge and South Ruislip we have 518 military family homes, which is the fifth-largest military housing stock of any UK constituency. Having spoken to many families over recent years, and having seen at first hand the conditions they have to live in, I find it shocking that their experience of military housing often falls far below what we in this House would all expect for our own homes. Damp, mould, disrepair, cracks in walls big enough to put your hands in—it is truly shameful. I am therefore particularly pleased that through this Bill the Government are delivering on their commitment to reverse decades of under-investment and to end the scandal of poor-quality military housing.”
“They are the best and bravest among us, and they continue to put their lives on the line for our collective security in the west. I am proud of them and I know this House is proud of them. The Bill is part of our re-commitment to them not just in words, but in action. Uxbridge and South Ruislip has a proud and long military history and connection. It was a key base from which we fought and won the battle of Britain, and today it is part of our present and future armed forces capabilities. It is home to RAF Northolt and the nearby Northwood Headquarters military base, and it has a significant military community. I welcome the creation of a new, publicly owned Defence Housing Service, backed by a £9 billion armed forces housing strategy to build, renew and repair thousands of military homes.”
“I am pleased to speak in this evening’s debate on the Armed Forces Bill, which shows that this Labour Government put our forces and veterans and their families first. In the light of recent international events and increasing global instability, we have an almost daily reminder, when we turn on our televisions screens, that our brave men and women are the first port of call and our last line of defence in times of conflict and instability, so it is entirely right that as we increase our investment in equipment and defence facilities, we also invest in our No. 1 military asset: our defence personnel. We should also be clear, in the light of the recent reprehensible comments from President Trump, that UK and other NATO country military personnel have always been there when called upon.”
“T3. Wealdstone FC is a fantastic, fan-led club in my constituency, but it is again facing an uncertain future because of protracted negotiations over the lease of their current ground. Does the Minister agree that it is vital that the landowner engages in good faith with the club, and will she meet me to discuss how we can give the club the stability and security off the pitch that they need to succeed on it?”
“Last week was the seven-year anniversary of the death of one of my constituents’ sons, Kieran Patel. Unfortunately, the House has not given me time to do justice to his story. His mother Manjo was in touch with me last week and shared the horrific experience of the loss of her much-loved and talented son, who was a medical student at Southampton University. We have heard many horrific stories of potential that has been cut short today. Manjo and other family members left behind would like to know that the action that the Minister is outlining will take place with urgency. The Minister has pointed to a number of previous reviews, debates and discussions. Can he confirm that the Government are seriously looking at a statutory duty and all possible levers to ensure that no parent has to experience a tragic loss like Manjo’s again?”
“There should be a duty and responsibility on airport authorities to collaborate on issues like transport displacement with the local authorities in which they are based. Lastly, there should be real clarity in the design and communication of any measures. Like others, I recently drove to the airport to pick up a friend who had missed the last train and drop him off at a different tube line. It was incredibly difficult to work out exactly what is and is not within the drop-off charge zone, and where the ANPR cameras are and where they are not. The signage and communication are incredibly poor, both before and after the journey to the airport. I hope the Minister will consider those points and ensure that if drop-off charges are to continue, they work for local residents and the surrounding communities.”
“They are struggling to make ends meet given the cost of living crisis and the increasing charges that they and their customers have to bear. They feel under-engaged and under-consulted by the airports; as important stakeholders, they clearly should be engaged and consulted. I hope that the Minister, in considering the many issues raised today, will also consider the role that could be played by better guidance and regulation on charges. In particular, will he look at the options for making it clear that the funds raised through such mechanisms must be spent on alternatives to driving to the airport? There has to be transparency about the funds raised and how they are spent because, as many Members have said, it is very hard to get that information out of the airports.”
“The smaller, infrequent buses make it difficult for people with luggage to travel. With the introduction of the Elizabeth line, we have seen a really positive improvement in transport connections, but it is ultimately the taxpayer who has led investment on that route. There is concern and frustration that as Heathrow potentially expands—a lot more will be said on that should proposals come forward—it will again be the taxpayer who continues to fund public transport options, rather than Heathrow airport making an adequate contribution. As has been said, self-employed people who work for Uber, and other app-based drivers to the airport, have reported feeling increasingly squeezed by the increasing charges.”
“There is also a significant increase in unregulated car parks popping up on private land, where people sell parking at competitive and preferential rates, leading to significant impacts on local communities. I agree that airport charges could support alternatives that discourage people from driving to the airport, along with the related impacts, but all too often we do not see the investment following the charges. In Heathrow’s case, the transport funds that the airport hold are unspent, and a large amount of investment has not been put back into improving local bus routes. Bus connections from my community to Heathrow are incredibly poor, both for airport visitors and for staff, who have to take indirect routes to get there by bus, on infrequent services and undercapacity routes.”
“In my constituency, given the nearby bus routes and the Elizabeth line connection at West Drayton, people are clearly getting around drop-off charges by parking in and around airport communities, causing a huge amount of frustration and nuisance. That has led to local authorities, such as Hillingdon and many others, introducing controlled parking zones, which charge residents significant amounts to park in their own streets to avoid the impacts. Even then, CPZs are only as good as the enforcement. We have a massive issue with parking enforcement, particularly out of hours, at evenings and weekends. People park in streets and neighbourhoods, often blocking residents’ drives, and there is no enforcement activity.”
“It is a pleasure to serve under your chairship, Ms Vaz. I thank my hon. Friend the Member for Bolton South and Walkden (Yasmin Qureshi) for securing this important debate for airport communities. Residents in my constituency know very well the impacts of airports, with Heathrow on our doorstep. The recent decision to increase the drop-off charge at Heathrow from £6 to £7 has been met with increasing frustration. Another issue mentioned in respect of the impact of airports on nearby villages is displacement. All too often, significant numbers of vehicles park in and around the Heathrow drop-off zone. If my right hon. Friend the Member for Hayes and Harlington (John McDonnell) were here, he would vividly describe the impact on Heathrow villages of the antisocial parking of people who are avoiding drop-off charges.”
“I am just a bit confused. The hon. Member suggests that drop-off charges are the responsibility of this Government. At Heathrow, the charge is £7, but it was £6 during the 14 years of the last Government, so proportionally—following his argument—90%, or whatever the maths says it is, of the cost came from the last Government and only 10% from this Government. I do not exactly follow the logic of his argument.”
“Community audiology offers a practical evidence-based opportunity to improve access, quality and value for money, but realising this opportunity will require national leadership, clear standards and some sustained investment. I thank all Members and the Front-Bench teams for being here. I hope the Minister can address the issues in his response. If we are serious about prevention, reducing health inequalities and delivering care closer to home, then community audiology must be part of the conversation. I hope that, as we do so often in this place, we can all say “Hear, hear!”, not only as a mark of agreement, but as a promise of a better future for hearing services in every part of our country.”
“Fifthly, the framework should require sustained investment in the audiology workforce, including for expanded training places, improved retention measures and the implementation of the Kingdon review’s recommendations on professional registration and governance. Finally, it should require action to ensure equitable access to core interventions such as earwax removal, so that access to basic hearing care is not determined by postcode or ability to pay. Audiology services may not often feature prominently in political debate, but they matter deeply to millions of people. They matter to older people striving to remain independent, to working-age adults seeking to stay in employment, and to children, whose language, development and life chances depend on early and effective intervention.”
“Secondly, the framework should mandate system-wide quality assurance for all NHS-funded audiology services, regardless of provider, building on existing frameworks. Thirdly, it should require a clear national direction on the movement of audiology services into community and neighbourhood health models, setting out how services should integrate with primary care, ENT, social care and broader support services. Fourthly, it should require the reinstatement of referral-to-treatment waiting time reporting for audiology, so that performance is transparent and improvement efforts can be properly targeted.”
“NHS England is supporting providers and ICBs to improve audiology services through capital investment, upgrading audiology facilities, expanding testing capacity via community diagnostic centres, and direct support through the national audiology improvement collaborative. All those developments are welcome, but clearly there is much more to do. We now need a coherent national framework that gives audiology the strategic attention it deserves. That should include, first, a national commissioning framework for audiology services, including standardised tariffs and activity planning to reduce unwarranted variation and ensure that services are commissioned on the basis of patient need rather than short-term financial constraints locally.”
“This is incredibly important given the predicted increase in demand for services, and I hope that audiology services, and community and primary care workforce issues more generally, will feature centrally in the Government’s promised new workforce plan, as we seek to shift activity away from secondary care towards primary and community-based care. I welcome the steps the Government have taken to move forward improvements in audiology services. The commissioning and publication of the Kingdon review was a very helpful step. The 10-year health plan for England, published in July, committed to enabling self-referral to clinical audiology, using the NHS app where appropriate, which is welcome.”
“There are fewer than 10,000 audiologists and hearing therapists in the UK, and work by the National Deaf Children’s Society and the British Academy of Audiology found that 48% of audiology services have seen a decline in staffing since 2019, equating to an overall reduction of around 8% of the total workforce. The Kingdon review described the audiology workforce as having been “neglected for years”, with low status, poor professional representation, limited governance and insufficient investment in research and training and development. Coherent workforce planning could be facilitated by the introduction of a single professional register for audiologists, as well as a much more consistent approach to professional development, training pathways and retention measures.”
“NHS England recently decided to stop referral-to-treatment waiting time reporting for audiology services, which has removed visibility of the full patient pathway. Diagnostic data suggests that audiology is now a poorly performing diagnostic service, with over 70,000 people waiting and some regions experiencing delays of more than 40 weeks. Without consistent data, commissioners and providers, and policymakers such as us, simply cannot understand where pressures are greatest and where intervention is needed most. Like many areas of community services, audiology services are also seeing significant workforce planning issues.”
“Following a change to the GP contract in 2012, it was no longer designated as a core service, and now, over a decade later, the majority of GP practices no longer provide it. As a result, patients who cannot self-care or self-fund their treatment in a private setting often have no option other than to refer themselves to specialist hospital ENT services when the problem gets much worse, unless they live in one of the very small number of ICB areas that do still commission the service as part of the community audiology pathway. Wax removal is a simple, basic procedure, and it is nonsensical that it is not always delivered in the community. Data collection and oversight is also extremely poor.”
“While many independent and third sector providers deliver high-quality services, there is clearly variation in quality of service, and currently no mandatory system-wide quality assurance requirement for all NHS-funded audiology provision. That lack of oversight has also led to certain services falling through the gaps of NHS provision. The starkest example is earwax removal, about which I am sure many of us will have had emails from our constituents. It is perhaps not the sexiest of issues, and not one that we often like to talk about. I will hold my hand up: I have had earwax removal several times—historically from my GP, and more recently in private Specsavers-based settings—so I can speak at first hand about the impact of these services, or the lack of them. Historically, wax removal was carried out by GPs and nurses in GP practices.”
“In some areas, audiology service tariffs have been set below the cost of delivering care, which has forced some providers to reduce and compromise service quality by, for example, cutting follow-up appointments, outcome measurement and rehabilitation support. In some areas, local commissioning within limited financial envelopes has resulted in activity caps based on financial envelopes rather than patient need, resulting in predictable waiting list growth. Some services have reportedly been asked to reduce throughput or pause the issuing of hearing aids entirely in order to remain within their contractual limits. This practice undermines the principle of care based on clinical needs and risks storing up greater costs for the future. The lack of national oversight has produced issues with quality assurance.”