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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“As I have said, only 30 of 42 ICBs commission adult community audiology services. In around half those areas, coverage is only partial, and in 12 ICBs no service is commissioned at all. In those areas, patients who are concerned about their hearing must first visit the GP and then be referred to a hospital-based service. As I have set out, the lack of community provision leads to longer waits, poorer services and more expensive provision in some areas of England. NHS England’s 2023 guidance encouraged direct access and self-referral to audiology services to reduce pressures on GPs, yet evidently not all ICBs have implemented that guidance. Local commissioning and tariff setting has also created substantial inconsistencies in tariffs.”
“That is apparent from the fact that, astonishingly, the Kingdon review found that there is no national audiology lead in the Department of Health and Social Care, resulting a lack of ownership and accountability for the performance of services. It found that communication between the DHSC and NHS England on known service issues did not meet expected standards. I hope that the merging of the functions of NHS England and DHSC will be a key opportunity to resolve those challenges. There is patchy coverage of audiology services throughout the country, with a significant postcode lottery of access. NHS audiology services are commissioned locally by ICBs, with tariffs set locally. Although local commissioning can support responsiveness to local needs, in this case it has resulted in wide variation in availability, quality and value for money.”
“However, despite the opportunities, there remain several structural barriers to the rapid roll-out of community audiology services in every area. The recent Kingdon review of children’s audiology services set out many of the barriers in great detail. Its findings, which I would argue are relevant to audiology services in our country more generally, can be summarised in the words of the introduction: audiology is “a ‘Cinderella’ service…often overlooked, undervalued and underfunded.” The most significant issue is that the current system is fragmented and inconsistent, with a clear lack of national oversight.”
“Lastly, audiology provision in the community, especially models that enable patient self-referral without a GP appointment, are better for patients. They empower patients and support the early identification of hearing loss. They reduce travel time and other geographical barriers to access, particularly for older people and those with mobility issues. Community audiology services are particularly impactful for deaf children and their families. Children with hearing loss issues require more frequent appointments than adults—for example, to replace ear moulds for hearing aids as they grow—so community provision with appointments closer to home is particularly helpful for those families. Taken together, the case for driving a quick shift to community-based audiology is clear.”
“For example, the ICB in my constituency in north-west London commissions community audiology services, with self-referral across our whole area, providing a more consistent and accessible model than many parts of England have today. Fourthly, delivering audiology in community settings assists the preventive healthcare agenda. People are not always forthcoming about seeking help for hearing loss. On average, it takes around seven to 10 years to acknowledge hearing loss and seek help, meaning that by the time most people present to services, the impact on their health and wellbeing can already be significant. Any barriers or difficulties in getting help can put people off asking for it, further delaying treatment and increasing their personal risk of things such as dementia, falls and mental health challenges, which I have outlined already.”
“Thirdly, because audiology services are commissioned at a local level by integrated care boards and have in some cases already been transferred to community services, community audiology is not a new concept. We already have many good examples of good practice to build on, but unfortunately provision is variable and patchy. Thirty of the 42 ICBs in England already commission community-based services, with NHS services delivering assessment, hearing aid fitting, rehabilitation and long-term aftercare in primary care settings, community hospitals, outreach clinics and high street locations. Those services are delivered in partnership with GPs and private providers such as Specsavers.”
“She has been waiting around a year for a specialist appointment and follow-up at NHS ENT services to have the issue resolved. Shifting less complex cases out of secondary care settings would mean more capacity, more appointments and quicker health for my constituent’s wife, and many more people like her. Secondly, delivering audiology services in community settings is far more cost-effective. Research by the University of York found that NHS adult audiology pathways delivered by community providers cost between 15% and 25% less than the same pathways delivered by an NHS hospital-based service. There is an obvious financial case for reform to a community-based model.”
“That is difficult to justify clinically or operationally, and sending those patients through complex hospital pathways places unnecessary pressure on ENT services, contributes to longer waiting times and is an inefficient use of specialist capacity. Instead, such procedures can be managed in a safe and effective way by audiologists in community settings. Just this morning, as if perfectly set up for this debate, I met a constituent at the Christmas present-wrapping event for the fantastic ShopMobility charity in Uxbridge. This gentleman shared with me his wife’s experience in accessing audiology services in our community. His wife faces a more complex hearing issue—not something run of the mill that could be dealt with on the high street—that requires specialist intervention.”
“That means that at the age of 50, around 50% of people will experience some level of hearing loss, while 80% will by the age of 80. As our population ages, the pressure on audiology services will grow. As we embark on our mission to rebuild our NHS so that it is a first-class health service fit for the 21st century, it is crucial that we get our approach to audiology services right and in line with the Government’s three key shifts. Audiology is exceptionally well suited to a nationally directed, community-based model for care, for five key reasons. First, most audiology services are low-risk procedures that can be easily carried out in community-based settings. Currently, 50% of national referrals to hospital ear, nose and throat teams are for uncomplicated non-surgical procedures such as earwax removal and age-related hearing loss.”
“In the context of an ageing population and the growing prevalence of dementia, that statistic alone should place hearing services firmly within our prevention agenda. There are significant economic implications to poor service provision. The UK loses an estimated £25 billion a year in lost productivity and unemployment as a result of untreated hearing loss. On average, a person with hearing loss will see around £2,000 less a year than a non-disabled person, and 40% of people with hearing loss will retire early due to the challenges of communicating at work. The demand for audiology services will only increase over the next few decades. The incidence of hearing loss increases by approximately one percentage point for every year of life.”
“Untreated hearing loss has far-reaching consequences for physical and mental health, independence, employment and social participation. People with hearing loss are 2.5 times more likely to experience mental ill health related to social isolation and difficulties finding employment. Elderly people with hearing loss are 2.4 times more likely to experience falls, which in turn increases the risk of hospital admission, loss of independence and long-term care needs. Untreated age-related hearing loss is one of the single largest modifiable risk factors related to dementia. Evidence suggests that treating adult-onset hearing loss between the ages of 45 and 65 reduces the incidence of dementia by 7%.”
“Hearing loss is a serious issue—it is not a mild inconvenience—and it can be life-changing. It has a profound impact on the lives of millions of people across England and on the effective functioning of our health and care system more broadly. Audiology services diagnose, treat and support people with hearing loss and deafness. They are critical to the quality of life and health of a significant proportion of constituents in all our communities. In 2024, 5.8% of people in England reported deafness and hearing loss. Although 94% of hearing loss is related to ageing, that is by no means the only patient group affected. In particular, I note that children’s audiology services are incredibly important to the life chances of children who are born deaf.”
“I beg to move, That this House has considered community audiology. It is an honour to serve under your chairmanship, Mr Vickers. I thank those who have joined us for the debate and the Front-Bench teams for giving up their time to put in the final shift of this sitting just before Christmas. I realise that I may not be on many people’s Christmas card lists after detaining them to the bitter end, but I appreciate their giving up their time and responding to this important debate. I am grateful to the Backbench Business Committee for securing this debate on community audiology, an under-discussed topic and a very important one in our communities. Hearing and hearing loss are often the subject of stigma and shame, and sometimes light-hearted jokes in the media and film.”
“I also welcome his recognition of the need to deal with the issue of variation across the country. In his response, he mentioned the key opportunities in developing the workforce plan, which we expect in the spring, and this Government’s broader neighbourhood health agenda, and I hope that audiology will feature strongly in those developments. Thank you, Mr Vickers, for your time and the Clerk for their time. I wish everyone a merry Christmas and a happy new year. Question put and agreed to. Resolved, That this House has considered community audiology.”
“Friend the Member for Bury St Edmunds and Stowmarket (Peter Prinsley) made a powerful point about the importance of quality assurance of services. Yes, we want more community access, but it needs to be quality community access. I thank the shadow Minister, the hon. Member for Hinckley and Bosworth (Dr Evans), and the Minister for their kind remarks. I thank the Minister for visiting what he called the fantastic development of neighbourhood health services in Hillingdon. We are fortunate in that, as well as the developing neighbourhood hubs, we have an ICB community-based audiology service. Hillingdon is very fortunate in having community audiology services, and I hope such services will be provided in all ICB areas. I welcome the Minister’s recognition of the importance of self-referral and the Government’s continued commitment to it.”
“We certainly heard about some issues today that I did not expect to be on the agenda. The waxiness or not of dogs’ ears will certainly stay with me for a while. I am glad that the hon. Member for Winchester (Dr Chambers) clarified that he is a vet. I wondered whether checking dogs’ ears was a particularly Lib Dem thing to do to, so I am glad he clarified that he does it professionally rather than personally. We have had contributions from experts across the health sector and experts by experience of hearing loss, and I think we covered many of the key issues for audiology, such as workforce challenges and occupational hearing loss, as well as rural areas, regional variation and unacceptable delays. My hon.”
“They are seeking unregulated providers of these drugs, so is not a clinical trial both appropriate and the best and safest way of managing any potential risks?”
“The hon. Member for Sleaford and North Hykeham (Dr Johnson) asks, “Why?” Well, it is because trans people exist and their health needs exist. As the Secretary of State has clearly outlined, an independent review made a series of recommendations. There were clearly failures of healthcare, and a further recommendation was that a clinical trial should address this issue. I believe that the Conservatives supported the Cass review, but when it comes to implementing this part of it, they suddenly have collective amnesia about what Dr Cass recommended. Does the Secretary State agree that, in the absence of a trial, there will still be access to these drugs? We know that young people are seeking out private provision.”
“I encourage the Minister to see what the NHS can do to support trans-led health organisations within it. Unfortunately and increasingly, a hostile environment is being developed across much of the media. It seeks to erase the existence of trans people from our past, present and future. It is vital that we speak up about their existence, and about the experience of our constituents. I have been contacted by many of my constituents who are trans to detail the impact that the media, political and public discourse is having on their lives. I welcome this debate as part of resetting that discourse in this place and in our society. Fundamentally, this is about treating all people with dignity and respect, and about recognising that trans people exist, as do their health needs.”
“It is unacceptable that those who have waited years or decades for initial appointments, who have jumped through all the hoops possible to get NHS gender care, and who are finally in receipt of NHS prescriptions from NHS doctors, are then in practice unable to receive a prescription because their GP has unilaterally decided not to perform blood monitoring tests and provide that shared care support. It is vital, as has been said, that we ensure access to a range of health services beyond gender-specific needs, whether sexual health services, reproductive health services, or primary and secondary care more generally. The voluntary and community sector, including trans-specific groups, perform a vital role in providing services, brokerage, networking and support in the health service but they are often poorly funded.”
“Once a gender clinic deems a trans person’s medical transition complete, it discharges them from its care to that of the GP, who will then authorise hormone prescriptions and contact the clinic about any issues. However, GPs in my constituency —and many that we have heard about in this debate—are increasingly refusing to enter into shared care agreements. The rate of such rejections has gone up from 5% to 21% in the last 12 months. Will the Minister therefore commit to clarifying the roles and responsibilities of different NHS services for the provision of gender-related healthcare?”
“We have heard much in this debate about the delays in receiving this care and the devastating impact that has on the lives of transgender people. With that in mind, I would like to ask the Minister whether waiting times for transgender patients are included within the current target to cut waiting times to 18 weeks by the end of this Parliament. Can she commit specifically to decreasing the length of waiting times for gender care by the end of the Parliament? The second issue that I want to raise—which we have heard about already—is the operation of NHS gender care services more generally, and shared care as an important component of them.”
“It is an honour to serve under your chairmanship, Mr Turner, and I thank my hon. Friend the Member for North Warwickshire and Bedworth (Rachel Taylor) for bringing us this debate. I am proud to call her a colleague and a friend. She is an exemplary part of the LGBT movement, and I am proud to associate myself with her and her comments in this debate. We have heard already about the extraordinary length of waiting lists for gender-affirming care. Based on current appointment rates, a trans person can expect to wait an average of 25 years across the UK for an initial appointment to start gender-affirming care. That is simply not good enough, and we would never accept this in any other patient category in our NHS.”
“Will the Minister and his team meet me to discuss the adequacy of the support available in the UK, and how we can stop playing politics with this complex historical issue and continue to find solutions?”
“I welcome the Minister’s clarification that the Chagossian community will be involved in the operation of the trust fund. Turning to support in the UK for the Chagossian community, which is a significant issue, the previous Government—including Conservative Members who now sit on the Opposition Benches, pretending they have no idea where some of these issues come from—legislated in 2022 to expand the rights of Chagossians to settle here in the UK and to claim citizenship up to 2027. I represent the port authority of Hillingdon, and we are seeing a significant movement of people based on the historical rights given by the Conservatives without adequate planning.”
“I welcome the Government’s new approach to Africa and the shift from discussion of the continent and our role as donors to that of investors and partners. In the last 50 years we have seen the importance of Asia, with the tiger economies of India and China driving the global economy. It is quite clear that the next 50 years will be an African future, with demographic growth, economic growth and the role of critical minerals and other resources in Africa. I welcome recognition of the importance of that in the approach. In the light of the continent’s growing importance, will we see a shift in FCDO and diplomatic resources to ensure that our resources to discuss and build those relationships align with the new strategy and the continent’s importance?”
“First, I associate myself strongly with the Secretary of State’s comments about today’s regrettable decision by the BMA and its members. In the light of the pressures of flu and RSV, does my right hon. Friend think it is time to ask the Joint Committee on Vaccination and Immunisation to look again at its recommendations on the ages at which the two vaccines are made available? Specifically on RSV in infants, does he think it is time to ask NHS England to look again at the decision to switch from an infant-based delivery model to a maternal-based delivery model on the ground of cost, without taking into account the lower infant RSV vaccination uptake now?”
“To achieve this, does the Minister agree that, first, NHS trusts will have to start accurately counting those in hospital who are homeless, which shockingly does not already happen; and, secondly, that more support teams such as the wonderful Pathways teams in many trusts need to be rolled out across every eligible hospital trust?”
“I thank the Minister for announcing a bold, radical and ambitious plan—much needed after the appalling record of the last 14 years—to end homelessness. I draw her attention to the target for eliminating the use of B&Bs for families. Having grown up in temporary accommodation and spent time in bed and breakfasts, I know that this is long overdue, so I thank the Minister. The strategy is a major undertaking and will require cross-Government working. As a member of the Health and Social Care Committee, I am pleased that the awful practice of discharging people back to the street will end under the plan.”
“T10. Around 700 young people in Uxbridge and South Ruislip are not currently in employment, and that needs to change. I have met the local college, the jobcentre and employers in Uxbridge, and they are keen, eager and willing to support the establishment of a youth jobs hub in the constituency. Will the Secretary of State outline what support is available in constituencies such as mine to set up youth jobs hubs, so that every young person can reach their potential?”
“There has been a significant increase in unmanaged houses in multiple occupation in Hillingdon. Despite calls for proper licensing, the Conservative council has taken 15 months just to bring forward a simple consultation. During that time, there has been additional antisocial behaviour, crime and significant community concern. Does the Leader of the House agree that residents deserve better than this? Can we make time in this place for a debate about a proper national regulatory framework for HMOs?”
“Does he support me in encouraging councils to adopt those public space protection orders to prevent this crime and to make it easier for councils to pass those measures?”
“I thank the hon. and gallant Member for securing this important debate. As in his constituency, significant amounts of wildlife crime are being reported by residents of Uxbridge and South Ruislip. I recently met with the Save our Swans group and the Royal Society for the Protection of Birds. The horrific events that he describes in Spelthorne are also common on the canals and rivers in Hillingdon. Does he agree that prevention is better than cure, and that taking these catapults off people before crime has happened is vital? Does he also agree that there is a role for public space protection orders, which councils can introduce, to ban the possession of catapults and other items in public spaces?”
“I thank my hon. Friend for his excellent advocacy on this issue, which is much appreciated across the House. In Uxbridge and South Ruislip, which has a significant and important BNO community, I recognise the concerns that he has outlined. I welcome the fact that the Government have moved, but does my hon. Friend agree that, under the amended proposals, so few BNO holders qualifying for ILR would have a real impact on people’s ability to access student finance and study in the UK, and to integrate into society, and that people being unable to access their pensions back in Hong Kong would have a massive economic impact?”
“Hillingdon council has applied for exceptional financial support due to years of underfunding under the previous Government and local financial mismanagement. Will the Minister assure me that, as part of our updated funding criteria, councils such as Hillingdon will get more of the funding that they need, and that there will also be improved accountability and management requirements on local councils?”
“The hon. Member talks about people in his community not wanting the measures in the Bill. I do not know about his constituents, but my constituents often talk to me about the many abandoned shops on the high street, and there are measures to tackle that in this Bill through the community powers, right to buy and the rent review powers. My constituents are frustrated about the lack of economic growth over the last 14 years and the lack of house building over a number of years. Again, there are a number of measures in the Bill to tackle those issues. Is it not true that the issues that people care about are directly addressed by the additional powers that local areas will have from the Bill?”
“It is no wonder that we failed to grasp the issue of devolution and community empowerment in the previous 14 years, given that the Conservative party is still so obsessed by the form of devolution rather than by its function, which is to give away power and empower communities.”
“I thank the hon. Member for his generosity and am happy to take him up on his offer to visit his constituency, have a drink and discuss local issues. He is welcome to come to my constituency, too. I listened carefully to the 20-minute speech of the shadow Minister, the hon. Member for Hamble Valley (Paul Holmes), but did not hear many proposals for the functions of devolution—the powers that could be given and the extra devolution empowerment that could take place. I heard a lot about the form of devolution—whether the county or regional mayor structures are right, for example.”
“However, as well as seeing that potential, those of us who served in local government will often have seen it held back and felt frustration at communities lacking powers and often funding to respond to social and economic challenges. Our country differs greatly: local areas and communities are not all the same and they face different challenges. My Uxbridge and South Ruislip constituency in Hillingdon in west London is very different from the constituencies of and challenges faced by many other hon. Members. It is right that cities, areas and regions of our country have the ability and the powers, and the funding when necessary, to respond to those issues.”
“I welcome the English Devolution and Community Empowerment Bill that the House is considering again this evening. I must make a confession: I was not on the Bill Committee. It sounds like I missed out, according to some of the descriptions of the fun that was had. It is not the first time I have heard that a Bill Committee was such an enjoyable cross-party affair. Many of us across the House had extensive experience in local government prior to entering this place—I had 10 years’ experience of local government in a London borough—and will all have seen the fantastic role that local government can play, connecting communities, responding to concerns, and understanding, often before national Government, emerging economic and social issues that require action and a response.”
“I thank my hon. Friend for that contribution and wholeheartedly agree. We should be guided by the principle of subsidiarity. Power should be given and exercised as locally as possible. Clearly, some powers have to be exercised in this place, at national level, and also at regional level it makes sense to act, and the mayor rightly has the ability to co-ordinate our transport system in London. We do not want multiple decisions about transport infrastructure such as our tube network.”
“Our communities must be able to meet the challenges that they face, and that is why I welcome the raft of new powers in the Bill and the Government amendments. They will drive growth and provide opportunities to respond to new local challenges, now and in the future.”
“That is almost certainly true. There are strategic issues that need to be considered, and whether they are strategic powers for planning or licensing, as we are discussing in some of the amendments, there is the need for a greater role for regional mayors and authorities. It is right that local communities can respond to local issues, but there is a need for guiding infrastructure decisions on things such as heating networks, energy networks and data centre networks, and co-ordinating them at regional level makes a great deal of sense. Despite the need for greater decision making at a local and regional level, we still live in one of the most centralised political systems in the western world.”
“I respectfully disagree. One of the challenges of having one of the most centralised decision-making systems in the world is that we have to decide, in this House, how we give power away and devolve it. To be frank, while hopefully being respectful, we hear a lot from the Conservatives about the desire to empower communities, but their record speaks for itself. The last Labour Government set up the first mayoral authorities, including the Mayor of London and the London Assembly, and devolution to our nations, which has been built on over the years. With this Bill, we are taking another step forward on devolution. The Conservatives talk a good game on this issue, but they had 14 years to act.”
“The hon. Gentleman did not respond to my offer to come to his constituency for a drink, but he would be welcome in Uxbridge and South Ruislip at any time. It is a lovely place, with many fantastic options for drinks. I do not agree with the Conservatives that every structural change to local government requires a full referendum of current or potential constituents. As far as I am aware, no one voted for the establishment of the current London borough arrangements, or the county council arrangement. Apart from some less positive ones at a national level, I do not remember many referendums undertaken or proposed by the Conservatives about devolution or structural changes to our political system, so I do not agree with the hon. Gentleman. There are different ways of consulting residents and engaging with communities.”
“I wholeheartedly agree. My hon. Friend’s comment speaks for itself. We can look at the Conservatives’ record, and at what they now preach in opposition.”
“Clearly, tourism has huge benefits for our communities, including jobs, the cultural enrichment of visitors coming to our cities, support for existing and new businesses, and the revenue that tourism brings to our country.”
“I speak in support of a number of amendments that will give local government, particularly in London and my constituency, new tools. These will improve the lives of residents in Uxbridge and South Ruislip. New clause 31, tabled by my hon. Friend the Member for Liverpool Wavertree (Paula Barker), to which I am a co-signatory, will allow mayors to implement a tourist levy on overnight stays. For many years, many councils have been calling for this change; during my time in local government, I remember calling for an overnight stay levy. There is a range of reasons why one might want such a levy, and I note the welcome support from Labour Mayors Sir Sadiq Khan and Steve Rotheram.”
“I thank the hon. Gentleman, my friend from the Health and Social Care Committee, on which we have had many good and fruitful discussions, but I disagree with him on this point. There are significant steps forward in the Bill in devolving powers to communities at different levels—at individual and community level, as well as at regional and mayoral level. I would say that if we look at devolved regional arrangements, we see that the Mayor of London’s powers have not kept up. Arguably, greater progress has been made with the Mayor of Greater Manchester, given his range of powers and the number of areas in which he operates. There are different arrangements in different parts of the country, so I would not agree with the hon. Gentleman’s characterisation.”
“Communities in Cornwall, Dorset and Devon, in common with many in London, have experience of the overnight stay and tourist economy, and of the impact on local communities. They know about the powers, budgets and fiscal freedoms that councils and mayors have to respond to the issues. I agree that the levy should be charged per night of travel. One challenge that I have often heard is that if the levy were to apply to the hotel sector or formal visitor stay sector only, and not to the informal sector or the short-term let sector, that might disadvantage important businesses, jobs and institutions, and not tackle that more informal visitor economy that can pose challenges in London, and in places like that represented by my hon. Friend.”