Paediatric Continence Forum 

Political and Parliamentary Monitoring
Week Commencing 29th October 2018 


The Chancellor presented The Budget to Parliament this week. In it, he announced additional funding for disability facilities and schools, as well as extra investment in health funding and Air Ambulances. In the last Budget before the United Kingdom leaves the European Union, Mr Hammond set aside additional funds for contingency planning, and vowed to do “whatever is necessary” to support the country. 


Whilst this was one of the biggest ‘giveaway’ budgets ever, this was almost entirely because of the extra £20 billion allocated to the National Health Service. Whilst the announcement about additional funding was originally made in the Summer, the Chancellor did provide a little extra insight in to where the extra cash was headed. New mental health crisis services are to be established across the UK, along with a 24/7 support hotline for those vulnerable people with mental health challenges who need immediate support. 


Nonetheless, many other aspects of The Budget were underwhelming. Whilst there was an announcement of more funding for social care, there was no mention of the need to address the increased demand in the NHS, or of improving the integration between health and social care by providing extra money for local government. A consensus is emerging amongst experts from trade and national press that, despite the positive impact the extra £20 billion of investment will have in the NHS, away from Health, “per-capita spending cuts are due to continue in the coming years”. 


Away from Health, the Chancellor also announced an additional £400 million investment for school “cosmetic” changes, equating to £10,000 for each Primary school and £50,000 for each Secondary school. The Chancellor said the extra funding was for “little extras”, and wouldn’t be repeated next year. In response, the Shadow Chancellor John McDonnell, said that some parents and teachers had been “really angered” by the remark.  


Whitehouse has provided expert analysis of The Budget, which it will circulate with this monitoring to the Paediatric Continence Fpri, 





  • Territorial injustice likely to increase 
  • School toilet policies breach child rights 
  • Charities fear over children’s centres cuts 


Continued fall in health visitors, school and learning disabilities nurses 

The numbers of health visitors, school nurses and learning disability nurses in England have continued to fall over the last year, analysis from the National Health Service, has shown. Whilst the overall nursing numbers have increased, they have yet to make up for the decline in some specific areas the of the Health Service. The monthly figures show that, as of July 2018, there were 3,199 full-time equivalent learning disability nurses working in hospitals and the community, 124 fewer than in the year before. 


The latest drop continues a steady decline in numbers, with more than 2,000 fewer learning disability nurses working in the profession that there were eight years ago. Similarly, there are fewer health visitors working the NHS, with numbers falling from a peak of 10,300 in October 2015 to just 7,852 in July this year. School nurses – who are included in the community nursing stats – saw full-time numbers drop from 2,422 in July 2017 to 2,213 in July 2018. Again, this is part of a steady downward trend, with a peak of more than 3,000 school nurses having been employed in 2010. 


Whilst the figures alone are cause for concern, they also reveal a growing postcode lottery o are. Whilst North West London saw full-time equivalent nursing numbers increase by over four per cent, there was a steep drop n the West Midlands. This evidence will reiterate the conclusions of the PCF’s 2017 FOI audit, which found under-resourced service in many of the UK’s major towns and cities. 


The news that the number of community, school and public health nurses continue to fall will be of concern to the PCF, which has long campaigned to increase awareness of the value of the school nurses. As Whitehouse prepares to run a new campaign with the Paediatric Continence Forum, we will highlight where necessary the current staffing issues. 



Doubling the number of medical students ‘not affordable’ 

Doubling the number of medical students is “not affordable” and could results in “too many”, the Chief Executive of Health Education England has said. Speaking at the Westminster Health Forum this week, Ian Cumming said that Health Education England was now trying work out how many more medical students were needed, adding that “I think doubling the number of people we need to be doctors in this country is not affordable on the current funding model”. Health Education England, the education and training body, is now devising a workforce strategy. Mr Cumming added that this strategy would factor in the number part-time workers currently trained to work in the NHS. HEE is also currently exploring giving doctors more flexibility during training, by extending in to seven years rather than five, so trainees can spend time working in other areas. 


Mr Cummng reiterated comments made earlier in the year regarding predictions about the demand for clinical workforce in the NHS rising by between three and five per cent a year over the next decade. However, he stressed that a five per cent increase in the workforce year-on-year over the next decade would be unaffordable, and has instructed the workforce strategy to examine ways to keep the figure as low as possible. One particular aspect of NHS workforce which will come under great scrutiny, which Mr Cumming said was facing a “demographic timebomb” as the number of people retiring increases and the average age of those leaving the profession continued to creep down.  


The announcement by HEE comes in the same week that it was revealed the organisation will be made more accountable to NHS Improvement, in an effort to create “a ore coherent approach to workforce development”. In a statement, HEE and NHS Improvement said they would “work more closely together to ensure the national workforce system is well aligned”.  


The PCF welcomes any attempt to increase the number of staff working in the NHS, including this strategy. One priority must be ensuring that all aspects of the health service get the resources they need to respond to rising demand. This includes making sure there are enough school, community and paediatric nurses to support young people and their families.  



Tax on Toilets are abolished 


The Chancellor announced additional, much-needed, investment in local authorities in his budget this week.  An extra £650 million will be made available for social care funding, as well as a £45 million grant for disabled facilities and the abolition of business rate tax on toilets made available for public use. This news will be welcomed by many in the wider continence care sector who have been campaigning for better investment in public facilities. Whitehouse has reported on the efforts of Paula Sherriff MP, who has campaigned for more Changing Places facilities in the UK’s towns and cities. 


The All-Party Parliamentary Group on Continence Care, which The Whitehouse Consultancy attends, has made improving toilet facilities and Changing Places provision a priority, and the announcements made by the Chancellor today indicates a recognition of the importance of urology care. As such, this announcement will be considered a major victory for those who have campaigned for a more accessible net work of public toilets, including the Paediatric Continence Forum. The Whitehouse reached out in support of Paula Sherriff MP in the summer, and the Forum will welcome today’s announcement. 


The PCF will welcome the news, after supporting the APPG’s concerns that the lack of resources was a breach of the human rights of disabled people and those with bladder and bowel issues. Whitehouse will continue to monitor the implementation of this policy.