Westminster Hall
(1 day, 9 hours ago)
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Vascular Sector Reform
(1 day, 9 hours ago)
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Westminster Hall is an alternative Chamber for MPs to hold debates, named after the adjoining Westminster Hall.
Each debate is chaired by an MP from the Panel of Chairs, rather than the Speaker or Deputy Speaker. A Government Minister will give the final speech, and no votes may be called on the debate topic.
This information is provided by Parallel Parliament and does not comprise part of the offical record
Jim Shannon (Strangford) (DUP)
I beg to move,
That this House has considered the potential merits of reform of the vascular sector.
It is a real pleasure to serve under your chairship, Dr Huq. Last night, you were in the Adjournment debate, and today you are chairing a Westminster Hall debate. Your talents are incredible—well done to you. We appreciate all the efforts that you make for us in this House in all ways.
It is, too, a pleasure to introduce this debate on something I am particularly interested in. A number of people in the Public Gallery have much more medical talent than I have—I am interested in the subject, but in the Gallery are some of those who carry out some of the operations and so have a deep interest. I pay a special thanks to Roger Greer, who is the administrator for the all-party parliamentary group for vascular and venous disease, which I chair—I declare that interest. That gentleman and others with him make the effort on this subject matter, which I am interested in.
Back home, I have had the opportunity to visit the Royal Victoria hospital. On vascular health, unfortunately some of the statistics for Northern Ireland, which I will mention, are worrying. I suspect that they will illustrate where we are in Northern Ireland, and that what is happening there will be mirrored here on the mainland.
It is a real pleasure to see the Minister in his place. We had a wee chat beforehand, and I think—although I am not a prophet or the son of a prophet—we will all agree on the subject matter of this debate. I very much look forward to the Minister’s response, and to his encouragement in some of the responses that we need as we move forward.
I am speaking on an issue vital to thousands of families across our great nation, the United Kingdom of Great Britain and Northern Ireland, and yet one that too often remains hidden in the shadows of our health service. I just said that to the Minister before—this is one of the issues that is slightly hidden. We might not always know everything about it, unless we have a particular interest. I know that other Members present—I thank them for coming—will have a particular interest in the pressing need for comprehensive reform of lower limb vascular care.
This debate gives this Westminster Hall Chamber the opportunity to highlight an often forgotten health issue. Vascular disease affects the very network of life within us, the arteries and veins that carry blood around our bodies, and encompasses peripheral arterial disease, chronic limb-threatening ischaemia, venous disease and devastating diabetes-related foot complications. I declare an interest as a type 2 diabetic, although I Richard in the Gallery might say, “Well, after that cake you had the other day, perhaps you’re not as careful as you should be with your diabetes”—but I do try to be careful and look after it.
Those are not mere clinical terms; they represent real human suffering, unbearable pain, non-healing wounds, severe loss of mobility and, in far too many cases, major limb amputation and premature death. I will put a bit of focus on that for us in Northern Ireland, because some of the figures for amputations in Northern Ireland are scary. I think they are probably scary here on the mainland as well. We have seen inspiring progress in cardiac and stroke care, which is very much welcome, but outcomes for vascular patients have simply failed to keep pace. That is the issue I want to highlight, if I can.
The risk of developing PAD is four times higher among smokers than non-smokers, and two to four times higher among people with diabetes than people without diabetes. That is another reason for this debate and the importance of where we are. One in five people over the age of 60 is affected by PAD, and more than 80% of amputations among people with diabetes are preceded by a foot ulcer. People might say, “A foot ulcer? That is not too bad”, but it can well be. Often, it is the precipitation of a disorder in your blood, which ultimately could lead to amputation. That statistic clearly demonstrates the enormous opportunity we have in prevention and early intervention.
One of the main thrusts of my comments today will be about early intervention and how we do that. We have experts in the Chamber who will speak, and I thank all hon. Members for coming along to make their contributions.
Approximately 4,200 major lower-limb amputations are performed every single year due to PAD, each representing, I believe, a personal tragedy, and an average cost of £28,000 to the NHS. We have to consider the costs, because they are part of what the NHS has to look at. Managing CLTI alone costs our health service an estimated £244 million annually, while the overall bill for NHS wound care reached a staggering £8.3 billion in 2017-18. That included some £5.6 billion spent on wounds that failed to heal. That perhaps gives a clinical look at where we are.
The human toll, of course, is tragic. Patients suffering from CLTI with rest pain or tissue loss face a 60% risk of death within five years, a prognosis that is worse than for many end-stage cancers. Following an above-knee amputation, a quarter of patients die within 90 days, and median survival among diabetic patients is just 1.68 years. Those stats illustrate the extent of the problem and, I believe, confirm the importance of where we are.
Dr Zubir Ahmed (Glasgow South West) (Lab)
The statistics that the hon. Gentleman highlights should shock us all. If those were the statistics for dealing with any cancer, we would simply find them unacceptable. Does he agree that vascular disease, because it is not treated in the same way as cancer, in some cases ends up being treated as a “second-class” disease, and that we should be mindful of that?
Jim Shannon
I thank the hon. Gentleman for that intervention. He has rightly said that, when it comes to vascular disease, while it is equal with cancer in its severity and in the numbers who lose their lives, it is not treated the same. Today’s debate perhaps gives us a chance to illustrate that, and I am hopeful that the Minister responsible for answering can give us some encouragement in relation to it.
Furthermore, this crisis starkly reinforces health inequalities. Just as an example, among individuals aged 45 to 54, those in our most deprived communities face above-knee amputation rates nearly five times higher than those in the least deprived areas.
I thank the Library, as always, for the information that it made available to us. It said that
“gaps in vascular care are resulting in avoidable harm for patients. In particular, the report highlighted ‘delayed diagnosis, inconsistent referral pathways and variable access to specialist care’ for people with PAD, venous disease and diabetes-related foot complications. It said these problems are resulting in ‘thousands of avoidable lower-limb amputations each year.’”
If we were to achieve something from today’s debate, it would be first to ensure an improvement in vascular health, but secondly for the issue of amputations to be addressed through early diagnosis and looked at much more significantly and strongly than it has been.
As the Member for Strangford in Northern Ireland, I feel a particular responsibility to shine a light on how this national crisis presents itself in Northern Ireland. I do that because I think it will help add to the debate; I am ever mindful that the Minister here today has responsibility for the United Kingdom but not directly for Northern Ireland—I understand that—but I use the figures, stats and information from Northern Ireland as an illustration of the issue. What I want to see, and what I think the Minister will want to see as well, is an improvement in this across the United Kingdom and elsewhere.
My job is to shine a light on how the national crisis presents itself in Northern Ireland. While the briefing outlines the systemic challenges across the UK, the reality on the ground in our region underscores an even more acute urgency. Across Northern Ireland, hundreds of patients undergo limb amputations each year due to vascular complications and diabetes-related foot ulcers. In fact, diabetes prevalence in Northern Ireland continues to rise steadily, with local health trusts treating thousands of individuals at high risk of developing severe foot complications.
People sometimes think that diabetes is not that serious. I used to be almost 17 stone. I realised, when the doctor confirmed that I had diabetes some 18 years ago, that I had to lose weight. I lost 4 stone and I have kept it off, but I have to work hard to ensure I do not develop any other complications, which can quite often happen.
The stats in Northern Ireland reflect stark and unacceptable regional inequalities, and they are mirrored by the stats and figures from the mainland. On healthcare inequality, patients from the most socio-economically deprived communities in Northern Ireland face significantly higher amputation rates, nearing the alarming national trend here on the mainland, where deprivation increases the likelihood of a major amputation nearly fivefold.
Hopefully, when the Minister responds, he will tell us how the issue of higher levels of deprivation can be addressed, because it must be done. The lack of hospital bed capacity, dedicated wrapping access and community foot protection services forces vascular patients into prolonged, acute hospital stays. Managing severe vascular conditions and non-healing wounds accounts for millions of pounds annually across our health and social care costs. Those resources could be saved through early preventative community intervention. Again, that means early diagnosis, early community intervention and savings to the NHS, which can then be used in other parts of the health service.
Turning to survival rates, a patient in Northern Ireland who undergoes a major lower limb amputation faces a staggering mortality risk within their first year post surgery. It is the same across the UK. Preventative care is quite literally a matter of life and death. I could not express that any better than the hon. Member for Glasgow South West (Dr Ahmed), who underlined that in his intervention.
If we are to relieve pressure on local hospitals in the United Kingdom of Great Britain and, ultimately, in Northern Ireland and protect our most vulnerable citizens, we must ensure that any national reform framework, including the national foot attack pathway, and standardised waiting times are fully integrated across all HSC trusts, and we cannot allow postcode lotteries to dictate whether a patient keeps or loses her limb depending on where she lives.
I hope the Minister can address the issue of postcode lotteries, which seem to happen with unfortunate regularity. I know he will be keen to change that, and this House is keen to hear what he says. The cardiovascular disease modern service framework rightly focuses on shared risk factors and acknowledges PAD, but its immediate priorities lack the explicit, detailed pathways, treatment standards and outcome measures urgently required for lower limb vascular care.
To close that gap—because that is what we are trying to do—clinicians, patient representatives, professional bodies and NHS leaders across the vascular sector are coming together to publish a definitive best-practice document this autumn. I am sure that document will be made available to the Minister, hopefully in advance. I think that will be helpful for the Minister and others in this debate who want to make changes.
The APPG on vascular and venous disease has highlighted a practical programme for reform, which I endorse. Obviously, I would endorse it because I am its chairman, but it is a positive, focused vision for the future that, if delivered, could make a difference. It includes the national foot attack pathway, backed by public awareness; same day or next day triage for urgent foot issues; and a multidisciplinary foot protection service in every integrated care system linked directly to specialist arterial centres.
When I go for my diabetes test once or twice a year—I have one next Wednesday—they make me close my eyes and do that wee prick of my foot to see if I react and if I can feel it. I am glad to say that I always do. The point is that if someone cannot, that is a serious problem. That is an issue for diabetics, in particular, and it is really important that they are checked regularly, especially their feet.
Thirdly, there should be national maximum waiting times enforcing urgent vascular assessment within five days for in-patients and two weeks for out-patients. Setting a standard to be achieved and having a clear focus on outcomes that reward early diagnosis, fast healing and reduced amputations, are ultimately about patients having a better quality of life—a more normal life—without their health deteriorating. There should also be faster adoption of innovation, including community diagnostics, compression therapies and digital wound monitoring.
When it comes to research and development, the Minister is always very keen to know about advancements in vascular health and how the Government are helping. One of the people involved from one of the hospitals back home in Northern Ireland is with us today in the Public Gallery. She is clearly very aware of these issues and I thank her for her work. There is some great work being done in our hospitals, particularly in the Royal Victoria hospital back home, and in the rest of the Northern Ireland health service.
Will the Government ensure that the cardiovascular disease modern service framework includes distinct pathways and outcome measures for vascular conditions? Will the Minister support a national foot attack pathway and clear waiting time standards? With respect, standard rhetoric and warm words will not heal a failing wound; nor will they save a limb. Thousands of our fellow citizens face devastating, life-altering amputations—tragedies that are, in so many cases, entirely preventable if they are caught early enough.
As a type 2 diabetic myself, I know the personal anxiety that comes with those risks. I also know about early intervention. For me, that was losing 4 stone, taking the medication and being careful about what I eat. Cake became a once-a-week treat—my doctor told me we are allowed to have a wee treat now and again—and I am allowed to have a fry on Saturday morning, but the rest of the week it is best to abstain and not have any of those things. I know that early intervention, proper community pathways and timely care can work. They have worked for me and I know that they have worked for many others.
The Government have rightly pledged to shift the focus of the NHS from sickness to prevention and from treatment to early intervention. Today, I am asking the Government and the Minister to produce a clear and actionable blueprint to do precisely that. The vascular sector is coming forward this autumn with clear solutions, and I am very impressed by the sector’s ideas and suggestions about how to improve the strategy, including a national foot attack pathway, dedicated foot protection services and enforceable maximum waiting times, because we need to make sure that waiting times reflect the needs of those seeking help. The real test for the Minister is whether the Department can step up, grab this opportunity with both hands and deliver the system-wide reform that our patients deserve.
I thank all hon. Members for coming along to participate in the debate. I also thank those in the Public Gallery for being part of this work and for their expertise and input into the strategy. I think that the Minister will see that it can bring about the change that he and we all want.
Juliet Campbell (Broxtowe) (Lab)
It is a pleasure to serve under your chairmanship today, Dr Huq. I thank the hon. Member for Strangford (Jim Shannon) for securing this debate.
The publication of the 2026 cardiovascular disease modern service framework is a welcome step towards realising our commitment to a more preventative, community-focused health service. It rightly seeks to move care away from expensive and reactive hospital treatment towards earlier diagnosis and joined-up cardiovascular care in our communities. As we consider the future of vascular services, we should take this opportunity to go further and give attention to heart failure, where many of these conditions end. Heart failure places a significant burden on patients, families and the NHS. It affects more than 1 million people in the UK, and is the most common cause of hospital admissions among those over 65. The number of people living with heart failure is set to double by 2040.
Early intervention on a cardiovascular journey can do more than treat established diseases and the associated life-changing impacts that the hon. Member spoke about; it can also prevent more people from reaching heart failure. Evidence-based treatment can relieve symptoms, extend life and reduce hospital admissions, but patients can benefit only if the condition is recognised, diagnosed and treated without delay.
In my constituency, in towns such as Eastwood and areas such as Inham Nook, rates of heart failure are more than double the national average. People there are four times more likely to die from heart failure than those elsewhere. Access to diagnosis and specialist care varies from area to area, but no one’s postcode should determine how quickly they are diagnosed, when they see a specialist or when they receive treatment that could keep them well and out of hospital. The modern service framework must establish consistent national standards, with targeted support for deprived, rural and high-risk communities.
More than 1 million people are living with heart failure in the UK, with around 200,000 diagnosed each year. In England, 80% of diagnoses are made in hospital, despite 40% of the patients having previously experienced symptoms. That clearly demonstrates the urgent need to move from crisis-driven care to early diagnosis and planned treatment.
The modern service framework acknowledges that NHS health checks do not include the NT-proBNP blood test, which identifies whether the walls of the heart are stretched or there is a pressure overload on the heart. Although the framework proposes new testing models, valuable opportunities for early diagnosis such as that test can be missed. Heart failure must be explicitly mentioned in the modern service framework, and supporting measures must be clear, funded and measurable.
We also need stronger links between primary care, community services, hospitals and specialist centres. Those pathways need to be supported by a specialist workforce, as reform cannot simply mean reorganising structures. We need diagnostic capacity, specialist staff and community services; otherwise, pressure will just move from one part of the NHS to another.
I ask the Minister to make heart failure an explicit and measurable national priority within the modern service framework. That should include guaranteed access to testing, diagnosis, evidence-based treatment and multidisciplinary heart failure care, supported by investment in specialist staff, increased diagnostic capacity and community services. I hope the Minister will ensure that he goes further than considering reform of the vascular services and makes heart failure a national priority.
Dr Zubir Ahmed (Glasgow South West) (Lab)
It is a pleasure to serve under your chairship, Dr Huq. I welcome the Minister, my hon. Friend the Member for Bury North (Mr Frith), to his place—he knows that I was in his place not too long ago, and I will be kind to him in my asks. I also welcome the Opposition spokesperson, the hon. Member for Solihull West and Shirley (Dr Shastri-Hurst), who is a former orthopaedic surgeon, so he knows a thing or two about the blood vessels that run around the bones of the body. It feels like a unique privilege for me to stand here today as the Member of Parliament for Glasgow South West—where we have one of the largest hospitals in the country—a trained vascular surgeon, and a former Minister who was partly involved in bringing forward the cardiovascular modern service framework when I was in post.
Vascular surgery was my bread and butter when I was a surgeon. There is no greater feeling for a surgeon and their team than returning blood flow to the limb—usually a lower limb—of a patient with critical limb ischemia, preventing them from undergoing a near-certain amputation, and watching them walk out of hospital. That is usually the culmination of many years of surgical training. I shall take this opportunity, because I may never get it again as a parliamentarian, to thank those who trained me and many like me in the west of Scotland and enabled us to acquire and practise those skills: people like George Welch, Wesley Stuart, Keith Hussey, David Kingsmore, David Wallace and Steven Boom, and colleagues in the Public Gallery such as my good friend Tamim Siddiqui, a consultant vascular surgeon in the west of Scotland. I am biased, but I believe that the west of Scotland vascular surgery is a cut above the rest, although other vascular surgeons are available in the Public Gallery.
One of the reasons I think the west of Scotland vascular surgeons are a cut above the rest is that, unfortunately, our area suffers from some of the highest burdens of vascular disease in the country. That is reflected in the statistics more widely. In Scotland, life expectancy and healthy life expectancy are going down, having steadily increased from 1980 until about 2012. We now have some of the lowest life expectancy rates anywhere in western Europe. We have to reflect on why that is.
Scotland spends more on its NHS and has more staff and resource relative to the rest of the country, yet productivity is lower. Scottish hospitals are treating fewer patients now than before the pandemic, unlike English hospitals, which have surpassed pre-pandemic activity levels under the Labour Government. We have to reflect on where the political failure lies. On behalf of my constituents in Glasgow South West, it is only responsible to reference the fact that the SNP Government have proposed a massive restructuring of Scotland’s NHS, seemingly without any detailed consultation with anyone. It is not clear who that structural change serves, how much it will cost, or how we can judge its success or failure.
I urge the Minister, who also has responsibility for four-nation engagement, to ask the Scottish Government how we can help to reverse the trend by imparting our wisdom and what we have learned over the last couple of years about turning around waiting lists and optimising clinical pathways. We have become habituated to the idea that there is a physical border between Scotland and England that cannot be transcended, whereas I believe that we can co-operate and problem solve instead of point scoring. I urge the Minister to lend the weight of his office so that patients near the border can benefit from services each way and do not have to travel 80 or 100 miles to receive services simply for lack of political will. I shall be grateful if he does that and writes to me about the outcome.
Will the Minister consider the asks from the Circulation Foundation and the APPG, with which I have done some work in the recent past? As we all know, diabetes is unfortunately on the rise. Synonymous with diabetes is diabetic foot, which is now the primary cause of limb loss in this country. A concerted effort is required because early intervention on a diabetic foot can prevent major limb amputation. I ask the Minister that we think about the national foot attack pathway, with a same-day or next-day triage service for urgent cases that enables much quicker treatment of diabetic feet and diabetic foot sepsis.
The model of stroke care that we have established, particularly in England with thrombectomy services, which I understand will become near-universal in only a few months—it is far from universal in Scotland—is a good model to follow for diabetic foot care and the national foot attack pathway. We need community foot protection services in every single integrated care board, with multidisciplinary hubs linked to specialist centres, so that we can offer more care not in hospital, but in the community, which is a linchpin of our 10- year health plan in England; and the implementation of national waiting time standards of five days for in-patients and two weeks for out-patients with transparent reporting. If we do that, we will save not only money, but limbs and lives.
On commissioning, we have all become too habituated to paying for activity and inputs. It is time to shift the dial and pay for an outcome. In many ways, vascular disease and diabetic foot disease offer an early win—an early exemplar—of how we can shift the dial on commissioning services from input to output.
Alongside that, it is important to think about how we support innovation, which is in the Minister’s title. I know at first hand that there are so many innovative vascular scientists and specialist surgeons doing things very differently from what we were doing only five years ago. They need the Government’s support. The Government will be pushing at an open door if they come forward with new ideas for how to innovate so that patients benefit directly from effective technologies and digital technologies. We can even optimise the NHS app to produce end-to-end digital pathways for these patients. I know that the Minister takes these matters very seriously and will consider them in his response.
I end where I began, by thanking everyone who has attended today, particularly the colleagues from the vascular community in the Public Gallery. I reiterate that it has been an honour and a privilege to be part of this debate, as a parliamentarian serving a constituency with a diverse community that suffers from diabetes and vascular disease, but also as a proud member of the vascular surgical community.
Helen Morgan (North Shropshire) (LD)
It is a pleasure to serve under your chairship, Dr Huq. I welcome the Minister and the shadow Minister, the hon. Member for Solihull West and Shirley (Dr Shastri-Hurst), to their places. Most of all, I thank the hon. Member for Strangford (Jim Shannon) for securing this important debate. He outlined the issues comprehensively in his opening speech, as we would expect.
According to the Circulation Foundation, vascular disease is as common as cancer and heart disease, accounting for 40% of deaths in the UK. That represents a huge disease burden on individuals and the NHS, yet we rarely discuss it in Parliament. It is a leading cause of preventable disability, with associated complications being worsened by the fragmented care available to patients.
Living with vascular disease means living with chronic pain, reduced mobility and often an isolating loss of independence. Many patients are left with a sense of powerlessness, which has a huge impact on their mental health and wellbeing. Sadly, we are all too familiar with the issues in the vascular sector: inconsistent standards and access to care; the dreaded postcode lottery in services; pathways and referral routes that disproportionately impact deprived communities; and under-investment in prevention. It seems to be yet another area of the NHS where, as we have been arguing this week on the Health Bill, too much time and money is spent responding to failure rather than improving the quality of services for patients and preventing and delaying deterioration in the first place. We must do better for people with vascular disease and for their families.
Having dealt with the harrowing case of a constituent, I know that a lack of care and the medical risks and implications of vascular disease can spiral out of control, leading, in the worst cases, to the premature death of a family member. It is incredibly upsetting when that happens. I cannot begin to imagine how devastating that experience must be.
A report from the all-party parliamentary group on vascular and venous disease highlighted the avoidable harm that gaps in vascular care can cause to patients. It confirmed that gaps in vascular care are resulting in avoidable harm, highlighting:
“Delayed diagnosis, inconsistent referral pathways and variable access to specialist care”
for people with peripheral artery disease, venous disease and diabetes-related foot complications. It said that those problems are resulting in
“thousands of avoidable lower-limb amputations each year.”
Discussions with the primary care network in my North Shropshire constituency have revealed that our county has one of the highest rates of lower-limb amputations because of these gaps in care. I cannot imagine the trauma caused to those who have lost a limb, knowing that it might have been avoided. It is time we aspired to ensuring a consistent level of care across the country.
I have been contacted by companies in the pharmaceutical sector that have highlighted the disconnect between acknowledgment and action. PAD is named as a “neglected” CVD risk factor, but it lacks the priority status, funding mechanisms and performance standards given to other conditions. They have also highlighted that the need for new surgical and interventional techniques is acknowledged but not operationalised with delivery timelines or resource allocation, and that there are no metrics for PAD. The absence of PAD standards or metrics in the main performance monitoring tables means that progress cannot be tracked and local ICBs cannot be held to account if they are falling behind.
The modern service framework is obviously a welcome step forward, but the Government should also take a look at the all-party parliamentary group’s calls for a national foot attack pathway, a community foot protection service, national maximum waiting times for patients, the reform of commissioning to reward outcomes and the acceleration of proven innovation, which must be rolled out more widely.
Beyond that, the care that the NHS provides at its front door must be strengthened so that symptoms are caught and treated early. The APPG’s report highlights how prevention-led, community-first care is needed to transform the vascular sector, diagnose conditions earlier and relieve pressure on acute services. Liberal Democrats want everyone with vascular disease to have a named GP to ensure continuity of care, which has been shown to improve outcomes and quality of life for those with long-term conditions.
Fixing the back door of the NHS is just as crucial for us. We have long been pressing for better social care, including free personal care and more support for family carers. Obviously, we welcome the steps that the Prime Minister took over the summer recess to ensure movement on the social care issue.
Our proposed package would make it easier for people with long-term conditions and disabilities to access flexible working. It would support those suffering from vascular disease to access the world of work wherever possible, and hopefully transform their mental health and independence, too.
Given the prevalence and severity of these conditions, I urge the Government to develop a strategy to transform the vascular sector to give patients the timely support and treatment they need. I look forward to hearing what steps the Minister will be taking to address this issue.
Dr Neil Shastri-Hurst (Solihull West and Shirley) (Con)
It is a pleasure to serve under your chairmanship this afternoon, Dr Huq. As the hon. Member for Glasgow South West (Dr Ahmed)—I call him my hon. Friend—pointed out, I have a particular interest in this subject. It is a number of years since I held a licence to practise, but the debate has taken me back to clinical days. Even worse, it took me back to vivas for Royal College examinations—I am still a member and am proud to support that community.
I start by thanking the hon. Member for Strangford (Jim Shannon) for securing this debate. I congratulate him and the APPG on vascular and venous disease on their work. As has been noted, vascular disease perhaps does not attract quite the same attention as cancer or heart disease. However, that does not make it any less serious. The consequences for patients can be extreme. We have heard about pain, loss of mobility, prolonged hospital stays and, in the worst cases, amputation.
What makes this particularly frustrating is that a great deal of this harm is avoidable. The problems identified by the APPG are not especially complicated. There are delayed diagnosis and treatment, inconsistent referral pathways, variable access to specialist care and fragmented services. The result is that patients who might have retained their limb and their independence do not always do so.
The APPG’s report therefore makes five fairly practical recommendations: the national foot attack pathway, with same-day or next-day triage; community-based foot protection services in every integrated care system; maximum waiting times for vascular assessment and revascularisation, with national reporting; commissioning that rewards outcomes rather than simply activity; and faster adoption of proven innovation. None of those propositions strikes me as particularly revolutionary. Indeed, much of the thinking behind them is not new.
The “Getting it right first time” programme established under the previous Conservative Government produced a vascular surgery report in 2018, which recommended a hub-and-spoke model to improve early diagnosis, specialist decision making and timely intervention. The NHS long-term plan subsequently committed to universal access to multidisciplinary foot care teams. In 2022, NHS England introduced a two-year commissioning for quality and innovation scheme intended to encourage timely revascularisation for patients with chronic limb-threatening ischaemia.
The Government have said that they welcome the APPG’s report. They have said that the Department of Health and Social Care and NHS England have engaged with stakeholders, and that recommendations will be considered as part of the cardiovascular disease modern service framework. That sounds encouraging, but there is a rather obvious difficulty: although it is welcome that the modern service framework, which was published in July, contains considerable material on cardiovascular disease, it contains no specific reference to vascular or venous disease.
If the Government accept that vascular disease is an important part of the cardiovascular picture, why does their new modern service framework not specifically address it? If the answer is that the framework is intended to cover vascular disease through its wider approach to cardiovascular risk, that poses a second question: where precisely are the specific standards against which vascular services are to be judged? The APPG has given the Government some specific proposals, and it would be helpful if the Minister could tell us which of the five recommendations the Government accept and, perhaps more importantly, which they reject.
The question then is who will deliver the services? The Government have embarked on a major reorganisation of the NHS, including the abolition of NHS England, and a substantial reduction in the size and cost of integrated care boards, with the Government saying that ICB budgets are to be reduced by 50%. How does the Minister expect ICBs to deliver these additional responsibilities at precisely the point when their budgets and staffing levels are being substantially reduced? Has his Department assessed the effect of those reductions on the commissioning of vascular care and foot protection services? I am far from opposed to reducing bureaucracy in the health service, but the test of any NHS reform has to come down to patient outcomes.
I hope the Minister will also address the question of clinical leadership in this area. Currently, although there are clinicians with huge experience and expertise in the field, including vascular clinical leads for GIRFT, there is no national clinical director specifically responsible for vascular and venous disease. The Government have previously said that national clinical directors play an important role in policy development and implementation, which is right, but we know that the future role and responsibilities of national clinical directors are being reconsidered as part of NHS reorganisation. Could the Minister set out the Government’s position on future clinical leadership for vascular and venous disease after NHS England has been abolished? Will a clearly identified senior clinical voice continue to be responsible for that important area, and if not, who will have responsibility for ensuring that the specific recommendations on vascular care are implemented?
It is helpful that the national vascular registry already collects data on major vascular procedures, including bypass surgery and major lower-limb amputations, and there has been some improvement in the proportion of vascular providers meeting the relevant CQUIN framework, but we need to be careful not to confuse the mere collection of data with improvements in care. Will the Government therefore introduce national maximum waiting times for vascular assessment and revascularisation? If they do not propose to do so, why not, and if they do, when will it take place?
Returning to the national foot attack pathway proposal, the principle behind it seems difficult to argue with. Where a patient presents with a potentially serious foot problem, particularly in the context of diabetes or vascular disease, as we have heard, they should have a clear route to an appropriate specialist assessment. Will the Government commit to establishing such a pathway nationally? Will the Minister ensure that data on performance against that is published?
The same principle applies to innovation. The NHS has no shortage of good ideas, but it has traditionally lacked a reliable mechanism for taking an idea that works in one hospital and making it available elsewhere. Therefore, the APPG’s recommendation to make greater use of mechanisms such as the NHS innovator passport is sensible. However, what happens at the other end? If a technology is demonstrated to be clinically effective and cost-effective, does an NHS organisation have an obligation to consider adopting it? How will the Government prevent another postcode lottery, where an effective treatment is available to patients in one part of the country but not in another?
In this debate, there is not much disagreement on the broad objectives: we all want to see earlier diagnosis, faster treatment and fewer amputations, as well as better use of NHS resources. Any disagreement is about whether the Government have set out a sufficiently specific plan for achieving those objectives. It is easy to welcome a report or publish a framework; it is much harder to deliver it. The Government have a genuine opportunity to take the practical recommendations of the APPG and turn them into measurable outcomes. That is the test: will they do that, or will they just allow vascular services and vascular disease to remain a subsidiary issue within the much broader context of cardiovascular disease and hope that local services are simply able to deal with it?
The Parliamentary Under-Secretary of State for Health and Social Care (Mr James Frith)
It is a genuine pleasure to serve under your chairship, Dr Huq, and to join you again in Parliament. We worked together before and it is an honour to be here today.
As is customary, I would like to thank the hon. Member for Strangford (Jim Shannon) for securing this important debate and for his insights. Some of us were wondering if he would write one of his famous letters of congratulations and courtesy to himself; we hope that somebody else will step up and show him the same courtesy that he affords us all by being so generous in his support of colleagues across the House.
I also thank my hon. Friend the Member for Glasgow South West (Dr Ahmed), who spoke so well and with such insight, for the leadership and expertise that he showed in pulling together the Government’s ambitions for not just the 10-year plan but, as has been mentioned, the cardiovascular framework. I am of course minded to listen to anything further that he says. On his point about Scotland, he is right that I also have responsibility for the devolved nations in a seemingly ever-growing brief—he will have sympathy with me over that. I am happy to have those conversations to ensure that we learn from the Scots and that the successes here can be transported north of the non-border to which he rightly referred.
The report published by the APPG earlier this year sets out suggested actions for improving vascular care. The Opposition spokesperson, the hon. Member for Solihull West and Shirley (Dr Shastri-Hurst), is right that there is much in this debate on which we agree. The calls to action include reducing waiting times, reforming commissioning, accelerating innovation, and establishing a national foot care pathway and community-based foot protection services in every local system. I commend the APPG for focusing their challenges on structural reforms and system changes, and not on simply making a new request for funding.
We can all agree with the improvements the actions intend to deliver, which are,
“earlier diagnosis, reduced travel and access barriers for patients, and relieving pressure on acute services by preventing deterioration and avoidable hospital admissions.”
That is crucial. At the election, I was pleased to stand for a party that wanted, when in government, to bring its power and might to bear on the biggest killers. The Government very much intend to deliver those improvements through the core shifts set out in the 10-year plan for the NHS.
For patients with vascular disease, that will mean fewer trips to hospital as we shift care closer to home and into the community. It will mean better use of digital technology—my hon. Friend the Member for Glasgow South West referred to the innovation part of my title, and there is more to come on that—to identify vascular disease, monitor its progression and, finally, stop it from developing or worsening.
In preparation for this debate, I have been encouraged—mercifully, I am pleased to say—to use my remarks reflect the call to action from the APPG.
Dr Ahmed
The Minister is making a powerful case that to govern is to make decisions. Does he agree that when it comes to the NHS, while we talk a lot about money, input and investment, today we are ultimately talking about reform, taking different decisions and showing leadership? Does he agree that, given the situation in Scotland and my constituency of Glasgow South West, where there is more money and more staff, it is quite obvious that it is political will that ultimately makes the difference?
Mr Frith
I concur fully with my hon. Friend’s point. I noted his earlier remark about the commissioning of outcomes, and I think that one of the developing themes adjoining my own thinking and my brief is the need to get better at commissioning outcomes, considering whole populations, communities and places, and determining how we spend our money based on outcomes, not just activity. My hon. Friend makes a very powerful point with his question.
The hon. Member for Strangford and other members of the APPG feel strongly about the establishment of a national foot attack pathway. The Government’s ambition for integrated care boards to act as strategic commissioners focused on the needs of local populations is very much determined to assist that. The prevalence of vascular disease is not evenly distributed, as the hon. Member for North Shropshire (Helen Morgan) mentioned. ICBs are expected to use their nationally supported local commissioning power and their local data and intelligence, which includes user feedback and outcomes data, to develop a deep understanding of local need as well as local plans to develop and deliver.
Jim Shannon
I thank the Minister very much for that response; it is incredibly helpful. There seems to be a postcode lottery, where those who need care get it in some places but not in others. Does the Minister feel that his policy will ensure deliverability across all postcodes, not just in single places?
Mr Frith
That is a very fair and right challenge. This is not about endorsing patchwork provision; it is about understanding that, whether because of the physiological, social, environmental or behavioural differences that exist, care is not evenly distributed. We should have standards that we expect nationally, but we should also commission and empower local ICBs to commission, and we should hold them accountable through the frameworks and the work that we do in the Department.
Helen Morgan
I agree with the Minister that services should be locally commissioned, particularly where there is a high prevalence of a certain type of disease or condition, because it allows for the shaping of those services to local circumstances. There is evidence, is there not, that local commissioning has not given us a consistent level of service across the country. What steps are the Government taking to ensure that that does not become more entrenched as we empower ICBs even more through the Health Bill?
Mr Frith
I hope that my further remarks will address that very point; I am happy to pick it up with the hon. Member in due course if they do not satisfy.
ICBs will use national modern service frameworks set by the Government and guidance to create the right services for their areas. That means local systems coming together to create neighbourhood services that reform the health and care system and are rooted in the needs of people and communities.
On the issue of maximum waiting times for vascular disease, this Government recognise that it is imperative that any patient requiring a vascular assessment receives that in a timeframe that reflects their condition and enables the best possible health outcome. The Government are committed to making progress on NHS waiting times, including returning by March ’29 to the NHS constitutional standard of 92% of elective care patients’ waiting times from referral to treatment being within 18 weeks. Of course, that includes those patients waiting for vascular services.
The NHS met the first interim target of 65% in March ’26, and we are now focused on driving improvements to achieve our second interim target of 70% by 2027. To help support the commitment to reduce waiting times, the podiatry workforce pipeline is currently being strengthened through NHS England’s focus programme for small and vulnerable professions, with the NHS workforce plan to be published shortly.
The health service also has clear guidance on what is required in delivering services for people with vascular disease or at risk of developing it. In March ’26, NHS England published guidance on standardising community health services. That guidance identifies podiatry, diabetes and tissue viability, and wound care as core components of ICB-funded community provision. People who need urgent wound assessment—for example, those with suspected infection, rapid deterioration, or diabetic foot ulcer—should be seen within 24 hours. The guidance also makes it clear that routine assessments should occur within five to seven working days, with data collected on healing and complications. The purpose and goal of community health services must be to support people as well as to avoid their needing to be admitted to hospital and, critically, the need for amputations.
Jim Shannon
I thank the Minister for his generosity in giving us a chance to ask questions. One of the areas that the APPG and we elected representatives have identified is that there are areas of deprivation where levels of vascular ill health and amputations are higher. What can be done to reduce that in areas of deprivation? I know I have them in my area. I am sure the hon. Member for Glasgow South West (Dr Ahmed) and others have them in theirs. I would like a focus on that, please, if the Minister does not mind.
Mr Frith
The hon. Member is absolutely right. We have to keep ICBs and their commissioning powers accountable to local jurisdictions. I will say a bit more on that in due course, but we are on the same page.
To facilitate faster assessments we also need to speed up and make earlier diagnoses, which is why the Government plan to open four new community diagnostic centres during ’26-27. That expanding capacity will help meet our March ’29 target that no more than 1% of patients should wait over six weeks for a diagnostic test.
On reforming commissioning to reward outcomes, as set out in the 10-year health plan, we want to develop new ways to pay healthcare providers based on clinical practice that maximises productivity and outcome, as my hon. Friend the Member for Glasgow South West mentioned. Under the best practice tariffs, providers receive payment when they follow agreed standards of care. On the adoption of proven innovation, the APPG report rightly identifies the importance of the NHS being able to quickly adopt new innovations.
As part of my responsibility to oversee further development and enhancement of the use and usability of the NHS app, one development coming through the House at the moment is the creation of the single patient record. The future exciting development of NHS online, or digital doctor, as I might yet call it, is about the digitisation of our NHS service—embracing innovation, personalising healthcare and responsive to individual need—as well as the innovator passport, delivered through a phased approach to accelerate access to and adoption of technologies.
The APPG’s report says that preventing vascular disease and its deterioration should be at the centre of the system, and I agree. Identifying people with vascular diseases and providing care centred on their needs is critical to ensuring vascular disease does not progress to the point where somebody needs incredibly serious interventions, such as a leg needing to be amputated. In this modern era, such amputations are wholly avoidable and should be prevented.
The distinction between the APPG’s report and the Government’s most recent announcement of the MSF has been mentioned. I was delighted to join the British Heart Foundation yesterday at the celebration event for the MSF ahead of the delivery plan later in the year. It is a reasonable challenge to ensure that we distinguish between conditions, a point made by the Opposition spokesperson, the hon. Member for Solihull West and Shirley. It was a point made to me—and a point I thought was likely to be raised with me—by stroke and diabetes charities at the event yesterday. We are on the same page on that. He made an excellent point and challenge on the distinction that is needed.
As hon. Members will know, prevention is at the heart of the Government’s health agenda—the prevention of health conditions and the prevention of them worsening. The cardiovascular disease modern service framework, which was published in July, sets a clear direction for how health and care systems should accelerate progress on the Government’s ambition to reduce premature mortality from heart disease and stroke by a quarter within a decade.
My hon. Friend the Member for Broxtowe (Juliet Campbell) talked about irregularity and different areas having different levels of heart failure, which she said was four times more likely in the area she represents. I would be very happy to have conversations about how we can embrace that insight and intervene. Prevention is fundamental to the Government’s efforts around an annual heart failure review, improving access to rapid diagnosis and embedding heart failure support in cardiac rehabilitation, as well as the wider Government goal to reduce premature mortality by a quarter within the next decade.
Central to the cardiovascular disease modern service framework is a holistic approach with a strong focus on reducing inequalities. The principles apply here, too: the missing millions; the need for healthy intervention and to understand the difference between the physiological, behavioural, environmental and social; an appreciation that living standards and the cost of living have as much impact as any knowledge of what to eat and when; and looking after each other. It is about commissioning for outputs, not just diktat, which means recognising that several conditions and risk factors share common causes and contribute to most heart attacks and strokes. Members have described them in their speeches: high blood pressure, smoking, diabetes, high cholesterol, unhealthy diet and lack of exercise.
At its core, the framework is about a fundamental shift towards proactive, whole-person, preventive care that is located in communities and neighbourhoods and makes better use of hybrid, traditional, in-person and digital models to increase uptake and treatment. Podiatry and related foot-health services align with the shift towards local community hub delivery. The framework’s approach is backed by wider Government, including the creation of the first smoke-free generation, which began under the Conservative Government.
Dr Ahmed
I will be quick, because I know the Minister wants to wind up and I am sure he has plenty of things to do. He is talking powerfully about the digital offering that the Labour Government are providing to patients today in England and, more importantly, our ambitions for the digital offer in the future. This will seem like science fiction to many of my constituents in Glasgow South West, where we have no NHS app and very little digital connectivity in the healthcare system. Will the Minister please take the learning and markers of quality—particularly the digital quality markers—that he is describing in the modern service framework to our friends and colleagues in the Scottish Government? My constituents cannot wait any longer.
Mr Frith
In the humblest of terms, I would be very happy to visit and speak to my Scottish counterparts to ensure that they take that opportunity, and that any development, whether on compatibility, operability, the learnings from the NHS app in how we then develop NHS Online—that sounds a bit too much like building a website; we have to be more ambitious and describe it as what it is, which is the digitalisation of our NHS—helps to ensure that our brothers and sisters in Scotland get the same level of digital access that we expect to deliver across the NHS in England.
Jim Shannon
The hon. Member for Glasgow South West (Dr Ahmed) has nabbed my request—it is not about green cheese, by the way, Minister. My request is that the kindness the Minister has extended in respect of the hon. Gentleman and the Scottish health service is also extended to us in Northern Ireland, because expertise gained here can be shared so that we can all benefit.
Mr Frith
I will take any excuse I can to come to Northern Ireland, and I hope my private office has noted that.
In closing, our approach to improving the treatment of vascular diseases is closely aligned with the reforms in the APPG report and the APPG’s ambitions. I know that, of course, there will be other areas in which the APPG, and the hon. Member for Strangford, will rightly continue to push for further progress. I thank hon. Members for their contributions, and I thank the APPG for its important work and report. I look forward to continued dialogue on this issue to improve the NHS, especially services for vascular disease.
Jim Shannon
I thank everyone for their contributions, including the hon. Member for Broxtowe (Juliet Campbell). It is perhaps disquieting to understand that the hon. Lady has four times the number of people with vascular health issues in her constituency compared with elsewhere. That indicates a level of deprivation that is seen in certain areas of my constituency, across Northern Ireland, and in Glasgow South West. I thank her for outlining those issues. The hon. Lady also said that investment needs to go further, and was very kind to share the experiences of her constituency.
We are pleased to have the hon. Member for Glasgow South West (Dr Ahmed) here. He brings vast knowledge. The great thing about these debates is that everybody brings their expertise. The hon. Gentleman has done that, and we are very pleased that he shared some of his lifetime of knowledge, which resonated with some of those in the Public Gallery. The hon. Gentleman learned the business, so to speak, and is now able to contribute to others along life’s way. That is incredibly helpful.
Glasgow has one of the largest hospitals in the country, and there is a need to ensure that some of the highest stats in Scotland are addressed, such as those relating to lower life expectancy, the diabetic foot protection service, vascular community waiting times and improvements, and pay for output and outcome. There was an incredible focus on all those things in the debate, and we thank the hon. Gentleman for that.
Over the past few days in the Chamber, the Liberal Democrat spokesperson, the hon. Member for North Shropshire (Helen Morgan), has made valuable contributions and proven herself be an expert on all health subjects when it comes to the Health Bill. Today, she referred to vascular disease as being as “common as cancer” and a “preventable disability”, and spoke about a “postcode lottery” of care, the issue of “delayed diagnosis” and how her county has one of the highest rates of lower-limb amputations. She also mentioned the issues of waiting times and care for those with long-term diseases.
We do not always think about the mental health impact of this issue—its impact on someone’s anxiety, depression or ability to cope with life. If someone is able to walk about and do things and then suddenly something happens and they lose a limb, their mental health will be affected.
The Conservative spokesperson, the hon. Member for Solihull West and Shirley (Dr Shastri-Hurst), also brings his interest to this place. We spoke about this in the morning and the other day. He referred to the treatment and the access for services. He referred to the five recommendations from the APPG—getting it right first time, the foot care teams and all those things. If ICBs’ budgets are to be reduced, how will the vascular and venous strategy be delivered? The Minister gave us some indication of how that was going to happen, and there is certainly a commitment to it. We appreciate that.
When will national waiting times be addressed? When will the needed national foot attack pathway be in place? Again, it is about better use of NHS resources.
I am very pleased to have a Minister who responds to us, takes the subject matter on board and gives us the reassurance that we seek. He focused on the APPG report and committed to a national foot attack pathway, with ICBs and neighbourhood services having accountability. The Government are on the same page. The Minister talked about deprivation of access, and we all see that it is harder for people in some areas to get the treatment that they need.
I welcome the four new diagnostic centres that the Minister referred to. There will be further development and enhancement. “Digital doctor” is becoming a common phrase. I suspect we will hear it very often—I might even use it the odd time myself. The Minister is embracing innovation, as we all have to do. He spoke about prevention policy, accelerating the progress, targets set by the Government, a holistic approach, sorting out the outputs, and ensuring that we have facts about risk factors.
The hon. Member for Glasgow South West talked about the reform of systems and leadership. It is really important that the APPG focuses on that.
The APPG would be very pleased to have a meeting with the Minister—I think he will agree to that, although I will not judge him—and other Members here who have brought their expertise. That would be a beneficial meeting, because we are all on the same page, trying to achieve the same goals. If we can help the Minister to do that, we would be very pleased to take that forward.
I again thank everyone for taking part. Thank you, Dr Huq, for having patience with a fella who was supposed to have only two minutes—I think you have given me five.
Question put and agreed to.
Resolved,
That this House has considered the potential merits of reform of the vascular sector.
Fathers and Positive Male Role Models
(1 day, 9 hours ago)
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Sam Rushworth (Bishop Auckland) (Lab) [R]
I beg to move,
That this House has considered the contribution of fathers and positive male role models to families and society.
It is a privilege to serve under your chairmanship, Mrs Hobhouse. I thank Members from across the House for supporting this debate. As I prepared for it, I had in my mind’s eye the children and young people I represent across the Bishop Auckland constituency, who need active fathers and male role models in their lives, as well as the men who do their best to nurture, guide, teach, protect, provide, entertain and love as they raise children, often while juggling multiple other responsibilities and worries.
I want to make three points: first, that fathers and positive male role models are essential for addressing the challenges we face as a nation; secondly, that active fatherhood is good for men’s mental health and wellbeing; and, thirdly, that good public policy should support active fatherhood and the presence of positive male role models in young people’s lives. The importance of fathers and positive male role models cannot be overstated.
In 2015, Pope Francis observed that we are living through not an era of change, but the change of an era. Today’s children and youth are growing up in an uncertain world that is very different from the one I grew up in during the ’80s and ’90s. Our country faces profound challenges that have increased people’s sense of insecurity and worry. Tomorrow marks 25 years since 9/11 and the start of the war on terror, which has never really ended. Next came a global financial crash and a fall in living standards from which households in our communities have not recovered. We face a new cold war with Russia, economic uncertainty, extreme weather, and AI accelerating at such a pace that we do not know what the world will look like in five years from now. Our rising generation—the first to grow up in the era of social media—are experiencing a mental health crisis, a youth unemployment crisis and even an identity crisis.
What is consistent in this world of uncertainty? It is the love and security offered by familial bonds—the unique, deep connections of love, trust and mutual support that tie family members together—and the role of fathers is important in that. I must add a caveat: implicit in my definition of fatherhood is a positive, supportive and loving individual. I know that, sadly, there are children who suffer under the scrutiny and abuse of the men in their family unit. If I may be so bold, those men are not fathers, hence I also speak of positive male role models from whom young people can receive care and mentorship outside of the home.
The evidence is compelling: having an active father and positive male role models is strongly associated with positive outcomes in young people, while their absence is linked to bad outcomes and distress. A 2021 literature review by the University of Kent, commissioned by the previous Government, found that fathers’ increased involvement with their children positively affected their emotional, psychological and educational development, their future careers, and the future division of housework. In 2017, Klemera et al found that greater adolescent-father closeness was linked to a lower likelihood of a person self-harming. In 2008, Flouri found that higher levels of involvement by fathers and father figures correlated with higher levels of prosocial behaviour, self-esteem and happiness in adolescence for both sexes.
Mark Sewards (Leeds South West and Morley) (Lab)
My hon. Friend is making a powerful speech. I should declare that I speak as the dad of two young boys with a third on the way in November, so I have a vested interest when I say: what better way to make sure fathers are as involved as possible, as early on as possible, than to extend paternity and maternity leave? That is why it is so important that when the Government respond to their review into both those things, they extend paternity leave, in particular, to six weeks.
Sam Rushworth
I fully agree, and I am setting out the evidence base for that.
In 2018, Tracy et al found that higher levels of father involvement in children aged nine to 10 were associated with lower self-reported “violent perpetration” by both boys and girls when they reach 18 to 20. In 2010, Keung and Rees found that the frequency with which young people talked to their father about the things that mattered to them was positively associated with higher wellbeing and self-esteem. On the other hand, the Centre for Social Justice has warned:
“The disappearance of male role models is creating a generation of unhappy young boys.”
Its report “Lost Boys” found that fatherlessness and a lack of mentorship is deeply harming young men’s mental health, education and life paths.
Those are all things that I know from my own personal experience. We have this culture in politics—particularly those of us in the Labour party—of everyone needing a backstory to prove how working class they are, but while there are probably not many Members in this place whose family struggled financially like mine did, I want to be honest about how absolutely privileged I am. I grew up in a stable, loving home with a mum and dad who made raising us children their world.
Early memories of my dad include being taken on hikes through the countryside, and being dragged around old cathedrals and art galleries, if they were free—he was from Yorkshire—and taught to appreciate history and culture. We did not have a car in my early childhood, but mum and dad insisted I was a member of the “strong legs brigade” as I learned to walk everywhere. Rain was no problem; we had cagoules. Most of my clothes were hand-me-downs, but dad insisted on buying me Clarks shoes because he thought they were better for my growing feet, even though I noticed that his own shoes were often falling apart—he always gave us the best. As a lay church leader, dad would take me to visit older people and do acts of service for them. At Christmas we would spend our pocket money on gifts from B&M Bargains for kids less fortunate than us and drop them off on their doorsteps on Christmas eve.
Dad taught me to think of others. Sometimes that was explicit. We had a programme encouraged by our church, which we called family home evening, where one night a week was set aside for family time. It would include some sort of instruction—I remember being taught words like “integrity” and “kindness”—some fun game or activity, and always a home-made dessert.
As a junior civil servant in the auditing department, dad used to travel away from home, and when others were at the bar, he would always phone home to talk to us all. Wherever he went, he would get us a postcard with information about the place, expressions of love and some bad attempt at humour. I have kept them in a folder to this day. Another thing my dad taught me, and still teaches me today, is that the kindest thing I can do for my children is to love their mother. He taught me respect for women and womanhood.
Active fatherhood is not only good for children and youth; it is good for dads too. The Fatherhood Institute found that more active and involved fathers report lower levels of depression and higher relationship satisfaction than less involved fathers. That is certainly true for me; I am never happier than when spending time with Siobhain and the kids at home. Whenever I have faced disappointments or setbacks in my career, financial setbacks or times of stress and anxiety, and whenever I have questioned my worth, I have always known that I can walk through my front door and find my biggest fan club to welcome me back. They put my life in perspective.
I think my dad jokes are rubbing off on them, too. The other day, my 16-year-old daughter Jesse said to me, “Dad, you know you shouldn’t brush your teeth with your right hand?” I said, “No? Why’s that?” She said, “You’re supposed to use a toothbrush.”
But we have to be honest and recognise, too, that fatherhood is tough. The men’s health report commissioned by the former Health Secretary, my right hon. Friend the Member for Ilford North (Wes Streeting), notes that
“the transition to fatherhood can be a stressful and isolating experience. Men may turn towards unhealthy coping mechanisms, such as alcohol and drugs, or neglect their own health and wellbeing by prioritising supporting their family…
Estimates suggest 5 to 15% of fathers experience anxiety during the perinatal period and 5 to 10% of fathers experience depression. The mental health of fathers during this period is not routinely assessed, which can result in fathers missing out on opportunities for diagnosis, support and interventions. Fathers frequently report feeling ignored or considered unimportant by healthcare professionals during the perinatal period. Additionally, fathers often question the legitimacy of their own mental health challenges and entitlement to support, emphasising their partner’s needs over their own.”
That brings me to my final point: good public policy can be pivotal in making fatherhood a positive experience for dads and children, while bad policy or the absence of support can limit fathers’ potential positive impacts. I will quickly highlight two ways in which I think that matters. I will not go into great detail, because I imagine that other people will do so in their speeches.
Dr Luke Evans (Hinckley and Bosworth) (Con)
I applaud the hon. Gentleman for raising this topic. Although he and I are in different parties, we have long been on the same page about how important it is to have male role models and about the role of men and boys. Under the previous leadership, we were making progress, with a men and boys summit due to take place this summer. Unfortunately, it did not happen, but I am keen to see the Government bring it forward again. I hope he shares my ambition for it to happen, because for all the reasons he has talked about, it is imperative that the new leadership—the new Administration—keep grasping the nettle and take this forward. Does he agree?
Sam Rushworth
As I suspected I would, I agree with everything that the hon. Gentleman said. I think that there will be cross-party consensus in much of this debate, and I am sure that the Minister was listening to his intervention and may want to comment on it.
The first weeks of a newborn child’s life can be not only stressful, but a beautiful bonding experience. But while mothers, typically, are full-time nurturing and feeding the newborn baby, fathers are often immediately back to work. I therefore support the Dad Shift campaign for six weeks’ paternity leave at 90% of pay. The dads who miss out tend to be working class men—people who are self-employed, people who work on the tools. Paternity leave should not be a preserve of the middle classes, and yet that is too often the case. The evidence for its benefits in terms of early bonding with a child is immense.
This is not just about the early years. It is also about rewarding employers that introduce flexible and family-friendly working practices. That is one of the reasons why I supported the Union of Shop, Distributive and Allied Workers campaign to Keep Sunday Special and limit the extension of Sunday trading hours. It is important to have at least a day when parents know they can be with their children. It is also why I will not shop late on Christmas eve. I do not think that shops should be open on Christmas eve; parents should be with their families and able to enjoy that time.
Jayne Kirkham (Truro and Falmouth) (Lab/Co-op)
Does my hon. Friend recognise that it can be particularly difficult for men in the armed forces, who are often away? Even were there a willingness to provide paternity leave at 90% of pay, sometimes they simply cannot get the time. That is another thing that we need to consider when we are talking about male role models—men who work away.
Sam Rushworth
I do recognise that, and it is an important thing for the armed forces to consider. We need to ensure that all careers are as family friendly as possible. Let me take a moment, too, to pay respect to the people who make that sacrifice for us.
The final point that I want to put on the record is about family hubs and even parenting classes, which are slightly taboo. People get easily offended by the suggestion that they may need support with being a parent, as though somehow we are all born knowing these things. I know that if I could wind back the clock 19 years, I would be a better parent to my firstborn, because of the things that I have learned not only on the journey of being a parent, but through academic study of childhood.
The Government are rolling out Best Start family hubs, but not at the rate that we really need them. It should be a statutory provision. I remember attending antenatal classes with my wife. I learned about what those first few weeks of having a baby would be like, but after that you are on your own. There are so many important things about childhood development that parents want to learn and to do better.
Let me finish where I started. A Government who support fatherhood are a Government who support fathers to join mothers in doing just about the most important thing we can do: raising the next generation, during times of trouble and uncertainty, and building the resilience we need in that generation.
Several hon. Members rose—
Wera Hobhouse (in the Chair)
Order. I intend to call the Front Benchers just before 4 o’clock and there are 10 people who wish to speak in the debate, if I am counting correctly. An informal speech limit of about four and a half or five minutes should allow us to get everyone in.
Jim Shannon (Strangford) (DUP)
It is always a pleasure to serve under your chairship, Mrs Hobhouse. I thank the hon. Member for Bishop Auckland (Sam Rushworth) for leading the debate and sharing some of his childhood experiences. I think he has turned out all right, by the way; I think we probably all think that, and we congratulate him.
I deeply value the opportunity to be a positive role model myself, in my role as a father and a grandfather. I have six grandchildren, three girls and three boys. It is different being a grandfather. A dad has a stronger role, but a grandfather enjoys all the good times. The great thing about being a grandfather is that at 7 o’clock at night, I can give them back, just at the stage when they are getting stroppy and want things that maybe their grandfather cannot give them.
I am very pleased and privileged to have a good relationship with my three sons. I am also very thankful for my good wife, who has stuck with me over 39 years of married life. I am also very thankful for our godly father, who believed in loving his son and expecting good things, but also giving grace and love. My dad is dead some 11 years, but not a day passes that I do not miss him. I can only hope to have a similar relationship with my three sons and indeed with my grandchildren.
One of the headings in the House of Commons Library briefing is “Lads Need Dads”. They do. Many young men today find themselves facing what can only be described as a real crisis of value and purpose. While personal testimony alone is powerful, the research backs it up. Fatherlessness has been proven to have profound consequences for young men’s mental health, educational achievements and futures. This is an issue that is aptly termed not as lads need dads, but as a lost boys crisis.
In Northern Ireland, there are specific education and employment challenges facing working-class men, with male working-class pupils continuing to experience some of the poorest educational outcomes. That, combined with the decline of traditionally male-dominated, skills-based manufacturing industries, has removed many of the employment opportunities that were once accessible to those young men, and especially to their dads. That has led to concerning levels of economic inactivity among young men, creating a worrying cycle in which young men are left without a clear sense of purpose or belonging. The “Lost Boys” report of 2025 highlighted that, shockingly, boys in the United Kingdom are more likely to own a smartphone than to live with their father.
What difference does this make to young boys growing up today? As the presence of a positive role model is increasingly removed, boys turn, lost, to other things or people—people like controversial social media influencer Andrew Tate, who promotes harmful ideologies and reinforces damaging attitudes towards women. The hon. Member for Bishop Auckland referred to that. I was brought up to be respectful towards women, and that is what we should do.
We should certainly not underestimate the devastating consequences. Northern Ireland’s male suicide rates remain consistently higher than those of England and Wales. That is in my constituency, among the people I represent—it is real and it is happening. It should make every one of us stop and think about what we can do to ensure that these young men have the support that they need. I am pleased to see the Minister in his place. Does he agree that more needs to be done to support positive male role models, perhaps through mentorship programmes, which will ensure the wellbeing of our young men for the future?
This is not about suggesting that a child must grow up in a certain type of family. A positive role model can be a father, a teacher, a youth worker, a sports coach or an employer. In a world where children have access to so many voices, what matters is that they see men who demonstrate responsibility, integrity, kindness and respect for others. If we can demonstrate those four things, we can inspire young people for tomorrow. There are those whose mums take on both roles. These women are to be admired, and we are so thankful for all that they do, but there is a place for men. We need to encourage men to understand that while their relationship with others may sour, their children are theirs to help guide and love for life. That is an honour we should all cherish.
Josh Newbury (Cannock Chase) (Lab)
It is a pleasure to speak under your chairship, Mrs Hobhouse. I thank my hon. Friend the Member for Bishop Auckland (Sam Rushworth) for leading this debate so brilliantly, and of course for securing it. I am sure every dad in this room has at some point been asked, “Are you so-and-so’s dad?” I have, and it is one of my favourite things to hear. I am immensely proud when I am asked whether I am the father of my daughter or son—it even beats being asked, “Are you the MP?”
There are two core aspects of this conversation: the practical side, which is about supporting fathers to be active parents; and the cultural side, which is about the role models and the pride that we instil in young men. Starting with the practical, we recently welcomed a new member of my team who is just coming back from maternity leave. Her partner, who is self-employed, had to work six or even seven-day weeks for months before the birth of their daughter to build up enough of a financial buffer to simply be able to spend time with his partner and their newborn. She told me that, in situations like that, resentment can creep in as you begin to feel almost like a single parent. That is awful for both parents; the lack of support that others take for granted throws up so many financial and emotional challenges.
It is hardly surprising that many fathers feel that they do not have a choice. Currently, as we have heard, we have two weeks of paternity leave on less than £200 a week for employees. Meanwhile, Spanish dads get 16 weeks’ leave on full pay. Rights for employed British parents are miles behind our European neighbours, and self-employed dads do not even get those two weeks. As my hon. Friend the Member for Bishop Auckland said, the Dad Shift campaign for six weeks of paternity leave for all dads makes sense not only for families but for our economy.
That takes me on to what happens when families separate. The fathers I have spoken to want to support their children. Most want more time with their kids, but feel that the system still views them, first and foremost, as a financial provider, rather than as an equal parent. Take my constituent Matthew, who had heart surgery in June and was signed off sick for a month. When sending over his child maintenance, he underpaid by 5p due to a typo. That resulted in him being moved on to collect and pay, where a 20% collection charge is added to his payments.
Matthew is not alone; many constituents have described stress and anxiety linked to Child Maintenance Service disputes and separation from their children. Fathers have a responsibility to provide, but the current system seems out of step with where we are now at as a society. We have rightly moved on from the outdated concept that mothers’ contributions are confined to childcare and homemaking. Our systems must therefore dare to imagine that fathers are capable of more than just breadwinning.
That brings me to my second point: role models for boys and young men. In decades gone by, our role models were often fathers, stepfathers, grandfathers, uncles, teachers, coaches and scout leaders. Those influences mattered, but the world is now a much larger place. The number of voices reaching or even targeting young men has exploded. The stories we tell about men matter. They shape how young people see themselves. In a world bristling with thousands of narratives, young men are all too often bombarded with negativity, whether it is about their role in society or about the whole concept of masculinity.
We hear a lot about so-called “toxic masculinity”. I do not think any of us doubt that there are behaviours that must be challenged, but rather than leaving a void, we need positivity—around what it means to be a man and a dad—to rush in. I want my son to grow up knowing that being a man means looking after the people you love, being a dependable friend, showing courage and treating others with respect. The answer, of course is not to abandon masculinity, but to reclaim the best parts of it. That means giving boys somewhere to go and something to work towards. If a teenager sees no apprenticeship, no sports provision and no trusted adult—if, like in Staffordshire, there is a total lack of youth provision—we should not be surprised if young men look elsewhere for belonging.
I am short for time, so I will finish where I started: one day my children will be old enough that people will not stop me in the street and say, “Are you so-and-so’s dad?” That is something I will profoundly miss when I get to that point. I want more fathers to have the chance to feel the immense pride of being at the centre of their children’s world, and more men and boys to feel proud of their masculinity in all its complexity. Let us make sure that that is the message that radiates out from this House.
Wera Hobhouse (in the Chair)
Please do not feel rushed, because this is an important debate. I have put an informal time limit on the annunciator. If Members stick to it roughly, we should get everybody in.
Mr Luke Charters (York Outer) (Lab)
It is a pleasure to serve under your chairship, Mrs Hobhouse. I am chuffed that we are having this debate, as, reportedly, I am the youngest parent in Parliament. I was the first dad to take extended parental leave as an MP by appointing an MP representative, but we want a similar opportunity for all dads across the country.
Post-war Britain was built by working-class families, who frankly deserved more time with their kids. The fact is, they never really got it, and that continued into the ’60s and ’70s—my dad’s generation. My dad came from a council house to become a joiner, but it was his dad who went down the pit, and it was my mum’s dad who worked on the floor of a bacon factory—one powered the nation, one fed it, and my dad helped to build it. I will never shy away from telling their stories, because I am proud of them. For their generation, work came first, because they felt it had to. The role of a dad in society has shifted and continues to evolve. Fathers rightly taught important lessons about graft, grit and hard work, but the role is changing, and now, as society shifts, the greatest contribution a man can make to society is by being a present father.
The biggest barrier to that is the fact that Britain’s paternity leave remains among the weakest in western Europe, and I am proud that this Labour Government are committed to ending that injustice. We have been lagging behind, because Sweden began normalising hands-on fatherhood in the ’70s. The image was simple: the latte papas—a dad with a toddler, a pram and a coffee, spending time with his children alongside his friends. Norway went further in 1993, introducing four paid weeks reserved for fathers with full-wage compensation. Yes, it was a Labour Government who introduced statutory sick pay in the noughties, but the fact of the matter is, right here, right now, in Britain, we are 40 years behind Norway and Demark. Research from the University of Copenhagen links longer parental leave with better wellbeing, better emotional stability and behaviour later in life.
Swap Stockholm’s pastries for Yorkshire puddings, swap Copenhagen’s Lego and follow the shared Viking heritage, and we can see that York is leading on advocacy for greater parental rights today. The Joseph Rowntree Foundation, which is headquartered in my constituency, has published research that shows that six weeks of statutory paternity leave at 90% of earnings could deliver a net economic gain of £2.7 billion a year to the UK economy. Whether it is the University of York’s equal parenting project, or my constituent Joeli Brearley, founder of Pregnant Then Screwed, York is putting parental rights firmly on the national agenda.
I try to balance my job with being a present father, including bringing my boys here to Parliament. That might mean explosive nappies before votes, running around in the family room, or even sneaking them into the Tea Room for jelly and toast. My boys have become two little mascots who have joined me every step of the way in my campaign for better paternity leave for dads. I remember being at the Movember head office, where I was talking to the legendary Dad Shift and Mother Pukka. I will never forget the kindness of Amy O’Connor at Movember, who made Robin, my son, some slices of toast.
Putting my kids first does not make me a worse MP; it makes me a better, more grounded one. When my boys are here with me in Parliament, we make happy memories together as a family, but when they are not here, we miss each other. This week, we all cried at the end of a FaceTime call. Even at three, Robin understands that when his daddy is away, he is out there maybe fighting for other families. I really believe that a world powered by a parent’s love of their children is just a world that is better for all of us.
Sureena Brackenridge (Wolverhampton North East) (Lab)
That speech has brought tears to my eyes. It is a pleasure to serve under your chairship, Mrs Hobhouse. I thank my hon. Friend the Member for York Outer (Mr Charters) for that insight, and I wish him and his family the very best. He really is a champion for dads across the country, including our constituents. I also thank my hon. Friend the Member for Bishop Auckland (Sam Rushworth) for securing this debate.
When I ask young people what springs to mind when they hear the term “masculinity”, they quickly respond with words that we have already heard today: “toxic”, “manosphere” and the names of influencers that I choose not to mention in this place. I then dig a little deeper and ask them what they think makes a good dad, a good son, a good brother, a good cousin or a good mate, and I hear very different words—words such as “kindness”, “caring”, “protective”, “loyal”, “supportive”, “hard-working”, “loving”, “respectful” and “someone you can rely on”.
That contrast is incredibly important, because masculinity is not the problem; the problem is the version of masculinity that young men are being sold and who is selling it to them. I use those terms “sold” and “selling”, because monetary value is indeed driving this situation. Alarmingly, young people are encountering online characters who tell them that being a man is about dominance; we see the aggression, money, status and control of others. But such messages should not define what masculinity is.
Thanks to my hon. Friend the Member for Bishop Auckland, we are here to debate the contribution that positive male role models make in everyday society. I took a moment to consider my constituency of Wolverhampton North East, and specifically what has taken place during the recent summer holidays. There are so many men in Wolverhampton North East who might not even realise how important they are to so many boys and young men in our communities.
I am proud of the role models that we have in Wolverhampton North East, such as the guys from Wednesfield’s Men Walking and Talking group; Joe Jackson and the coaches from Newpark Village Football Academy; Raj and the team from Wolverhampton Wrestling Club; Mac and the coaches from Wolverhampton Judo Club; Nigel at Willenhall Lock Stock, who has long supported local talent; Ben and Ryan, who run a truly community-centred pub called The Milestone in New Invention; and James at The Hub at Ashmore Park. We have so many wonderful teachers and pastoral staff who regularly go above and beyond—including those involved in cadets and scouts groups, and so many others—that I just do not have time to mention all of them, but they all give their time to mentor young people, and they also spend time helping other people’s families, sometimes at the cost of their own. I want to put on the record my thanks to them all.
Not one of those people is selling a lifestyle and or telling young men how to behave. They are simply showing what they believe—their values—through their actions and what it means to be a good man: to be there, to listen, to encourage others, to take responsibility, but also to give something back.
We have to challenge the harmful messages around masculinity. We all— Government, MPs and all responsible people who are part of the community—must take responsibility for giving young men positive examples of what they can be. I ask the Minister to look at what more the Government can do to support the mentors, youth services, sports clubs and community organisations that are already doing this work, and to make sure that they have the funding and support they need to reach as many young people as possible, in order to give them positive role models and something better to listen to than the toxic voices that we hear online.
Jayne Kirkham (Truro and Falmouth) (Lab/Co-op)
It is a pleasure to serve under your chairship, Mrs Hobhouse. I congratulate my hon. Friend the Member for Bishop Auckland (Sam Rushworth) on securing this debate; it has been fascinating so far.
The Centre for Social Justice’s recent report, which a number of people have talked about, revealed that 76% of people surveyed believed that teenagers today lack proper role models in popular culture. The opportunity for young men to find positive male role models is limited. We have talked about there being 1,000 fewer youth clubs today than there were 15 years ago, and the number of youth workers has fallen by over a third. When young men feel disconnected and lack representations of positive masculinity, an empty space can open up, and unfortunately some of the loudest and most harmful voices are all too keen to fill it.
That disconnection can carry real-world consequences. Between April and June 2026, 530,000 young men aged 16 to 24—13.7%—were not in education, employment or training, compared with 12.3% of young women. The CSJ highlights that the proportion of young men who are NEET is climbing. That can snowball into strain on health and relationships or tip over into the criminal justice system; when it gets really bad, we see very high suicide rates, as we have in Cornwall, particularly for men.
However, there are examples of community-led interventions that help young men to find positive male role models. I see them across my constituency. We have a Men Walking and Talking Group, which brings men together to walk, talk openly and support each other. It is often much easier to talk walking side by side than face to face. That group has been meeting for over 75 weeks, with good turnout. We also have ABandOfBrothers, which mentors young men aged 18 to 25 who are caught up in or at risk of getting into the criminal justice system. They are paired with older men who volunteer to act as mentors. They get outside, talk to each other and offer a community-based opportunity to strengthen cohesion and support young men who have often had chaotic lives and are trying to navigate the complexities of growing up.
Having a supportive foundation is really important when young men become dads themselves. That was the goal of DadPad, created in 2012 by Julian Bose from Truro. Having personal experience of the lack of guidance for expectant fathers, he developed a guide himself to support men navigating that transition. We need to reach boys far earlier to avoid the formation of the empty space in the first place. Across Cornwall, we have holiday and sports programmes, such as football camps run by Plymouth Argyle’s community trust, that give young people healthy environments and men to look up to outside of home and school.
Those community-led initiatives are important, but they cannot fill the gap on their own. The men’s health strategy published by the Government last November provides a policy framework to tackle the empty space. By addressing early on the physical and mental health inequalities that boys and men face, we create the structural conditions whereby young men can succeed.
For the last three years, I have tried to be both dad and mum. Obviously, I cannot, but I am very lucky that there are uncles, teachers, sportspeople, godparents, grandparents and cousins who can all provide effective examples for my son and other young men. In Cornwall, we have great examples of groups providing those opportunities. When the national policy and local initiatives align, we can ensure that young men have many positive examples so that they can build their aspirations, grow into their masculinity and benefit themselves, their future families and society as a whole.
Jon Pearce (High Peak) (Lab)
It is a pleasure to serve under your chairship, Mrs Hobhouse. I thank my hon. Friend the Member for Bishop Auckland (Sam Rushworth) for securing this important debate. There are so many positive male role models in my constituency and across the country that I could talk about, but I want to focus on one hugely important group: dads.
I was lucky with my first child that the job I had then allowed me to be present—not just to lend a hand or spend time with my baby, but to co-parent. In this job, I have noticed the difference. I am often back too late for school and nursery pick-ups; indeed, I will be today. When I get home, I find myself asking, “What do they like to eat? What is the toy that they should be playing with in the bath? What bedtime story are they into at the moment?” Little things—but parenthood is all about the little things. Miss those moments, and we risk missing the bigger picture.
For most children, their first, most important male role model is not an influencer or a celebrity; it is dad. The alternative—the toxic masculinity offered by the likes of the brothers Tate—is not worth thinking about. That is not the society I want my girls to grow up in. Real strength is having the character to step up for those who need us—not standing alone, flexing our muscles in front of the mirror. Real resilience is getting up, tired, night after night, rocking a baby with no end in sight; I can tell Members that it does more for the biceps than going to the gym.
We should do everything we can to support dads to be there, but we have a real socioeconomic divide in Britain. Some 90% of claimed paternity leave goes to the highest earners. A right that people cannot afford is no right at all. If people are self-employed—our farmers, plumbers and delivery drivers—they have no right to paternity leave at all. What message are we sending to the dads who keep Britain working?
That matters particularly in rural constituencies such as mine in High Peak. After a caesarean section, which my wife had, mothers are advised not to drive for six weeks. In rural constituencies, not being able to drive can mean isolation. If dad goes back to work after two weeks, who picks the other children up from school? Who takes them to nursery? Who nips to the supermarket to get nappies when they run out? In those first few weeks, just being there is priceless.
The economic evidence is compelling. New research from the King’s Global Institute for Women’s Leadership shows that six weeks of paternity leave, paid at 90% of earnings, could deliver a £2.6 billion net boost to the UK economy every year. That is because, when fathers have proper paid leave, mothers are better able to remain in work and increase their hours. There is also good evidence that better paternity leave reduces relationship breakdowns, keeping more male role models in the home, which means huge savings for the state in housing and benefits.
Extending paternity leave should not be seen as a cost. It is an investment in Britain. We have the worst paternity leave in Europe, and it is time we called time on it, by offering six weeks at 90% of earnings reserved for fathers and second parents, with the equivalent entitlement for self-employed and insecure workers. If we want boys to see caring, responsibility and kindness as strengths, we need to help the men in their lives to be there. I have been the father who was there for the little things, but I have also been the father who has missed them. I can tell you, Mrs Hobhouse, that a little change to paternity leave can make a big difference to the lives of men and women and their children.
Kevin McKenna (Sittingbourne and Sheppey) (Lab)
It is a real pleasure to serve under your chairship, Mrs Hobhouse. Massive congratulations to my hon. Friend the Member for Bishop Auckland (Sam Rushworth) on securing this very timely debate on a topic that lights up the attention of many Members of this House. For me, the discussion about fatherhood and paternity leave has brought recollections—well, not really recollections, because I do not remember the first few weeks of my life, but my father died last year, and his death has put me in a particularly reflective cast of mind. He was so important in getting me through those first few weeks.
I was born with a cleft palate, as about 700 children a year are in the United Kingdom. That was a big shock to my father and my mother, and it put additional strain on my parents, because I was unable to swallow and feeding was very difficult. I failed to thrive in the first couple of weeks as a baby. I was losing weight quite rapidly. The medical team was insisting on one particular mode of feeding implement to get me to take food in. My mum and dad knew that it was not working, but they could not get the help they needed. Thankfully, in the end, one of the nurses in the hospital sidled up to my dad and said, “Look, the doctors won’t tell you this, but this old-fashioned device works so much better.” It was just an implement that went on the top of the bottle, and my dad put his feet right to the floor to try to find it somewhere. He went all over London, all the way from Kent to the south-east London border, and eventually wound up at a pharmacist’s in Camden Town that had it in stock. That was a huge amount of support that he had to put in. It took him away from his work. We are talking about 1974; it is not like paternity leave was a thing back then, and the expectations on men were so different.
That is just an example of how much so many fathers have to put in to support their families through those first few precious days of a child’s life. That is replicated across the country: dads are doing so much for their children and their partners—their wives and girlfriends and the mothers of their children—and it is something we have to facilitate. Not everyone will have that kind of situation, but every father, mother and parent of a new-born child will face big challenges. Particularly with the first child, it always feels like the biggest challenge you have faced in your life up to that point.
That all really matters, because the inspiration and caring that my father showed then, which were reflected through his whole life, gave me the confidence to move into a caring profession as a nurse and to have a take on masculinity that is not so bound by the conventions of society and the manosphere problems we are talking about.
I see versions of that all over. In my constituency, there is an inspirational boxing club, the Apex Boxing Academy in Sheerness. Absolutely, it is a boxing club; it is about young people learning how to channel their aggressive impulses into discipline. There are the dads who support it as volunteers, and it has also built in not just practical support around the boxing, but counselling and mental health support for the boys and girls learning to box. The club is really showing how masculinity, fatherhood or just being a man in the world do not have to fit into any preconceived box—whether that is this aggro, toxic masculinity or, indeed, some other form of masculinity that people may not feel so confident buying into—because it is a very complicated world that we live in.
All of that is inspirational to me. It is why I strongly support this push for six fully paid weeks of paternity leave for fathers. The Women and Equalities Committee published a report pushing for that last year. I was lucky to go to Spain with the Committee this year to see how the policy is working in Spain. It is brilliant; from talking to people, it is clear that it has been transformational. If we followed the Spanish example in my constituency, 880 dads a year would absolutely take the offer up. That would be an incredible change for people in Sittingbourne and Sheppey. I strongly commend it to the Minister.
Chris Kane (Stirling and Strathallan) (Lab)
I want to start by asking all of us to think of a positive male role model from our youth. If you are lucky, you now have a face in your mind and a smile in your heart. If you do not, we as a society owe you our apologies and a promise to do better for those who will come next.
I have been very lucky in the positive male role models I have had throughout my life. My dad was the first; he ran his own electrical business in Stirling. Back then, he was not—and he still is not—particularly good at talking about emotional connection. He taught mainly by example: work hard, treat people properly and earn their trust. I helped out in his shop from a young age, alongside characters such as Colin, Keith, Andy and Bill. I doubt any of them ever went to work thinking that they were going to be positive male role models, but I was watching.
Of course, when we talk about positive male role models, there is one relationship at the heart of this debate: fathers and their children. When my wife and I brought our daughter home from the hospital, we unclipped the car seat and carried it into the house. We sat on the couch, with the car seat on the carpet in front of us, and we stared at this tiny baby. I looked at my wife and said, “What the hell do we do now?” We both burst out laughing—well, I think it was laughter; it may have been hyperventilating. But we worked it out, as parents do.
I can look back now and admit that I was not as supportive in those first weeks as Anne would have wanted. I felt huge pressure to get back to work—I was self-employed at the time—so when I read that financial pressure is the biggest barrier that fathers identify to taking more leave, I recognise something of my own experience.
When our children were young, I presented a radio show from Monday to Friday, and Anne worked as a radio journalist on Saturday and Sunday. That is how we kept two careers going while raising a family and paying the bills. For my parents’ generation, many families could be supported by one salary. For my generation, that could perhaps be managed at a stretch. For my children’s generation, two salaries are not a choice but a necessity. If we are content with this economic model, we have to make it easier for fathers to take their share of the parenting responsibility. That means looking seriously at paternity leave, including the financial barriers to taking it and the position of self-employed fathers.
This is not simply about fathers. If we want mothers and fathers to have equal opportunities in the workplace, we need to make it possible for them to take a more equal share at home. The two go together. The connection between fathers taking on more care and us tackling the motherhood penalty is important.
I would go further: we need to look at the wider economics of family life, and that means housing. Building more council houses and reducing the cost of putting a roof over a family’s head is a key family policy. The less pressure there is on the family budget, the more choices parents have about work, childcare and that most precious commodity: their time.
There is something else we should say in this debate to those thinking about not just positive role models but doing something a little more formal, such as volunteering with a charity of a group: it is hugely rewarding. We all want a sense of belonging, and to feel that we are getting something from and giving something to our families and communities. There is something profoundly rewarding about watching a child develop, find their confidence, form their own views and gradually become the next generation. Perhaps we should get better at asking men to step forward, and make it easier for them to do so.
I hope my children would say that I have been a present, approachable and loving dad—I have not asked them today, just in case—although I do know my place in the family hierarchy. When my daughter was about four, she asked me who my favourite child was—her or her younger brother. I said, “I love you both equally. That is like me asking who your favourite parent is.” She went very quiet, and I asked what was wrong. She said, “I can’t tell you, Dad. I don’t want to make you sad.”
If I could give my 30-year-old self, starting out as a father, one piece of advice about fatherhood, it would be this. Do your best. Accept that you are human—I am going to start crying here—and that you will get things wrong. Try again, and try to do better. That approach in itself is a valuable lesson to show all children.
Matt Turmaine (Watford) (Lab)
It is a pleasure to serve under your chairmanship, Mrs Hobhouse. I congratulate my hon. Friend the Member for Bishop Auckland (Sam Rushworth) on securing this important debate, and I thank those who have given such meaningful and touching speeches.
The role of fathers and positive role models is more important than ever in our society. Our country has so many things better than it used to years ago. We have better housing, physical healthcare and quality of life than previous generations. However, it is also a country in which old certainties are being eroded. The challenges include, of course, social media and the toxic constant of online harms, and there is also the challenge to young people of finding secure, meaningful work and somewhere to live and maintaining good mental health. The way societal developments impact our children clearly demonstrates the need for positive male role models and parenting provision in Britain and around the world.
So what can we do to help make fathers more present and engaged in the lives of our children? Better paternity pay would undoubtedly feature. The report “Economic and Social Benefits of Enhanced Paternity Leave” was published this week. As we have heard, the UK’s statutory paternity leave is the worst in Europe, with two weeks’ leave paid at less than half the minimum wage. That is truly shocking. The evidence is mounting that substantial, well-paid paternity leave is the key to unlocking better outcomes in the UK. Better paternity leave reduces postpartum depression rates and the gender pay gap in the workplace, improves children’s performance at school and enhances fathers’ wellbeing.
British parents deserve to be accommodated and supported in the workplace and have the opportunity to equally share parenthood between them, leading to a more prosperous country for us all. We cannot discuss the importance of male role models and present fathers if we do not discuss the measures we can take to facilitate that. Improving paternity leave is the first step towards recognising fathers as equally important parents.
The challenge to our young people and the risk of becoming NEET—not in education, employment or training—has become ever more worrying for young fathers and those they parent. Alan Milburn has recently published a report diagnosing the problem, and it makes for very concerning reading. The Centre for Social Justice reported back in April that a lack of male role models is partly responsible for teenage boys’ collapsing happiness and wellbeing. The report found that the number of male volunteers in sports and leisure clubs is falling, and that there are now 1,000 fewer youth clubs than there were 15 years ago—something I have seen in my constituency of Watford.
The report also found that, tragically, more young boys in the UK today grow up with a smartphone than with a father figure in the home. Is it any wonder that young boys are turning to alternative male role models online and falling down the toxic manosphere rabbit hole? We cannot rescue this generation from online extreme hate and declining school performance without filling the gaps that have been created in their lives. We must invest in more clubs, sports teams and youth centres so that our boys get the same socialisation and learning opportunities as previous generations. Fathers and positive role models have a vital part to play in ensuring the physical and mental health of our children and their ability to experience high-quality education and find meaningful work.
Wera Hobhouse (in the Chair)
Thank you all for sticking so beautifully to the voluntary time limit. Everybody got in. I call the Liberal Democrat spokesperson, Alex Brewer.
Alex Brewer (North East Hampshire) (LD)
It is a pleasure to serve with you in the Chair, Mrs Hobhouse. I congratulate the hon. Member for Bishop Auckland (Sam Rushworth) on introducing this really important debate.
There is a contradiction between the widely shared agreement, certainly in this Chamber, about the vital importance of a positive male role model in shaping young lives and the lack of support, services and policy to support that. But let me say something equally important at the outset: a child does not need a father in the house to flourish. Children raised by single mothers, two mothers, grandmothers or kinship carers are not children with something missing. I represent many such families, and we have heard powerful testimony about them today. They do an extraordinary job, often with less support than they deserve.
Children benefit from care, stability and good examples of how to be in the world. It matters whether every child has adults around them modelling something worth copying, but a good role model must first be a present one, and presence is a question not simply of character but of how we structure our society. If we want fathers to be there in the earliest weeks and years, we have to build a society that fosters that through policies, including paternity leave.
The evidence on why this matters is strong. Research led by the University of Leeds found that children whose fathers regularly drew, played and read with them at age three did better at school by age five, and that fathers’ involvement at five improved key stage assessment scores at age seven. That effect held regardless of the child’s gender, ethnicity, age in the school year or household income.
We know that couples separate. For separating couples, we can reduce conflict with better early support, perhaps via family hubs. On the Women and Equalities Committee, we have examined the impact of paternity and shared parental leave. We recommended raising paternity pay to the level of maternity pay for the first six weeks—90% of average earnings—and setting out a pathway to six weeks of paid statutory paternity leave over this Parliament. Unfortunately, the Government did not commit to taking up that recommendation.
Last year, the Committee visited Iceland, where we had the opportunity to learn from and hear about one of the most progressive parental leave policies in the world. Iceland’s parental leave is framed explicitly around ensuring that children can receive care from both parents—or carers—and enabling women and men to combine family life with work. It is grounded in gender equality and children’s rights. Countries that provide fathers and co-parents with substantial, well-paid leave generally have better gender pay gaps—around four percentage points smaller than those that offer less than six weeks of leave. Increasing women’s workforce participation and earnings while reducing pay inequality should be a long-term priority, and it goes hand in hand with providing good male role models. I wonder whether, if that phrase was less awkward to say, we would talk about it more.
Role modelling does not stop at the front door. Only around 24% of teachers in England are men; in primary schools it is 14%, while in early years it is only 3%. Those are professions built around care, patience and emotional literacy, and we have allowed them to become, in practice, “women’s work”. That says something to every child at school: it teaches boys that caring is not for them, and it means that the children who most need a steady male adult in their lives are even less likely to find one. Patriarchal values upheld by society have taught boys that care is weakness, that what is associated with women or femininity is worth less, and that asking for help is failure.
Before I came to this place, I worked in a domestic abuse refuge. I saw what happens when the male role model in a child’s life is a violent one. Many children in the refuge had witnessed violence at home, usually directed by a father or partner against their mother. That is role modelling, too. To prevent the trauma from those circumstances affecting the next generation, we need to ensure that young boys in particular have at least one stable, secure, positive male role model in their life, and we need to enable a system that keeps children safe from violence in the home.
As a society, we have spent over a century examining what it means to be a woman. We have barely begun the equivalent conversation about being a man, so others have stepped in with a much uglier answer. We tell girls that feelings are okay and that it is good to talk, but we tell boys the opposite: that strength is silence and the only acceptable emotion is anger. Talking is “what girls do”, and what girls do is weak, so when a boy has a question he is too embarrassed to ask his dad, he does not ask anyone; instead, he types it into a search bar. Movember’s research, which surveyed more than 3,000 young men, found that nearly two thirds of them regularly engaged with men and masculinity influencers, and those who did reported worse mental health, less willingness to prioritise their mental health, and higher rates of risk-taking behaviour such as steroid use.
We have also, as a society, grown accustomed to male violence—in pornography, on television, in the street. That content, which is a feature of the manosphere, is landing because it offers men and boys a story about themselves. One in 10 girls aged 11 to 16 have missed or avoided school to escape sexual harassment, and that is more likely still for girls who are neurodivergent, disabled or LGBTQ+. The manosphere results in worse outcomes for everyone. When we build a country where men can be present, caring and visible in the home, nursery, classroom and youth club, we give boys something better to become, and as a result, we all gain.
Rebecca Smith (South West Devon) (Con)
It is a pleasure to serve under your chairship, Mrs Hobhouse. Like other Members before me, I congratulate the hon. Member for Bishop Auckland (Sam Rushworth) on securing this Backbench Business debate. I was pleased to support the application several months ago, and I am glad to be able to respond to it from the Front Bench today.
We need to be honest about what the evidence tells us: good fathers make an overwhelmingly positive contribution to their children’s lives, yet around 2.5 million children in this country have no father figure at home, and by the age of 17, 47% of young people are no longer living with both parents at the same address. The relationship between a child and their father matters. For sons, a father can demonstrate how to be a man, how to behave around women and how to raise a family of their own one day. For daughters, a father can embody the positive attributes that she looks for in a man when she is older, making her less vulnerable to those who would exploit or mistreat her. Children with secure relationships with their fathers are less likely to experience depression, anxiety, low self-esteem or self-harm.
I was fortunate to grow up with a strong father figure—my dad, Mike. I slightly disagree with the hon. Member for Bishop Auckland (Sam Rushworth) about Christmas eve. Since I was four years old, my dad and I have gone shopping together on Christmas eve to buy presents for my mum. He bought them; I, like a bit of a silly girl, went home and wrapped them for him—something I have to admit I still do at the age of 45. It is part of the story and bond I share with my dad, knowing that each Christmas eve, whether it includes lunch and, as we have got older, an alcoholic drink or two, we will go out together, do our shopping and then head home. My little sister never gets to do it, so it is definitely part of my relationship with my dad.
Unfortunately, not everybody gets to have that experience. One UK study found that 14-year-old girls who did not have a close relationship with their father or a father figure were at significantly greater risk of mental health difficulties. Researchers also link secure father-daughter relationships with better educational and career outcomes, stronger social skills and better mental health. For sons, close relationships with fathers are associated with a reduced risk of antisocial and criminal behaviour, along with other risky behaviours. Those outcomes affect a child’s life long after they turn 18.
When we look at the wider challenges facing boys and men, this topic becomes even harder to ignore. The “Missing Men” report tells us that in the final quarter of 2025, more than 450,000 young men aged 16 to 24 in England—nearly one in seven—were not in education, employment or training. At school just 61% of boys reached a good level of development by the age of five in 2024-25 compared with 75% of girls. Three quarters of children in custody report having an absent father. We must stress that none of that means that an absent father automatically causes poor outcomes. There are many factors involved, but it should make us ask a straightforward question: are we doing enough to support fathers to be involved in their children’s lives? Too often, fathers seem to be an afterthought; that needs to change.
We need to look at what happens when relationships break down. There is a widespread perception that family courts make it difficult for fathers to maintain a meaningful relationship with their children. There is a presumption that it will aways be the mother who takes custody of the children, with the father permitted to see them once a fortnight if he is fortunate enough. Meanwhile, that same child has easy access to content from harmful male online influencers, starting as soon as they get their first smartphone, if not before. We are replacing a positive male role model with an inherently negative one and then claiming to be shocked by the results.
Where there are safeguarding concerns, the child’s welfare must come first, but where there is a safe, loving and willing father, the starting point should be meaningful involvement and as much contact as possible. The Government’s position, laid out in clause 17 of the Courts and Tribunals Bill, is to repeal the statutory presumption that a child’s welfare is generally furthered by the involvement of both parents. Existing law already allows courts to restrict unsafe contact; repealing the presumption without a suitable replacement, such as a child-centred parental relationship test, could lead to greater inconsistency and conflict. It may also weaken children’s relationships with safe parents.
A child should have real men in their lives: fathers, grandfathers, teachers, coaches and mentors can show them what responsibility and good character look like. That brings me to the language we use. We need to ditch the worst excesses of identity politics when it comes to boys and men. For too long, the phrase “toxic masculinity” has been used in a way that blurs the distinction between masculinity and genuinely harmful behaviour. Let me be clear: violence, abuse, cruelty and misogyny are wrong, but masculinity is not. Masculinity should be an extremely positive force for good. There is nothing toxic about being strong, courageous, ambitious, competitive, protective or determined. When combined with responsibility, self-control and respect, they are the exact attributes that enable society to flourish.
In Plymouth, where I am a MP, there is a great network call Man Culture, which puts those principles into practice. Man Culture organises workshops for men right across the city, tackling issues such as toxic masculinity and preventing male violence against women and girls. It seeks to address issues identified by the Plymouth Violence against Women and Girls Commission, which I chaired a few years ago. That work was a direct response to two tragedies in the city: the incel-inspired Keyham shooting, where five people and the shooter died, and the abduction from a bus stop and brutal murder of a young woman a few months later. The report also recommended working with young boys, because to challenge harmful behaviours, we need to have honest conversations, and those have to start young.
We should teach boys how to use strength responsibly and not to be ashamed of having strength in the first place. We should teach boys how they can use their strength to build things rather than to tear things down. The approach must be not to tell boys that masculinity is the problem, but to give them examples of men worth becoming. Fathers are some of the most important examples of that. A good father can show his son that strength does not mean aggression, confidence does not mean arrogance, and responsibility means keeping your word and looking after the people you love. Positive male role models are also needed beyond the home. As has been mentioned, only 14% of nursery and primary schoolteachers in England are men, and although I am proud that my brother is one such teacher, that figure is not high enough. We need men as teachers in early years and primary settings.
The problems will not be solved by another strategy document alone. Prevention starts earlier, with families, fathers and communities, and with giving boys a sense of purpose, responsibility and belonging. I pay tribute to the men who volunteer in scouting and uniformed groups across my constituency; we should recognise and be grateful for such men. However, that is not enough. We need to do even more. Having this conversation does not mean turning the issue into a competition between men and women. It must be about supporting mothers and fathers who are working together to create something greater than the sum of their individual parts, ensuring that family services properly involve fathers, where they can safely contribute, and making sure that, where it is safe and appropriate, children can maintain meaningful relationships with both parents.
This debate is not about pretending that fathers are the answer to every problem, but they are an important part of the answer whose absence makes everything else more difficult, and Government policy should recognise that. If we want stronger families, better outcomes for children and boys who grow into responsible men, we need to stop treating fathers as an optional extra. Fathers matter, masculinity matters and male role models matter; it is time that our politics treat them as such.
As my hon. Friend the Member for Hinckley and Bosworth (Dr Evans) mentioned, the former Prime Minister, Keir Starmer, asked the former Deputy Prime Minister, the right hon. Member for Tottenham (Mr Lammy), to take on a national summit on men and boys. My hon. Friend and I would be grateful to hear from the Minister what has happened since then. Is that summit still going ahead, and when will we hear more information about it?
The Parliamentary Under-Secretary of State for Justice (Jake Richards)
It is an honour to serve under your chairship, Mrs Hobhouse. I am grateful to the hon. Member for Bishop Auckland (Sam Rushworth) for introducing this debate. I am cheered by the fact that since the general election, when I and most hon. Members at this debate—at least those on the Labour Benches—entered Parliament, the issue has been raised repeatedly in both Chambers. Members from all parties should be heartened that we are talking about such matters and making sure that they have the prominence they deserve.
We have heard a number of thoughtful and important contributions, but I was particularly moved by what my hon. Friend the Member for Stirling and Strathallan (Chris Kane) said about being a father and parent, and sometimes feeling like you are failing in that. That is an incredibly important emotion for us public servants to consider when we think about public policy. Often, fathers may feel unable to provide for their children, materially or emotionally, and we have to think about how we, as a society and as a Government, can support men and parents through that difficult period. That important point is not often made, so I am grateful to my hon. Friend for doing so.
To answer the questions of the hon. Member for South West Devon (Rebecca Smith) and the hon. Member for Hinckley and Bosworth (Dr Evans) directly, when I was reappointed to my role, the Prime Minister made it explicitly clear that the cross-Government men and boys agenda would be right at the heart of his Government. The conversations I have had with him, both prior to and post him entering Downing Street, have only cemented that. We will undertake a summit in due course and at the right moment, and the change of Prime Minister and Government gives us an opportunity to work out the best mechanism for doing that.
It is one thing to hold a summit in Downing Street, but could we be more interactive across the country? We are looking at different mechanisms to make that a real moment for the country to talk about these issues and would be genuinely open to suggestions on a cross-party basis about how we can get that conversation going, out of this building and around the country, not just in Westminster. That is an ongoing discussion, and no doubt we will be able to update the House.
It is a great personal honour to be speaking in this debate. I am the father of a three-year-old girl—she turned three just yesterday. I think I speak for all parents when I say that from the moment you find out you are going to become one, your life is never quite the same again—that feeling is correct, because it never is. On a professional level, every day since becoming a Member of Parliament, I have been struck by the incredible work that organisations and groups do to support men. In my constituency, that includes Better Today in Kiveton Park, Andy’s Man Club in Maltby, Bramley and Kiveton Park—it operates across the country; I know we have a lot of Andy’s Man Club supporters in the Chamber today—and Dinnington boxing club. Sport is such a big part of this conversation about reaching and supporting men, and there is brilliant work in my constituency, too.
As all Members have said, fathers clearly matter, and where a father is not present, another male role model can also make an extraordinary difference—a granddad, a stepdad, an uncle, a teacher, a youth worker, a football or rugby coach, or a mentor. Indeed, the hon. Member for South West Devon raised the issue of teaching. I am always struck by the fact one in three primary schools does not have a male teacher. That is a massive problem, which I know colleagues in the Department for Education are trying to change. However, we all have a role, as parliamentarians and indeed as society, to perhaps try to change attitudes to teaching, particularly in early years, because this issue is vital.
My hon. Friend the Member for Wolverhampton North East (Sureena Brackenridge) talked about the importance of mentors. Absolutely, and there is a lot of good work happening already, including in her constituency, which she touched upon. Gareth Southgate is working on a mentorship scheme—many of us will have seen the documentaries—and there are other great organisations, such as Football Beyond Borders. I am also looking at what is happening internationally—some brilliant work is being done in California to recruit 10,000 new mentors to mentor young men and boys. There is a big opportunity here because there is already good work happening. What can we do as a Government to turbocharge that and make sure it is happening across the country? Watch this space on that one, because I am looking forward to developing this further.
We know, as has been touched on in the debate, that men are sometimes bombarded with competing ideas about what it means to be a man. The Government recently issued new guidance, which schools are following from this month, that rightly talks about young people developing positive conceptions of masculinity and femininity and learning from positive male role models. We will not counter the kind of toxic masculinity that we have spoken about in this debate by simply wagging our fingers at teenage boys, telling them just to get off their phone, or suggesting that all men are evil or that all masculine traits are wrong. We have to offer something positive—something better, something in the real world—to get them away from that narrow online space and back to participating again in society. If we cannot give boys a convincing idea of masculinity, built on confidence and kindness, responsibility and respect, and a sense of purpose, the algorithm will be only too eager to provide another one instead.
There is also a wider challenge, which is fuelled by a really difficult backdrop for men and boys in our country, and public policy must be made through that lens. We know that boys fall behind girls at every stage of education, from early years through to GCSE and beyond. Boys are more than twice as likely to be excluded from school and make up a far larger proportion of the NEET population, which is of course an issue that this Government are prioritising—my hon. Friend the Member for Watford (Matt Turmaine) spoke about that. Indeed, the gender pay gap, which is a huge systemic issue in our country—the Treasury is doing good work to try to narrow it more generally—is in reverse for those aged 18 to 24. That does not mean that we take our foot off the pedal in trying to get equality for women, but it does mean that we have to consider that age group and what is happening for young men in our labour market, and I know that this Government will.
We know that men continue to have a lower life expectancy than women, and we know that suicide is still one of the leading causes of death for men under 50—a fact that is particularly poignant today, on World Suicide Prevention Day. Again, that was mentioned by my hon. Friend the Member for Truro and Falmouth (Jayne Kirkham). We lose so many men to suicide—75% of suicides are men. That does not mean that we ignore women by any means, but when we think about mental health provision, we need to look at the facts and the data. What we are being told is that this is a particular issue, and it should inform policy.
Across a lot of areas—health, education, employment, family life—men and boys experience poorer outcomes. That is all part of a broader pattern that requires a broader cross-Government response, which is why my role as the Minister with responsibility for men and boys is a cross-Government one. Many of the industries that once provided generations of men with secure work and an identity have declined. Work and working-class communities were mentioned by my hon. Friend the Member for York Outer (Mr Charters). I see the decline in my own constituency. I am hugely proud to represent former mining towns built on the graft of working-class communities and often working- class men.
We should not of course romanticise the past. Many of the gender expectations of previous generations were highly restrictive, particularly for women, and nobody would want to turn the clock back completely. But we do have to understand what disappeared when those industries went and that post-industrial period occurred. What went were the routes into skilled work and institutions with social connection and status, and for many men a sense that they had an almost automatic, useful role to play in society and our economy. Where do boys and young men find that purpose today? When I speak to men and organisations working with them, three things come up: a need for purpose, belonging and connection. The decline of our industrial base in this country has greatly challenged that. We have to look for new mechanisms. We cannot just turn back the clock. Again, that is partly economic policy, but no doubt social policy as well. And it all goes back to the theme of this debate and why fathers and role models are so important, not as a social ideal, but as people who are present in young men’s lives to set an example, provide stability and help anchor them when life becomes difficult.
Supporting fathers is preventative: by strengthening relationships early on we can stop problems taking root. We can keep an eye on the longer term prize, because the boys we support today will become the fathers, partners and role models of tomorrow. The Government are doing that in several ways. I am proud to be part of a pro-family Government, something that I am very pleased to say explicitly. We are supporting families from the very beginning. We want family services to be accessible and welcoming to all parents, and for fathers to feel that support is for them, too. That includes recognising that the transition to fatherhood itself can be really challenging and making sure fathers are supported during those critical months around birth.
I mentioned Best Start family hubs and our wider family support services. No doubt my hon. Friend the Member for Bishop Auckland will push us to go further and faster. He mentioned parenting courses—I am a big fan. There is good evidence in Australia on the use of online parenting courses. It is less about telling parents how to parent, and more about giving them the opportunity to take stock, have a moment and consider how they are parenting and whether their routine and their life is building a healthy family environment. I think we could all do with that every now and again. “Parenting courses” is sometimes the wrong term, but it is a moment for families to consider how they are raising their children. The Best Start family hubs agenda is reaching men in ways that hopefully work for them and includes flexible weekend provision, dedicated groups and outreach through trusted community settings.
Government Members will no doubt be pleased to hear that we are reviewing parental leave and looking carefully at how the system can better support working families and allow parents to play an active role during those crucial months. We heard from my hon. Friends the Members for High Peak (Jon Pearce) and for Sittingbourne and Sheppey (Kevin McKenna) about how important that is. Again, there was powerful advocacy for that change. They know that the Government are reviewing it and will return to Parliament with an update early next year. No doubt the Chancellor will hear their cries. Even if he is not here today, it will be noted.
We are also actively recognising the importance of positive role models and strong support networks more generally. Just yesterday I held a roundtable in Downing Street with a number of men’s mental health charities on the issue of suicide prevention to try to look at how we as a Government can work with partners in the communities as part of our developing agenda on devolution in place. There is no point in us in Whitehall just saying things. We have to work with the organisations that actually deliver. Too often public policy does not work for them.
Jim Shannon
On the issue of suicide, in my contribution I referred to the stats. It is unfortunately true that the level of male suicides in Northern Ireland is the highest in the whole of the United Kingdom—higher than in Scotland and Wales and higher than in England. Will the Minister share his thoughts with the relevant Minister in Northern Ireland—Robbie Butler, the Health Minister —to ensure that the good things that the Minister and the Government are doing here can be shared and we can take advantage of what they have learned?
Jake Richards
Absolutely. This agenda has to include our devolved nations as well, and I will make sure that we do that. The disparities in suicide rates across the country are really striking. The north-east in particular has far higher suicide rates than London. More generally, the areas that are more isolated are where people become more isolated. There is also a link to economic factors, deprivation and unemployment, with unemployment being the metric that aligns most. We know that work is not just about financial support, but about purpose, routine, structure and connection, which are so important.
All of this feeds into our wider agenda. That includes tackling health inequalities, and we have launched England’s first men’s health strategy. It is focused on opportunity, which means ensuring that boys and young men can succeed in education. We have heard about the Milburn report, and all the work happening now and in the coming weeks and months. It is also focused on connection and belonging, which are fundamental. That means supporting healthy relationships, positive understandings of masculinity and strong community ties.
I once again thank my hon. Friend the Member for Bishop Auckland for securing this debate. I reassure him and all Members that, as we develop the Government’s work on men and boys, fatherhood, mentoring and positive male role models, they will absolutely remain at the heart of this conversation. I want this to be a collaborative process across Government and with parliamentarians from both sides of the House, because this issue is clearly vital to all the communities we represent.
Mr Charters
I welcome the Minister back to his post. Will he commit to working with the new class unit set up by the Minister for Women and Equalities as part of her work?
Jake Richards
Yes. We are working very closely with the Department for Women and Equalities, and I was heartened by that announcement earlier this week, because there is a particular issue with working-class boys. The educational statistics are even more pronounced and acute for working-class boys in communities like my hon. Friend’s and mine.
We know that giving a young man opportunity means giving him a stake in his future. If we give him strong relationships, we give him people to turn to if the future does not go to plan. If we give him purpose and belonging, we give him reasons to look after himself and look out for others. That is how we can assure that boys and young men thrive. It is how we can build a better society for everyone, and that is what this Government are determined to do.
Sam Rushworth
It was important to me to speak from the heart in my remarks today, but that meant taking time from being able to address various points. I trusted in my colleagues across the House to make those points for me in their speeches. That trust was not misplaced, and I thank everybody for that.
I particularly thank the people who spoke about paternity leave. We heard several comparisons of the UK and the much more generous offers in Europe. People mentioned the social inequality about who gets it, the importance of supporting mothers when they are recovering and the wellbeing benefits. People also brought in the family courts, CMS, social housing, and the importance of increasing the numbers of male teachers and caregivers. I appreciate the Opposition bringing up the men and boys summit and the response the Minister gave to that, and I really hope that there can be some cross-party work on how we address it.
It was wonderful to hear the Minister proudly confirm that this is a pro-family Government and set out those ideas of purpose, belonging and connection. I feel that we too often look just to Government, and teachers sometimes say that we look to them for all the answers to the problems in the rising generation, but a lot of it starts in the home. Fathers play such an important role. We cannot keep overlooking it, because it is vital for the future of that generation.
Question put and agreed to.
Resolved,
That this House has considered the contribution of fathers and positive male role models to families and society.