National Care Service

Clive Efford Excerpts

Thursday 15th October 2026 Commons Chamber

[Alison McGovern]

I do not accept what the right hon. Gentleman has just said, and I do not agree with it either.

[Clive Efford (Eltham and Chislehurst) (Lab)]

I very much welcome the statement and any move towards a national care service, but my hon. Friend knows as much as I do that people often experience a clash of bureaucracies, which leads to a slowdown in the delivery of care or care packages. People are stuck in hospitals for a variety of reasons, but for many it is because that clash cannot be resolved to move them from hospital in a timely fashion. We cannot wait for that to be resolved; we need to resolve it now. Can she reassure me that she is working on that, because if we can solve that, we can solve large parts of the problem in this Parliament and not have to wait for the next?

[Alison McGovern]

My hon. Friend makes exactly the argument as to why we have to take steps now to improve the system. In my statement, I mentioned the increase in the number of organisations using digital care records to help smooth the system, but it also takes the working together of NHS organisations, local authorities and care companies. That is happening in some places. The problem is it is not happening everywhere, and he is absolutely spot on that we have to take steps now.

Health Bill

Clive Efford Excerpts

Report stage
Monday 7th September 2026 Commons Chamber

[Madam Deputy Speaker (Ms Nusrat Ghani)]

Order. Back-Bench speeches are on a five-minute speaking limit.

[Clive Efford (Eltham and Chislehurst) (Lab)]

I rise to speak to amendment 97 in my name, which would remove clause 10 from the Bill. Clause 10 gives powers to the Secretary of State to vary the proportion of public and private provision of health services if they consider that to do so is in the interests of the health service. In evidence to the Health and Social Care Committee, the chief executive of the Nuffield Trust said that clause 10

“seems to make it more possible for the Secretary of State to explicitly set out to increase private or public provision.”

Why does the Secretary of State need this power?

Introducing an extra level of nuance now, as clause 10 will do, has the potential to raise fears within the NHS that it could be abused in future. The clause has the potential to create unintended consequences. The explanatory notes for the Bill say that this new flexibility is necessary

“where there may otherwise be a breakdown in provision of a health service.”

Can we imagine a situation where the Secretary of State has concerns about a health service and that an approach to assist a local provider would be rebuffed? It is hardly likely to happen. The explanatory notes suggest that, in such circumstances, the Secretary of State needs the power to direct local decisions, rather than to work with local health service providers to resolve any difficulties. How does the power to influence the proportion of public and private provision help in resolving a breakdown in service?

Labour’s 2024 plan to make work pay set out a welcome desire to bring more essential services back into public control—something that is welcomed by health workers across the country, because so far the

“biggest wave of insourcing in a generation”,

as was promised, has felt more like a trickle when it comes to the NHS.

The new Prime Minister and new Secretary of State have inherited the Health Bill from their predecessors, so hopefully they will be able to stamp their own mark on it before it becomes law. Removing clause 10 would be one way of making that mark. The concern for those who work for the NHS and those who support it is that the clause has the potential to be exploited in future by those who would seek to move away from the public provision of healthcare. There are ample powers to enable the Secretary of State to intervene and resolve breakdowns in the provision of a health service. On clause 10, we must balance what it adds in those situations against its potential misuse by an ideologically driven Government that are determined to privatise our NHS. To remove any ambiguity and to protect the NHS from the possibility of the clause being abused by a future Secretary of State, I urge that it is dropped from the Bill.

[Madam Deputy Speaker]

I call the Liberal Democrat spokesperson.

Meningitis Outbreak

Clive Efford Excerpts

Tuesday 17th March 2026 Commons Chamber

[Wes Streeting]

The hon. Member is absolutely right about the atypical nature of this outbreak. I can reassure her and the House that UKHSA is in regular contact with the devolved Administrations.

[Clive Efford (Eltham and Chislehurst) (Lab)]

My heart goes out to the bereaved families affected by this terrible tragedy. Their pain must be unimaginable, and I wish those who are being treated in hospital a swift recovery. I commend UKHSA for its swift response; notwithstanding any lessons that need to be learned, it seems to have reacted very quickly and effectively. How confident can we be that the outbreak is contained within the identified area, and is there a contingency plan for any outbreaks in other areas? As a south-east London MP, I have concerned constituents.

[Wes Streeting]

I am very grateful to my hon. Friend for his question, and I am mindful of the concerns of neighbouring communities across his part of London and the wider south-east. I can provide reassurance on two points. The general risk is low because of the nature of the transmission of this disease and because of the active contact tracing that is under way, on which UKHSA has done a particularly impressive job, given the unusual nature of this outbreak. We can be reasonably confident that we are tracing people and managing risk in that way. Even as students return home from university, we are managing the risk, proactively contacting people and making antibiotics available. We are preparing for a targeted vaccination campaign in the coming days, but we are also considering the wider cohorts that UKHSA may deem necessary to vaccinate.

Less Survivable Cancers

Clive Efford Excerpts

Tuesday 6th January 2026 Westminster Hall

[Clive Efford (in the Chair)]

I am told that the Minister is on her way, but we will proceed because so many people want to speak. I remind Members to bob if they intend to make a speech, to give me a fighting chance of working out how long each Member will have to speak. It looks like Back Benchers will have an average of three minutes each, once we start.

[Clive Jones (Wokingham) (LD) [R]]

I beg to move,

That this House has considered less survivable cancers.

It is a pleasure to serve under your chairship, Mr Efford. I declare an interest as a governor of the Royal Berkshire hospital; also, a family member has shares in a medical company. I am grateful to the Backbench Business Committee for allowing this debate, which I first asked for six months ago—[Interruption.]

[Clive Jones]

I apologise.

[Clive Efford (in the Chair)]

Is that the Minister calling?

[Clive Jones]

Yes, that was the Minister calling me to apologise. [Laughter.]

I asked the Committee for the debate six months ago, but having it one month before the probable publication of a national cancer plan is not a bad date for it. I also thank the less survivable cancers taskforce, Cancer Research UK and Myeloma UK for their help and guidance in securing and preparing for this debate.

As I have mentioned many times here and in the main Chamber, I am a cancer survivor. The experience has shown me how important early diagnosis and effective treatment are to our outcomes. My diagnosis was delayed, because I was sent away by the first GP I saw and had to wait several months again before being diagnosed with breast cancer. Fortunately, my treatment was successful, but many others are not so lucky, especially those with less survivable cancers.

Every year in the UK, 90,000 people are diagnosed with a less survivable cancer—cancers of the brain, liver, lungs, pancreas, oesophagus and stomach. Together, they represent 40% of all cancer deaths and account for 67,000 deaths every year. The less survivable cancers have been overlooked for far too long. While many other cancers have seen major advancements in survival, survival rates for those six cancers have remained staggeringly low for the past 25 years. The collective five-year survival rate for those cancers is just 16%. The sad reality for the 90,000 people diagnosed with one of the cancers is that 75,000 will not survive more than five years. That is a school play someone will not see, a set of exam results that they will miss, or a first day at university, a graduation, a significant birthday of their own or of a loved one, or the birth of a grandchild that someone will not see.

--- Later in debate ---

[Chris Coghlan (Dorking and Horley) (LD)]

I commend my hon. Friend for securing this invaluable debate. My constituent Billy was just four years old when he passed away due to DIPG—diffuse intrinsic pontine glioma—which is an incurable child brain tumour cancer. Every nine days a child is diagnosed with it. At the request of Billy’s parents I asked the Government whether there was any more they could do for brain cancer research. I am delighted that the Government have since announced that they have allocated £13.7 million in funding to the National Institute for Health and Care Research brain tumour research consortium. Does my hon. Friend agree that allocating research into rarer cancers not only benefits the children who suffer from these horrific diseases but enhances our research and development capability more broadly, clinically, which is also a vital industry for the UK?

[Clive Efford (in the Chair)]

Order. Interventions have to be a lot shorter. If Members are on the list to speak, it would be helpful if they saved their points for their speeches so that we can fit everyone in.

--- Later in debate ---

[Several hon. Members rose—]

[Clive Efford (in the Chair)]

Order. Before I call Paulette Hamilton, I want to say that we will stick to a three-minute limit, but it is very tight. I may have to shave a minute or two off the Front-Bench speeches at the end so that I can get everyone in. We will see how it goes.

--- Later in debate ---

[Monica Harding (Esher and Walton) (LD)]

It is a pleasure to serve under your chairship, Mr Efford. I congratulate my hon. Friend the Member for Wokingham (Clive Jones) on securing this vital debate on less survivable cancers.

As it is for many people across Parliament and the country, less survivable cancer is a personal fight for me. My brother-in-law, Group Captain Pip Harding, was diagnosed two years ago with glioblastoma, a devastating and aggressive brain tumour. His story illustrates both hope and what is still profoundly broken. Pip received pioneering oncothermia treatment from Dr Paul Mulholland, who has been mentioned by the hon. Member for Mitcham and Morden (Dame Siobhain McDonagh). The treatment shrank his tumour significantly; he had a prognosis of only six months to live with his five children and wife, but two years on he is still alive and well. But that treatment remains inaccessible on the NHS: he obtained it through his family and friends crowdfunding the treatment, which illustrates how those with the means and community support can access innovation while others cannot.

Glioblastoma remains one of the hardest cancers to treat, with little improvement in survival rates compared with many other cancers. We know that research funding for brain tumours has historically lagged behind need, and it receives a tiny fraction of overall cancer research pounds, which is a scandal when the disease disproportionately affects younger adults. I support the sterling work of the hon. Member for Mitcham and Morden on trials, and I echo her ask.

I have heard from many families in my constituency of Esher and Walton whose lives have been turned upside down by rare cancers. One constituent shared the anguish of watching their partner struggle with a less common blood cancer that had no clear trial available in the UK, even though promising research was under way abroad. These stories are not isolated. They reflect systemic issues, including diagnostic delays. Here, I will bring in my lovely sister Mary, who died just before Christmas. She waited for a diagnosis, but was misdiagnosed and died from bowel cancer. Trial access is limited and specialist expertise across regions is patchy. Just 82.5% of cancer patients in Esher and Walton began treatment within 62 days of an urgent referral, below the operational standard of 85%. Every per cent represents the heartbreak that my family felt this Christmas.

I also want to raise lobular breast cancer. It is the second most common form of breast cancer, yet it remains under-researched and under-supported. In collaboration with the lobular moonshot project, my constituent Kate Ford has been campaigning for the Government to commit £20 million for a dedicated research programme. However, after Kate had a meeting with the Secretary of State in July, the Government chose not to commit to that. Instead, they supported a broader research base, but that largely misses the point, because the status quo of research programmes means that rare cancers such as lobular breast cancer are effectively left behind.

Finally, I want to return to brain cancer and Owain’s law, which addresses issues where patients lose access to cutting edge therapies due to improper tissue preservation—

[Clive Efford (in the Chair)]

Order. I call Dr Peter Prinsley.

--- Later in debate ---

[Rachel Taylor (North Warwickshire and Bedworth) (Lab)]

It is a pleasure to serve under your chairmanship, Mr Efford. I thank the hon. Member for Wokingham (Clive Jones) for securing this debate. I pay tribute to my hon. Friend the Member for Birmingham Erdington (Paulette Hamilton) for all the valuable work she does in this space, and to everyone who has shared very personal stories today, particularly my hon. Friend the Member for Southport (Patrick Hurley).

Pancreatic cancer is one of the least survivable cancers. Sadly, a number of constituents have written to me about the devastating impact this disease has had on their lives. One lost her stepmother to pancreatic cancer. For months, her stepmother’s symptoms were repeatedly misdiagnosed—she was even sent home from A&E on several occasions with painkillers or antibiotics—before she was finally diagnosed with stage 4 pancreatic cancer. She died just three months later, only three days after my constituent’s son was born. My constituent told me that she feels her son was robbed of a grandma.

Similarly, Jacqui wrote to tell me about the close friend she lost to pancreatic cancer and the profound effect it has had on her. Tracey, Irene and Janice also wrote to tell me about the loved ones they have tragically lost, and to advocate for better research and treatment for this cruel cancer. Each story is different, but every constituent who has written to me about pancreatic cancer has called for improved screening, earlier diagnosis and greater investment in research.

Kelly and Jennifer both wrote to me while a loved one was undergoing treatment for pancreatic cancer and was forced to deal with shortages of the medication they desperately needed. It is unacceptable that patients and their families must tackle medicine shortages on top of battling cancer.

I truly believe that this Government’s 10-year health plan will support patients fighting less survivable cancers by ensuring that they have access to new treatments and technologies that can diagnose cancer earlier. We must ensure that these cancers are detected sooner and treated more effectively, so that fewer families endure the heartbreak of supporting a loved one with a less survivable cancer. Also, as the Minister has done so well, we must continue to speak out so that people become more aware of symptoms early and seek help and diagnosis.

In my remaining seconds, I pay tribute to my local hospice, the Mary Ann Evans hospice, which provides care at home for many people across my constituency and neighbouring constituencies.

[Clive Efford (in the Chair)]

I want Mr Jones to have a couple of minutes at the end, which means the Front Benchers have about eight minutes each.

Obesity and Fatty Liver Disease

Clive Efford Excerpts

Tuesday 28th October 2025 Westminster Hall

[Dr Cooper]

I thank my hon. Friend for that excellent point and agree absolutely. In our society, we focus on how people look for many reasons, cultural and commercial, but this is purely about health. This is about keeping people healthy on the inside and allowing them to live good quality lives. My hon. Friend is absolutely right in that sense.

Poor diet is now the leading risk factor for death and disability. It is responsible for millions of preventable deaths each year. In the UK, almost two thirds of adults are overweight or are living with obesity, increasing the risk of fatty liver disease, cardiovascular disease and a multitude of cancers. In my job as a public health consultant, I see a lot of data and read many papers, but this statistic shocked me: four in 10 children with obesity may already have fatty liver disease. That demonstrates the urgent need to act now to prevent an even greater epidemic of disease in future.

That has not happened by accident; it is the result of a broken food system, which has made the UK Europe’s third most obese country and one of the world’s biggest consumers of ultra-processed food. We have a system that makes the unhealthy choice the cheapest, easiest and most available choice. Healthier food now costs more than twice as much per calorie as unhealthy food. That is £10.24 per 1,000 kilocalories compared with £4.50. For fruit and vegetables, the cost is even more at £11.90 per 1,000 kilocalories.

For the lowest income households, following a recommended healthy diet would swallow half or more of their disposable income. It is no surprise that obesity and fatty liver disease hit hardest in poorer communities. As I said at the beginning, this is not about personal failure. As hon. Members have said, sometimes people feel that that they are failing to lose weight and failing to keep themselves healthy. This is not about personal failure; it is a political failure. It is our collective failure to create a food environment that protects rather than undermines public health. If we are serious about prevention, we must be serious about reform—the right type—with stronger fiscal and regulatory measures to reduce the availability and marketing of foods that are high in fat, salt and sugar, and to rebuild a food system that serves public health and not profit.

Why have we not addressed this yet? Weighted against the commercial gain of the food and drink industry, our obesogenic environment is killing our population and costing the taxpayer billions. Economic analysis last year suggests that excess weight costs the economy £126 billion a year. A Budget is coming up next month; I am fairly sure that our Chancellor would like £126 billion a year. That figure takes in wider factors, such as lost productivity, care costs and lost years of healthy life. The direct NHS cost of obesity is projected to rise from £6.5 billion to £9.7 billion by 2050. We cannot separate our health and our wealth, and we cannot hope to achieve economic growth without tackling issues such as obesity and fatty liver disease.

Since 1990, there have been nearly 700 policies proposed by Government to reduce obesity. Imagine having 700 policies about your life! Past strategies fell short because they targeted behaviour change—individual choice—rather than the structural and commercial drivers of diet. Many lacked delivery plans, timelines or evaluation frameworks, leading to fragmented progress and limited long-term impact.

What can we do now to ensure that this public health emergency is addressed? My key asks for our Health Minister, who is kindly listening here today, are as follows. First, there is a clear need for a national liver strategy, ensuring increased public awareness, early liver checks and primary care pathways. As stated earlier, every integrated care board should have a pathway for the early detection of liver disease.

Secondly, we need strong planning and co-ordination to be ready to deliver the next generation of medication for liver disease. Thirdly, if we truly mean to deliver the left shift to prevention, promised in the 10-year health plan for England, then we have to change the environment that is driving poor health. There is strong consensus about the necessity of upstream interventions to regulate the unhealthy food and drink environment. We can build on that strong consensus to extend the levy model to high-sugar and high-salt foods; to enforce the 9 pm watershed for high fat, salt and sugar advertising, closing brand mark loopholes; to provide stable funding for local food partnerships, so that councils can act on local needs; to reinstate the full childhood obesity plan; and to address food affordability via fiscal reform.

None of this is easy or it would have been done already, but right now our environment is draining our health service of billions each year and weighing heavily on the nation’s health—no pun intended. Let us not keep repeating our mistakes, but rather embed food policy as a national health priority. Through our work on preventing obesity and fatty liver disease, let us support and finally see the long-discussed and essential shift towards prevention and a healthier, wealthier country.

[Clive Efford (in the Chair)]

I remind Members to bob in their places if they intend to speak.

[Several hon. Members rose—]

[Clive Efford (in the Chair)]

Right, that gives me a better idea. We will bring in the Front Benchers at 10.28 am, so that gives an idea of how much time there is for the six or seven Members who wish to speak.

[Jim Shannon (Strangford) (DUP)]

It is a pleasure to serve under your chairship, Mr Efford. I thank the hon. Member for Worthing West (Dr Cooper), who is co-chair of the all-party parliamentary group on liver disease and liver cancer, for setting the scene incredibly well. I thank her for the detail and for her requests to the Minister. It is, as always, a pleasure to see the Minister in her place. I wish her well and I look forward to her answers. I also thank the British Liver Trust and the Foundation for Liver Research, which supplied me with a briefing that made clear the excellent work at the Roger Williams Institute of Liver Studies, which continues to drive world-leading research into metabolic liver disease to shape how it is diagnosed and treated.

Liver disease is a growing cause of premature mortality and lost years of working life in all four nations of the United Kingdom. It has been estimated that some 4,878 potential years of life were lost due to chronic liver disease in Northern Ireland. It is clear that the UK is in the midst of a liver disease crisis, to which the hon. Lady referred. It is as serious as that, and we should all take note. While premature mortality rates from other major diseases have fallen over the past two generations, deaths from liver disease have risen 400% since the 1970s. There are more than 18,000 deaths from liver disease and liver cancer each year in the United Kingdom.

[Clive Efford (in the Chair)]

Order. Members are asking that you speak into the microphone, Mr Shannon, so that they can hear you.

[Jim Shannon]

That has never been a problem in the past, Mr Efford. Do I need to lift it up to my mouth? I thought it was good enough to carry my voice; apologies if it is not. This would be the first time it has not worked.

Two thirds of adults are overweight or living with obesity, and one in three children are classified as overweight or obese when they leave primary school. Sadly, four in 10 children with obesity may already have liver disease. One in five people are affected by liver disease and liver cancer in the UK, and as many as 12% of those—more than 1 million people—go on to develop the more severe form of fatty liver disease.

The stats for Northern Ireland are unreal. That is not the Minister’s responsibility, but it gives a flavour for the debate. Some 64% of adults in Northern Ireland were overweight or obese, a marked increase from 23% in 2010-11. My goodness me—if ever we needed a reality check, that is one for us. Shockingly, Northern Ireland has the highest rate of overweight or obese primary 1 children in the UK, with 25.3% of children fitting that category. In my constituency of Strangford, 27% of year 8 children were overweight or obese. It is estimated that 70% of adults and 40% of children who are overweight or obese have fatty liver disease, so urgent work must be done to prevent this health crisis in the making.

Shockingly, 37 million extra sick days are estimated to be taken by people living with obesity, harming economic output on a massive scale—a figure of 1% to 2% of UK GDP as estimated by the Institute for Government. The NHS alone is expected to shoulder an estimated £10 billion per year obesity bill by 2050, with obese patients costing twice as much as those of a healthy weight. Reducing obesity prevalence by 10% could save £6 billion per year in the UK economy.

Let me tell a personal story. I am a type 2 diabetic. Some 16 or 17 years ago, I realised that I needed to drastically change my eating habits. I was 17 stone. To be honest, to put it very starkly, I was a big fat pudding. I realised that if I did not lose weight for my diabetes, I was going to be in trouble, so I reduced my weight quite substantially, by 4 stone. I have managed, by and large, to keep at that reduced level. First, it was down to stress but, secondly, it was down to Chinese takeaways five nights a week with two bottles of Coca Cola. That just does not work; when it is added up, you just get fatter and fatter. I took that away and tried to reduce my chocolate intake.

My hon. Friend the Member for East Londonderry (Mr Campbell) has said that he is reducing his sugar intake—well done to him; he does not need to, but it is definitely a good purpose to have. The point I am making is that not everyone can. For those who cannot, it is important to look towards the weight-reduction injections, to which I will refer in a moment. I have been able to control my diabetes for the last 10 years by tablets. I take nine tablets in the morning and five at night to keep everything under control.

Newly released weight-management drugs such as Ozempic and Mounjaro have been shown to reduce the weight of patients by an average of 5%, reducing the risk of a variety of health effects, including fatty liver disease. However, although those drugs are available for those who obesity and type 2 diabetes, they are not for those with fatty liver disease. Making that happen would be my one request of the Minister. If someone has a body mass index of over 40, and does not yet have those comorbidities, unfortunately they will not qualify.

There is a new generation of drugs targeting advanced fatty liver disease. Resmetirom has recently been approved by the US Food and Drug Administration and is expected to be approved in the UK within 12 to 18 months. Could the Minister give us an indication of where those drugs are in the system? Those new drugs—some of which improve liver function and some of which enable weight loss—can reverse fatty liver disease and must be made available in a timely fashion to save lives. The NHS needs to ensure that services are ready to support that, as previously no treatment has been available for those patients.

The UK faces a very challenging commercial environment for drug pricing. Lilly recently announced that it will increase the price of Mounjaro by as much as 170% in response to pressure from the US Government and historic pricing inconsistencies. My second question to the Minister is about what has been done to ensure that the price of drugs is reduced or kept controlled in a way that can make a difference.

Thirdly, I say to the Minister that ICBs must have an effective pathway for the early detection of liver disease. A new nationally endorsed pathology pathway to improve early diagnosis of liver disease is essential. Every community diagnostic centre should also have a fibroscan to assess fibrosis.

Finally, I say to the Minister that patients with advanced liver disease and cancer need access to weight management services in line with access for people with type 2 diabetes. This is a ticking timebomb, but there are scientific breakthroughs there to address it. I believe in my heart that the Government need to cut that wire and stop that timebomb now.

Oral Answers to Questions

Clive Efford Excerpts

Tuesday 21st October 2025 Commons Chamber

[The Parliamentary Under-Secretary of State for Health and Social Care (Dr Zubir Ahmed)]

In September, Hampshire Hospitals NHS foundation trust reported step-down immediate care capacity as the primary reason for discharge, and at Portsmouth Hospitals University NHS trust, the discharge figure was 13% lower than the average. As important as immediate care is, we know from the evidence that getting home is better; we are putting record amounts of money into the better care fund to make that possible.

[Clive Efford (Eltham and Chislehurst) (Lab)]

I draw Ministers’ attention to the Prostate Cancer Research report published last week. It busts the myth that a screening programme for prostate cancer would cost the NHS too much money. It would focus on the people most at risk—in other words, black men over the age of 45, and those who, like me, have a history of it in their family. Will the Secretary of State join me in commending this report to the UK National Screening Committee?

NHS 10-Year Plan

Clive Efford Excerpts

Thursday 3rd July 2025 Commons Chamber

[Wes Streeting]

We work closely with NICE to make sure that we consider, in an evidence-based way, the case for prescribing new medicines. We want patients to have access to the latest treatments and technology, and we work with the pharmaceutical industry to get as many medicines as possible to patients. We definitely need growth in this area.

I have a counter-offer for the hon. Gentleman. I notice that the Scottish Government are now on their fifth health plan; none of the others has worked. We are always willing to help, and I will put a copy of the plan in the post to my Scottish counterpart, but I will not hold out much hope. In England and Wales, where a Labour Government are in place, waiting lists are falling; in Scotland, waiting lists are rising, and we have heard astonishing admissions of failure from Ministers whose party has been in power for almost 20 years. It is very clear: Scotland needs an alternative. Scotland’s NHS needs an alternative: Scottish Labour.

[Clive Efford (Eltham and Chislehurst) (Lab)]

I welcome my right hon. Friend’s statement. Yesterday was one year to the day since I completed my radiotherapy treatment for prostate cancer. I was very lucky—my cancer was caught at stage 3 and was treatable—but I had to ask my GP for the prostate-specific antigen test that got me my treatment. I know my right hon. Friend has that said he wants to see a national screening programme aimed particularly at black men over 45, one in four of whom will get prostate cancer, people like me who have a family history of prostate cancer, and men over the age of 50. Will he ensure that we have a national screening programme as part of the 10-year plan?

[Wes Streeting]

My hon. Friend is absolutely right about the importance of screening, and it is brilliant to see him fighting fit. That is exactly the sort of outcome that we want from effective diagnosis and treatment. He is also right to highlight the racial inequalities in this area. It cannot be right in this decade of the 21st century that black men are twice as likely as white men to die of prostate cancer. The national cancer plan will come out later this year, and the screening committee is looking at the case he makes. He will find at the centre of the 10-year plan a commitment not just to diagnose earlier and treat faster, but to tackle the gross health inequalities that blight our society in a way that is simply not tolerable in the 21st century.

Health and Adult Social Care Reform

Clive Efford Excerpts

Monday 6th January 2025 Commons Chamber

[Clive Efford (Eltham and Chislehurst) (Lab)]

When I raise concerns about GP appointments, GPs tell me that they have difficulty recruiting to posts in their practices. Too few newly qualified doctors choose general practice as their profession. What can we do to get those doctors in place, so that we can make diagnostics in the community work?

[Wes Streeting]

That is an excellent question. Having put in place funding to ensure that there are 1,000 more GPs on the frontline before April, and having announced just before Christmas a significant uplift for general practice, I hope that in the first six months of this Government, we have sent the strong message to people who aspire to long careers in medicine that general practice has a huge role to play in the NHS in the 21st century. It is an exciting place to be, but I recognise that we have to fix the front door to the NHS to make it more attractive. The situation is even worse than my hon. Friend has described, because when the Conservatives left government, there were qualified GPs unable to find jobs, at a time when patients were unable to find GPs. We got to work on that issue within weeks of taking office, and we will do more over the next 12 months.

Hospice Funding

Clive Efford Excerpts

Thursday 19th December 2024 Commons Chamber

[Karin Smyth]

To govern is, indeed, to choose. The Conservative party chose neither this sector nor any other health sector and it refused to govern. Within five months, we have not only increased the funding to the health sector to stabilise it but made today’s announcement.

Beneath all that, there might have been a welcome for the announcement—I am not entirely sure—whereas the sector is pleased to have the money. The chief executive of Hospice UK said:

“This funding will allow hospices to continue to reach hundreds of thousands of people every year with high-quality, compassionate care. We look forward to working with the government to make sure everyone approaching the end of life gets the care and support they need”.

The chief executive of Haven House children’s hospice said that it is

“very positive to hear about the government’s plan to invest significantly in the wider hospice sector; we hope that there will be as much flexibility as possible to determine locally how this new money is spent.”

This is an important issue for many hon. Members, and we look forward to working with the sector in the new year on the specifics of the announcement.

[Clive Efford (Eltham and Chislehurst) (Lab)]

This is a very welcome announcement and I am sure the hospices are breathing a sigh of relief after the level of funding they endured for 14 years under the Tories. If we are to move palliative care out of hospitals and into care situations or people’s homes, the money needs to be passported to the hospice sector for it to play its part. Integrated care boards have been charged under the Health and Care Act 2022 to provide that funding. Will the money go through ICBs or will it be passported straight to the hospice sector?

[Karin Smyth]

My hon. Friend makes an important point about the need for more people to be treated at home. That is absolutely the direction of travel that we want to see. This money will help, for example, with technology to support more people to be treated at home. ICBs are responsible for commissioning and allocating funding, so that will be done in the normal way.

Musculoskeletal Conditions

Clive Efford Excerpts

Tuesday 17th December 2024 Westminster Hall

[Clive Efford (in the Chair)]

I understand that Sonia Kumar has agreed that another hon. Member can make a contribution. I will then go straight to the Minister. As is the convention with half-hour debates, there will be no opportunity for the mover to sum up at the end.

[Sonia Kumar (Dudley) (Lab)]

I beg to move,

That this House has considered the diagnosis and management of musculoskeletal conditions.

I am grateful for the opportunity to have this debate. As chair of the all-party parliamentary group on osteoporosis and bone health, and as an advanced practice physiotherapist and first-contact practitioner, musculoskeletal health is my speciality. I am here to discuss the provisions needed to improve the diagnosis and management of MSK conditions.

My experience as an advanced practice physiotherapist is very much autonomous. I do not think many people know that physiotherapists work from paediatrics all the way to elderly care—from nursery all the way to palliative care. Most people do not know the work of a first-contact practitioner, which is a new service in which physiotherapists work with GPs to diagnose, assess and refer to secondary care, if needed. I was part of that vital service at Dudley Group hospitals, so I declare my interest as working on the bank there.

MSK physiotherapists work not only across hospitals and primary care but also in tertiary care. They work in fracture clinics, rheumatology, pain management and A&E. Not many people realise what we do. MSK physiotherapists are the specialists and experts in musculoskeletal diagnosis. That could include referring people for X-rays to look for suspicion of fractures or for MRI scans to look for sinister pathology, a differential diagnosis, masqueraders that look like Pancoast tumours, metastases or spinal or multi-joint cysts. Along with ultrasounds, guiding injections and prescribing, the scope of physiotherapists has expanded year on year, to a point where they are now specialising and moving their practice on to do simple surgeries, such as carpal tunnel releases.

I look not only from a diagnostic point of view but at the importance of managing MSK conditions, including in respect of rehabilitation.

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[Sonia Kumar]

Of course. One of the things MSK physiotherapists look at is spinal fractures, 70% of which happen in the thoracic spine, generally in older women who have had poor bone health. It is essential to look after bone health from a really early age, while women are in their 40s, so that when they are older, in their 50s, 60s, 70s and 80s, they are on the right medication and doing bone health exercises to help for the future. For MSK conditions and osteoporosis, physiotherapists are essential. Spinal fractures are very often undiagnosed, and those who suffer spinal fractures as they get older are more likely then to have a hip fracture, after which the mortality rate becomes really high. My hon. Friend makes a very good point.

Let me explain why MSK physiotherapists and MSK care are so important. By 2035, two thirds of the population are expected to have two or more long-term conditions, which include MSK conditions. Versus Arthritis reports:

“Arthritis and related musculoskeletal conditions affect 20.3 million people in the UK.”

That means that one in six people has arthritis, which is a staggering amount. MSK conditions cost the NHS £5 billion a year, accounting for one in five GP appointments, 1.6 million hospital admissions and 30 million prescriptions a year. People with low confidence who feel that they cannot manage their conditions are more likely to attend hospital, while those who are most confident with long-term conditions have 38% fewer hospital admissions.

That is what we can do for the economy, but this issue is also about first-contact practitioners, as I mentioned at the beginning. With first-contact practitioners, we can save so many GP appointments. It is part of the long-term plan, which has been created to improve the impact on GP care and allied health professions that work in general practice. Working adults with MSK conditions are twice as likely to be economically inactive compared with those with long-term conditions. Of the people who are economically inactive due to ill health, 21% report having MSK conditions. It is about not just health but the economy and the wellbeing of the society that we are hopefully building together now that we are in government.

It is really important that we look at this issue in a holistic way. MSK conditions affect not just affect somebody’s mental health but their relationships and how they build them. They affect whether they can get into bed and sleep well, as well as their sleep hygiene. Perhaps a person eats poorly because they cannot get out, so they put on lots of weight. A person’s emotions, self-esteem and ability to work can be affected. I do not believe there is a silver bullet or that if we manage MSK conditions it will just fix one part. It has to be effective in respect of all the facets of somebody’s general wellbeing. We cannot tackle waiting lists and return people to work without that, and we need a strong workforce to plough back into the economy. It is incredibly important for people to understand that it is about holistic management and how we can improve health literacy and self-efficacy for people with MSK conditions.

I came to this debate to talk about solutions, as I am a solution-led person. We need to recognise the allied health professions in the NHS and build a workforce for MSK physios. That includes not just MSK physios but paramedics, podiatrists and every single person in the 14 allied health professions, all of which help to build resilience in the NHS, reduce waiting lists and build a healthier society.

MSK assessments need to happen from day one in nursery. We cannot expect paediatrics or care to be delivered well if we wait until the future, look back and say, “We should have done a better job when that person was younger.” If we looked at MSK conditions from day one—early in a child’s development and in their early years of support—there would not be a massive impact on society later in that person’s life because of having to do delayed diagnosis with multiple appointments and to look after their general wellbeing.

We also need to embed into society notions of what good health looks like from day one. That includes keeping active, going to classes and going to rehabilitation. We need a bigger awareness campaign about what being well looks like. It should not just be that the person leaves school and that is it; it needs to be lifelong. In the same way that people do continuous professional development, they should learn what looking after their body entails, and that should be translated into health policy.

We also need to increase the scope of physiotherapists’ practice. At the moment, they do not do DEXA scans, but they look at bone health in every other way. We look at X-rays, and work in fracture clinics, rehabilitation and trauma orthopaedics, but we do not look at the full picture of bone health. Will the Minister consider inputting that in future?

We need to increase the roll-out of community appointment days. We must provide same-day services for patients, including assessments, advice, health promotion and rehabilitation, and the community and volunteer sectors should provide support in a non-medicalised environment. If somebody has shoulder, knee or back pain, there should be a one-stop shop where they can be assessed appropriately, and they can then move on and get the right care at the right time.

We also need to put community care services on high streets and in places of worship. There are people who are not getting access, and there are massive health inequalities, so how do we promote care and health in difficult-to-reach communities? I would love to see care being put into places of worship and other locations people do not normally think of. I very much welcome the fact that the Government are already moving away from hospital care.

We also need to increase the number of first-contact practitioner places. A consultation with an FCP physio is £30 cheaper than the traditional GP-led pathway. MSK issues are one of the most common reasons to visit GPs, accounting for about 20% to 30% of appointments. Will the Minister meet me to discuss more of the solutions that I think need to be put forward to manage MSK issues? Would he be happy to visit my constituency to look at our fracture liaison service? I hope we will continue to fund that and that the service will be rolled out nationally.

[Clive Efford (in the Chair)]

I call Lizzi Collinge.

[Lizzi Collinge (Morecambe and Lunesdale) (Lab)]

I was told that I would not be able to speak today, and that I could merely intervene, but I am happy to speak if you allow it, Mr Efford.

[Clive Efford (in the Chair)]

I was told that it had been arranged for you to speak.

[Lizzi Collinge]

Excellent news. It is a pleasure to serve under your chairship, Mr Efford. I apologise for the confusion.

Musculoskeletal conditions are very serious, particularly when looked at through the lens of the health and social care workforce. In Morecambe and Lunesdale, 27% of the sickness rate in the health and social care workforce is caused by musculoskeletal conditions. It is clear that if we want to fix our health and social care workforce, we must fix the prevention, diagnosis and treatment of musculoskeletal conditions.

As my hon. Friend the Member for Dudley (Sonia Kumar) pointed out, the conditions do not just have a physical impact, affecting mobility and the ability to work, but can have a particularly serious effect on people’s mental health, relationships and ability to live their life to the full. I believe that health and social care and public health should be framed around allowing people to live their absolute best lives. They need to focus on enabling individuals, whether or not they have long-term health conditions, to work, socialise and have a good family life.

I am passionate about preventing ill health as much as possible. We must prevent musculoskeletal conditions, which can cause a lot of pain and discomfort. I welcome the proposals set out by my hon. Friend, and I look forward to hearing from the Minister about the Government’s plans.