Duchenne Muscular Dystrophy

Karin Smyth Excerpts

Thursday 12th June 2025 Commons Chamber

[The Minister for Secondary Care (Karin Smyth)]

It is a real pleasure to respond to this moving debate. I know that many people with Duchenne muscular dystrophy and their families will have wanted to tune in to hear what was said this afternoon. I thank Members who have contributed in different ways to the debate. In particular, I thank my hon. Friend the Member for Stockton North (Chris McDonald), who secured this debate and advocated so powerfully for these families. He really brought to life the experiences of Benjamin, Jack and Eli, and I commend him for doing so.

I first acknowledge the profound impact that this debilitating disease has on those living with it, and their families, and the urgent need for new and effective treatments. As has been said, my right hon. Friend the Secretary of State for Health and Social Care heard at first hand from people affected by this condition earlier this year, when he attended an event hosted by Duchenne UK. He met many young patients and listened to what they said about the challenges that they face. As we all know, meeting families and individuals from our constituencies leaves a long-lasting effect on us, and it is important that we continue to meet them.

Timely and equitable access to innovative medicines for the treatment of DMD and other rare diseases mentioned today is of the utmost importance. The National Institute for Health and Care Excellence is the independent body responsible for assessing whether new licensed medicines can be recommended for routine use in the NHS, based on a thorough assessment of their clinical effectiveness and cost-effectiveness. Through this process, many thousands of patients, including those with rare diseases, have been able to benefit from effective new treatments at prices that represent value to the NHS. NICE has been able to recommend two medicines for the treatment of DMD: ataluren, recommended in 2023, and vamorolone, which was recommended in January this year and is now available on the NHS to around 1,700 eligible patients, in line with NICE’s recommendations.

As my hon. Friend has said, NICE is appraising givinostat, and the first NICE committee meeting is scheduled for July this year. If the medicine is recommended, the NHS in England will be legally required to fund it. I am aware that a small number of patients in the UK have been receiving treatment with this drug through a company-led early access programme, established by the pharmaceutical company Italfarmaco, as we have heard. It is important to note that participation in these programmes is decided at NHS trust level, and although the drug is free to patients taking part in it and to the NHS, NHS trusts must still cover administration costs and provide clinical resources to deliver the EAP.

NHS England has published guidance on free-of-charge medicine schemes, such as the givinostat EAP, providing advice on financial, administrative and clinical risks. NHS England cannot, however, centrally direct NHS trusts to participate in company sponsored EAPs like this one, or in any other private activity. To issue any form of national direction around participation in EAPs would both pre-empt and undermine the role of NICE, whose purpose is to advise the NHS on whether particular treatments should be made routinely available on the NHS.

Even when there is an agreement that a company will continue to provide a drug free of charge in the event of a negative decision by NICE, participating trusts remain liable to cover the significant costs of delivering that service, including the cost of the clinical resources and staff time needed. That would be outside their funding allocation and in addition to paying for any subsequent NICE-recommended treatments that they would be mandated to fund.

[Chris McDonald]

I thank the Minister for her response, to which I am listening very carefully. I appreciate her point that it would be inappropriate for the Department of Health and Social Care to direct what trusts should do, but what we have heard from the trusts is that they would like to issue this drug, but have certain issues and problems. Perhaps it might simply be a matter of the Department giving help and support, and facilitating information-sharing between trusts that have made this work and those that have not. Perhaps it could be more encouragement than direction.

[Karin Smyth]

I thank my hon. Friend for that constructive suggestion. We need to wait to see how the NICE recommendation goes in July. With this disease and so many others, it is important to share learning and information, and trusts should be encouraged and supported in doing so. We will work with him on that constructive recommendation.

I understand my hon. Friend’s concerns about the fact that non-ambulant patients are not yet able to access givinostat, but it is important to note that the eligibility criteria for participation in the early access programmes have been determined by the pharmaceutical company. NHS trusts that decide to participate in the EAP must only provide treatment in line with the criteria, which state that patients must be ambulant. A clinical trial is being carried out by the pharmaceutical company to evaluate the safety and tolerability of the drug in non-ambulant patients, and to further explore the efficacy of the drug in this population. I know that for the patients and families affected, it will be disappointing to hear that there is no access to the drug for ambulant patients before a NICE decision, or for non-ambulant patients prior to clinical trials being concluded. I want to assure my hon. Friend that we have arrangements in place to support rapid access to new medicines.

[Freddie van Mierlo]

Will the Minister give way?

[Karin Smyth]

I will not; I want to finish in the time available, and I think Members want to hear the full response.

Outside of company-led EAPs, there are established routes for patients to get access to new, innovative medicines prior to them being licensed. The early access to medicines scheme, or EAMS, helps give people in the UK with life-threatening or seriously debilitating conditions early access to new medicines that are not yet licensed where there is a clear unmet medical need. EAMS is supported by key partners, including the MHRA, NICE and NHS England, and is a key part of this Government’s commitment to accelerating patient access to innovative, life-changing treatments, in support of the UK’s position as a global leader in life sciences. In fact, since the scheme launched in 2014, over 50 medicines, including for this disease, have benefited from being accessed early through EAMS.

The innovative medicines fund has also made available £340 million of ringfenced funding for the NHS to fund early access to medicines that NICE has recommended with managed access. Through this process, licensed treatments that demonstrate substantial clinical promise but still have significant uncertainty around their clinical and cost-effectiveness can be funded. Further evidence is then collected on the drug for a defined period of time. That is considered by NICE in determining whether the drug can be recommended for routine NHS funding.

The Secretary of State has been clear that if givinostat is recommended by NICE in draft guidance, NHS England should aim to work with the pharmaceutical company to provide early funding through the innovative medicines fund. This could potentially speed up access by up to five months, and the treatment could be funded as soon as this summer, if recommended.

This scope of this debate is wider than just access to new medicines. It is important to note that while rare diseases are individually rare, they are collectively common. One in 17 people will be affected by a rare condition over their lifetime. The UK rare diseases framework outlines four priorities, based on engagement with the rare disease community. They are: helping patients to get a final diagnosis faster, increasing awareness of rare diseases among healthcare professionals, better co-ordination of care, and improving access to specialist care, treatments and drugs. In England, we publish a rare diseases action plan annually. These detail the specific steps we are taking to meet the shared priorities of the framework. I am pleased to highlight the 2025 England action plan, which was published in February this year on Rare Disease Day. One such action is reviewing the effectiveness of early access schemes, such as the early access to medicines scheme, the innovative licensing and access pathway, and the innovative medicines fund. They are all designed to help make innovative treatments available earlier to patients who need them. We are specifically considering how well they support access to treatment for people living with rare diseases like Duchenne.

NHS England, NICE and MHRA will meet annually to continue to discuss progress on these schemes. These meetings will include representatives from patient advocacy groups and from industry, and clinical researchers, and the next one will happen in the summer.

Managing a complex rare condition can be challenging, and it often means interacting with many different specialists and providers of health and social care. It can mean travelling across the country to access highly specialist care from experts. All of that can add up to a significant emotional and physical burden, and it can deepen inequalities. Co-ordination of care can minimise this burden on patients and their carers, and it can ensure that healthcare professionals work together to provide the best possible care, as we have discussed this evening.

In the 2025 action plan, we have introduced a new action to incentivise providers to run clinics for multi-system disorders, in order to reduce the number of appointments and improve co-ordination of care for families. The NHS is also working to include the definition of “co-ordination of care” that is set out in the CONCORD—co-ordinated care of rare diseases—study in all new and revised NHS service specifications for patients with rare diseases.

I recognise how hard it is when patients want access to these new treatments. I also recognise the distress and worry it causes, not only to patients, but their families and friends. Hon. Members have articulated that well on behalf of their constituents this evening. The Government are committed to providing access to the most innovative medicines, but it has to be at a price that provides value for the NHS, and it has to be clinically safe and effective. That is why we are working hard with industry, NICE and MHRA to make that happen. I know that my hon. Friend the Member for Stockton North will continue to work with the Government and providers to make that happen. I am grateful for the opportunity to respond to this debate on such an important issue.

Question put and agreed to.

NHS Funding: South-west

Karin Smyth Excerpts

Wednesday 11th June 2025 Westminster Hall

[The Minister for Secondary Care (Karin Smyth)]

It is a pleasure to serve under your chairmanship, Dr Huq. I thank the hon. Member for Torbay (Steve Darling) for securing the debate. We could have had more time, as this is an important issue for us all across the whole south-west. I thank colleagues for taking part.

The hon. Gentleman is right that the system has real challenges receiving deficit funding in our part of the NHS recovery support programme. He will rightly be following that closely. In the autumn Budget, which I think virtually everyone in this room disagreed with, the Chancellor took the necessary decisions to put our NHS on the road to recovery, with a more than £22.5 billion increase in day-to-day health spending and over £3 billion more in the capital budget over this year and the last. Today, the Chancellor has announced the conclusion of the spending review, with £29 billion more day-to-day funding in real terms than in 2023-24. There is a £2.3 billion real-terms increase in capital spending over the spending review period—something I hope everyone welcomes.

The SR puts the NHS on a sustainable footing by cutting waiting lists so that by the end of this Parliament 92% of patients will start consultant-led treatment for non-urgent health conditions at 18 weeks, delivering on the Prime Minister’s plan for change commitment and prioritising people’s health. To respond to the hon. Member for Bath (Wera Hobhouse), we do encourage use of the independent sector for capacity, and that is a decision for ICBs to make sure they achieve those standards. The settlement also supports the shift from analogue to digital, with a total investment of up to £10 billion in NHS technology and transformation between ’26-27 and ’28-29, and an almost 50% increase from ’25-26. I agree with the right hon. Member for Salisbury (John Glen) that technology offers huge opportunities in geographies like ours.

Thanks to the Chancellor, we are taking the necessary steps towards fixing the foundations of our NHS and making it fit for the future. Since coming into office, the Government have published our urgent and emergency care plan, which will support the NHS across England to improve the timeliness and delivery of care to patients requiring urgent and emergency care over the next year, including for next winter. We are delivering on our plan for change through the accelerated roll-out of the NHS app. We will create an NHS fit for the future and continue to invest in the latest technology, shifting healthcare from analogue to digital.

Our investment and reform in general practice, to fix the front door to the NHS and bring back the family doctor, includes an additional investment of £889 million. We have published our elective reform plan, which will cut waiting times from 18 months to 18 weeks. We have exceeded our pledge to deliver an additional 2 million appointments, tests and operations—we have delivered over 3 million more. Waiting lists have fallen for the sixth month in a row and have now been cut by over 219,000 since we came to office. The Government have committed to a10-year health plan that will lead the NHS to meet the challenges set out in the plan for change to build the NHS for the future, and it will be coming very soon.

I know that hon. Members across the House share the concerns of the hon. Member for Torbay about the crumbling NHS estate after years of neglect. I wish to assure Members that my right hon. Friend the Chancellor has given us the funding to begin reversing the trend of decline in the south-west and nationwide, with health capital spending rising to £13.6 billion this year.

In the south-west region, allocations have been made totalling £448 million in operational capital, empowering systems to allocate funding to local priorities; over £238 million from our constitutional standards recovery fund to support NHS performance across secondary and emergency care; and £83 million from the £750 million estates safety fund to deliver vital safety improvements, enhance patient and staff environments and support NHS productivity. This includes £7.3 million for Torbay hospital in the constituency of the hon. Member for Torbay; £10 million from our primary care utilisation fund for improvements in the primary care estate; and almost £5 million to help to reduce inappropriate out-of-area placements for mental health patients in the south-west.

ICB allocations have been talked about a lot today. For the south-west, they have been confirmed as totalling £11.5 billion out of a total of £116.7 billion allocated for England. The regional allocation per capita for the south-west is above the national average. We heard from my hon. Friends the Members for South Dorset (Lloyd Hatton) and for Bournemouth East (Tom Hayes) that the signs are being seen in their constituencies.

[Richard Foord]

Will the Minister give way?

[Karin Smyth]

I am going to just complete these points, so that I can try to address as many points as possible.

In the constituency of the hon. Member for Torbay, the local ICB, NHS Devon, receives £2.5 billion of the £11.5 billion for the south-west. The allocation per capita for Devon is higher still, and above the south-west regional average. Likewise, NHS Cornwall and the Isles of Scilly ICB received just over £1.2 billion of that £11.5 billion total. The allocation per capita for Cornwall and the Isles of Scilly is above the south-west regional average and national average.

To respond to the hon. Member for St Ives (Andrew George), I understand from NHS England that the ICB has had the debt written off, so that might be something he wants to follow up. My hon. Friend the Member for Truro and Falmouth (Jayne Kirkham) and others talked about funding allocations—we could talk about this for a very long time. They are difficult things to get right, and are controversial, but the funding formulation does account for older people and for rural populations.

The latest financial performance position publicly available is for quarter three of last year. It showed an overall deficit position of £51.7 million against the year-to-date plans, of which Dorset ICS had the largest variance of £27.7 million. Final end-of-year positions are still being finalised and will be made publicly available in due course. For ’25-26, NHS systems overall have received £2.2 billion of deficit support funding in their allocations. All systems in the south-west have now agreed a balanced plan for ’25-26. The position on deficit support for ’26-27 will follow the spending review settlement for individual organisations agreed as part of the planning guidance process.

NHS England will continue to support all organisations to deliver financially sustainable healthcare through a range of improvement measures, some of which we have heard about today. Devon integrated care board, and three trusts within the ICB, are currently part of the recovery support programme, which provides intensive support to challenged organisations. Where organisations are struggling significantly, the Department of Health and Social Care provides cash support to support the continuity of patient services—obviously, that is critically important. So that colleagues are aware, I am personally meeting with finance colleagues from NHS England and the Department of Health every week to support that work. We are clear as a Government that we need to be certain that every pound of taxpayers’ money is used to best effect, and that best practice is followed in this region and across the entire NHS.

The hon. Member for Torbay asked about coronary services, and that is a local decision. NHS Devon and Torbay Foundation Trust have proposed undertaking a test-and-learn process for out-of-hours primary percutaneous coronary intervention. That service will be provided in Torbay and Exeter, which would involve a temporary change to provide out-of-hours services at Exeter only. Members will be aware that the ICB was due to make a decision on the pilot at its board meeting in May. However, following significant local feedback, the ICB has decided to reflect on those issues raised, and I am sure the hon. Member for Torbay will be following up on that. The ICB will be providing an update at its board meeting in July.

In conclusion, the Government are taking the necessary steps to fix the NHS, and the Chancellor’s spending review settlement puts the NHS further on the road to recovery. I assure Members that we will write back to them on any other individual points raised.

Attention Deficit Hyperactivity Disorder

Karin Smyth Excerpts

Tuesday 10th June 2025 Westminster Hall

[The Minister for Secondary Care (Karin Smyth)]

It is a pleasure to serve under your chairmanship, Ms Jardine.

I thank the hon. Member for Henley and Thame (Freddie van Mierlo) for securing this important debate on support for people with ADHD, and for sharing the experiences of his constituents in Oxfordshire. I know that the hon. Gentleman and others wrote to the Minister for Care, my hon. Friend the Member for Aberafan Maesteg (Stephen Kinnock) about many of the issues he raised today; I hope he found the Department’s response to that letter useful. I thank other colleagues for their interventions. These issues also affect my own constituents, and I see them in my inbox, so I understand their impact on families and communities.

First, we must be honest about the challenges. The Government inherited a broken NHS with too many patients facing long waits to access services, including ADHD assessments and support. Lord Darzi’s report laid bare that the growth in demand for ADHD assessments nationally has been so significant in recent years that it risks completely overwhelming the scarce resources available. The report also shows that, at current rates, it would take on average eight years to clear the backlog of adult ADHD assessments and that for many trusts the backlog would not be cleared for decades. We absolutely recognise the need to better understand the factors behind the rise in demand for services to ensure that we offer the right support.

The hon. Member for Henley and Thame asked why his trust has closed its waiting list. In preparing for the debate, I asked officials to give me a clearer understanding of what is happening in the Buckinghamshire, Oxfordshire and Berkshire West ICB, which saw a near 50% increase in referrals year on year between 2019 and 2024. I am pleased that the hon. Gentleman has had contact with the chief executive. The trust felt that it could not cope with that level of demand because it viewed it as an unmanageable risk to patient safety and staff wellbeing. That is why it made the difficult decision to close the waiting list for new adult ADHD assessments in February last year. That was the trust’s decision.

As someone who worked in the system over the peak years of austerity—some people may remember them—I completely understand how trusts are often confronted with such decisions. The recent growth in demand seems quite exceptional. Integrated care boards are responsible for commissioning services in line with the health and care needs of the people they serve. It is up to local decision makers to make tough choices, because they know the situation on the ground better than Ministers in Whitehall.

I understand that the ICB has established an ADHD programme steering group to stabilise its services, and it is working with local partners, including people with lived experience, to develop a new service model aimed at addressing health inequalities, providing a single-service model across the ICB, with a single provider, and providing support for people who do not benefit from medication. I understand that the trust is working to open a service for 18 to 25-year-olds as an interim measure to help those who transition from children and young people’s services to adult services, which we know is a difficult time in their lives. I am sure that the hon. Gentleman will maintain a close watch on those commitments.

[Carla Lockhart (Upper Bann) (DUP)]

Following on from the intervention by the hon. Member for North Down (Alex Easton), I know that this is a devolved matter, but the issues are exactly the same in Northern Ireland as in GB, with long waiting lists and a lack of access to services. Does the Minister agree that people with ADHD are being discriminated against right across the United Kingdom because of the lack of access to services? Does she also agree that, in the interim, those who go for a private diagnosis should be able to enter into a shared care arrangement so that they can access the medication that assists them to function day to day, live normal lives and be part of our society?

[Karin Smyth]

I will come on to shared care agreements. As the hon. Member says, this is a devolved matter, and I am focusing on support for issues facing ADHD services in England and what we are doing to support trusts to get back on top of waiting lists and improve access to services.

First, NHS England has commissioned an independent ADHD taskforce, which is working to bring together those with lived experience and experts from the NHS, education, charity and justice sectors. The taskforce is developing a better understanding of the challenges affecting those with ADHD, including timely and equal access to services and support. I can confirm today—I know that this will be of interest to many hon. Members—that the taskforce will publish its interim findings shortly, with a final report expected after the summer recess. The interim report will helpfully focus on recommendations that support a needs-based approach, beyond just the health system, in which people can access support based on their needs, not their diagnosis. The report will also set out recommendations for support to be provided beyond medication, and by healthcare professionals other than specialists.

Secondly, NHS England recently published an ADHD data improvement plan to inform future service planning, and on 29 May it published management data on ADHD waiting lists. Thirdly, it has been capturing examples from ICBs that are trialling innovative ways of delivering ADHD services and using that information to support systems to tackle waiting lists and provide support.

Fourthly, as part of the Government’s five long-term missions, we have launched the 10-year plan to deliver the three big shifts that our NHS needs to be fit for the future: from hospital to community, from analogue to digital, and from sickness to prevention. All those shifts are relevant to supporting people in all parts of the country with a range of conditions such as ADHD.

Fifthly, we are supporting innovation. Earlier this year, at a parliamentary event, many of us will have met innovators who are supported by NHS partners. I heard about the QbTest technology that complements the knowledge and skills of clinicians as part of the ADHD assessment process. I understand that 70% of NHS children’s ADHD services already use that technology, and the evidence suggests that it has a positive impact in making the assessment process swifter and simpler.

[Freddie van Mierlo]

Will the Minister comment on the fact that in Oxfordshire there is no commissioned service for the specialist reviews that NICE requires annually as a condition of being on the powerful medication? How can it be that someone can be started on medication but have no route to continue on it because they cannot get their annual review?

[Karin Smyth]

I am not aware of the detail of the pathway in the hon. Member’s ICB. I suggest that that is a matter for him to discuss with the ICB, which will have heard his question about how it is delivering those services on the ground.

Members raised issues around shared care agreements and the difficulties that people with ADHD are experiencing in accessing medication through such agreements, particularly when they have received a diagnosis through a private provider. It is the responsibility of secondary care specialists such as consultants, rather than GPs, to initiate treatment of ADHD. However, sometimes a shared care agreement, in which the GP takes over monthly prescriptions and routine monitoring once the patient is happy with their medication and dosage, can be put in place. The General Medical Council, which regulates and sets standards for doctors in the UK, has issued guidance to help GPs decide whether to accept shared care responsibilities for any condition. NHS clinicians need to be content that any prescriptions or referrals for treatment for any condition are clinically appropriate. All shared care arrangements are voluntary, so even where arrangements are in place, practices can decline shared care requests on clinical or capacity grounds.

If I may, Ms Jardine, I will take the opportunity to update the House on the supply of medicines, which has also been raised by colleagues; I understand that it was raised at business questions recently, too. The Government recognise the difficulties that some people have experienced with accessing ADHD medication due to medicine supplies. We know how worrying and frustrating those shortages are for patients and families. I am pleased to say that we have resolved many of the outstanding issues affecting the supply of lisdexamfetamine, atomoxetine capsules, atomoxetine oral solution and guanfacine prolonged release tablets. However, some specific manufacturers continue to have issues with methylphenidate.

We continue to work with manufacturers to resolve remaining issues. In fact, I met the medicine supply team this morning, as I do very regularly, to make sure we are on top of these issues as much as we can be. The team is working hard to make sure that the situation improves. Where issues remain, we are directing suppliers to secure additional stocks, expedite deliveries where possible, and review plans to support continued growth in demand for the short and long term. We have worked with specialist clinicians during this time to provide comprehensive guidance to healthcare professionals where there is a disruption to supply. We keep the Specialist Pharmacy Service website up to date with the latest availability of ADHD medicines. I commend it to people listening to the debate and to hon. Members. It also provides comprehensive guidance on switching to alternative treatments, supporting clinicians to make informed choices with their patients.

I can assure colleagues that, as the Minister responsible for medicine supply, I will instruct officials to keep a close eye on this issue, so we do not see any of the progress we have made undone. I plan to hold an event, hopefully in Parliament and possibly in the autumn, to keep updating hon. Members on this issue, because I know it is one that concerns us all.

In closing, I want to address the young people who may be watching or tuning into the debate at home. I know it is tough for many neurodivergent kids today. You might be stuck on a waiting list, suffering at school or struggling to find your medicine. We really do care about this. We are trying to get to grips with some of the problems we found when we came into office, and I hope you will start to feel that progress within the next few years.

[Rachel Gilmour]

May I bring the Minister back to the subject of my earlier intervention? Will she, as a matter of urgency, take it up with the Home Secretary and get a decision? We should not discriminate against people with ADHD by preventing them from joining the services, whether it be the police, the Army, the Royal Navy or the RAF. I am so shocked about this I am like a dog with a bone—I cannot let it go.

[Karin Smyth]

I will ensure that the hon. Lady gets a reply on that issue.

I thank the hon. Member for Henley and Thame for securing this important debate and for giving me the chance to put on the record some of the issues the Government are addressing. The Government know there is much more to be done to get better access to timely diagnosis and support for all our constituents, but I hope the actions I have set out today provide some reassure to the hon. Gentleman and other colleagues.

Question put and agreed to.

Breast Cancer Screening: Bassetlaw

Karin Smyth Excerpts

Monday 9th June 2025 Commons Chamber

[The Minister for Secondary Care (Karin Smyth)]

I thank my hon. Friend the Member for Bassetlaw (Jo White) for bringing forward this debate on a really important topic that is close to my heart and, I know, the hearts of so many other hon. Members. It is really important to ensure that as many women as possible take up the offer of screening. They should not feel embarrassed to seek help if they feel something untoward when checking their breasts.

My hon. Friend has spoken really eloquently, and has been supported by other colleagues. As she has done on other occasions, she has highlighted her family’s experience of losing a loved one due to the fear of seeking medical advice, and she is right to raise the issue of the downturn in women choosing to be screened in her constituency and, sadly, across the country.

Survival rates for breast cancer can be good. If breast cancer is found early, at stage one, the five-year survival rate can be as high as 98.2%, but the five-year survival rate plummets to 26.6% when breast cancer is not found until stage four. The earlier breast cancer is caught, the earlier it can be treated, and the more likely it is that the patient will recover.

Everyone is encouraged to check their breasts for lumps. There have been some excellent public health campaigns over the years from various charities explaining what to look for, be it a lump, a discharge or a dimpling of the skin on the breast. If a change is found, it is essential that no time is wasted before contacting a GP. That is why screening is an essential tool in our arsenal when trying to prevent this disease.

A mammogram can identify breast cancer before it is large enough to be felt. The NHS national breast cancer screening programme invites all women aged 50 to 71 to attend a screening appointment once every three years. Mammograms can be uncomfortable, as those of us who have had them know, and many women have anxiety about having to get undressed in front of strangers, but that short discomfort could save a life. It is important that we encourage all women not to put off their scans.

The NHS breast screening programme was badly affected by the pandemic, as we have heard this evening. Screening for breast cancer was paused, and when it restarted, the number of women taking up the offer did not recover to pre-pandemic levels. Even after the backlog of missed appointments had been cleared, the take-up of invitations was low, and data indicates that lots of women are still not coming forward to start their screening journey. The NHS is doing more to help to drive up engagement, and we can all do more to help, as my hon. Friend is doing.

The most recent NHS data shows that breast cancer screening uptake in the area including my hon. Friend’s constituency is reported at 74.1%, with an achievable standard of 80%. That is higher than the national average of 70%, but it is short of that achievable high standard. Also, the percentage of women screened within 36 months of their previous screen is reported at 97.5%, versus the acceptable standard of 90% and the achievable standard of 99%.

While more can clearly be done to increase uptake, I hope that those figures for the entire patch that includes my hon. Friend’s constituency provide some reassurance that women are coming forward to be screened. However, I absolutely take the point made by her and her colleagues that the data needs to be understood at a more granular, local level—particularly data on the women coming forward in areas of high deprivation. I will ensure that my hon. Friend has access to that information following this debate.

I am pleased that the Doncaster and Bassetlaw teaching hospitals breast screening service has made significant improvements over the past year to improve attendance at appointments. I really commend my hon. Friend’s “Love your boobs” campaign, and the work that she has highlighted with local women like as Liz, Maria, Barbara, Claire and Lynn, and with men such as Danny, which makes the point that is important that men also check. The service has recently expanded availability by offering more appointments outside traditional hours. It has extended its clinic hours, and has regular Saturday appointments. The invitation method has also been changed from open appointments to timed and dated appointments, which has been shown to help increase engagement, and the service has met with the Cancer Alliance and commissioners to review ways of increasing uptake. I understand that Doncaster and Bassetlaw teaching hospitals’ breast screening service is planning to invite my hon. Friend to visit a clinic in her constituency. I hope that visit will furnish her with further information about local efforts to increase uptake, and I know she will make sure that visit happens.

In February this year, the NHS launched a national breast screening awareness campaign to encourage more women to take up the offer of screening, and debates such as the one we are having tonight help raise awareness of its importance. We are not complacent: as well as increasing the uptake of routine screening, we need to make sure that the women who are most at risk are screened more frequently. The breast screening after radiotherapy dataset, or BARD, programme is working to identify and invite women who received radiotherapy involving breast tissue when aged between 10 and 35. As we have heard this evening, genetic tracing programmes are also looking at identifying carriers of genes, including BRCA, that predispose individuals to a higher risk of breast cancer. Those women are entitled to more frequent screening, and we need to ensure that they are identified and informed.

The UK national screening committee is considering other changes to the breast screening programme. It is looking at whether women with denser breasts need to be screened differently, and an ongoing trial called BRAID—breast radiography to aid identification of cancers in dense breasts—is looking at breast density. The UK NSC is discussing the first findings of that trial, which I am sure hon. Members will maintain a close interest in. It will continue to review BRAID and other findings as they become available to ensure that early decisions can be made to keep the screening programme updated and dynamic.

We are also investigating the age thresholds for screening. Currently, only higher-risk women are invited for screening below the age of 50. The programme stops at the 71st birthday, although women aged over 70 can choose to opt back into regular screens. A trial called AgeX is reviewing whether an additional screen three years before and three years after the existing age thresholds would increase the effectiveness of this programme and ultimately save more lives, and the EDITH research study is looking at whether artificial intelligence can be used to support the reading of mammograms. If it can, that could relieve pressure on the workforce and allow more screens to take place, as there would be increased capacity to translate the results. The Government have already invested £11 million in that trial, and we keenly await the results.

More widely, the Government are committed to tackling breast cancer and ensuring that women get diagnosed and treated faster and more efficiently. That is why we will publish a national cancer plan later this year. That plan will have patients at its heart and will cover the entirety of the pathway, from referral and diagnosis to treatment and ongoing care, as well as prevention, screening, research and innovation. It will seek to improve every aspect of cancer care to improve the experience of, and outcomes for, people with cancer. Our goal is to reduce the number of lives lost to cancer over the next 10 years.

I again thank my hon. Friend the Member for Bassetlaw and other hon. Members for being in the Chamber this evening, giving this House an important opportunity to shine a light on the lifesaving importance of breast screening. My hon. Friend is doing a great service in publicising her work with the NHS, and I wish her good luck with Race for Life. We all have the same goal, and together, we can improve outcomes and increase the number of women surviving breast cancer.

Question put and agreed to.

NHS Urgent and Emergency Care Plan 2025-2026

Karin Smyth Excerpts

Monday 9th June 2025 Written Statements

[The Minister for Secondary Care (Karin Smyth)]

Today I am updating the House on the publication of our NHS urgent and emergency care plan for 2025-26. This plan sets out the key actions and milestones across 2025 and 2026 that will support the NHS across England to improve the timeliness and delivery of care to patients requiring urgent and emergency care.

The most recent winter clearly showed that, despite the hard work and compassion shown by NHS staff up and down the country, patients did not receive the standard of care we all expect.

Every day, more than 140,000 people access urgent and emergency care services across England. Since 2010-11, demand has almost doubled, with ambulance service usage rising by 61%.

A&E waiting time standards have not been met for over a decade, while the 18-minute target for category 2 ambulance calls has never been hit outside the pandemic. We know that something has to change.

This Government have committed to a 10-year health plan, which will lead the NHS to meet the challenge set out in the plan for change, here www.gov.uk/government/publications/plan-for-change to build an NHS that is fit for the future.

But we know that we cannot stand still. That is why we asked the Department of Health and Social Care and NHS England to work together to develop an urgent and emergency care plan for 2025-26.

This delivery plan focuses on improvement activity in line with the current round of NHS operational planning guidance. It is vital that we have clear, shared objectives, which is why we have instructed the NHS to focus as a whole system on those improvements that will have the biggest impact. We will make sure that this winter is significantly better than recent winters by setting ambitious but achievable targets and increasing transparency about progress.

In hospitals, the plan will ensure at least 78% of patients who attend an A&E department are seen within four hours—more than 800,000 people receiving more timely care than last year. To support care settings, the plan confirms that we will allocate almost £450 million of capital investment, including for same day emergency care and mental health crisis assessment centres, ensuring that patients who would otherwise be unnecessarily admitted to hospital can be assessed, diagnosed and treated on the same day and then discharged without an overnight stay.

We know that at least one in five people who attend A&E do not need urgent or emergency care, while an even larger number could be better cared for in the community. We will renew our focus on improving vaccine uptake, making it easier than ever to access vaccination appointments closer to home. We will also improve vaccination rates among health staff to prevent them from getting flu—reducing the number of sick days and ensuring that staff are well and able to care for patients across the busy winter period.

We will continue to invest in data and digital tools to speed up and improve patient care, ensuring that paramedics across the country can access patient records on the move, enabling them to provide better care and avoid unnecessary admissions.

These measures mark a fundamental shift in our approach to urgent and emergency care—moving from fragmented efforts to genuine collaboration across the whole system—and mean better co-ordination between NHS trusts and primary care to identify patients who are most vulnerable during winter.

[HCWS686]

NHS Supply Chains: Eradicating Modern Slavery

Karin Smyth Excerpts

Thursday 5th June 2025 Written Statements

[The Minister for Secondary Care (Karin Smyth)]

Modern slavery includes forced labour, human trafficking and exploitative labour conditions and it remains a significant global rights violation, with an estimated 50 million individuals affected worldwide. The UK Government are committed to eradicating the presence of this heinous crime in its supply chains, including those within the health sector.

The NHS is one of the UK’s largest procurers of goods and services, and as such has a significant role to play in combating modern slavery. The Government, supported by NHS England and the Department of Health and Social Care, will send a clear signal that there is no place for goods and services linked to modern slavery in our healthcare system. I am pleased to announce that we are taking decisive action to eliminate modern slavery in NHS supply chains in England by proceeding to introduce robust regulations.

In my statement published on 21 November 2024, I confirmed DHSC’s pledge to create regulations to eradicate from the NHS goods and services tainted by slavery and human trafficking, as required by the National Health Service Act 2006. The Department has worked hard to ensure that regulations are fit for purpose and interact with the current legislation and updated policies.

The review of modern slavery risk in NHS supply chains published on 14 December 2023 found that 21% of suppliers are at high risk of slavery and human trafficking. The review recognised the need to improve and standardise the approach to modern slavery risk management. It recommended that DHSC proceed to introduce regulations to enforce and enable a consistent approach to risk management across the NHS.

Modern slavery is a complex issue that cannot be tackled through a singular legislative measure. There are existing measures in place to tackle modern slavery both in terms of criminalising it and addressing it through commercial levers. The Modern Slavery Act 2015 provides a legal framework for punishing those committing modern slavery offences. These provisions do not regulate public bodies or provide a framework for public bodies to address modern slavery in their supply chains. The Procurement Act 2023 provides a single framework for the rules and procedures that public procurement bodies must follow. It includes grounds for the mandatory or discretionary exclusion of suppliers from a tender process where modern slavery offences have been committed. Procurement of healthcare services for the NHS in England—approximately £60 billion—are not in scope of the Procurement Act 2023. They are covered by the Health Care Services (Provider Selection Regime) Regulations 2023, which give NHS decision-makers flexibility to arrange services in the best interests of patients, the taxpayer and the population. We aim to introduce a single, enforceable approach to modern slavery that sets a standardised risk management approach across the NHS, covering all the supply chains for goods and services provided to the NHS.

These regulations will require all public bodies to assess modern slavery risks in their supply chains when procuring goods and services for our health service in England. We are then asking public bodies to take reasonable steps to address and, where possible, eliminate the modern slavery risks when designing procurement procedures, when awarding and managing contracts, and when setting up frameworks or dynamic markets.

Reasonable steps may include: ensuring robust conditions of participation and assessment criteria are built into procurement processes; using specific contract terms to monitor and require mitigation where instances of modern slavery are discovered; and monitoring suppliers’ compliance and reassessing risk throughout the life of the contract.

We invited views and contributions from a wide range of stakeholders through extensive engagement and public consultation. We sought and considered input from public bodies, suppliers, trade associations, interest groups and the public. This has been a valuable step in the development of our regulations, which we intend to lay before Parliament soon.

The public consultation ran from 21 November 2024 to 13 February 2025. We are pleased to announce that the Government’s response to feedback received has now been published.

This is a step towards strengthening the Department’s leadership role in championing ethical procurement, setting a benchmark for other sectors beyond health. Modern slavery is an abhorrent crime that exists everywhere, not just the UK or within supply chains of the health sector. It demands a collective international response. DHSC has a duty to eradicate the use of goods and services tainted by modern slavery in NHS supply chains. We have a continued commitment to work across Government and sectors to ensure our efforts align with these priorities and uphold the responsibilities of public bodies within our jurisdiction.

[HCWS683]

Yeovil Hospital: Maternity Unit

Karin Smyth Excerpts

Tuesday 3rd June 2025 Commons Chamber

[The Minister for Secondary Care (Karin Smyth)]

I thank the hon. Member for Yeovil (Adam Dance) for securing this important debate about the temporary closure of maternity services at Yeovil district hospital. I know, having given birth to three myself, that choosing where to give birth and the planning of that journey, as has been outlined, is incredibly important for women. We are determined that all women are given choice over their care and are listened to and supported with compassion. The hon. Member is an advocate for the Yeovil community, and I welcome his representations, ensuring that his constituents’ voices are heard. That is an important role for Members of Parliament.

I will start by acknowledging the concerns that hon. Members have raised on their constituents’ behalf, both in their letter and in this debate, and I hope I can update them on the relevant issues as they stand. In preparing for this debate, I have met the trust and Somerset ICB, and I am grateful for their time and briefing on these issues.

As hon. Members know, the trust cannot safely staff the paediatric service as well as the special care baby unit. This means that it has taken the difficult decision to close the special care baby unit, which also means that it cannot safely provide maternity services—I think that point was acknowledged by the hon. Member for Yeovil.

The hon. Member is concerned about the process followed by Somerset NHS foundation trust in coming to this decision, particularly about it not having consulted the local council, MPs or other stakeholders. He also identified concerns about the information going to staff. In some situations, such as this one, NHS providers may need to make a temporary service change due to a risk to the safety or welfare of patients or staff. Legislation allows them to do so without consulting the scrutiny committee beforehand, provided that that service change is needed for safety or welfare reasons. I understand that the trust briefed Somerset county council’s health overview and scrutiny committee on 15 May, and has committed to further updating the committee in October. The trust has had one-to-one conversations with affected women and families to help them with alternative plans, which have been supported by Somerset Maternity and Neonatal Voices Partnership.

[Adam Dance]

Does the Minister agree that the timescale given to our NHS staff, and telling them on Teams or not telling them at all—with them finding out on social media—is not the right way to treat them? Imagine how that makes those staff feel.

[Karin Smyth]

I am not aware of the operational details of how the decision was communicated, but I am happy to come back to that. As I have said, when decisions are made for reasons of safety—which is of primary importance—sometimes staff will not be able to be consulted in the usual way. Of course, some staff will not be working at a given time, or may be on holiday, and organisations have to take particular measures to inform staff. I appreciate that that is very disruptive and personally distressing for staff who have been working in a unit and need to know where to go, but emergency situations sometimes necessitate things not being done as robustly as might be desired.

Local leaders have assured me that this closure is not intended to be permanent—that is very important for hon. Members and their constituents to understand. The trust is committed to reviewing the position in three and six months, and following the three-month review, Somerset ICB will provide an update in September. Finally, once a decision is made, any permanent change would need to be based on clear evidence of better outcomes for patients.

On the wider issue that has been raised this evening, as hon. Members will be aware, the Government’s position is that changes to NHS services should always be locally led and clinically evidenced. Any decision about the next steps for the neonatal and maternity services at Yeovil hospital should be taken by the local NHS, with support from the Care Quality Commission. I understand that work is currently under way to mitigate the impact of the closure and move towards safe operation of services. The NHS England South West regional team is working with the trust and the ICB to mitigate the risk of the closure and ensure that the wider systems work together to provide safe services. The trust is working closely with neighbouring hospitals in Bath, Salisbury, Poole, Dorchester and Exeter to ensure sufficient capacity, which should provide assurance to local people.

Regional team clinical leaders have attended a rapid quality review meeting with ICB and trust clinical leaders, and work continues on mitigating the risks that have been identified. I have been assured that Somerset ICB will monitor progress against improvement plans, formally noting any new or emerging risks and actions required. It will also be monitoring the impact on Musgrove Park maternity unit. I understand that Somerset NHS foundation trust and Somerset ICB have also written to the hon. Member for Yeovil since the closure and that there is due to be a call with local MPs tomorrow. I think that is good progress; as I said to representatives of the trust when I met them, I commend that way of operating with local Members of Parliament. I hope it is helpful in having detailed conversations locally to reassure hon. Members and—more importantly, if I may say so —their constituents at what I appreciate is a really difficult time for women who are either due to give birth, or are thinking about starting a family.

We are committed to tackling staffing challenges that the NHS faces, such as this one. For the maternity workforce, NHS England is undertaking a programme of targeted retention work for midwives. This includes a midwife retention self-assessment tool, a mentoring scheme, strengthened advice and support on pensions, and flexible retirement options.

NHS England has also invested in unit-based retention leaders, who focus on retention and give pastoral support to midwives. This initiative, alongside investment in workforce capacity, has seen a reduction in the number of vacancies and in leaver and turnover rates. Maternity care remains a top priority for providers, as is demonstrated in the planning guidance, in which the NHS was instructed to improve safety in maternity and neonatal services as a priority.

I know that there is concern in Somerset more widely about how this change will affect services in the local area. Let me reassure Members that NHS Somerset is committed to investing in local services for both hospitals there. That includes a commitment to a fully functioning district general hospital in Yeovil. The Yeovil diagnostic centre, which is due to open later this year, will be a modern, three-storey, state-of-the-art centre based at Yeovil district hospital. It will have the capacity to deliver an additional 70,000 diagnostic tests and out-patient appointments each year and to be open seven days a week, providing radiology, endoscopy and cardiology services, audiology tests and out-patient appointments.

I thank the hon. Member for Yeovil again for raising this important issue. I know that he and his colleagues will keep a close eye on progress. I hope that I have responded to his immediate concerns tonight, and I will of course write to him and other Members shortly in response to their letter of 19 May.

[Sarah Dyke]

May I raise the issue of maternity services at Musgrove Park hospital, which will be taking on a number of patients? An upgrade that was due has now been pushed back to the mid-2030s. At present, maternity services are provided in a 1940s dormitory-style building. Does that really show mothers-to-be that their needs are being prioritised?

[Karin Smyth]

I am of course aware of that, because I lead on the new hospital programme. The Government are committed to a clear timetable for the programme, which includes Musgrove Park. In our Budget last autumn, we announced decisions—which the hon. Lady and her colleagues did not support—involving capital plans and ensuring that that programme is now on a financial footing that it was not on previously.

I am confident that the local NHS is aware of the impact of this change and continues to work hard to improve the situation. Any change in NHS services must be made with the utmost sensitivity to local views, while also prioritising safety. I know that Members will continue to monitor this issue, and I will ensure that they receive a response to the letter of 19 May.

Question put and agreed to.

Access to NHS Dentistry

Karin Smyth Excerpts

Thursday 22nd May 2025 Commons Chamber

[The Minister for Secondary Care (Karin Smyth)]

I thank the hon. Member for Sleaford and North Hykeham (Dr Johnson); I could not have asked for a better set-up. I pay great tribute to my hon. Friend the Member for Great Grimsby and Cleethorpes (Melanie Onn). This is an issue she has pursued for some time, and I am grateful for her securing this important debate. I know many more Members would have liked to speak. I will not take any interventions in the short time I have to respond because I want to address some of the questions raised.

This issue continues to be a matter of great concern to Members and all our constituents. Poor oral health can have a devastating effect on individuals, as we have heard, impacting their mental and physical health alike and, indeed, their opportunities for work, as my hon. Friend the Member for Leigh and Atherton (Jo Platt) made clear. Yet it is a largely preventable issue through good oral health hygiene and regular visits to a dentist. We inherited a broken NHS dental system, and our ambition is to rescue and restore NHS dentistry so that we deliver more NHS dental care to those who need it. Fourteen years of neglect, cuts and incompetence by the previous Government have left NHS dentistry in a state of decay. That is simply unacceptable and needs to change, which it will.

As of March 2024, more than 36,000 dentists are registered with the General Dental Council in England, and yet less than 11,000 full-time equivalent dentists were working within the NHS. Lord Darzi said in his report:

“There are enough dentists in England, just not enough dentists willing to do enough NHS work”.

That is why this Government are prepared to take strong action. Since coming into office, we have made good progress on our plan for change. We have already taken action to address the immediate needs of patients in pain and requiring urgent dental care through our manifesto commitment to deliver an additional 700,000 urgent dental appointments per year. Integrated care boards started to deliver those appointments from April, and each area has been given expectations for delivery based on their local needs.

That point was noted by my hon. Friends the Members for Filton and Bradley Stoke (Claire Hazelgrove) and for Amber Valley (Linsey Farnsworth), who campaigned studiously in opposition and continue to bring this to the House. ICBs have returned detailed plans for delivering against the expectations, and the Minister for Care is holding regular meetings with officials in the Department and with NHS England to monitor and drive progress against those plans. I commend my hon. Friend the Member for Gloucester (Alex McIntyre) for pursuing the matter with his ICB—that is exactly the right thing to do.

To have a truly effective dental system, we cannot focus just on those already in pain. We must have a system that prioritises prevention, particularly for children—a point well made by my hon. Friends the Members for North Ayrshire and Arran (Irene Campbell), for Blackpool South (Chris Webb) and for Morecambe and Lunesdale (Lizzi Collinge). That is why we have invested over £11 million to roll out a national supervised toothbrushing programme for three to five year olds. That will reach up to 600,000 children a year in the most deprived areas of England. Alongside that, we have launched an innovative partnership with Colgate-Palmolive, which is donating more than 23 million toothbrushes and toothpastes over the next five years. That is incredible value for the taxpayer and a fantastic example of how businesses and Government can work together for public good.

We have also taken the decision to expand community water fluoridation across the north-east of England. That is the first expansion for decades and will bring benefits to an additional 1.6 million people in the region.

Our workforce is crucial, as we have heard this afternoon. A strong dentistry system needs a strong workforce, and we recognise the incredible work that dentists and dental professionals do. I pay tribute to Mr Dobranski mentioned by my hon. Friend the Member for Leigh and Atherton—what amazing service. I also mention my own dentist Aidan Moran, who has been seeing me for the best part of three decades.

A central part of our 10-year health plan will be our workforce and how to make sure that we train and provide the staff, technology and infrastructure the NHS needs to care for patients across our communities—a point well made by my hon. Friend the Member for Bury St Edmunds and Stowmarket (Peter Prinsley). We will publish a refreshed workforce plan to make sure the NHS has the right people in the right places with the right skills to deliver the care that people need.

As my hon. Friend the Member for South Norfolk (Ben Goldsborough) highlighted, we are all sadly familiar with the term “dental deserts” to describe parts of the country where access is especially difficult. We are continuing to support integrated care boards through the golden hello scheme, but of course dentists are only part of the team; dental therapists, hygienists, nurses and technicians all play a vital role, and we need to make the NHS a better place to work for all of them.

We are committed to fundamental reform of the dental contract. It could have been done sooner; it could have been done at any point over the last 14 years by the coalition or the Tories, but they left it for us to do. It will take time, but I assure everyone here that development of these proposals is under way. We continue to work with the British Dental Association and other representatives to deliver our shared ambitions for dentistry. My hon. Friend the Minister for Care met the BDA recently and they have a productive relationship.

In the spirit of honesty, let me be clear: there are no perfect payment models, and any changes to the complex dental system must be carefully considered, so that we deliver genuine improvements for patients and the profession. It is an immense challenge. There are no quick fixes and no easy answers, but people across the country deserve better access, and we are determined to make that happen.

We know we must deal with the immediate crisis. That is why we will deliver 700,000 extra appointments each year, get more dentists into the communities that need them the most, and make sure that everyone who needs an NHS dentist can get one. NHS dentistry will not be rescued overnight. It will take time, investment and reform, but improving access to NHS dentistry is key to our mission to get the NHS back on its feet and fit for the future.

GP Services: Christchurch

Karin Smyth Excerpts

Tuesday 20th May 2025 Westminster Hall

[The Minister for Secondary Care (Karin Smyth)]

It is a pleasure to serve under your chairmanship this morning, Mr Dowd. I thank the hon. Member for Christchurch (Sir Christopher Chope) for raising GP surgeries, which is a vital matter to so many of our constituents. That is because GP surgeries are the front door to our NHS, and visiting a GP represents far better value for taxpayers’ money than accident and emergency departments. That is why, since coming into office, fixing general practice has rightly taken up a lot of our bandwidth, energy and focus.

It is worth remembering that we inherited a system in total disarray, and a bizarre situation in which we simultaneously had a GP shortage and newly qualified GPs looking for work. I am proud of everything we have done to turn GP services around in the nine or 10 short months we have had. However, before I come on to that, let me address some of the hon. Gentleman’s points.

Ahead of this debate, I asked my office to get in touch with the integrated care board locally so that we had a fuller picture of what is happening on the ground. My understanding is that Burton surgery was previously a branch of Christchurch medical practice, which is just under two miles away. The surgery closed in August last year because the owners wanted to sell. Although the ICB did not approve of the closure, it recognised that it had little influence over the sale as GPs are independent practitioners.

I am informed that the local community were—as they often are—understandably unhappy with the news about changes to the services, and that the hon. Gentleman got in touch with Dorset ICB. When a veterinary business tried to buy the site, the application received over 100 objection letters and the sale did not go ahead. The ICB then received two further applications to renew the site, about which it considered a number of factors, as is normal practice: whether there is good access to surgeries in the area; what the impact would be on patients and on community needs; how it would affect the quality, equity and safety of provision; and how it might affect the stability and ability of other local GP services to run viable surgeries in their area.

I have been assured that the decision that Dorset ICB took was not taken lightly but based on the needs of and the benefits to all prospective patients in the area. The surgery catchment area for Burton is covered by Christchurch medical practice and Farmhouse surgery. As the hon. Gentleman outlined, reopening would have required additional costs, which were not justifiable given the financial challenges facing the NHS—something that we all understand. Consequently, Dorset ICB felt that those costs would reduce provision in the area and lead to significant financial pressures on other local surgeries, which could lead to further closures.

Dorset ICB has seen no degradation of services for patients since the surgery closed and the number of appointments has not decreased overall. I take the hon. Gentleman’s point about the numbers, and I do not know why that information is not available; I am happy to take that question back to the Department. Local MPs should have as much information as possible about services in their areas. These are taxpayer-funded services, so I will check as to why that information is not available. Dorset ICB has not received what it calls formal complaints from patients, but it has received communications from a local campaigning group, which is important. On balance, however, it decided that it could not reopen the practice.

On the point about housing needs, which I talked about for many years when I was an Opposition Member of Parliament, the Government absolutely understand the issue of additional demand and the challenge it poses to primary care infrastructure.

[Clive Jones]

Will the Minister give way?

[Karin Smyth]

I will not, because the hon. Member for Christchurch wants me to answer his questions.

We are working closely with the Secretary of State for Housing, Communities and Local Government to address the issue of additional demand in national planning guidance and ensure that all new and existing developments have an adequate level of healthcare infrastructure for the community. The NHS has a statutory duty to ensure that there are sufficient medical services, including general practice, in each local area, with funding and commission reflecting population growth and demographic changes. The hon. Gentleman highlights an important point that we will continue to pursue.

Those are the facts about the decision made by the ICB, which was its decision to make. I am not going to stand here and tell the hon. Gentleman that he is not right to do what he is doing; he is absolutely right to fight for the best possible service provision for the people of Christchurch, and I would do the same for my constituents—all hon. Members do that. These decisions are best made locally, however, and it is for Dorset ICB to use its autonomy to make them, not Ministers in Whitehall.

[Sir Christopher Chope]

The ICB is not elected or accountable. We have an elected and accountable council—BCP council—which decided that the surgery in Burton, a community facility that had been there for more than 30 years, should remain and that permission should not be granted to change its use, because of its value as a community asset. Why should the ICB be able to second-guess the elected representatives of the community? Is that not intolerable?

[Karin Smyth]

I could talk for a long time about the accountability of health services, but we do not have time for that. The legislation, as set up by the previous Government and others, is clear that ICBs have responsibility for commissioning services on behalf of the local population within the resources that they have available. They need to do that under particular guidelines, which I have outlined, and it is important that they keep up communications with Ministers and local people.

I am not au fait with the day-to-day running of Dorset ICB—that is not for Ministers—but at a strategic level, I recognise that Dorset currently has the fifth-highest ratio of GP clinicians to patients in the country. I know that everyone wants to be in first place, but I am sympathetic to the ICB’s arguments that other practices may suffer if the surgery were reopened. Closing the former site has made the services at Christchurch medical practice and other neighbouring practices slightly larger, which has given them greater resilience in the long term.

The hon. Member for Christchurch mentioned the new Labour Government and what we are trying to address. I do not have the figures in front of me, but every hon. Member present will know there have been hundreds of GP service closures—not just branches but practices—over the past 14 years. The trend has been for primary care to receive a smaller share of the NHS budget, and as a result, secondary care has had much more activity. We all know about the 8 am scramble, and some GPs have been forced to work in appalling conditions with leaky roofs and buckets catching rainwater.

That is why our priority is to stem the flow of resources away from primary care, shift the focus of the NHS from hospital to community, and begin building a much better neighbourhood health service. Our objectives are to hire more GPs, reach an agreement on a new contract, rebuild surgeries through increased capital spend, and bust the bloated bureaucracy that has built up. In the summer, we committed to bringing in an extra 1,000 GPs through the additional roles reimbursement scheme, which we backed with an extra £82 million of funding after changing a technicality that prevented primary care from hiring more new doctors. We have surpassed our initial target and 1,500 more GPs are now serving patients on the frontline. Since we took office, I am happy to confirm that 11 have been recruited by Dorset ICB, including, as I understand, three in the hon. Member’s constituency.

In conclusion, we are committed to shifting the NHS from hospital to community and to building a neighbourhood health service. We are bringing back the family doctor.

[Sir Christopher Chope]

One of the issues is that since the branch surgery was closed, Christchurch medical practice has reduced its number of full-time equivalent GP doctors. There used to be 10.7 and now there are only 10.2, which may be part of the problem. Surely it must be in the interests of the Government, the taxpayer and everybody else to allow a branch surgery to reopen, at minimal additional cost, to the benefit of 4,500 people in the Christchurch area.

[Karin Smyth]

As I said, decisions about how the additional costs are borne and the resilience of the rest of primary care in the area are for the ICB. It has been very clear that that is not the case, so the hon. Member may want to take it up with the ICB.

Since we came into office, we have been doing the hard yards of restoring the role of general practice at the heart of our health service, including in the hon. Member’s constituency, by investing in people, places and programmes that cut bureaucracy. We are laying the foundations for an NHS that is fit for the future, particularly based around primary care and neighbourhood health centres.

Question put and agreed to.

NHS and Care Volunteer Responders Service

Karin Smyth Excerpts

Monday 19th May 2025 Commons Chamber

[Dr Caroline Johnson (Sleaford and North Hykeham) (Con)]

(Urgent Question): To ask the Secretary of State for Health and Social Care if he will make a statement regarding the volunteer and care service.

[The Minister for Secondary Care (Karin Smyth)]

I thank the hon. Member for giving me the opportunity to speak about this topic and highlight the important role that volunteering plays in our health and social care system. The NHS has always benefited from the generous contribution made by volunteers, who play a vital role in supporting our patients, staff and services. We are grateful to the thousands of volunteers who donate their time to support the NHS in a wide variety of roles, from helping patients to leave hospital faster and settle in at home, to supporting emergency cardiac incidents and providing companionship to patients during end-of-life care.

The national NHS and care volunteer responders programme was first established as part of the covid response, and then adapted to respond to other organisational pressures. However, a model that worked well in that national crisis is no longer the most cost effective way of facilitating the important contribution of our much valued volunteers, so NHS England has recently taken the decision to close the current programme. Instead, a new central recruitment portal for NHS volunteers will be fully launched this year, providing opportunities for the current pool of volunteer responders to continue to play their part. Volunteers will have had that information emailed to them recently.

NHS England will also work with NHS providers that draw on the support of the volunteer responders programme to ensure that they are helped in developing other volunteering interventions that meet their service needs.

The roles of 50,000 additional volunteers who are recruited and supported by NHS trusts directly will be unaffected by the closure of this programme. That is in addition to many more thousands of volunteers who support the NHS either directly or indirectly via other local and national voluntary sector organisations.

Successive volunteering programmes in the NHS are primarily run locally by individual trusts and integrated care systems identifying the best opportunities for volunteering interventions that meet their specific service needs. That means local NHS action to build relationships with voluntary sector organisations and co-developing volunteering programmes and pathways that support patients, staff and NHS services. There will continue to be opportunities to strengthen and encourage innovation in NHS volunteering at national level. The Government recognise the need for sufficient and agile volunteering capacity and capability of support in particular scenarios, such as pandemics and flu seasons, when the health and care sector is particularly stretched.

[Dr Johnson]

Thank you, Mr Speaker, for granting this urgent question. At the start of the covid pandemic, NHS volunteer responders were set up to support vulnerable people. Following its success, the previous Government expanded the scheme into adult social care, forming a joint NHS and care volunteers programme. That service has mobilised more than 750,000 ordinary citizens who have completed more than 2.7 million tasks and shifts, including more than 1.1 million telephone support calls, 1 million community response tasks and almost 400,000 steward shifts. I saw at first hand as a volunteer and doctor during the pandemic that NHS and social care teams benefit from volunteer support, and I put on record my thanks to all those who give up their time to support those around them.

Out of nowhere, the Labour Government have decided to cancel this service at the end of the month. No tasks allocated after 31 May will be completed, seemingly leaving patients in the lurch. Has the Minister thought about the real-world implications of the additional pressure placed on NHS local authorities, the loss of institutional knowledge and the impact on vulnerable patients? What alternative measures are being put in place to support the people who were supported by volunteers? The Minister said that something would be put in place later this year, but when? Why leave a gap? The telephone helpline is open only until 31 May, so what happens if people need support after that?

Will the Minister explain why the decision was taken so suddenly and which Minister signed it off? The volunteer website says that the decision was taken due to financial pressures, so can the Minister tell us how much the scheme costs? What is that cost as a proportion of the total NHS budget?

The Public Accounts Committee report published last week on the reorganisation of NHS England was damning. The Secretary of State said he would

“devolve more resources and responsibility to the frontline, to deliver…a better service for patients.”—[Official Report, 13 May 2025; Vol. 763, c. 1286.]

However, cancelling the volunteer programme takes services away from the frontline. This seems to be yet another example of Labour rushing into decisions without thinking them through properly, and yet another promise broken by this Government at the expense of the most vulnerable people.

[Karin Smyth]

The hon. Lady is right to highlight the tremendous effort that went into establishing the programme very quickly at a time of great crisis, and to thank the hundreds of thousands of volunteers across the country who took part and stepped up. It was a huge effort to get the scheme running and we were all very grateful for it. Everyone learned a great deal from that; as I outlined in my initial response, we will be taking forward those lessons as we look at the role of volunteering in the future.

The hon. Lady says that the changes have come out of nowhere; they have not. We are looking critically across the piece as we fix the foundations of our NHS and ensure that it is fit for the future. We are looking at the most cost-effective means of delivering the same outcome, which is why we will be moving to a centralised portal for part of this work. We have emailed people about that; some people may not have scrolled to the bottom of that email, where there is an option to push a button to register their details, so that they will be updated as new systems come online and we can make sure that we do not lose that great volunteering spirit. That is about digital techniques for the future, using the most cost-effective means and developing clear outcomes.

[Paulette Hamilton (Birmingham Erdington) (Lab)]

Does the Minister agree with me that as we rebuild our NHS, volunteers at NHS trusts will not be used to plug gaps in service and staff will be allowed to focus on clinical matters?

[Karin Smyth]

I am happy to give my hon. Friend an absolute assurance. Volunteers support and complement the existing workforce; they do not replace it. Including volunteers signals a recognition of the important role they play in supporting staff, services and patients. Many hon. Members are volunteers and we have all seen how those volunteers can support the wider system. However, it is important that we keep our staff and respect their important roles.

[Mr Speaker]

I call the spokesperson for the Liberal Democrats.

[Helen Morgan (North Shropshire) (LD)]

I was a volunteer vaccination steward during the pandemic, and the Liberal Democrats are hugely grateful to the thousands of volunteers who have made a difference to the lives of patients and vulnerable people in their communities since the pandemic ended. Their compassion and commitment have been inspiring.

We are concerned that the end of the programme has been announced at extremely short notice; there will be no further shifts in just 12 days’ time. Will the Minister reassure the House that those currently receiving help from the volunteer scheme, such as collecting prescriptions or fetching shopping, will not be left high and dry after next Saturday? Has the Department conducted an impact assessment? If so, will it publish it? As with so many major decisions, such as dropping cross-party talks on social care or cutting funding for integrated care boards by 50%, it is concerning that the Government did not come to the House first to answer questions from hon. Members. Will the Minister reassure the House that these decisions will improve patient care and that they are not just a cost-cutting exercise dictated by the Treasury?

[Karin Smyth]

I thank the hon. Lady for her work volunteering and supporting the scheme during covid. The announcement is about NHS England. The organisation will continue to work with the NHS and voluntary organisations to ensure that where people are volunteering, that will continue, and that volunteers continue to be recruited, ahead of a fuller launch of the recruitment portal later this year. On her wider point, this Government are not dropping talks with other parties about social care, which is being taken forward by the independent commission under Louise Casey.

[Josh Fenton-Glynn (Calder Valley) (Lab)]

I pay tribute to all the volunteers across Calder Valley and the rest of the country who helped with the fantastic vaccine roll-out. Will the Minister confirm that despite scaremongering from the Conservatives, people will of course still be able to volunteer for the NHS and support others?

[Karin Smyth]

This is a good opportunity, which I very much welcome, to highlight again how important volunteering is to the NHS and the care system. It will remain an important part of our plans going forward that. People may have had an email and thought that something is stopping and that there is not more to do, but they should ensure that they press that button and register for upcoming opportunities and are in contact with their local NHS systems. As I said, volunteering is done locally, and it is important that we support those local systems and encourage more and more people to come forward to undertake this important work.

[Dame Caroline Dinenage (Gosport) (Con)]

I pay tribute to some of the volunteers across my constituency, who make such a difference to people’s lives. The Minister will have noticed that polling by More in Common today found that more and more people feel disconnected from society. That is compounded by the fact that so many of our community spaces are struggling to make ends meet as a result of a combination of business rate changes, national insurance rises and energy price rises. Those health and care volunteers make such a difference by chatting with those who are lonely and vulnerable in my constituency. Has the Minister considered the impact of this decision, particularly in the interim period, on communities such as mine? What cost will not having this voluntary service to support people in their times of need drive into our health services?

[Karin Smyth]

I agree with the hon. Lady about the roles that people play, particularly by having conversations and connecting with people who feel disconnected. To be very clear, this decision is about particular arrangements: it does not mean that things are stopping across our country or with local health systems ensuring that volunteers are still available. We want to ensure that we use that knowledge in building systems for the future. I was very pleased to host a roundtable with organisations as part of our 10-year plan process. There are some fantastic ideas and opportunities out there to use the knowledge we have learned, particularly during covid, to use technology to link with people and to recognise where people are not linked by technology and ensure that they remain connected. All of that will form part of our future plans.

[Anna Dixon (Shipley) (Lab)]

Before I ask my question, I draw attention to my entry in the Register of Members’ Financial Interests: I am an unpaid trustee of Helpforce, a charity that supports volunteering in health and care and works with more than 100 NHS partners to embed volunteering in trusts.

As we have heard, volunteers make a huge contribution every day across the country, giving their time and skills to free up doctors and nurses to focus on their clinical tasks. Helpforce runs a scheme called Volunteer to Career, which enables people to try out through volunteering before making the transition into a frontline healthcare career. Does the Minister agree that schemes such as Helpforce’s Volunteer to Career programme could play a huge role in filling some of the vacancies in NHS roles and that volunteers will play a central role in delivering the 10-year NHS plan?

[Karin Smyth]

I thank my hon. Friend for her work, expertise and knowledge. She is absolutely right—she almost pre-empted my answer—that embedding knowledge where it is needed in the frontline in our communities is exactly what we need to look to do, and we need to recognise where we can use volunteers well. We have micro-volunteering these days, which can help people to link in where it suits them, so that we can take advantage of people—I do not mean “take advantage”; that sounds bad. We can utilise people’s opportunities—perhaps they are working different or irregular shifts—so that they can give more, because we know that there is a great appetite out there to support the system more.

[Martin Vickers (Brigg and Immingham) (Con)]

This appears to be another rather muddled decision from the Government. The Minister has acknowledged that these volunteers provide a vital service, but if they want to continue they now have the inconvenience of going to the new portal, registering and so on. Would it not have been better at least to maintain the current arrangements until a new alternative was in place? By the time we have provided extra support to medical professionals and so on during the interim, will it have saved any money at all?

[Karin Smyth]

I am afraid that I have to disagree with the hon. Gentleman—it is not muddled. The analysis undertaken by NHS England indicates that the current system is not providing good value for money, and we are making sure that we produce something better for the future. This Government will continue to act in the best interests of volunteers, patients and taxpayers in setting up the NHS of the future.

[Mr Richard Quigley (Isle of Wight West) (Lab)]

I congratulate all the volunteers in my constituency, who do a great job. Does the Minister agree that the huge increase in volunteers over the past few years is because the Conservatives ran down the NHS? Now they are in opposition, they can no longer run down the NHS, so they talk it down instead.

[Karin Smyth]

Well, we could—[Interruption.] Sorry, the hon. Member for Farnham and Bordon (Gregory Stafford) is chuntering from a sedentary position. I partly agree with my hon. Friend. Yes, the Conservatives did run down the NHS and we inherited a broken system, but volunteering has always been a really important part of the NHS and the care system, so I pay tribute to those people who come forward. It is both good for the system and the people they help, and for many individuals. We talked earlier about people feeling disconnected, perhaps as receivers of volunteering, but we know how valuable it is for individuals themselves to be giving and volunteering, and we want to see more of that.

[Sarah Dyke (Glastonbury and Somerton) (LD)]

This closure follows today’s no-notice closure of the special care baby unit and maternity unit at Yeovil district hospital, and comes amidst a crisis in our health services. I take the opportunity to thank the hundreds of NHS volunteers in Glastonbury and Somerton, who give millions of volunteer hours to the NHS, but with NHS trusts implementing staffing freezes to keep afloat, there does not seem to be any consideration of the impact that this closure might have. How will the Government ensure that patients do not lose access to vital support and suffer as a result of these changes?

[Karin Smyth]

The hon. Lady makes an important point: it is important to make sure that people do not suffer from changes and that the impact is minimised. As I said, the programme was not delivering effective value for money, and we think the future system will. We encourage more people to come forward, to increase the sustainability of volunteering in local systems.

[Jenny Riddell-Carpenter (Suffolk Coastal) (Lab)]

It is no exaggeration to say that during the pandemic, thousands of constituents were helping out in volunteering roles with the NHS and across their community in Suffolk Coastal. Will the Minister reassure my constituents that those who want to play a part in volunteering can continue to do so? Perhaps she would outline the steps they can take to register their interest.

[Karin Smyth]

My hon. Friend is absolutely right. We want to make sure that people in her constituency and all our constituencies who have volunteered or who want to—those who perhaps could not at the time, but want to in the future—can do so. Those who are already on the system and have received an email can register via that portal, and we will make sure it is easy for people to do so in future.

I have been reminded by a note that people who volunteered in the very early weeks of the pandemic might have been on a slightly different system from those who volunteered later on, so I think there will be a slightly different process for them. We do not want to lose them. Those who have received an email can register through that portal, but we will make sure that more opportunities are available when that is launched, and I will be happy to update the House when that happens.

[Tim Farron (Westmorland and Lonsdale) (LD)]

I take this opportunity to say a massive thank you to all the NHS volunteers across the country, but especially those in Westmorland. It was a privilege to join with them—alongside my children, actually—to deliver prescriptions during that period, but the work of the volunteers in the NHS is not over. In communities such as mine, we particularly depend on volunteer drivers to help people in rural communities who live hours away from hospital or from doctors’ appointments. As such, will the Minister take this opportunity to direct integrated care boards and trusts in Cumbria to support those volunteer drivers, so that volunteers are valued and patients are not isolated?

[Karin Smyth]

The hon. Gentleman makes an excellent point on behalf of his community, as well as rural communities more widely, about the role of volunteer drivers. We need volunteer drivers across a range of areas—in fact, my husband is out volunteering as I speak, driving for another charity. We need more of these people. There are plenty of opportunities for people who have time, and NHS England will continue to work with ICBs to make sure we take forward the best of what we already have into the rest of the NHS.

[Katrina Murray (Cumbernauld and Kirkintilloch) (Lab)]

I thank the Minister for her answers so far. Prior to my election, I spent 23 years running a volunteer programme in the NHS, including during covid and the covid response. We should thank not only all the volunteers who have been involved, but those who run the volunteer programmes locally. Local infrastructure is important. It is all well and good having a national system, but where the infrastructure works well, the system works well. Where the system does not work well, it is due to lack of local infrastructure. What steps is the Minister putting in place to ensure that local infrastructure can support volunteering and make things better for all those who contribute?

--- Later in debate ---

[Karin Smyth]

I thank my hon. Friend for that contribution and her service in that role. She is absolutely right to highlight not just the people who come forward, but the people who run that local infrastructure. As I said in my opening remarks, much of this work is done at a local level. The learning we must take from what the national scheme did is how we bring that together in a crisis. We want to make sure that the learning is spread across the country and that we can use digital technology and a portal, where that suits the many people coming forward. She is absolutely right about local infrastructure and people to make sure things happen. They are best placed to know where the service gaps are and where the people are who can support them. They provide an important link. We will make sure that that is part of our 10-year plan.

[Jim Shannon (Strangford) (DUP)]

I thank the Minister for her answers. The importance of the work of the voluntary sector in the NHS cannot ever be overstated, whether it is those who volunteer to help people find their way around the hospital maze, those who provide vital phone support and work within communities or the volunteers in hospital radio. It is a huge loss, and the question is clear: who will replace these volunteers and the support they have given, which has made such a difference to so many at a time of vulnerability when they need it most?

[Karin Smyth]

The hon. Member is absolutely right. We should be clear that the NHS and the care system need people. He is right about many hospitals being a maze and the importance of that friendly face to greet someone when they go into hospital. They are knowledgeable and know that most people go into hospital not for a good reason, so they recognise the anxiety people have when they enter those places. We know the cheer that is brought by hospital radio and so on.

I just gently correct the hon. Member: we are not losing the volunteers. This is a change to a contractual arrangement, so the volunteers are still there. We still want to make sure that they come forward, as we have discussed. Volunteering is more generally handled by local situations, and this is about the best way we can get the national system to spread into a local system. We need the local infrastructure, and we need to keep encouraging people to come forward. I hope that, as a result of this urgent question this afternoon, we are highlighting the role of volunteers and that more people will come forward.

[Emma Foody (Cramlington and Killingworth) (Lab/Co-op)]

I echo the comments made today about the huge contribution that volunteers make up and down the country, helping and supporting NHS staff, day in, day out. I declare a bit of an interest, as someone who similarly started their volunteer journey with the responders programme and continues now as a community first responder with my local ambulance service. Can the Minister reassure me that those who wish to continue to play their part and to carry on volunteering in other ways with the NHS can do so? Will she join me in taking the opportunity to encourage those who are interested in volunteering to check for opportunities with their local trusts?

[Karin Smyth]

We are learning so much about each other this afternoon, are we not? I am pleased to hear that that is how my hon. Friend started her journey, and I am so impressed that she is continuing to do that. I was out with the ambulance service last week talking to staff, who highly praised those community first responders. The work that she and others are doing is valuable, and I know she will continue to use that knowledge to feed into the work we want to do in the future.

[Chris Vince (Harlow) (Lab/Co-op)]

I thank the Minister for answering the urgent question.

May I pay tribute to the many volunteers in Harlow, both those who supported people during the pandemic and, in particular, the Butterfly Volunteers who support people receiving end of life care at Princess Alexandra hospital? I feel emotional just thinking about that they do. We found that it was best to seek volunteers locally in Harlow, both through Rainbow Services and through the volunteer co-ordinator Della Nash, who is wonderful but who, sadly, was made redundant by the last Government. How can local charities and other organisations feed into the Government portal once it is up and running?

[Karin Smyth]

I thank my hon. Friend for what he has said, and I thank the Butterfly Volunteers. Supporting people at that really important end of life stage is hard and critical work, and I commend them for it. The local link is also critical: we need to ensure that people can be directed from the national system to local systems, through NHS England and perhaps—if it is appropriate, Mr Speaker—through the House. It is in the interests of local Members of Parliament for us to ensure that what we have learnt from the national scheme is continued into the local scheme, and, as my hon. Friend says, we need the local co-ordination and infrastructure about which we have heard this afternoon.

[Dr Caroline Johnson (Sleaford and North Hykeham) (Con)]

On a point of order, Mr Speaker. Notwithstanding the response to the urgent question that you were kind enough to grant, we still have no idea how long the gap in the service will last, or what will happen to the most vulnerable people who are using it. What other parliamentary mechanisms could I use to secure the answers to these questions?