Puberty Suppressants Trial

Carla Lockhart Excerpts

Wednesday 17th December 2025 Commons Chamber

[Wes Streeting]

I am very happy to receive further clinical representations on this issue and to hear from experts on it. I hope the public will understand why, on this particular issue, I am not simply led by opinion polling. I have to follow the clinical advice and evidence, particularly given the enormous risks that surround these children and young people, including the risks that weighed on my shoulders and conscience when I denied access to puberty blockers by upholding the temporary ban and then making it permanent.

[Carla Lockhart (Upper Bann) (DUP)]

It is nigh-on child abuse to give children puberty blockers. This trial will take confused little minds and vulnerable children and place them on a medical pathway with profound, life-altering consequences. Childhood is a time of uncertainty, yet the state is intervening with drugs that many former patients now say they were never even capable of consenting to. How can this Government justify experimenting on children, rather than prioritising safeguarding, evidence and psychological support?

[Wes Streeting]

The hon. Lady has offered a political opinion, not a clinical judgment. By that logic, we would not have any medicine for children and young people; we would never have undertaken clinical trials or studies, because we would have judged that children and young people could not take part in them. That is objectively not a sensible position.

I understand the sensitivity surrounding this issue, and the hon. Lady is right to say that people in our country have received life-changing clinical interventions that they later regretted. As part of that regret, they have shared that they did not feel, at the time, that they were making or could have made an informed decision. That is why this trial is set up in such a way that it has such strong clinical oversight locally as well as nationally. It cannot happen without not just the assent of a young person but the consent of their parent or guardian. Those are important protections and safeguards. I do not share the hon. Lady’s characterisation of the trial.

Sudden Cardiac Death in Young People

Carla Lockhart Excerpts

Monday 15th December 2025 Commons Chamber

[Carla Lockhart (Upper Bann) (DUP)]

I commend the hon. Member for Harlow (Chris Vince) for securing this debate. I believe I saw him with a little person—a little man—in the corridor, so I congratulate him and welcome him to parenthood. When he spoke of Clarissa, as parents we could not help but be moved.

I know this may be a slightly different direction, but many out there are concerned about the increase in the numbers of particularly young people dying from sudden death syndrome, and the potential link to vaccination and covid vaccination. This is not to get controversial, but can the Minister just assure the House that data is being looked at and assessed? The Minister has spoken of labs and technology. Can she give some information to the general public about the Government’s interest in this subject, and assure them that this is being looked at?

[Ashley Dalton]

The hon. Member will know that all vaccines are assessed and are not issued unless they are considered safe. We collect data on conditions and potential impacts right across the medical estate. I have not seen any data that would suggest there is a link to any particular vaccine, but if there is, the data would show us that and it would be considered.

My hon. Friend the Member for Harlow and I stood on a manifesto to tackle the biggest killers, including cardiovascular disease, to halve the gap in healthy life expectancy between the richest and poorest regions in England, and to reverse the legacy left to us by the previous Government. Through his work with the CRY campaign and everything he said in the Chamber this evening, it is evident that he is staying true to those promises. I also thank my hon. Friend the Member for North West Leicestershire (Amanda Hack) for further highlighting the work of CRY. Any MP who campaigns on prevention is pushing at an open door with this Government. We are shifting the focus of our NHS from sickness to prevention. As my hon. Friend the Member for Harlow rightly points out, it is a tragedy when young lives are lost to preventable illness. He and others make a powerful case for a national screening programme, so let me address that point head-on.

I fully support a national screening programme, as long as the experts agree that it would do more good than harm. Our National Screening Committee gives advice based on a range of factors and while balancing the pros and cons of screening population level groups, the committee has previously given evidence that introducing mass screening for sudden cardiac death could cause harm by misdiagnosing some people. For example, receiving a false diagnosis could lead to people being prescribed medication they do not need; people undergoing medical procedures they do not need, such as having an implantable defibrillator fitted; and people living in fear of sudden cardiac death when they are not genuinely at risk. However, the committee is currently reviewing the evidence for sudden cardiac death screening and will open a public consultation in early 2026. We will look carefully at the findings of the consultation and I know that the CRY campaign will make its voice heard.

Several Members discussed defibrillators, and their training and use. NHS England runs training sessions on first aid, CPR and the use of defibrillators both in the community and in schools under the Restart a Heart programme. NHS England has trained over 35,800 adults and children in CPR and defibrillator use in the past 13 years, and 2,134 so far this year. NHS England delivers the sessions via its resuscitation team and via its community first responders, and also runs lifesaving skills workshops for harder to reach communities and ethnically diverse groups. It has trained 407 people in lifesaving skills in that group so far this year.

It is important to remember the care and support that loved ones receive when they lose a loved one to sudden cardiac arrest, or when they find out that a family member has an inherited heart condition. NHS England’s service specification sets out how that care should be provided by specialist teams in a way that is tailored to meet the needs of families.

Pandemics: Support for People with Autism

Carla Lockhart Excerpts

Tuesday 2nd December 2025 Westminster Hall

[Jack Abbott]

The hon. Gentleman is absolutely right, and I will come to some of that in a moment. I pay huge tribute to those who were working in Northern Ireland at the time. The pandemic was worldwide and the response hit all parts of our communities.

The years of the pandemic were very difficult for many people, but for people like Ivan they were deeply and profoundly traumatic. Ivan still bears the scars of that time. He lives with post-traumatic stress disorder and continues to experience flashbacks. He has not left the house at all in four years, and to this day the TV stays off. I will be really blunt: Ivan and those like him were betrayed by the previous Conservative Government. They utterly failed him, along with so many other autistic and neurodivergent people.

[Carla Lockhart (Upper Bann) (DUP)]

The hon. Member is speaking so eloquently about his constituent Ivan. Does he agree that children with autism were failed by school closures during lockdown? That was particularly difficult for children who rely on structure and routine. Research from Queen’s University Belfast shows that that measure harmed children’s rights to play, rest and leisure, with autistic young people reporting fear, uncertainty and isolation. Does he agree that any future response should avoid school closures?

[Jack Abbott]

The hon. Lady is absolutely right that that had a huge impact on many autistic and vulnerable children, not least because of the lack of clear and consistent communication that I am outlining. I will not go into the issue of school closures—the Minister may touch on that in a moment—but of course they had a profound impact on all children, and we are seeing the effects of it.

Budget Resolutions

Carla Lockhart Excerpts

Tuesday 2nd December 2025 Commons Chamber

[Carla Lockhart (Upper Bann) (DUP)]

Despite all the “lines to take” that the Labour Whips have handed their MPs in an attempt to sell the Budget as something positive, the reality is very different. The content of this Budget is deeply damaging to pensioners, employees, employers and the wider economy. This is a Government who, it appears, are making up reasons to take back double or treble. While the rise in pension is welcome, it is not a new policy. Yes, the protection for pensioners’ ISA savings is welcome, but it penalises those who have not yet reached pension age and limits their ability to save. Where do hard-pressed workers get the benefit to invest their money? At the same time, saving into pension schemes has become yet another tax grab.

We have been consistently told of a £20 billion black hole, and for weeks we have been fed the line that it has ballooned into a £50 billion crisis in just one year, but now we hear that there is no black hole at all. The OBR has been keeping both the Prime Minister and the Chancellor updated on a bi-weekly basis in respect of their forecasts. We now know that when the Chancellor and other Labour Ministers were out in the media painting their stories of doom and talking down the situation, creating volatility in the stock market, the Government knew all along that their briefings were inaccurate.

What we have in this Budget penalises those who work. I noted a quote yesterday from the Leader of the Opposition about how a working family needs to earn £71,000 per year to be as well-off as a family of three on benefits. This Budget is a burden on workers, and it is clear that Labour Members are not the friends of workers. For years in opposition, they made great promises to the nation that they would lead, but the reality has been very different, with broken promises and broken manifesto pledges, and they are slowly breaking our country’s workers, who cannot give any more.

Looking closer at the Budget, the increase in the minimum wage is positive in principle, but it will mean little in practice when employers are hit with the double blow of the national insurance rise and higher wage costs. Retailers and other businesses will inevitably raise prices to cover these additional burdens, and perhaps have to make redundancies, wiping out the benefit for many workers.

[Blake Stephenson]

Does the hon. Lady agree that while Labour in government pretends that it is the party of fairness, this Budget is deeply unfair to both her constituents and my own constituents?

[Carla Lockhart]

I thank the hon. Member for his point.

The poorest will become poorer while workers are asked to pay more to support people who come here from overseas and go straight on to benefits, with little incentive to work. The system means it is more lucrative not to work than actually to contribute. It is time that this Government put British citizens, British workers and British employers first. It is time for the Chancellor to get tough on tax avoidance and offer genuine support to the hard-pressed workers who are doing the right thing and paying their way.

Perhaps the most appalling tax grab in this Budget is the attack on our family farms. The announcement making business property relief and agricultural property relief transferable is a meaningless gesture and an insult. The family farm death tax remains fully intact—farmers gain nothing. Across the UK, the picture is grim. The Government seem intent on taxing family farms beyond profitability. It is a tax on death and a tax on tragedy. What can be more immoral? This path will damage agriculture at its core. Farming is the backbone of our nation. Food security is national security. Undermine it, and food prices will rise and we will rely on lower-quality imports at higher cost. There is no good news for farmers in this Budget, and when we vote on that resolution later, I urge Members to do the right thing.

Furthermore, the Budget does nothing to remove the trade barrier separating Northern Ireland from the rest of the United Kingdom. The £16.6 million package does not change the reality that businesses still face checks, paperwork, delays and extra costs when trading with Great Britain. If the Government remove the checks, they will save the £16.6 million immediately. We look with some envy at the Department of Government Efficiency in the United States, and wonder why the UK cannot match that level of waste reduction. There are quick, real-time savings available such as to cut excess immigration spending, make work genuinely rewarding, ensure everyone pays the tax they owe, pulp the costly madness of net zero and tackle waste across Government.

This Budget offers presentation rather than substance. It fails workers, employers, farmers, policing, health, hospitality and our taxpayers. There is a clear solution: get tough on immigration, tough on crime and tough on tax evasion, and get our country back to being the envy of the world. That is where we belong.

Myalgic Encephalomyelitis

Carla Lockhart Excerpts

Wednesday 19th November 2025 Westminster Hall

[Tessa Munt]

Probably most of us have constituents in exactly the same situation. In just over a year, two prevention of future deaths reports have been issued related to severe ME. I have already referred to one of them, regarding the case of Maeve Boothby O’Neill; the other was on the case of Sarah Lewis. Neither report has yet resulted in satisfactory action. The risk of death, specifically from malnutrition, is real and ongoing.

Earlier today I spoke with Dr Binita Kane, a private sector clinician with a special interest in ME and long covid. She told me about the case of a 25-year-old woman, a medical student, who developed severe ME after a viral infection in 2018. The young woman has been in an acute NHS hospital for 17 months with nutritional failure and has deteriorated to the point that palliative care is being instituted. Her family is being prepared for the worst—it is dreadful. She has been disadvantaged not because of the individual clinical decisions, but because she suffers from a condition for which there is no safe or established service model. There have been multiple missed opportunities to prevent her condition progressing to this stage.

Sadly, that young woman is not alone. I have heard of many other cases today, and before today. What is being done to help patients like her? In the foreword to the final delivery plan, the Minister stated that

“tragically avoidable deaths of people with ME/CFS, in England…must become never events.”

However, the plan does not clearly set out what actions the Department will take to guarantee patient safety. No one is being held to account. The plan committed the DHSC and NHS England to

“explore whether a specialised service should be prescribed by the Secretary of State for Health for very severe ME/CFS”.

I hope that the Secretary of State will do the right thing and commission that service, but it is frankly astonishing that the option of leaving this group of patients without specialist NHS care, as they are now, is even on the table.

I ask the Minister to clarify what progress has been made in commissioning such a service. That is not to mention that developing a new service from the ground up is, at best, a medium-term solution. It may take years. It is astonishing that no interim solution has been proposed to ensure that patients with very severe ME, whose lives are at risk right now across the country, do not become tomorrow’s mortality statistics. How many more preventable deaths will it take? I ask the Minister to commit to work with groups such as #ThereForME to rectify the situation immediately, for example by convening a national advisory group to advise in these cases and by undertaking a full review of the lessons learned from ME deaths. Will the Minister clarify what data is being collected to better understand the number of those with ME who are affected by life-threatening complications?

The third area on which I would like to see the Government do much more is accelerating ME research. I spoke earlier about the need for investment in research and improving healthcare. For many patients, biomedical research represents their best hope of regaining their former life, yet the condition has historically received very low levels of research funding from the UK Government.

Based on parliamentary answers and official announcements, I estimate that around £10 million has been invested in ME research over the past 12 years. To put that figure into context, on the current numbers that is about 60p per person living with ME per year. Four times as much was spent on a helicopter for the former Prime Minister as has been spent on ME. We spent £125 million—12 times as much—on a bat tunnel for HS2. We spent £10 billion—about 1,000 times as much—on personal protective equipment that turned out to be unusable. Money talks, and the record of the past decade makes it clear to people with ME that their collective futures have been valued by successive Governments at astonishingly little.

[Carla Lockhart (Upper Bann) (DUP)]

Will the hon. Lady give way?

[Tessa Munt]

Forgive me, but I am going to carry on.

The final delivery plan rightly points to the need to build capacity in ME research, given the small UK research community and very few funded research projects. The University of Edinburgh’s DecodeME project has been a notable exception, recently reporting groundbreaking findings that revealed distinct genetic signals in people living with ME—medical, not psychological. This gives us a solid and compelling foundation for future research. Can the Minister explain what plans are in place for future funding to capitalise on this research? Again, the delivery plan is light on actions to build UK capacity in any research. A consensus recommendation for a post-infectious disease research hub was not funded.

A joint showcase event was held earlier this month by the National Institute for Health and Care Research and the Medical Research Council, with the goal of stimulating research, yet it is not clear whether this will yield tangible results or how its outcomes will be monitored. Again, I ask the Minister what the plan is if, as seems possible, it is not a lack of information holding back capacity, but secure long-term finance to encourage researchers to build a career in the field.

The final delivery plan gestured to HERITAGE and PRIME, which were effectively pre-existing funding announcements. The only genuinely new funding announced through the plan from the National Institute for Health and Care Research for research into repurposed therapies was capped to grants of £200,000. The Government’s response on this issue, including in the letter sent in response to concerns raised by the 72 Lib Dem MPs, tends to be that it is not usual practice to ringfence funds for specific conditions, and that researchers can apply for funding in open competition. Yet historical funding imbalances mean that it is not realistic to expect ME researchers to compete with researchers of diseases that benefit from more advanced research and much stronger institutional capacity.

The UK Government do, in fact, set aside funding for specific conditions when they are considered a strategic priority. Just this June, £50 million of funding was announced for cardiovascular disease research to be awarded through open competition. In 2021, £50 million was committed to research into motor neurone disease. If we can award ringfenced funding through open competition for those conditions, why not ME? To echo a question asked at a recent research showcase event, why is ME not considered a strategic research priority? Can the Minister clarify that?

The fourth and final point on which I would like the Government to go further is support from wider Departments, particularly the Department for Education and the Department for Work and Pensions. Children and young people are uniquely affected by ME. The condition disrupts and can derail key life stages and developmental milestones. Among educational professions, poor understanding of ME contributes to a lack of adjustments, limiting access to education and increasing school absences. The final delivery plan acknowledges the need for access to education and improved life chances among children and young people with ME, but while this is in theory a cross-Government plan, engagement from the Department for Education seems to have been extremely limited. Can the Minister outline what engagement has taken place so far and commit to speaking with colleagues in the Department for Education to ensure that they will engage with the delivery plan moving forward and ensure that children and young people with ME receive appropriate accommodations?

Meanwhile, welfare benefits are the most common issue that constituents with ME raise with me. Many have struggled for years to access the benefits they are entitled to, feeling that they are fighting a system that works against them. Like most people living with disabilities, my constituents are terrified at the prospect of future welfare reforms and losing the support that they have and rely on to meet their basic needs.

Looking at the current situation, I am indebted to a benefits adviser focusing on ME for her summary.

“People with ME face intersectional and compounding barriers when interacting with the Department for Work and Pensions (DWP). These include structural flaws in benefit design, widespread misunderstanding of their conditions, systemic disbelief, inaccessible systems, poor-quality assessment practices, and the cumulative harm of being required to repeatedly prove their illness. The current benefit system and emerging reform agenda both fail to reflect the fluctuating, energy-limiting multisystemic nature of these conditions.

And then, the Universal Credit Act 2025, together with the proposed abolition of the Work Capacity Assessment (WCA) and on-going threats to PIP eligibility, signals a fundamental shift in how disabled people meet entitlement to financial support.”

I am particularly concerned about the proposals to replace the new-style employment and support allowance with a time-limited unemployment insurance and to abolish the work capability assessment. Replacing the new-style ESA would disproportionately harm individuals who are not eligible for means-tested support, for example because their partner works. Among other harms, that would increase the risk of domestic abuse while heightening financial dependence—a particularly pressing concern, given that ME is considerably more prevalent in women.

Abolishing the work capability assessment removes critical safeguards in regulations 29 and 35 of the Employment and Support Allowance Regulations 2013 for those whose health would be seriously harmed by work or work-related activity. Those protections are vital for people with ME, who are at particular risk of harm and long-term health consequences if they push beyond their energy limits.

Time prevents me from providing more detail, but I will conclude my observations by saying that, on the whole, what people with ME want most is to recover their capacity to contribute to their families, their community and wider society. They hate being ill. An appropriate benefits system must acknowledge that and treat them with dignity and fairness. The way to get people with ME and those caring for them back into work is not to take away crucial support, but to invest in helping them to get better.

Many will be watching this debate from home, desperately hoping that we are doing everything we can to build them a better future. They deserve the assurance that the Government are committed to a clear, ambitious and, crucially, properly funded vision for change across healthcare, research and all forms of Government support. I ask the Minister for a meeting to discuss myalgic encephalomyelitis and the way forward for the 1.35 million people affected. I very much hope that today’s debate represents a big step forward in delivering that for them.

Suicide: Reducing the Stigma

Carla Lockhart Excerpts

Wednesday 19th November 2025 Westminster Hall

[Jim Shannon (Strangford) (DUP)]

It is a pleasure to serve under your chairship, Mr Mundell. I thank the hon. Member for Richmond Park (Sarah Olney) for setting the scene, as she so often does. I know that this issue is very close to her heart; indeed, it is very close to all of us. I will give a couple of examples from Northern Ireland. They are never easy stories to tell, but both of them are solution-based. I will tell them without mentioning any names or specific details, so we can consider what steps we are taking to address the issue.

It is a real pleasure to see the Minister in his place—I wish him well in his role—and, as always, to see the shadow Minister, the hon. Member for Hinckley and Bosworth (Dr Evans). He and I seem to be tag-teaming all the time on health issues in Westminster Hall and the main Chamber.

When I thought about this issue, and I have given it a lot of thought because it is so real to all of us, I went back and forth in my mind about the title of this debate. The motion refers to “reducing the stigma associated with suicide”. I believe that we need to normalise talking about how we feel. I say that as a man, because men—myself included—seem to have some difficulty in understanding the issues that we face, especially the difficult aspects, relating them to others and acknowledging that we are not alone in having these thoughts. It is important that we recognise that, and that there is help for so many.

The hon. Member for York Outer (Mr Charters) is not here, but anyone who heard his Prime Minister’s question today will know that he lived the story that he told. We need to recognise what suicide truly is. He took us through his experience: he did us proud and did his family proud in how he dealt with the things he faced up to.

When I was first elected to this House back in 2010, the constituency of Strangford took in a new part, Ballynahinch. Around that time—in 2010, 2011 and certainly in 2012—there was a spate of suicides of young men in the area. It was horrendous. It was almost impossible to comprehend what was happening. However, a local Presbyterian minister, Rev. Mairisine Stanfield, galvanised the community in Ballynahinch to come together. What a lady she is! She organised all the churches and the individuals, who were all hurting and all wanted to know what to do. She was the prime mover: she created a hub in the area, which was a brand-new idea that gave young people and others a place to come together, talk about things, relate, socialise and have a chance. Alongside other things that were happening, the hub helped to reduce the suicides in that town, so I have never forgotten Rev. Mairisine. Indeed, I met her last Friday night at the mayor’s do over in Bangor. There she was, as bright as ever and with that wonderful smile. That lady motivated the people of the area, the community groups and others to come together and try to help, so I am always deeply indebted to her.

I remember that when I was younger—this goes back to the title of the debate—a stiff upper lip was expected. That was the demand of the day, but that approach is not helpful attitude to take to mental health. If we look at the cultural climate across most western countries, attitudes were shaped by fear, silence and, in some cases, religious views. This was not spoken about.

[Carla Lockhart (Upper Bann) (DUP)]

My hon. Friend will know that in Northern Ireland there are somewhere in the region of 200 suicides per year, which is deeply troubling and terrible for each family walking that difficult pathway. Online platforms and social media now play a huge part in some of those suicides. Does he agree that this Government need to go further in regard to platforms that are sharing information on how to commit suicide, and that we all need to play a role? Our mental health champion in Northern Ireland has said that by asking someone how they are, we are not likely to make the situation worse. There is a challenge for us all to reach out and ask people how they are, so that we can be more in tune with them and help them through difficult situations.

[Jim Shannon]

I thank my hon. Friend for her words of wisdom. I know that she has tried, before and during her time in this place, to address the issue of online access to information about how to commit suicide. I cannot conceive how that can be available; maybe I am from a different generation, but the availability today is scary. It is not the Minister’s responsibility, but I know that he will give us some ideas on how to tackle that.

People did not talk about mental health in the past. There was no awareness, and psychological conversations were not had day by day in the way they are today. We had a spate of suicides of young men in Newtownards a few years ago, and it was so tragic. There was a wee group of young boys who ran about together. One committed suicide, and unfortunately the other four or five all did the same. It is really difficult, sometimes, to deal with things.

The hon. Member for Ashford (Sojan Joseph) spoke about the suicide rate among farmers. This is not about pointing fingers—I do not want to do that—but I can say from the family farms that I know in Northern Ireland that the pressure on farmers today due to the family inheritance tax is incredibly worrying. I will leave it at that.

While any suicide is devastating, I would like to focus on the stats surrounding male mental health and suicide in Northern Ireland. The Northern Ireland Statistics and Research Agency revealed that there were 171 male suicides registered in Northern Ireland in 2023, which accounted for some 77.4% of all suicides. My goodness me! We men—that includes me and every one of us—need to have a look at how we deal with these things. Males in Northern Ireland are consistently three to four times more likely to die by suicide. It also noted that for males aged 15 to 49, such as those I referred to in Ballynahinch and Newtownards, suicide was the leading cause of death in 2023, followed by drug-related deaths.

Male suicide in Northern Ireland has been a painful and persistent issue for years, and the stigma around it can make things even harder for those who are struggling. The harsh reality is that men do not talk. We tend to be private about our health issues. There is a very strong cultural script back home that we just get on with it; we do not want to come across as weak or unable to cope, which is how we fear it would be perceived. Furthermore, for many men and their families, the pattern is passed down from our parents. To give a Northern Ireland perspective, our dads and grandads who suffered during the troubles were told to be silent at that time and swallow their feelings. Some of them had PTSD—we never knew what that was until the last few years, by the way. That has had a knock-on effect on how we deal with issues now.

We must do more to ensure that talking about mental health is as normal as talking about the weather or the news. That is how we will reduce the stigma. Transparency and openness is the way forward. First and foremost, we must ensure that help is accessible and available in this country. That is our responsibility.

Our mental health services are not where they need to be. More should be done to provide counselling services, as opposed to going to the GP and walking out with a prescription for anti-depressants. With great respect, they are not always the answer. I urge the Minister to tell us how the Government will do more to ensure that those services are properly funded so that we can help more people stop making that final decision, which some feel is the only way forward.

World Stroke Day

Carla Lockhart Excerpts

Tuesday 28th October 2025 Westminster Hall

[Munira Wilson]

I 100% agree. The post-stroke support is critical, and I will share some stories about people who have felt abandoned and isolated in exactly the way that my hon. Friend describes.

Despite guidelines from the National Institute for Health and Care Excellence, the Chartered Society of Physiotherapy says that 20% of people do not receive the minimum specialist rehabilitation required in the first five days following a stroke, and 68% do not have an assessment for rehabilitation, which is required after discharge. The reality is that those who want to regain a level of independence need to be able to fund support privately.

I pay tribute to Richard Sealy, who runs the Neuro Rehab Practice in Hampton, which is in my constituency. He and his whole team are doing brilliant work in trying to fill that gap. Over the summer, I had the privilege of visiting the practice and speaking to stroke survivors and their carers about their experiences. What runs through so many of their stories—I am sure Members will have heard similar—is the cliff edge that people fall off when they leave hospital, and the devastating knock-on impact that can have.

I would like to share some of their testimonies. One stroke survivor said:

“I felt lost, like I had been thrown out of the boat, not knowing what to do or where to find help”.

Another survivor’s family member said:

“Although the NHS took care of her while she was in hospital, we felt that after the six weeks had finished, it was very much goodbye. You’re now on your own”.

Another, when asked what happened when the NHS rehab ended and whether they were given any further options, simply replied, “Nothing.”

Those survivor stories are far from unique, and that is unacceptable. According to the Stroke Association, only 17% of community-based rehab services have appropriate access to each core therapy—physiotherapy, speech and language therapy and occupational therapy. The Right to Rehab campaign argues for the simple idea that rehabilitation should be accessible to everyone who needs it, for as long as they need it.

We know that stroke survivors continue to make incremental improvements over many months, even years, so I welcome the Government’s ambition to rebuild our NHS through transitioning care from hospital to the community, and to improve integration of rehabilitation. While the Government target to reduce stroke and heart attack deaths by a quarter in the next 10 years is also welcome, given the devastating impact that stroke can have and the struggle to recover faced by many, the scope of that target must be widened to also reducing disability.

Take Miriam, a resident of Twickenham, who at just 21 years old suffered a stroke only three months after graduating with a BA in music. After spending four days in hospital without diagnosis or treatment, where she suffered two more strokes, she was unable to play an instrument or even grasp a pencil. She suffered significant challenges, including depression and isolation, but through therapy and determination, she was able to rebuild her life. Miriam is now a neurological music therapist, working with children and adults with learning disabilities, and I believe she is here, watching today’s debate.

Chris Stirling, who suffered a stroke in his 60s, was told by doctors after six months in hospital that he should go into a care home. He left hospital in a wheelchair, unable to shower. Thanks to privately funded neuro physiotherapy and the support of his family, he is now able to play golf, one-handed. Not everyone is as lucky as Chris to have both the means and the family support.

Miriam and Chris’s stories, and the testimonies I shared earlier in my speech, show just how important it is to get both stroke diagnosis and rehabilitation right.

[Carla Lockhart (Upper Bann) (DUP)]

The hon. Member is making a powerful speech. Family friend Hannah Garrity, who is now in her 20s, took her stroke at the age of eight. She was a little girl, who woke up one day and took a severe headache, and out of that, she had a very severe stroke. She is an inspiration. She is now teaching art in schools. She is a Sunday school teacher in her local church, and she gives so much back to society. Would the hon. Member agree that more research is needed, particularly in relation to strokes in young people and children, given the increase in the number of them who are taking strokes?

[Munira Wilson]

Absolutely. I am sure that in stroke, as in so many other areas of medicine, more research would be welcome, particularly into how we can prevent stroke in younger people. It is shocking to hear that a child so young suffered a stroke.

The stories that I have shared today demonstrate the impact that good care and rehab can have on quality of life, regaining independence and restoring people’s identity. The moral, social, health and economic cases for better rehab support are overwhelming. Will the Minister therefore commit to expanding the Government target to cut deaths caused by stroke and heart attack to include reducing disability? With stoke and cardiovascular disease a trailblazer for the modern service framework, what discussions is he having in the Department and with the Treasury to resource implementation and ensure there is a lead in the Department on this area? With 40% of physiotherapists saying that insufficient staffing is leading to their patients experiencing increased levels of pain and ill health, what work is he undertaking to expand the physio workforce? Will he look at ensuring that integrated care boards’ data plans capture and report on performance and rehabilitation, including in relation to populations who are not accessing rehabilitation?

On this World Stroke Day, stroke survivors and their carers are not asking for the impossible: a concrete plan to make stroke rehabilitation accessible across the country, no matter what someone earns or where they live. As the Secretary of State himself said only at the start of this year,

“Whether in the NHS or in social care, we definitely need to do more on rehabilitation, because rehabilitation is often secondary prevention.”—[Official Report, 6 January 2025; Vol. 759, c. 608.]

He was right, and now that needs to be delivered. I look forward to the Minister’s response. I would welcome the opportunity to meet him to discuss these issues alongside patient groups and representatives.

Oral Answers to Questions

Carla Lockhart Excerpts

Tuesday 22nd July 2025 Commons Chamber

[Ashley Dalton]

I thank my hon. Friend for raising this matter. Lily’s story really lays bare the heartbreak that rare diseases can bring and the vital role that early diagnosis can play. I am happy to meet my hon. Friend and Lily’s family. May I suggest that we meet when the UK National Screening Committee has completed its review, so that the Government have received advice on this important matter? We can then discuss that advice together.

[Carla Lockhart (Upper Bann) (DUP)]

In my constituency, there is a little boy called Teddy, who was diagnosed with MLD—one of the most cruel and degenerative diseases, which is now treatable if diagnosed at birth. Teddy was diagnosed too late because there was no screening. He has lost his ability to walk and talk, and he even fights to smile—a battle that no child should ever have to face. The Minister knows that the treatment is now available, yet MLD has not been added to the simple heel-prick screening tests. Will she also agree to meet Teddy’s family when she meets the family mentioned by the hon. Member for Hertford and Stortford (Josh Dean) to discuss this issue? It is too late for Teddy, but for so many other children it is not.

Prostate Cancer Treatment

Carla Lockhart Excerpts

Tuesday 17th June 2025 Commons Chamber

[The Minister for Secondary Care (Karin Smyth)]

I thank my hon. Friend the Member for Ealing Central and Acton (Dr Huq) for securing the debate, and I thank the other Members who have spoken.

As my hon. Friend has said, more than 50,000 men are diagnosed with prostate cancer every year, and one in eight will be diagnosed with it during their lifetime. I commend her for raising an issue that I know is very personal to her, as she has articulated so well. I am sure that her late father is watching her carefully. She was also right to support her constituent Peter by raising this issue, which affects so many men, and to highlight the number of black and minority ethnic men presenting with the disease. That is something on which we have all campaigned very strongly.

Timely and equitable diagnosis and access to innovative medicines for the treatment of prostate cancer are of the utmost importance. To support faster diagnosis, NHS England has redesigned pathways to maximise capacity. We are also aware of very early-stage trials of the use of artificial intelligence in prostate cancer detection, and we look forward to a formal report on those trials, so that the evidence can be considered carefully.

[Carla Lockhart (Upper Bann) (DUP)]

The effects of prostate cancer have been well noted tonight, as has the number of men who are affected. About 12,000 die from it each year, more than 300 of them in Northern Ireland. Does the Minister agree that Northern Ireland should be included in the commissioning, and will she undertake to speak to the Health Minister in Northern Ireland about the issue? Does she also agree that this needs to sit alongside a UK-wide prostate cancer screening programme, targeting in particular people with a family history of the disease?

[Karin Smyth]

We talk regularly with our colleagues in Northern Ireland, and I am always happy to do so. As the hon. Lady knows, this matter is devolved, so it is a matter for Northern Ireland, and we respect the devolution settlement.

Our elective reform plan, published in January 2025, builds on the investments already made with an ambitious vision for the future of diagnostic testing. This will include more straight-to-test pathways, increasing and expanding community diagnostic centres, and better use of technology. With nearly 170 community diagnostic centres up and running, they can take on more of the growing diagnostic demand in elective and cancer care. We will also deliver additional capacity in 2025-26 by expanding some existing centres and building up to five new ones. We will address the challenges in diagnostic waiting times, providing the CT, MRI and other tests that are needed to reduce the elective and cancer waits.

Members know that the National Institute for Health and Care Excellence—we have heard a little about it this evening—is an independent body responsible for assessing whether new licensed medicines can be recommended for routine use in England, based on a thorough assessment of their clinical and cost effectiveness. The NHS is legally required to fund NICE recommended medicines, ensuring consistency of access for NHS patients wherever they live in England.

NICE is able to recommend promising new cancer medicines for use through the cancer drugs funds, which supports patient access while real-world evidence is generated to address clinical uncertainties. Through the cancer drugs fund, NHS patients also benefit from access to cancer medicines from the point of positive draft NICE guidance, accelerating access to clinically and cost effective medicines by up to five months. Through this process, many thousands of patients, including patients with prostate cancer, have been able to benefit from effective new treatments at prices that represent value to the NHS.

The drug that is the subject of this debate, abiraterone, is licensed, as my hon. Friend the Member for Ealing Central and Acton said. It is recommended by NICE for use in the treatment of certain types of metastatic prostate cancer, and it is now routinely available to NHS patients in England in line with the NICE recommendation. NHS England has recently put in place an interim commissioning policy that makes abiraterone available for men with high-risk, hormone-sensitive metastatic prostate cancer, pending the outcome of NICE’s update of its negative guidance. I am pleased that this approach was agreed between NICE and NHS England late last year to ensure uninterrupted access to abiraterone for men leaving the STAMPEDE trial.

My hon. Friend raised particular concerns about access to this drug for men with non-metastatic prostate cancer. First, it is important to note that abiraterone is not licensed by the MHRA for use in this indication, and it is therefore off-label. NICE does not evaluate the off-label uses of medicines, and the drug is also now off-patent and available generically, which means there is no single manufacturer that could sponsor an MHRA licence application or NICE evaluation. It is therefore for NHS organisations to take decisions on funding based on the available evidence.

NHS England considered abiraterone for the treatment of non-metastatic prostate cancer through its clinical prioritisation process last year. Through this process, NHS England concluded that evidence supported the routine commissioning of the drug in this indication. Approximately 7,000 men per year could be eligible for this drug, and it is estimated that it would cost an additional £20 million per year to fund that.

While, as my hon. Friend said, there may be some cost savings in the pathway from preventing the disease’s progression, these are unlikely to materialise for about five years and would not impact the up-front costs of the £20 million per year for the additional out-patient monitoring and drug cost. I had not heard the figures she outlined, but I will get back to her on some of the questions she asked, and it would be helpful to know where those figures are from.

Unfortunately, it has not been possible to identify the necessary current funding to support the commissioning of abiraterone for this purpose or any other treatments in this prioritisation round. I know that is disappointing for those affected, and I want to acknowledge that this is a really difficult and unusual situation. However, I want to assure my hon. Friend and other hon. Members that the funding position for this treatment does not mean that there are no treatment options. The NICE guideline on prostate cancer recommends the treatment of non-metastatic prostate cancer with surgery and radiotherapy.

I want to assure hon. Members that NHS England is keeping this position under review, and would reconsider funding for abiraterone for non-metastatic prostate cancer if the funding position changes. Earlier this month, NHS England met Prostate Cancer UK, which shared its financial model of the expected cost impacts. NHS England is reviewing this in more detail, and I encourage it to continue those discussions.

In closing, I recognise how hard it is when patients want access to effective treatments. I also recognise the distress and worry it causes not only for patients, but for their families and friends. The Government are committed to ensuring that we provide access to the most innovative and effective medicines, but it has to be in a way that is sustainable and affordable for the NHS. It is right that NHS England continues to engage with Prostate Cancer UK, and I know that my hon. Friend and other Members will keep an eye on this and similar issues with drugs coming forward. The national cancer plan will seek to improve every aspect of cancer care, to better the experience and outcomes of people with cancer. Our goal is to reduce the number of lives lost to cancer over the next 10 years. I am grateful for the opportunity to respond to the debate this evening.

Question put and agreed to.

Terminally Ill Adults (End of Life) Bill

Carla Lockhart Excerpts

Report stage
Friday 13th June 2025 Commons Chamber

[Lloyd Hatton]

I respectfully disagree with that position. I believe that there are already levels of safeguarding in the legislation.

New clause 15 is a compassionate and practical clause that would ensure the law works not only with the individual making the choice, but for the family they leave behind.

I move now to speak briefly on new clause 5, which I would strongly encourage Members to vote against. Tabled by my right hon. Friend the Member for Walsall and Bloxwich (Valerie Vaz), the new clause would require the Government to publish a report on any impact the Bill might have on civil procedure rules and probate proceedings. As has already been pointed out, the chief medical officer has warned that we are at serious risk of creating a “bureaucratic thicket” with this legislation. In my view, new clause 5 would do just that: requiring the Government to publish such a report would create unnecessary bureaucracy and divert resources without adding any material value.

As Members will be aware, the Government have already published an impact assessment on the relevant impacts that they deem the Bill could have. There is nothing in the Bill likely to result in any changes to civil procedure rules, so there is no obvious justification for producing a formal report on that issue. It is important that we remain focused on practical and meaningful safeguards, rather than procedural requirements based on immaterial impacts. Introducing extra reporting requirements based on speculative impacts risks creating unnecessary red tape without delivering any practical benefits. I therefore urge Members to reject new clause 5 and accept that no additional reporting in that area is needed.

As we rightly scrutinise the Bill today, on top of nearly 97 hours of scrutiny so far, which is more than many Government Bills receive, we must keep dying people at the centre of the debate. I speak today in support of new clause 15 and its consequential amendment 54 and in opposition to new clause 5 for exactly that reason—to keep terminally ill people at the centre of this discussion, and at the centre of this piece of legislation. No matter where we stand on this pressing matter—whether Members support it or have reservations—it is crucial that we collectively ensure that the Bill is workable, compassionate and truly centred on the dying person. As legislators, that must always be our chief concern.

[Carla Lockhart (Upper Bann) (DUP)]

I rise to support and speak briefly to amendment (a) to amendment 77, tabled by the hon. Member for South Antrim (Robin Swann), and I will speak to new clause 13, amendment 96 and other amendments if time permits.

I was rather confused when I looked at the amendment paper a few days ago and noticed that amendments that would directly impact on Northern Ireland had been tabled. When last I checked, the Bill as a whole extended only to England and Wales, so I find amendments 76 and 77 perplexing. To be clear, health and criminal justice are devolved matters. The people of Northern Ireland elect their own Assembly to make precisely these sensitive decisions, including whether to legislate for assisted suicide, which is an issue of profound moral weight and cultural consequence.

[Jim Shannon]

My hon. Friend is right to pursue this matter. The hon. Member for Mitcham and Morden (Dame Siobhain McDonagh) said it earlier on: the NHS was formed by the Labour party and is of the Labour party. These amendments would ensure that the Secretary of State could overrule Assembly Members. In other words, 90 Members of the Assembly could make a decision, but the Secretary of State could overrule it—surely that is incredibly wrong. It flies in the face of the democratic process that we are here to uphold.

[Carla Lockhart]

My hon. Friend is absolutely right. On a constitutional basis alone, amendment (a) to amendment 77 is necessary, and I hope that hon. Members will feel they can support it.

Moving on to factors beyond the constitution, I am concerned that there is a dangerous absence of an adequate regulatory framework for lethal drugs under the Bill. At present, clause 25 gives the Secretary of State powers to approve lethal drugs, while clause 34 mandates the Secretary of State to make provision for prescribing, dispensing, transportation, storage, handling, disposal and record keeping, as well as enforcement and civil penalties. However, the fundamental issue of how these approved substances are actually approved remains alarmingly weak. The Bill defines “approved substances” simply as

“a drug or other substance specified”

by the Secretary of State in regulations. There is no explicit requirement for those substances to undergo specific, rigorous testing for their use in assisted dying.

When this issue was debated in Committee, I was disappointed to see good-faith amendments to engage, such as amendment 443, being dismissed.

[Lizzi Collinge]

Will the hon. Lady give way?

[Carla Lockhart]

No, I will not.

Amendment 443 sought to mandate that those substances be approved through the Medicines and Healthcare products Regulatory Agency and either the National Institute for Health and Care Excellence or the All Wales Medicines Strategy Group processes. I therefore strongly support amendment 96, tabled by the hon. Member for Sleaford and North Hykeham (Dr Johnson), which

“ensures that drugs can only be approved if the Secretary of State is reasonably of the opinion that there is a scientific consensus that the drug is effective at ending someone’s life without causing pain or other significant adverse side effects.”

That is a common-sense approach that should attract support from across the House.

This week, more than 1,000 doctors wrote a powerful letter to all MPs to outline their deep concerns about this Bill, calling it a

“real threat to both patients and the medical workforce”.

I strongly urge this House and colleagues to read that letter before Third Reading. The Government’s own impact assessment does not provide any comfort with regard to the use of lethal drugs under the terms of the Bill, which the doctors’ letter picks up on, saying that

“there is no requirement for…[the drugs]…to undergo rigorous testing and approval that would be required of any other prescribed medication, nor indeed for them to be regulated by the Medicines and Healthcare products Regulatory Agency”.

They go on to say that that is

“contrary to all good medical practice”.

This matters not just for regulation, but with regard to patient safety and complications. There is no requirement in the Bill to inform patients about how risks—including a prolonged death, rather than the promised peaceful and dignified death—will be managed. Complications do occur, and this is not scaremongering. In Oregon, when complications have been recorded, patients have experienced difficulty swallowing, drug regurgitation and seizures, and they have even regained consciousness. In Canada, a Canadian association has noted that patients have experienced regurgitation, burning and vomiting.

I draw Members’ attention to the written evidence submitted to the Bill Committee by a group of expert senior pharmacists and pharmacologists. In their submission, they warn that the approach of the Bill puts the cart before the horse. Specifically, they caution against proceeding without

“a comprehensive review of the evidence for efficacy and safety”,

and note that that review

“should be scrutinised by MPs before…consideration of legalising assisted suicide”.

These are not small details or incidental matters, yet, even at this late stage in the Bill’s passage through the Commons, we are still being asked to pass legislation without satisfactory answers to basic questions from experts in the field. That is simply not good enough.

I am grateful to have had the opportunity to speak, and I will close by saying simply that whatever mitigating amendments may be passed, this Bill remains morally and ethically wrong. It is flawed and should not be passed.

[John Grady (Glasgow East) (Lab)]

I rise to speak to amendments 8, 13, 82, 83, 85 and 86, but first I turn to amendment 77, which would extend some of the provisions of the Bill to Scotland. My review of the Bills in Scotland and England that are proceeding at the minute suggests that if someone moved permanently from Glasgow to Bradford or Newcastle, they would lose their right to an assisted death in Scotland and would have to wait a year to acquire their right to an assisted death in England. Imagine the heartbreak if somebody was diagnosed as terminally ill three or six months into their permanent move to Newcastle. That is a natural consequence of the law of habitual residence; there is long-standing case law on that. One matter that has not been addressed satisfactorily is how the relationship between Scots and English law and the Scottish and English Bills will be worked out. I suspect that that will require further primary legislation in this place and in Holyrood if both Bills pass.

I turn to the remainder of the amendments. Amendment 13 is very sensible and would introduce much-needed scrutiny and oversight to the appointment of a commissioner. The right hon. Member for Salisbury (John Glen) has set out in detail the very sensible reasons for the introduction of his suite of amendments. Amendment 86 is particularly important, because the panel faces real difficulties in compelling people to come before it if they have relevant evidence. It seems manifestly reasonable that the panel should hear from people who have relevant evidence. I am also concerned that the panel process does not provide a clear role for people who love and care for the person seeking an assisted death. Amendment 8 would require the panel actively to consider hearing from such people, which addresses a serious gap in the Bill.