Oral Answers to Questions
Caroline Johnson Excerpts(3 days, 12 hours ago)
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Dr Caroline Johnson (Sleaford and North Hykeham) (Con)
The Secretary of State has previously said that he accepts all the recommendations in the Cass review. One such recommendation is that the Secretary of State mandate the release of data for the data linkage study. Can the Minister tell us what specific steps have been taken to mandate the release of that data?
Karin Smyth
We absolutely stand by that work, and we are working with NHS England to make sure it is mandated to do exactly that.
Dr Caroline Johnson (Sleaford and North Hykeham) (Con)
The maternity and neonatal plan is due in the spring, nearly two years after the Secretary of State took office. The maternity review has been delayed. There are no signs of the 1,000 additional midwives the Secretary of State said he would train. Gynaecology waiting lists are rising, with the number waiting for admission 6% higher than it was a year ago. The Secretary of State has an opportunity to save many lives, and I know that he wants to use all the opportunities available to him. May I ask him to concentrate on making more improvements in maternity care?
Advanced Brain Cancer: Tissue Freezing
Caroline Johnson Excerpts(1 week, 2 days ago)
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Dr Caroline Johnson (Sleaford and North Hykeham) (Con)
It is a pleasure to serve under your chairmanship this morning, Mr Western. I thank the hon. Member for Caerphilly (Chris Evans) for securing this debate, and the cancer charities, including Brain Tumour Research and Brain Tumour Charity, who provide invaluable support to my constituents. I also thank Owain’s family for their important campaign. I want to recognise the contribution of the hon. Member for Mitcham and Morden (Dame Siobhain McDonagh), who has shown such incredible energy and dedication to the cause over the last few years. It is impressive to get a trial up and running that offers real hope to people, so I thank her for that work.
Each year sees around 13,000 new cases of brain and central nervous system cancers and 5,500 deaths. As has been said already this morning, brain cancers are the leading cause of cancer-related death for those under the age of 40. As a doctor and a granddaughter, I have witnessed the devastation that brain cancers can exact on patients and their loved ones. Despite advances in detection, neurosurgery and radiotherapy, the mortality for brain cancers has barely changed since 2000, whereas the most common cancers have seen substantial decreases over the same period. Demographics are working against us. Epidemiological modelling indicates that a quarter of the growth in brain cancer cases can be attributed to population ageing, a pattern that is expected to continue in the coming decades.
Research published last year found that in England the median survival for patients with a glioblastoma was seven months. It rose to 16 months for patients with the most aggressive treatments. The reason those patients survived longer is because they had access to personalised treatments, experimental drugs or trial pathways, and much of that begins with tissue freezing. Two people can be diagnosed with glioblastoma, but their underlying genetics can be completely different. Frozen tissue enables a pathologist to undertake gold standard genomic sequencing, which not only leads to a more precise diagnosis, but helps doctors predict how a tumour is likely to behave, identify more personalised treatment strategies based on the genetic mutations driving the tumour, and determine whether the patient would be able to benefit from clinical trials that are available.
Unfortunately, as we have heard, access to genomic sequencing is characterised by stark geographic inequality. High volume specialist centres, typically in urban areas, are more likely to have established tissue freezing and integrated genomic diagnosis than centres serving more rural communities. A report by the Tessa Jowell Centre of Excellence found a nearly 300% increase in whole genome sequencing activity since 2021, and around three in 10 NHS centres within its network were still not requesting it. Among centres that do freeze tissue, the activity rates vary from zero samples to several hundred, and diagnostic times are worsening. The median time from tissue collection to final integrated molecular diagnosis in 2024 was 21 days, whereas the benchmark is 14 and only 30% met that. What does the Minister intend to do to improve that speed?
Tissue freezing is a basic requirement for advanced testing, but every year thousands of patients’ tissue samples are soaked in formaldehyde and embedded in wax blocks. Although formalin-fixed paraffin-embedded tissue preservation has been used in pathology labs since the early 20th century, it is not adequate for molecular work because it causes the cross-linking and fragmentation of nucleic acids and protein, meaning that any DNA or RNA that is extracted is degraded and often unsuitable for genomic sequencing and creating those important personalised cancer therapies. The British Neuro-Oncology Society has described FFPE as “suboptimal”. It results in patients being locked out of cutting-edge treatments, regardless of clinical suitability, with knock-on effects on patient outcomes and the pace of scientific research. Will the Minister explain why FFPE, rather than tissue freezing, is still determining access to personalised brain cancer treatment for some NHS patients?
The Government’s 10-year health plan anticipates that by 2035 half of all healthcare interactions will be informed by genomics. That is a bold mission, but the contributions to today’s debate show that there is a gap between where Ministers want to be and where we are at the moment. In response to a written parliamentary question, the Government acknowledged:
“Information on the number of NHS trusts in England that have facilities for fresh freezing brain cancer tissue samples is not currently collected.”
That is a serious problem, because without the data it is difficult for Members and cancer charities to ascertain whether progress is being made, and for the Minister to make progress on delivery. Will the Minister confirm whether her Department has plans to start collecting that information? If it does not, why not?
Patients should always be fully informed before they have treatment, and it has been disturbing to hear today that some have not been given all the information, particularly about what will happen to the tissue afterwards and the potential consequences of that. What are the Government doing to improve the consent process in such cases to ensure that, before the biopsy, patients are fully informed about what is happening to their tissue and are given the choice?
We have heard that sometimes only a small percentage of the tissue is frozen, limiting the treatment options available. Will the Minister tell us why that is the case, and what she is doing to improve the proportion that is frozen? Every trust taking brain cancer samples must have the capacity and facilities to freeze the tissue they obtain.
We are all waiting for the delayed cancer plan, which we expect to be published on World Cancer Day. I have said before that I think delaying it for presentational purposes is wrong, but I hope it will be published soon. Will the Minister confirm that the cancer plan will deliver fully informed consent, provide the necessary capability—both human resource and equipment—for freezing, and ensure that the research landscape improves, in terms of both ease of access and financial metrics, to encourage UK research investment?
Everyone in this House wants treatments to improve and a cure to be found. I know the Minister is hugely committed to this issue and is working hard on it. I am interested to hear her response and to see the cancer plan, which she has been working on, as soon as possible.
Less Survivable Cancers
Caroline Johnson Excerpts(1 week, 3 days ago)
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Dr Caroline Johnson (Sleaford and North Hykeham) (Con)
It is a pleasure to serve under your chairmanship, Mr Efford. I congratulate the hon. Member for Wokingham (Clive Jones) on securing this important debate.
It is sadly the case that one in two of us will get cancer in our lifetime. We all know someone who is battling cancer, someone who has beaten it and, sadly, someone whose life has been cut short by it. Cancer survival rates have consistently improved, but they are still far from where we would like them to be. When we talk about less survivable cancers, we refer particularly to six types of cancer with low survival rates: pancreatic, liver, brain, oesophageal, stomach and lung cancers. Over 90,000 people in the UK are diagnosed with one of the less survivable cancers every year—20% of cancer cases—but those cancers are responsible for 42% of cancer deaths in the UK.
I pay tribute to hon. Members who have shared their personal stories in this debate, because behind each statistic is an individual. As I prepared for this debate, I thought of my granda, who died of brain cancer; my Nana Burton, who died of lung cancer; and of my husband’s good friend and confidante, Richard, who died of oesophageal cancer.
A key reason for the troublingly disproportionate mortality rate for less survivable cancers is their later-than-average diagnosis. Just 28% of less survivable cancers are diagnosed at stages 1 or 2, which is well below the 54% rate for cancers as a whole. That cuts survival rates significantly. Pancreatic cancer is particularly lethal, with less than 7% of people with pancreatic cancer in the UK surviving beyond five years.
I am pleased that the last Conservative Government launched the targeted lung health check programme in June 2022. It led to more than 5,500 people being diagnosed with lung cancer by January 2025, with 75% of cases found at stages 1 or 2 through screening. That is encouraging progress, but clearly there is much more work to be done to improve the diagnosis rates for all six less survivable cancers.
I have personally been supportive of the current Government’s Tobacco and Vapes Bill, which will ban the sale of tobacco to young people born after 1 January 2009. That will tackle one of the key risk factors for lung cancer. Will the Minister update us on the Bill’s progress, given that it was introduced on 5 November 2024 and has still not passed through Parliament? Prevention is said to be a big focus for the Government, so what is the Minister doing to improve prevention and to get the Bill passed?
The APPG on less survivable cancers launched an inquiry into earlier detection and faster diagnosis in March 2025 and found that doubling early diagnosis could save an additional 7,500 lives a year. What is the Minister doing to implement the inquiry’s recommendations, which were published last June? In particular, what is she doing to explore the benefits of technology in commissioning new detection tests? What assessment has she made of the new VAPOR breath test for pancreatic cancer, which could support GPs in diagnosing less survivable cancers from unclear symptoms?
I am hopeful that many of the answers to these questions, and others posed by hon. Members, will be found in the forthcoming national cancer plan. The Government have delayed that plan, along with several others, until 2026. We are now in 2026, so can the Minister confirm when the plan will be published? Rumours were swirling that it had been delayed for presentational purposes until World Cancer Day in February, but there are now further rumours that it may be delayed until early March. Can the Minister give us a date?
It is encouraging to see that NHS staff carried out over 3 million cancer checks in 2024, double the number carried out a decade prior. However, as with much of the war against cancer, this is another case of positive progress with more work needing to be done. Much of that work is dependent on the workforce.
The last Government built five new medical schools, including one in Lincolnshire, which are now producing their first medical graduates. However, British graduates need British jobs, and heavy competition from a surging number of international medical graduates is leaving many British graduates without a job. What action is the Minister taking to improve the recruitment of British graduates from British medical schools? Can she confirm when the further delayed 10-year NHS workforce plan will be published? Can she also assure us that that workforce plan, in combination with the long-anticipated cancer plan, will make provision to increase the number of oncologists, radiologists and specialist cancer nurses across the NHS?
As other Members have said, research is absolutely critical if we are to beat cancer, particularly the less survivable cancers, where new technologies for testing and treatment could save lives. Yet the cutting-edge, world-leading research that Britain has to offer does not feel as though it has the Government’s backing. Merck has scrapped its plans for a £1 billion research centre in King’s Cross and has announced plans to make 125 scientists redundant. AstraZeneca has halted a £200 million expansion of its research site in Cambridge and abandoned a £450 million vaccine manufacturing investment in Liverpool. Eli Lilly and Sanofi have both expressed frustration at the undervaluation of innovative medicines in the UK.
When I raised life sciences in a previous debate on cancer, the Minister for Secondary Care, the hon. Member for Bristol South (Karin Smyth) said that the Government
“want to make this country the best place to do life sciences.”—[Official Report, 23 October 2025; Vol. 773, c. 464WH.]
What support is the Minister providing to businesses in the life sciences and pharmaceutical industries to make that political slogan a reality? What work is she doing with her colleagues in the Departments for Science, Innovation and Technology and for Business and Trade to revive lost life sciences investment and to use British research, which has the world-class facilities needed to innovate and save lives? As my hon. Friend the Member for Berwickshire, Roxburgh and Selkirk (John Lamont) said, it is important that we work together as a United Kingdom. What work is the Minister doing with our counterparts in Scotland in particular?
As my hon. Friend the Member for Keighley and Ilkley (Robbie Moore) said, there is a growing crisis in the hospice sector. Hospice care, provided for those with terminal illnesses such as some cancers, improves symptom control, comfort and support—it adds life to days. What is the Minister doing to press the Chancellor to recognise that her tax and national insurance changes are creating a crisis in the hospice sector, and what is she doing to save hospices from closure in many cases?
In summary, I am concerned that, 18 months in, the absence of definitive Government action for the cancer community has left us without a cancer plan or a workforce plan, while critical research continues to be driven out of this country. I encourage the Minister to provide clarity for cancer sufferers, cancer charities and the cancer workforce, who are doing such sterling work to improve people’s lives, and to get on with innovating lifesaving treatments to improve the tragic survival rates for the less survivable cancers.
Puberty Suppressants Trial
Caroline Johnson Excerpts(4 weeks, 2 days ago)
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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 on the pathways puberty blockers trial.
The Secretary of State for Health and Social Care (Wes Streeting)
Let me just start by acknowledging the sensitivities around this issue and the strong beliefs held around this House. For all the division and divided opinion, I believe that there is a determination shared by everyone in this House to do the right thing by a vulnerable group of children and young people. It is for those reasons that I am taking the course of action that I am. Put simply, that is to follow expert clinical advice and take an evidence-led approach.
The Cass review found shocking levels of unprofessionalism, a lack of clinical oversight and puberty blockers prescribed to children without sufficient evidence that doing so was safe or beneficial to those children and young people. What Dr Hilary Cass uncovered was a scandal. That is why, on coming to office, I made the temporary ban brought in by my predecessor, the right hon. Member for Louth and Horncastle (Victoria Atkins), a permanent one. Dr Cass also recommended a thorough study to establish how best to support children and young people who suffer gender incongruence. That is the pathways study.
The study has four main parts, one of which is the clinical trial to study the effects of puberty-suppressing hormones on young people’s physical, social and emotional wellbeing. The other aspects of the pathways study will track the physical, social and emotional wellbeing of all young people attending UK NHS gender services. It will look at young people’s thinking and brain development, following both those who are and are not taking puberty-suppressing hormones, and it will gather evidence directly from young people, parents and staff about their experiences of living with gender incongruence.
The bar for the trial to be approved was extremely high and oversight will be rigorous. Children cannot consent to being on the trial, so places will require parental consent, as well as the assent of young people. It is because protecting and promoting the health and wellbeing of affected young people is our primary concern that there are also strict eligibility criteria in place to join the pathways clinical trial. As such, the number of young people who would expect to qualify for the trial will also be low. Participants must undergo thorough mental and physical assessments and will be followed over a number of years with regular wellbeing checks. Puberty blockers have also been used to delay puberty in children and young people who start puberty much too early. Use in those cases has been extensively tested and has met strict safety requirements for that use.
The study is led by King’s College London and the South London and Maudsley NHS foundation trust. It has been carefully checked by independent scientists who advise the National Institute for Health and Care Research and by the Medicines and Healthcare products Regulatory Agency, and received approval from a research ethics committee. I am treading cautiously in this area because the safety of children must come first.
Dr Johnson
I must first declare my interest as a consultant paediatrician who has looked after children with gender dysphoria in the past and is likely to do so in the future. We must remember that we are talking about vulnerable children.
The first and most obvious question is: why? Why have this Government chosen to fund experiments with puberty blockers on physically healthy children? Despite saying he was comfortable with this trial in a briefing to MPs, the Secretary of State told the media on Friday and the Select Committee this morning that he is in fact uncomfortable with it. Why is it even being considered before the data linkage study is complete?
Some 9,000 children went through the Tavistock clinic, and many of them came out regretting being encouraged to irreversibly damage their bodies. We should look carefully at those outcomes before we make the same mistakes. What steps is the Secretary of State taking to secure the data from the Tavistock and have it analysed? What steps is he taking to hold to account those obstructing access to data linkage information? What assessment has he made of the motivations of those obstructing that data, when this is a study to safeguard children?
And what of the trial itself? We know that 226 children will go through this trial. Is that a limit or a target? Those children will be randomised to get puberty blockers now or in a year’s time, and all will be analysed at two years. They will still be children. They might be only 11 years old. How can the results demonstrate a meaningful outcome? The control group is not properly randomised, but chosen from the Horizon intensive trial group. Is the Secretary of State concerned that this will introduce bias?
The criteria for getting puberty blockers in this trial require just one parent to consent and the clinician to think that it will benefit the child, but on what basis will the clinician decide? The Cass review said that the vast majority of children with gender dysphoria would recover, with only a few persisting with trans identities into adulthood. It is not possible to predict which those children will be, so does the Secretary of State accept that the vast majority of children in this, his Streeting trial, who will be given drugs will be physically healthy children whose distress would get better without any puberty blockers, and that the vast majority of the children in this trial are therefore being unnecessarily experimented on with risky medications under his leadership?
Wes Streeting
The shadow Minister asks, “Why?” There is a simple answer. It is because this was recommended by Dr Cass in the Cass review, which was commissioned by my predecessor, Sir Sajid Javid. I think that was the right thing to do, and it is why, when my predecessor brought forward the Cass review, I supported it in opposition. I certainly did not try to play politics with an extremely vulnerable group of children and young people.
I will tell the hon. Lady why. It is because, under the previous Government, those puberty-suppressing hormones were prescribed without proper oversight, supervision or safety, yet we did not hear a peep about that fact for years until Dr Cass, commissioned by Sir Sajid Javid—who deserves enormous credit—did the study, which was published and widely supported and which contained this recommendation. The Conservatives may have changed their tune in opposition, but I remember what they said in government when they published the Cass review and supported its recommendations, so I think their response now is a real shame.
The shadow Minister accuses me of inconsistency, so let me be clear. Am I comfortable that this clinical trial has undergone the proper process and ethical approval to ensure the highest standards and supervision? Yes, I am comfortable about that. Am I uncomfortable about puberty-suppressing hormones for this group of young people for this particular condition? Yes, I am—because of risks. It is why I was also uncomfortable when I upheld the temporary ban by my predecessor and then put in place a permanent ban. The reason I was uncomfortable with that, too, is because I had to look children and young people, and their parents, in the eye when they told me in no uncertain terms that that decision was harmful to them, as have many other clinicians who have opposed that decision.
Whatever my discomfort in this extremely sensitive area, the reason that I have made this decision is that I am following clinical advice and, as Health Secretary, it is my responsibility to follow expert advice. Had the Tavistock clinic faced such challenge and scrutiny a decade ago, we would not be in this mess. The Conservatives were right to commission the Cass review and they were right to accept its recommendations. I accept that there is now a difference on this particular recommendation, but I would urge Members not to walk away from the cross-party consensus we built behind that approach but to build on the work that Dr Cass has done.
Let me turn to the important questions raised by shadow Minister. There will be two groups within the trial, as well as a further control group of children and young people with gender incongruence who do not receive puberty-suppressing hormones. At least 226 participants are required in order to detect a statistically significant difference between the two treatment groups. However, this is not a target and no young person will find themselves on this trial because there is a drive to make sure that a certain number of young people are participating. In order for anyone to participate in this trial, it has to have the most robust clinical oversight from clinicians within the service, as well as national oversight and the consent of parents. It is only where young people will be deemed to benefit that they will be on this programme.
The shadow Minister asks about the data linkage study. That is important. The data linkage study will be undertaken, but when it is completed it will not provide us with the same evidence as this clinical trial. That is why Dr Cass made a distinction between this trial and the data linkage study.
The hon. Lady also asks about the motivations of those who withheld data. That is an extremely important question. It is utterly appalling that anyone in a position of responsibility in the NHS withheld data on a very vulnerable group of children and young people. I accept that there were many well-meaning people involved in these services at the Tavistock clinic, but the fact that Dr Cass found such a lack of rigour, such a lack of standards and such a lack of proper oversight is disgraceful. It is the clinicians who are well meaning and ideologically driven who have given me the most cause for concern in this whole debacle and who have done more harm to children, young people and the trans community than most other people who have taken part in this debate.
I appreciate the work that Dr Cass has done, and I am glad that she is in the other place, bringing welcome scrutiny. Were she not supportive of this approach, I might think again, but she has made her recommendation and given her support. I am following clinical advice. It is not comfortable, but I do believe it is the right thing to do, on balance.
Transgender People: Provision of Healthcare
Caroline Johnson Excerpts(1 month ago)
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Dr Caroline Johnson (Sleaford and North Hykeham) (Con)
It is a pleasure to serve under your chairmanship, Mr Turner. I congratulate the hon. Member for North Warwickshire and Bedworth (Rachel Taylor) on securing this important debate. I declare an interest: I am an NHS consultant paediatrician and I have cared for those with gender dysphoria in the past, and am likely to do so in the future. As we discuss a fairly heated topic, we need to remember that there are people experiencing significant challenges, and they deserve the very best healthcare based on need and the best evidence.
One challenge is that name and sex records are sometimes different from how people are referred to in a ward. The previous Conservative Government launched the Sullivan review, which found that a failure of NHS bodies to record biological sex meant that some people were not invited to sex-specific screening. It recommended that we should not combine questions on sex and gender, and that putting politics before patients threatens clinical care. When will the Government formally respond to the Sullivan report? When does the Minister expect to implement its important recommendations? How will the Government ensure that intimate care is provided by someone of the same biological sex where possible?
I would also like to raise the issue of phalloplasty, which is a major surgery on healthy bodies, creating a penis. According to the NHS website, it causes urinary incontinence, loss of sexual function, and in 3% of cases, necrosis and loss of the penis. Is the Minister confident that the NHS is doing the right thing with this surgery?
I want to move on to talk about children with trans identity. We have been talking about the puberty blockers trial. Why is that trial occurring? Drugs are, unusually, being given to children with physically healthy bodies. Despite telling Members of this House that he was comfortable with the trial, the Secretary of State said on Friday to the media that he was “uncomfortable”. Why is it being considered before the completion of the data linkage study recommended in the Cass report?
Some 9,000 children went through the Tavistock gender identity and development services. Many regretted irreversible damage to their bodies. Why have the Government chosen to experiment on a new batch of children before the data linkage study recommended by the Cass report is complete? What steps is the Minister taking to secure that data? What steps is she taking to hold to account the people who are obstructing the data linkage study? What assessment has she made of the motivation of those obstructing a study that, at its heart, is designed to protect children?
What of the trial itself? Some 226 children will receive puberty blockers—is that a limit? Will there be no more by law? They will be randomised into treatment now or treatment after 12 months, and analysed after just two years. When someone receives the drug for only a year, they will still be a child. What meaningful results can be obtained over that period?
The true control group of those not receiving the drugs is not randomised, but chosen or matched from a different trial—the Horizon Intensive trial. Is the Minister concerned that that may introduce a bias? The criteria for getting puberty blockers under the trial require that one parent consents, not necessarily both—one might disagree—and the clinician must think it will benefit the child, but on what specific criteria will the clinician make that decision? Is the Minister concerned to ensure that ideology does not affect judgment?
The Cass review said that the majority of children with gender dysphoria will recover from their distress without any medication, and that it is not currently possible to predict which children they would be. Does the Minister accept that the vast majority of children in this, the Streeting trial, are physically healthy children whose distress would get better without puberty blockers, and that this Labour Government are choosing to give potentially dangerous drugs to children, most of whom will not need them?
Acquired Brain Injury Action Plan
Caroline Johnson Excerpts(1 month, 1 week ago)
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Dr Caroline Johnson (Sleaford and North Hykeham) (Con)
It is a pleasure to serve under your chairmanship, Dame Siobhain. I congratulate my right hon. Friend the Member for South Holland and The Deepings (Sir John Hayes) on securing a debate on a subject that I know is important to him, to many of our constituents and to the whole House. The brain is so important. It is responsible for moving and thinking, homeostasis, consciousness, our senses and how we interpret the world—essentially, it makes us the people that we are. Acquired brain injuries are therefore an important issue.
As other hon. Members have said, acquired brain injuries are the leading cause of death and disability in those aged between one and 40. Every 90 seconds, someone somewhere in this country—over 330,000 people per year—is admitted to hospital with acquired brain injury. They can have difficulties with walking, with talking, with moving, with thinking skills, with tiredness and fatigue, and with changes in personality. People can have one large brain injury with devastating effects, but they can also have multiple, small, almost unnoticed brain injuries, the cumulative effect of which can be quite severe, and the long-term effects of which can lead to dementia.
The previous Government began work on an acquired brain injury plan and made a public call for evidence in 2022. Unfortunately, that work was interrupted somewhat by the general election. It has been picked up by the current Government, who say they will publish such a plan; it is nearly the end of the year, and I hope they are not going to break that promise, and add to the list of the many other plans that they have delayed. Will the Minister tell us when the plan is going to be published? When it is published, will it include the evidence given in response to the 2022 public call for evidence by so many stakeholders, charities and other relevant organisations?
What should that plan contain? I will look at it from the perspective of this Government, who are looking for the three shifts in healthcare. First, they want to move toward prevention. It seems sensible to prevent brain injury in the first place, if we can, and we know some things that we can do. When I was a teenager, horse-riding and skiing were usually done without helmets; that would be very unusual now. We have not been so successful with cycling: people know that wearing a helmet is wise, to prevent brain injury, but if we looked outside into Parliament Square, we would see lots of cyclists, many of whom are not wearing a helmet that could protect them from brain injury. What are the Government doing to make people more aware of ways that they can protect themselves from brain injury? Concussion management guidance for those taking part in elite, amateur and school sport is important, as others have said today.
Stroke is a form of acquired brain injury and I spoke to representatives of the Stroke Association earlier this term. They talked about two things that can help to prevent or limit brain injury from stroke: first, blood pressure checks and identifying previously undiagnosed hypertension, and secondly, mechanical thrombectomy, which limits the injury that occurs.
The previous Government rolled out blood pressure checks to thousands of pharmacies across the country. Will the Minister update us on what further steps have been taken to identify undiagnosed hypertension since she came into office? The previous Government also began to roll out mechanical thrombectomy. I understand that this Government intend to ensure that a universal service for that technique is available by Easter next year. Essentially, mechanical thrombectomy is when an interventional neuroradiologist takes a wire into the vessels, floats it up into the brain and mechanically removes a clot. It is particularly helpful for people who have had a large stroke where the damage is not yet complete in the brain. Damage can be limited significantly by the use of that very clever procedure.
Earlier this week, I was kindly invited to visit the mechanical thrombectomy service in Romford and see the work done there. I was told about the delay that can occur due to inter-hospital transfer. The Minister, in response to written parliamentary questions, has talked about what constitutes a universal service: it is being able to access a service within four hours. One limit to that ability, as I understand it, is that when someone who has had a stroke attends a hospital that does not offer a mechanical thrombectomy service, the time it takes to transfer them to a hospital that does, after acceptance for the process, affects people’s ability to have that lifesaving in some cases, and certainly disability-saving, treatment.
When I was a junior doctor, I was lucky enough to care for people taking part in the total body hypothermia for neonatal encephalopathy trial—the TOBY trial. Essentially, we took babies who had suffered a brain injury around the time of birth and cooled their whole body to reduce the brain injury that they suffered. That was very effective, and became standard practice. What is the Minister doing to help people who want to do research into other ways of reducing brain injury? How is she helping with research, and what is she doing to sponsor it?
What work is the Minister doing with the social care teams at the Department for Education? One of the sad things that I have seen during my time as a consultant paediatrician is children with inflicted injury—particularly babies. In many cases their injuries should have been preventable because those families were known to social care before the injury occurred. What is being done to protect those extremely vulnerable children? There are other causes of acquired brain injury too. Could the Minister talk about what she thinks the most important causes are and what she and the Government are doing to reduce their incidence?
The other shift that the Government want is from hospital into the community. I was lucky to meet Headway Lincolnshire this week, which told me that there were only 12 in-patient beds available for acute brain injury rehab across Lincolnshire. That is not sufficient. When the charity provides counselling services, it has to do so online from outside the county because there is no one available in the county to provide them. What is the Minister doing to ensure that there is good neuro-rehab across the country, including in rural areas? Also, what is the Minister doing to make sure that rehab is long term? Neuro-recovery takes a long time. It is not just a case of a couple of appointments on leaving hospital; it needs to be over a more sustained period.
For people suffering complex injury, there are many professionals involved. Some people will have a physio, an occupational therapist, a speech and language therapist, nurses, doctors, carers and many others. NICE’s new neuro-rehab guidelines, published in October, talk about how it is difficult for patients to negotiate that, and they recommend a single point of contact. Does the Minister plan to ensure that that NICE recommendation is delivered? If so, how and when?
I would like to pay particular tribute to a young lady I met recently who is one of my constituents. She experienced a traumatic brain injury as a child, but with her determination, great family and community support and rehab, she has made a good recovery and is training as a nurse so that she can help others who suffer as she has. She is an incredibly impressive young woman. She highlighted to me the need for better rehab and school support. I urge the Minister to ensure that they are delivered.
The final shift that the Minister has talked about is from analogue to digital. Digital offers us huge capacity in rehabilitation from acquired brain injury. I talked to a gentleman who had had a stroke and was admitted to a rehab unit where he got involved in Wii Fit—a Nintendo game from some time ago. He was using it along with another person who was recovering from a stroke at the same time, and they became very competitive at these balance and movement games. That really helped them to recover. What is being done to make rehab more fun or competitive? Some of the exercises that people are asked to do can be quite difficult. How can we make them more enjoyable? There are apps available to improve communication, memory and fine motor skills, and virtual reality can help with cognitive rehab. How is the Minister ensuring that those are available to all who would benefit from them?
In summary, we need a detailed plan looking at prevention, acute treatment and rehabilitation. I hope it will not be delayed in the same way as all the other Government plans seem to be. I also hope that it will contain a delivery chapter that sets out not just what the Government want to do, but how they want to do it and when they want to do it by. Will the Minister confirm whether the relevant workforce will be included in the plan, or whether we will have to wait for the long-delayed workforce plan? Neuro-rehabilitation is really difficult, but many people show huge courage and determination in their work to rehabilitate. We need to support them in every way that we can.
Oral Answers to Questions
Caroline Johnson Excerpts(1 month, 3 weeks ago)
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Dr Caroline Johnson (Sleaford and North Hykeham) (Con)
I would first like to say I am sorry that the Minister for Public Health and Prevention is unwell and convey to her the best wishes of the Opposition.
I would like the Secretary of State to consider a patient who has waited a year for a procedure and then, after three waiting list validation calls, finally sees the consultant to check that the procedure is still necessary. If the consultant agrees that it is, do the Government figures show that patient as waiting for a year or a much shorter period?
Wes Streeting
A clock stop would be in place from the moment the patient saw the consultant. The reason we have had to do waiting list validation is that, in addition to driving waiting lists up, the Conservative party presided over a total shambles where patients were often waiting in duplicate slots on the waiting list, removed from waiting lists unnecessarily or waiting far too long. That is the mess we inherited from the Conservative party.
Wes Streeting
It is no use shadow Ministers heckling from the sidelines. When they had the chance, they drove waiting lists up, and they drove the NHS into the abyss.
Dr Johnson
The Secretary of State does not seem entirely sure, so perhaps he can write to us with an answer—
Dr Johnson
As someone who is on the waiting list myself, I do hope that the Secretary of State is correct. Waiting lists for procedures and operations requiring day care or overnight admission are both rising and higher than they were a year ago. Orthopaedic surgery waiting lists are up, yet this Government scrapped our major conditions strategy and say that they have no plans for a musculoskeletal conditions framework. Gynaecology surgery waiting lists are up, yet the Government scrapped and are now reviewing the women’s health strategy. Waits for procedures and operations in ophthalmology, general surgery, neurology and gastroenterology are going up too. When is the Secretary of State going to get a grip of the surgical waiting lists?
Wes Streeting
I honestly cannot believe the brass neck of Conservative Members; their time in government led to the longest waiting times and lowest patient satisfaction in the history of the national health service. The best news I can offer the shadow Minister, and others like her who are on a waiting list, is that we have a Labour Government who are reducing waiting lists for the first time in more than 15 years.
Moles: Histological Testing
Caroline Johnson Excerpts(2 months, 2 weeks ago)
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Dr Caroline Johnson (Sleaford and North Hykeham) (Con)
It is a pleasure to serve under your chairmanship, Ms Jardine. I congratulate the hon. Members for Isle of Wight West (Mr Quigley) and for South Norfolk (Ben Goldsborough) on securing this debate and on their very emotional speeches. I thank the hon. Member for South Norfolk for his bravery in talking about his own care. I commend Zoe’s family for their bravery and for their work to turn a family tragedy into something positive for other people, which is fantastic.
Melanoma is the deadliest form of skin cancer and, frighteningly, the fifth most common cancer in the United Kingdom: almost 20,000 people are diagnosed each year. It usually starts in skin or a mole that is over-exposed to ultraviolet radiation, and then it spreads to vital organs such as the lungs or the liver.
One of the challenges is that melanomas can be difficult to identify. I am a paediatrician, not a dermatologist, but I remember looking at pictures of melanomas and moles in medical school, and in lots of cases I struggled to see the difference that the lecturer was pointing out. They can be brown, red or pink; small or large; flat or raised. Unlike other cancers, which tend to progress as they grow larger, melanomas can be lethal even when they are very small, which means that there is no time to lose in having the diagnosis.
All suspicious moles removed by the NHS should be tested, but those judged benign or removed in cosmetic or beauty settings are not necessarily tested, as has been said. There is therefore the risk that, if that judgment was wrong, the cancer can go undetected and it can have tragic consequences. I want to ask the Minister what steps she is taking to strengthen the regulations in the aesthetics and beauty sector, in particular, and in the private medical sector. What will be done about lasering moles in a way that prevents identification of a melanocytic lesion?
We know that AI can help. There are now computer systems that look at moles in photographs and are reasonably reliable at discerning whether something is malignant. That can be done in conjunction with doctors and histology as an additional layer to ensure there are no mistakes. Will the Minister update the House on what she is doing with AI? One of the big shifts that the Government have talked about is digital, and that is one of the options available to them.
The Government have said that improving diagnosis is a key part of their national cancer plan. Will the Minister give us some highlights from the plan? We were expecting it to be published this year, but it is apparently now delayed until next year. There are rumours that that is to have a presentational effect on 4 February. Given that more than 1,000 people are diagnosed every day across the UK, I really hope that there are not presentational reasons for the delay. It would be helpful to know when she intends to publish the plan.
What assessment has the Minister made of the impact that the plan will have on the progress of speeding up cancer diagnosis for patients? How does she plan to expand access to genomic testing, which can also help to identify the most at-risk patients?
The Government have talked a lot about the shift to prevention, which is always better than cure. In about nine out of 10 cases, melanoma can be prevented. Avoiding over-exposure to the intensity of the sun, applying sunscreen and wearing suitable clothing can help to defend our bodies from the risk of developing melanoma. What assessment has the Minister made of the impact of the VAT charged on sun cream to the incidence of skin cancer? Sun cream can be quite expensive and young people may find that a barrier to applying it. With the Budget coming up just next month, the Minister is in a prime position to make that case.
It takes only one blistering sunburn to more than double someone’s chances of developing melanoma later in life. What steps is the Minister taking to ensure that young people are aware of the risks of sunburn? What discussions has she had with the Department for Education about making sure that young people are aware of the risk? Figures show that 65% of 18 to 32-year-olds report annual sunburn. Alarmingly, in May 2024, researchers predicted a record high of 20,800 skin cancer cases for the year. I worry that sunburn is increasingly regarded as one of those things—a sort of hallmark of a foreign holiday. What steps is the Minister taking to raise awareness of the link between sunburn and skin cancer?
It is not always sunny in the UK. That is why over one in four people, and 43% of 18 to 25-year-olds, use sunbeds to top up their tan. However, that comes with significant health risks. Researchers estimate that sunbeds cause 440 cases of melanoma and around 100 deaths every year in the UK alone. I was surprised to discover that only 62% of people know that sunbed use increases the risk of skin cancer. Worryingly, researchers found that 23% of 18 to 25-year-olds thought that using sunbeds instead of the sun would reduce their risk of skin cancer. What steps is the Minister taking to bust those myths? Will she consider using her women’s health strategy to raise awareness of these issues, which put mostly young women at risk?
Banning under-18s from using tanning beds was undoubtedly sensible, but insufficient enforcement mechanisms have been set up. Unfortunately, a 2025 survey by Melanoma Focus of 100 16 and 17-year-olds in the UK found that 34% were still using sunbeds despite the ban. Exposure to indoor tanning before 35 is associated with a 59% increase in the risk of developing skin cancer. Does the Minister have any plans to strengthen the enforcement of regulations that restrict the use of sunbeds by young people?
Frustratingly, not only do the regulations not stop vulnerable people using sunbeds, but they fail to restrict irradiation levels. A report suggested that over half of Tyneside sunbed salons exceeded the irradiation limits, putting users at even greater risk of cancer and melanoma. What steps will the Minister take to put safety first and ensure that sunbed irradiation levels are enforced?
The key measures against a cancer as deadly as melanoma, and our best defences against fatalities, are prevention, early testing, catching it early and good treatment. Given that such a high proportion of cases are preventable, I am interested to hear more about the Minister’s plans for further prevention and to know how the cancer plan will help. What are her thoughts on the plan for Zoe’s law to ensure that a histology test is always done so that no one slips through the net?
Obesity and Fatty Liver Disease
Caroline Johnson Excerpts(2 months, 2 weeks ago)
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Dr Caroline Johnson (Sleaford and North Hykeham) (Con)
It is a pleasure to serve under your chairmanship this morning, Mr Efford. I congratulate the hon. Member for Worthing West (Dr Cooper) on securing this important debate, and I thank the British Liver Trust and others who provided information and reading material in advance of today’s debate.
Fatty liver disease, as has been said, is often asymptomatic in its early stages. Even when symptoms do occur, they can initially be non-specific symptoms such as tiredness and feeling generally unwell. Initially, the fat deposits in the liver; in the next stage the fat causes inflammation, which causes metabolic dysfunction-associated steatohepatitis. It can then progress to fibrosis and then cirrhosis. As mentioned earlier, liver deaths have increased substantially in the last 50 years, but early detection can help to prevent them. What is the Minister doing to ensure that liver function tests and fibroscans are more available? Does she regret having to delay her workforce plan? Will that have an impact on the treatment of liver disease?
As many have said, fatty liver disease is caused by obesity. Two thirds of adults are now overweight or obese, but obesity starts in childhood. As an NHS consultant paediatrician, I have in my time seen a 12-year-old weighing 120 kg and a nine-year-old weighing over 90 kg—around three times the weight of an average nine-year-old. That has a serious cost in terms of life expectancy, taking three to 10 years off a person’s life. It also has an economic cost to the state of about £11.4 billion on the NHS, estimated at £75 billion per year when taking into account the wider economic factors.
We all know someone who has struggled with their weight and who has had huge success recently, including Members of this House who have talked about it in other debates, using Ozempic, Wegovy or Mounjaro. That is great, but do we want a future where a substantial proportion of the population are dependent on medication to maintain their weight?
Ben Coleman
If I may bring the hon. Member back to childhood obesity, does she agree that there is a serious problem with sugar being pumped into so much baby food? Does she therefore welcome what the Government have finally done after many years of the issue’s sitting unaddressed? They are giving the industry 18 months to take the sugar out of baby food and to stop marketing basically unhealthy products, which no one should buy, as healthy or healthier. Does she welcome what the Government are doing here?
Dr Johnson
I certainly think it is wise to ensure that people get off to a good start in infancy and that unhealthy products are not advertised as healthy if they are not, although the definition of healthy is somewhat elusive and difficult to pin down. It is also important that we do not routinely feed little babies under one high-sugar foods, although I do not want to see them fed artificial sweeteners, either. It is about making things less sweet, so the reformulation will need to be done carefully. That is my personal view.
Going back to the medications, we know they can be very helpful for some and can improve their health. They may be able to help with fatty liver disease as well, although they are not licensed yet. Can the Minister update us on when the Government expect applications to be approved and whether the NHS is ready to deliver for all eligible patients? We have heard about the prevalence and burden of the condition across the country and the number of people affected. What is she doing to ensure that the NHS is ready so that, when these drugs are licensed, it has the capacity, workforce and money to provide them?
We have seen that drug prices can change quite dramatically. In August, Eli Lilly announced a huge price increase for Mounjaro. What plans does the Minister have to guard against that? Will she update the House on negotiations on the voluntary scheme for branded medicines pricing and access?
We understand she is reviewing the National Institute for Health and Care Excellence quality threshold; when does she plan to reach a conclusion? We have seen investment in this country’s life sciences sector by companies such as Merck and AstraZeneca being withdrawn from the United Kingdom or paused due to the environment created by the Government. We need urgent action to support that sector. Will the Minister update the House on discussions she has had with industry and the Treasury on that?
Medications are part of the issue, but there are also surgical implications. Many people who have lost large quantities of weight require surgery for excess skin, which can cause further medical problems. What is the Minister doing to ensure there is an assessment of demand for post-weight loss surgery? Are surgeons and capacity available to deliver it where medically indicated?
As many have said, prevention is better than cure. We know that fewer than one in three people eat five portions of fruit and veg a day, and that that is falling. We also know that starting early is important and have talked about children and infants. What is the Minister doing to ensure that school food is healthy and good for children? What work is she doing with the Department for Education on food choices and preparation, particularly advice on food that can be made in advance or quickly? We know that many young people will become adults in households where there are two working parents, where one of the largest challenges is not just the money needed to buy food, but the time required after returning from work to prepare and deliver it to children before they do their homework and go to bed.
We have talked about reformulation. The soft drinks industry levy has reduced sugar per 100 ml by 47.4%, but I am concerned that is leading to an increase in artificial sweeteners rather than a reduction in the sweetness of the product, ultimately meaning that people are still hooked on the sweetness. What does the Minister think of that? Some hon. Members talked about the advertising ban on less healthy food. Will the Minister tell us why that has been delayed until next year?
Why have the Government added the brand exemption? Do they think the addition of the brand exemption will make it harder for new market entrants, compared with well established brands? If I whistled the short tune for one food brand—I will not—it would be immediately recognised, without further introduction. That would be more difficult for advertising new entrants to the market.
The 10-year plan talks about mandatory healthy food sales reporting. Will the Minister update us on what she defines as healthy? There are also mandatory targets on healthiness of sales. What does that mean and when will it be implemented? We understand there is a planned update to the nutrient profile. Some are concerned that the free sugars that that includes mean that items such as date paste will fall under unhealthy sugars. Will the Minister provide information on that? Has she made an assessment of the Conservative Government’s step of informing people by adding calories to menus? What effect has that had on consumption and food portion sizes in the restaurant sector?
Exercise is also important. We know that physical exercise strengthens joints, increases weight loss and helps in the reduction of diabetes, depression and dementia. The previous Government gave £1 billion to support the sports and leisure industry during the pandemic so that it could continue, and had a school sports action plan, guaranteeing at least two hours of PE and supporting after-school clubs.
The current Government have pledged £400 million for new sports facilities, but delivery of that money seems to be at a standstill. Will the Minister update us on that? Many grassroots sports facilities need that money. Will she also update the House on what the Government are doing to improve girls’ attendance in sports? We know that teenage girls in particular are not taking the advised amount of exercise.
In summary, we need an NHS pathway to detect liver disease in the early stages so that it can be treated; an NHS that is ready to deliver the new treatments that are becoming available; and action to tackle obesity to prevent liver disease in the first place. There has been an emphasis throughout the debate on what the Government can do to prevent obesity and on state culpability in that regard. It is important that people recognise that they have agency and do not need to wait for the Government to do something about this. People do not need to wait for the soft drinks industry levy or for changes to regulations. They have the agency to help themselves; they can do that.
Ben Coleman
Will the hon. Member accept that there is now a general body of opinion that it is time to stop blaming people for not having the willpower not to eat bad food when they are constantly bombarded with advertising and marketing? Some £6.4 billion a year will be spent by the food industry on advertising and marketing to people, and in many areas it is very difficult to get food that is both affordable and healthy. Is it not time to stop blaming people for being fat and to support them to tackle obesity in the ways that I and many of my hon. Friends here have described? Is it not time to stop sticking up for the food industry and to start sticking up for ordinary people?
Dr Johnson
I do not think it is sticking up for the food industry to suggest that people have agency over what they eat. I will give an example. I saw a very small patient—about five years old—who was very obese. I asked the mum what sort of things the child was being fed, and the answer was, “Well, Doctor, he eats lots of crisps all the time.” But there is a simple point there: where was he getting those crisps from? He was getting the crisps from the cupboard without asking, but the crisps did not get in the cupboard because the five-year-old put them there. It is a question of making sure that what is available is healthy and what is being fed to children is healthy.
I have seen even in the last few weeks patients who have low vitamin D levels, critically low vitamin B12 levels and critically low iron levels as a result of the diet that they are getting. It is not just a case of, “It’s all the Government’s fault. The state must make sure that everyone eats healthily.” People have a responsibility of their own as well. This is about working together.
There are wider policy impacts as well. The hon. Member for Chelsea and Fulham (Ben Coleman) talked about food pricing and food security. This Government want to cover Lincolnshire—the breadbasket of the UK, where a third of the country’s fruit and vegetables are produced—in glass solar panels. That is what his Government want to do, so there is a wider policy framework about food affordability. Food inflation is going up hugely under this Government, so they need to look in the mirror and see what they are doing to reduce food prices for people. We need to work together: it is a combination of what the Government can do and what the individual can do.
World Stroke Day
Caroline Johnson Excerpts(2 months, 2 weeks ago)
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Dr Caroline Johnson (Sleaford and North Hykeham) (Con)
It is a pleasure to serve under your chairmanship, Ms Vaz. I congratulate the hon. Member for Twickenham (Munira Wilson) on securing this important debate.
Strokes are life-threatening medical emergencies that affect more than 100,000 people in the UK every year, taking over 38,000 lives and leaving many survivors with life-changing disabilities. A study in The Lancet Healthy Longevity estimated their annual cost to be £8 billion, comprising public spending on care and lost economic productivity. The number of cases is rising—in England, stroke admissions increased by 28% from 2005 to 2024—and, as the Stroke Association has said, demographic reality makes it all the more urgent for the Government to take action today to improve stroke care and reduce modifiable risk factors. As we have heard, when stroke care is delayed, the typical victim loses 1.9 million neurones for each minute they are untreated. Of course, delay is measured not just in brain cells, but in lost independence, lost potential and, all too often, lost lives.
The Government cannot just acknowledge the challenge; they must act. The previous Government designated stroke as a national priority area in the 2019 NHS long-term plan, with several commitments to improve prevention, treatment and care. We set out to increase the proportion of people receiving clot-removing thrombectomy to end their stroke, improve post-hospital stroke rehab models for patients, and enhance the Sentinel Stroke National Audit Programme. That important work was led by a network of 20 integrated stroke delivery networks, which were established in 2021, with a national service model setting out best practice. The previous Government also invested more than £57 million in mechanical thrombectomy, and by the end of 2023, 24 centres were open and delivering mechanical thrombectomy across England. Do the Government have a delivery plan to create more of those centres, or do they think there are enough?
Prior to the general election, the previous Government began work on a major conditions strategy to improve the prevention, diagnosis and treatment of six major conditions, including stroke, but rather than see it through, this Labour Government chose to take an axe to progress, pausing the scheme in August 2024 and, a year later, announcing a service framework for cardiovascular diseases in the 10-year plan. Have the Government incorporated the strategy’s findings in the 10-year plan? The plan mentions stroke just twice, and only in the context of smoking and obesity.
I am pleased that the Government have shown an interest in reducing modifiable risk factors. Prevention is always better than cure. Those categorised as obese face an elevated risk of stroke—64% higher than those of healthy weight—and one in five children leaves primary school obese. We spoke about obesity in this morning’s debate, but I did not get answers to most of my questions. I appreciate that the Minister is covering for someone this afternoon, but will he undertake to get answers not just to the questions asked in this debate, but to those asked in this morning’s?
I am encouraged to see Ministers showing an interest in furthering the previous Government’s work to tackle smoking, a habit to which one in four strokes is directly attributable, but it seems to be taking quite a long time. Just yesterday, health leaders warned that more than 120,000 young people have started smoking since the Tobacco and Vapes Bill was introduced. Will the Minister assure us that the Government will prioritise the Bill and pass it without delay?
High blood pressure remains the single biggest risk factor for strokes, and it is generally asymptomatic, which is why it is so important that tests are carried out in locations that are convenient for people. Last year, community pharmacies in England delivered more than 140,000 blood pressure checks and diagnosed nearly 11,000 cases of hypertension. As the Government complete the latest round of pharmacy negotiations, will the Minister commit to expanding that service further, so that pharmacies can detect more cases and prevent more strokes?
The Government’s delay to the NHS workforce plan is particularly concerning. We need enough doctors to train to perform thrombectomy and care for patients, and enough physios, occupational therapists, nurses, speech therapists and so on to support rehabilitation. After the Government cancelled the major conditions strategy last summer, their 10-year plan promised a service framework, as I said. Given that they have now delayed the workforce plan, the cancer plan, the neonatal and maternity plan and the HIV plan, will the Minister assure the House that they will not also delay the service framework for cardiovascular disease? We need action and not just words, so will the Minister explain what the Government have done materially to improve early stroke diagnosis since they came to office?
Stroke care is not only about medical interventions. For many survivors, recovery starts when they return home and have to re-learn to walk, speak and carry out daily tasks, so access to physiotherapy, occupational therapy, speech and language therapy and other support is vital. How do the Government plan to improve that provision, and what are they doing to provide psychological support to the families of stroke victims and victims themselves, especially in cases where there is a change of personality or emotional disturbance?
Prevention is better than cure. Work on smoking, obesity and high blood pressure are important. In the event of a stroke, every minute counts. Every minute the Government spend perfecting plans instead of putting things into action is a minute of suffering that could have been spared.
Dr Ahmed
My hon. Friend must have read my mind. As I was saying, our plan is only for England. Hon. Friends have already articulated the fact that in Scotland, despite the best efforts of clinicians in Glasgow, Edinburgh and Dundee, there has not been the ability—or the intent from the Scottish Government—to bring forward a proper 24/7 stroke thrombectomy service. That means that the time of day that Scottish patients have a stroke determines the outcome. They are literally being dealt a roulette wheel of care: 20th-century care out of hours and 21st-century care within office hours. It is simply unacceptable, and the UK Government stand ready to assist the Scottish Government in any way, shape or form they require to make sure that access to the highest quality of care is as available to patients in Scotland as it is to those in England.
Dr Caroline Johnson
I am grateful to the Minister for answering the question and talking about universal services being available from next year. Can he confirm whether they will be 24/7 and what he means by “universal”? If someone is living in a rural area, what is the greatest distance or time they should expect to travel to get to their local thrombectomy centre?
Dr Ahmed
What I mean by “universal” is indeed 24/7. As the hon. Member well knows, there are always challenges in delivering stroke care and heart attack care to rural communities. She, as a clinician, knows that we try our best, through the ambulance service and other forms of repatriation, to try to make sure there is equitable access wherever we can achieve it.
I thank my hon. Friend the Member for Stratford and Bow again for her kind words about the very small part that I played in her husband’s diagnosis. I am glad that he continues to do so well. I want to pay tribute to some of the charities involved in this space, because they have been instrumental in the innovation in stroke care over the past 20 to 30 years. I thank the Stroke Association, Different Strokes and Chest, Heart and Stroke Scotland for the incredible work that they do, including in my own constituency.
As the fourth largest cause of death for adults, stroke has a devastating impact on patients, families and the wider community. About one third of people who suffer a stroke will be left with some form of long-term disability. This is an important inequalities issue, as has already been discussed in this debate. Cardiovascular disease hits hardest in the most deprived parts of our country, including in parts of my own constituency, where people are more likely to smoke and less likely to have access to decent food and open green spaces. This Government were elected on a manifesto to tackle the biggest killers, including cardiovascular disease, and our health mission is committed to reducing deaths from heart disease and strokes by a quarter in the next 10 years.
I want to set out our reforms to the NHS, especially those which are part of our 10-year health plan, which will drive down rates of disease while helping people to live well for longer. Many Members in this Chamber are familiar with our three shifts: moving more care into the community, advancing the cause of digital health, and prioritising prevention over treatment.
On prevention, as much as I love my job as a surgeon I am still rooting for the public health Minister to put me out of business. She is taking forward strong preventive measures in her brief, through our Tobacco and Vapes Bill and by beefing up the NHS health check, which is England’s flagship cardiovascular prevention programme. That programme helps to target the abnormalities common to heart disease, to stroke, sometimes to diabetes and to kidney disease, and in many cases even to dementia through behavioural and clinical interventions. Each year, the programme engages 1.3 million people, preventing around 500 heart attacks or strokes. To improve access and engagement, we are developing the NHS health check online so that people can use it at home. That is being piloted by three local authorities until December.
We have already begun trialling more than 130,000 lifesaving heart health checks in the workspace—in offices, shop floors and commercial areas—all across the country. That will also help to reduce the risk of stroke. The hon. Member for Sleaford and North Hykeham asked about community pharmacy. Community pharmacy can and will continue to provide free blood pressure check services for anyone over the age of 40.
On rehabilitation, the stroke quality improvement for rehabilitation programme has increased the percentage of patients discharged from hospital to community stroke services from just under 66% when this Government took office to almost 70%. There is much more to be done, of course, but I believe that we are moving in the right direction.
As hon. Members are aware, the NHS fell behind in the last 14 years—certainly behind the private sector—in using digital technology. That was an appalling inequity, so let me come to our shift from analogue to digital. Half of all people who experience a stroke in England are now recovering thanks to revolutionary scanners that mean patients can avoid the risk of serious disability. The world-first technology that is coming online will analyse CT scans of stroke patients arriving in hospital, identifying them within 60 seconds. That means that the average time between a patient arriving at a hospital and starting life-saving and life-changing treatment is shortened from 140 minutes to only 79, resulting in less disability and a greater quality of life. I am pleased to update the House that since the roll-out last summer, the tool has been used to interpret the brain scans of more than 60,000 patients.
This Government believe that working people have the right to expect the same level of rehabilitative services as the wealthy. That is why we are so gladdened by the new state-of-the-art rehab gym hub at Montagu hospital in Doncaster, which is a perfect example of the best of the NHS that we wish to bring to the rest of the NHS. The suite relies on robotic therapies, which are otherwise provided only in private healthcare. The machines combine robotics with gamified, interactive activities to enhance both physical and cognitive recovery following a stroke—an example of what the seamless integration of physiotherapy and investment in digital health can achieve for stroke patients.
We are also forging partnerships with medtech companies to deliver the next generation of healthcare for patients. Reneural, which has partnered with Hillingdon Hospitals NHS foundation trust, is bringing virtual reality stroke rehabilitation to patients, and enabling therapists to remotely deliver and monitor stroke rehabilitation. Our shift from analogue to digital is supporting both in-hospital and community-based therapy, and, in many ways, allowing equality between rural and urban communities.
I am not saying that everything is perfect—far from it—or that there will not be bumps along the way. However, in a few short months, we have improved the outcomes of more than 60,000 patients, which is a testament to the actions of this Government. Through focus, and by delivering on the promises of digital and bringing the best of the NHS to the rest of the NHS, we can, and we will, do better for stroke patients and their loved ones.