Jhoots Pharmacy

Cat Smith Excerpts

Wednesday 15th October 2025 Commons Chamber

[Stephen Kinnock]

I thank the hon. Lady and pay tribute to her work as Chair of the Select Committee. I am very proud of the fact that we delivered a £500 million uplift to pharmacy—19% across the two-year period. It was the highest uplift of any sector, not just of my portfolio but the entire NHS. I am also very proud of the fact that we are taking forward hub-and-spoke legislation to enable pharmacists and pharmacy technicians to operate at the top of their licence. The day before yesterday we signed off on a statutory instrument to improve the ability of technicians to do more in the area of dispensing. We are looking to empower the workforce and enable them to operate at the top of their licence. That is a fundamental part of the shift from hospital to community that is at the heart of our 10-year plan.

[Cat Smith (Lancaster and Wyre) (Lab)]

Jhoots pharmacy moved into the village of Knott End in 2023, and it was not long before constituents were getting in touch with me to explain that they could not access their prescriptions because pharmacies were closed and unreliable. We do have the very good Over Wyre medical centre, which has dispensing rights, but it is restrained by the one-mile rule, which means that it cannot dispense prescriptions within one mile of a pharmacy, whether that is open or closed. I feel like we are in a Catch-22 situation. What help can the Minister give my constituents to ensure that those who are within one mile of the Jhoots pharmacy that is never open can access their prescriptions from the dispensing Over Wyre medical centre?

[Stephen Kinnock]

My hon. Friend rightly puts her finger on the Catch-22 situation in which we find ourselves. It is patently absurd that a pharmacy that is not operating, as she just described, is blocking the ability of others to step in and fill the gap. That is something we have to resolve, and it is part of the work I have commissioned urgently. We clearly have gaps in the regulatory framework. This is an unprecedented situation, and we are working at pace to address it, but she has rightly put her finger on this Catch-22, which needs to be resolved. We need to move one piece out of the way so that we can deal with the situation.

Postural Tachycardia Syndrome

Cat Smith Excerpts

Tuesday 14th October 2025 Westminster Hall

[Cat Smith (Lancaster and Wyre) (Lab)]

I beg to move,

That this House has considered the matter of support for people with postural tachycardia syndrome.

It is a pleasure to see you in the Chair this morning, Sir Desmond. I am grateful for this opportunity to look at a health issue that is often overlooked, misunderstood and under-resourced within our national health service: postural orthostatic tachycardia syndrome, or PoTS for short. It is not a rare disease, yet for too long people living with PoTS have fallen through the cracks of a system that was never designed to recognise or support them. My notes are based on the heartbreaking reality faced by my constituents and the tens of thousands of people across the UK who have PoTS. I must declare, Sir Desmond, that I have had a diagnosis of PoTS since 2012, so some of what I will say is taken from my own experience as well.

[Jim Shannon (Strangford) (DUP)]

I spoke to the hon. Lady beforehand, and she said that whenever I ask for an intervention, she will take it, so I thought I would get it done early. I commend her for her dedication and commitment, which I always admire, and I wish her well in this campaign. Does she agree that the nature of PoTS means that it can be difficult to diagnose, which leaves the sufferer feeling unheard and not believed? Does she believe that enhanced research into diagnostic tools would ensure that people get the support they need to live with PoTS, rather than surviving life with it?

[Cat Smith]

I thank the hon. Gentleman for his intervention; I recognise that a lot of hon. Members are here for this debate, more than I have ever seen for a 30-minute debate before. Hopefully, next time I make an application, I might be granted a bit more time. I am happy to take early interventions from colleagues, if anyone wants to make them.

[Andy McDonald (Middlesbrough and Thornaby East) (Lab)]

My constituent has contacted me about his daughter, who lives with PoTS and faces exhausting weekly travel for costly private IV treatment due to the lack of local NHS provision. They have now found support in York, but it is still far from home. Does my hon. Friend agree that the absence of national clinical guidelines and clear care pathways leaves too many families in that position, and that the Government should do more to ensure consistent and accessible care for people with PoTS, wherever they live?

[Cat Smith]

I agree with my hon. Friend; I will address that point later in my speech.

[Douglas McAllister (West Dunbartonshire) (Lab)]

Health is obviously devolved to Scotland, but this is a UK-wide issue. My constituents Ewan, Robert and Louise are among a group living with PoTS and they too advise of unacceptably lengthy waiting times for a diagnosis—causing many years of untold suffering. Does my hon. Friend agree that greater support for this syndrome is needed right across the UK?

--- Later in debate ---

[Cat Smith]

The lack of services across the UK is part of my speech; I look forward to discussing it.

[Cameron Thomas (Tewkesbury) (LD)]

You are looking as suave as ever, Sir Desmond. On behalf of many of my Gloucestershire residents, I thank the hon. Member for bringing forward this debate. She will know that PoTS UK reports that it takes an average of seven years to get a diagnosis, and that half of those people are initially misdiagnosed with a mental health condition. Considering this additional strain on sufferers and families, will she agree that the Government should focus on improving diagnoses as a priority?

[Cat Smith]

I will address that issue in my speech too.

[Warinder Juss (Wolverhampton West) (Lab)]

I thank my hon. Friend for giving way again. Like others in this room, I have had many constituents ask me to represent them today. One such constituent, Sophie Evans-Carey, has spent the last six months in hospital and just wants to get her life back. Does my hon. Friend agree that we need to increase support and services available for PoTS sufferers? The average time for diagnosis is seven years. We need faster diagnoses and proper funding for treatment to enable people such as Sophie to go back to work, and help the economy in the process.

[Cat Smith]

I thank my hon. Friend for that intervention; I will take another.

[Jim Allister (North Antrim) (TUV)]

I am much obliged to the hon. Lady. On the theme of this being a nationwide problem, in Northern Ireland not only does it take seven years for diagnosis, but we do not, it appears, have a single PoTS specialist, which is aggravating the situation. If the Government are to address this issue, they need to address it on a nationwide basis and they need to give it the urgency and funding that it obviously deserves and that to date has been neglected.

[Cat Smith]

The hon. and learned Gentleman has picked up on a theme later in my speech, which I hope he will enjoy.

[Jim Dickson (Dartford) (Lab)]

A decade ago my constituent Laura Cordell, who has lived with PoTS for 10 years, was rushed to A&E with a dangerously high heart rate. She was later told by a doctor that she had PoTS symptoms, but she was just told to go away and take more salt, with no follow-up or referral. Over the next 10 years she sought help on a number of occasions but was not diagnosed; in the end she had to go private for a diagnosis, which is obviously not an option available to most people. Does my hon. Friend agree that we need a lot more research and greater awareness of PoTS, particularly among frontline medical professionals such as GPs, who are often the first port of call for our constituents?

[Cat Smith]

I very much agree.

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

I thank my hon. Friend for raising awareness of this very important condition. It is, as always, an honour to serve under your chairmanship, Sir Desmond. I am here because, like everyone else, I have had several of my constituents raise the problem of diagnosis taking far too long, the crippling impact that this condition can have on their lives and the difficulty that they face in accessing healthcare. As chair of the all-party parliamentary group for sport and physical activity, I particularly want to raise the impact that PoTS has on people’s ability to continue to play the sport that they love. It may be that, because they are not being diagnosed, they think it is something that will impact their ability to continue their ordinary, everyday life. It is not right that diagnosis takes on average seven years. We must put more effort into and more emphasis on diagnosis and treatment.

[Sir Desmond Swayne (in the Chair)]

Order. Interventions should be shorter.

[Cat Smith]

That intervention was an important one; sport was not included in my speech, but as someone who has PoTS and has run three London marathons, I can say that people can have PoTS and be sporty—it is just a lot harder.

[Rachael Maskell (York Central) (Ind)]

I am really grateful for this debate. Dr Gupta is a leading specialist in PoTS but, although he knows the physiological changes that take place and he knows how to treat it, he has been stopped in his practice because we do not have the clinical guidelines in place. The Government must now ensure that that happens, so that he can continue his practice, which he knows has an impact on patients—indeed, they recover well.

[Cat Smith]

Absolutely. Those clinical guidelines need to change, and I will address that later in my speech.

[Lillian Jones (Kilmarnock and Loudoun) (Lab)]

I share my constituents’ concerns about the average time for diagnosis of PoTS; seven years is simply too long, and it is unacceptable—and that is in Scotland too. Given the limited awareness of postural tachycardia syndrome among healthcare professionals, does my hon. Friend agree that the introduction of one dedicated care pathway across all health boards, including the devolved nations, would help to improve early recognition, streamline referrals and ensure that patients receive timely and appropriate care?

[Cat Smith]

I very much agree.

[Laura Kyrke-Smith (Aylesbury) (Lab)]

I am grateful to my hon. Friend for securing this debate. One of my Aylesbury constituents has become a full-time carer for her 25-year-old son, who is affected by PoTS; he developed it at university, had to drop out and now is unable to work. Does my hon. Friend agree that, given that we know that PoTS is most likely to develop in young adulthood, we need a particular focus on that age group as we think about increasing recognition, diagnosis and treatment of PoTS?

[Cat Smith]

I very much agree.

[Adam Jogee (Newcastle-under-Lyme) (Lab)]

I congratulate my hon. Friend on her knee exercises this morning in giving way to us all. May I give voice to my constituent Eva from Newcastle-under-Lyme? She has been in touch with me after I met her at a coffee morning recently. Her concerns are on early diagnosis, access to services and the fact that she is stuck on a waiting list down here in London and has been for a very long time indeed. The situation simply is not good enough, and I look forward to hearing from the Minister what action we will see—and sooner rather than later.

[Cat Smith]

There is a particular crisis in London, which I will address later in my speech and which my hon. Friend might be very interested in.

[Kim Leadbeater (Spen Valley) (Lab)]

I thank my hon. Friend for being so generous with her time in giving way. As we can see from today’s debate, this is not a rare condition. Maybe some people think that it is rare, but it affects many people, including Helen, who lives in Roberttown in my constituency. She was repeatedly misdiagnosed and has faced years of delays and fragmented care. I echo the calls from colleagues for clear NHS pathways, joined-up care and access to specialist support in every region, and that we should not underestimate the impact that PoTS can have on people’s mental health.

[Cat Smith]

Absolutely; that is a very good point. When someone is not believed by medical professionals for so long, it can affect their mental health—I recognise that.

[Sojan Joseph (Ashford) (Lab)]

I thank my hon. Friend for giving way. Some reports suggest that 50% of PoTS cases have been misdiagnosed as mental health conditions, adding pressure on the individuals themselves and on mental health services. Does she agree that there needs to be more support for people with PoTS?

[Cat Smith]

Absolutely—I thank my hon. Friend for that intervention, and I very much agree with him.

[Tessa Munt (Wells and Mendip Hills) (LD)]

I thank the hon. Member for allowing me to intervene. My constituent Julie told me about her adult daughter, who has myalgic encephalomyelitis, or ME, and believes she also has PoTS. After struggling to find a specialist, Julie’s daughter finally got a GP referral to a consultant in Bristol, who said that PoTS was “a TikTok fashion” and refused her any testing. She had spent ages travelling and had a long wait, it was quite an effort to get around the building, and she was bed-bound for weeks as a result of the experience. That terribly dismissive approach left her unable to believe that she could try to get any other help, and I understand that that is not uncommon. What steps might be taken to ensure that people with complex, debilitating conditions can access informed and supportive specialist assessments?

[Cat Smith]

I thank the hon. Lady for that intervention; I will address those points in my speech if there are no further interventions. One of the most difficult things for someone with PoTS is to have to sit and stand up repeatedly, so hopefully I will get to the end of my speech.

Colleagues have been really helpful in highlighting that the average time taken for diagnosis is seven years. Indeed, the fight for a diagnosis is one of the first and the longest fights that a sufferer of PoTS will have to go through in order to begin to consider accessing services, although that is a different matter altogether.

During that devastating period, where sufferers have huge uncertainty about whether or not everything is all in their head or they really are fainting and feeling dizzy, they struggle to access any support and are often disbelieved. That leads to many sufferers of PoTS having to drop out of education, losing employment and withdrawing from social settings, which also has an impact on mental health, as hon. Friends have mentioned.

I do not believe that that is because doctors do not care; I think it is because awareness of PoTS remains astonishingly low within the medical profession. Most GPs will never have encountered the term in their training, and even among cardiologists and neurologists expertise in autonomic disorders is scarce. As a result, patients often find themselves being referred to different specialists, bouncing from cardiology through neurology to endocrinology and psychiatry, without there being any one clinician to join up the dots and provide the diagnosis.

The crisis in accessing specialist services has been brutally highlighted this week: we have learned that in London a major teaching hospital clinic has closed its doors to new PoTS patients and a second has reduced its capacity, so that it will see only local patients. All the rejected referrals are now being forwarded to a third London clinic, which is already totally overwhelmed and has a two-year waiting list. Those referrals will put extra pressure on that clinic and leave patients in the south-east without any access whatsoever to healthcare pathways.

This is blatantly a postcode lottery, whereby someone’s access to diagnosis and care depends entirely on where they live. This situation is summed up in an email that I received from a woman last week:

“I would like to note that I got involved with this as I am still unable to get a formal diagnosis of PoTS while suffering the symptoms, as the only specialist we had in Plymouth retired and my GP said they were currently unaware of where to send me for help. Please. I am begging. Please help.”

That is the desperation that many people experience: they can recognise their symptoms, they can use the internet and are quite confident that their symptoms match those of PoTS, but they have no way to get a diagnosis and then to access support.

The crisis has been made even more urgent by a recent surge in PoTS cases associated with long covid. Clinics that were already stretched thin are now being overwhelmed by more referrals, which is adding further pressure to a system that was already struggling to cope pre-covid.

Ultimately, these challenges point to a systemic gap, which is a lack of clinical understanding of the autonomic system. That system sits awkwardly between medical disciplines and is often overlooked in medical education. Until that changes, thousands of people with PoTS will continue to fall through the cracks—dismissed, misdiagnosed and left without the support they need to live well with a complex and chronic condition. The challenges I have described are not simply matters of medical complexity; they are also matters of policy and system design. People with PoTS are not falling through the cracks by accident. They are falling through because the system was never built to recognise or support them.

PoTS predominantly affects women, which contributes significantly to the fact that it takes seven years to be diagnosed. The delay in diagnosis of PoTS is a stark example of a concerning gender health gap in the UK, where many women receive poorer healthcare than men. I welcome the Government’s 10-year plan, but have serious questions for the Minister about its ability to help the PoTS community. It focuses heavily on prevention rather than diagnosis, yet that is not a coherent strategy for chronic multi-system conditions, such as PoTS, which often have genetic or variable causes. The NHS cannot focus just on prevention; there also needs to be adequate access to diagnosis and ongoing aftercare for chronically ill patients, such as those with PoTS, when there is currently no cure. We need an explicit commitment on the Government’s plan to overhaul education and training curricula to create 1,000 new speciality training posts. Although those changes are welcome, will they include dedicated education and training on PoTS for frontline clinicians, and will the new posts include specialists in autonomic disorders?

Finally, with the plan’s commitment to health data research service investment and making wearables standard in chronic care, I ask the Minister whether that investment will include dedicated research into PoTS. Will PoTS patients be explicitly included in the initiative to provide wearables, which are vital for monitoring a heart-rate driven condition? It is clear we need change and a clear co-ordinated strategy that brings together awareness, research, clinical care and social care.

My ask of the Government is clear, but it is fivefold. First, we need national guidelines, ideally from the National Institute for Health and Care Excellence, to provide the evidence-based framework that clinicians, including our overstretched GPs, need to diagnose and treat the condition. Secondly, the Government must require and ensure that commissioning bodies and integrated care boards execute their statutory duties to understand the prevalence of PoTS in their communities and provide for the needs of those patients. Thirdly, we need to ensure that every ICB has a clinical pathway and that all patients requiring secondary care have access to a high-quality service regionally and not just in central London—ultimately, the postcode lottery must end.

Fourthly, we must fully support existing specialist services, which are currently overwhelmed and under threat from closure by hospital management. That includes immediately intervening in the London crisis and protecting every single specialist across the country. Health is devolved in some countries of the United Kingdom, so that is more challenging, but this is a UK-wide issue—although I recognise that the Minister is responsible only for England. Finally, I ask the Government to make PoTS and related disorders a health and social care priority to ensure that affected people have equitable access to the NHS healthcare and social support that they deserve.

We have an opportunity to fix a long-standing wrong. We must not allow the thousands suffering with PoTS to remain invisible any longer. I thank hon. Members for coming out in numbers that I did not expect to support this 30-minute Westminster Hall debate; I hope that demonstrates to the Minister the strength of feeling across the country. All our constituencies have many people suffering from PoTS who are struggling to get diagnoses or to access services, and ICBs are letting down people with PoTS right across these islands. I urge the Minister to use this opportunity to take decisive action and set out how the Government are going to take people with PoTS seriously and ensure that they are no longer invisible.

[The Parliamentary Under-Secretary of State for Health and Social Care (Ashley Dalton)]

It is a pleasure, as always, to serve under your chairmanship, Sir Desmond. I congratulate my hon. Friend the Member for Lancaster and Wyre (Cat Smith) for bringing forward this important issue.

This place is vastly enriched by our experiences, and it is nothing short of inspiring how my hon. Friend’s diagnosis has led her to become a passionate advocate for the PoTS community, raising awareness and holding the Government to account. I thank her for sharing her story and Elise’s case with me. I assure my hon. Friend and Elise that tackling health inequalities is my No. 1 priority as the Minister for Public Health and Prevention.

I also thank many hon. Members for their interventions and for sharing their constituents’ stories. Given this short debate, there is not time to respond to each intervention—I will not even attempt to do so—but I assure hon. Members that their points have been noted and that their presence today is testament to the importance of the issue for hon. Members on both sides of the House. I recognise that people with PoTS wake up and confront every day through sheer willpower, and that showering, cooking and walking to the corner shop each become small expeditions that need endless rest and planning. We are determined to help improve their lives.

Postural tachycardia syndrome, more commonly known as PoTS, is not a rare condition. It affects around 120,000 people in the UK. It is a debilitating, multi-system disorder that can significantly impact someone’s quality of life. As my hon. Friend the Member for Lancaster and Wyre points out, the path to a PoTS diagnosis is often a long and arduous one, filled with frustration and misdiagnosis as patients fight to be heard. Even after a diagnosis is made, patients may struggle to access the services that they need due to a lack of specialist care and limited understanding among health professionals. That results in long delays in treatment, often leaving those affected unable to work or live their lives.

I turn to the specific issues raised by my hon. Friend, starting with guidance. For too long, patients have faced systemic barriers to care and an unacceptable postcode lottery for support. It cannot be right that in modern Britain, where someone happens to be born determines the care that they receive. She rightly points out that that inequality is rooted in the lack of clear national guidance for healthcare professionals. Without guidance from bodies such as NICE, clinicians often lack the confidence and know-how to identify and manage this complex condition effectively.

There are some reasons for the difficulty in providing such guidance, including the amount of available evidence, the fact that PoTS is often managed with lifestyle changes, and the overlap with other conditions such as long covid and myalgic encephalomyelitis/chronic fatigue syndrome, which can bring similar debilitating symptoms. All those issues can make the development of clearcut guidelines challenging. However, in its clinical knowledge summary on blackouts and syncope, NICE sets out in black and white a clear definition of PoTS with the right tests to diagnose it, and symptom-based management. NICE has also published guidance that mentions PoTS in relation to other conditions, such as its guideline on ME/CFS, which acknowledges the overlap between these syndromes. Several other organisations, including PoTS UK and the international Heart Rhythm Society, provide information too.

Services for long-term conditions such as PoTS are commissioned locally through integrated care boards. That approach gives local clinicians the flexibility that they need to tailor services to the specific needs of their communities. Providing a PoTS specialist service is a fundamental part of the ICBs’ statutory role in planning and delivering health to the people they serve, and when an ICB fails to meet its statutory functions, NHS England has a range of proportionate enforcement powers. Let me be clear: we expect NHS England to hold ICBs to account by demanding that they provide clear assurance on how they are meeting their responsibilities, and where they are failing people with PoTS—let me say this very clearly, publicly, now—we expect them to rectify it.

[Cat Smith]

On the point about ICBs, many have zero options in terms of pathways. What steps will the Minister take to ensure that they are forced to do that by NHS England? I thank her for her comments.

[Ashley Dalton]

I thank my hon. Friend for her intervention. As we know, guidelines are only as strong as the evidence and research that they are based on. We need systematic, robust data to determine which treatments and interventions are most effective.

While we are backing our life sciences sector to come up with tomorrow’s treatments for long-term conditions, we are also directly funding research through the National Institute for Health and Care Research. The NIHR is currently backing a study, known as the LOCOMOTION study, with more than £3 million to examine the connection between long covid and autonomic nervous system disorders, especially PoTS. The NIHR funds research proposals through open competition, based on their scientific quality, value for money and impact on patients. The NIHR welcomes research proposals, and I appeal to any researchers to apply with proposals for PoTS-related research that this Government could fund. We want to see proposals and fund those that can be brought forward. Those researchers’ work could be life-changing for thousands of people across our country.

Locally developed care pathways are clearly important for supporting people with PoTS, because they help to address the condition’s unique challenges.

Alcohol and Cancer

Cat Smith Excerpts

Tuesday 8th July 2025 Westminster Hall

[Cat Smith (Lancaster and Wyre) (Lab)]

I beg to move,

That this House has considered alcohol and cancer.

It is a pleasure to serve under your chairship, Mr Stuart. I am grateful to the Backbench Business Committee for granting us the opportunity to debate alcohol and cancer. This issue affects all of us; it affects our constituents, our families and friends, and our local health services. I thank the Alcohol Health Alliance and the World Cancer Research Fund for providing me with detailed figures and materials that helped me to prepare for this debate.

As parliamentarians, we often need to know a little about a lot, but I confess that even I was shocked at how little I knew of some of the latest alcohol harms and cancer risks when I started to investigate this issue. I find it astounding that although alcohol has been designated a group 1 carcinogen since 1988—the same grouping as both tobacco and asbestos—almost 40 years later, this is the first debate in this place on alcohol and cancer. That speaks candidly to the lack of awareness that perhaps many of us have about alcohol. Were we better informed, perhaps we would pursue more changes to the drinking culture in our workplace. I therefore sincerely hope that we can do this issue justice and raise awareness—both among Members of the House and members of the public who might be watching at home—about the harm that alcohol causes, including cancer. Given the poor record of numerous Governments on tackling alcohol harms over the past 20 years, that is perhaps the least we can do.

It is hard to argue against public health experts who say that we are amid “an alcohol harm crisis.” The figures are frightening, and they have been rising at an explosive rate since the pandemic. For any other health condition, a 42% increase in deaths over a five-year period would be treated as a health emergency, but for alcohol it feels like just another day in the office. Those statistics are only for alcohol-specific deaths, and the numbers spike even higher once alcohol-related deaths are factored in.

I will return to that later in my speech, but I would first like to set the scene on alcohol and cancer. The reality is that alcohol is toxic to our bodies. Risks are present even at low consumption levels, and they increase the more someone consumes. That has led the World Health Organisation to declare in recent years that there is “no safe level” when drinking alcohol. Evidence now links alcohol to at least seven types of cancer, including breast and bowel, which are two of the most common cancers in the UK, and oesophageal, which is one of the hardest to treat. The other cancers that alcohol can cause include mouth, throat, liver and stomach. In addition, a new study released in May by the International Agency for Research on Cancer presented evidence linking alcohol to an eighth cancer: pancreatic cancer.

I am afraid that it gets worse. In the UK, 17,000 cancers a year are attributable to alcohol, which is close to one in 20. When it comes to breast cancer, which is the UK’s most common cancer, research figures from Cancer Research UK attribute as many as one in 10 cases to alcohol. We are already at a diagnosis rate of around 46 new alcohol-related cancers a day, and experts have warned that if the nation’s alcohol consumption does not start to return to pre-pandemic levels, we could see an additional 18,875 cancer cases by 2035.

With 46 alcohol-related cancers already being diagnosed every single day, that would add up to the equivalent of an alcohol-related cancer diagnosis for every Member of this House in just two weeks, which I find simply staggering. I know those are big numbers, but they are not faceless figures. Each is someone’s mother, father, spouse, sister, brother, colleague or friend.

The harm is disproportionate, and it is concentrated in our most deprived communities. Lancaster and Wyre is ranked worse than the national average in four of the six key alcohol harm categories, including hospital admissions, cancer cases and alcohol-related deaths. Government after Government have not got a grip on alcohol harm, and our constituents continue to pay the price.

My interest in this subject started just over 12 months ago when local stats on alcohol-related deaths were released. I was shocked to see my area at the top of the English league table. I thank the Alcohol Health Alliance for supplying me with so much information, including my constituency figures, in the lead-up to this debate, though it makes stark reading.

We are a year into this Government and, if nothing changes and we do nothing in this Parliament, my local figures suggest that I will have to explain to my constituents why we did nothing to stop another 195 alcohol-related cancer cases, as well as 225 alcohol-specific deaths and 9,400 hospital admissions in my constituency alone. Doing nothing is not good enough.

Figures in the north-west are not much better, with alcohol estimated to cost my region almost £4 billion a year. That pattern is repeated across neighbouring regions, including the north-east and the west midlands. Time and again, our most deprived communities suffer the most harm from alcohol, despite often drinking less than their more affluent counterparts.

Alcohol harm and health inequalities walk hand in hand: alcohol-related deaths, alcohol-related cancers and alcohol-related hospital admissions. Those are people’s lives. They are being chewed up and spat out by an alcohol industry whose main concern is delivering the highest profits to its shareholders and board members, at the expense of our national health.

[Mr Gregory Campbell (East Londonderry) (DUP)]

I congratulate the hon. Member on the timeliness of her debate. Does she agree that we need more research on the health costs endured by society and the NHS due to this problem? That has to be offset against the tax revenues that accrue from alcohol overconsumption. Those things have to be analysed and researched to address a worsening problem, to which she is right to draw attention.

--- Later in debate ---

[Cat Smith]

The hon. Gentleman is right that we should look at the cost to our communities. This debate is specifically about alcohol and cancer, but other costs beyond its scope include the impact on the criminal justice system, productivity in the workplace and violence, particularly against women and girls. Alcohol carries many costs to our communities, but I would like this debate to be tight in addressing the impact on cancer and cancer deaths.

I might sound dramatic, but I looked at a recent job advert posted by the global alcohol giant Diageo. It was bold enough to state publicly:

“Our industry is facing unprecedented challenges from the WHO and its NGO network globally and regionally.”

In response, Diageo is planning

“a global approach to member states’ engagement, to increase support for our industry at the UN/WHO fora.”

Although that is not surprising, I do not think it should be tolerated. It is for Governments to dictate our public health policies and to protect citizens’ health, as that is not in the commercial interests of multibillion-pound alcohol producers, which have no vested interest in protecting the nation’s health. As the hon. Gentleman mentioned, the NHS is often left to pick up the pieces of alcohol-related cancers, with preventable cancers costing the NHS £3.7 billion in 2023.

In addition, findings published today by the Royal College of Physicians from a snapshot member survey report that 25% of respondents said that at least half of their average caseload is made up of patients whose conditions have been caused or exacerbated by alcohol dependence. A third of those surveyed report seeing alcohol dependence increase their caseloads.

The Institute of Alcohol Studies reported that, in 2009-10, there were 1.4 million alcohol-related ambulance journeys—a staggering 35% of the total—and that alcohol-related A&E admissions accounted for as much as 40% of the total, approaching 70% during peak times. Alcohol is putting unsustainable pressure on our health service.

The reality is that alcohol harms will increase. The number of alcohol-related cancers will in turn increase, and therefore the price tag for our NHS will go up, too. The national cancer plan, the men’s health strategy and the work to reduce violence against women and girls are opportune moments for the Government to recognise the role alcohol plays in all three areas, and I really hope that alcohol is given the required attention.

We might expect almost 40 years of research to mean that the public are already very aware of the links between alcohol and cancer, but that could not be further from the truth. Recent polls commissioned by the World Cancer Research Fund for Cancer Prevention Action Week found that just 7% of UK adults know that alcohol increases the risk of cancer. That means that as many as 93% of us are essentially drinking in the dark, with little knowledge of the harms that our nation’s drug of choice is doing to our bodies.

Even more worrying, one in four of those polled thought that no health risks at all were attached to drinking alcohol. We have a product that is linked to more than 200 different health conditions and injuries and is the leading cause of death, ill health and disability among 15 to 49-year-olds in the UK, but that staggering lack of awareness is leaving the public unable to make informed choices about what they are consuming.

The situation is compounded by the fact that the alcohol industry is still not required to display the health risks of alcohol on product labels. It can pop a quick “Drink responsibly” line on the label, ignoring the addictive, harmful nature of its product, and walk away, washing its hands of the consequences. The industry has no interest in putting health information on product labels and, in fact, it is actively mobilising against it.

I hope that the Minister, a strong Lancashire woman, will hold her nerve in the face of the alcohol industry’s activism. We have previously seen such activism from the tobacco industry and in relation to anti-obesity food labelling. For the benefit of public health, I urge my hon. Friend to hold her nerve and stand up to it.

I now turn to the factors driving alcohol harms, which, if left unchecked, will continue to fuel more alcohol-related cancers, bringing misery to individuals and families caught in the crossfire. I for one am increasingly frustrated by the lack of motivation shown by one Government after another in tackling alcohol harms. Back in 2012 we had a promising national strategy, which over the course of that year was eroded and undone until very little remained. There has since been no national alcohol strategy, and the 10-year health plan’s prevention measures on alcohol fall far short of what is needed. With harm rates continuing to skyrocket, it is time to look again at what we can do to reverse that alarming trend.

The UK has astoundingly few alcohol control policies to mitigate the harmful effects of high alcohol consumption. The World Health Organisation recommends policies to tackle the price, marketing and availability of alcohol, which it describes as the “best buys” for Governments to deploy to reduce alcohol harms. Looking at all three, I am afraid my analysis is that we continue to fail miserably, and I will address them in turn.

In the UK, alcohol is more affordable than it has ever been. Overall, it has become 14% more affordable since 2010, but we can go back even further. Since 1987, off-licence wine and spirits have become 163% more affordable. Drinking patterns have also changed in that time. Almost 80% of alcohol is now purchased from supermarkets and off-licences for home consumption. That is driving people out of supervised and safer community drinking environments, such as pubs, bars and restaurants, and into the unseen confines of the home, where harms stay hidden.

Policies such as minimum unit pricing in Scotland have been bold steps to tackle the affordability of alcohol. Public Health Scotland’s comprehensive evaluation of MUP concluded that it has resulted in alcohol-specific deaths reducing by 13.4%. Were the Government to implement MUP in England, it could be a public health legacy we could be proud of. Instead, we are watching as first Wales and then Northern Ireland are moving to implement MUP in their respective nations, leaving England as the outlier. I was baffled to hear rumours about MUP being included in the 10-year health plan and then subsequently removed. Will the Minister share her thoughts on that?

Availability is the second of the WHO’s “best buy” policy areas, but I am afraid we are not doing much better on that. Without public health as a licensing objective, local authorities have their hands tied when it comes to rejecting licensing applications on public health grounds, including in respect of moves to sell alcohol in areas where there is a real and persistent public health concern, or in areas that are already saturated. Licensing laws also struggle to keep up with newer forms of consumption. Rapid home deliveries and online sales mean that those who are already struggling can have alcohol delivered to their door at any time, day or night, with almost no protections or safeguards in place.

The WHO’s third “best buy” policy idea relates to marketing. I have particularly grave concerns about this, because we are lagging behind other countries when it comes to alcohol marketing restrictions. We do not have so much as a 9 pm watershed, despite alcohol being an age-restricted product. I started to prepare for this speech on my journey from Westminster back home to Lancaster last week, and it was shocking how many times I saw alcohol advertised on that one reasonably short journey. It was on billboards and bus stops, and I walked past posters on the tube platforms and in the walkways.

On the final train, an advert on the screen advertised a thirst-quenching summer drink that was alcoholic. We all know the advertisements on the train Tannoy: “The café in coach C is open for alcoholic beverages”—they often come at 9 or 10 o’clock in the morning. Alcohol advertising is absolutely everywhere, and we know it works because companies spend millions of pounds on it. Advertising is doing one thing: it is driving people to drink more, more frequently, and exposing them to far more harms, including alcohol-related cancers.

I suspect we will hear arguments in the debate about the nanny state and the importance of free choice, but in a world where we are surrounded by relentless messages to drink alcohol, are we really making a free and informed choice? We are bombarded by industry advertising, sports sponsorships, celebrity endorsements, influencer partnerships, brand logos and product placements in everything we see day to day. Is it surprising that consumption and the related harms are rising? The industry has been allowed to go far too far for far too long, and it is fuelling alcohol-related health risks. There is now a serious need for the Government to step in.

I fear that, four years from now, colleagues and I will not be able to defend decisions on alcohol harm to the electorate if the current alcohol trends persist and nothing is done. Although I welcome the measures in the 10-year plan to address alcohol labels and improve consumer awareness, in some respects a lot of the damage has already been done by decades of inaction, misinformation and spiralling consumption. Forty years on, the public still do not know the real risks to their health or the growing evidence that links drinking alcohol to cancer. In this environment, alcohol-related cancer cases will continue to rise. It seems that the horse has bolted, and we now need robust prevention policies, alongside the promised improvements to alcohol labelling, to even begin to reverse the damage.

The consumption of alcohol must be an informed choice. I acknowledge that some people are predisposed to the disease of alcoholism, and society must do more to support and better understand that, but those who decide to consume alcohol still do not have sufficient information to make that a fully informed choice. There is no safe level of drinking alcohol. As I have pointed out, alcohol is linked to at least eight cancers, and every day 46 people are diagnosed with alcohol-related cancers. My ask of the Government is no more than to give the public information about alcohol and clear labels that make the link between alcohol and cancer.

[Several hon. Members rose—]

--- Later in debate ---

[Cat Smith]

I thank all hon. Members for making time to take part in the debate. I am disappointed that there are no plans from the Government at this stage for a national alcohol strategy. I urge the Minister to take a message back to the Department that such a strategy would be an important tool for improving health outcomes and reducing cancer diagnoses.

The debate has been specifically about alcohol and cancer and how to prevent that link. Many hon. Members have personal reasons for taking part. My hon. Friend the Member for Blackpool North and Fleetwood (Lorraine Beavers) has been a good friend for 20 years. I know her family well and the impact on them. She is not the only person to come to the debate with a personal motivation to drive down the harm caused by alcohol in our communities.

I welcome what the Minister said about labelling, which is an important first step to reducing alcohol harms. At the moment, alcohol needs to display only alcohol by volume, product volume and allergen information; even the pregnancy warning is optional for the industry to add. Anyone going into a pub or bar in this country today to buy a bottle of beer and a Fruit Shoot, will find that the latter provides more nutritional and health information than the beer, which is unsustainable.

Labelling should be clear that there is a link between alcohol and cancer, because it is easy to play that down. I believe in freedom of choice—I am not trying to restrict anyone’s right to drink alcohol, but that needs to be an informed choice. We should know that there is no safe level of drinking alcohol when it comes to its potential to cause cancer. At the moment, with only 7% of our constituents knowing that fact, they are not able to make that informed choice.

I hope the Government’s actions on labelling that the Minister is taking forward will see that figure of 7% massively increase, so that our constituents will make informed choices about what they put in their bodies. I again thank everyone for making the time this morning to take part in this important debate, and I thank you, Mr Stuart, for chairing it so ably.

Question put and agreed to.

Resolved,

That this House has considered alcohol and cancer.

Oral Answers to Questions

Cat Smith Excerpts

Tuesday 7th January 2025 Commons Chamber

[Wes Streeting]

The Conservatives cannot, on the one hand, welcome the investment and, on the other hand, condemn the means of raising it. Would they cut NHS and care services, or would they raise other taxes? They have to answer.

[Cat Smith (Lancaster and Wyre) (Lab)]

T9. I thank my right hon. Friend for securing the land purchase for the new hospital in Lancaster. Will he meet me to discuss how a new hospital will transform health outcomes for my constituents?

[Wes Streeting]

I would be delighted to meet my hon. Friend. She was literally the first person to lobby me immediately after the general election, about her hospital, having already lobbied me before. I am delighted that, thanks to her efforts, we have been able to deliver for her community; indeed, thanks to your efforts, Mr Speaker, we have done so for yours too. I would be delighted to meet her.

Oral Answers to Questions

Cat Smith Excerpts

Tuesday 23rd July 2024 Commons Chamber

[Stephen Kinnock]

I welcome the shadow Minister to his place and congratulate him on his appointment. It is a little bit rich to receive a question like that, given that the Conservatives had 14 years to address the issue; I have been in this position for 16 days. If he looks at the plan that we are bringing forward, he will see that we have more ambition and more boldness in our plans than what we have seen in the last 14 years. We will introduce legislation that will address those extremely important issues for people who have some of the more severe conditions.

To the shadow Minister’s specific point on a code of practice, the first step will be to see the legislative process moving forward. But, of course, we remain open to looking at any solution or reform that will help to address this extremely important issue.

[Cat Smith (Lancaster and Wyre) (Lab)]

10. What recent progress his Department has made on the new hospital programme.

[The Secretary of State for Health and Social Care (Wes Streeting)]

It is painfully clear that the previous Government’s new hospital programme—they said that they would deliver 40 new hospitals by 2030—is not deliverable in that timeframe. I want to see the new hospital programme completed, but I am not prepared to offer people false hope about how soon they will benefit from the facilities they deserve. That is why I have asked officials as a matter of urgency to report to me on the degree to which the programme is funded along with a realistic timetable for delivery. We will not play fast and loose with the public finances, nor will we play fast and loose with people’s trust as the previous Government did.

[Cat Smith]

Lancaster’s royal infirmary is at capacity. It is a Victorian hospital, and I am sure it was cutting-edge back then, but it is now not fit for purpose. Yesterday, the joint investment strategic committee expressed its support for the new build scheme in Lancaster, so it will soon be on the Secretary of State’s desk. Will my right hon. Friend commit to meeting me and other interested local MPs in north Lancashire to ensure that, after 14 years of chaos under the Conservatives, the Labour Government will deliver a new hospital for Lancaster?

[Mr Speaker]

And a hospital for Chorley.

Oral Answers to Questions

Cat Smith Excerpts

Tuesday 23rd January 2024 Commons Chamber

[Victoria Atkins]

I am delighted that the House is as happy about that expansion as the hon. Gentleman and I are. I will meet him to go through his plans, because I know how carefully he has campaigned for this important asset in his constituency.

[Cat Smith (Lancaster and Fleetwood) (Lab)]

T9. In the early hours of Friday morning, I arrived at the Royal Lancaster Infirmary with my sick son in an ambulance. As we walked past trolleys in the corridor, the nurse who was treating him said, “Our A&E unit is too small. We were promised a new hospital four years ago, but I think they have forgotten about us.” Can the Secretary of State tell that nurse, my constituent, whether we have indeed forgotten about that new hospital?

[Victoria Atkins]

The hon. Lady is aware of my knowledge not only of that hospital, but of her local area. I will look into this matter for her, because I want to ensure that the good people of Lancashire, Mr Speaker, are looked after as we would all hope and expect.

International Health Regulations 2005

Cat Smith Excerpts

Monday 18th December 2023 Westminster Hall

[Cat Smith (Lancaster and Fleetwood) (Lab)]

I beg to move,

That this House has considered e-petition 635904, relating to the International Health Regulations 2005.

In March 2021, a group of world leaders including the then UK Prime Minister Boris Johnson announced an initiative for a new treaty on pandemic preparedness and response. The initiative was taken to the World Health Organisation and will be negotiated, drafted and debated by a newly established, intergovernmental negotiation body. This is the second time that the Petitions Committee has scheduled this issue for debate. In April this year, a petition that called for the Government to

“commit to not signing any international treaty on pandemic prevention and preparedness established by the World Health Organization (WHO), unless this is approved through a public referendum”

was debated after it reached the threshold of 156,086 signatures. Today’s e-petition calls on Parliament to

“Hold a parliamentary vote on whether to reject amendments to the IHR 2005”.

The Government have responded to the petition, explaining that the UK supports strengthening the IHR and the amendment process.

Having met the petitioner, I know that she would like the Minister to address the concerns of the petitioners in his response, specifically which amendments, if accepted, would require changes to UK domestic legislation; who represents the UK; if the information will be publicly available; the Government’s position on the amendments that change language in the regulations from “may” to “shall”; and if the UK will vote against those changes. What is the UK’s position on whether the regulations should be binding or non-binding, and has it proposed any amendments? I hope that the Minister will be able to address those issues in his remarks when we get to that stage of the debate.

In the March 2021 joint article, the group of leaders said:

“The main goal of this treaty would be to foster an all of government and all of society approach, strengthening national, regional and global capacities and resilience to future pandemics. This includes greatly enhancing international co-operation to improve, for example, alert systems, data-sharing, research and local, regional and global production and distribution of medical and public health counter-measures such as vaccines, medicines, diagnostics and personal protective equipment.”

Given the weekend news coverage of the fallout from some of the challenges faced in the procurement of PPE, it is perhaps timely that we debate the petition today. When the next pandemic happens, I hope that any future Government will have learned the lessons from the past.

On specific questions of UK sovereignty and amendments relating to restrictive measures, the UK Government have explained in their response to the petition that

“we have been clear that the UK will not sign up to any IHR amendments that would compromise the UK’s ability to take domestic decisions on national public health measures. There are currently no plans to hold a vote on IHR amendments. Should the UK Government wish to accept an IHR amendment, then depending on the content of the respective IHR amendment, changes to domestic law considered necessary or appropriate to reflect obligations under the IHR amendment, may be required. The Government would prepare such draft legislation before Parliament in the usual way. In all circumstances, the sovereignty of the UK Parliament would remain unchanged, and the UK would remain in control of any future domestic decisions about national public health measures.”

Finally, I take the opportunity to thank all our healthcare workers who worked through the pandemic. As we go into the Christmas period, many of them will be working while we are enjoying turkey dinners with our families, so I pay tribute to their commitment and to all others who work in our healthcare systems. The pandemic affected us all differently, and I hope that in this season of good will we are mindful of all those who are more vulnerable than ourselves. With that, and on behalf of the Petitions Committee, I thank all members of the public who have engaged with e-petitions, including this one in 2023. I look forward to hearing the well-informed contributions of hon. Members.

[Dame Maria Miller (in the Chair)]

Before I call the first speaker, I remind Members that if they wish to contribute, they should bob. I remind those sitting in the Public Gallery that there should be no applause and no photographs at any time.

Hospice Services: Support

Cat Smith Excerpts

Wednesday 14th June 2023 Westminster Hall

[Cat Smith (Lancaster and Fleetwood) (Lab)]

I congratulate the hon. Member for Eastleigh (Paul Holmes) on securing this debate and on volunteering to join the community of those of us who do daft things to fundraise for our local hospices.

Lancashire and South Cumbria hospices have been informed that our ICB has offered them a 0% uplift on their 2022-23 funding. Following on from last year’s 1.7% uplift, that results in significant pressure, with the cost of living crisis and the need to retain doctors and nurses and be competitive with the NHS.

People often do not realise that our hospices rely on the good will of local communities and on fundraising. On average, two thirds of adult hospice income and four fifths of children’s hospice income is raised through fundraising. St John’s Hospice in Lancaster costs more than £5.1 million a year to run, and only about a third of that is provided by Government funding. That is why I decided two months ago that I would run the 26.2-mile London marathon to try to plug that gap, but I only managed to raise £1,500.

Hospice funding has never been a sustainable model. The crisis, rising energy costs and inflation are creating a perfect storm. The cost of living crisis is putting pressure on charitable donations. Hospices cannot simply reduce their energy use, and they need to remain competitive with NHS pay to recruit and retain staff.

Trinity Hospice in Blackpool’s hospice-at-home service directly supported 70% of all those who died at home on the Fylde coast last year. The Minister will also be aware of Brian House Children’s Hospice, which is part of the Trinity service. For many years, it has served families on the Fylde coast who have the joy, but also the challenges, of raising and loving a child with a life-limiting diagnosis.

I want to press the Minister on the issue of children’s hospices. I have visited the hospice on many occasions and have seen the amazing work to support so many of my constituents living in the most unimaginable circumstances, yet Brian House has seen a huge challenge to its funding, with its grant cut by £50,000. It is already one of the children’s hospices with the least Government and health authority funding in the country: only 14% of its expected £1.6 million annual operating costs. A further loss of £185,000 next year is unimaginable.

I thank the Minister for meeting my constituency neighbour, the hon. Member for Blackpool North and Cleveleys (Paul Maynard), and me. Unfortunately, the hon. Gentleman cannot be here today, but he shares my concerns about the funding for Brian’s House Children’s Hospice. Can the Minister reassure him and me that this issue is on her radar and that she is doing all she can to ensure that no children’s hospice loses out on funding because of changes to formulas?

Oral Answers to Questions

Cat Smith Excerpts

Tuesday 6th June 2023 Commons Chamber

[Steve Barclay]

I am delighted to hear that the enabling works are under way. I know that my right hon. Friend has championed both Hillingdon and the new hospital building programme. I am sure that he will welcome the investment of more than £20 billion. I can confirm that Hillingdon will be fully funded. In addition to the enabling works, we are working closely with the trust to incorporate the Hospital 2.0 design into Hillingdon, as we will at Whipps Cross, as part of taking that programme forward.

[Cat Smith (Lancaster and Fleetwood) (Lab)]

When will the Government announce capital funding for the new hospital in Lancaster: before or after 2030?

[Mr Speaker]

And Chorley, of course.

Sudden Unexplained Death in Childhood

Cat Smith Excerpts

Tuesday 17th January 2023 Westminster Hall

[Cat Smith (Lancaster and Fleetwood) (Lab)]

I congratulate the right hon. Member for Spelthorne (Kwasi Kwarteng) on starting the parliamentary conversation on this important issue. The fact that this is the first debate on the subject suggests to me that it is the beginning of a productive conversation.

I speak today on behalf of my constituent Alexander. On Friday I sat down with Alexander’s mum, Emily, and his dad, Darren, at their home in Lancaster. I also met his younger brother Freddie and baby sister Isabelle, who Alexander never got to meet because he died suddenly with an unexplained death on Boxing day 2021. He was three years old.

I will start my contribution by saying a little about Alexander. He was a happy, healthy three-year-old. He was doing well at nursery, and he loved Peter Rabbit and all things vehicles. He was a really loving big brother to Freddie, and he was really looking forward to meeting his new baby sister, as his mum was six months pregnant when he passed away. After a perfect Christmas day, Alexander appeared under the weather, and his mum took his brother Freddie out for a walk to give Alexander time to have a rest and a nap. Emily did not know that by the time she returned to the family home in Lancaster, her world would have changed forever.

Aside from a previous history of febrile seizures, there were no signs that Alexander was seriously ill or at risk of dying suddenly and unexpectedly. That is the reality of SUDC. It is sudden, and we currently do not know if there is any way to reduce the risk. There is no preparation and no warning, and families are left with little or no answer about why their child has died.

It would be very easy to use this debate to set out all the things that went wrong and could have been done better, but I want to talk about something that went really well. Emily and Darren were given a SUDC nurse, Jo Birch, who has been a real support to the family through a year that has been, quite frankly, horrific. This is something that is in place in Lancashire, but not everywhere. I take this opportunity to thank Jo for her work and share with the House her role. Jo is part of a nurse-led SUDC service. It is the first nurse-led SUCD service in the country—most are paediatric-led. The service began in 2008 and covers the whole of Lancashire. It follows each case through until the final stage of the process, which is the child death overview panel. For the first 10 years, the service was just two nurses working Monday to Friday, but since 2018 it has become a seven-day service. I am pleased to learn that there are now a couple of other nurse-led teams, although Lancashire remains the only one like it in the north of England.

Emily, Darren and their family ask the Government to do better by the families who are affected. They would like the Minister to take up the issue, as outlined by the hon. Member for Westmorland and Lonsdale (Tim Farron), of consistent national medical education on SUDC. Alexander’s parents feel that we particularly need to examine the links between febrile seizures and SUDC, as the limited research that exists suggests that there is an association. His parents were frequently told that such seizures were normal and he would grow out of them.

One thing that was very clear in my conversation with Alexander’s parents is that they never want any other family to have to go through what they have been through. They want to improve public information on SUDC, and that has to start with the information on the NHS website. I ask the Minister if he will encourage the NHS to urgently and immediately include appropriate information on SUDC on the NHS website. None of us can do anything to bring Alexander back, but we can all learn from his life and take action to ensure there is more research and more information on SUDC.

Finally, I want to say that Alexander is blessed to have a mummy like Emily and a daddy like Darren. Their love for their son shines through in all that they are doing in his memory. In his three years with us, Alexander touched the lives of so many people that he met, from his key workers and staff at the Lancaster University Pre-School Centre, to friends and neighbours. I thank all those constituents—there have been so many—who have written to me about today’s debate, asking me to attend and speak on behalf of Alexander.