Meningitis Outbreak

Daniel Francis Excerpts

Tuesday 17th March 2026 Commons Chamber

[Wes Streeting]

Following the right hon. Member’s question, I will ask whether expansion to Tonbridge would be a sensible thing to do, given the number of people who may have been in Club Chemistry on the relevant dates. I take his point about some people not being willing or able to travel to the four sites that have been made available in Broadstairs and Canterbury. None the less, and not least because some students have left university for the Easter break, we are making sure that GPs are able to prescribe antibiotics through the NHS. I know he is talking about different cases—they will not be students—but we will make sure that people can get access to antibiotics via their GP. If I have not fully answered his question—he is shaking his head—I will catch him after this session to make sure that I do.

[Daniel Francis (Bexleyheath and Crayford) (Lab)]

May I share my condolences with the friends and families of the two young people who have very sadly lost their lives? Nine years ago, I saw my own daughter have a 42-minute seizure. Thanks to the work of the NHS and the drugs, she recovered from meningitis B, but I know exactly how terrifying that situation can be. For lots of families around the country, their children are currently at university and are hundreds of miles away. What advice can the Secretary of State give families about the conversations they should have with their young people in Canterbury about the health advice that they should seek and the symptoms that they should look for?

[Wes Streeting]

I thank my hon. Friend for sharing his awful experience, and for once again emphasising the importance of good public health information and advice, including for parents whose students will still be in Canterbury and who may therefore be particularly worried. UKHSA is now advising anyone who visited Club Chemistry on 5, 6 or 7 March to come forward for preventive antibiotic treatment as a precautionary measure; it can be collected from four sites. If they or people they know develop symptoms of meningitis or septicaemia, they should urgently seek medical help by going to the nearest accident and emergency department or dialling 999. If it is not an emergency but people are concerned, they can contact their GP or NHS 111.

Symptoms of meningitis and septicaemia can include a rash that does not fade when pressed with a glass; a sudden onset of high fever; a severe and worsening headache; a stiff neck; vomiting and diarrhoea; joint and muscle pain; a dislike of bright lights; very cold hands and feet; seizures; confusion or delirium; and extreme sleepiness or difficulty waking. I want to underscore that the general risk of transmission is low and that it takes place through close, direct and prolonged personal contact through things like kissing or sharing vapes and drinks. We need to get the balance right between promoting awareness—people thinking about their own situation and whether any of these factors apply to them—and not spreading unnecessary anxiety, because most people, including the overwhelming majority of students at the universities and people in Canterbury, will not be at risk.

Disability Equipment Provision

Daniel Francis Excerpts

Wednesday 11th March 2026 Westminster Hall

[Daniel Francis (Bexleyheath and Crayford) (Lab)]

It is a pleasure to serve under your chairship, Mr Betts. I declare an interest as chair of the all-party parliamentary groups for access to disability equipment and for wheelchair users. It is also well known that one of my children has cerebral palsy and uses a wide range of equipment, from a wheelchair to postural seating for eating and for bathing and so on, so I have become a bit of an expert in some of these matters over the years. I pay tribute to the hon. Member for Aberdeenshire North and Moray East (Seamus Logan) for securing the debate. There will be a separate debate later this year, through the Backbench Business Committee, on wheelchair provision, which I will be sponsoring.

On the point made by the hon. Member for West Dorset (Edward Morello), the collapse of NRS Healthcare last summer has caused real issues across the country. My Bexleyheath and Crayford constituency borders Kent and I know that there have been issues there, as there have been for other local authorities, and I have been working with organisations to try to reduce them. However, recycling continues to be an issue, and it is addressed in the recommendations of the APPG’s report.

As chair of the APPG for access to disability equipment, I am delighted to contribute to this debate, and I pay tribute to Newlife, the charity for disabled children, and the British Healthcare Trades Association for their dedication and hard work in advocating for users of disability equipment. As has been said, our first report, “Barriers to Accessing Lifesaving Disability Equipment”, was published in October. The report resulted from our inquiry—our first inquiry, in fact—into the systemic barriers that prevent millions of disabled children and adults across the UK from accessing the medical and community equipment that they need to live safely and independently.

I want to highlight some of the evidence that we heard. We found that 71% of people feel that the system providing hoists, grab rails and other essential medical equipment is not currently meeting their needs, and our first key recommendation was the implementation of a national strategy. Currently, there is no cohesive national strategy for community equipment and care provision, which has resulted in inconsistent experiences across the country. The APPG recommended that a national strategy should be overseen by a Minister, who would ensure that a national directive is issued to local authorities to clarify whose responsibility it is to provide equipment. That would ensure consistency and reduce confusion.

The APPG heard evidence that the system responsible for delivering essential community equipment is fragmented, inconsistent and too often failing the people it exists to support. Responsibility is split between local authorities and integrated care boards, but in practice that joint responsibility—I know this at first hand—frequently leads to unclear accountability, variation in provision and what many families and professionals describe as a postcode lottery. Often, delays are such that families order equipment and then wait a year or two, by which time it is obsolete. We heard that in the feedback we received for the report.

The report highlighted the consistently long waits for assessments and equipment, which worsen conditions and increase costs. In fact, 74% of professionals and equipment providers said that they are aware of patients who have experienced delayed hospital discharge because essential equipment was unavailable at home. Not only do those delays increase the financial strain on the NHS and pressures on hospital beds and staff time, but they slow down elective care and place further strain on the social care system.

One of the report’s key recommendations is to implement a co-ordinated national plan that includes clear targets, workforce investment and the streamlining of processes to reduce delays and prevent unnecessary hospital stays. Maximum service timeframes should be aligned with the wheelchair service standard of 18 weeks to ensure consistent, accountable delivery. Equipment providers from across the country said that every authority works differently, with little alignment between local areas and very limited national oversight of how services are delivered. Our inquiry found that 33% of equipment users are still waiting to receive approved equipment, with one in five waiting more than two months. That highlights the real consequences these failures have for the people who rely on the support. Despite the scale and importance of this sector, there is no single Minister with clear responsibility for ensuring that services are working effectively for patients.

It is clear that the system needs change, and I would be grateful if the Minister would consider the APPG’s recommendations to introduce a national strategy for community equipment and wheelchair services in order to eliminate the postcode lottery in provision and provide proper national oversight and monitoring of services, and to introduce of a co-ordinated national plan to reduce delays in the provision of community equipment. The APPG will be meeting on 26 March, and the Minister and all other Members will be welcome, if they can find time in their busy diaries, to join us.

Adult Cerebral Palsy: National Service Specification

Daniel Francis Excerpts

Tuesday 10th March 2026 Westminster Hall

[Daniel Francis (Bexleyheath and Crayford) (Lab)]

I beg to move,

That this House has considered the national service specification for adult cerebral palsy in the NHS.

It is a pleasure to serve under your chairship, Ms Jardine. I am grateful to secure this debate. Approximately 130,000 adults in the UK have cerebral palsy. Although the NHS now officially categorises it as a lifelong condition, there is clear evidence that specialist support stops at the age of 18. A national service specification for adult cerebral palsy in the NHS would ensure that the transition from childhood to adulthood is supported by relevant healthcare services and the necessary support. It would ensure that support continues to be provided throughout adulthood. I pay tribute to Up—the Adult Cerebral Palsy Movement, and Action Cerebral Palsy, for their dedicated advocacy for people with cerebral palsy throughout the UK, their campaigning on this issue and their support in preparing for this debate.

I will start by talking about my experience. As hon. Members will be aware, one of my daughters has cerebral palsy. Although she is still a child, I remain concerned about the level of support that will be provided to her when she reaches adulthood—a concern that I am sure many parents of children with cerebral palsy will relate to. During childhood, layers of support are provided, ranging from paediatricians to services that often are supplied at school and through the NHS such as physiotherapy, speech and language support, and occupational therapy. Parents are rightly concerned about what the transition at 18 looks like and whether wraparound healthcare remains. Sadly, the reality for many people with cerebral palsy is that after the transition, they are left with little support for their health needs and to help them function in life, including for day-to-day activities such as work.

Throughout this debate I will refer to the 2022 report of the all-party parliamentary group on cerebral palsy, “Barriers for adults with Cerebral Palsy on achieving full life participation: access to healthcare services and progressing at work”. Although the APPG is now disbanded, the key recommendations remain relevant. I pay tribute to my hon. Friend the Member for City of Durham (Mary Kelly Foy) and the former Member for Blackpool North and Cleveleys, Paul Maynard, for their work to commission the report.

For many adults with cerebral palsy, their experience is similar: they receive care and support through paediatric services before reaching adulthood, then find themselves facing a cliff edge. In essence, they are left without the support that they received for the first 18 years of their life. Cerebral palsy affects about one in every 400 children in the UK, but the severity of each child’s cerebral palsy varies greatly, and many have more complex issues, with one in two having a learning disability and one in four having a severe learning disability.

The first recommendation in the APPG report outlines that NHS England and social care, education and employment specialists must agree a national service specification for adult cerebral palsy, to be commissioned based on the needs of local populations within the 42 integrated care boards across England. Furthermore, in the 10-year health plan, the Government made the commitment that 95% of people with complex needs should have an agreed personal care plan by 2027. Many adults with cerebral palsy have complex needs and, with that, elevated health risks. They are 14 times more likely to die from respiratory disease and three times more likely to die from cardiovascular disease. In 2023, a review of 69 studies to assess the prevalence and incidence of chronic conditions among adults with cerebral palsy showed that 21% had depression, 21% had anxiety, 24% had asthma, 28% had epilepsy, 32%8 had incontinence and 38% had malnutrition.

I would welcome the Minister’s response outlining how the commitment in the 10-year health plan can be achieved for adults with cerebral palsy. I would also welcome the Minister considering how a national service specification for adult cerebral palsy could be implemented within the 42 ICBs, including by encouraging ICBs to implement the NHS framework for the commissioning of services for children and young people with cerebral palsy as a blueprint for adult cerebral palsy commissioning and provision.

In March 2021, the then APPG on cerebral palsy published its first report, entitled “Early identification, intervention and pathways of care of infants and young children with cerebral palsy: the case for reform and investment”. One of the report’s key recommendations was that all health authorities should be required to implement NICE—National Institute for Health and Care Excellence—guidelines. Dr Charlie Fairhurst, head of children’s neurosciences at the Evelina London children’s hospital and chair of the committee for NICE guidelines on cerebral palsy, accepted those recommendations, which have been implemented in the NICE guidelines for children. It is therefore disappointing that the recommendations for adults outlined in the 2022 report, including the full implementation of NICE guidelines, have not been implemented for adult cerebral palsy in the NHS.

In May 2025, NHS England published the commissioning framework for children and young people with cerebral palsy. The framework aims to simplify and summarise the existing guidance available. It also highlights best-practice care pathways that could be replicated by other systems and enables systems to identify population need through data. Over the past year, eight ICBs have been piloting that framework for children, which involves undertaking a baselining exercise to understand existing service provision and to identify service gaps for children with cerebral palsy. However, as we know—and as the 2022 APPG report highlighted—the needs of local populations differ across the country, and the results from just eight ICBs are not enough to provide an accurate representation of the effectiveness of the framework.

The existing postcode lottery of specialist support constrains the lives of adults with cerebral palsy and results in worse health outcomes, not to mention lower education and employment participation for individuals, with the subsequent substantial economic loss. Analysis from the Northern Ireland cerebral palsy register has shown that the prevalence of cerebral palsy in adults is comparable to that of multiple sclerosis or Parkinson’s disease.

[Jim Shannon (Strangford) (DUP)]

I congratulate the hon. Gentleman for securing this debate, and I thank him for sharing his personal story. That personal knowledge adds to the debate.

Studies by Queen’s University Belfast indicates that adults with cerebral palsy often struggle to navigate adult health and rehabilitation services after moving on from paediatric services. That can limit their access to physiotherapy, occupational therapy, speech and language therapy, orthopaedics and neurology. Does he agree that the best way to navigate this issue is to establish a clear, co-ordinated transition pathway from paediatric to adult services, with dedicated case management so that nobody is left behind when it comes to their care?

[Daniel Francis]

I absolutely agree. Between the APPG’s 2022 recommendations and the example the hon. Member gave of the analysis in Northern Ireland, it is clear that the evidence is there, and hopefully we will hear from the Minister about how we can continue to progress some of those matters.

I would welcome a commitment from ICBs across the country to implement the framework as a blueprint for adult cerebral palsy commissioning and provision, as the hon. Member outlined.

The 2022 report’s second recommendation highlighted the need to support GPs in identifying adults with cerebral palsy by extending the UK-wide quality and outcomes framework to incorporate the creation of general practice-level cerebral palsy registers along the lines of the expansion of the QOF to learning disabilities. That would make a profound difference in the health outcomes of children with cerebral palsy when they transition into adulthood care pathways. Would the Minister look to extend the quality and outcomes framework to incorporate the creation of general practice-level cerebral palsy registers, similar to the expansion of the quality and outcomes framework to learning disabilities?

The third recommendation aims to ease the transition into adult care pathways through a national service specification for adults with cerebral palsy in the NHS, which must include training covering adults with cerebral palsy for those working in general medicine, general practice and nursing from entry level. For many adults with cerebral palsy, their primary co-ordinator of care is their GP, who, despite their best efforts, often does not have the specialist knowledge or training to support their patients.

Written evidence submitted to the APPG as part of the report highlighted that medical undergraduate students do not receive training about cerebral palsy in adults. One way to support GPs in identifying adults with cerebral palsy is to extend the UK-wide quality and outcomes framework to incorporate the creation of general practice-level cerebral palsy registers along the lines of the expansion of the quality and outcomes framework to learning disabilities. That would make a profound difference in the health outcomes of children with cerebral palsy when they transition into adulthood care pathways. Would the Minister outline how the current NHS staffing guidelines could be amended to include the incorporation of training for those in general medicine, general practice and nursing from an entry level to cover adults with cerebral palsy?

The report’s fourth recommendation outlined that each ICB should be required to undertake a gap analysis of existing cerebral palsy services for adults against NICE guidance and use the results to inform and guide their local commissioning decisions. This must include investment in services to support and address associated conditions. The results should then be used to establish regional multidisciplinary cerebral palsy clinics for adults, providing access to a range of psychological, physical and complementary therapies. The recommendation highlights that disability access co-ordinators appointed in both acute and primary centres would be able to provide referrals to the clinics and ensure that reasonable adjustments are made.

The report also highlighted that the provision of a neurologist during the transition from childhood to adulthood is an essential component of adult cerebral palsy care to ensure that, when a patient is discharged from their paediatrician, they do not face that cliff edge in support. Will the Minister agree to investigate how ICBs can undertake a gap analysis of existing cerebral palsy services for adults against current NICE guidance, and how they can include adults with cerebral palsy in their integrated needs assessments?

The report’s fifth recommendation suggests that, to ensure the provision of specialist services, the Department of Health and Social Care should provide ringfenced funding to ICBs to enable them to develop the much-needed specialist services at a local level. Will the Minister agree to look at ringfencing funding for the 42 ICBs so that they can develop specialist cerebral palsy services?

Finally, I want to demonstrate why national service specification is so needed. Emma Livingstone, the co-founder and chief executive officer of UP, The Adult Cerebral Palsy Movement, is in the Public Gallery, and her lived experience perfectly encapsulates why national service specification for adults with cerebral palsy is needed. Emma was diagnosed with cerebral palsy at two years old. At 16, she was discharged from medical services after being told that she was the best that she would ever be.

Unfortunately, without any integrated care during Emma’s adulthood, she experienced a significant decline in mobility in her late 30s. That led to Emma having multiple surgeries, and unfortunately having to give up her work as a speech and language therapist. In Emma’s own words,

“In my late thirties, my mobility declined rapidly. I needed hip surgery, then more surgeries, and eventually had to give up work. What shocked me wasn’t the physical deterioration—it was the silence. The coordinated care I’d received as a child simply vanished when I turned 18.”

Emma is sadly not alone in experiencing that. The APPG report found that

“the transition into adolescence and adulthood is often accompanied by a decline in physical function,”

with up to 50%

“of people with Cerebral Palsy experiencing deterioration in walking function between 20 and 40 years of age.”

That statistic alone is reason enough to show why national service specification for adult cerebral palsy in the NHS is so greatly needed.

I would welcome the Minister’s response to the five recommendations from the APPG report that I have highlighted today.

Hughes Report: Second Anniversary

Daniel Francis Excerpts

Wednesday 11th February 2026 Westminster Hall

[Daniel Francis (Bexleyheath and Crayford) (Lab)]

It is a pleasure to serve under your chairship, Dr Allin-Khan. I thank the hon. Member for Chesham and Amersham (Sarah Green) for securing the debate.

I spoke in last year’s debate to raise the experience of my constituents Paula and Gillian, who had experienced the impact of having pelvic mesh fitted. Unfortunately, not much has changed since then, and Paula tells me she is still living with the devastation that pelvic mesh has caused in her life. She had the mesh implanted in 2012, and between 2020 and 2023 she experienced painful bladder stones that were linked to the mesh. She finally had surgery last year to remove a 3 cm bladder stone, which revealed that the mesh had completely eroded into her bladder. She will need further surgery to remove the remainder of the mesh, and will need to undergo a further recovery period. That story is like many others we have heard.

As I did when I spoke about valproate last year, I would like to thank Emma, Janet and the campaigners who are here today, who do so much in this area. With regard to the Hughes report, the Epilepsy Research Institute continues to ask the Government to allocate dedicated ringfenced funding for research into epilepsy drugs and to ensure that regulatory bodies act swiftly on safety concerns, and that pregnant women with epilepsy have access to the best possible information and care.

I will take us down a slightly different path now because, as some Members know, my wife and one of my daughters have epilepsy. When my wife and I tried to conceive, I saw at first hand the issues women have when they have to come off valproate. My wife was seizure-free for 12 years, and her life was turned upside down when she started having seizures again. Those resulted in her falling all the way down the stairs; falling into a bathroom cabinet and trapping her head—I had to try to disengage her; having a seizure in the bath, after which I had to resuscitate her on the bathroom floor; and having to surrender her driving licence. At one stage, she thought she would never go back to her teaching job, although she has now successfully gone back to it. She will be three years seizure-free this year, mainly because she has gone back on to valproate.

Those many years when she had seizures and other issues show why research is desperately needed for drugs to control epilepsy. Unfortunately, for many people, valproate is the only drug that allows them to lead a normal life. I have seen that; the rules are there for a good reason, but my daughter, who is 12 and who, as Members may know, has no mental capacity, has had to come off valproate because of the rules. We need to understand these issues and that wider issue, because for many people valproate is the drug they need to support them. That is not to disrespect Emma and Janet for the work they do to support those, including their children and families, who have been so desperately impacted by valproate.

I welcome the noises we have heard recently about forthcoming updates from the Department, but I also say, on behalf of my constituents and the wider community, that we need concrete measures for the implementation of financial and non-financial redress, and I would welcome the Minister’s comments on that.

Unpaid Carers: Inequalities

Daniel Francis Excerpts

Thursday 20th November 2025 Westminster Hall

[Daniel Francis (Bexleyheath and Crayford) (Lab)]

It is a pleasure to serve under your chairship, Ms Vaz. I thank my hon. Friend the Member for Shipley (Anna Dixon) for securing the debate and support the asks that she has made of the Minister. It was a pleasure to join her, carers, Ministers and colleagues last night at the “State of Caring” report launch and it is a pleasure to support Carers Rights Day today.

No one expects to become a carer. It is not something we set out in our plans for the future or our lifetime goals. It usually happens because a loved one falls ill, or, as in my family, because a child has a complex disability, identified early on in life. The burden of care usually falls on women. It is absolutely right that we acknowledge that and discuss today the huge inequalities they face.

One of my children has quadriplegic cerebral palsy. My wife and I decided to give up full-time work in 2016, the year my daughter had 110 medical and physiotherapy appointments, to job share the care components at home while we both worked part time. I accept that the majority of the burden has fallen on my wife over the years. Although we have not been in poverty, it did at that point leave a subsequent hole in our finances, with difficult decisions about the things we could no longer do. Those are the decisions that so many carers make, and they have a wider impact on the economy.

My day started, as it does the majority of days, at 6.15 this morning. I was changing a 12-year-old’s nappy before getting her dressed, fed and putting her in a wheelchair ready for the school bus to come and collect her. There is complexity at the other end of the day, too. This afternoon and tomorrow night, my wife and I will be doing rotas, as we normally do, to work out who is doing the care at the other end of the day. Real pressures are caused by the shortage and affordability of paid carers to support the many families across the country that experience what we do daily.

I strongly welcome the announcement yesterday from the Department for Business and Trade on the terms of reference for the review of employment rights for unpaid carers, and the comments made by the Under-Secretary of State for Business and Trade, my hon. Friend the Member for Halifax (Kate Dearden), at last night’s reception. The review will allow engagement from carers, employers and trade unions to understand how the existing unpaid carer’s leave entitlement is working; to examine options for different models of paid carer’s leave; to consider the options and principles for additional interventions; and to identify options with low or no cost to business and the Exchequer, and the appropriate routes for implementation.

I thank my right hon. Friend the Minister for Social Security and Disability for visiting my constituency back in May, when he met representatives of local charities —Carers Support Bexley, Bexley Mencap, Age UK Bexley, Citizens Advice Bexley, Irish Community Services, Bexley Voice, Bexley Deaf Centre, Inspire Community Trust and Bexley Voluntary Service Council —to discuss the support they give to carers through respite, equipment provision and, notably, access to financial guidance. I have worked with those groups for many years, both as a councillor and a carer, and I thank them for all they do to support my constituents across Barnehurst, Bexleyheath, Crayford, Northumberland Heath and Slade Green. At that roundtable, they set out how they are trying to provide financial support and introduce new innovative ways of working, which I know the Minister will have taken away and be looking at in detail.

I also thank two other local charities, Crossroads Care South East London and Evergreen Care, for their work supporting my constituents, and I pay tribute to carers across my constituency. As a parent collecting my child outside the gates of respite care, I know those parents. I am not just their MP; I have worked with them for many years. They may bring their cases to me, but they are my friends and fellow carers, and I pay tribute to them for all they do in very challenging circumstances.

Lastly, I have a few asks for the Minister. I hear what my hon. Friend the Member for Shipley said about the cycle of issues facing carers. We were lucky because we were working part-time in occupations that paid enough of an hourly rate to keep us going, but carers can face a cycle of poverty. They can also face health conditions as a result of being a carer. I am still lifting a 12-year-old around my house, which is still not fully accessible; she will never walk. We need to face those issues burdening carers, and the support in the 10-year-health plan will help with that.

In Parliament, we are employers too. We have a good ParliCare network for parliamentary staff, but we must always be setting an example. In Parliament, and through the ParliCare network, we as Members and employers must do all we can to demonstrate that we will support carers and that we expect others in the country to do the same.

--- Later in debate ---

[Stephen Kinnock]

I will be very happy to do that. We have launched the 43 sites, so I would be happy to share the documentation on how we launched them and the terms of reference. [Interruption.] I can see the representative from my private office is taking notes.

[Daniel Francis]

I do not expect an answer now, but can I also ask the Minister to take away a point about the complexity of some of these disabilities? Sometimes people are under several different consultants in several different hospitals, perhaps for a neurological condition, for their sight, for epilepsy and so on. I am thinking about both the complexity of the different apps, and different parts of apps, used by different NHS trusts and hospitals, and the complexity of the distances travelled —it is the carer who manages all those aspects. How can we take that away and support the carer in managing the care of the person for whom they are caring?

[Stephen Kinnock]

I absolutely agree with my hon. Friend’s points; I think that neighbourhood health, as a strategy, addresses his points about both the proximity and complexity. By definition, through shifting from hospital to community, we are addressing the proximity point. The fact that neighbourhood health will be based on multidisciplinary teams creates the idea of a one-stop shop for the patient, where their complex needs are addressed in one place.

To ensure that local areas can meet their duties under the Care Act, the 2025 spending review allows for an increase of more than £4 billion in additional funding for adult social care in 2028-29, compared with 2025-26, to support the sector in making improvements. The Health and Care Act 2022 strengthened expectations around identifying and involving carers and ensuring that services are shaped by carer feedback.

NHS England is helping local systems to adopt best practice through co-produced tools, case studies and events such as Carers Week and the Commitment to Carers conference. Initiatives such as GP quality markers for carers, carer passports and digital proxy access are already making a real difference and increasing the number of carers who are identified in the NHS.

Balancing paid work and caring responsibilities remains a significant challenge, and too many carers risk financial hardship as a result. That should never be the case. Supporting carers to remain in or return to work is central to our plan for a modern, inclusive labour market. Employers benefit enormously from the skills, dedication and experience that carers bring. That is why in April we increased the carer’s allowance earnings limit to £196 a week—the largest rise since its inception in the 1970s—meaning that carers can now earn up to £10,000 a year without losing the allowance.

The Carer’s Leave Act, which came into force in April 2024, gives employees one week of unpaid leave each year to help to manage planned caring commitments. We are now reviewing how the Act is working in practice, listening to carers and to employers of all sizes. That includes exploring the potential benefits and implications of introducing paid carer’s leave. To ensure transparency, and as hon. Members have noted, the Department for Business and Trade yesterday published the terms of reference for that review and we will hold a public consultation in 2026 on employment rights for people balancing work and care.

Young carers make an extraordinary contribution, often taking on responsibilities far beyond their years. Our ambition is that every young carer should receive the support that they need to succeed at school and beyond. This autumn, we published key stages 2 and 4 attainment data for young carers for the first time—an important step in understanding and addressing the educational disadvantage that they face. Reforms across education and children’s social care will strengthen identification and support. Ofsted’s new inspection framework, introduced on 10 November, explicitly references young carers in the expected standards for inclusion, safeguarding and personal development.

Local authorities must identify young carers who may need support and assess their needs when requested. We strongly support the “No Wrong Doors for Young Carers” memorandum of understanding that promotes collaboration across children’s and adults’ services, health partners and schools. I encourage all local authorities to adopt it.

NHS England is supporting the identification of young carers through GP guidance and improved data sharing. It is also leading a cross-Government project, co-produced with young carers and voluntary, community and social enterprise partners, to support identification, strengthen support pathways and join up services across education, health and local organisations. Engagement workshops have already helped to shape the next young carers summit, in early 2026.

Our 10-year plan sets out strong foundations for change, and we are now fully focused on delivery. Baroness Casey’s independent commission will shape the cross-party and national consensus around longer-term reforms, including proposals for a national care service. As noted by the shadow Secretary of State, the right hon. Member for Daventry (Stuart Andrew), however, supporting unpaid carers requires commitment across Government. That is why I chair a ministerial working group, working closely with my counterparts at the DWP, the DBT and the Department for Education, to ensure that our policies reflect the realities of caring.

My hon. Friend the Member for Shipley and others asked about the Government’s response to the Sayce review. I can confirm that we will publish that response this year and I am receiving regular updates from DWP colleagues on that matter. Additionally, our research arm, the National Institute for Health and Care Research, is evaluating local carer support programmes to identify what works and where improvements are needed.

As we look to the future, prevention must sit at the heart of our approach. Too many carers reach crisis point before they receive help. That not only places huge strain on families, but leads to avoidable pressure on hospitals, primary care and social services. By intervening earlier—through better identification in primary care, strengthened community networks and improved signposting —we can ensure that carers receive the right support before challenges escalate.

Children with Serious Neurological Conditions

Daniel Francis Excerpts

Thursday 20th November 2025 Commons Chamber

[James Asser (West Ham and Beckton) (Lab)]

I am pleased to have secured this Adjournment debate on the support available to children—and, crucially, their families —living with serious neurological conditions. I applied for this debate after hearing the moving testimony of my constituent, Shelina, a mother who, like so many parents in similar circumstances, never expected to find herself navigating the complex and overwhelming world that confronted her when her daughter Tafida fell seriously ill.

Following Tafida’s diagnosis, Shelina not only became an advocate for her own child, but went on to support others facing similar paths. She founded the Tafida Raqeeb Foundation, a charity dedicated to helping families understand treatment options, access specialist knowledge and feel supported at a time when many can feel at their most isolated. The foundation now supports families both here and abroad, and the insights it has gathered are invaluable in helping to shape thoughtful and compassionate reform.

Shelina’s story, sadly, is not unique. Each year, thousands of children in the UK are diagnosed with life-limiting neurological conditions.

[Daniel Francis (Bexleyheath and Crayford) (Lab)]

I thank my hon. Friend for securing the debate. Today, on Carers Rights Day, will my hon. Friend join me, as the parent of a child with a neurological condition, in paying tribute to all carers and charities for their work in supporting families like the family in his constituency?

[James Asser]

I am very happy to join my hon. Friend in that. I certainly know, and I think the House knows, his expertise in this area and the knowledge he brings to the House. That is something I will touch on further in a little while.

Some conditions present at birth and others emerge unexpectedly in early childhood. What unites the families is not only the complexity of the diagnosis, but the emotional, financial and practical challenges that follow. When faced with these circumstances, support is not an optional extra; it is the difference between families coping or reaching breaking point. Today, I want to focus on areas where the Government can continue to make a tangible difference, while also reflecting on several principles identified by families and organisations working closely in this space.

The first is access to high-quality information and specialist expertise. In the early weeks and months after a child’s diagnosis, many parents simply do not know where to turn. Conditions may be so rare that even highly experienced clinicians have encountered only a few cases. Understandably, families seek second opinions, sometimes internationally, in their search for clarity and reassurance. That is why proposals for more consistent access to second opinions, including clarity on how families can request them and where they may come from, are so important. Ensuring that such opinions are available promptly and from appropriately qualified clinicians would help prevent misunderstandings and reduce distress at an already emotional time. Similarly, early involvement of mediation and clinical ethics support can help families and clinicians work through complex decisions collaboratively, rather than feeling pushed towards formal disputes. When available at the right moment, these mechanisms can preserve trust and keep conversations centred on the child’s best interests.

Families have also highlighted the importance of having clear and safe hospital transfer options. Where another suitably qualified hospital, whether in the UK or abroad, is willing to accept a child, and where the clinical risks are manageable, families understandably value the reassurance that such a transfer could be facilitated. Greater clarity on how transfer decisions are made would help families feel respected as partners in their child’s care. I would be grateful if the Minister outlined, when she replies, what further steps might be taken to strengthen these early support mechanisms and to ensure that families across the country have timely, consistent access to the specialist guidance they need.

The second area where the Government can make a difference is in emotional and practical support for families. Caring for a child with a serious neurological condition frequently requires round-the-clock care. Parents become experts in medical equipment, emergency responses, symptom patterns and complex medication schedules. This can take an enormous emotional toll. Consistent access to counselling, respite breaks, community nursing and psychological support can make an extraordinary difference. However, we know that this provision can vary. Some families receive exemplary support, while others find themselves waiting months or navigating multiple agencies before help arrives. Strengthening those forms of support so that they are reliable, accessible and sensitive to the pressures that families face would greatly reduce the emotional and financial burden that parents often shoulder.

The third area is ensuring that public services are co-ordinated, compassionate and connected. Many parents describe the system as fragmented, not through lack of dedication from professionals but because structures do not always align. Families may find themselves repeating their child’s history multiple times, facing delays in equipment provision, or juggling unco-ordinated appointments. For children with complex neurological needs, health, education and social care are deeply interconnected. A more joined-up approach can relieve pressure and help ensure children receive the right support at the right moment.

--- Later in debate ---

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

I congratulate my hon. Friend the Member for West Ham and Beckton (James Asser) on securing this important debate and acknowledge the journey of his constituent Shelina Begum and the work she has done on behalf of her daughter, Tafida Raqeeb, with the establishment of the Tafida Raqeeb Foundation and all the work it does.

I thank my hon. Friend the Member for Bexleyheath and Crayford (Daniel Francis) for his contribution. His tireless work raising issues around supporting and caring for children with neurological issues is well known in this House. My hon. Friend the Member for Leeds South West and Morley (Mark Sewards) raised the issue of access to EHCPs—which are provided through local authorities—which continues to need work, and my hon. Friend the Member for Newcastle-under-Lyme (Adam Jogee) highlighted the need for joined-up care and services.

I am grateful for the opportunity to speak on a subject that touches on the lives of thousands of families across the country. There are hundreds of serious neuro- logical conditions that affect children, ranging from epilepsy and cerebral palsy to rare, genetic and degenerative disorders and acquired brain injury. I will speak on the common themes that unite people’s experiences: the need for timely diagnosis, integrated care and comprehensive support for every child and family, regardless of the specific condition they face.

Living with a serious neurological condition is a life-altering reality for children and their families. Whether congenital, acquired or progressive, these conditions often bring profound physical limitations, developmental delays and complex care needs. Families face relentless hospital visits, financial strain and the emotional toll of uncertainty, all while navigating fragmented health, education and social care systems.

The Government recognise these challenges and are committed to improving access to care, reducing inequalities and providing holistic support through health, education and social care systems. Our 10-year health plan will transform care for children with serious neurological conditions by delivering integrated, community-based services that put families at the centre and by prioritising early identification and intervention, ensuring that children receive timely diagnoses and treatment to prevent complications. Through neighbourhood health centres, multidisciplinary teams—including paediatric neurologists, therapists, mental health professionals and social workers—will provide wraparound support that meets medical, emotional and practical needs. Digital tools will empower parents to manage appointments and access records as easily as they bank online. This is about creating a system that works for families, not against them.

Through NHS England’s neurology transformation programme, we are creating pathways that wrap around families. The national bundle of care for children and young people with epilepsy sets clear standards for paediatric epilepsy care. For cerebral palsy, new commissioning frameworks ensure early intervention and co-ordinated services. Specialised paediatric neurosciences services provide access to life-changing procedures, such as epilepsy surgery and selective dorsal rhizotomy—that is a difficult word to say, Madam Deputy Speaker.

The Government are committed to improving lives for those affected by rare diseases, which includes some serious neurological conditions, under the UK rare diseases framework. This includes better co-ordination of care and improving access to specialist care, treatment and drugs. We also hear that children and families impacted by these conditions can struggle to access mental health support, which is just not right. To address that, the NHS genomics education programme has published new resources on rare diseases for healthcare professionals to help them with sensitive conversations. The 10-year health plan also sets out ambitious goals to transform mental health services across the country so that everyone living with a rare disease, along with their loved ones, can get the support they truly deserve.

We know that timely access to care is critical, yet many families face delays of months. That is unacceptable. That is why we have committed to meeting the NHS constitutional standard of patients seen within 18 weeks by March 2029. For the elective reform plan and the neurology transformation programme, we are expanding diagnostic capacity, rolling out virtual consultations and opening more community diagnostic centres seven days a week. Those steps will cut waiting lists and ensure that children and families get the care they need when they need it.

We know that neurological conditions often come with emotional and behavioural challenges. That is why mental health support is being embedded into paediatric neurology pathways. Initiatives such as the national bundle of care for children and young people with epilepsy include psychological support as a core component. We are also expanding mental health support teams in schools and launching young futures hubs to provide integrated local support. This holistic approach recognises that physical and mental health are inseparable.

For many families, the move from paediatric to adult services is a key time of uncertainty. We are addressing that through structured transition planning, as set out in the National Institute for Health and Care Excellence guidance and NHS England frameworks.

[Daniel Francis]

Transition is a key issue for families in this area. In the last Parliament, the all-party parliamentary group on cerebral palsy issued recommendations about health pathways for adults, because for a lot of these conditions, including cerebral palsy, there are not the same health frameworks for adults as there are for children. Will the Minister take that point away and look at how we can replicate some of the pathways that are there for children in the adult sector?

[Ashley Dalton]

I am more than happy to do that. All too often, we have seen that the transition is a really difficult time, and as he points out, where services are perhaps not as joined up and cohesive for adults as they are for children, that is hugely jarring—a huge problem for families to navigate. We are committed to making sure that transition plans start early, involve families and ensure that continuity of care. Our goal is to make the process smooth and supportive, not stressful and fragmented.

Health is only one part of the picture. Children with serious neurological conditions often have special educational needs and disabilities, and their success depends on a joined-up approach across sectors. That is why the SEND reforms that the Government are working on are so important. We are moving towards earlier intervention, stronger inclusion in mainstream education, and better collaboration between health, education and social care. These changes will ensure that support is needs-led rather than diagnosis-driven, with clear accountability across integrated care boards and schools. By embedding mental health provision, improving workforce expertise and planning smooth transitions into adulthood care, we aim to deliver consistent, high-quality support that helps children to thrive and restores confidence in the system.

Caring for a child with a serious neurological condition can place enormous financial strain on families. The welfare system is designed to provide a crucial lifeline, ensuring that no family is crushed by the additional, often substantial, costs associated with their child’s condition. The Government provide support through a range of benefits, including disability living allowance, carer’s allowance, personal health budgets and local authority support, including respite care and equipment provision. Financial support is not just about money; it is about giving families the stability and security they need to focus on what matters most—their child’s wellbeing.

Our commitment to children with serious neurological conditions reflects the core values of our society: compassion, fairness and the belief that every child deserves the chance to reach their full potential. By improving healthcare access and providing comprehensive support systems, we are building a more inclusive and resilient future for all. We will ensure that no child or family feels abandoned, and that compassion and co-ordination define the care that they receive.

Oral Answers to Questions

Daniel Francis Excerpts

Tuesday 22nd July 2025 Commons Chamber

[Wes Streeting]

When this Labour Government came to office, we promised 2 million more appointments, but we have actually delivered 4.5 million. We have cut NHS waiting lists month after month, and they are now at their lowest level in two years. Of course there is more to do. I regret that we had to delay Watford general hospital; the previous Government left a plan that was not credible and had no available funding. We are cleaning up their mess, and the hon. Member has a cheek to complain about it.

[Daniel Francis (Bexleyheath and Crayford) (Lab)]

The report, “Barriers for adults with Cerebral Palsy on achieving full life participation”, published by the former all-party parliamentary group on cerebral palsy, highlighted the cliff-edge in support for those with cerebral palsy when they transition at the age of 18 and the need to end the separation of neuro and musculoskeletal knowledge within the NHS, given that cerebral palsy is a neuromusculoskeletal condition, and that those living with it need easy and ready access to both areas. I would therefore be grateful if I could understand—

[Mr Speaker]

Order. Let me help the hon. Gentleman. If you have a main question and I call you in topicals, you really need to shorten your question in order to let other Members in.

Oral Answers to Questions

Daniel Francis Excerpts

Tuesday 17th June 2025 Commons Chamber

[Wes Streeting]

I should just say for the record that it is thanks to my friends at the Treasury that we are able to do so much to invest in our health service. It is important to put that on record ahead of the Budget. The hon. Lady raises a really serious issue, and we are looking carefully at what we can do to ensure that we get great people into our health service and that they can look forward to a great career. We are not in the right place as a country now; we need to be in a better place. The 10-year plan will set out our ambitions on workforce and we will publish a new workforce plan later this year.

[Daniel Francis (Bexleyheath and Crayford) (Lab)]

T5. It is 16 months since the publication of the Hughes report, but those patients harmed by sodium valproate continue to await the outcome on the redress that the Government will provide. Will the Secretary of State please provide an update on when they can expect an announcement on the redress that will be made available to them?

[The Minister for Secondary Care (Karin Smyth)]

I thank my hon. Friend for that important question. The Government are carefully considering the work of the patient safety commissioner and her report, which sets out the options for redress. This is a complex issue involving input from different Government Departments. We will provide a further update on the commissioner’s report soon.

Hughes Report: First Anniversary

Daniel Francis Excerpts

Thursday 27th March 2025 Westminster Hall

[Daniel Francis (Bexleyheath and Crayford) (Lab)]

It is a pleasure to serve under your chairship, Ms Furniss. I thank my hon. Friend the Member for Washington and Gateshead South (Mrs Hodgson) for securing this important debate.

I pay tribute to my constituents Paula and Gillian, who have experienced the impact of pelvic mesh. I raised Paula’s experience in a debate on 5 December, but not much has changed for her. She is still living with the devastation that pelvic mesh has caused to her life and wellbeing. As we have heard, Paula and Gillian are not alone in their experience. According to the Patient Safety Commissioner, the lower-end estimate suggests that 10,000 women have been harmed.

I pay tribute to all those who have campaigned for many years on the issue of sodium valproate. My good friend Teresa Pearce, the former MP for Erith and Thamesmead, worked very closely with many of the families over many years. She knows that the issue is close to my heart.

The Epilepsy Research Institute welcomed the Hughes report’s recognition of the vital role that research plays in understanding and mitigating the risks of anti-seizure medication. It continues to raise its key asks on how we can move forward with the report’s recommendations. The institute’s view is that Ministers need to provide a clear timeline for implementing the redress schemes and research funding that are recommended in the Hughes report. There is a need for dedicated, ringfenced funding for epilepsy research, particularly into the effects of anti-seizure medications taken during pregnancy.

My wife and daughter are both on sodium valproate. I know that sodium valproate did not affect my daughter, even though she has cerebral palsy from a brain injury at birth. However, I saw what happened to my wife: being taken off sodium valproate turned her life upside down. She went from being 12 years seizure-free to having to surrender her driving licence and not being able to work for some periods. I saw what it does to women in that situation, even though she had the correct advice. She eventually had to return to sodium valproate because of the number of seizures she was having and the impact it had on her life. I cannot imagine for a moment what the families present have gone through, but I know the impact that sodium valproate can have on women’s lives.

The Epilepsy Research Institute’s asks include:

“Ensuring that regulatory bodies act swiftly on safety concerns and that pregnant women with epilepsy have access to the best possible information and care. Working alongside experts and patient groups to ensure policies reflect the needs of those affected.”

I ask the Minister to address those recommendations.

We need to consider the people impacted by mesh and sodium valproate, as well as the wider impact. Sodium valproate continues to be prescribed, and we need a continuing review of how that affects women through their lives.

Terminally Ill Adults (End of Life) Bill (Twenty-fifth sitting)

Daniel Francis Excerpts

Tuesday 18th March 2025 Public Bill Committees

[Danny Kruger]

I was not suggesting that pentobarbital has a paralytic effect. Often in assisted dying, a paralytic is administered first as part of the cocktail of drugs. Subsequently, we discover that while the patient may have appeared entirely calm, sleeping peacefully, significant trauma may have been occurring beneath the surface.

I defer to the hon. Member’s knowledge, but my understanding from the scientific evidence I have read, and that medics have given to me, is that the extent to which people executed by lethal injection, by pentobarbital, have their lungs fill with fluid is peculiar—it is remarkable. They effectively drown beneath their peaceful exterior.

I intend to press amendment 464 to a vote, and I intend to support other amendments in this group. Although I support the aspiration of amendment 532 to make provision for what to do in the event of a procedure’s failure, I think it gives too much leeway to the Secretary of State, so I will oppose that amendment. I think the amendments that the hon. Member for York Central and I have tabled are preferable.

To make the obvious case for those amendments, and as I said in a previous debate, there are three choices in the event of failure. The first is to ignore the plain signs of distress, of things going wrong and of the patient suffering, which is clearly a failure of the doctor’s duty of care. The second is to expedite the death, which we have decided would be illegal under the Bill. Therefore, the only option is to revive the patient and escalate treatment, rather than actively or passively facilitate their death.

I hope Members will agree that, on the rare occasions when assisted suicide goes wrong, it is right that the patient is immediately revived and taken to hospital, or for the doctor to take whatever action is necessary. I am interested to understand why those amendments should not be supported.

[Daniel Francis (Bexleyheath and Crayford) (Lab)]

It is a pleasure to serve under your chairship, Sir Roger. I will speak to amendments 429 and 430 in my name. During oral evidence, we discussed the issues in subsections (9) and (10) of clause 18 and whether there is a contradiction. Subsection (9) states that the co-ordinating doctor

“must remain with the person”

and subsection (10) says:

“For the purposes of subsection (9), the coordinating doctor need not be in the same room as the person”.

We also discussed how that works in other jurisdictions. My amendment 429 would deal with that conflict. If the Bill were to become law, that conflict could be queried.

We also need to consider the possibility of complications. Clearly, if there are complications and the doctor is not in the same room, they would not necessarily be aware of those complications. I accept that, in some normal circumstances, doctors and medical professionals are not present in the room at the time of death; at other times, they are present. The amendment would mean that if something were to go wrong and someone was having a painful reaction to the drugs, the doctor would be there to see and help.

I do not understand what the Bill means when it says the doctor does not have to be in the same room. How far away would the doctor have to be? One subsection says the doctor has to remain with the person, and the following subsection says they do not have to be in the same room. If the Bill were to pass, we would be asking doctors to do something that is unprecedented. If the person were to suffer complications such as seizures or vomiting, or if they were exhibiting signs of distress, it appears that the doctor should be present. Members may think this could encroach on a patient’s privacy, but I think there is a discrepancy between the two subsections.

On amendment 430, I am conscious that my hon. Friend the Member for Ipswich has tabled a similar amendment. The intention of my amendment is to ensure there are regulations in responding to any unexpected complications that arise in relation to the administration of the approved substance, including when the procedure fails. I am conscious that if a doctor intervenes, they could end up in breach of the Suicide Act 1961. I therefore left the wording in that vein, as I understand that we will receive more information in due course.

Again, we received oral evidence from a number of people that what a doctor is meant to do in the event of unexpected complications is a matter of concern from both a legal and a medical perspective. We know from the evidence received from other jurisdictions that—I accept in a small minority of cases—there can be complications or the death can take much longer than expected. We also received evidence that, on rare occasions, death can take days.

Amendment 430 would show we have thought about those circumstances and provided for them by giving doctors a code of practice to refer to, rather than being left in the dark if a difficult situation arises at the time of death. We must not find ourselves in a circumstance in which doctors and patients are unprepared. It is important for us to think through, provide for and safeguard against all possible scenarios, however rare they might be. Of course, we would not want them to happen, but in some circumstances they might, and we would not want there to be a legal hole. Accepting the amendment would mean the Secretary of State has the opportunity to provide a code of practice for such circumstances. I hope hon. Members will be able to support the amendments in my name.

[Sarah Olney (Richmond Park) (LD)]

It is a pleasure to serve under your chairmanship, Sir Roger. I support amendment 429, tabled by the hon. Member for Bexleyheath and Crayford.

I do not understand how subsection (9) can require the doctor to remain with the person until they have self-administered and died, or until they have decided not to self-administer, while subsection (10) states that the doctor need not be in the same room. The Bill becomes even less coherent when we consider subsection (11), which requires the doctor to remove the substance immediately if the person decides not to self-administer—how can the doctor do so if they are not in the same room? Amendment 429 would make the scheme more coherent and I support it for that reason.

I accept that there are downsides to having the doctor present, especially before the administration, as people have a normal desire for privacy, but that needs to be balanced against the risk of someone else taking the substance or something going wrong in the process of self-administration. In Australia, there is no requirement for the doctor to be present, which has led to some cases of abuse. I understand why the Bill’s promoter has chosen not to go down the Australian route, but the position arrived at in subsection (10) lacks coherence and is unclear.

What does it mean to remain with the person without being in the same room? Does it mean being in the corridor just outside the room, but with the door open? What if it is closed? What if, as a result of the door being closed, the doctor is no longer within earshot? I am not the only one who is confused, as so are the doctors who will have to apply the legislation. For example, Dr Janet Menage, a retired GP, told us in written evidence—TIAB 182—that the provisions

“are mutually exclusive: doctor ‘must remain with the patient’ but ‘not in the same room’…This makes no sense. In any case, if the attending doctor is not in the same room there could potentially be an intervention by another person to the patient’s detriment. Or the patient may wish to cancel the suicide at the last moment and be unsupported in voicing that decision.”

With or without subsection (10), I would like to know whether the Minister has made an assessment of the workforce impact of such a requirement for the doctor to be present. As Dr Rebecca Jones told us:

“As the death may take many hours, I’m uncertain of the practicalities of this”.

--- Later in debate ---

[Dr Opher]

I will make a little progress and will then take my hon. Friend’s intervention.

On amendment 436, all medical practitioners are required under their code of practice to record any event they come across. I feel there should be better data and I agree with the hon. Member for East Wiltshire that we need to collect data. We are actually very good at doing that in the NHS. Under clauses 21 and 22 there are provisions for the Secretary of State to collect data on complications. I am therefore not sure that particular amendment tabled by my hon. Friend the Member for York Central is necessary. I think I have covered amendment 464, from the hon. Member for East Wiltshire.

On amendment 429, about the doctor being in the same room, I totally understand the anxieties presented by my hon. Friend the Member for Bexleyheath and Crayford, but I feel that whether the doctor is there should be the choice of the family and the patient. There may be some confusion about this, but to me, what the Bill implies—I am interested to hear the Government’s opinion—is that the doctor should deliver the medicine to the patient, check that the patient is willing to take the medicine as per amendment 462 from the hon. Member for East Wiltshire, give the medicine to the patient, and then ask the family whether they want them to be there or in the next room. They need to be available, but do they need to be in the same room? I think that should be the choice of the family.

[Daniel Francis]

I hear what my hon. Friend says, but the wording of clause 18(9) and (10) is ambiguous. Subsection (9) says that the co-ordinating doctor must remain with the person until “the person has died”, but subsection (10) says that the doctor

“need not be in the same room”.

I do not want to get into measuring metres, but where exactly is that place? Is it in the same room or is it in the same building? If it is in the same building, you cannot possibly be with the person until they die. Does my hon. Friend have comments on that?

[Dr Opher]

I am interested to hear what the Government say about the wording around that amendment and whether it is safe. I would defer to the Minister on that.

Amendment 430 from my hon. Friend the Member for Bexleyheath and Crayford, about a code of practice that must address complications and failures, is quite a strong amendment and I am willing to support it. If as doctors we have a code of practice about how we handle this type of thing, the amendment would potentially help, and perhaps answer some of the questions from my hon. Friend the Member for Banbury.

I do not believe that amendment 255 from my hon. Friend the Member for Filton and Bradley Stoke is necessary. I believe it should be dealt with under clause 21.

I believe that the very well put amendments 532 and 533 from my hon. Friend the Member for Ipswich could be covered by amendment 430.