Women’s Health Strategy

Danny Chambers Excerpts

Thursday 30th January 2025 Commons Chamber

[Madam Deputy Speaker]

I call the Liberal Democrat spokesperson.

[Dr Danny Chambers (Winchester) (LD)]

Nearly 600,000 women are waiting for treatment on gynaecology waiting lists in England; the longest waits are leading to preventable diseases progressing and it is one of the worst specialties for long waits. The Care Quality Commission has investigated and reported that 65% of maternity units are not as safe as they should be. That high number could almost be considered a public health crisis, and it has led to the highest amount of negligent payouts due to avoidable injury and even death. This absolutely needs to be addressed.

Many women, such as my partner Emma, have had to fight for years to get just a diagnosis for endometriosis, let alone any treatment, having been told for years that the symptoms are completely normal and do not need investigating. In the Government’s—

[Madam Deputy Speaker]

Order. I know I am being difficult on time limits, but the Liberal Democrat spokes- person should have one minute in an urgent question, which the hon. Gentleman has already far exceeded. Perhaps he will come up with a question in one sentence for the Minister.

[Dr Chambers]

Apologies, Madam Deputy Speaker. Yes, in one sentence: the Government’s manifesto rightly said that

“Never again will women’s health be neglected”.

Can we have assurances that we will not remove the ICB requirement to have women’s health hubs?

[Karin Smyth]

The hon. Gentleman is right to highlight those long waits. That is why we particularly highlighted gynaecology for attention in the elective reform plan. It is shocking that the last Government left 600,000 women on these lists, and moving back to making sure people wait no longer than 18 weeks will predominantly be helping those women.

The hon. Gentleman is also right to highlight the appalling maternity situation. The Secretary of State and my noble Friend Baroness Merron, who leads in this area, have met many families to discuss their experiences, and we know those experiences are unacceptable. We know there are big issues around staffing, and it is a priority to work with NHS England to make sure that we grow workforce capacity as quickly as possible so that we can be sure that those situations are safe. There are many debates in this place about the issue and we will continue to update the House.

Tobacco and Vapes Bill (Thirteenth sitting)

Danny Chambers Excerpts

Committee stage
Tuesday 28th January 2025 Public Bill Committees

[Andrew Gwynne]

We want to ensure that people who are smokers are not criminalised. Public space protection orders do potentially go down the criminal route. We want to ensure that that is not the case, which is why the Enfield scheme would of course be obsolete under the later provisions—which we are going to discuss today, hopefully—in relation to extending national outdoor smoke-free places.

[Dr Danny Chambers (Winchester) (LD)]

It is reassuring to hear the Minister talk about consulting before bringing in smoke-free places in specific public outdoor areas. Personally, as a non-smoker and someone who is very concerned about the public health impacts of passive smoking, I think we must also be mindful of the need for evidence-based interventions, and of the trade-offs. A good example is that of some fantastic pubs around Winchester and the Meon valley that have maybe two beer gardens, one to the side and one to the back. There would genuinely be no public health risk if smoking was permitted in one of the beer gardens and not the other.

The Liberal Democrats want reassurance on that. One of the reasons we tabled our amendment to clause 136, which is coming up, is simply to get assurances that the hospitality sector will not be impacted by any of these decisions, especially if the public health benefits are negligible.

[The Chair]

Order. We will discuss the specifics of the hon. Gentleman’s amendment when he moves it.

--- Later in debate ---

[The Chair]

No. Okay. That is fantastic. No problem. [Interruption.] I mean it is fantastic and we can hear you on another clause or amendment, just to be clear.

Amendment, by leave, withdrawn.

[Dr Chambers]

I beg to move amendment 4, in clause 136, page 77, line 8, leave out from “smoke-free” to the end of line 15 and insert—

“a place in England that is—

(a) an NHS property or hospital building,

(b) a school, college or higher education premises,

(c) a children’s play area or playground,

including outdoor public areas and frontages adjoining or surrounding such premises or designated areas.”.

This amendment would specify which places the Secretary of State has power to designate as additional smoke-free places in England on the face of the Bill.

[The Chair]

With this it will be convenient to discuss the following:

Amendment 95, in clause 136, page 77, line 12 at end insert—

“The Secretary of State may only make regulations designating external or open spaces as smoke-free in England outside—

(a) an NHS property or hospital building,

(b) a children’s playground, or

(c) a nursery, school, college or higher education premises.”.

This amendment restricts the Secretary of State to only being able to designate open or unenclosed spaces outside a hospital, children’s playground, school or nursery.

Amendment 94, in clause 136, page 77, line 21, at end insert—

“The Secretary of State may designate a place or description of place under this section only if in the Secretary of State's opinion there is a significant risk that, without a designation, persons present there would be exposed to significant quantities of smoke.”.

This amendment would re-instate existing section 4(3) in the Health Act 2006.

[Dr Chambers]

It is a pleasure to serve under your chairmanship, Mr Pritchard. To reiterate what I said before, the Liberal Democrats’ aim is to avoid unintended consequences that really damage the hospitality industry that we totally support. Amendment 4 would limit the places where we ban smoking or designate smoke-free to an NHS property or hospital building, a school, college or higher education premises, and a children’s playground or play area. We are not against public health measures; we are trying to ensure that we do not end up with provisions that are a bit over the top and damage hospitality businesses.

--- Later in debate ---

[Andrew Gwynne]

The point is that that is open to interpretation; that now runs counter to our ambition to have a smoke-free United Kingdom. We have put in place a much more flexible and workable measure. The measure from 2006 was right for 2006, but it is not right for 2027, when we hope to introduce the Bill. That is why we are looking to the measures in the Bill rather than the measures as they stood in 2006.

Lastly, I remind the shadow Minister that her amendments apply only to the clause in the Bill that relates to England. If we agreed to them, the powers in England would not be consistent with the powers in the rest of the devolved jurisdictions across the United Kingdom. This is a UK-wide Bill that provides a consistent legislative framework for the whole of the United Kingdom—all four nations—while allowing devolved nations to go further on subsequent regulations if they so wish. For these reasons, I ask hon. Members to withdraw their amendments.

[Dr Chambers]

I think that the official Opposition’s amendment is better, so I beg to ask leave to withdraw the amendment.

Amendment, by leave, withdrawn.

Amendment proposed: 95, in clause 136, page 77, line 12, at end insert—

“The Secretary of State may only make regulations designating external or open spaces as smoke-free in England outside—

(a) an NHS property or hospital building,

(b) a children’s playground, or

(c) a nursery, school, college or higher education premises.”.—(Dr Johnson.)

This amendment restricts the Secretary of State to only being able to designate open or unenclosed spaces outside a hospital, children’s playground, school or nursery.

Question put, That the amendment be made.

Speech and Language Therapy

Danny Chambers Excerpts

Monday 27th January 2025 Westminster Hall

[Dr Danny Chambers (Winchester) (LD)]

It is a pleasure to serve under your chairmanship, Mr Vickers. I thank Mikey for being here today and for all his hard work to get to the point of having a debate. It takes a lot of campaigning to get as many people involved in a petition as he has done, and that is a fantastic tribute to him.

I also thank the hon. Member for Lichfield (Dave Robertson) for introducing the debate. I was struck by his comment that speech therapy is not just a treatment, but a lifeline. That was certainly brought home to me recently. In Winchester last year, I visited an aphasia support group. Its members meet every couple of weeks and they all have speech issues caused by various types of brain damage, which could be caused by a brain injury, a stroke, a brain tumour or dementia. They told me that aphasia affects about 350,000 people in the UK. Jez Hodgkinson, who is part of the group, said:

“Learning to live with aphasia takes hard work, luck and lots of support—and this isn’t helped by the lack of knowledge of the condition. I’d never actually heard of aphasia until I had a stroke so hence it’s so important to share our stories both inside the group and with the wider public—including those with a voice in parliament.”

I also have personal experience of living with my father who had a series of mini-strokes and then dementia, and really struggled to communicate. He knew what words he wanted to say but he could not reach for them. It made communication difficult, and especially did not help a very independent farmer who had quite a hot temper at the best of times.

All people who have difficulty communicating, whether it is the result of a hearing impairment, special educational needs or conditions such as strokes and Parkinson’s, have the right to participate in society fully and independently. Too often, those rights are not fully recognised. Everyone has talked about how fundamental it is for us to be able to communicate, because we are a social species; we function because we can communicate. Even with my veterinary background, I understand how fundamental that need is. Puppies communicate primarily by body language; when they have had their ears cut off or their tails docked, they lose that ability to communicate and cannot socialise—they get psychological issues or behavioural problems that last for their entire lives. And the issue is so much more important for humans who need to communicate with friends and family, access services and interact with strangers on a regular basis to be able to work and get an education. Everyone deserves independence and the opportunity to flourish, with them and their families supported so that they can express themselves and communicate with ease in the most comfortable way for them.

Speech and language therapy can make a life-changing difference to the people it supports. It is a vital and overstretched service. In recent years, demand has risen at a faster rate than the number of therapists or the support they can offer. That desperately needs to be addressed. By improving outcomes, speech and language therapy can help to deliver better care, and actually save money for other parts of the NHS. We heard about supporting people who are unable to swallow properly; that can have a significant impact on reducing repeat chest infections. The hon. Member for Leicester South (Shockat Adam) mentioned how every £1 spent on speech therapy can save £2.30 of NHS costs. When people ask how we can afford to do this, we have to ask, “How can we afford not to do this?”

Children and adults are waiting far too long for the speech and language therapy they need. As the hon. Member for Lichfield has already said, it is a postcode lottery; there are huge differences in outcomes depending on where someone lives. Helping people to swallow, eat and communicate is an essential service, and everyone should be able to expect that support if and when they need it.

We, the Liberal Democrats, are pressing for the NHS 10-year plan to address specifically the inadequate access to these speech and language therapies, and how that will be improved. We want the Government to develop a workforce strategy to end the chronic shortage of speech and language therapists, so that everyone can get the support that they need.

As a slight aside, but on a related note, we have also long campaigned for more support for those communicating through British Sign Language. We have campaigned for it to have equal official status to the UK’s other languages, and we are campaigning for free access to sign language lessons for parents of deaf children.

I visited St Peter’s primary school in Winchester recently. The headteacher was discussing how, since the covid pandemic, they had noticed a sharp rise in pupils struggling to communicate, as their speech and language had not developed as quickly as it did before the pandemic. We need to remember that it is not just people’s educational needs that are affected—both by covid and by speech and language challenges—but their entire social development and friendship groups as well.

We are really pleased that this issue has been highlighted, and that we have had this debate today. I urge the Minister to push forward on this issue as fast as possible.

A&E Services: Solihull Borough

Danny Chambers Excerpts

Monday 27th January 2025 Commons Chamber

[Saqib Bhatti]

I cannot disagree with the hon. Gentleman. He makes a really valid point. Of course, it is about not just the travel time, but the time that is spent there. As I will come on to say, there is discussion about the A&E at Heartlands hospital, which has similar issues.

[Dr Danny Chambers (Winchester) (LD)]

On the point about time spent waiting in A&E, one issue we have found in Winchester is that a significant proportion of the caseload consists of people with mental health issues—sometimes suffering a mental health crisis. Many of them are already on a waiting list, but some mental health waiting lists are hitting 18 months or two years from the point of referral to the necessary specialist treatment. That is putting a huge amount of pressure on our A&E departments, as it takes a huge amount of resources to deal with mental health crises. Does the hon. Gentleman agree that investing heavily in mental health services will also help to reduce A&E waiting times?

[Saqib Bhatti]

Of course, investment will make a big difference. That is why I think integrated care boards play an important role, because there is accountability all the way up to the Minister. It is also about how resources are distributed locally for the needs of the community.

I spoke about the journey to Heartlands hospital. At any given time, it can take 40 minutes, and it quite regularly takes more than an hour. In a situation where every minute matters, I am afraid that is just not good enough for my constituents. It could quite literally be a matter of life or death.

Solihull borough has a population of approximately 216,000 people, and that is set only to grow.

Tobacco and Vapes Bill (Twelfth sitting)

Danny Chambers Excerpts

Committee stage
Thursday 23rd January 2025 Public Bill Committees

[Dr Danny Chambers (Winchester) (LD)]

To reinforce the point that athletes may be uncomfortable wearing that type of branding, they are not only role models for children, but the epitome of health, fitness and what the human body can achieve. It seems outrageous that they should be advertising harmful products.

[Andrew Gwynne]

Well, some of them are—the way Man City have been playing this season, I am not quite sure. Anyway, we will get back on to the Bill as quickly as possible.

The ban will apply to agreements entered into after the clause comes into force, two months after Royal Assent. It will be an offence if a contribution is made from either party after the specified date, which will be set out in future regulations. The ban will apply to any agreements entered into after that date, and will therefore not apply to existing contracts. The reason for the two-month period is to provide businesses with advance warning and to prevent them from entering into new agreements.

The hon. Member for South Northamptonshire asked whether this could create a rush to get sponsorship deals in place within that two-month window. That is a fair question, but I think that is unlikely for a number of reasons. First, sponsorship deals are pretty tricky contracts and it tends to take more than two months to reach contractual agreement. Secondly, even if matters were expedited, most clubs already have their deals in place, and they would not replace something when they already have a contractual arrangement for something else. Were that unlikely scenario to play out, we would be looking at only a small number of cases anyway.

When drawing up the regulations, we will have to be careful to ensure that no new contract can be signed, and certainly not for the kind of time period that the shadow Minister set out. That would be really out of the spirit of this legislation and the Government might have to come back to tighten it up further.

Tobacco and Vapes Bill (Eleventh sitting)

Danny Chambers Excerpts

Committee stage
Thursday 23rd January 2025 Public Bill Committees

[Gregory Stafford]

The hon. Lady makes an interesting point. I will not labour my point any further, because I think I have made it; I am sure that the Minister can respond to it when we get there.

The only other thing I will mention is the online advertisements mentioned in a number of the clauses. Is the intention to do with the website displaying the advert, the person who has put forward the advert or the intermediary companies? Online, a lot of adverts are now tailored via cookies. When the Minister goes on to a website, the adverts that he sees are tailored to the things that he has been looking at. I could go on to exactly the same website at exactly the same time and receive a different set of advertisements based on my internet viewing preferences—[Laughter.] I do not know why my hon. Friend the Member for Windsor is laughing. I get a lot of weird stuff, mostly for hoof trimming videos—I am not sure what I typed in to get those. Maybe it is my rural seat. I do not know.

My point is that those advertisements are totally unconnected to the website that I am looking at, which essentially has no control over what adverts are being displayed, as far as I understand it. Because the internet is so complicated, what thoughts does the Minister have about the fact that essentially, the internet provider and the website may not have any knowledge of what adverts are being put on?

[Dr Danny Chambers (Winchester) (LD)]

As part of the solution, legislation must already be in place, because human and veterinary prescription-only drugs are not allowed to be advertised to the public, but they can be advertised to medical professionals. There must be legislation that prevents rogue companies from advertising in the UK products that they are not allowed to advertise to the general public, and I imagine that it should be incorporated into the Bill to address the problem that the hon. Gentleman talks about.

[Gregory Stafford]

Forgive me; I am not sure I fully understand the hon. Member’s point in relation to what I was just saying, but that is probably because I have not explained myself well enough, not because he has misunderstood it. I entirely agree that the advertising of tobacco and vape products should be banned, and I agree with the sentiment and the outline in the law. All I am saying is that when the Minister or the relevant authority seeks to prosecute somebody for this offence, there may be occasions, given the complexity of the internet these days, when people may not know that their website is hosting said adverts. I do not want to labour that point again, but I am sure the Minister can respond.

New Hospital Programme Review

Danny Chambers Excerpts

Monday 20th January 2025 Commons Chamber

[Madam Deputy Speaker (Judith Cummins)]

I call the Liberal Democrat spokesperson.

[Dr Danny Chambers (Winchester) (LD)]

In Hampshire and across the country in 2019 and 2024, Conservative MPs stood on the promise of delivering new hospitals, including one for Hampshire. However, it turned out that there was never any funding for that, and that those were just false promises to try to get votes. I have fought tirelessly to save and improve Winchester’s A&E and consultant-led maternity unit. With the announcement that construction of a proposed new hospital in Hampshire will not even start until between 2037 and 2039, we absolutely need to ensure that the current services are invested in and improved so that they remain fit for purpose.

Given that the new hospital programme is delayed, it is more urgent than ever to increase capacity by fixing social care, so that those who are well enough to leave hospital can be cared for in the community, thus freeing up beds immediately. We cannot endure both insufficient social care packages and crumbling hospitals. Given this delay to the new hospital programme, will the Secretary of State commit to prioritising more social care packages now, rather than waiting three years for a review to be complete?

Although the Health Secretary is not responsible for the state of the NHS or the state of the economy, which the Government inherited, the new hospital programme was seen as part of the solution to the crisis in the NHS, and people across the sector have warned that delaying the programme will only mean more treatments cancelled and more money wasted plugging holes in hospital buildings that are no longer fit for purpose. We are therefore concerned that one of the biggest announcements to affect the NHS over the next few years is coming out right now, during Donald Trump’s inauguration, because it will not get the media attention it deserves. Liberal Democrats therefore urge the Health Secretary to promise to release a full impact assessment on how the delays to the new hospital programme will affect patients and NHS staff.

[Wes Streeting]

I will take those points in turn. With enormous respect for the momentous democratic event taking place in Washington today, I do not think that the new President, last time I checked, had declared an interest in any of our hospital schemes. I am sure he will forgive us for getting on with the job of British government, even as the American handover takes place.

I committed some time ago to coming to the House in the new year. I have kept that promise and I dare say that the decisions that we are taking and setting out today will receive good coverage. I reassure the hon. Gentleman, and other Members across the House with an interest in particular schemes, that my hon. Friend the Minister for Secondary Care and officials from the programme team will be happy to meet as early as tomorrow to take questions on individual schemes.

The hon. Gentleman raises broader challenges for the NHS and social care pressures in our country. That is why the Chancellor prioritised investment in our NHS and social care services in the Budget, with £26 billion of additional funding for my Department of Health and Social Care. On social care specifically, we have taken a number of actions in our first six months: fair pay agreements for care professionals, the biggest expansion of the carer’s allowance since the 1970s and an uplift in funding for local authorities, including specific ringfenced funding for social care. We will be setting out further reforms throughout this year, as well as phase 1 of the Casey commission reporting next year for the duration for this Parliament.

Opposition Members cannot have it both ways. They cannot keep on welcoming the investment and opposing the means of raising it. If they do not support the Chancellor’s Budget, which is their democratic right, they have to say which services they would cut or which alternative taxes they would raise. Welcome to opposition, folks. We’ve been there. Enjoy the ride: you’ll be there for some time.

Finally, let me just say this to the Liberal Democrats, who have constructively raised a range of challenges. This is at the heart of the challenge facing this Government. The hon. Gentleman is right to mention the capital challenges facing the secondary care estate. The same is true of the primary care estate and of the community and mental health estates. As I have spelled out, every single one of my Cabinet colleagues also has significant capital pressures. That is the consequence of 14 years of under-investment in our public infrastructure and in our public services, which means that we are paying a hell of a lot more for the Conservatives’ failure than we would have if they had built on, rather than demolished, Labour’s record of the shortest waiting times and the highest patient satisfaction in history.

Tobacco and Vapes Bill (Sixth sitting)

Danny Chambers Excerpts

Committee stage
Tuesday 14th January 2025 Public Bill Committees

[Dr Johnson]

I thank my hon. Friend for his intervention. Last Tuesday, we heard in evidence from various medical sources, and both the Select Committee and our processor Bill Committee heard in evidence that nicotine is, of itself, harmful, and that the chemicals added to vapes are harmful. In some cases, they are extremely harmful. I will talk more about vaping chemicals later. Indeed, sometimes the products do not contain what they are expected to contain, and that can be worse still. I will return to that subject later, too.

Nicotine is highly addictive and can permanently affect the development of the adolescent brain. We have heard how the industry targets young people, and that is because the adolescent brain is particularly vulnerable. Nicotine can permanently affect its development. Nicotine also fulfils all the criteria for drug dependence. Giving it up is very difficult, and withdrawal symptoms can include cravings, irritability, anxiety, trouble concentrating, headaches and other mental symptoms. Symptoms associated with nicotine and dependence are often not recognised by novice smokers, particularly if they are young.

[Dr Danny Chambers (Winchester) (LD)]

On the subject of how nicotine affects the brain and brain development, one thing we have not really touched on—and we have touched on many physical health issues—is the incidence of smoking among people with mental health issues. One submission was from the Mental Health and Smoking Partnership, which said that 45% of people with a serious mental health issue smoke, and around 25% of people with clinical anxiety. It would stand to reason that the impact on a young person’s brain could also start to lead to serious mental health issues, as well as all the physical health and development issues.

[Dr Johnson]

The hon. Gentleman is right to raise the importance of managing nicotine dependence for those with mental health conditions. We know that smoking, in particular, is more likely to take place among people with mental health conditions or those who are in mental health in-patient units. I am sure we will go on to discuss the issue of vending machines.

Last May, in the previous Bill Committee, we heard evidence from the Mental Health Foundation about the myth that tobacco helps with anxiety, and how that myth needed busting. We also heard about the importance of giving extra support to people with mental health conditions to enable them to kick the habit of nicotine—whether that habit is smoking or vaping—because it will help both their physical and mental health. However, it can be more challenging for them to complete. I am grateful to the hon. Gentleman for raising that important issue.

Returning to clause 10, a study considering the effects in adolescents of nicotine dependence after the initiation of smoking cigarettes found that the symptoms of nicotine dependence can appear only a few days after initiation. Given that oral nicotine pouches contain similar or higher levels of nicotine, similar symptoms may appear following initiation of oral nicotine pouch use, which is why it is particularly important for children that we pass clause 10 and ensure that children are protected from these nicotine products.

Tobacco and Vapes Bill (Fifth sitting)

Danny Chambers Excerpts

Committee stage
Tuesday 14th January 2025 Public Bill Committees

[Andrew Gwynne]

That is precisely the point I was coming to. We will take the argument away because it is a reasonable argument, and we will perhaps consider returning to this issue on Report.

I know that the shadow Minister has every sympathy with the fact that cigarette papers are dangerous when used for the consumption of tobacco, which is what we want to bear down on. As I have said, there are powers in part 5 to restrict the flavours of cigarette papers, but we want to get the balance right so we will take the argument away and consider it.

[Dr Danny Chambers (Winchester) (LD)]

I am reticent to extend the discussion about cigarette papers; I was unaware it was possible to discuss something to such an extent. I am not legally trained, so I ask this for my own understanding as someone who is not a learned Member. If the exact same product was renamed and rebranded as model paper or musical instrument paper, would this law still apply to it?

[Andrew Gwynne]

That is a good question. Of course, if it was to be used for the consumption of tobacco, it would come within the scope of the Bill. We have to be clear that many of these products have dual uses, as we have heard. I am as guilty as anybody of making pipe-cleaner characters for my children and grandchildren—grandchild, rather, because I have only one so far.

We want to make sure that those who want to continue smoking are able to do so, but that obvious restrictions and boundaries are put in place regarding the accessibility of these products, so that no child born after 1 January 2009 will ever legally be sold them.

Tobacco and Vapes Bill (Third sitting)

Danny Chambers Excerpts

Committee stage
Thursday 9th January 2025 Public Bill Committees

[Dr Johnson]

Wisdom or age, but I shall be cautious not to answer too closely.

[Dr Danny Chambers (Winchester) (LD)]

I accept the view that having to provide ID will be inconvenient and frustrating for some people, but all the expert witnesses on Tuesday pointed out that many smokers do not wish the younger generation to continue smoking. I think that most of them would probably be of that view that the slight infringement of their civil liberties in having to carry ID is a small price to pay for the knowledge that they are preventing smoking from being taken up.

[Dr Johnson]

The hon. Gentleman is right that the measures have broad support. Certainly, the pollsters who have investigated people’s views of this legislation—that proposed by the previous Government and the legislation as it is now, with some tweaks to it—have found the public to be overwhelmingly positive. We legislate because we are elected by those people. On the basis of their opinions and given that policing in this country is done by consent—