Cross-border Healthcare

David Chadwick Excerpts

Tuesday 4th November 2025 Westminster Hall

[David Chadwick (Brecon, Radnor and Cwm Tawe) (LD)]

I beg to move,

That this House has considered cross-border healthcare.

It is an honour to serve under your chairmanship, Mr Dowd. Last year, hopes were raised that two Labour Governments working together would put an end to conflict between Cardiff Bay and Westminster, yet few issues trouble my constituents more than the daily reality of cross-border healthcare between England and Wales. Powys is a beautiful county, but it is also the largest in Wales, with no district general hospital of its own. Nearly 40% of the health board’s budget is spent commissioning services across the border in Herefordshire and Shropshire, because that is where the nearest hospitals are. When co-ordination between the Welsh and UK Government fails, it is Powys patients who feel it first and hardest.

[Rachel Gilmour (Tiverton and Minehead) (LD)]

My hon. Friend is making a point about the border between England and Wales, but I represent a constituent who lives in a spot equidistant between two hospitals in Exeter and Taunton. Only one hospital could provide the treatment she needed, but the consultant there recommended rehabilitation at a third hospital across the border in Tiverton. After a lengthy back and forth, she was allowed treatment on the grounds of extenuating circumstances. Will my hon. Friend join me in pressing for a clear, binding system to allow seamless cross-border referrals where clinically appropriate?

[David Chadwick]

My hon. Friend makes a valid point, and I am sure her constituents will be pleased to hear her make it. The 2018 cross-border statement of values and principles promised that no patient would face delay or disadvantage because of which side of the border they live on, but my constituents know that those principles are not being applied in practice.

The clearest recent example of what has gone wrong is the new waiting list policy introduced by Powys teaching health board this summer. From 1 July, the board instructed English hospitals treating Powys residents to deliberately and artificially extend their waiting times, bringing them into line with the longer averages elsewhere in Wales. Until now, Powys patients had been treated in hospitals, such as Hereford and Shrewsbury, in exactly the same way as English patients, but from this summer they have been asked to wait up to twice as long.

We are told that hospitals in Herefordshire and Shropshire are treating Welsh patients “too quickly” and that Powys’s budget does not allow for the current number of people being treated each year, so patients have to be spread out over more years. How appalling it is to say that a patient can be treated “too quickly”. Swift treatment should be an objective, not a problem.

Worse still, this supposed cost-cutting exercise may not save a penny, because both the Wye Valley NHS trust and the Shrewsbury and Telford hospital trust believe that it could cost Powys more, because they will have to bill Powys teaching health board for the administrative cost of running two parallel waiting list systems. That is before we consider the hidden costs: the human and financial price of patients deteriorating while they wait longer, needing emergency admissions, extended rehabilitation and, in some cases, never recovering the quality of life they once had.

My constituents are not just numbers on a spreadsheet; their lives are on hold. Those months are months of agony, of lost work, of isolation, and of watching opportunities and life slip away while waiting for operations that should already have happened. Agnes is a patient from Llandrindod with Parkinson’s disease. She has been told that she must wait another 52 weeks for a knee replacement after already waiting a full year. That means a total of two years waiting for surgery. The delay has made it increasingly difficult for her to stay active, even though regular exercise is vital to managing Parkinson’s symptoms. The prolonged wait is worsening her mobility and pain, and it is undermining her ability to live independently.

Hazel, from Builth Wells, is awaiting spinal surgery in Hereford. Her expected waiting time has doubled to 104 weeks. She has been unable to work during this period due to numbness in her legs and feet, and she now fears losing her job. Once financially independent, she now relies on family support—an experience she describes as “degrading and unfair”—through no fault of her own.

Kelly was diagnosed with serious spinal disc problems in September 2024. She was given a surgery date for December, then March, but both were cancelled. Even though her pre-operative assessment had been completed, she later discovered—on her own—that her operation had been postponed by at least another year under the new policy. This is despite her being classed as an urgent P3 case and being told that existing bookings would not be affected. The delay has left Kelly in constant pain, which has taken a serious toll on her mental health and has contributed to her losing her job.

Those stories are not isolated; they speak for hundreds of others who are being quietly told to wait, not because of capacity or clinical need but because of budgetary decisions. Behind every statistic is a person whose life is being diminished while they wait for care that should already have been delivered.

What makes this even worse is that patients are sometimes not being told that their treatment has been delayed. Many have found out only through news reports or by doing their own investigations. Labour Governments at both ends of the M4 talk about driving down waiting lists and getting people back into work, yet this policy, which Ministers could stop tomorrow, does the exact opposite. The health board and senior Welsh Labour politicians call it “fairness” that Powys residents should wait no less than anyone else in Wales. However, fairness and ambition should mean lifting standards everywhere, not dragging Powys down to the lowest common denominator.

It is not equality; it is equal punishment for the Welsh Government’s failure to fix the NHS after 25 years in power. The response from Ministers thus far, particularly in Cardiff Bay, has been nothing short of disgraceful. The Health Minister, Jeremy Miles, could not appear more uninterested if he tried—no action, no intervention and no urgency from the one man who has the power to stop the policy and to get people out of pain and back to their lives. Several constituents have told me that they have written personally to him and have received no response at all. That is despite the fact that it is his Government who are forcing Powys teaching health board to make significant cuts to its budget.

As for the First Minister—who, I remind the House, represents Powys in the Senedd, as well as being a Member of the House of Lords—she brushed off my constituents’ concerns, saying that she thinks it is just “smoke and mirrors”. I invite her to say that directly to Kelly, Agnes and Hazel, because months or even years of their lives have been stolen and spent living in pain.

The decision institutionalises inequality between Wales and England. If the waiting list policy exposes a failure of funding, the digital infrastructure of cross-border healthcare exposes a long-term failure of systems. Despite 25 years of devolution, we still have national health services across our four nations that cannot share data efficiently. Both NHS England and NHS Wales still operate separate digital systems that do not talk to each other. When a Powys GP refers a patient to Hereford or Shrewsbury, information often travels by post, fax or unsecured email. Discharge summaries arrive late or not at all. Test results are duplicated because clinicians cannot see each other’s records, wasting time and often causing distress for patients.

Even in emergencies, A&E doctors in England cannot automatically view a Welsh GP’s records, and vice versa. To paint the picture more vividly, one Powys resident told me that he was admitted to Shrewsbury hospital with a serious heart condition, yet staff could not access his medical records. Because it was a Sunday, they could not even reach his GP by phone.

That should not be happening in 2025. It puts lives at risk across our border regions. The lack of interoperability affects anyone moving between the four nations of the United Kingdom, as their health records tend not to move with them. The Welsh Affairs Committee has been calling for change since 2015, yet a decade later, nothing has happened. The Welsh Government alone do not have the funding to overhaul their systems, which is why we have called on Westminster to step in, as obviously this is a consequence of devolution. For a fraction of the cost of other Government digital projects, modernising NHS IT across the UK would directly improve patient safety, continuity of care and confidence in the system. Every week that remains unresolved, more patients are put at risk, which is a failure of politics, not just technology.

[Jamie Stone (Caithness, Sutherland and Easter Ross) (LD)]

I can bring a Scottish context to the subject. A doctor in my constituency had a cataract problem and was told that the waiting list was ages. In the end, because she knew how to do it, she found out about an operation that was available in the north of England. She paid for the travel and paid to go private. The point is that if the database that my hon. Friend is talking about could show patients where to look in other parts of the UK, saying, “This is on offer, if you are willing to travel”, it could make such a difference to health services across the four nations.

[David Chadwick]

My hon. Friend is right to say that these system failures are putting extra responsibility, extra stress and often extra cost on individuals, which is why the system needs to be improved. Beyond the funding and IT problems, our systemic weaknesses make cross-border care even harder. Many Powys residents are registered with GPs in England simply because of geography—they might be closer—while others just across the border stay with Welsh practices. GPs who want to work in both nations must register twice, fill out the same forms twice and follow two sets of rules, which wastes time and discourages flexibility.

A constituent of mine in mid-Wales with a rare artery condition needed ongoing treatment from Hereford hospital. Because the two NHS systems do not share results, they had to collect their own blood tests and email them to their consultant each month. Prescriptions issued in England were not approved in Wales, causing months of delay. That is the daily reality of an unco-ordinated system.

At the governance level, the 2018 cross-border statement of values and principles remains voluntary and unenforceable. Each Welsh health board negotiates its own arrangements with English trusts. There is no single tariff, no unified billing system and no consistent data reporting. Audit Wales has warned for years that this patchwork leaves patients in limbo, between two systems that both claim to care for them, but neither fully owns responsibility when things go wrong.

Those problems did not appear by accident. Powys residents do not mind which NHS logo is printed on their appointment letter; they care that their care arrives on time, that their doctors can speak to one another, and that they are treated fairly. The border should not be a barrier to treatment, data or fairness. I say to the Minister that although several of these issues fall within devolved areas, they are of direct concern to the UK Government because they are also directly influenced by NHS England and by decisions taken here in Westminster.

My asks are simple. First, convene a meeting with counterparts in the devolved nations to finally address these cross-border challenges, and invite border MPs to that discussion. Those of us who represent border communities see these failures at first hand and know where the solutions are needed. Secondly, provide the funding required to make NHS IT systems interoperable across the United Kingdom, so that clinicians can share patient information safely and instantly wherever care is delivered. Thirdly, work with devolved Governments to give the cross-border statement of values and principles legal force, turning it from a voluntary pledge into a real, accountable framework that protects people in border communities like Powys.

We owe it to the people of Powys, and to every border community, to end this quiet injustice and to build a system that treats them not as second-class citizens but as equals who are entitled to the same care, dignity and chance to live free from pain. Labour Governments at both ends of the M4 talk about driving down waiting lists and getting people back into work. However, this policy, which Ministers could stop tomorrow, does the exact opposite. I look forward to the Minister’s response and the contributions from other Members.

--- Later in debate ---

[The Minister for Secondary Care (Karin Smyth)]

It is a pleasure to serve under your chairmanship, Mr Dowd. I am grateful to the hon. Member for Brecon, Radnor and Cwm Tawe (David Chadwick) for securing this important debate. I knew that hon. Members from across the United Kingdom would come here for it, and so it has proved. There are no end of technicalities that devolution has brought us, but we respect devolution and difference while recognising that we are all citizens of the United Kingdom. On the initial point made by the hon. Member, I gently remind him that an extra £1.5 billion has been allocated by the Welsh Government to public services in Wales, to put Wales on a path back to growth, undoing the damage of the last 14 years. That money includes an extra £600 million for health and care, which was voted against by the Welsh Conservatives and by Plaid Cymru. That is the difference made by having a Labour Government at one end of the M4 and a Labour Senedd at the other. Let us hope that arrangement can continue into next year so that we can get on with resolving those issues for the people of Wales.

I am very proud of my Irish heritage, with family on both sides of the Irish border, and I represent a city just across the Severn from Wales, so I am no stranger to the issues that arise from sharing a border. I spent many years in the British-Irish Parliamentary Assembly and on the Public Administration and Constitutional Affairs Committee, looking at constitutional issues across the United Kingdom. As my hon. Friend the Member for North Northumberland (David Smith) said, given the reality of people’s lives across our borders, we need to be better at joining those dots, and—as my hon. Friend the Member for Carlisle (Ms Minns) said—at remembering those people who live at the edge of some people’s maps.

To assure everybody, with my hon. Friend the Member for Aberafan Maesteg (Stephen Kinnock) as the Minister for Care and with my hon. Friend the Member for Glasgow South West (Dr Ahmed) as the Minister for Health Innovation and Safety, on whose behalf I am speaking, we in the Department of Health and Social Care are well served by all voices in the United Kingdom. I reaffirm our commitment to ensuring that all patients on both sides of borders can access timely, high-quality care. Healthcare is devolved but patients cannot be left to navigate a fragmented system or face delays just because of where they live.

I assure hon. Members, in response to points made by the Opposition spokesperson, the hon. Member for East Grinstead and Uckfield (Mims Davies), that officials meet regularly. That co-operation is happening, and they will continue to meet. My colleagues and I also meet members of those Governments. However, I will come on to that at the end when discussing the requests for my colleague, the Minister for Health Innovation and Safety, to meet with hon. Members.

The spiritual home of the NHS is Tredegar. This Government will not leave anyone behind, not least patients in Welsh border communities who rely on services in England—the point of the debate. My hon. Friend the Member for Montgomeryshire and Glyndŵr (Steve Witherden) raised problems with data sharing and patient record transfer, confusing and inconsistent referral pathways and some of the disputes across borders. However, as we have heard, such disputes sometimes happen within countries and over more local borders. As we heard from the hon. Member for Berwickshire, Roxburgh and Selkirk (John Lamont), they happen internally as well, so let us not underestimate how hard it is to resolve such disputes.

Around 30,000 people who live in England have a GP in Wales, and vice versa. That is why the statement of values and principles for cross-border healthcare was published in 2018. That statement remains the foundation for our approach. It sets out clear expectations that patients living in defined border areas, whether they are registered with a GP in England or in Wales, should receive care without delay or administrative burden. Emergency care is available to all patients, regardless of residency or GP registration. We expect both integrated care boards in England and local health boards in Wales to consider the impact of commissioning decisions on cross-border communities.

The hon. Member for Brecon, Radnor and Cwm Tawe raised the issue of waiting times for residents in Powys who seek treatment in England. Waiting times on both sides of the border are falling. Whenever I appear in the media or speak in a debate, I hear people still saying, even to their television, “Well, where’s my appointment?” Nevertheless, it is the case that waiting times are falling, which is helped by the allocation of money from the Welsh Government to reduce waiting lists.

[David Chadwick]

Will the Minister give way?

[Karin Smyth]

I will get through all the points, if I can, because I know there are lots of issues to address.

As I was about to say, too many people are still waiting, but we are committed to working with the Welsh Government to keep the cross-border arrangements fair, transparent and patient-centred.

Patients also face challenges in accessing specialist services. NHS England commissions a number of these services on behalf of the devolved nations and we are willing to explore further contract arrangements with NHS Wales to improve access to them.

As we have heard this afternoon, travel to appointments can be a barrier. In England, patients referred for specialist NHS treatment may be eligible to claim a refund of reasonable travel costs under the healthcare travel costs scheme, and a similar scheme exists in Wales. I join my hon. Friend the Member for Shrewsbury (Julia Buckley) in welcoming the tremendous changes that we are seeing at Shrewsbury and Telford hospital, which are starting to benefit not only her constituents but people travelling from Wales. That is really good to see. It is a long way for people from Wales to travel, but we are still very pleased to see those changes being made.

The hon. Member for Brecon, Radnor and Cwm Tawe also raised the issue of digital interoperability. Again, I wish I could say that that was only a problem for hospitals on the border between England and Wales, but I am afraid that it is an issue for trusts across the country and across each country. It does not help that, after 14 years of under-investment, IT in the NHS lags behind IT in the private sector by at least a decade. That is why this Government are investing £10 billion into improving how patients access services through technology. My hon. Friend the Minister of State for Science, Innovation, Research and Nuclear, Lord Vallance, is currently giving the NHS the biggest digital makeover in its history as part of our 10-year plan.

I can also tell the hon. Member for Brecon, Radnor and Cwm Tawe that NHS England is working with NHS Wales to improve interoperability, especially through the shared care record and technical collaboration on the so-called fast healthcare interoperability resources, or FHIR for short, which allows systems from different manufacturers to exchange messages and data, regardless of the setting that care is delivered in. I commend my hon. Friend the Member for Montgomeryshire and Glyndŵr on meeting leaders in the local cross-border system to understand that issue better. However, I gently say to him that we cannot get very far without the private sector working with us, not only across genomics and future healthcare but in IT and the way that we develop some of these services.

In October, the chief information officers across all four nations agreed to start looking at digital architecture and standards. They are exploring what we can do to improve how we use shared systems, common standards for better communication, which was raised by nearly everyone this afternoon, and the potential of future alignment. This work should lead to some progress in the short term, ahead of our long-term ambition of building a single patient record.

We are also making cross-border billing arrangements easier. Although the NHS payment scheme applies only to services in England, we sat down with the Welsh Government and agreed that Welsh commissioners will pay English tariff prices for Welsh patients who are treated in England. For English patients who are treated in Wales, local agreements are in place and we are open to making those agreements more efficient through the provision of clearer guidance.

As for our constructive co-operation with devolved Governments, the Government were elected on a manifesto to reset our relationship with the devolved Governments, and from day one that is what we have been doing. In that spirit, and without downplaying many of the issues that the hon. Member for Brecon, Radnor and Cwm Tawe and others, including the hon. Member for Ynys Môn (Llinos Medi), have raised today, I will highlight some of the positive examples of collaboration between our healthcare systems.

In many areas along the border, NHS staff in England and Wales are showing the rest of the UK how joined-up care is done. For example, patients in south Wales regularly access paediatric intensive care services in my home city of Bristol, and there are long-standing arrangements for cancer care, renal services and mental health support that cross the border seamlessly. Such partnerships are a testament to the professionalism and dedication of our NHS workforce, but cross-border healthcare is just one part of our partnership.

First, we have seen immense progress through the Interministerial Group for Health and Social Care, which met last September. Such meetings are really important. They bring together all four nations to find common ground on key priorities, such as elective recovery for those on waiting lists, innovation and health reform, and we look forward to continuing these discussions at the next meeting in December.

Secondly, all four nations are working to protect our kids through the Tobacco and Vapes Bill, which is UK-wide in scope but tailored to the specific needs of each nation. If the representative of the Opposition, the hon. Member for East Grinstead and Uckfield, could indeed talk to her colleagues in the House of Lords, who are battling very hard to get some of this legislation through, we could start making this generation the first smoke-free generation and support kids with this public health measure.

Thirdly, the Mental Health Bill that applies to England and Wales has been a masterclass in constructive engagement between compatriots who want to put their differences aside and get stuff done. May I echo the words of the hon. Member for Strangford (Jim Shannon) and add my support to the hon. Member for South Antrim (Robin Swann) in his efforts to ensure progress on that often forgotten part of the Good Friday/Belfast agreement that deals with healthcare? It is not easy. If they can do it over there, it is not beyond the rest of us to do it in Scotland, Wales and England. I was so grateful when my own mother was being cared for at Altnagelvin hospital during the covid crisis in 2021 to see the co-operation across the border and staff just getting on with treating the patients wherever they came from. We have a lot to learn from our colleagues in Northern Ireland.

In conclusion, I want to assure colleagues that the UK Government remain committed to supporting cross-border healthcare arrangements that work for patients. I will not offer hon. Members lots of individual meetings, but what I have heard today is that there is a lot of good work going on among officials. People here have issues to raise, including things from the past. I will take that up and share that more widely. I will also endeavour to write to the hon. Member for Strangford on the issue he raised to do with university students.

We are building bridges with Wales to work through our issues in the national interest, but I am afraid to say that although waiting lists are falling in England and Wales, in Scotland they are rising, which is a great shame. My friend Anas Sarwar, a former NHS dentist, is committed to resolving that. The NHS is in his DNA, given his own professional work. Getting waiting lists down will be his No. 1 priority, should Labour be successful in Scotland next year. It is a shame for Scottish people to see waiting lists rising while we make progress in England and Wales.

The greatest Welshman in history, Nye Bevan, founded our national health service. The hon. Member for Brecon, Radnor and Cwm Tawe might want to dispute that and give the title to Lloyd George—we will politely disagree on that one. But the serious point is that Bevan’s vision was for a health service where no one was left behind, not least in his own country of birth. Working in partnership, we will fix the NHS across the United Kingdom and make it fit for the future.

[David Chadwick]

First, NHS waiting lists in Wales are not falling; Wales has the highest waiting list in the United Kingdom. Nearly a third of our population are stuck on waiting lists. I wanted to intervene to make the Minister aware that I agree that extra funding is required to tackle the waiting list that we face in Wales. But when extra funding was announced for the Welsh NHS in June by the Welsh Government, it later transpired that none of that money could be spent on this issue because none of it could be spent on English commissioned services, which meant that the problem we are here today to discuss could not be solved. That is why it is so important to bake in a sort of border by design when designing national healthcare systems, because, as we have heard today from so many Members, it is often very typical and much easier for our constituents to cross borders to access their nearest hospital or their nearest GP practice; and it is important for our Union to facilitate that practice by making it easier and faster.

The hon. Member for Shrewsbury (Julia Buckley) talked of the progress being made in her constituency to bring down waiting times. Clearly, that is good news and shows what can be done—I know that my hon. Friend the Member for North Shropshire (Helen Morgan) has campaigned very hard for that. That is why it is so frustrating for my residents and constituents in Powys to know that access to faster healthcare is available just on the other side of the border, but their own Government and health board are preventing them accessing that treatment. Today we are calling on that to end.

What this debate has shown is that for too long, Powys residents have lived with a system that treats them as an afterthought. The waiting list policy introduced this summer has made that painfully clear. People are waiting longer not because of medical need or capacity, but because the funding simply is not there to pay for it. We have heard today that the problems run deeper than just funding alone. They are about systems that cannot talk to one another, Governments that will not work together, and patients who are left to navigate the gaps.

These are man-made problems, and they can be solved if there is political will. My message to Ministers in both Cardiff Bay and Westminster is simple: sit down together, bring in those of us who represent border areas, and fix this. Every week that passes without action means more people living in pain, more lives on hold and more families watching their loved ones deteriorate while they wait. This debate is about more than party politics; it is about people who simply want to be treated with the same respect and urgency as everyone else. We owe it to them to get this right. Diolch yn fawr.

Question put and agreed to.

Resolved,

That this House has considered cross-border healthcare.

Infant Feeding

David Chadwick Excerpts

Tuesday 1st July 2025 Commons Chamber

[Jess Brown-Fuller]

The hon. Gentleman highlights how important it is to have that community-based support in an area. Unfortunately, not every mother across the UK can say the same. There are areas where they have to travel up to an hour by car to attend that sort of group, and I will come on to that point.

When I had my daughter, five years after my son, the support that I had relied on had all but vanished. The Milk group was now being run out of, in effect, a broom cupboard at my local leisure centre, with no opportunity to socialise with other mums. Only six months later, the pandemic hit and my daughter’s health visitor reviews were done via Zoom, often without my daughter even on the screen. The local children and family centre in my constituency never reopened in the same way after the pandemic.

I was one of the lucky ones because I had already built my village around me five years earlier and I had a network of friends and family that I could call on. However, for those who have become new mothers in the last decade, that support has been all but vaporised, with community support groups patchy and often delivered by volunteers or those wonderful midwives in their time off.

It is essential to acknowledge and support those parents who cannot or choose not to breastfeed, to ensure that they feel empowered and confident in the decisions they make for their children’s nutrition and wellbeing. I am a proud advocate of every parent having choice, but that choice should be an informed one. Currently, it is not a level playing field, with formula companies preying on the vulnerability of parents.

The Competition and Markets Authority launched a market study into the formula industry in February 2024 and published its results earlier this year. The study provided a comprehensive, in-depth and up-to-date exploration of the infant formula market in the UK through a consultative process that has offered unique insights into the industry. A short extract from the CMA’s overview of its findings states:

“parents are often in vulnerable circumstances when they first make choices about whether and which infant formula to use, their brand choice is often based on incomplete or unclear information, and they are typically then reluctant to switch brands. Against this backdrop, manufacturers place significant emphasis on building their brands—including through their willingness to supply the NHS below cost—and differentiating their products to attract parents, rather than competing strongly on price. And price competition between retailers has typically been weak…Our analysis indicates that these features, in combination, are leading to poor outcomes for parents in terms of the choices they make and prices they pay for infant formula.”

In short, a vulnerable, extremely tired new parent is making choices on which formula to buy, but the claims on boxes of commercial infant formula are often unfounded. Parents have to choose between a £7 tin of formula and a £14 tin of formula, even though they are nutritionally equivalent. At a recent event, we heard the testimony of parents who had purchased the more expensive brand with the bold claims on its packaging, believing that they were doing the best for their child, only to then use fewer scoops when making a bottle to make the tin last longer. We have only to look at our supermarket shelves and see the formula milk locked in glass cabinets to understand that we have a crisis in families being able to feed their babies.

The cost of living challenges have spiralled into a food insecurity crisis, yet formula manufacturers increased prices by 24% in one year in 2023 and prices continue to rise well beyond inflation. Research shows that parents rarely switch brands once they have introduced a formula milk. This gives formula companies a clear incentive to offer their products to maternity wards at reduced prices, knowing that parents are likely to continue using the same brand when they go home. To address this, the CMA recommends standardised infant formula labelling in healthcare settings, which would eliminate this form of exploitative marketing.

Formula companies are also restricted from advertising newborn formula, but they get round this by advertising their follow-on, or stage 2, milk and making the packaging look exactly the same. The CMA recommendations ask for the Government to assess whether infant formula and follow-on milks are “clearly distinct”, then communicate that assessment to the manufacturers and enforcers. A Mintel report from 2016 reported that in 2015, for every baby born in the UK, companies spent a staggering £21 just on marketing follow-on formula. The CMA has made 11 recommendations to the Government, all of which aim to improve outcomes for parents. I am calling on the Government today to implement all 11 recommendations and finally to level the playing field for those parents who rely on formula to feed their babies.

This debate is timely, as last week I was delighted to host the World Breastfeeding Trends Initiative’s launch of its 2024 report here in Parliament. I would be delighted to give the Minister a copy if she does not already have one. The key takeaway from the report is that the UK has one of the lowest breastfeeding rates in the world. The report not only highlights the gaps in policy but creates a report card system for each of the four nations. I want to highlight a few things that were mentioned in the report.

Importantly, data—though its collection is uneven across the four nations—shows that the majority of mothers do set out to breastfeed. Despite this, by six to eight weeks, around 70% of babies in the UK receive some formula, and by six months only 1% of babies are exclusively breastfed.

[David Chadwick (Brecon, Radnor and Cwm Tawe) (LD)]

I commend my hon. Friend for the great work she is doing to improve the relationship between a mother and her infant—the most important relationship in the world. Will she join me in paying tribute to the midwives of Powys teaching health board, who have the largest county in Wales to cover? Will she also join me in paying tribute to Susan Grounds, who, after being a midwife for over 20 years, retired in March and was elected as a Lib Dem councillor in April?

[Jess Brown-Fuller]

My hon. Friend is absolutely right to say that these women have often been embedded in their communities for many years, helping women to raise their babies, and that they go on to do marvellous things in the community.

The majority of those who stop breastfeeding early wanted to breastfeed for longer, but did not receive the help they needed to resolve problems, all of which could be addressed with support from trained health workers, skilled peer supporters or specialist help in hospital, at home or in the community. The World Breastfeeding Trends Initiative report highlights the absence of national policy and governance in England. The devolved nations have pulled ahead on this front, with Scotland publishing a strategic framework, Wales having had an action plan since 2019 and Northern Ireland currently finalising its strategy. Support needs to be baked into policy and legislation because communities cannot do this alone. It being so early in this Parliament, the Government have all the opportunities to act. I was delighted to see today’s announcement of a review of the parental leave and pay system, and I hope that infant feeding will play into the considerations of better support for parents on maternity and paternity leave.

Health visitor teams have also dwindled over recent years, and an estimated 54,000 GP appointments could be saved every year if a professional feeding service was available in every community. Any strategy must be properly funded and integrated with current programmes across communities and healthcare settings, such as family hubs and Start for Life, which should themselves be expanded, particularly Start for Life, which is funded only in half of England’s local authorities. Some councils are choosing to make this an area to improve on, and I am pleased to see my local authority—West Sussex county council—include the early years as part of its health strategy for the next five years, even without the Start for Life funding, which it does not receive.

I would like to use an example of a mother who got in touch just last week to share her story. She had a traumatic birth with unexpected interventions. Her baby was quickly fed formula by hospital staff. The pump kit did not work in the hospital, and no meaningful help was available. She wants to feed her baby herself. She looked online when she got home to find help nearby, but there was nothing less than an hour away by car. She is struggling with which formula to use and does not understand the differences between them. She does not know other women with babies. She is feeling lost and isolated. Social media is full of conflicting advice, so she has gone out of the area for paid support, which she cannot afford on maternity pay, to help her try to regain a sense of reality. I am sure this lady’s story is the same for parents across the country.

If the reasons I have highlighted are not compelling enough, maybe the economic impact is. UK research back in 2012 on the costs of four diseases showed that even reaching moderate breastfeeding levels could save the NHS millions, and that the implementation of proven breastfeeding support systems would pay for itself within a year. For babies, breastfeeding strengthens the immune system and significantly reduces the risk of infections, obesity, asthma and long-term conditions, such as type 2 diabetes. For the mother, breastfeeding lowers the risk of breast and ovarian cancers and cardiovascular disease, and supports post-natal mental health.

I could say much more, but instead I will move to my asks of this Government. When will the Government make their decision on whether they will accept the 11 recommendations from the Competition and Markets Authority? Will the Minister consider following the devolved nations and introduce a comprehensive national infant feeding strategy to end the postcode lottery and provide support to all parents in their feeding journeys? Can we expect to see something about infant feeding in the upcoming NHS 10-year plan? Finally, there is little about breastfeeding in most health professionals training, but primary care has successfully integrated assisted roles into services such as pharmacists and social prescribers. Could the same model be extended to lactation consultants?

I would like to finish by thanking all those tireless activists and campaigners who have been fighting for all women to have support, guidance and trusted information when they begin motherhood. I will not risk trying to name them all as I will no doubt miss some, but a special thank you goes to the World Breastfeeding Trends Initiative steering group, First Steps Nutrition Trust and the former hon. Member for Glasgow Central who chaired the APPG before the general election.

National Cancer Plan

David Chadwick Excerpts

Tuesday 4th February 2025 Commons Chamber

[David Chadwick (Brecon, Radnor and Cwm Tawe) (LD)]

Many of my constituents have to travel to England to access cancer treatment. This presents many problems, one of which is a lack of data sharing between NHS England and NHS Wales. Will the Minister assure Welsh patients that if they are treated in an English hospital, their data will follow them home and that it will be accessible to NHS Wales?

[Andrew Gwynne]

The hon. Gentleman raises an important point. I also have regular meetings with ministerial colleagues in the Welsh Government, and this is an area of interest to both Governments. We need to make sure there is better sharing of data and information for patients from Wales, Scotland and Northern Ireland when accessing NHS services in England, so that there is joined-up, smarter use of the data held on patients by our respective NHS systems in order to get better outcomes. I assure the hon. Gentleman that I am already taking this up with ministerial colleagues across the devolved Administrations.