Community Audiology

Edward Leigh Excerpts

Thursday 18th December 2025 Westminster Hall

[Sir Edward Leigh (Gainsborough) (Con)]

I congratulate the hon. Member for Uxbridge and South Ruislip (Danny Beales) on moving this timely motion. I declare an interest: I am someone who suffers from hearing loss—it is good to be honest about these things. I recently found a picture of myself in uniform in the pouring rain, looking very miserable in Germany or on Salisbury plain, leaning against a 25-pounder. I can assure Members that those guns went off next to my ear on many occasions, and it is a very loud bang indeed.

I am not alone in suffering from some hearing loss. As the hon. Gentleman made clear, if we group together deafness, hearing loss and tinnitus, some 18 million people in the UK are affected by hearing conditions. Of those among us who are 55 or over, more than half suffer from hearing loss, as he said. Of those of us who are 70 and older—Mr Vickers, you and I were born just weeks apart—over 80% have some form of hearing loss. Some 2.4 million adults across Britain have hearing loss that is severe enough for them to struggle with conversational speech in some situations.

We all know that an ounce of prevention is worth a pound of cure. That is even more true in medicine than in any other walk of life. I am one of 2 million people in the UK who use a hearing aid. People should not be ashamed of using a hearing aid. People are not ashamed of wearing glasses—the Minister, Mr Vickers, and the distinguished consultant from Suffolk, the hon. Member for Bury St Edmunds and Stowmarket (Peter Prinsley), are all wearing glasses. It is a fact of life, and we should support people.

The British Academy of Audiology estimates that there are 6.7 million people who could benefit from a hearing aid but do not currently use one. The impact is not limited to wives, irritated that we have not heard them—although I must admit that if someone is known in the family to have hearing loss, it is very convenient. I am frequently ticked off by my wife because I am generally completely useless, and sometimes I pretend I have not heard her, so there are some benefits.

[The Minister for Care (Stephen Kinnock)]

The right hon. Gentleman is busted now.

[Sir Edward Leigh]

At the risk of giving in to economic reductionism, there is a significant impact on the economy. The Royal National Institute for Deaf People has estimated that untreated hearing loss costs the UK economy around £30 billion per year in lost productivity. Adults of working age with hearing loss have an employment rate of 65%, compared with 79% for those without any disabilities. Hearing loss has a social cost as well, as it has an impact on daily life and often increases isolation. Too often, we are embarrassed by hearing loss when we should be tackling it head on.

Another problem is a lack of audiologists. Unwisely, the Government have maintained the cap on the number of people allowed to study medicine—a restrictive measure that the doctors’ unions cling to regressively. The first priority should be the health of the public. We should allow anyone who meets the high standards that we expect of those studying medicine to do so.

Instead, the doctors’ unions ensure there is a lack of domestic supply to protect their bargaining position, but that means we are forced to make up the shortfall by importing doctors from other countries, often less developed ones. Many countries, not just fully developed ones, have high standards of medical education. It seems to me, and to many others, morally dubious for the NHS to pick the cream of doctors from any developing country and bring them here. Their diligence, training and expertise are much needed in their home countries. Meanwhile, we have excellent people here who cannot get into medical school—not because they are not good enough, but because the numbers are capped.

The shortfall in audiology is yet another reason why we need to address this issue. We have over 3,000 registered audiologists working in the UK, across the NHS, the private sector and educational settings. Figures from the British Academy of Audiology show that 48% of services have reported reduced staff, with an overall decline of 8% in the audiology workforce. Nearly one in 10 clinical posts in audiology are currently vacant, and 65% of audiology services have at least one vacancy. Those shortages exist across multiple salary bands, from junior to senior clinicians.

I am not blaming this Government, by the way; I am not being party political. This problem is the fault of successive Governments and Health Secretaries, who have failed to address it. Back in 2006, the Royal National Institute for Deaf People pointed out in evidence to the Health Committee:

“A recent NHS workforce project has suggested an additional 1,700 qualified audiologists are required to cope with current pressure. This could take between 10 and 15 years to realise under the current training programmes.”

That was back in 2006, so what has happened since then? It will not surprise the experienced observer that not enough action was taken. Hearing loss is one of the most prevalent long-term conditions in England, yet it is often treated as a low-priority service. If we treated it as a core part of prevention and independence, the rewards would be innumerable. As I said, an ounce of prevention is worth a pound of cure.

Demand for audiology services is rising, and the International Longevity Centre estimates that by 2031, one in five Britons will have hearing loss. There is at least increasing public awareness, but with an ageing population, the demand for audiology services is rising. That puts additional pressure on the workforce and on service capacity. Community audiology should not be a marginal service. It is a preventive intervention with clear implications for the wellbeing of individuals and families, economic productivity and long-term public spending. Delivering audiology close to home is ideal, particularly for older patients and those managing long-term conditions.

The current model relies heavily on local commissioning decisions. There is wide variation in access, as well as in the scope and quality of provision across England. Patients in some areas benefit from straightforward self-referral and timely community services, while others face longer waits or unnecessary hospital referrals. I suspect that the service in London and other big cities is better than that in our home county of Lincolnshire, Mr Vickers.

We need to improve the way we collect data on audiology services, so that we can evaluate their impact across the country. Good data will help us to focus on outcomes, as any reform should. National minimum service standards would provide clarity without imposing uniform delivery models. We should preserve local flexibility while ensuring that patients know what level of service they are entitled to expect. Community audiology should be integrated into broader prevention and healthy ageing strategies.

Hearing care supports people to remain economically active and socially connected for longer. That is immensely central to maintaining human dignity as we all get older. Early intervention reduces downstream costs in social care and mental health services. The social and economic impact is huge. There is much we can do now that will produce worthwhile results, so we need action from the Minister.

--- Later in debate ---

[Peter Prinsley (Bury St Edmunds and Stowmarket) (Lab)]

It is a pleasure to serve under your chairmanship, Mr Vickers. I thank my hon. Friend the Member for Uxbridge and South Ruislip (Danny Beales) for securing this interesting debate, and I declare a series of interests. I am an ear, nose and throat surgeon, so I have been interested in audiology for 40 years. In this place, I chair the deafness all-party parliamentary group. Until I came here, I was the chair of the Norfolk Deaf Association, which is also called Hear for Norfolk, and I will say a bit about that as we go on. I have worked overseas dealing with patients with hearing loss, and I have been a specialist ear surgeon for 30 years or so. Audiology has really been much of my life.

As many Members have already said, deafness is a hugely common problem and is often much neglected. The statistics that have been cited regarding the percentage of elderly people who begin to develop hearing loss are quite familiar to me. What happens is that couples age together, but they might not always appreciate that fact. There is the story of the man who decides to test his wife’s hearing. He comes up behind her and says, “Mavis?” There is no response, so he says, “Mavis”, then “Mavis!”. She turns around and says, “For the third time, what is it that you want?” It is very familiar to me that many elderly people have hearing loss.

As I think has already been said today, about 2 million people in the country use hearing aids. There are probably about 6 million people in the country who would benefit from a hearing aid and probably about another 2 million hearing aids that are in drawers; they have been distributed to people, but are simply not used. Some people have a lot of hearing aids. They come in and say, “I’ve got all these hearing aids. None of them are any use, doctor.”

The story of NHS hearing aids is that we started with great big cream-coloured plastic boxes with little plaited wires that led to earphones; some of us will remember children at school who had those. Then, of course, the so-called BE hearing aids came later. When I was a young ENT surgeon, I never knew what “BE” stood for. A few years later, somebody told me that it just stood for “behind the ear”. Those were analogue hearing aids and they were quite good. They were extremely inexpensive and were distributed in their millions in NHS hospitals, which is how we ran hearing aid services.

Then, about 25 years ago, digital hearing aids were invented. They were not immediately available in NHS hospital clinics, because they were a little more expensive, so they started to be distributed by private hearing aid providers that sprung up all over the place. Members will know that in many high streets there is an audiology service and in the window there will be one hearing aid in a little box on a felt cushion. Curiously, hardly anybody ever goes in and out of those services. The reason is that those companies do not need to sell many hearing aids to stay in business because of the difference in cost. The digital hearing aids provided by those private providers often cost in the thousands, so they need to sell a hearing aid only once or twice a week to stay in business. At first, those hearing aids were a bit better than the ones we could provide in the hospitals.

Some time later, we began to distribute digital hearing aids through the NHS, which was brilliant. People would come to me and ask, “Do you think I should get a private hearing aid?”, and I would say something like, “Well, you can get a private hearing aid, but it is a bit like a hi-fi.” Someone can go to Argos and get a hi-fi or they can go to Bang & Olufsen and get a hi-fi. There is a big difference in price and they do actually sound quite different. I would say to people, “The hearing aids that we can give you are like John Lewis hearing aids; they are pretty good, and they are good enough for most people. I don’t think you should go and spend £4,000 on two private hearing aids. You should have the hearing aids that I can give you for nothing in my NHS clinic, because most people will be very happy with that.”

That was the model we used until a particular Government came along—I cannot remember which one—and decided that we ought to have something called the “any qualified provider”, or AQP, system. Suddenly, all sorts of people could provide hearing aids willy-nilly. We had a different acronym for it: “any willing provider”. Anyone who wanted to provide hearing aids could do so because, as has been said, there was not a particularly close supervisory mechanism. I have a feeling that anybody could set themselves up as a hearing aid provider, if they wanted to. We had this completely variable system in which some people spent large amounts of money on hearing aids that they kept in a drawer, and some people received hearing aids for nothing from hospital services.

That was how we went on, until somebody mentioned earwax. As some people may remember, general practices used to remove earwax with large stainless steel syringes that had a spout on the end. Those procedures were done by nurses until about 2012 when it stopped being part of the GP contract. There was a problem with the syringe: the little stainless steel nozzle on its end could become a bit worn, so it would not be completely connected. As a result, when somebody pushed the syringe, the stainless steel nozzle could fly off into the ear. I have repaired numerous eardrums over the years that had been smashed by syringing, so that system was not completely without its problems. Of course, we had aural care nurses in hospitals looking after patients and coming to take out their earwax, or if a patient had undergone an ear operation, the nurse would have to clean out their mastoid cavities.

We then, however, began to see all sorts of community providers of earwax services, sometimes set up by people who had been nurses in ear clinics, and sometimes set up by somebody from another occupation—they could have been a Member of Parliament who decided that they were now going to do earwax removal. There was a fee to be gathered from this, and some people did fairly well from removing earwax, but the provision was of very variable quality.

I would like to talk about Hear for Norfolk, or the Norfolk Deaf Association, which I chaired for quite a few years before I came here. It is a community-based audiology service that employs qualified nurses who have previously worked in NHS hospitals, and they perform what we call aural care, which includes removing earwax. People can just turn up to have that done; if they are referred by their GP, it is free on the NHS as there is a contract, or they can pay £50. We have vans that go around the district into nursing homes and small villages to do that work.

We now have a contract for hearing aid provision from the NHS, meaning that our not-for-profit charity provides thousands of hearing aids and treats thousands of patients in a community-based setting. I think that such a model could be developed and rolled out around the country so we have community-based, county-wide, not-for-profit aural care services that provide hearing aids.

I am not confident about simply distributing the contracts for hearing aid provision to a whole lot of private providers—Specsavers is one but there are many others—because the quality of their services is variable, and there will always be an incentive to provide private hearing aids. If someone walks into a service, they will be told, “Well, you can have this NHS hearing aid, but you know what? You could have this private one.”

[Sir Edward Leigh]

The hon. Gentleman is giving an absolutely brilliant speech. It is such a pleasure to hear a Member of Parliament speaking from direct, personal experience. I want to emphasise one important point that might come out of this debate: a lot of people are paying a lot of money for private hearing aids, but I know from personal experience that, nowadays, NHS hearing aids are perfectly satisfactory.

[Peter Prinsley]

I could not agree more, given the number of people who have come to me with handfuls of hearing aids on which they have spent thousands of pounds, telling me that they are just not working—and there is no proper follow-up for many of those people.

The issue with a hearing aid is that it needs to be looked after: it has a mould, it has batteries and it needs cleaning, so there needs to be an arrangement for follow-up. That is the sort of thing that an organisation such as the Norfolk Deaf Association, or Hear for Norfolk, is able to provide—it knows that that needs to happen. We need to be cautious about the quality of community audiology provision. We must not think that just because we are distributing it to respected private providers such as Specsavers, we are necessarily doing the right thing.

It has rightly been said that there is no national lead for audiology. Audiology is in a pickle, and it would be brilliant to get a proper national lead for audiology in the Department of Health and Social Care. There are issues with shortages of audiologists, but when questionnaires ask which healthcare professionals—or even which professionals—have the happiest lives, audiologists come out right at the top. Audiology is a particularly lovely occupation because people come in deaf and you send them out hearing. You hardly ever make them worse; it is not like going to the dentist, where it hurts. There is really nothing not to like about doing audiology, and it is a very interesting career, so I would like us to think of ways of encouraging people into it.

There is a bit of a confusion between medical practitioners and audiologists. The right hon. Member for Gainsborough (Sir Edward Leigh) referred to the issues relating to how we recruit medical practitioners from overseas. I am not aware that we are recruiting large numbers of audiologists from overseas; I actually think that we are not, although we did have audiologists who came from the EU when we were members of it. We can train enough of our own audiologists, but we need to get on and organise it.

I could talk about this for the rest of the day but it will be Christmas soon, so I shall sit down. I thank my hon. Friend the Member for Uxbridge and South Ruislip again for securing this important debate.

--- Later in debate ---

[Dr Chambers]

I am honoured to have educated an ENT surgeon. Spaniels do have worse ear problems, given that there is a lack of airflow, and one thing that vets can get experienced at is taking a swab so that we are not using unnecessary antibiotics or inappropriate antibiotics. With a bit of experience, it is fairly easy to smell the difference between Malassezia yeast, pseudomonas bacterial infection or streptococcus intermedius—to anyone who thinks being a vet is glamorous, I say, “Spend a day sniffing ears to determine what type of microbes are down there, and it will change your mind.”

It is very interesting that many Members spoke today about the impact of hearing loss on dementia. We know that dementia is multifactorial—there is no single cause—but certainly my father had hearing loss for a long time, and he developed dementia. Hearing loss certainly affected his quality of life, dementia aside. He lost the confidence to go out to socialise and barely left the farm unless he had to. We are pretty sure that a significant factor in that was that he felt he could not hear what other people were saying. He could not perform business at the market as he used to, because markets are very noisy places.

The Father of the House touched on the fact that one in three adults have either deafness, tinnitus or some other type of hearing issue. What surprised me was that only 38% of people who suspect that they have hearing loss themselves have contacted a professional about it. I read that stat and was quite surprised, but I then realised that for years my partner Emma and other family members have often said, “Why do you have the TV so loud?”. I have also often noticed in a pub everyone else is talking, and I find it really hard to hear the conversation over any external noise, yet I have never gone along and had a hearing test. Quite clearly, I do not hear as well as everyone else in my vicinity, so I should probably get one. That could be a new year’s resolution for me—to go and work out whether I actually have some kind of hearing issues as well.

I also note the weight given to the importance of community audiology, especially when such a high percentage of hearing loss is age-related. Those people have no need to go to a hospital to get the initial assessment, and community audiology could free up hospital time for children and other people with more acute hearing issues that need to be investigated. Audiology is one of the worst performing diagnostic services in the NHS for speed of assessment, with 40% of patients waiting more than six weeks simply for the initial assessment. That is one reason respondents to the British and Irish Hearing Instrument Manufacturers Association are advocating for open self-referral and expanded community clinics simply to minimise those delays. Delivering audiology services in the community costs 15 to 20% less than from a hospital, so it is an economically sensible model as well.

We often call for more community-based services for a whole variety of medical issues to keep costs down. It should be the default for most people with age-related hearing loss. We also urge the Government to consider trialling hearing tests as part of routine health checks for people over 70 and at-risk groups and to investigate how best to support everyone, from GP surgeries to high street pharmacists and opticians, to deliver free earwax removal. They are already being successfully run by some GP practices with positive impacts on health outcomes, and the cost can be small, especially where GPs co-ordinate to pay for a service that covers a large area.

[Sir Edward Leigh]

The hon. Gentleman makes a good point that we often hear about national screening programmes. It has just occurred to me that if everybody over the age of 70 was sent a text message through the NHS, summoning them into a screening programme, we could make huge advances in this area, particularly with things such as dementia—because, as he made clear, many people are either embarrassed by hearing loss, or not aware that they have it.

[Dr Chambers]

I completely agree. As we approach the busiest and loudest time of the year and every shop and pub has music playing, which is fun for most people, it is a good time to urge people to go for a hearing test in the new year, as I will be doing. We urge the Government to look at supporting community-based services so that everyone can get the hearing assessment they need. People need information to be able to act, and if someone does not know their hearing status, they will not know what other problems they will be dealing with in the future.

Budget Resolutions

Edward Leigh Excerpts

Tuesday 2nd December 2025 Commons Chamber

[James Murray]

As the hon. Gentleman knows, Madam Deputy Speaker, I give way to him week in, week out in this place, so I know pretty much what he is going to say. I do not have much time, so I am going to make some progress. [Interruption.] The Opposition are very loud at the moment, but time and again there is deafening silence when they are asked to defend their record in government. They simply refuse to own up and face up to the damage they caused to our economy by slashing investment.

Our decision not to slash investment and to reject uncontrolled borrowing means that we have had to take fair and necessary choices on tax. We are being up front that those choices will mean everyone contributes more, but, as we promised last year, we are keeping taxes on working people as low as possible. We are doing that by reforming the tax system, increasing the rate of tax on property income and on those with £2 million-plus homes, increasing tax rates for online gambling while removing bingo duty, and ensuring that HMRC has the right technology for a modern, effective tax system. We are making the changes that the Conservatives always ducked, and we are keeping taxes on working people as low as possible.

When it comes to growth, the Chancellor has already beaten the forecasts once, with improved growth reported this year. We are determined to beat the forecasts in future years too, because we will not let the previous Government’s record hold Britain back in the future. We are backing entrepreneurs with tax breaks for businesses to scale and stay in the UK. We have secured hundreds of billions of pounds of private investment, and we are making sure that investment goes to every region and nation of the UK, so that everyone across the country feels the benefits of growth.

Families across the country plan how much to spend week in, week out. They budget, save and economise to stay on top of their household finances. We will hold ourselves to the same, and higher, standards when it comes to taxpayers’ money. We will always make sure that the Government live within their means and make every penny count. We have already begun to improve the efficiency of Government, saving £14 billion a year by 2029 through greater use of AI and automation, as well as reducing unnecessary bureaucracy and duplication through the abolition of NHS England.

At last week’s Budget, we set out our plan to make a further £4.9 billion of efficiencies by 2031, beginning by getting rid of police and crime commissioners, cutting the cost of politics and selling Government assets that we no longer need. This means we can make sure that taxpayers’ money—

[Sir Edward Leigh (Gainsborough) (Con)]

Will the Minister give way?

[James Murray]

Oh, go on then.

[Sir Edward Leigh]

As a matter of interest, why did Labour Chancellor Hugh Dalton resign?

[James Murray]

The right hon. Gentleman may not have been here, but a colleague of his asked me that same question before. Unfortunately, I did not know the history of that story; I shall have to look it up on Wikipedia tonight to find out. [Laughter.] Clearly, it was before my time.

Our focus on spending public money wisely means we can make sure taxpayers’ money is spent on what matters: the NHS, schools, roads and railways, our armed forces and the police. This Budget means that we can continue to invest in the future. That investment in our future includes our decision to lift 450,000 children out of poverty. Those children should not go hungry simply because of the circumstances of their birth, and their life chances should not be written off before they have even got going.

We do not want to be a country where one in ten 15-year-olds goes hungry once a week because they cannot afford a meal. We want to be a country that recognises the profound damage that child poverty causes to us all. This Labour Government are taking the opportunity to change that. We do not want to be a country where £1 in every £10 of public money is spent on the interest on our national debt alone. That is why it is crucial that we cut borrowing and increase our fiscal headroom. That is the way to make sure that our country is less vulnerable to global shocks. We are determined to make our economy more resilient and ensure that taxpayers’ money is spent on taxpayers’ priorities.

There is an old saying that to govern is to choose. Politics is about making choices, yet the Conservatives are never keen to be judged by the choices they made when they were in government. They chose to cut investment in the foundations of our society, gutting our NHS, failing our schools and abandoning great swathes of the country and the next generation. They botched the Brexit deal, which stifled British trade and wrapped our businesses in red tape. They oversaw a covid recovery that left us lagging behind our neighbours while their donors and cronies pocketed millions of pounds of taxpayers’ money, and they were responsible for a mini-Budget that crashed our economy, did great damage to our global reputation and cost mortgage payers hundreds of pounds a month.

Our Government are willing to choose and ready to stand by our choices. I am proud of the choices that we have made in this Budget. Those are choices that protect the NHS and get waiting lists down; cut the cost of living and take £150 off energy bills; and reduce the national debt and bring down the cost of borrowing. We will invest in the infrastructure that will drive growth and productivity across the country. We will not leave the broken welfare system unchanged, and we will spend every penny of taxpayers’ money wisely. Those are fair choices, those are necessary choices, and those are the right choices for the future of our country.

Question put and agreed to.

Resolved,

That income tax is charged for the tax year 2026-27. And it is declared that it is expedient in the public interest that this Resolution should have statutory effect under the provisions of the Provisional Collection of Taxes Act 1968.

The Deputy Speaker put forthwith the Questions necessary to dispose of the motions made in the name of the Chancellor of the Exchequer (Standing Order No. 51(3)).

2. Income Tax (Main Rates)

Resolved,

That for the tax year 2026-27 the main rates of income tax are as follows—

(a) the basic rate is 20%,

(b) the higher rate is 40%, and

(c) the additional rate is 45%.

And it is declared that it is expedient in the public interest that this Resolution should have statutory effect under the provisions of the Provisional Collection of Taxes Act 1968.

3. Income tax (default and savings rates)

Resolved,

That—

(1) For the tax year 2026-27 the default rates of income tax are as follows—

(a) the default basic rate is 20%,

(b) the default higher rate is 40%, and

(c) the default additional rate is 45%.

(2) For the tax year 2026-27 the savings rates of income tax are as follows—

(a) the savings basic rate is 20%,

(b) the savings higher rate is 40%, and

(c) the savings additional rate is 45%.

And it is declared that it is expedient in the public interest that this Resolution should have statutory effect under the provisions of the Provisional Collection of Taxes Act 1968.

4. Income tax (dividend rates)

Question put,

That—

(1) In section 8 of the Income Tax Act 2007 (which provides, among other things, for the dividend ordinary rate and dividend upper rate)—

(a) in subsection (1) (the dividend ordinary rate), for “8.75%” substitute “10.75%”, and

(b) in subsection (2) (the dividend upper rate), for “33.75%” substitute “35.75%”.

(2) The amendments made by this Resolution have effect for the tax year 2026-27 and subsequent tax years.

And it is declared that it is expedient in the public interest that this Resolution should have statutory effect under the provisions of the Provisional Collection of Taxes Act 1968.

Women and Girls with Autism: Mental Health Support

Edward Leigh Excerpts

Tuesday 15th July 2025 Westminster Hall

[Sir Edward Leigh (in the Chair)]

I will call Jessica Toale to move the motion and then call the Minister to respond. I remind other Members that they may make a speech only with prior permission from the Member in charge of the debate and the Minister. As is the convention for 30-minute debates, there will not be an opportunity for the Member in charge to wind up.

[Jessica Toale (Bournemouth West) (Lab)]

I beg to move,

That this House has considered mental health support for women and girls with autism.

It is a pleasure to serve under your chairmanship, Sir Edward. I am grateful to have secured this debate today to discuss a matter of deep importance for one of my Bournemouth West constituents, Lindsey Bridges, as well as the thousands of families across the country affected by the failings in our mental health and autism care system. I rise today not only as a Member of Parliament, but as a voice for Lindsey and her daughter Lauren, known as Lolly to her friends and family, who is no longer here to speak for herself.

Lauren was just 16 when she died. She was a bright, compassionate young woman, and a straight A student who dreamed of being a doctor or a paediatric nurse. She was also autistic, and like many girls and young women with autism, she faced serious challenges getting the support she needed. In 2021, Lauren was detained under the Mental Health Act 1983. She was placed in an in-patient unit in Manchester six hours from her home in Bournemouth. As a result, her mental health deteriorated severely. In February 2022, Lauren went into cardiac arrest and died in that unit. Her mother Lindsey had begged for her to be moved closer to home, but her pleas went unheeded. This is not an isolated incident. Like too many others, she was let down by a system that promised care but failed in that promise.

Resident Doctors: Industrial Action

Edward Leigh Excerpts

Thursday 10th July 2025 Commons Chamber

[Wes Streeting]

I strongly agree with my hon. Friend—he is absolutely right. I am happy to stand corrected, but there is genuinely no historical precedent in the history of British trade unionism for a trade union to have successfully negotiated with the Government of the day a 28.9% increase for its members and then go out on strike. I think that undermines the BMA, and the more reasonable voices in the BMA with whom we continue to work constructively. It certainly undermines our NHS.

It also reinforces the grossly unfair caricature, which is often thrown at trade unions by the Conservatives, that they are all unreasonable, do not want to work with the Government of the day and are only interested in combat and agitation. In my experience, the vast majority of trade unions and trade unionists are interested in constructive engagement, striking good deals and moving forward the interests not just of their members, but of our whole country. I urge the BMA resident doctors committee to stand in that proud tradition of British trade unionism and in the proud traditions of the wider Labour movement, but I am afraid I do not see those traditions or behaviours reflected in the current approach of the BMA RDC.

[Sir Edward Leigh (Gainsborough) (Con)]

We can all argue about the past, but if it helps the Secretary of State, I think we should just say today that the whole House absolutely 100% supports him in his robust attitude. [Hon. Members: “Hear, hear.”] Of course we all love doctors, but the starting salary is not so very bad. They have a job—a very good job—for life, which most people do not have, and he could also mention that they have a much better career structure than most people. A far higher proportion of them get the top job—namely, as a consultant—and the consultant’s starting salary of £110,000 a year is not a bad whack.

[Wes Streeting]

First, I think that the right hon. Member’s opening statement and the response across the House underline to the BMA and the resident doctors committee that they do not have support across this House—from the left across to the right, with maybe one or two noises off—and that is not typical in my experience of being in this House for the last decade.

I think the career of resident doctors and the prospects they can look forward to, which the right hon. Member described, have worsened. That is one of the things that is at the heart of the dispute they have taken up with the previous Government and now with this one. Many of the things doctors used to be able to look forward to—guaranteed jobs and progression into consultant roles or general practice—have steadily eroded. We have far too much doctor unemployment and far too many specialty bottlenecks. We have what I think is a really unreasonable set of behaviours towards resident doctors in terms of placements, rotations and the ability to take time off work to attend weddings and other important life moments. The tragedy of the position we find ourselves in is that I recognise that and I want to address it. We can do that together without the need for strike action, and those are not reasons for strikes. Worse still, especially at a time when I am prioritising dealing with doctor unemployment, they are inflicting further costs on the NHS, patients and the taxpayer. That makes my freedom and flexibility and my resources to deal with those issues more limited—that is the tragedy of their tactics.

NHS 10-Year Plan

Edward Leigh Excerpts

Thursday 3rd July 2025 Commons Chamber

[Wes Streeting]

I thank my hon. Friend for that question. On whether people feel cautious optimism or quiet scepticism based on the experience that he describes, I have heard the same thing so many times. “I love AI, genomics and machine learning—yep, great. But can you just give me the basic technology that works?” Well, I can confirm that in 2026-27 we will make sure that we create a single log-on for staff. I am not holding my breath for that to be the front-page splash tomorrow, but that one thing, as well as saving loads of staff time, will give them confidence that genuine change is coming.

[Sir Edward Leigh (Gainsborough) (Con)]

As always, the Secretary of State makes a good fist of an impossible job, but I think we all know in our heart of hearts that this model, which takes 38% of public funding, is unsustainable in the long term. He mentions the Australian outback; I have been a voice in the wilderness, urging him to replicate the excellent Australian system, which is a mix of public and private. I will not do that again now, but may I ask him to at least look at Australia’s pharmaceutical benefits scheme, which ensures national procurement of medicines, so that people who have a medical card there get their medicines cheaper than people here?

[Wes Streeting]

I am always willing to search the world for ways to spend taxpayers’ money more effectively, and the right hon. Gentleman makes some good arguments on making sure that we get a good deal on medicines pricing, and on using the real procurement power of the single payer model—but therein lies the answer to the other part of his challenge. It is the single payer model, created in 1948, that makes the NHS ideally placed to get much better value in procurement, and to harness and lead the revolution in AI, machine learning, genomics and big data, in a way that many insurance-based systems struggle with. I assure him that if there were a better way of funding the NHS, I would have the political courage to make the argument, but we looked at other systems of funding and concluded that that is really not the problem. It is not the model of funding; it is the model of care, and that is what we are going to sort out.

Spending Review: Health and Social Care

Edward Leigh Excerpts

Thursday 12th June 2025 Commons Chamber

[Madam Deputy Speaker (Caroline Nokes)]

I call the Father of the House.

[Sir Edward Leigh (Gainsborough) (Con)]

Our spending on the NHS is now as much as the entire GDP of Portugal. We used to be a country with an NHS attached to it, but we are almost becoming an NHS with a country attached to it. Of course we would welcome this spending if we got the same outcomes that people get in civilised countries, like the Netherlands or Australia, but every time I mention fundamental reform, I am dismissed as wanting to bring in privatisation, so it is hardly worth raising that issue. Australia has an extremely successful pharmaceutical benefits scheme; I know that the Secretary of State for Health and Social Care went out there, and I have talked to Australian doctors about it. Will the Minister at least look at the successful outcomes, including some of the highest life expectancies in the world, that are being delivered in countries like Australia and the Netherlands, to see how we can deliver better outcomes? There is no point spending more money if people’s only right is to join the back of a queue.

[Karin Smyth]

I was expecting the right hon. Gentleman to talk about the funding model, and I am disappointed that he did not; it is something that he has talked about for many years. I do not know the details of the Australian model, but will ensure that he gets a proper answer. I am always happy, as is my right hon. Friend the Secretary the State, to look at models from across the world. We want to learn from the best, and we want to deliver the best in the NHS.

The Conservatives seem to have an obsession with input into the health service. It is true that the last Government put more money in, but it went into a leaky bucket and they got nothing out. This Government have taken a different approach. We are not just taking money from the Treasury, handing it out and then coming back for more. We are being very clear with providers and the system more generally. My right hon. Friend the Secretary of State is talking at the NHS Confederation conference this afternoon; we are working with them to ensure that we look not just at the inputs, but at what goes on in the system. We want to ensure value for taxpayers’ money in all our constituencies. There are outstanding examples of both financial and operational good practice across the country. We want to take the best to the rest, and make the best of every taxpayer pound.

Parkinson’s Awareness Month

Edward Leigh Excerpts

Thursday 1st May 2025 Commons Chamber

[Graeme Downie (Dunfermline and Dollar) (Lab)]

I beg to move,

That this House has considered Parkinson’s awareness month.

I extend my gratitude to the Backbench Business Committee for granting me this debate, and I thank hon. Members for attending, especially given that local elections are taking place across some parts of the country—I know the pull of the doorsteps is strong for politicians, as can be the power of persuasion from party bosses and headquarters.

I thank hon. Members for supporting my application for the debate, including my hon. Friends the Members for Aldershot (Alex Baker), for Newcastle-under-Lyme (Adam Jogee), for Redditch (Chris Bloore) and for Weston-super-Mare (Dan Aldridge), who are sadly unable to be here but who I wanted to mention. I also thank the current and former chairs of the all-party parliamentary group on Parkinson’s, my hon. Friend the Member for Newcastle upon Tyne East and Wallsend (Mary Glindon) and Baroness Gale.

I found it surprising and, to be honest, a little shocking that there has never been a full debate in this Chamber on Parkinson’s, so I hope to lend my voice to the approximately 225 people in my constituency, and to the community of some 153,000 people across the UK, who are navigating life with Parkinson’s, along with their loved ones and the dedicated professionals who support them. Yesterday concluded Parkinson’s Awareness Month, but we must commit to doing much more than simply raising awareness; we must act. Awareness is not progress, and people with Parkinson’s can no longer afford to wait.

Parkinson’s is the fastest-growing neurological condition in the world, ironically due mainly to people living longer lives and being diagnosed in their later years. It is sometimes said that people do not die from Parkinson’s, but the condition is life-limiting, complex and relentless. It does not discriminate by postcode, profession, political affiliation or any other characteristic. It strips away not only physical ability, but voice, independence and identity. It affects not only those diagnosed, but their loved ones in profound and lasting ways. There is no cure, no treatment to slow or halt progress and no respite, yet there is hope. There is a path to change, and today I call on the Government and this House to walk that path with the urgency and compassion that the Parkinson’s community deserves.

When I was preparing for this debate, I was given a copy of a poem called “A Jump Too Far”, by Bobbie Coelho, a Parkinson’s UK campaigner who was diagnosed in 2002. I will read it out to put it on the record, because I feel that these words are important:

“I wish you could jump into my shoes for just an hour or so

To know just how I feel, for then you would know

The truth about PD, as far as it goes



I wish you could jump into my shoes when my face freezes

You can’t understand when I talk (I know it’s not easy)



To hear me called a miserable cow

How I wish I could talk happily as they’re doing now

I wish you could jump into my shoes when I can’t move across the floor.

How I admire your movements, so easy and so free

I just wish it could also be me



I wish you could jump into my shoes when I can’t walk down the street

And get stares from the people that I meet



I wish you could jump into my shoes when I can’t do anything at all

And, reluctantly, have to watch my husband do it all



I wish you could jump into my shoes to see a future I don’t want to see

With no cure in sight and I know there never will be



You hear about cancer there’s adverts all around

But awareness of PD there’s not a sound



If you could jump into my shoes

You would see how frightening PD can be”.

[Sir Edward Leigh (Gainsborough) (Con)]

The hon. Gentleman must be congratulated on bringing forward this most important debate. The charity Parkinson’s UK organises voluntary support groups across the country—the nearest ones to Gainsborough are in Doncaster, Brigg and Scunthorpe. Does he think that the Government and local authorities can do more to encourage people to volunteer? Voluntary action across the country is quite uneven, so that might be one step forward.

[Graeme Downie]

The right hon. Gentleman has anticipated a point that I will make later, but I could not agree more about the need for volunteer support. Increasing the awareness of that volunteer support at the point of diagnosis is absolutely key, and I will refer to that later in my remarks. I thank him for the intervention.

I found Bobbie’s poem so moving because it reflects precisely what I heard in preparing for this debate, which I suspect colleagues in the Chamber also hear, from constituents living with Parkinson’s. I have been truly touched by the willingness and openness of those constituents, supported by Parkinson’s UK and Cure Parkinson’s, to share their experiences and stories. They do so in the hope that their voices combined will be greater than the sum of their parts, and that together they can improve the journey for those following in their footsteps.

The reality of living with Parkinson’s can be harsh. Although it is categorised as a movement disorder, it can affect movement, speech, swallowing and cognition. It can cause hallucinations, depression and pain. For many, their condition fluctuates unpredictably throughout the day, so what might seem like a good morning can spiral very deeply into a challenging afternoon, and too many people still wait too long for a diagnosis.

I draw the attention of the House to the Movers and Shakers, a group of people with Parkinson’s whose outstanding contribution and production have been a beacon of support for those with Parkinson’s. Some of them are in the Gallery and will be familiar to many in this House, including Gillian Lacey-Solymar, Rory Cellan-Jones, Mark Mardell and Sir Nicholas Mostyn. I thank them for being here today.

Tobacco and Vapes Bill

Edward Leigh Excerpts

Report stage
Wednesday 26th March 2025 Commons Chamber

[Dame Caroline Dinenage (Gosport) (Con)]

I think you may agree, Madam Deputy Speaker, that the longer we spend in this job, the more we realise that almost nothing is ever straightforward. Even the best intentions nearly always have unintended consequences, and there is absolutely no doubt that smoking, and specifically smoking tobacco, has done untold damage in my constituency and continues to do so. The health of my constituents has suffered as a result of the well-documented effects of regular smoking, and, moreover, smoking is a driver of social and economic inequality. Smokers earn, on average, 7% less than non-smokers. I could not believe that statistic when I first read it, but when I thought about it, I realised that it made complete sense. Those who take more time off work because of the inevitable ill-health effects of smoking, those who spend more of their disposable income on tobacco, and those who develop a dependency on a drug such as nicotine will obviously experience, over time, an impact on their earnings. Smoking is like an extra tax on the most disadvantaged communities, and I can see why this Government have maintained the last Government’s ambition to phase it out.

[Sir Edward Leigh (Gainsborough) (Con)]

I agree with everything that my hon. Friend is saying about smoking, but the elephant in this room is the dramatic decline in legal tobacco sales. According to HMRC, they have declined by 44% since 2021, while the number of smokers has declined by only 0.5%. We are reaching a stage at which we are taxing cigarettes so heavily that we are fuelling the black market and criminality, and we have to be aware that, as my hon. Friend says, these are unintended consequences.

[Dame Caroline Dinenage]

It is almost as if my right hon. Friend had read what is written next on my piece of paper. I was about to say that unfortunately we do not live in a perfect world, even our noblest ambitions have unintended consequences, and the Bill is not a silver bullet. There is already a thriving black market for tobacco in Gosport, and I am extremely concerned about the possibility that prohibition will exacerbate the problem. I am keen to hear from the Minister what action she plans to take, alongside the phased prohibition, to provide proper resources for the police forces in Hampshire and the rest of the country to ensure that the law is upheld, and what plan she has to take on the criminals who are already profiting, and who will only profit more as the age at which a person can legally buy tobacco rises.

Even without the Bill, smoking rates are falling across the UK as a result of a number of policy interventions, including education, smoking support and awareness campaigns. I recently visited a company in Gosport that provides innovative smoking cessation support. It is a vaping company, but it has a partnership with Mid and South Essex NHS foundation trust, which signposts smokers to its stores, where they are given continuing support to further enhance their shift away from tobacco. Hampshire county council has a similar Smokefree Hampshire scheme, which it says contributes to 500 quits per year. Interventions such as these have proven to be successful, so has the Minister weighed up their merits against the possible implications of the Bill?

New Hospital Programme Review

Edward Leigh Excerpts

Monday 20th January 2025 Commons Chamber

[Madam Deputy Speaker (Judith Cummins)]

I call the Father of the House.

[Sir Edward Leigh (Gainsborough) (Con)]

Will the Secretary of State forgive me if I give the House a few seconds’ respite from the blame game by trying to make a positive suggestion? Everyone accepts that the real problem facing our hospitals is the number of frail and elderly people who do not need to be in hospital and should be in some sort of care facility. Does the Secretary of State agree that while building brand-new, all-singing, all-dancing hospitals is very expensive, there is a future for smaller cottage hospitals such as the one in Gainsborough and a case for opening other facilities so we can move elderly, frail people out of those big hospitals into a caring environment and free up space?

[Wes Streeting]

I thank the right hon. Gentleman for a rare constructive contribution from the Conservative Benches—not rare from him, for he is regularly constructive; it is the rest of the Conservative party that we have a problem with. Let me reassure him that one thing we are determined to do is deliver a shift in the centre of gravity, out of hospitals and into communities, with care closer to home and indeed in people’s homes. As I saw on a visit to Carlisle over the new year, good intermediate step-down accommodation sometimes provides better-quality and more appropriate care and better value for the taxpayer. That intermediate care facility in Carlisle, funded through the NHS by a social care setting, was providing great-quality rehabilitation in a nicer environment at half the cost of the NHS beds up the road. This Government will deliver both better care and better value for taxpayers.

Hospice and Palliative Care

Edward Leigh Excerpts

Monday 13th January 2025 Commons Chamber

[Danny Kruger (East Wiltshire) (Con)]

I will not focus on assisted dying/assisted suicide this evening, because as the hon. Member for Wimbledon (Mr Kohler) said in a good opening speech, we are all united in this place in our desire to see improvements in the palliative care system, but I feel compelled to make this simple point of fact. Studies and research show that in jurisdictions and countries around the world that have introduced an assisted dying/assisted suicide law, the investment in and the quality of palliative care has declined, relative to those that do not have an assisted dying/assisted suicide law. That is for reasons that are fairly comprehensible. That is a fact. I implore the House: let us fix our palliative care system before we consider opening up the law on assisted dying.

The United Kingdom is, of course, the birthplace of the hospice movement, and we have some of the best palliative care services and specialists in the world, but as we have heard this evening, our system simply is not working. We have demand for palliative care and hospice services on a scale that was never anticipated in the post-war years in which the NHS was developed. The challenges of growing demand have been sadly exacerbated by decisions that the Government have made, as we have heard.

[Sir Edward Leigh (Gainsborough) (Con)]

On Friday, I went to St Barnabas hospice in Lincoln, our local hospice, which does wonderful work, and talked to its chief executive officer, who is tearing his hair out. Because of the national insurance increase, he is losing £300,000 a year. He pays his nurses less than the local hospital; he has to. He is literally funding the NHS and cutting his own service in the hospice. I beg the Government to think again about the national insurance increase on hospices.

[Danny Kruger]

My right hon. Friend makes absolutely the right point. It echoes the experience of hospices across the country. Prospect House, which is on the edge of Swindon and is in my constituency of East Wiltshire, receives only 23% of its funding from the taxpayer. It faced a significant deficit this year, so it took immense pains and steps to bridge its funding shortfall. There was a huge response to a public fundraising appeal, and it raised over £170,000 from the local community, but that was before the Budget. The effect of the national insurance increase alone on Prospect House is £170,000, so the public’s generosity has been entirely wiped away by the Chancellor, and Prospect House is back exactly where it was.

Julia’s House in Devizes is a children’s hospice, and the most wonderful, moving place that I have visited in my time as an MP. It has had a similar experience. It gets only 8% of its budget from the taxpayer. Its deficit has gone up from £900,000 before the Budget to £1.1 million now. We therefore desperately need a comprehensive review of palliative care.

I pay tribute to the hon. Member for York Central (Rachael Maskell), and to Baroness Finlay in the other place. They are leading a review of palliative care, with a view to coming forward soon with recommendations for the Government on how to improve the system. Indeed, thanks to Lady Finlay’s amendment to the last Government’s Health and Care Act 2022, integrated care boards are required to commission palliative care. Unfortunately, no money was attached to that amendment, and as we have heard, the way in which some ICBs commission care is not good enough. I regret, for instance, that the ICB in our area will not commission Julia’s House, the children’s hospice that I mentioned, so we need a better commissioning model.

I take issue with the point made by the hon. Member for Birmingham Erdington (Paulette Hamilton) that ICBs cannot find the money for these services in their budgets. They could if they did their job properly and commissioned services locally. They should be able to move budgets around. The fact is that if proper investment is made in palliative care, money is saved elsewhere in the NHS; that is the crucial point. Expensive bed stays in hospital would be reduced, as would demand on ambulances and other services. It should be possible to improve palliative care within the ICBs’ current envelope.

We do not want a system of enforced uniformity, or a great new national bureaucracy. I am concerned to hear some hon. Members suggest that we nationalise the system; I do not think that is right. We need to ensure that ICBs can do the job that they need to do, and that hospices can innovate as they want.