NHS 10-Year Plan

Ellie Chowns Excerpts

Thursday 3rd July 2025 Commons Chamber

[Wes Streeting]

I am grateful for my hon. Friend’s support. Given his expertise, it means a lot. I am especially grateful to the GPs in his constituency with whom he and I spent time; that experience really had an impact on my thinking about neighbourhood health.

On cancer, I am happy to look at the issue he raises with the Under-Secretary of State for Health and Social Care, my hon. Friend the Member for West Lancashire (Ashley Dalton). We want to get this right. Cancer alliances have played a valuable role, and we want to see that approach to joined-up working between research, diagnostics and treatment go from strength to strength, so I will happily pick that up.

[Ellie Chowns (North Herefordshire) (Green)]

In the constructive spirit that has characterised much of this discussion, I welcome much of what the Secretary of State has announced today: bringing care closer to people in their homes, investing more in prevention—it is all good stuff. But there seems to be a missed opportunity here. In the 143 pages of this document, there is virtually no mention of social care. Lord Darzi told us last year that we cannot fix the NHS without fixing social care. Six months ago today, the Secretary of State promised cross-party talks and urgent work on the Casey commission, but the commission is delayed and the cross-party talks have never materialised. Will the Secretary of State please treat the care crisis with the urgency it deserves and bring forward that work, so that we can build the necessary cross-party consensus to fix the care crisis?

[Wes Streeting]

First, I thank the hon. Member for the Green party’s support for so much of the 10-year plan. She is right to highlight the importance of social care to resolving the NHS crisis. Let me reassure her that we are acting urgently as we await the first report of the Casey commission. The Chancellor did that with the Budget and the spending review, providing £4 billion more of investment. We have done that with the biggest increase in carer’s allowance since the 1970s, and with the disabled facilities grant, which does not just mean more ramps and home adaptations but more freedom, more dignity and more independence for disabled people. The Deputy Prime Minister and I will shortly set out how we will deliver fair pay agreements, and social care will absolutely be part of the neighbourhood health team. I hope that that reassures the hon. Member.

Let me also reassure parties across the House that we will wait for the Casey commission to launch. I would like to be able to proceed with the actions we will be taking in this Parliament and, crucially, with the long-term plan for social care in a cross-party way, to build that genuine national consensus—I would be delighted to achieve that.

Oral Answers to Questions

Ellie Chowns Excerpts

Tuesday 17th June 2025 Commons Chamber

[Stephen Kinnock]

I thank my hon. Friend for that important question. The role that midwives play, alongside other community health services such as district nurses, has been chronically underfunded and neglected over the past 14 years. She will be pleased to know that the role of community healthcare is front and centre in our 10-year plan, and I think she will be interested in and pleased with what she sees when that plan is published.

[Ellie Chowns (North Herefordshire) (Green)]

The Darzi report pointed out that 13% of hospital beds are occupied by people who are fit for discharge but who cannot get out because social care is broken. Lord Darzi said that we cannot fix the NHS until we fix social care. It is nearly six months since the Secretary of State promised cross-party talks and a commission, but the talks were cancelled and never rescheduled and the commission is delayed. Please, when will the Government stop going slow on social care? Please, when can we all get around the table to talk about fixing social care so that everyone gets the care they deserve?

[Stephen Kinnock]

I have to correct the hon. Lady: the commission is up and running, Baroness Casey has started meetings and she had a roundtable just a few weeks ago with people who have lived experience. The hon. Lady is therefore not correct on that point and I am sure that she will want to correct the record.

On the point about delayed discharge, the hon. Lady is absolutely right. We are reforming the better care fund to get much better interface between hospitals, care and local authorities. That system and those relationships can and should work much better, but there are pressing, long-term challenges. We are conscious of that and are working at pace with Baroness Casey to ensure that those reforms are delivered.

Terminally Ill Adults (End of Life) Bill

Ellie Chowns Excerpts

Report stage
Friday 13th June 2025 Commons Chamber

[Ellie Chowns (North Herefordshire) (Green)]

I rise to speak in support of new clauses 13 to 15, tabled by the hon. Member for Spen Valley (Kim Leadbeater), to support amendments 94 and 95, and to oppose amendment 42. I pay tribute to the hon. Member for Spen Valley for her compassionate leadership and immense hard work, to the Members of all views who served on the Bill Committee for their thoughtful and hard work, and to those who have worked behind the scenes to scrutinise the Bill and contribute to the debate.

I thank all the constituents who have been in touch with all of us. I am sure that, like me, hon. Members have carefully reflected on those contributions and taken them into account. It is clear that the status quo is not acceptable. That is why it is right that we have this legislation before us, and that we are scrutinising it so carefully and looking at it in such immense detail.

Turning to new clause 13, regarding the regulation of substances for use in assisted dying, those substances obviously have to be properly regulated, although it is equally obvious that they cannot be subject to conventional clinical trials in the same way as other medicines, which is why the proposal to make that process go through the MHRA is inappropriate. The regulations provided for in new clause 13 will ensure that that critical part of the process is carried out with the highest possible level of scrutiny and harm prevention. It is essential that there is transparency and assurance of the process, from manufacture all the way through to administration, which is what new clause 13 does.

[Ms Billington]

I am interested in what the hon. Lady says about the safety of those drugs. Does any adverse event data exist globally to quantify how much harm and suffering could be caused while inducing the dying process?

[Ellie Chowns]

I thank the hon. Member for raising that issue and giving me the opportunity to speak about the detailed evidence given by my constituent Emeritus Professor Sam Ahmedzai, with whom I spoke at length yesterday about precisely this detail. I have reviewed a number of tables of data about this. Any substance has side effects but, as the comments made today have indicated, in reality those substances are being held to a far higher standard than substances routinely used in palliative care.

We have to recognise that there is a huge amount of evidence about the efficacy of the substances that are talked about in relation to assisted dying. There is a huge amount of published, peer-reviewed evidence about the effectiveness of those substances, and people like Professor Ahmedzai, who has 40 years of experience and is a global expert in this area, point out that we know how to assist people to have a peaceful, compassionate death effectively, and that is what the Bill is about: helping people who are terminally ill to die with dignity and to face those final moments with the support, love and care of their family around them; not in agony, but in whatever degree of peace is possible when facing death.

As the hon. Member for West Worcestershire (Dame Harriett Baldwin) said, new clause 14, which relates to advertising, has been developed in consultation, as a result of concerns raised by opponents to the Bill, to try to ensure the crucial fact that assisted dying is not an advertised service. There is a crucial distinction between advertising and information, and this new clause will ensure that assisted dying remains a careful, clinical process and not something that would be promoted commercially. It is a balanced, cross-party safeguard supported by people on all sides of this debate.

[Jonathan Davies]

Will the hon. Lady give way?

[Ellie Chowns]

I am very short of time, so I think I had better continue.

Turning to new clause 15, which relates to the role of coroners, if the Bill is passed, assisted dying would be a very strictly regulated process—the choice of an individual; not a death caused by others, but by the individual themselves. As Aneez Esmail has pointed out, this would be the most scrutinised type of death in the country, and it therefore makes no sense to require another legal process at the end when there have already been multiple layers of scrutiny before the death.

[Dr Opher]

Will the hon. Lady give way?

[Ellie Chowns]

I am so sorry, but we are very short of time.

New clause 15 is a compassionate and practical clause. There are strong safeguards already in place, and requiring a coroner’s inquest would go against the spirit of compassion that should be driving us all.

I will briefly turn to amendment 42, tabled by the hon. Member for Newcastle-under-Lyme (Adam Jogee), which would remove the backstop commencement. Essentially, the amendment would leave it in the hands of the Secretary of State to decide when, or if, the Bill comes into effect. That would go against the will of the House. If the House passes this Bill, it is perfectly reasonable and workable for the detail of it to be worked out within the next four years. We have already doubled the length of time allowed for that to happen. Amendment 42 is effectively a wrecking amendment that seeks to kick the Bill into the long grass. [Interruption.] That would be its effect.

To conclude, I will briefly address the misconception that seems to have informed some of the comments I have heard in today’s debate, which is the assumption that families would want to pressure family members to die quicker. My mum is a specialist palliative care social worker, and she has told me that in all her years of practice she has never experienced that happening. It is the other way around.

[Several hon. Members rose—]

[Ellie Chowns]

I am sorry, but I am concluding. We are each speaking from our own experience and from the heart.

[Several hon. Members rose—]

[Madam Deputy Speaker (Ms Nusrat Ghani)]

Order. The hon. Lady has made it clear that she is not taking interventions at this time.

[Ellie Chowns]

The evidence shows that it is dying people themselves, facing the end of life, who wish to have the choice. Only small numbers of them will take up that choice, but it is crucial, humane and compassionate for us to offer them the choice. Assisted dying is complementary to palliative care, not contradictory, and this Bill has been through a huge amount of scrutiny—far more than any other Bill in this Session. Therefore, I deeply hope that the House will pass this compassionate, humane, clearly drafted and tightly structured Bill, to offer a dignified death to those who are facing death.

[Patricia Ferguson]

I rise to speak to my amendment 13, which concerns the appointment of the voluntary assisted dying commissioner. In Committee, it was decided that the Prime Minister would appoint the voluntary assisted dying commissioner, and that the appointee would serve for five years and be responsible for appointing the assisted dying review panels. The commissioner would also oversee the training of panel members, give them guidance on the procedures to be used and, crucially, decide when a case that a panel has refused should be referred to another panel for reconsideration. According to the Bill, the commissioner will not be acting as a judge, but they must be a current or former senior judge of the Supreme Court, Court of Appeal or High Court. However, they are not required to have any expertise in medicine or healthcare.

Importantly, following our considerations in Committee, the Bill no longer requires that the chief medical officer be responsible for monitoring whether or not the assisted dying regime complies with the law. That responsibility has now been transferred to the voluntary assisted dying commissioner, so the person in charge of overseeing the process and setting up the panels will also be the person deciding whether the Act is being administered correctly.

--- Later in debate ---

[Sir John Hayes]

I give way to the hon. Member for North Herefordshire as I cited her.

[Ellie Chowns]

I am afraid that the right hon. Gentleman has misrepresented what I said. I was contributing an observation from somebody who has been deeply involved in palliative care practice, who reports that it is far more frequent that the dying person wishes to die, while it is their family who are pressuring them and encouraging them to stay alive as long as possible. The fears about coercion appear to be worry about something that is not actually the case in these cases of dying people.

[Sir John Hayes]

I am afraid that I disagree. There are numerous cases where people will be encouraged, and perhaps even forced, to take a decision, when they are coping with illness and at their most vulnerable—when they are frightened, doubtful and distressed, and may be unbalanced. Of course we have to protect against that eventuality if the Bill is to be passed.

Spending Review: Health and Social Care

Ellie Chowns Excerpts

Thursday 12th June 2025 Commons Chamber

[Karin Smyth]

I thank my hon. Friend for welcoming the Government’s investment in the health service. She has been such a strong campaigner for Shotley Bridge, and it has been a pleasure to work with her; I know she has continued to advocate strongly on behalf of her local population. The hospital is needed, but as she knows, in her community—and all our communities—patients should not always be expected to travel to hospital for care that can be delivered closer to home. We see massive improvements in virtual care and technology, which is why we have announced a £10 billion increase for technology over the spending review period. We are improving the NHS app and ensuring that people are enabled to do more digitally, but I recognise that does not suit everybody, so we will ensure that parallel processes are available for everybody. Our constituents deserve and need care closer to home, and want more of it.

[Ellie Chowns (North Herefordshire) (Green)]

More money for the NHS is of course welcome, although if we in the Green party had our way, it would be raised by taxing extreme wealth fairly, rather than by taxing work. The small amounts of money for social care announced in the spending review are nowhere close to the funding needed to tackle the social care crisis, and the burden is put on local authorities. In the Minister’s Department, there is a reduction in the revenue budget for social care and public health. When will her Government stop going slow on social care? When will they hold the long-promised and much-delayed cross-party talks? When will they recognise, as Lord Darzi has said, that we cannot fix the NHS without fixing social care? A truly joined-up approach to health and social care is long overdue.

[Karin Smyth]

The economics of the Green party are even more fantastical than the economics of the Conservatives and Reform; we all dread to think what things might be like under that party. We see that in the local council in my city of Bristol, and it is an absolute disaster. If the council could just get on with building council houses and social homes, it would help more people to live a better life, and would aid prevention. We are getting on with tackling social care. That was announced in the spending review, and that is what the Casey review will do.

Oral Answers to Questions

Ellie Chowns Excerpts

Tuesday 6th May 2025 Commons Chamber

[Ashley Dalton]

I agree with my hon. Friend. We are making great strides in developing our cancer plans. We will be launching a national cancer plan later this year, and the targeted lung cancer screening programme has been particularly effective. The SNP has had a record settlement for Holyrood, and we expect the Scottish Government to deliver. If they cannot, I am sure that Anas Sarwar and Jackie Baillie would be willing to take over.

[Ellie Chowns (North Herefordshire) (Green)]

Yesterday’s report from the Health and Social Care Committee is explicit that we cannot build an NHS fit for the future without effectively reforming social care. Back in January, the Secretary of State promised cross-party talks as well as Baroness Casey’s commission. He cannot outsource political leadership to Baroness Casey. Political will is the sticking point with the reform of social care. Will he show that leadership and bring the parties together to find the solutions to unblock this crisis?

[Wes Streeting]

Since we came into government, we have already taken action on social care with the investment we have put in—the biggest expansion of carer’s allowance and the funding for home adaptations through the disabled facilities grant. Now that the commission is up and running, there will be cross-party engagement, but it is an independent commission and for Baroness Casey to decide how to engage.

Oral Answers to Questions

Ellie Chowns Excerpts

Tuesday 11th February 2025 Commons Chamber

[Karin Smyth]

I commend my hon. Friend on his research into the previous Government, and for the hard work that he is doing on behalf of his constituents. We are committed to the rebuild of Hinchingbrooke and have put the new hospital programme on a sustainable footing, which is something that his constituents can look forward to.

[Ellie Chowns (North Herefordshire) (Green)]

5. What progress his Department is making in reducing waiting times for elective care.

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

This Government inherited a waiting list with a staggering 7.6 million people on it. Since July, that waiting list has already been reduced by almost 145,000, and ensuring that the NHS once again meets the 18-week standard for elective treatment is at the heart of the Government’s plan for change. Our elective reform plan sets out how we will meet that standard by the end of this Parliament, through a combination of investment and reform that Labour knows from past experience delivers results.

[Ellie Chowns]

I get regular messages from constituents facing terrible waits for care with potentially serious consequences, including a one-year delay for an early dementia referral and an 18-month delay for a cardiology review. Although I understand the case for the short-term, one-off use of spare private capacity to tackle the backlog while the NHS is rebuilt, can the Secretary of State please outline his longer-term thinking regarding privatisation of the national health service? In particular, why is he encouraging the development of long-term relationships with the private sector?

[Wes Streeting]

The NHS has always worked constructively with the independent sector, and I do not believe that ideological hobby horses should come before patients getting faster access to care. This Government are investing in our NHS, and before the hon. Lady complains about that, I would just point out that the Green party’s manifesto on the NHS said that it would require an

“additional annual expenditure of £8bn in the first full year”

of this Parliament, rising to £28 billion later. The Chancellor has just delivered a Budget that delivers £26 billion of additional investment, and the Greens complain about it.

Hospice and Palliative Care

Ellie Chowns Excerpts

Monday 13th January 2025 Commons Chamber

[Ellie Chowns (North Herefordshire) (Green)]

Like other Members, I begin by paying tribute to our hospices and to everyone who works and indeed volunteers in palliative and end of life care, providing such amazing support to patients and their loved ones around their death—that most difficult time of life—and helping people to have a good death. As many Members have said, that work is so crucial. I would particularly like to mention St Michael’s hospice, Hereford, in my constituency. It is a place I have had an association with for many years, as it has provided amazing care to friends of mine who have died there. It is so well loved in the community.

Is it not such a shame, as so many colleagues have said today, that palliative care is so dependent on charitable funding? As the hon. Member for Huddersfield (Harpreet Uppal) said, it is integral to our healthcare system—except it is not, because it is not fully funded by our healthcare system. It is not actually free at the point of need, except thanks to the grace and kindness of strangers and charitable funding. Government Members have made mention many times this evening of the £100 million capital injection from the Government, which is absolutely welcome; it has been so frequently mentioned, in fact, that one might think the Whips have gently encouraged its mentioning. However, the problem is that this £100 million is a short-term capital injection, when what is needed is a long-term revenue funding solution.

Despite the amazing efforts of fundraisers, revenue budgets in hospices are under extreme pressure. That has been made worse by the rise in employer national insurance contributions; St Michaels will have an additional bill of £240,000 next year because of it. That is a problem. The current funding model for hospice care is a problem. It is good that there is now a statutory requirement for ICBs to fund palliative care, but there is a complete lack of parity across the country. Hospices have to negotiate individually with ICBs all across the country every year. A hospice leader said to me that they have no sight of the future; another said that when they are considering redundancies, it is no use telling people they are going to be resurfacing the car park with the new capital funding.

We need a sustainable revenue funding solution for hospices—a clear, fair, multi-year, long-term funding solution—with parity across the country, to provide those doing that amazing work to support patients and the patients themselves with the support they need and deserve.

Health and Adult Social Care Reform

Ellie Chowns Excerpts

Monday 6th January 2025 Commons Chamber

[Wes Streeting]

Further to the previous question, we will be refreshing and updating the NHS workforce plan alongside the long-term plan that we will publish in May, and my hon. Friend is right that rehab is key not just to good recovery but to prevention of future demand on the NHS. I saw a great example of that rehabilitation delivered in social care settings only last week. Whether in the NHS or in social care, we definitely need to do more on rehabilitation, because rehabilitation is often secondary prevention.

[Ellie Chowns (North Herefordshire) (Green)]

I agree with the Secretary of State that community-based services are crucial. My local NHS trust contacted me in the week before Christmas about Hereford community diagnostic centre, which is currently in the process of being built. It was told to be ambitious with this project, but in December it was told that only a sixth of the funding that it needs is available. Does today’s announcement mean that the Government will fully fund Hereford community diagnostic centre?

[Wes Streeting]

We will certainly write to the hon. Member with further information about Hereford CDC. On capital investment, I say to her and to other right hon. and hon. Members that we were very pleased with what the Chancellor was able to deliver in the Budget. We recognise that the stop-start we saw on a number of capital programmes under our predecessors was frustrating and we are determined not to repeat that. That is why we are setting out clear and consistent proposals for capital investment in the NHS.

NHS Backlog

Ellie Chowns Excerpts

Monday 6th January 2025 Commons Chamber

[Ellie Chowns (North Herefordshire) (Green)]

Thank you, Madam Deputy Speaker. I would like to thank the hon. Member for North Shropshire (Helen Morgan) for securing this debate on the vital area of NHS backlogs, which is of great importance to me and my constituents. We are short of time so I will not talk, as I wished to, about the need to tackle the crisis in social care and the need to invest heavily in public health. I will focus my comments on responding to the Government’s announcement today on elective care.

I hope the Minister will be able to respond in a moment to some of the questions I want to pose, because it is one thing to use spare capacity in the private sector to tackle the absolute crisis we have with waiting lists and backlogs—I can understand that as an emergency measure—but it is quite another to propose in effect long-term outsourcing from the NHS to private providers. To be honest, I fear that today’s announcement could essentially be a form of creeping back-door privatisation of aspects of NHS care, and specifically those in which is easiest for private sector providers to make a profit. We only have to look at PFI to understand the dangers of that approach.

I have read today’s partnership agreement between the NHS and the independent sector, and I am afraid I find it the opposite of reassuring. I will briefly canter through some of the reasons why. Section 2 indicates that the Government do envisage increased private provision of both surgical and diagnostic services.

There is some text in section 3 about trying to seek assurance that those private providers will not essentially cherry-pick the most attractive, easy and profitable patients. However, all it says is that the independent sector will review its patient criteria; there are no teeth there.

There is nothing in section 4 about measures to protect the NHS from the risk of private providers making excessive profits from the services they provide. We have recently heard in this Chamber cases of that happening in the social care sector and the children’s social care centre. Is there not a real risk that that could also happen in the healthcare sector if this is not actioned?

Finally, there is nothing in section 5 to address the risk of transferring services to private providers leading to leaching of staff from the NHS services into the private sector. How can we be guaranteed that there is not going to be excessive competition in a workforce that is already extremely stretched?

For the Green party and myself, the profit motive has no place in our NHS. I hope the Minister will provide assurances that the NHS will continue to be publicly owned and publicly run for public benefit, and that the concerns I have highlighted will be addressed so that the agreement between the NHS and the independent sector has teeth.

[Madam Deputy Speaker (Judith Cummins)]

I now call the Liberal Democrats spokesperson, Jess Brown-Fuller.

National Insurance Contributions: Healthcare

Ellie Chowns Excerpts

Thursday 14th November 2024 Commons Chamber

[Karin Smyth]

I thank the hon. Gentleman for his comments and for supporting his local hospice. He is an experienced parliamentarian; he knows that this is not simple and that the provider landscape is complicated. As we heard from my hon. Friend the Member for Sheffield South East (Mr Betts), large private equity companies own many social care providers. We want to ensure that any additional funding from the Budget goes exactly where it needs to be: supporting patients—our constituents—where they live and need care. That is why, over the next few months, we will continue to talk to providers in the usual way about the allocation of those funds.

[Ellie Chowns (North Herefordshire) (Green)]

Since the Budget, I have been contacted by GPs, care providers and charities in my constituency, all expressing concern about the impact of the rise in employer NICs on their ability to serve the most vulnerable in our community. Will the Minister reconsider the change by finding a way to exempt the charitable sector in the same way as the public sector? I have written to Ministers and tabled early-day motions on this issue. Will she take this opportunity to assure the charitable sector that it will not be impacted by the measure?

[Karin Smyth]

The hon. Lady tempts me to make specific commitments, which I am not prepared to do, as I am sure she understands. She is right that people are expressing concerns about some of these decisions. That is because they are in such a precarious situation as a result of what we have inherited from the past 14 years. As the Prime Minister and the rest of the Government have been clear throughout the election and afterwards, we have a 10-year plan because it will take a long time to fix the foundations and build up the sector to make it more resilient and sustain it for the future. We want to fix those foundations, and we will talk closely with everyone affected over the coming months, but this will take a long time. Those providers are precarious because of the mess that we inherited.