Lobular Breast Cancer: Moon Shot Project

Helen Maguire Excerpts

Thursday 9th July 2026 Westminster Hall

[Helen Maguire (Epsom and Ewell) (LD)]

It is an absolute pleasure to serve under your chairship, Mrs Hobhouse. I thank my hon. Friend the Member for Horsham (John Milne) for leading this important debate on Government support for the Lobular Moon Shot Project.

On the first anniversary of her death, I want to pay tribute to Dr Susan Michaelis and her tireless campaigning. Today’s debate celebrates a legacy that continues to inspire researchers, clinicians, patients and parliamentarians alike. While the debate is about her story with lobular breast cancer, I would like to focus on what made her Susan. Although Susan was known for her campaigning on lobular breast cancer, she was so much more than that—something her loved ones, who are here today, know all too well.

Susan was an Australian who grew up in Melbourne before moving to the UK in 2003. As a child, she had dreams of becoming a pilot, but because of the lack of women in the industry at the time she settled on working in the travel industry instead. However, she soon realised that she really did want to become a pilot, so she set about becoming a qualified commercial pilot. Her dream came true and she trailblazed as the co-pilot on the first all-female crewed flight for the Qantas Group.

Susan also obtained a PhD at the University of New South Wales in Sydney in 2010. Her thesis was titled “Health and Flight Safety Implications from Exposure to Contaminated Air in Aircraft”. She was a researcher who devoted her career to improving public health and aviation safety, and her contributions towards aircraft cabin air contamination remain recognised today.

In 2007, Susan and her husband raised concerns with the world’s leading jet engine oil manufacturers about crew and passenger exposure to engine oil decomposition products. While most ignored the issue, the French company NYCO investigated and confirmed that the fuel additives affected gene expression. As a result, NYCO developed a new, less hazardous jet engine oil, NYCO 940 SE. The oil received SAE approval in 2023 and US military approval for use in all NATO aircrafts in 2024.

However, her legacy undoubtedly remains the Lobular Moon Shot Project and the change that she championed while knowing that she would not live to reap the benefits. Susan was diagnosed with lobular breast cancer in 2013 after a small 1 mm mark was noticed on her left breast. She had no lumps and had experienced no pain. Two mammograms and two ultrasound scans showed no cause for concern. However, an MRI scan suggested the presence of a 2.5 cm area of lobular breast cancer, which was later confirmed by a biopsy.

Susan underwent a double mastectomy, and post-operative pathology revealed that the cancer actually measured 7 cm. That was much larger than what had initially been detected and was missed entirely by mammograms and ultrasounds. Had Susan been given regular MRI scans in the last 10 years before her diagnosis, her lobular breast cancer would have been detected much earlier. For all cancers, early diagnosis and effective treatment is essential to increase survival.

Susan’s story tragically highlights how those challenges continue to be experienced by the millions of patients living with lobular breast cancer. Current NHS imaging techniques can fail to detect the disease accurately, which often leads to diagnosis at a later and more advanced stage. Unlike other breast cancers, lobular breast cancer tends to spread out in straight lines rather than amassing to form a firm lump. A patient is more likely to have a thickened area of breast tissue as a symptom, rather than the expected lump. That is what makes lobular breast cancer so difficult to detect during a physical examination, and when using imaging scans, such as mammograms and ultrasounds.

Research indicates that MRIs, which can produce detailed images of the inside of the breast, offer improved detection and characterisation of lobular breast cancer. If Susan had been given a regular MRI scan in the 10 years prior to her diagnosis, there is a very real chance that her cancer would have been detected sooner. That would have reduced the risk of it metastasising and ultimately claiming her life. Susan also only received generic breast cancer treatments as there is currently no specialised treatment for lobular breast cancer. Susan underwent eight systemic treatments over the span of 12 years. That led to the lobular breast cancer spreading to her spine in 2021. A PET-CT scan was unable to detect the disease progression, but once again, it was detected on an MRI scan—something that is not available on the NHS.

Lobular breast cancer accounts for one in seven—or 15%—of all new breast cancer diagnoses. It is the second most common sub-type of breast cancer. There are approximately 8,400 lobular breast cancer diagnoses in the UK each year. That amounts to 22 people being diagnosed every single day. More women are impacted by lobular breast cancer than cancers of the kidney, brain, pancreas, liver or ovaries. The impact of any cancer for both the patient and their loved ones is always devastating, and lobular breast cancer is no exception. We must better our understanding of this disease to improve treatment and outcomes for all those affected. It is unacceptable that this cancer has no specific treatments and is treated in the same way as the more common types of invasive cancer.

The Lobular Moon Shot Project, created in May 2023 in Horsham by Susan alongside her husband, is striving to change that. The campaign is asking for the Government to invest £20 million over five years to understand the biology of the disease to enable targeted treatments. Alongside all my Liberal Democrat colleagues, I wholeheartedly support and will continue to support this very important project. The Liberal Democrats were the first major party to fully endorse this campaign. My right hon. Friend the Member for Kingston and Surbiton (Ed Davey) has written to both the Prime Minister and the former Health Secretary on Susan’s behalf, and our Chief Whip, my hon. Friend the Member for North East Fife (Wendy Chamberlain), has repeatedly raised this issue in the Chamber.

Support for the Lobular Moon Shot Project has grown to 465 Members of Parliament, making it the most widely supported health campaign in Parliament. On 15 July 2025, the then Health Secretary, the right hon. Member for Ilford North (Wes Streeting), stated that he had instructed his chief scientific adviser to plan a path forward to understand the biology behind this cancer to make a difference to those affected. One year on, and with a new Health Secretary, this research project has still not got the green light. We cannot allow this to fall through the cracks. I urge the Minister and all Members here today, regardless of their party, to continue to advocate on this issue.

Alongside supporting the work of the Lobular Moon Shot Project, the Liberal Democrats are clear: cancer must be a top priority for any Government, and the UK should be a global leader in cancer research and outcomes. The Liberal Democrats would introduce a guarantee that 100% of patients would be able to start treatment within 62 days from urgent referral. The Liberal Democrats would also recruit more cancer nurses so that every patient has a dedicated specialist supporting them throughout their treatment.

To end, I once again want to honour the legacy of Dr Susan Michaelis and her Lobular Moon Shot Project. The contributions made here today show the continuing impact of her legacy, which inspires me, and everyone in the room and beyond. I once again ask the Minister to play his part in ensuring that Susan’s legacy continues for her and all those who have been and continue to be impacted by lobular breast cancer. Will he today commit to finding the £20 million to fund the research so that more people survive lobular breast cancer?

--- Later in debate ---

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

rose—

[Helen Maguire]

rose—

[Stephen Kinnock]

I think my hon. Friend the Member for Bexleyheath and Crayford (Daniel Francis) was first.

--- Later in debate ---

[Helen Maguire]

Thankfully, the Minister has clarified some of the issues that I was going to ask about. He says the Government are not necessarily looking to ringfence the £20 million, but are waiting for applications for research. The Lobular Moon Shot Project has already put forward some ideas on research. He has said that he stands ready to support the project, so I would just like some more specific detail. He says that we are waiting for applications for research, but does not what the Lobular Moon Shot Project has submitted or talked about fall within that?

[Stephen Kinnock]

As I mentioned earlier, unfortunately I am not the lead Minister on this issue, so I do not have the most up-to-date information on the proposal that has been submitted. If it is okay with the hon. Lady, I will speak with the ministerial colleague, my hon. Friend the Member for Washington and Gateshead South, and write to the hon. Lady on that subject, providing an update on exactly where the proposal is in terms of the overall process that we have. Have I understood her intervention correctly?

[Helen Maguire]

indicated assent.

[Stephen Kinnock]

Okay. I thank the hon. Lady. That is what we will do.

NHS Corridor Care

Helen Maguire Excerpts

Wednesday 8th July 2026 Commons Chamber

[Dr Allin-Khan]

The hon. Member is right, but I know that the Government care deeply about this. This is not something on which I am in tension with the Government in any way. I have spoken to the Ministers and the Secretary of State, and I know that they are committed to acting and ensuring that every single patient across our country gets the best possible care. Let us be really clear: the NHS should not be a political football. Safe and dignified healthcare should not be a political football. I hope that we are all in agreement on this issue today. I would have hoped to see more Members on the Opposition Benches today, and I hope that their absence is not a reflection of how much they care about the issue, because, quite frankly, we owe it to all our communities to get this right.

I know from my own experience, as will other hon. Friends in the Chamber, that when someone comes to A&E, it is often the worst day of their life. It could be the worst day of their life because of their experience as a patient, or it could be the worst day of their life because someone they love—their child, their partner, their mother or their father—is dying or has died. When we think about the dignity and care that we give, we have to look at it holistically—not simply as a set of symptoms that we are treating but as a family and the experience that they take away with them of what has happened on that day. People are in tears, people are in pain, and we owe it to them to get this right.

[Helen Maguire (Epsom and Ewell) (LD)]

Many people in my constituency have written about experiencing corridor care, and that loss of dignity when vulnerable and elderly patients are sitting in corridors. Does the hon. Member agree that we desperately need urgent action to ensure that dignity is prioritised wherever care is given?

Department of Health and Social Care

Helen Maguire Excerpts

Tuesday 30th June 2026 Commons Chamber

[Helen Maguire (Epsom and Ewell) (LD)]

Today we are being asked to approve a motion on the main estimates for the Department of Health and Social Care for 2026-27, in which pharmaceutical spending is not separately identified, in either the estimate or its accompanying memorandum. We are being asked to approve spending without clear visibility of exactly how much is budgeted for medicines. That is against the principle of estimates day, which is to scrutinise spending before it is authorised.

This is yet another example of the lack of transparency around the murky UK-US pharmaceutical deal. It was drawn up in secret and the Government are refusing to publish the impact assessment. The Government must be clear on how much is budgeted for medicines, how much they expect the deal to cost and the risks to the frontline associated with diverting money from elsewhere in the NHS.

The UK-US pharmaceutical deal should never have been allowed to go ahead. The deal will see the NHS paying out at least £1.5 billion more in higher medicine costs by 2028, rising to over £9 billion by 2036. The Government have made it clear that there will be no additional money to fund that over the next spending period. That means frontline NHS services will be plundered at the behest of a foreign Government, while patients suffer in crammed hospital corridors and cannot get a GP appointment.

We must support the British life sciences sector. We can find ways to achieve that, but it must be a domestic matter for the UK Government to solve holistically through negotiations with the sector. It should not be dictated from Washington. The Government refused to publish an assessment of the impact of the deal. What are they trying to hide? The bottom line is that medicine procurement should be based on sovereign health needs. This is not a matter of being pro or anti the pharmaceutical industry. We need to find a solution that works for patients, the NHS and the life sciences sector.

Rather than defund vital NHS services in a knee-jerk deal, the Liberal Democrats would take real action to strengthen our life sciences sector by: developing a long-term plan with the sector to ensure certainty on issues such as VPAG—the Voluntary Scheme for Branded Medicines Pricing and Access—and rapid licensing by ensuring that the needs of our society are reflected in the approach of NICE and other regulatory bodies; promoting investment into upscaling UK life sciences manufacturing; encouraging investment in vaccine, medicine and antibiotic medicine manufacturing plants; reviewing the relationship between research and development tax credits and manufacturing; and establishing a fellowship programme for scientists working on health conditions, such as cancer, so they can continue the research Trump has defunded in the US. We would also cut the cost of visas for researchers, as well as boost R&D funding to 3.5% through a decade-long programme of public investment. Rather than spending billions to pay off a bully in the White House, the Liberal Democrats would oppose the deal, develop a plan for our life sciences that reflects our national interest and invest money in vital frontline services that are in dire need of funding. The Institute for Fiscal Studies has indicated that the deal could cost as much as £9 billion by 2036. That money would be transformative for so much of the NHS: it would end corridor care, hire thousands more staff, buy countless radiotherapy machines, or deliver high-quality care and help for elderly and disabled people.

Any choices over money spent in our NHS must be made by the British people, not Trump. It is unacceptable that Trump thinks he can meddle in our NHS, and, worse still, that the Prime Minister lets him. That is why the Liberal Democrats wrote to the Prime Minister in December, demanding that the deal was put before Parliament for a vote. If the Prime Minister cares as much about the NHS as he claims, I encourage him to set the record straight, show his true feelings on the deal and, at the very least, bring it before the House for approval.

This House, and the voters who elected us, decide matters of national importance, not the White House. That is why the Liberal Democrats tabled new clause 76 to the Health Bill, which would bring the deal before the House for a vote. Any deal that diverts billions of pounds away from NHS frontline services must be subject to democratic process and parliamentary scrutiny.

[Madam Deputy Speaker (Ms Nusrat Ghani)]

I call the shadow Minister.

NHS Breast Screening

Helen Maguire Excerpts

Monday 29th June 2026 Westminster Hall

[Helen Maguire (Epsom and Ewell) (LD)]

It is a pleasure to serve under your chairship, Mr Vickers. I thank the hon. Member for North Ayrshire and Arran (Irene Campbell) for leading this important petition debate on NHS breast screening.

It is hard to follow the passionate speech by the hon. Member for Mid Cheshire (Andrew Cooper), but this is important, because there are about 60,000 new cases of breast cancer in the UK each year. Breast cancer represents 15% of all new cancer cases and 30% of all new female cancer cases. It is the most common type of cancer among women: a woman is diagnosed with breast cancer every nine minutes and there are approximately 11,200 deaths due to breast cancer each year in the UK. The human costs behind those statistics cannot be overstated. In the short span of today’s debate, 10 women will be diagnosed with breast cancer and two will tragically lose their lives to the disease.

Over recent decades, we have made huge strides in the diagnosis and treatment of breast cancer. It is remarkable that approximately 76% of women now survive for 10 years or more following their diagnosis. But as with any cancer, diagnosing breast cancer early remains vital and saves lives. Breast screening remains the most effective way to detect cancer at an early stage, which is also when treatment is most likely to succeed. More than 95% of people diagnosed at stage 1 will survive for at least five years, compared with about 25% diagnosed at stage 4.

The Marmot review estimated that the current screening programme prevents about 1,300 deaths a year. In 2024-25, about 2.75 million women aged 50 to 71 were invited to be screened—a 10% increase on the previous year—and 2.15 million of them took the offer up. Nearly 20,000 women had breast cancer detected through that screening, but as those figures highlight, around 600,000 women did not take up the essential offer of breast cancer screening.

Recent screening data reveals an alarming trend of women not attending their first screening appointment. The impact of not taking up the screening offer only compounds the issue. Women who do not attend their first breast cancer screening appointment are much less likely to take up subsequent screening invitations. In 2024-25, only 20.9% of women in England who had never previously taken up screening invitations attended, compared with the 89.1% uptake among women who had been screened in the last five years. Since the creation of the modern NHS breast screening programme, uptake for first-time screening invitations has never reached 70%.

Had the screening uptake level reached the NHS achievable standard target of 80% in 2024-25, over a quarter of a million more women would have undergone routine screening, and that would have resulted in an estimated additional 2,228 cases of breast cancer being found. The scale of the missed opportunity to catch more cancer early is unacceptable, and women and their loved ones are paying the tragic price. I urge anyone who is eligible to take up the offer of breast cancer screening.

The Liberal Democrats are clear that so much more must be done to ensure that every eligible woman attends screening when invited, particularly in England, where uptake is lagging behind the devolved nations and pre-pandemic levels. There are many reasons why women do not attend their breast cancer screening appointments, including misconceptions about the screening process and breast cancer, the fear of receiving a diagnosis, and cultural beliefs and attitudes. Others may not be able to attend due to everyday challenges such as limited transport, clashing work schedules or the burden of caring responsibilities. Health inequalities also affect screening uptake. Women from ethnic minority communities, those living in disadvantaged areas and women with disabilities often face additional barriers that reduce their access to breast screening services.

What actions are the Labour Government taking to improve screening uptake nationally, particularly among disenfranchised women? What steps are the Government actively taking to support pop-up screening initiatives in community settings, and what is being done to ensure that those vital health services are meeting people where they are and at times that work for them? What steps is the Minister taking to ensure that women are able to receive the best screening test for their individual health needs? That might include, for example, providing women with an increased risk of breast cancer with an ultrasound if they are unable to have an MRI or they have dense breasts. That is particularly relevant to younger women with an increased risk, for whom an ultrasound will provide greater accuracy in screening their dense breast tissue. Mammograms can struggle to identify cancer in dense breasts, as cancers and dense tissue present in exactly the same way on imaging.

The Liberal Democrats are also very concerned that so much NHS equipment, including diagnostic and scanning equipment, is out of date and decrepit. A quarter of England’s 280 radiotherapy machines are now operating beyond their 10-year lifespan, with a further 26 due to exceed the recommended lifespan by 2027. England has fewer radiotherapy machines than comparable European countries. Radiotherapy UK’s research reveals that England has just 4.8 linear accelerator machines per million population, well behind France at 8.5 and Italy at 6.9.

Radiotherapy lacks clear accountability. While responsibility for commissioning it sits with integrated care boards, freedom of information requests found that around 70% of ICBs do not have a named person responsible for radiotherapy. Access to radiotherapy is well below international expectations. Around 52% to 53% of cancer patients are estimated to need radiotherapy, but only around 35% receive it in England. In some areas, the figure is as low as 22%. Radiotherapy also has the longest waiting times. Only around four in 10 patients—and, in some areas of the country, as few as two in 10— receive radiotherapy on time.

Whether it is radiotherapy deserts or the mammogram machine glitch that left 7,000 women in parts of Essex without a screening service for almost two months, breast cancer patients are routinely being let down by faulty and inaccessible equipment. That is unacceptable and we must take action now. To address that, the Liberal Democrats are campaigning for a 10-year capital investment programme, under which all patients, including women with breast cancer, would benefit from easier access to newer, quicker and more accurate machines.

Alongside screening, speed and quality of treatment are central to increasing breast cancer survival rates. The Liberal Democrats would introduce a guarantee that 100% of patients would be able to start treatment within 62 days of urgent referral. We would also replace the ageing radiotherapy machines and increase their numbers to guarantee that no one must travel ridiculous distances to receive the treatment that they desperately need. Currently, 3.4 million people in England live further away from a radiotherapy centre than the NHS target of 45 minutes.

Taking those steps now is vital. We need to prepare our local cancer services for the future, as demand is increasing. Cancer cases are expected to rise by about 30% by 2040, and the new national screening programme is likely to identify more patients who need curative radiotherapy treatment. Without urgent action, the existing pressures on radiotherapy services will only worsen. We would also recruit more cancer nurses so that every patient had a dedicated specialist supporting them throughout their treatment, and halve the time for new treatments to reach patients by expanding the capacity of the Medicines and Healthcare products Regulatory Agency.

The future looks bright, with early pilots and trials using AI to analyse mammograms showing promising signs of potential improvement in both the speed and the accuracy of screening, but we must support our life sciences sector much more to champion vital research and innovation. The Liberal Democrats would pass a cancer survival research Act requiring the Government to co-ordinate and ensure funding for research into the cancers with the lowest survival rates.

I want to reflect on the 10 women who were diagnosed with breast cancer and the two who will have tragically lost their lives to the disease in the short span of today’s debate. For them and the thousands of people—mostly women, but also men—living with breast cancer and their loved ones, I urge the Minister to carefully consider the important points and perspectives raised in the debate.

Nottingham Maternity and Neonatal Services

Helen Maguire Excerpts

Wednesday 24th June 2026 Commons Chamber

[James Murray]

I commend my hon. Friend on mentioning his constituent, Louise Thompson, who is campaigning on this important issue. He mentioned the impact of racism, discrimination and inequality in maternity services and their failures—all raised powerfully by Donna Ockenden’s report today. As I said earlier, the action plan, which the taskforce will be producing, will be published by the end of this year. We are determined to break that cycle where recommendations get accepted and then get left on the shelf to gather dust. We want an action plan that can be implemented. We want to make sure that delivery is set out and is progressed by the Secretary of State and the Department. That is a key part of the accountability in making sure that the delivery plan is put into action.

[Helen Maguire (Epsom and Ewell) (LD)]

I thank Donna Ockenden and her team, the hon. Member for Sherwood Forest (Michelle Welsh) and all the Nottingham families who are involved in the development of this report. Today, I am angry and upset for all the families concerned, because this report reinforces what we already know: the maternity crisis must end and it must end now. Babies should have lived and mothers deserved better. The same systemic issues have come up again and again: unsafe staffing, lack of training, unchanging culture and a failure to listen to women. At the same time, we have increasing maternity negligence payouts of £2.5 billion. Following the report today, and bearing in mind the £2.5 billion of negligence payments, will the Minister commit to restoring the service development funding to support complex births and bereavement, after it was cut from £95 million to £2 million?

[James Murray]

I thank the hon. Lady for expressing how she feels angry and upset. I think that that feeling is shared by all of us in the House today. The publication of Donna Ockenden’s report today has exposed the lifelong suffering of those families. The details of the action plan will be published by the end of the year, because we want to make sure that recommendations are not simply accepted and then not implemented. The recommendations must go into the taskforce, and the taskforce must produce that clear action plan, which we can then implement, and people can see us doing so. That is the way to break the cycle of recommendations that do not get implemented and to make progress towards the justice, accountability and change that I understand from families is so important to them.

Community Hospitals

Helen Maguire Excerpts

Tuesday 16th June 2026 Westminster Hall

[Helen Maguire (Epsom and Ewell) (LD)]

It is a pleasure to serve under your chairship, Sir Jeremy. I thank my hon. Friend the Member for South Cotswolds (Dr Savage) for securing this important debate on community hospitals.

Community hospitals have been a core part of our healthcare system for more than 150 years. They are rooted in a strong tradition of providing care and a range of clinical services to support their local populations. There are over 500 community hospitals throughout the UK, and they vary considerably in the services they deliver as their fundamental focus is to adapt to ensure that they serve the needs of their local area.

Community hospitals serve as multidisciplinary sites for immediate care across both health and social care, bridging the gap between primary and secondary care services. This adaptation and integration of services in particular makes community hospitals so valuable in bringing vital health services into the community and truly serving the specific needs of the community they represent, whether they have a significant older population or are situated in an area of high deprivation.

The value of community hospitals cannot be overstated, as we have heard today. They are ideally placed to support effective prevention and the management of long-term conditions. They have the ability to be flexible, change and adapt with their population. By reimagining what we can do with community hospitals, based around the needs of an ageing population and rising complexity, we can make a significant difference to patients.

I have seen the benefits of community hospitals at first hand in my constituency of Epsom and Ewell. Leatherhead community hospital, which is highly valued by the local community, demonstrates the importance of maintaining strong accessibility, continuity of care and patient flows across community health infrastructure. Leatherhead community hospital provides more than 33 specific consultation and out-patient services, including a stoma clinic, physiotherapy rehab, and speech and language therapy, for the diverse population it serves. We must support community hospitals to ensure they can continue to provide such services.

Community hospitals also play a core role in reducing the pressures on larger acute hospitals. Their role will only continue to grow in importance as demand on NHS services continues to rise. Community hospitals support earlier discharge and step-down care to patients who are medically fit to leave acute hospitals, but still need further support to regain their independence prior to being fully discharged.

The Health Foundation estimates that, in England, about 125,000 people enter intermediate care services each month. The cost of providing this care continues to rise, increasing the pressure on these underfunded services. The average local authority spend on a single episode of care in 2022-23 was 27% higher in real terms than in 2019-20.

Community hospitals provide intermediate care beds, so they free up hospital beds, reducing the high demand on A&E departments. That intermediate support is particularly important in rural and coastal areas where, as we have heard today, access to acute hospitals is often limited.

In 2021, the chief medical officer’s annual report on health in coastal communities provided official recognition of the range of healthcare needs across different rural communities. Those living furthest from healthcare services in rural and coastal areas are most at risk of experiencing inequalities, particularly when there are poor and unaffordable transport connections—not to mention the patients who, due to old age or disability, are unable to drive long distances to access essential healthcare.

It takes twice as long for people in rural areas to reach their nearest GP by public transport as it takes people in urban areas; it also takes about a third longer for those who drive, according to the Rural Services Network. Those findings were affirmed by Lord Darzi’s report on the NHS, which found that across much of rural England—including nearly the whole south-west as well as much of the east of the country—there are fewer than 46 dentists per 100,000 people.

A Liberal Democrat freedom of information request found that waiting times for life-threatening calls are 45% longer in rural areas than in urban areas. Community hospitals, like rural GPs, pharmacies and other healthcare services, have frequently been an afterthought. That situation is unacceptable: we must take action to change it, particularly given that the Government say they want to move services into the community. Access to vital community healthcare cannot be dictated by an unjust postcode lottery.

Community hospitals receive less funding and less attention than larger acute hospitals, resulting in workforce shortages and rundown estates. There has also been an escalating process of service reductions at many community hospitals. Often, these changes are introduced under the guise of being trials, but they almost always become permanent. Pragmatic changes to services because of shifting demand are sometimes necessary, but too often changes are made without proper consultation or a proper explanation to the communities affected.

The Liberal Democrats are clear that we wholeheartedly support the ambition to shift more care into the community, but we must get community hospitals to a place where they can complement and play a vital role alongside neighbourhood health centres. Rural communities know all too well the pressure that the healthcare system in their areas is under, and the important role that community hospitals play. Consequently, we have been calling for a rescue plan for rural health services, in which rural community hospitals would be an essential pillar.

As part of the plan, we have called for a strategic small surgeries fund to sustain services in rural and remote areas, as well as a strategy to close the gap in access to primary healthcare between urban and rural areas. We are also calling for an emergency fund to reverse closures of community ambulance stations and to cancel planned closures of services where they are needed, which would particularly benefit rural communities. We would put an end to the postcode lottery of care provision, which disproportionately impacts rural communities, through a national care agency. We need a new national drive for first responders in rural communities. We need to protect air ambulances, integrating them into the emergency care system, and to ensure that they receive adequate NHS funding in addition to charitable donations.

Will the Minister heed these calls and take the necessary steps to ensure that community hospitals that serve rural communities receive the support they deserve? The bottom line is that community hospitals are a service to us all. They are vital in the provision of care closer to home; they bring multidisciplinary services closer to the community; they bridge the gap between hospitals and GPs; they relieve strain on hospital beds and A&E departments; they support faster discharge and rehabilitation, and so help patients to regain their independence; and they improve healthcare access for elderly and vulnerable patients by reducing travel burdens for both themselves and their families.

I urge the Minister to reflect on the important calls that I, my hon. Friends and others across the House have made in this debate, to ensure that we are all doing all we can to better support community hospitals.

--- Later in debate ---

[Mrs Hodgson]

As the hon. Gentleman has acknowledged, this is not actually my brief. As much as I can try to answer his questions, I think I might have to commit that the relevant Minister will write to him on that specific point.

For patients who still require hospital care, we are delivering millions of additional appointments and reducing waiting lists across elective care. The Government’s elective reform plan sets out commitments to reduce disparities across elective care access and waiting times, including by improving practical support for patients through better transport options. Virtual care models will offer patients in remote areas better access and more convenience by providing services that are more responsive to their needs. Expanding digital access is also crucial to improving the experience and health outcomes for rural communities. Digital services can improve access for many patients, but they must complement, not replace, high-quality, local face-to-face care.

[Helen Maguire]

I want to expand on that point because, as we have heard from Members, there are many elderly people in rural communities who may or may not have access to digital services. Will the Minister provide some assurances to me and my hon. Friends that elderly people will not be excluded because they cannot access services digitally?

[Mrs Hodgson]

Absolutely. Digital services will complement and not replace the face-to-face care, so we are developing the NHS app and expanding online consultations for those for whom it will be helpful. There will be digital triage and remote monitoring, allowing patients in rural areas to access more NHS services, but I take on board the hon. Lady’s point about ensuring that we do not exclude people.

It is important to recognise that decisions about individual services are made locally by NHS organisations, which are responsible for assessing the needs of their populations and planning services accordingly. As strategic commissioners, ICBs work closely with health and wellbeing boards, local authorities and other partners to identify the most impactful outcomes for their population. ICBs will choose the right delivery model for their local area to deliver these outcomes, enabling capable providers to lead local services designed to meet the needs of their patients. That means looking carefully at local need, rurality, the workforce, clinical evidence and the long-term sustainability of services, rather than applying a one-size-fits-all model. Those decisions must be accompanied by appropriate engagement with patients, staff and local communities.

The hon. Member for South Cotswolds highlighted an important challenge. Whether national ambitions are matched by what people say and experience on the ground is a question we must take seriously. If we are to successfully shift care closer to home, community-based services must be equipped to meet growing demand. In Cirencester, as we have heard, local provision remains very important. Existing services continue at the hon. Member’s local hospital, including in-patient and out-patient care, therapies and the minor injury and illness unit. Local NHS partners are also testing how services can better meet local need, including a specialist 15-bed frailty complex care unit alongside a 28-bed intermediate care ward. These changes are being tested locally and evaluated carefully; I am told that no permanent decisions have been made.

I have made a careful note of the hon. Member’s five questions, as I am sure my officials have. I will ensure that the relevant Minister writes to her with further details on her specific questions; I will also request that they meet her, as her fifth request was about when that could be arranged. On staffing in particular, I can update her: the NHS workforce plan is to be published imminently.

The pressures that hon. Members have described are familiar across much of the country. We have an ageing population, an increasing prevalence of long-term conditions, growing demand for rehabilitation and recovery services and, in some areas, significant population growth driven by new housing developments. These pressures make local community-based services more important, not less. Meeting those challenges will require strong, joined-up community services, with community nursing, therapies, rehabilitation, urgent community response, virtual wards, and primary care and social care working together across the needs of patients.

Ultimately, the future of community hospitals should not be considered in isolation. They form part of a broader community heath infrastructure that includes neighbourhood teams, community providers, primary care, mental health services, social care and the voluntary sector. The question is not simply how many community hospitals we have, but how we use our community assets and services to provide high-quality care closer to home.

I am very grateful to the hon. Member for South Cotswolds for bringing this important issue before the House. The debate has highlighted both the enduring value of community hospitals and the important role that they can play in supporting local populations, especially rural ones. As we continue our work to strengthen neighbourhood health services and shift care closer to home, the experiences and concerns raised by hon. Members today will make an important contribution to that discussion. I thank all hon. Members for their participation in this debate.

Secondary Breast Cancer

Helen Maguire Excerpts

Thursday 11th June 2026 Westminster Hall

[Helen Maguire (Epsom and Ewell) (LD)]

It is a pleasure to serve under your chairmanship, Mr Betts.

I thank both my hon. Friend the Member for Wokingham (Clive Jones) and the hon. Member for City of Durham (Mary Kelly Foy) for securing this important debate, and for sharing their experience with cancer. I also thank the hon. Member for West Lancashire (Ashley Dalton) for her frankness and openness in describing her own experience.

Secondary breast cancer is now the leading cause of death in the UK for women between 40 and 49. Each month, around 1,000 people lose their lives to secondary breast cancer. That is one person every 45 minutes, so two lives will be lost to this disease in the short span of this debate.

Secondary breast cancer is incurable; treatment can slow down the disease, but it cannot cure it. Nevertheless, 13 years after data collection on secondary breast cancer became mandatory for all NHS trusts, the true number of people living with this disease remains unknown. It is estimated that the number is around 61,000. However, the lack of accurate data makes thousands of people who are in need of care invisible to the healthcare system. That is simply unacceptable. Those people count and we must count them. Collecting and publishing this data is essential. Without it, how can the NHS accurately assess the scale of need and appropriately plan services to ensure that support is available where required?

The Government’s commitment within the national cancer plan to define and count all secondary cancers, beginning with breast cancer, and the target to meet all cancer wait-time standards by 2029, are steps in the right direction. But to achieve those ambitions in full, we must be bolder and do so much more.

The Liberal Democrats are clear: quality and speed of treatment are vital to increase the survival rates for secondary breast cancer. The results of the research conducted by Breast Cancer Now in 2019 are damning. They make the lack of quality and the poor speed of treatment and care undeniable. They showed that 23% of respondents had to see their GP three or more times before they were diagnosed, and 53% of respondents said that they had not been given enough information about clinical trials by healthcare professionals. Just 30% of respondents said that they saw a cancer nurse specialist regularly and only 13% of respondents who had previously had breast cancer felt that they had been given enough information to recognise the signs and symptoms of secondary breast cancer.

Those figures show a healthcare system that is creaking under the strain after years of neglect by the previous Conservative Government. They highlight that professionals lack the time and capacity to effectively diagnose, offer follow-up care and share sufficient information, for which patients ultimately pay the price.

Every patient must get the care and support they need, when and where they need it. We must support the specialist cancer workforce, as well as GPs, to deliver the standard of care they would like and we expect. I therefore urge the Minister to take forward the Liberal Democrats’ proposals to introduce a guarantee that 100% of patients will be able to start treatment within 62 days from urgent referral; to recruit more cancer nurses so that every patient has a dedicated specialist supporting them throughout their treatment; and to expand the Medicines and Healthcare products Regulatory Agency’s capacity to halve the time for new treatments to reach the patients who desperately need them.

I think of the two people who will have lost their lives to secondary breast cancer in the 90 minutes of this debate. For them, and all the secondary breast cancer patients past, present and future, I implore the Minister to consider many of the calls raised by me and my colleagues here today.

[Mr Clive Betts (in the Chair)]

We move on to the shadow Minister, Dr Caroline Johnson, who has 10 minutes to make her contribution.

Compassionate Use Medicine Schemes: VAT

Helen Maguire Excerpts

Thursday 11th June 2026 Commons Chamber

[Mr Speaker]

I call the Liberal Democrat spokesperson.

[Helen Maguire (Epsom and Ewell) (LD)]

I was deeply shocked to hear about the change in HMRC’s policy. It is extremely worrying that pharmaceutical companies must now pay VAT on drugs available through compassionate use and early-access schemes. In April, HMRC told the pharma industry that it would pause enforcing VAT bills while the Government considered measures to support the industry in supplying patients who desperately need these drugs. The changes have been mired in uncertainty and misunderstanding, and there has been poor communication from HMRC from the start.

The Government must ensure that they create a workable long-term solution for the pharmaceutical industry to support these patients who are in desperate need. Patients must not lose access to medicines as a result and HMRC must communicate with pharma and patients effectively. For patients of all ages with rare cancer types, schemes such as these are the only way to access potentially life-extending treatment. Has the Minister spoken to cancer charities about the real-life effects that the changes will have? We should be making it easier for patients to access life-extending drugs, not harder. Will the Minister confirm that patients will not be denied lifesaving drugs as a result of these changes?

[Karin Smyth]

I thank the Liberal Democrat spokesperson for her comments. She knows that we engage with the sector all the time and, as I said in my earlier response, we will continue to work with bodies across the life sciences sector and with patients, the NHS, HMRC and the Treasury. A range of options are being considered and no decisions have been made.

Oral Answers to Questions

Helen Maguire Excerpts

Tuesday 9th June 2026 Commons Chamber

[Mrs Hodgson]

I commend my hon. Friend for her great work and that of the APPG in highlighting the importance of endometriosis and the impact it can have. We would be delighted to continue our close engagement with her and the APPG on this topic. We will consider the APPG’s findings carefully when they are published, as part of our ongoing work to improve diagnosis, treatment and support for women with endometriosis.

[Helen Maguire (Epsom and Ewell) (LD)]

Epsom and St Helier hospitals need urgent funding now, not just patchwork repairs. In 2024, 600 operations were cancelled due to ventilation issues and the situation is only going to get worse, so will the Minister address the backlog of hospital repairs now to ensure that patients and staff have safe and modern facilities in Epsom and Saint Helier hospitals?

[James Murray]

Under this Government, we have increased capital investment in our NHS estates, including hospitals. Under the previous Government, that was sorely lacking, which stored up the problems we are experiencing today. There is a huge amount that we need to invest in, to ensure that the NHS is fit for the future, but we also need to reform the service, which is why modernising the NHS is a key priority for me and this Government.

Maternity Commissioner

Helen Maguire Excerpts

Monday 20th April 2026 Westminster Hall

[Anna Dixon (Shipley) (Lab)]

It is a pleasure to serve under your chairship, Ms Jardine. I echo the thanks given by my hon. and learned Friend the Member for Folkestone and Hythe (Tony Vaughan) to all the petitioners who signed the petition, including 262 of my Shipley constituents.

My interest in maternity safety goes back to the time, over a decade ago, when I was director of policy at the King’s Fund. We set up an inquiry into the safety of maternity services, which was chaired by Baroness Professor Onora O’Neill. Despite the fact that that work was done more than a decade ago, the failures that we hear about today are sadly all too familiar. What struck us at that time was that there had been many reports in the preceding decade, including confidential inquiries into maternal and infant deaths, and that the recommendations had not been implemented. It makes me angry that there has been another decade of more inquiries and reviews, with the recommendations going unheeded.

That is why I am pleased to be an officer of the all-party parliamentary group on patient safety, and why I have worked with my hon. Friend the Member for Morecambe and Lunesdale (Lizzi Collinge) and the right hon. Member for Godalming and Ash (Sir Jeremy Hunt) to make maternity safety one of our priorities on the APPG. It has been fantastic to join colleagues, including my hon. Friends the Members for Sherwood Forest (Michelle Welsh) and for Rossendale and Darwen (Andy MacNae), across all-party parliamentary groups to share our insights and to contribute to the Amos investigation. There are still some of the same issues we heard about in the King’s Fund inquiry a decade ago: poor teamwork, weak accountability, defensive cultures and a failure to translate learning into sustained action.

Like many Members, I hear a range of stories as a constituency MP. Those are mainly centred on Bradford Royal infirmary, and I want to share the story of a constituent whose son was born with complications from the umbilical cord being wrapped around his neck. A late crash call was made after he had been delivered, but sadly he suffered catastrophic brain injury and was in a minimally conscious vegetative state. The women and her son were sent home with no diagnosis, and the child has grown up with epilepsy and other problems due to his brain injury. Sadly, it seems that midwives falsified the Apgar scores on the record and the time of the crash call. We have heard about defensive practice. We need a culture that changes it.

My constituent wrote to me:

“I have encountered significant barriers in navigating the NHS complaints system, particularly for marginalized communities. Language barriers further complicate the process, often leading to the dismissal of legitimate concerns.”

I am pleased to say that Bradford Royal infirmary has recently received good and outstanding ratings from the Care Quality Commission, for maternity and neonatal care respectively. I know that staff are not complacent about the care they give.

Others have mentioned the clinical negligence complaints system. I am a member of the Public Accounts Committee, and we have looked at how issues with that system have not only a human but a financial cost. One of our conclusions was that patients often pursue legal action because the complaints system itself is so confusing and unresponsive, which echoes the thoughts of my constituent. It is therefore vital that there are timely apologies from clinical staff and that we put in place effective, compassionate local resolutions. That will reduce claims, but is also ethically the right thing to do.

I would be grateful if the Minister could update us on the progress of the David Lock KC review, which we heard a lot about at the Public Accounts Committee. Alongside a better complaints system, we also talked about reform of litigation and potentially a no-fault compensation scheme, which would certainly go some way to creating a better environment. At the moment, families often experience long legal battles following harm, which leads to clinicians and organisations becoming defensive.

I want to finish with a brief example of what happens when people are failed but want to share any learnings with the NHS. My friend Martha’s second child died. It was a homebirth with complications. She started labour at 2.30 am. At 5.30 am she called the delivery suite, and staff told her to call back in a few hours. When she did, they sent out a midwife team who did not reach her until 9.40 am. A few moments later, her waters broke and she gave birth to her second daughter, but there was meconium in her discharge. As Members who are clinical will know, that is a sign of baby distress. The midwives called an ambulance immediately. It was another 19 minutes after the 999 call until the ambulance arrived and oxygen was given. Those minutes after birth were crucial, and that length of time without oxygen would have caused global brain damage and severe disability had their daughter survived. Sadly, she died in the care of Great Ormond Street hospital just a couple of days later.

The point of telling that story is that there are many missed opportunities to provide safer care. If the midwives had carried birthing equipment when they were attending, they could have provided immediate care. If the ambulance had prioritised the call from the midwife, it could have prevented the deterioration.

[Helen Maguire (Epsom and Ewell) (LD)]

Will the hon. Lady give way?

[Anna Dixon]

I am sorry but, respectfully, I am not going to give way.

If the ambulance had routinely carried a neonatal meconium aspirator, that could have prevented the death of my friend’s daughter. My friend said:

“I was not told who we could complain to following these experiences, or when we should do so.”

Whether it is through a maternity commissioner or another way, we need to learn systemically from women’s experiences so that safety recommendations can be implemented. When we hear from Baroness Amos’s investigation, I hope that Ministers will finally act swiftly to implement her recommendations and back them up with investment, so that families can have confidence that when tragedies like those of my friend and those of my constituent occur, the system will genuinely learn, improve and take action.

--- Later in debate ---

[Helen Morgan]

I thank my hon. Friend for his intervention—he was quick off the mark. Yes, I agree that it will be useful to have a maternity commissioner to share those experiences and ensure that people learn from them.

The campaigners, Theo and Louise, have shared their heartbreaking experiences. I commend their work in securing this important debate. Liberal Democrats wish to be their allies. As a previous co-chair of the APPG on baby loss, I am all too familiar with the acute need for better standards of care for mothers across the country. I was also a member of the APPG on birth trauma when it was headed so ably by Theo Clarke, when the need for a maternity commissioner was first discussed and recommended. I am delighted to see the traction that this proposal has had thanks to the campaigning of Theo, Louise and many others.

Last month, the Lib Dems launched our maternity rescue package, which would guarantee high-quality care wherever people live and would make Britain the safest country in the world to have a baby.

[Helen Maguire]

I have a constituent who had a history of rapid births. She wanted the safety net and support of a home birth team alongside the community team, as recommended, but she was unable to have both teams involved. Does my hon. Friend agree that it is difficult to have confidence in a safe birth if the right medical support simply is not there?

[Helen Morgan]

My hon. Friend makes a good point. Patient voice—listening to women, understanding their wishes and understanding the risks that their wishes might represent and how to manage them best—is such a critical part of safe maternity care.

In drawing up our rescue package, I have drawn from my experience on the all-party groups on birth trauma, on maternity and on baby loss. There is so much common ground with the cause of the petitioners. We hope that they are buoyed by the fact that someone in Westminster is listening. With our package, a national maternity commissioner would oversee improved standards of care nationally, while a director of midwifery would be appointed in every maternity unit, alongside an extra 300 consultant midwives, to drive clinical excellence in each unit.

Our plans would invest £600 million to tackle these vital staffing requirements, but the NHS could save billions of pounds on maternal clinical negligence claims, which cost more than £1.3 billion in 2024 alone. Those huge clinical negligence costs have consistently been reflected in the findings of local and national reviews, but most importantly, the package would save babies’ lives and spare families the trauma of injury or worse happening to mum and baby at what should be the most joyous time of their life.

Liberal Democrats welcome the recent interim review by Baroness Amos. The findings of the review were devastating, showing that too many mothers are not receiving the level of care that they need, with devastating consequences for women, babies and their families. But this is the latest in a string of national and local reviews and inquiries, which have produced more than 700 recommendations. Those reviews, with their myriad but similar recommendations, illustrate why we need a maternity commissioner—someone who can bring together the learnings from past failings, along with the best practice from around the country, and oversee a step change in training and culture that will enable all the health professionals in maternity to work as effective teams and give women the personalised and high-quality care that is needed.

People across the country were truly shocked by the findings of Donna Ockenden’s review of the Shrewsbury and Telford hospital trust, which serves my constituents. The review found that the deaths of more than 200 babies could have been prevented. Over the years, I have heard—sometimes as a friend, sometimes as an MP—from traumatised and grieving parents, each with their own experience of birth trauma, injury to their baby or worse. They have told me how important it is to them that the reports and inquiries spark the vital change that is needed, and do not lead only to warm words from politicians followed by decades of gathering dust on the shelves of the Department of Health.

Since the Ockenden review, the Shrewsbury and Telford hospital trust has accepted and taken steps to implement almost all the immediate and essential actions that Donna Ockenden recommended. While that process has not been perfect, it has clearly been conducted with appropriate focus. The latest CQC rating for maternity at SATH is good, showing that with the right recommendations and leadership, positive change can happen. The team at SATH should be commended for that achievement. They demonstrate the value of focusing on the steps needed to get care right.

As we found out subsequently, however, unsafe maternity care was not unique to Shropshire, or indeed to Morecambe, East Kent or any of the other places about which we have heard such awful stories. We know that women all over the country are still not receiving the care they need. None of the services that the Care Quality Commission inspected in its national review was rated outstanding. Some 65% of maternity units were unsafe for women to give birth in. It is a scandal that mothers in this country have to settle for potentially dangerous levels of care at what should be one of the happiest moments in their life.

The introduction of a maternity commissioner is not a quick fix, but a commissioner would provide the leadership required for serious change to the way women and staff on maternity wards are listened to. That commissioner could look at disparities in maternity care and the poorer outcomes that we see for black and Asian women and those in deprived communities, and drive the change needed to make having a baby safe, no matter what your background is. Other improvements are needed, too.

Our proposals are to guarantee specialist doctors on every maternity unit 24/7, and one-to-one midwifery care for every woman during labour to respond to the desperate need for safe staffing highlighted in each of the reviews and in the inquiries by the all-party groups that deal with maternity care. Previous research found that 73% of maternity units in England do not have a consultant present at night, despite most births taking place outside working hours. Many negligence claims for poor maternity care are linked to failings in care outside regular working hours.

The proposals come alongside a new capital investment programme to fix crumbling maternity units in need of urgent repair and to deliver new dedicated bereavement suites. We would start with the 7% of maternity units that are at risk of imminent breakdown, and would restore the 42% of units in need of major repairs. These crucial steps come alongside many other proposals to improve staff training, to invest in bereavement support, neonatal specialists and pre-conception services and to eliminate maternal health disparities.

It is really, really, really important to say that the vast majority of babies are delivered safely, even when things do not go to plan. But we should not dismiss those instances where they go wrong, and we should be tireless about making the improvements required. I congratulate the campaigners on the success of the petition so far. I continue to urge the Government to demonstrate that recommendations will be turned into actions, and that the cries for help from countless mothers and families will be listened to.