NHS Capital Spending

Helen Maguire Excerpts

Wednesday 4th March 2026 Westminster Hall

[The Minister for Secondary Care (Karin Smyth)]

It is a pleasure to serve under your chairmanship, Mr Western. I thank colleagues for their kind remarks about my hon. Friend the Member for West Lancashire (Ashley Dalton). We will miss her. She has set a great example, not only by continuing while undergoing cancer treatment but, as hon. Members have said, by recognising that sometimes we need to look after ourselves and prioritise our constituents. No doubt she will be doing that very well, and I look forward to her contributions from the Back Benches.

I congratulate the hon. Member for Carshalton and Wallington (Bobby Dean) on securing this important and timely debate. I hope that my name came up occasionally when he was perusing previous debates on this issue, because I am one of the few Members of Parliament over the past 10 years who has banged on quite a lot about capital. I am delighted to be the Minister, because the sound management of that capital is absolutely crucial to the provision of healthcare for all our constituents. I agree that it does not get enough airtime, and the hon. Gentleman made an excellent speech outlining most of the issues. We have heard a lot of contributions today, and I will try to do justice to this very wide-ranging debate.

Let me remind hon. Members of the problem. I have with me Lord Darzi’s report, which said:

“The NHS has been starved of capital and the capital budget was repeatedly raided to plug holes in day-to-day spending…Some £4.3 billion was raided from capital budgets between 2014-2015 and 2018-2019”.

It said:

“The result has been crumbling buildings”

and

“services were disrupted at 13 hospitals a day in 2022-2023. The backlog maintenance bill now stands at more than £11.6 billion”.

The report also said that the NHS was “in the foothills” of the digital transformation that the rest of the country—indeed, the rest of the world—was undergoing. There was also a shortfall in capital investment.

I kind of admire the hon. Member for Hinckley and Bosworth (Dr Evans) for defending that situation—it is a tough gig—but we all see what happened in our constituencies. I am very proud of the capital investment under the last Labour Government, and I will come back to PFI in a moment.

Reversing that trend and repairing and rebuilding our healthcare estate is a vital part of our ambition to create an NHS fit for the future. That is why we are prioritising the estate to support that task. First, we are prioritising core and safety technology equipment and—this is an important measure introduced by the Chancellor—changing the rules on capital to stop capital-revenue transfer. We are also incentivising the system and streamlining the processes; the hon. Member for Hinckley and Bosworth tells us how terrible the processes were, but his party was in government. We have taken control and used Government to good effect to start streamlining those processes. Part of that is about moving towards making one team of NHS England and the Department of Health—I hope hon. Members will support us in that. We are also building the capacity and capability of the staff in order to develop and do the work we need them to do. That capacity has been completely depleted over the last 14 years.

We have put a lot of information into the system to move things quickly, and I think we are all seeing the benefits of that in our constituencies. We will bring forward a capital plan in the spring to make all of that clearer for the system and for hon. Members.

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

The Minister is making an important point about the vital need for capital funding in the NHS. I and a number of colleagues are here in the Chamber because St Helier hospital is falling apart, and unfortunately patients are being affected, but the hospital build programme has been delayed another three years. There has been lots of goodwill in the debate, but we are looking for additional investment in the A&E. I hope the Minister will take that away, and that there might be something about it in a statement soon.

[Karin Smyth]

The Chancellor has made her key decision to put us back on track, announcing in the Budget that capital health spending would increase by £15.2 billion by the end of the spending review period in 2029-30. That funding will be used as intended; in previous years, as we heard, capital funding was diverted to cover day-to-day costs. We have tightened the Treasury rules; we have changed them, because that is what Government can do—who knew! As a result, capital funding will now be fully focused on repairing, upgrading and expanding NHS buildings and facilities to support long-term productivity. This settlement represents record levels of capital investment into healthcare, and it will support the three shifts set out in the 10-year health plan: moving care out of hospitals into the community, replacing outdated systems with modern digital services and focusing on preventing illness rather than just treating it.

Of course, rebuilding NHS infrastructure cannot happen overnight. I assure hon. Members that the Government do understand that long-term certainty over capital funding is needed for the NHS to move from these short-term fixes to more strategic investment. That is another key decision made by the Chancellor. That is why, through the 2025 spending review, we have delivered a four-year capital health settlement, extending to 2029-30. That is backed by a further five years of certainty for estates maintenance funding. I am genuinely grateful to hon. Members for recognising that that is a massive change that we have engineered into the system, and I think we are all seeing the benefit.

That change means there is a £30 billion commitment in capital funding over five years to support the day-to-day maintenance and repair of the estate, with a further five years of funding certainty, as set out in the 10-year plan. For the first time, NHS trusts have also been given multi-year operational capital allocations, with clear funding set out until 2029-30, and indicative funding for a further five years. This is an unprecedented opportunity for local health systems to plan with confidence over a nine-year period, and I continue to encourage all Members to engage with their integrated care boards, which will be prioritising schemes over that period.

Within the £30 billion, the estates safety fund will continue, providing £6.75 billion of investment over the next nine years to target the most critical building repairs, alongside £2 billion to continue supporting NHS England’s RAAC programme across the spending review. Additionally, £21 billion in operational capital over the five-year spending review will empower NHS organisations to invest in local priorities, including hospital infrastructure. It will take time to build up capacity and capability, but this marks the beginning of our rebuilding of an NHS that is fit for the future.

I also assure Members that this Government recognise the pressures faced across the system and are committed to bringing performance standards back to what patients expect. That is why we are investing to expand hospital and emergency care capacity, helping to reduce waiting times and improve care for patients. Over the next four years, there is £1.9 billion for urgent emergency care to support A&E departments, as well as to support ambulance services in reducing handover times.

There is also £1.5 billion for diagnostics, including funding to expand the hours of community diagnostic centres, shifting care from hospital to the community. The hon. Member for Hinckley and Bosworth noted that those centres were started under the previous Government, but we have ensured they have expanded hours and that there are more of them. Crucially, they are not built as add-ons, but are fundamental to the pathways experienced by patients in the system and ensure we have good value for taxpayers’ money.

There is £473 million for mental health services, including for people with learning disabilities and autism. I think we would all agree that the mental health estate needs recognition. There is more than £280 million for community care, supporting services closer to home, and more than £139 million for electives across the next two years. To move away from paper-based systems towards modern digital services, the autumn Budget confirmed £300 million in capital investment in technology, building on the combined revenue and capital investment announced at the spending review of up to £10 billion by 2028-29.

We are transforming healthcare by shifting care out of hospitals and into the community. Over the next four years, we are investing more than £400 million to upgrade primary care buildings and deliver neighbourhood health centres, as part of our commitment to those 250 neighbourhood health centres through the rebuild programme.

Oral Answers to Questions

Helen Maguire Excerpts

Tuesday 24th February 2026 Commons Chamber

[Karin Smyth]

I commend my hon. Friend for visiting her ambulance service, as many hon. Members do, to understand the pressures they are working under. It is a useful visit to understand those wider issues, as she says. She raised an important point about handover delays impacting staff as well as patients. Reducing these delays will ensure that staff are no longer stuck outside emergency departments. On the wider issue about the front door, NHS England’s model emergency department will set out core principles and pathways for high-performing emergency departments, which will improve patient experience and flow with lower waiting times and less overcrowding. We are committed to improving rest facilities to support staff wellbeing.

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

In November, I joined a local ambulance crew and saw at first hand the great work they do for our community, but services are under huge strain. Will the Minister designate ambulance stations as critical infrastructure to protect them from closure and set up an emergency fund to support them?

[Karin Smyth]

I commend the hon. Member for going out with her crews. One of the reasons we have been so successful this year in improving the services is by looking at things such as where ambulances are located and how they operationalise their services. We will continue to work with NHS England on the best model for local constituencies.

Brain Tumour Survival Rates

Helen Maguire Excerpts

Monday 9th February 2026 Commons Chamber

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

I congratulate my hon. Friend the Member for Witney (Charlie Maynard) and the hon. Member for Mitcham and Morden (Dame Siobhain McDonagh) on securing this really important debate in the Chamber, and I thank them for campaigning so tirelessly on this issue. I know how closely it affects families, including the family of my hon. Friend the Member for Witney. I was pleased to work with Georgie and Brain Cancer Justice on a letter to the Minister for public health and prevention, the hon. Member for West Lancashire (Ashley Dalton), regarding brain cancer vaccination trials before Christmas.

For brain cancer patients in the UK, no vaccine trials are running. The national cancer plan, published last week, committed to delivering up to 10,000 cancer vaccines. The ambition is that this kind of treatment will be more widely available by 2035. However, for many, that will be too late. Around 35 families every single day hear the news that a loved one has been diagnosed with a primary brain tumour, and many see that as a life sentence.

[Dame Siobhain McDonagh]

I have met Moderna, a leading company in developing cancer vaccines. I asked if it would give University College London a cancer vaccine for free for a trial on glioblastoma brain tumours, but it refused. Its excuse was that it could not make enough of the drug for 16 people. This is the rub: commercial companies do not get involved because there simply is not enough money in it, unless the Government intervene.

[Helen Maguire]

The hon. Lady brilliantly describes the real nub of the problem.

One of my constituents got in touch to tell me that in the space of a few months, four people that she knew received a brain tumour diagnosis. With symptoms ranging from seizures to changes in behaviour, the diagnosis process for brain tumours can be dramatic, lengthy and hard fought. That is why we urgently need improvements in diagnosis. The national cancer plan aims to make great strides in speeding up diagnosis, but I was disappointed that the Government did not take up the Liberal Democrats’ calls for 8,000 more GPs, to ensure that everyone can get seen quickly and be referred for treatment.

Once a referral is successful, the brain tumour should be treated. To see delays because of equipment shortages is a disgrace. The Government have pledged funding for 28 new radiotherapy machines, which is a step in the right direction, but the Liberal Democrats have long called for 200 new, fully staffed machines, so that we can end radiotherapy deserts and stop delays to vital treatment. Will the Minister set out when we can expect funding for more machines?

Brain cancer has a more complex element; it does not occur in stages like other cancers, but is defined by grades. The grading system can also differ, depending on the type of brain tumour that the patient has. The national cancer plan has looked to offer some relief to patients by giving a commitment that a clinical nurse specialist or other named lead will support them through diagnosis and treatment to hopefully make the path clearer. I look forward to seeing how the Government intend to support this ambition by providing enough staff through the 10-year workforce plan. While we are waiting for that plan, will the Minister give some clarity on how he plans to implement the commitment to providing 5,000 learning and training opportunities per year for the first three years of the plan for people in cancer-critical roles?

It is important that I mention benign brain tumours. Just because they are not cancerous, it does not mean that people do not experience a life-changing impact from being diagnosed with them. Those living with benign brain tumours must also receive the right treatment, care and lifelong support.

I really hope that we are at a turning point in cancer care, especially for brain tumours, which kill more children and adults under the age of 40 than any other cancer. I am pleased to see many organisations, including Brain Tumour Research, welcome the national cancer plan, especially the proposed access to clinical trials and increased research. There is a lot of ambition in the plan that must be accounted for, so will the Minister confirm that the annual summary of progress for the national cancer plan will be presented in the House every year for proper scrutiny?

[Madam Deputy Speaker (Caroline Nokes)]

I call the shadow Minister.

National Cancer Plan

Helen Maguire Excerpts

Thursday 5th February 2026 Commons Chamber

[Madam Deputy Speaker (Judith Cummins)]

I call the Liberal Democrat spokesperson.

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

I thank the Minister for advance sight of the statement and for her personal experience that has gone into this plan. After the Conservatives failed to invest in our NHS, it is no surprise that cancer survival in the UK is still around 10 to 15 years behind leading countries, with worse survival rates for some cancers than Romania and Poland. I am therefore pleased that this Government listened to my hon. Friend the Member for Wokingham (Clive Jones) and brought this national cancer plan to life, because cancer touches everyone.

One of my residents, a mum with a young family, discovered a lump in her breast. Despite attending the one stop breast clinic on four separate occasions, it took two horrendous years for her to be diagnosed with breast cancer. When she was finally diagnosed, the cancer was aggressive and required a mastectomy, chemotherapy and radiation therapy. That is why I welcome the Government’s target on meeting all cancer wait time standards by 2029, but the aim to halve the backlog in three years’ time is not ambitious enough. Will the Minister go further and back a Liberal Democrat plan to write into law a guarantee for all cancer patients to start treatment within 62 days from urgent referral?

The focus on ending delays in cancer care is a step forward, but funding 28 new radiotherapy machines is not enough when the treatment is so cost effective and successful. We need to end radiotherapy deserts, so will the Minister extend her ambition to 200 extra radiotherapy machines?

The Minister says that the plan will turn the NHS app into a gateway for cancer care, but how will she support older people and the digitally excluded? The plan promises to drive up productivity, end the postcode lottery, expand NHS diagnostic capacity, introduce personalised cancer plans and more. That is optimistic and will require more investment to increase NHS capacity, but without clear funding and capacity building plans, is it realistic?

Labour was right to put patients at the heart of this plan and incorporate the Liberal Democrat’s calls for a specialist cancer nurse for every patient. We costed for 3,000 extra cancer nurses; how many additional cancer nurses does the Minister believe are needed?

Finally, will the Minister confirm that the plan’s annual summary of progress will be reported in the House for Members to scrutinise?

[Ashley Dalton]

We listen to a lot of people on the need for a cancer plan. I want to take this opportunity to say that our friend Nathaniel Dye, who sadly died last week from stage 4 bowel cancer, challenged my right hon. Friend the Secretary of State to bring forward a cancer plan when we were in opposition. The Secretary of State made that commitment, and we have brought forward the plan 18 months after coming into government.

The hon. Lady mentions the NHS app, which we understand is not necessarily relevant for people who are digitally excluded. One reason we are bringing that forward is to open up capacity within the rest of the system, so that those who can use digital tools can do so. That will free up capacity for the one-to-one, face-to-face support that many people need, but every cancer patient will get support under this plan, whether that is through the app or through their named lead clinical specialist in their neighbourhood, who will support them throughout the process, including after treatment. We are working with NHS England to identify the appropriate number of people for the cancer workforce, and we will be able to announce more about that as the workforce plan develops.

Medical Training (Prioritisation) Bill

Helen Maguire Excerpts

Committee of the whole House
Tuesday 27th January 2026 Commons Chamber

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

Last year, research by the Royal College of Radiologists found that 76% of English cancer centres had patient safety concerns due to workforce shortages. While we welcome the Government’s recent commitment to ending the postcode lottery of cancer care, does my hon. Friend agree that the Government need to publish an assessment of the Bill’s impact on doctor numbers, broken down by speciality, to ensure that cancer treatment is not delayed because of staff shortages?

[Helen Morgan]

I thank my hon. Friend for her point, which I agree with fully. That is why we have tabled new clause 1. It will require the Government to publish a report on the Bill’s impact on the number of applicants to foundation and speciality training programmes and, crucially, to break that down by speciality. If applications fall as a result of these changes, the Government would be required to assess the impact on the total number of fully qualified doctors entering the NHS. This report would be produced annually after three years, allowing time for a full training cycle to complete. It is a sensible safeguard, one that ensures that we do not inadvertently exacerbate the very workforce shortages that we are trying to address. To return to the core principle that is at stake, we are not opposed to the Bill’s objective. We support the principle of prioritising those who have trained in the UK, but that principle must be implemented fairly, transparently and with proper oversight.

Medical Training (Prioritisation) Bill

Helen Maguire Excerpts

2nd reading
Tuesday 27th January 2026 Commons Chamber

[The Minister for Secondary Care (Karin Smyth)]

It is a pleasure to close on behalf of the Government. I welcome the support of the Opposition spokespeople and the Chair of the Health and Social Care Committee, the hon. Member for Oxford West and Abingdon (Layla Moran). I put on record my thanks to them for meeting me in advance of the Bill and for airing their concerns.

From the many contributions this afternoon, there is clearly a broad base of sympathy and support right across the House for the measures in the Bill to support our NHS staff, who have been at the sharp end of every ill-conceived policy of the past 14 years—not least since the previous Government lifted the visa restrictions in 2020, as outlined by my hon. Friend the Member for Bournemouth West (Jessica Toale). The last Government’s failure to do any proper workforce planning has also led to patients struggling to find a GP appointment while GPs struggle to get a job, bottlenecks for resident doctors and an over-reliance on overseas workers and a refusal to foster our own home-grown talent.

Although I welcome the support, I find it slightly ironic that some of the Opposition speeches were around the need for clear and consistent routes and for clarity. That is exactly what we intend to provide to fix the mess. We will bring forward wider issues in the workforce plan, which, as the boss said earlier, will be in the spring. That is as a result of the concerns around training from the Royal Colleges and other stakeholders and making sure that we do that properly. We will bring that forward in due course.

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

rose—

[Karin Smyth]

I am going to make some progress. Time is of the essence, I am afraid, but we can pick up more in Committee.

When I was a manager in the NHS, I worked alongside many overseas doctors, and I want to make it clear from this Dispatch Box this afternoon that they are, of course, welcome here. The NHS is and always will be one of the most diverse employers in the world. This Bill is about bringing future generations into the health service and giving them the secure future that we all know they need. It is about sustainable workforce planning so that patients are no longer at the mercy of the market. Crucially, it is also about fairness. How is it fair that every year the taxpayer picks up a £4 billion bill to train medics who cannot then get jobs? Those taxpayers deserve a return on their investment. How is it fair that medics in this country put themselves forward to train, make sacrifices, get into debt and work long hours only to find themselves trapped in bottlenecks?

I am going to try to address a number of colleagues’ points. I commend my hon. Friend the Member for Sunderland Central (Lewis Atkinson), for his experience and for outlining the capacity and demand issues that people like him have to face as managers, and also for his important point about our workforce needing to reflect our society. He talked about the great work being done in Sunderland, and I was pleased to meet the leaders there, including Dr Wilkes, to see the work they are doing so that we can take that elsewhere. That is exactly what we want to do.

I also commend my hon. Friend the Member for Carlisle (Ms Minns)—the mum of a nurse, as she told us—for putting on the record the work of the Pears Cumbria School of Medicine and the intention of growing doctors who are steeped in Cumbria. She also mentioned health inequalities, and I would be pleased to meet my hon. Friend to discuss those issues further. My hon. Friend the Member for Thurrock (Jen Craft) was right to highlight the soaring numbers of people we are losing and to recognise that it was all going back to front.

Why do we need emergency legislation? We need Royal Assent by 5 March at the latest to ensure that the change happens this year. We do not want medics to face another year of bottlenecks. Specialty training offers will be made from March, and any delay will risk vacancies in August. This emergency legislation gives the NHS the certainty and stability it needs to carry on bringing down waiting lists and to keep us on the road to recovery. The people applying for those posts need enough time to make decisions about their lives, including deciding where they will move, finding accommodation and sorting childcare, and they deserve enough time to get on with that.

A number of colleagues have raised the definition of prioritisation for training posts. Let us be clear that, for specialty training posts starting this year, we will prioritise UK medical graduates and others, using their immigration status as a proxy for having significant experience of working in the health service. Colleagues might wonder whether there has been some pulling of strings to include Irish doctors in that prioritisation, but I can assure them that that is not the case. Ireland is included because of our special and long-standing relationship with Ireland and very similar epidemiology. I thank the hon. Member for South Antrim (Robin Swann) for the important points he raised about Magee College and working with the devolved institutions. I can assure him that officials have worked closely with officials in Northern Ireland on this. If there are any other issues, he should please raise them, but we have worked closely on that point.

From next year, 2027, immigration status will no longer automatically determine priority. I accept some of the points from my hon. Friend the Member for Poole (Neil Duncan-Jordan) . He perhaps suggested that the proposal was crude, but it is a proxy for this year. Next year we will bring forward regulations to prioritise whether someone has significant experience as a doctor in the health service or by reference to their immigration status. This point was raised by the Chair of the Select Committee, the hon. Member for Oxford West and Abingdon, and many others. We will continue to work with all partners and the devolved Governments to agree those criteria in time for the autumn application round.

On international staff, my hon. Friends the Members for Birmingham Edgbaston (Preet Kaur Gill) and for Uxbridge and South Ruislip (Danny Beales), the Chair of the Select Committee and others raised the issue of foreign doctors. Let us be clear that international staff play an important role in our NHS and they always will. The NHS might be the most diverse public body in the world, and we would not have it any other way, but we are recruiting doctors from abroad—sometimes even from countries that are short of medical staff—when there is already a pool of applicants at home.

As my hon. Friend the Member for Morecambe and Lunesdale (Lizzi Collinge) said, we are not about nicking other people’s workforces. Home-grown doctors are more likely to work in the NHS for longer, and be better equipped to deliver healthcare tailored to the UK’s population, because having been trained in the UK’s epidemiology, they better understand it. It is not fair for British taxpayers to spend over £4 billion training medics every year, as my hon. Friends the Members for Worthing West (Dr Cooper) and for Cannock Chase (Josh Newbury) said. Nor is it fair for doctors who struggled to get into specialty training places. As my hon. Friend the Member for Birmingham Edgbaston said, a responsible Government get a grip on this.

I will refer to the amendments when we move into Committee of the whole House. We are seeing the green shoots of recovery as we repair the NHS following the damage done over the past 14 years. We are turning another page on that decline. However, the decision in 2020 to lift visa restrictions has done untold damage to the system and to staff morale, and contributed to a national mood of cynicism and pessimism, especially among the young, so we need to act. Those points were articulated well by the hon. Member for Weald of Kent (Katie Lam), and expertly, as always, by my hon. Friend the Member for Bury St Edmunds and Stowmarket (Peter Prinsley).

Let me end my remarks by talking about the many young people who will be affected by the changes that we are setting out. As my hon. Friend the Member for Ipswich (Jack Abbott) said, these are not abstract statistics but personal costs. When I speak to those in my family, my constituency and even my parliamentary office who have breached the first barrier of getting to a medical school from a state school, I am disheartened to hear how many of them feel that their careers would be better served by moving abroad. In the 1970s, James Callaghan said that if he were a young man, he would emigrate. I do not want young people to take that path; I would rather say to them, “By all means, travel, see the world and enjoy that time, but there are great opportunities for you all in this country, and we want you to rebuild the NHS with us.” My niece is currently in Australia, and we sometimes call this the “bring Talia home Bill”.

The NHS must play its part in training our young people and keeping top talent in the UK. If colleagues agree that that is worth doing, and if they want to keep our people here, they should join us in voting for the Bill.

Question put and agreed to.

Bill accordingly read a Second time; to stand committed to a Committee of the whole House (Order, this day).

ADHD Diagnosis

Helen Maguire Excerpts

Tuesday 20th January 2026 Westminster Hall

[Bill Esterson (Sefton Central) (Lab)]

I beg to move,

That this House has considered ADHD diagnosis.

It is a pleasure to serve with you in the Chair, Ms Vaz. This debate is about how pathways to attention deficit hyperactivity disorder diagnosis might be improved, including by offering screening in schools, so that people can access the right support in good time.

We all have a pretty good idea of what ADHD means, but I am here because a 19-year-old constituent of mine, Matty Lock, took his own life in September 2023. He was diagnosed with autism at the age of 14, but he and his parents, Christine and Richard, who are here this afternoon, did not know about his ADHD until much later. In Matty’s memory, Christine and Richard have set up the Matthew Lock ADHD Charity, and they have been part of the independent taskforce. One of the things that the taskforce has done—this has been accepted by the NHS—is to highlight the proven link between suicide and ADHD. The prevalence of ADHD is 10 times higher among men attempting to take their own lives.

Let me say a few words about Matty. I knew him because he was very interested in politics. He had become a town and parish councillor, and he had campaigned hard with me for some time. Those of us who knew him through politics believed that he would be in this place before much longer. It is very, very sad that that was not to be.

Matty was known on television as “The Vac Mat” for his repairs of vacuum cleaners and his advocacy of domestic appliances on “This Morning”. He was everywhere in the community of Maghull—clearing up and playing his part. He was a real, strong advocate of the community that he grew up and lived in.

Matty’s ADHD was linked to how hyperactive he was. We know that people with ADHD are restless, lack concentration, are impulsive, act without thinking and always talk over others—actually, as I go through the list, I can think of nearly 650 people in this place who have a lot in common with that description.

What is the impact of having ADHD? We know that it leads to a significant number of school exclusions and very high drop-out rates. We know about the link with addiction, and that the prevalence of ADHD among people in prison is five to 10 times higher than among people outside. Sadly, we also know about the link with suicide.

NHS figures suggest that about 700,000 people are waiting for a diagnosis, and that many of them have waited for several years. Nearly two thirds of those people have been waiting for more than a year. The economic cost is estimated to be about £17 billion a year.

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

The hon. Gentleman is making a powerful speech that has affected us all. In November 2025, NHS Surrey Heartlands integrated care board in my constituency paused assessments on the Right to Choose pathway until April 2026, which has caused major disruption. My constituent’s daughter does not know when she will be seen or if she will be seen at all. I have talked to the ICB and I know that there has been a massive increase in referrals for ADHD, so does the hon. Gentleman agree that the Government must set out plans to improve local NHS provision of ADHD assessments?

[Bill Esterson]

The example of the hon. Member’s ICB is typical of ICBs around the country. The purpose of this debate is to raise the issue with the Minister and highlight how important it is to improve diagnosis and speed up how quickly people can get access to treatment and medication.

Domestic Abuse-related Deaths: NHS Prevention

Helen Maguire Excerpts

Tuesday 20th January 2026 Westminster Hall

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

It is a privilege to serve under your chairship, Sir John. I thank the hon. Member for Stroud (Dr Opher) for securing this vital debate.

In November 2025, Surrey police recorded 45 incidents of domestic abuse in my constituency, an average of 1.5 incidents every day. Let us be clear, those are not just statistics. Those numbers represent real people: mothers, daughters, sisters and children, experiencing some of the most harrowing abuses imaginable. I have met local organisations such as North Surrey Domestic Abuse Service, the Rape and Sexual Abuse Support Centre in Guildford and East Surrey Domestic Abuse Services to understand the support available to survivors.

What I learned is deeply troubling. The overwhelming number of women whose lives have been shattered by domestic abuse is staggering. Many victims face financial hardship, debt and isolation. Children grow up in fear, forced to endure violence in silence, their innocence stolen. Yet for some escape never comes. Gemma Devonish, a much-loved teacher at a local girls’ school in Epsom, was found with 54 stab wounds in her home in December 2024. Her boyfriend was due to stand trial for her murder but justice remains delayed, as the trial is yet to begin.

Aliny Godinho, a mother of four, was stabbed to death by her estranged husband in front of her three-year-old daughter while picking up her children from school in Ewell. Despite emergency accommodation having been arranged for Aliny in Streatham, her children remained at a school in Surrey. An examination of her husband’s computer revealed that he tracked her phone, accessed her emails and knew her new secret address.

Those tragedies are not isolated incidents; they are symptoms of systemic failure. Recorded incidents are only the tip of the iceberg, because less than 24% of domestic abuse crimes are reported to the police. The NHS, however, has more contact with victims and perpetrators than any other agency. That places healthcare professionals on the frontline of the domestic abuse epidemic, not just for identifying and supporting victims but for monitoring potential abusers.

Let us consider the case of Emma Pattison, the beloved headteacher at Epsom college, and her seven-year-old daughter, Lettie. Both were shot and murdered by Emma’s husband and Lettie’s father, George Pattison. George legally owned a shotgun and held a valid licence. Before his last licence renewal, which requires a letter from a GP, he used an online consultation service to obtain antidepressants. The online doctor had access to his medical records but they were unaware that he held a gun licence, and the medication was never declared to his GP.

If medical professionals are a line of defence against abuse, it is unacceptable for them to be left in the dark about who owns a firearm. Mandatory medical markers would ensure that any health professional with access to a patient’s records could see if the patient held a gun licence. If necessary, the health professional could immediately notify the police.

That measure is overwhelmingly supported. A survey by the Association of Police and Crime Commissioners found that 70% of existing certificate holders in England and Wales believe that a marker should be placed on the medical records of gun holders. Among the wider public, support rises to 86%. Will the Minister commit to exploring the benefits of mandatory medical markers with colleagues in the Home Office?

The previous Government’s guidance for health professionals states:

“Domestic violence and abuse is so prevalent in our society that NHS…staff will be in contact with adult and child victims…across the full range of health services.”

Too often, however, staff feel ill equipped to support victims, and training opportunities vary widely across the country.

Standing Together Against Domestic Abuse looked at all domestic homicide and abuse-related death reviews published in 2024 and found that 89% had at least one recommendation for health professionals or the health system. Its analysis also revealed that delivering training for healthcare workers at scale could cost as little as £2.66 million per year. Will the Minister review those recommendations and consider including them in the long-delayed workforce plan?

I welcome the Government’s announcement of the Steps to Safety initiative, which aims to better equip GP surgeries to identify and respond to domestic abuse and sexual violence. However, any initiative must be grounded in lived experience. The IRIS programme, a specialist domestic abuse training support and referral programme for general practices, has shown remarkable success; practices with IRIS are 30 times more likely to recognise and refer domestic abuse victims to specialist support than those without. Will the Minister review the IRIS programme to ensure that Step to Safety mirrors its success?

Finally, it is clear that we are missing a critical opportunity to use the NHS to detect and help victims of abuse earlier. Will the Minister set out a national plan to ensure that NHS staff across the country are sufficiently trained to spot the signs of domestic abuse? For Emma, Lettie, Gemma, Aliny and all other victims of domestic abuse, it is time to tackle this national crisis once and for all.

Oral Answers to Questions

Helen Maguire Excerpts

Tuesday 13th January 2026 Commons Chamber

[Mr Speaker]

I look forward to the keys being handed in.

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

Last night, Surrey Heartlands ICB and two hospital trusts in Surrey declared a critical incident, which means that some hospitals cannot guarantee that patients will be treated safely and operations could be cancelled to make urgent care a priority. Will the Secretary of State confirm what action the Government are taking to support those trusts and what funding will be made available to ensure that such incidents do not recur?

[Wes Streeting]

A number of critical incidents have been running across the country this week. To be clear, a critical incident does not mean that there is unsafe care or that we are unable to provide care. A critical incident means that there is a challenge, and the system mobilises in response to help meet that challenge so that people do receive safe care. As I have said, we are investing more in our urgent and emergency care services and we are seeing the impact of that through year-on-year improvements to date. We are not out of winter yet; we still have lots of hard yards ahead. I am confident that when we emerge from winter, we will be able to tell a story of year-on-year improvement. However, while the NHS is on the road to recovery, I would not want anyone watching—not least the hon. Member’s constituents—to think that the Government believe that what we have seen this winter is acceptable every day, in every case everywhere. Until that is the case, we will continue to strive for further improvement day by day, week by week, month by month, and year on year.

Advanced Brain Cancer: Tissue Freezing

Helen Maguire Excerpts

Wednesday 7th January 2026 Westminster Hall

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

It is a pleasure to serve under your chairship, Mr Western. I thank the hon. Member for Caerphilly (Chris Evans) for securing this very important debate on equitable access to tissue freezing for brain cancer patients.

My constituent’s son was first diagnosed at the age of 10 with a very rare brain tumour. When he should have been playing with friends and going to school, he underwent surgery and intense radiotherapy. After treatment, he returned to normality, but 13 years later the tumour recurred and he received the same treatment. Earlier this year, when he was 28 years old, and just three and a half years after his last treatment, the tumour was back again. Further radiotherapy was not safe, so he underwent six months of chemotherapy. His mum told me about the devastation of undergoing chemotherapy, knowing that it was never going to be a cure and that the tumour is expected to recur. In the 18 years that he has been living with the diagnosis and undergoing treatment, there has been no progress in treatment options, and a cure has not been found. Sadly, my constituent’s son is not alone; every year, 13,000 people are diagnosed with this brutal condition.

Like many people, I was struck by the story of Owain, who was diagnosed with a 14 cm grade 4 brain tumour in his right frontal lobe. Similar to my constituent’s son, Owain was told that the standard treatment of radiotherapy and chemotherapy could only hold the tumour back for a period of time, until he sadly died.

Owain’s campaign is now run in his memory by his brilliant wife Ellie, who is here today in the Public Gallery. The campaign has exposed the lack of communication, clarity and consistency in brain tissue freezing. Fresh tissue freezing can help to deliver personalised treatment, research and diagnostics, but across the country there is unequal access to it. Brain cancers are difficult enough to tackle. Even when tumours are surgically removed, cancer cells have already infiltrated the brain, often causing a tumour to regrow, sometimes within just a few months.

We know that current drug treatments struggle to have an impact on tumour mass and that radiotherapy can only delay recurrence. Consistent access to brain tumour storage across the country could help to save future lives and improve outcomes for existing patients. A recent study by specialists from the department of neurosurgery at King’s College hospital and Guy’s cancer centre aims to implement a robust pathway whereby tumour tissue can be stored as a fresh frozen sample. Their report concluded that although the implementation of this pathway appeared to be straightforward, the limiting factor was the need for a fridge. There were also difficulties in liaising with the multiple teams involved, which was very time consuming, and disagreements about who should fund the freezer.

Such concerns have been reflected by the charity Brain Tumour Research, which highlighted the variations in the basic infrastructure needed to support brain tissue freezing. The Tessa Jowell Brain Cancer Mission has also noted the numerous barriers to genome sequencing, which requires tissue freezing to enable precise diagnosis, prognosis and tailored treatments.

Therefore, we are not struggling with unknown barriers. The solutions are right in front of us. When battling brain cancer, every day counts. Because of the lack of communication with Owain, there was not enough tissue frozen appropriately to create the vaccines needed to help tackle his tumour. Now his young daughter Amelia must grapple with life without dad.

The Government have an opportunity to finally make a real difference to the thousands of people affected by brain cancer, by ending the postcode lottery of cancer treatments. The Conservatives spent 14 years failing to make any progress on improving cancer outcomes, and now it is time for action. The Liberal Democrats urge the Government to pay close attention to the specific difficulties facing brain cancer patients in the delayed national cancer plan. This includes setting out tangible improvements for brain cancer patients and equitable access to tissue freezing. We also cannot ignore that quick access to treatment saves lives, which is why I once again call on the Government to make sure that 100% of patients start treatment within 62 days of urgent referral.

There can be no more families torn apart, left in the dark or blocked from possible treatments. With the UK lagging severely behind our peers on cancer outcomes, it is time for this Government to turn around the Conservative Government’s failure to improve cancer outcomes, and finally to place the UK as a global leader in cancer research and outcomes.