NHS Workforce Levels: Impact on Cancer Patients

Helen Morgan Excerpts

Thursday 23rd October 2025 Westminster Hall

[Helen Morgan (North Shropshire) (LD)]

It is a pleasure to serve under your chairship, Mrs Hobhouse. I thank my hon. Friend the Member for Wokingham (Clive Jones) for securing this important debate highlighting the issue of staff shortages and the impact on cancer patients and the outcomes that they achieve.

Cancer should be a top priority for any Government, and the UK—with its historically thriving life sciences sector—could and should be a global leader in cancer research and outcomes. Sadly, at the moment, that is not necessarily the case. The last Conservative Government broke their promise on a 10-year cancer plan that would have made a real difference to patients. We must put an end to the tragedy of people losing their lives because cancer treatment takes too long to start. No one should be unable to receive treatment because there is not enough equipment or sufficient staff to properly support them. It is a scandal that so many people live in treatment deserts and are forced to take incredibly long journeys for treatment, often after weeks of waiting for that treatment to begin.

In that context, the introduction of a national cancer strategy is incredibly welcome. It should help to boost cancer survival rates. I am very proud that my hon. Friend the Member for Wokingham—who, as we have heard, is a widely respected cancer campaigner—has helped to secure a commitment from the Government to introduce such a plan. It is really important that when this plan comes, it is meaningful. The Government should take bold action: ensuring that every patient starts treatment for cancer within 62 days of their urgent referral, recruiting the cancer specialists we need, and replacing ancient machines and delivering new ones.

The situation on the ground at the moment is not very good. My constituents in North Shropshire have had to deal with some of the worst backlogs and performance in England for years. One told me that they waited almost a year before their treatment began—that is simply not okay. Look at the target of treatment starting within 62 days of urgent referral: Shrewsbury and Telford Hospital NHS Trust only achieved 68.8% for the month of August this year, compared with a target of 85%. That, however, is a significant improvement on its previous situation, with performance against that target improving by more than 15.4% over the past year. That progress is welcome, obviously. I am optimistic that it will be sustained and I commend and thank the tireless work of staff across the trust in driving those improvements.

Staffing levels, especially for radiologists doing diagnostic scans, have been a large part of the problem in Shrewsbury and Telford. Outsourcing the interpretation of those scans has led to a dramatic improvement in the speed at which the results come back and demonstrates the importance of having enough skilled staff and the speedy diagnostics that can help with early treatment commencing. That issue is particularly severe in rural areas. I hope that the workforce plan, which will go with the cancer strategy, will address that. BMJ Group research found that every four-week delay to starting cancer treatment is associated with a 10% decrease in cancer survival. Constituents such as mine, who have had horrendous waits for treatment, are bearing the lethal brunt of delays.

NHS workforce statistics show that between June 2020 and June 2025, the number of full-time-equivalent cancer specialists has risen: by 32% for clinical oncologists, 48% for medical oncologists and 27% for the clinical radiology workforce. Clearly, those statistics are welcome. However, analysis from the Royal College of Radiologists argues that the increase in workforce capacity has not kept pace with the ever-growing demand for cancer services, which is inevitable in an ageing population with poor health.

In 2024, the Royal College of Radiologists estimated that the clinical oncology workforce was about 15% smaller than required to meet demand, and projected that that shortfall would rise to 19% by 2029. It also reported that, among the 50 cancer centres surveyed in England in 2024, 76% of heads expressed concerns about patient safety due to workforce shortages.

We also cannot ignore the reality of working conditions in our NHS and their impacts on staff retention. The previous Conservative Government left our NHS under unbearable strain, with professionals working under intense pressure in crumbling hospitals and often without the resources they needed, rather than in safe clinical settings. That does not help the retention of a highly skilled and experienced workforce.

There are also woeful shortages of specialist training places, meaning that we do not have the cancer specialists we need. At the same time, there is rising doctor unemployment despite growing need for their services. It is a damning indictment of the Conservatives’ mismanagement and failure to plan the workforce. A workforce plan for the NHS—including a workforce plan to support the cancer strategy—is imperative, and must address the issues of retention and career progression for doctors, nurses and other skilled staff across all specialisms.

While routine NHS workforce statistics are not available for nurses working in cancer specialities, a nursing fill-rate dataset obtained by FactCheck for “Channel 4 News” showed that a third of acute trusts in England were missing at least 10% of their planned nurses across haematology and oncology wards, based on monthly average data between January 2023 and November 2024. That is why the Liberal Democrats are pressing for more cancer nurses—so that every patient has a dedicated specialist nurse supporting them throughout their treatment—and for expanded community nursing.

We have also been campaigning for the UK to lead the world in cancer research through new funding and the waiving of burdensome fees and bureaucracy for international researchers. We would set up a dedicated fellowship scheme for US cancer scientists, who have seen their funding gutted by President Trump.

Without, for example, sufficient radiographers, specialist nurses and diagnostic equipment, even the most promising screening initiatives introduced here risk being delayed or underutilised. The Government need to commit to the funding of early screening programmes, and to training and retaining the workforce required to deliver them. A comprehensive, well-supported roll-out would allow thousands of people at risk to be diagnosed at a much earlier stage, when treatment is far more effective and survival rates are significantly higher.

The national cancer plan provides a huge opportunity for the Government to turn cancer care around in this country and deliver world-class care for every community. I look forward to seeing them deliver that plan, and ensure that it is deliverable through an associated workforce plan, at the soonest opportunity.

Oral Answers to Questions

Helen Morgan Excerpts

Tuesday 21st October 2025 Commons Chamber

[Mr Speaker]

I call the Liberal Democrat spokesperson.

[Helen Morgan (North Shropshire) (LD)]

Our maternity wards are in a state of crisis, with death and injury rising at an alarming rate. Sadly, this issue is not confined to Shropshire, and there has been a steady drumbeat of maternity scandals, with review after review finding consistent failings across the NHS. Can the Secretary of State explain to me and the many mothers I have met who have faced tragedy and unacceptable trauma why the Government are cutting national service development funding—ringfenced funding to improve maternity care—by more than 95% and why the immediate and essential actions from the Ockenden review into the failings at Shrewsbury and Telford hospital trust, which were to be implemented nationwide, are still not in place more than three years later?

[Wes Streeting]

We really are not; what we have done is devolve funding and responsibility to local level, which we think is the right thing to do. If I may say so, it is quite irresponsible to suggest that maternity funding and funding for services has been cut in the way that the hon. Lady describes. I think it causes unnecessary concern. We are taking into account the recommendations made by Donna Ockenden, as well as a wide range of other reviews and inquiries, as part of Baroness Amos’s rapid investigation, because I, like the hon. Member, want to see rapid improvement in maternity services across the country.

--- Later in debate ---

[Mr Speaker]

I call the Liberal Democrat spokesperson.

[Helen Morgan (North Shropshire) (LD)]

Every year we come here to discuss the winter crisis in the NHS, but this summer saw record waits at accident and emergency, with more than 74,000 12-hour trolley waits in June and July. That used to be unheard of. With winter looming and the potential for the A&E permacrisis to be even worse this year, what package of emergency measures is the Secretary of State putting in place to ensure that patients are not left to suffer on trolleys or worse in our hospital corridors this winter?

[Wes Streeting]

The hon. Lady is absolutely right to point out that the NHS is already running hot ahead of winter. We brought forward our winter planning for this year to get ahead. We are making sure that all NHS trusts and systems have developed plans that have been tested regionally. The flu vaccination programme is well under way, the autumn covid-19 vaccination began on 1 October, and we are driving improvements in urgent and emergency care. This will be a challenging winter—we are not complacent about that—but we are getting the system ready for it.

Jhoots Pharmacy

Helen Morgan Excerpts

Wednesday 15th October 2025 Commons Chamber

[Madam Deputy Speaker (Ms Nusrat Ghani)]

I call the Liberal Democrat spokesperson.

[Helen Morgan (North Shropshire) (LD)]

May I first thank my hon. Friend the Member for West Dorset (Edward Morello) for raising this appalling issue? Pharmacies are at the heart of our communities and are relied upon by millions. They are under increasing pressure across the country, where we are seeing irregular opening hours and unannounced closures. Families living in communities that rely on Jhoots pharmacies, such as those in the constituency of my hon. Friend and many other parts of the country, will be deeply concerned that they and their loved ones could be about to be left without medicines that they desperately need. Staff have been placed in an intolerable situation.

The National Pharmacy Association’s chief executive has said, as we have heard, that Jhoots risks damaging the reputation of community pharmacies. The Government urgently need to grip this issue and ensure that patients and the staff of these pharmacies are not being let down. Will the Minister and the Secretary of State agree to meet all the Members in this place whose communities are affected by potential closures? Will he update the House at the earliest opportunity as to what steps he is taking to stabilise the crisis in community pharmacy across the country? Is he confident that integrated care boards, which are distracted by 50% cuts to their budgets and top-down reorganisation, have the capacity to deal with this urgent situation as they head into planning for the next winter crisis?

[Stephen Kinnock]

I thank the hon. Member for those questions. I would certainly be happy to meet Members who have Jhoots in their constituency and are affected. I will update the House. We are looking at strengthening the regulation, but there are some constraints on what I can say, because so much of this is now going through legal process. There is pushback, and we do not want to do anything to jeopardise the legal action we are taking through the appeal process, so I will have to be relatively circumspect in what I say. I am happy to have those discussions and to update the House.

I am confident that ICBs can take this forward. In most cases across the country, our assessment is that there is a pharmacy within striking distance of a Jhoots, but certainly in those areas where there is not, that may require particular follow-up action. My officials and I will be following up with those ICBs to ensure that the appropriate action is being taken.

Non-surgical Aesthetic and Cosmetic Treatments

Helen Morgan Excerpts

Thursday 11th September 2025 Westminster Hall

[Helen Morgan (North Shropshire) (LD)]

It is a pleasure to serve with you in the Chair, Sir Desmond, and to take part in a debate where all the contributions have been so thoughtful. I thank the hon. Member for Bromsgrove (Bradley Thomas) for securing the debate and making an excellent speech about not only regulation, but the wider issues of negative body image, advertising, eating disorders and other medical conditions that we should consider as part of this debate.

As we have heard, non-surgical aesthetic and cosmetic treatments have become increasingly popular, including, but not restricted to, lip fillers, injectables, thread lifts, semi-permanent make up, laser treatments, piercing and tattoos. While there is a registration scheme in England for some treatments, such as epilation, tattooing, piercings, semi-permanent make up and acupuncture, some of the riskier and newer types of procedure are not within the scope of the current regulatory regime.

People paying for a procedure need to be confident that the person carrying out that procedure is appropriately qualified. Currently, there is no single system to ensure that that is the case. Distressing reports of lives shattered by botched cosmetic treatments—tragic cases such as that of Alice Webb, whose buttock augmentation procedure, as we have heard, was carried out by someone with no surgical qualifications—must drive meaningful change in how we approach aesthetic and cosmetic treatments.

It is crucial that anyone carrying out invasive treatment is properly licensed and meets high standards of safety. There are too many instances where that is not the case. I was horrified to read in The Guardian a story about a lady in Leeds who booked into a clinic to get something called an endolift procedure, a laser treatment that works by inserting a thin micro-optical wire deep into the skin layer and is used to boost collagen and melt little pockets of fat. She had visited the clinic before for other cosmetic treatments and thought that she was in safe hands, but she was not. After paying £100 for what looked like a good deal, she was administered a counterfeit version of the procedure, which normally costs around £2,000. It has left her with intense facial bruising and she describes herself as “maimed”.

The BBC reported on another horrifying case of a lady in Hull, who arranged more than 30 separate treatments at a clinic, including a breast filler procedure and facial fillers. She thought she had done her due diligence by checking the clinic’s reputation; its website claimed it had

“won Best Aesthetics Clinic in Yorkshire in 2022 at the England Business Awards”

and referred to the man who saw her as a doctor. He was actually a former tattoo artist who had bought an honorary doctorate in business consultancy on the internet. After multiple facial procedures, her face kept swelling, with this apparent doctor claiming that it was from an insect bite and urging her to continue. Eventually she needed hospital treatment, with plastic surgeons confirming that she had undergone botched procedures and suffered a subsequent infection, leading to the difficulties she was experiencing. More than two years later, she claims that she sees “a gargoyle” when looking at herself, and lives in a “nightmare every single day”.

Multiple other complaints have been made about the same clinic, all from people who were under the impression that the clinical director was a licensed medical professional. It is unacceptable that this could have happened. There is no mandatory licensing for those providing potentially dangerous treatments such as dermal fillers and botulinum toxin, as we have heard, while highly risky treatments such as the Brazilian butt lift are frequently administered by individuals with little or no training.

While a small handful of areas across England have introduced their own licensing schemes, including London, Nottingham and Essex, other under-resourced local authorities rely on a fragmented hodgepodge of byelaws, statutes and tangential regulations to try to regulate practitioners in their area. Many lack the resources to provide effective regulation. Can the Minister reassure us in her closing remarks that, if local authorities are to carry out any new scheme, they will be adequately resourced to do so?

Loopholes remain even for surgical procedures. For instance, any doctor on the GMC register can legally perform cosmetic surgery in the private sector, regardless of whether they have the relevant surgical training. Complex procedures such as liposuction are being performed by non-surgeons and potentially in non-clinical environments. That is without doubt a huge risk to patient safety. As things stand, not only are consumers being placed at risk of life-changing difficulties, but the NHS—and therefore the taxpayer—is footing the bill to pick up the pieces when things go wrong.

I have heard it asserted that any standardised regulation or licensing is somehow an impediment to people’s choice and self-expression, but I am sure that a lack of safety is not a crucial part of the appeal of getting these procedures done. If we do not act now, many more people will face unwanted, irreversible, life-changing and even life-threatening consequences.

It is notable that 90% of people working in the industry who were surveyed in 2020 support a new licensing regime. They know, as do the public, that no one benefits from the current arrangement other than those who want to cut corners and ignore their duty of care to clients. The Liberal Democrats therefore support organisations such as the Royal College of Surgeons in calling for a licensing scheme for non-surgical cosmetic procedures, such as lip filling and liquid enhancements. It is astonishing that one is not already in place.

The last Government consulted on a mandatory licensing scheme for non-surgical cosmetic procedures, but it has never been implemented. Minimum standards of safety, including training and premises that are clinically safe, are simple, basic steps that can make a huge difference. I welcome the Government’s announcement that they will be consulting on bringing forward new legislation to tackle this issue. We urge them to do so as soon as possible, and they will have our support to ensure a robust and speedy implementation of regulations.

In closing, I also draw the Minister’s attention to the issue of data collection on cosmetic procedures. There is no systematic collection of data on treatments and their outcome, even for the most invasive treatments. That makes it incredibly hard—or even impossible—for consumers or the Government to assess the risks associated with cosmetic procedures or what licensing changes might be needed. I urge the Minister to address this issue as the consultation progresses. As I have said, the Government will have our support in introducing a suitable licensing regime.

Glaucoma Awareness

Helen Morgan Excerpts

Wednesday 9th July 2025 Westminster Hall

[Helen Morgan (North Shropshire) (LD)]

It is a pleasure to serve with you in the Chair, Mr Pritchard. I thank the hon. Member for Leicester South (Shockat Adam) for securing this important debate and raising awareness of a life-changing condition following Glaucoma Awareness Week.

The hon. Member for Alloa and Grangemouth (Brian Leishman) outlined his personal experience, and particularly how regular checks are important as the condition is symptomless in its early stages. I thank the hon. Member for Strangford (Jim Shannon) for sharing his dad’s experience. And the hon. Member for North Ayrshire and Arran (Irene Campbell) brought her NHS expertise to the debate, so I feel slightly underqualified to be completely honest. Ironically, given that we are talking about eyesight, I did not print my speech in a larger font, so please bear with me.

Millions of people across the country are affected by sight loss, and hundreds of thousands of people have glaucoma. If untreated, glaucoma can have a profoundly detrimental effect on people’s quality of life and long-term health, yet one in every 10 people on an NHS waiting list is waiting for their first ophthalmology appointment. Ophthalmology waiting lists grew longer and longer under the previous Conservative Government, who oversaw a doubling of waiting times in England alone. Meanwhile, more than half a million people are waiting for follow-up appointments. As our population continues to age, demand is likely only to increase.

As with so many conditions, early intervention is key. One elderly patient in my constituency was sent for an urgent referral following a routine eye test. He was warned that if he was not seen in the next few weeks, he was at risk of losing sight in the affected eye. The appointment came through in time, only for it to be cancelled, along with the replacement appointment. By the time he was able to see a specialist, it was too late and he lost sight in that eye. This entirely avoidable incident demonstrates how it is crucial that we address the chronic shortage of ophthalmologists to deliver the care that people deserve.

A starting point would be to deal with the broken training system. Far too few specialist training spaces are offered, despite many graduates being keen to work in the field. A little over a decade ago, there were four and a half applicants per training place, and it has surged to 10 applicants per place. It is simply not good enough.

How will the Government deliver the ophthalmology workforce we need? In particular, will they look to reduce the extraordinary shortage of training places in this and other specialties? Will they consider publishing waiting list data for follow-up care? Transparency on waiting lists for follow-up appointments, not just for initial referrals, would help patients to make informed choices about the care they need and would illustrate the postcode lottery in NHS eye care.

Liberal Democrats know that fixing the front door of our NHS is crucial to achieving better outcomes on glaucoma and all conditions that impact sight. That means sorting out primary care and community services, so I am pleased to see that the Government agreed with that aim in the 10-year plan published last week. Fixing primary care means investing in local GP surgeries and giving everyone the right to see a GP within seven days, or 24 hours if they are in urgent need, and providing 8,000 more GPs to deliver that. It means ensuring that everyone over 70 and everyone with a long-term condition has access to a named GP.

As the hon. Member for Leicester South reminded me in our Opposition day debate on primary care in the autumn, optometry is a critical part of primary care and needs to be delivered locally. For glaucoma specifically, that means investing in eye services in the community and empowering the training of trusted, qualified optometrists to manage the condition. Optometrists are already in place to manage glaucoma across Wales and Scotland, so we have a strong base of evidence to inform that work. Research suggests that the additional training required is rewarding for optometrists, for the ophthalmologists training them and, more importantly, for the patients they are treating.

However, in England, glaucoma services vary drastically, depending on which integrated care board area people live in. With major organisational changes to the ICB structure under way, this could be an opportunity to standardise a better, more consistent, community-focused approach. Could the Minister set out how the Government will encourage true partnership between qualified optometrists and ophthalmologists, delivering care in the community wherever possible? What hurdles stand in the way of such an arrangement?

Finally, we need to ensure the highest possible uptake of regular eye tests so that we can catch this condition early and prevent damage to people’s sight. As somebody who has a close relative with glaucoma, I have my eyes tested regularly. It is not too unpleasant, and it gives me the reassurance I need that I am not currently developing the condition. The number of sight tests, including domiciliary visits, has still not recovered since the pandemic.

Given the scale of the challenges of ensuring that people are tested, of treating them when glaucoma is found and of training sufficient staff in a context of surging demand, the Government should produce a dedicated eye health strategy, as advocated by groups such as the Thomas Pocklington Trust. There clearly needs to be substantial work across the sector to strengthen eye care as part of primary care and better incorporate optometrists, to repair a broken training arrangement and to ensure that people get the eye tests they need.

NHS 10-Year Plan

Helen Morgan Excerpts

Thursday 3rd July 2025 Commons Chamber

[Mr Deputy Speaker]

I call the Liberal Democrat spokesperson.

[Helen Morgan (North Shropshire) (LD)]

I thank the Secretary of State for early sight of the plan this morning. After years of Conservative failure, a plan for the future of the NHS is welcome and Liberal Democrats support the Secretary of State in his vision to shift the NHS to a community-focused, preventive service. However, I seek his reassurance on some questions.

In the 143 pages of the 10-year plan, there is only a passing reference to social care. Everyone knows that we cannot fix the NHS without fixing social care. With so many people unable to return home from hospital to get the care they need, solving the crisis in social care is a huge part of moving care out of hospital and into the community. Will the Secretary of State bring forward the Casey review, so that it reports in full this year, and reinstate the cross-party talks, so that consensus can be reached on the future of care?

I welcome the idea of a neighbourhood health centre, but how does that interact with the plan for GPs? The 10-year plan implies that GP contracts will encourage them to cover a huge geographic area of 50,000 people. In North Shropshire, that would be two or three market towns combined and would span dozens of miles. Can the Secretary of State reassure me that there will still be a physical health centre, accessible to all, and that in areas with little public transport in particular, people will be able to access care when they need it?

Finally, the plan hinges on the shift to digital solutions, and that is not without risk. The use of the NHS app is critical to what happens. How will the Secretary of State ensure that those without a smartphone—because they cannot afford one, do not feel confident using one or simply do not have adequate broadband or internet—can access the NHS? Many elderly and disabled people in particular who are digitally excluded will feel worried by today’s announcement.

[Wes Streeting]

I welcome the Liberal Democrat support for the plan, and the constructive way in which Liberal Democrats have sought to work with us since the general election in pursuit of better health and social care services. I understand the point the hon. Member makes on social care. I will not repeat at length the points I made to the shadow Secretary of State, the right hon. Member for Melton and Syston (Edward Argar), but I hope the House is reassured by the action we are already taking on social care, whether through greater funding, the expansion of the carer’s allowance, increasing the disabled facilities grant, the fair pay agreements, and ensuring a partnership with social care to deliver better neighbourhood health services.

Given what we have said about the importance of data, digital connections and better systems, I should say that in some parts of the country, the social care system is ahead of the NHS; it makes better use of data, and joins up systems in a more effective and efficient way. The NHS can learn lots from social care, as well as the other way round. I will take on board the representations of the Liberal Democrat and Conservative Front Benchers on speeding up the Casey commission—that is duly noted.

I absolutely reassure the hon. Member for North Shropshire (Helen Morgan) on the point that she raises about neighbourhood health centres. One of the reasons we want to devolve so much power in the NHS is that I genuinely think that the closer decisions are made to the communities they serve, the better the outcomes and the provision. A one-size-fits-all approach to neighbourhood care simply will not work. My constituency is on the London-Essex border, and there are three hospitals within a 15-to-20 minute drive of where I live. In many rural towns, coastal communities and villages across the country, there is not even one hospital within that distance. In fact, people are driving huge distances across the country to get to a hospital. On our priority of rolling out neighbourhood health centres, I want to reassure Members on both sides of the House that we will start with the areas of greatest inequality and need, and communities where people have to travel far to their nearest hospital, so that people can genuinely receive care closer to home and, indeed, at home. Technology can play a big role in that.

I understand the cynicism about digital roll-out. Government IT projects do not have a great reputation historically; let us be clear about that. We are learning from past mistakes and ensuring that we have the right experts in the room to help us. So much of that is about the digital clinical leadership helping to marry the best scientific and technological minds in our country to the best clinical and scientific experience to ensure that we get this absolutely right. We cannot afford to fail or be left behind. The tragedy in the country today is that there are so many brilliant innovators in life sciences and med tech who are designing and making things here in Britain, but when it comes to scaling up, they are shipping out, because the NHS has been a poor partner and a poor customer. We will change that; we will create more in Britain, and ensure that it is rolled out right across the country. Staff will be liberated from the drudgery and toil of unnecessary bureaucracy and admin that can be automated, and patients will have more ease, convenience, choice and control at their fingertips. This revolution is happening, and it is crucial that no one is left behind.

I take seriously the point the hon. Member made about the digitally disconnected, and there are two responses to that. First, people like me who book via the touch of a button free up telephone lines, get out of the way of reception desks, and free up more capacity for face-to-face and telephone appointments. I believe strongly in horses for courses, and in patient choice. Those patients who want to pick up the phone or who want to be seen face to face must be given that choice and control, and we will give it to them.

Secondly, working with the Science, Innovation and Technology Secretary, we will deal with the fundamental problem of digital disconnection in our country. I knocked on the door of one of my party members when I was canvassing down her street because I had heard she was ill. She opened the door, and I asked if she was okay and if she needed anything from the shops. She looked me up and down as if I had just said the most ridiculous thing and said, “Oh no, dear. Thank you very much, but I do my shopping online with my iPad.” We should not assume that because people are older, they are naturally digitally disconnected. They are some of the most tech-savvy people, and we have to ensure that those skills are enjoyed by all, in keeping with the NHS’s principle of ensuring that healthcare is available universally to everyone, regardless of their ability to pay.

Department of Health and Social Care

Helen Morgan Excerpts

Tuesday 24th June 2025 Commons Chamber

[Helen Morgan (North Shropshire) (LD)]

I congratulate the acting Chair of the Select Committee, the hon. Member for Birmingham Erdington (Paulette Hamilton), on securing this important debate and on her excellent opening speech on the risks inherent in the spending review settlement.

The Conservatives left our NHS in a disgraceful state that is impacting every one of our constituents. On their watch, people with life-threatening emergencies were left waiting hours for ambulances, hospitals were left to crumble, and accessing a GP became a huge challenge. The collapse of NHS dentistry has left some people pulling out their own teeth at home. It is essential that the new Labour Government are bold and ambitious in turning the NHS and care sectors around. The Liberal Democrats support the principles of the Secretary of State’s three shifts and have stated on many occasions the alternative means we would use to raise the necessary funds, but today’s debate is about how the money should be spent.

I was pleased that the Chief Secretary to the Treasury’s statement last week incorporated a measure that the Liberal Democrats have long called for, not least in our last Opposition day debate in April: a ringfenced fund for maintenance, to deal with the huge repair backlog that has built up across the NHS estate. However, I must reiterate the need to go faster with the new hospital programme. We know that the Conservatives’ plans were unfunded, but this capital spend must be brought forward so that crumbling hospitals in places like Torbay, Watford, St Helier and Stepping Hill can be rebuilt as soon as possible, because spending billions on maintaining buildings that face demolition in the next 20 years is not a wise use of taxpayers’ money.

The Liberal Democrats believe that the crisis in the NHS—particularly in accident and emergency—cannot be solved unless we transform social care. We have long argued that investment in the NHS will be pouring good money after bad if hospitals cannot discharge patients because there are no care workers to help them recover. The fair pay agreement for care workers is a start, but it will not touch the sides of the yawning abyss of current and forecast vacancies in the care sector. At a bare minimum, we need a higher minimum wage for care staff to stop the sector haemorrhaging workers. It is more urgent than ever that the cross-party talks for which the Government had such enthusiasm at the start of the year are reinstated. The terms of the Casey review, which leaves fundamental restructuring of the care sector to 2036, are not ambitious enough. The review needs to be completed this year, so that meaningful change is not put off while our population ages.

I turn to mental health. The Darzi review outlined in stark terms the fact that mental and physical health are not given parity in the health service; mental ill health takes up 20% of the caseload and only 10% of the funds. Proper investment in mental health is essential to the shift from treatment to prevention. It was disappointing to see the Government abandon mental health waiting list targets and reduce the overall proportion of money spent on mental health, while proclaiming that they were meeting the mental health investment standard because, at integrated care board level, there had been a fractional increase. I urge the Minister to ensure that mental health is given priority, and to ensure that prevention, through early intervention, can bring about improved outcomes.

Yesterday, the Secretary of State announced a new national investigation of maternity services. I was disappointed that no oral statement was made. Many MPs represent constituents whose families have been left distraught by maternity service failings at Shrewsbury and Telford, East Kent, Morecambe Bay, Nottingham, and potentially other trust areas. Those voices deserve to be heard in Parliament, but that opportunity was denied.

I welcome the inquiry, but remain dismayed at the slow progress since Donna Ockenden’s shocking report into the Shrewsbury and Telford hospital trust in spring 2022. She recommended 15 immediate and essential actions for national implementation; three years later, that has not happened, and the Government have removed the ringfence from funding intended to ensure safe staffing levels. Her findings were consistent with those after other maternity scandals, and the Government accepted her recommendations. It is vital that the inquiry moves the situation forward and is not used as a distraction tactic to delay real action.

Before concluding, I will raise the subject of the fundamental reorganisation of the NHS, which is being undertaken without any meaningful parliamentary scrutiny. NHS England announced the decision to slash ICB running costs by 50% by the end of this year, with detailed plans to be submitted by the end of last month. No impact assessment for that drastic change was undertaken by the Department and, as far as I can see, there is no funding from the Treasury for potential redundancy costs and no confirmed redundancy scheme. ICBs will be expected to transfer some statutory duties to other trusts without that change being on any formal statutory footing. The guidance from the soon-to-be-abolished NHS England has been hastily prepared.

If ICB money can be spent more efficiently, the Secretary of State has our support, but surely such radical change requires scrutiny, particularly when it was not in the Labour manifesto and there has been no White Paper, no consultation, no legislation, and not even a short ministerial statement on the subject. We would all appreciate the opportunity to better understand how the process will improve outcomes for our constituents.

The new Labour Government face an enormous challenge in turning around an NHS left at breaking point by the Conservatives. The Liberal Democrats’ job as an effective Opposition party is to urge the new Government to go further, faster, in tackling the issue of access to GPs and dentists, in ending the appalling scandal of corridor care and dangerous ambulance waiting times, and in bringing urgency to the issues of spiralling mental health waiting lists and the crisis in social care.

Incontinence

Helen Morgan Excerpts

Thursday 19th June 2025 Commons Chamber

[Helen Morgan (North Shropshire) (LD)]

It is a pleasure to see you back in the Chair, Mr Deputy Speaker. I thank the hon. Member for Dudley (Sonia Kumar) for securing this important debate and for outlining the issues so well in her opening speech, particularly the importance of breaking down the taboos surrounding incontinence and the social isolation that can result from it. I have carefully scribbled out the term “incontinence” all the way through my speech and hopefully replaced it with “bladder and bowel control issues”—forgive me if I have missed one.

I recognise the importance of prevention and specialist treatment. The hon. Member for Dudley highlighted the benefit to both individuals and taxpayers from investing in women’s health up front, and I echo that call. There have been lots of excellent contributions, but I thank the hon. Member for Wolverhampton West (Warinder Juss) for raising the scandal of pelvic mesh implants. I thank him for highlighting that issue and the need for redress there.

Incontinence, or bladder and bowel control issues, can have a hugely detrimental impact on a person’s wellbeing and sense of dignity, as we have heard. Despite affecting millions of people across the UK, it is the subject of stigma, and the needs of those with bladder and bowel control issues are not properly considered in many aspects of life. All too often, people suffering from these issues are left without the right support, whether that is the uncomfortable bladder pressure tests that the hon. Member for Gravesham (Dr Sullivan) referred to, or the lack of access to sanitary bins in public and workplace toilets.

It has been widely assumed for many years that sanitary bins for men are not required in public toilet facilities. As we have heard, many millions of men are affected by bladder and bowel control issues. The absence of sanitary bins has a wholly unnecessary and damaging impact on their self-esteem, causing embarrassment and stress and, as we have heard, withdrawal from public places and the workplace. The cost is tiny but the benefits for those affected can be significant.

There has been progress in this area, thanks to the work of campaigns such as Boys Need Bins by Prostate Cancer UK, but there is much further to go. That is why it is crucial that we support all individuals with the condition by ensuring access to services such as public toilets and sanitary bins, as unfortunately that is not the case. Under the last Government, 19% of public toilet facilities—nearly 600—lost their local authority maintenance and funding between 2015 and 2021 alone. Liberal Democrat research from 45 councils found that the number of public toilets had fallen by 14% from 2018-19 to 2023.

Many local authorities are on the verge of bankruptcy and do not have the spare capacity for these vital services. Proper funding of local authorities to provide services such as public toilets and sanitary bins could make a truly meaningful difference for people with bladder and bowel control issues, and I hope the whole House will agree that these individuals deserve access to basic facilities.

There is also a clear need for more research into developing better treatments and mitigations for people suffering from bladder and bowel control issues. Crucially, these should avoid unnecessary discomfort or invasive procedures. As such, I support what the hon. Member for Gravesham has said. The University of Aberdeen has found that women with ongoing urinary incontinence can avoid invasive bladder pressure tests, and that non-invasive assessments work just as well in guiding treatment. An emphasis on respecting people’s dignity and reducing discomfort should be at the heart of how we approach the testing, treatment and mitigation of these issues.

We also know that these issues—particularly bowel incontinence—can place a significant strain on family carers carrying out personal care, who are often under-supported and suffer from ill health themselves. Many care requests go unmet; last year, the King’s Fund estimated that nearly a third of requests for local government funding result in no support for care at home. This means that there are many thousands of families struggling with the realities of caring for a loved one with bladder and bowel control issues, which can include not only feelings of shame and embarrassment —both for them and for their loved one—but difficulty with lifting and moving a family member to clean them, and in accessing the equipment necessary to cope. That is why dealing with the crisis in social care should be a top priority for the Government.

When the Secretary of State phoned me—and, presumably, the other national party health spokespeople —over the Christmas break to let me know that he was instigating the Casey review and cross-party talks to find a long-term solution to that crisis, I was hugely encouraged. Since then, the Casey review has been delayed, and the cross-party talks have apparently been cancelled. I must stress that each party giving its view to Baroness Casey is not the same as sitting in the same room and agreeing a long-term funding plan. The review’s terms of reference will not deliver meaningful reform until the next Parliament, and there is a huge risk that, again, nothing will be done by the Government of the day—in this case, despite them having a huge majority to achieve whatever they want. Meanwhile, the number of people needing care increases every year, and the step change required to transform the sector becomes larger and less politically palatable. As such, I urge the Minister to speak to the Secretary of State and help him to recover the enthusiasm for change that he showed over Christmas, because he will have my full support.

However, there are simple steps that can make a difference now, such as hospitals working with family carers ahead of discharge to ensure that they are equipped to carry out heightened personal care needs. In many places, that support is not delivered, let alone ongoing support and meaningful respite care. Wait times for a continence assessment vary across the country—it can take weeks and weeks. Improving those wait times would ensure that the right care and equipment is available much sooner. There is also a chronic shortage of speech and language therapists, who can make a real difference in helping people with limited or no speech to more easily communicate when they need the toilet or want to be changed or washed. That is particularly essential in cases in which those people suffer from bladder and bowel control issues.

Incontinence is not properly reflected in how we organise paid social care. For instance, too often the pay for domiciliary carers and the time they are expected to care for any one person do not reflect the fact that someone’s need for care might vary hugely from day to day. Any embarrassment, frustration and discomfort for the person being cared for will only be made worse if their carers are rushed, stressed and overworked, and if spending longer at one house could mean that those carers are effectively having to work for free.

I also want to highlight the importance of good care in hospital settings. NHS England’s 2018 “Excellence in Continence Care” guidance states that

“pathways of care should be commissioned that ensure early assessment, effective management of incontinence, along with other bladder and bowel problems such as constipation and urinary tract infections and their impact on social, physical and mental well-being”.

I highlight this because my constituent Trevor Collins died on 21 May 2022 as a result of aspiration pneumonia and small bowel ileus, due to a small bowel obstruction caused by constipation. The coroner concluded that neglect at Royal Shrewsbury hospital and a failure to manage Mr Collins’ constipation contributed to his avoidable death. It is essential that healthcare settings follow the NICE guidelines that are in place, not only to preserve dignity but to prevent serious harm and—in the worst cases—even death.

Liberal Democrats recognise the seriousness of the issues surrounding all types of incontinence and bladder and bowel control issues, and the critical importance of ensuring that people with those conditions can live in dignity. The Minister will have heard the calls in my speech. I hope she will commit to repairing our broken social care system, reinstating cross-party talks and wrapping up the Casey review this year, so that we can make the reforms that are necessary for long-term stability in the sector and the dignity of all those receiving and providing care.

[Mr Deputy Speaker (Sir Roger Gale)]

I call the Opposition Front Bencher.

Oral Answers to Questions

Helen Morgan Excerpts

Tuesday 17th June 2025 Commons Chamber

[Mr Speaker]

I call the Liberal Democrat spokesperson.

[Helen Morgan (North Shropshire) (LD)]

Across the country, community pharmacies struggle not only with supply chain problems but with dispensing some of the critical medicines for our constituents at a loss. I was concerned to read that higher prices for United States pharmaceuticals are on the table for the next stage of trade negotiations with Donald Trump, because an additional £1.5 billion would cost both the NHS and our community pharmacies dear. What steps is the Department taking to ensure that the NHS, and the vital medicine supply on which we rely, will not be used as a bargaining chip in a trade deal with a highly unreliable US President?

[Karin Smyth]

The hon. Lady has asked an important question about the pharmaceutical industry, which is key to the country’s growth mission and to supporting all our constituents and the entire country. As we know, my right hon. Friend the Prime Minister is currently attending the G7 summit. We have good relationships with America, and the Department is working closely across Government to ensure that the same stability of supply remains for our constituents.

--- Later in debate ---

[Mr Speaker]

I call the Liberal Democrat spokesperson.

[Helen Morgan (North Shropshire) (LD)]

As we have just heard, it is widely acknowledged that the crisis in social care is a cause of dangerously high occupancy rates in hospitals that lead to the horrors of corridor care, the dreadful ambulance waiting times that we have seen and a knock-on effect on the community. When I was contacted by the family of a terminally ill man in Wem in my constituency last month, I was reminded that not only is care often provided in the wrong place, but it is often not available at all. Will the Government bring forward the timeline for the horribly delayed Casey review to report back, get it done this year and heed Liberal Democrat calls for cross-party talks so that we can agree on a long-term solution for the crisis?

[Stephen Kinnock]

May I just tackle the idea that we are not working at pace on these issues? We have had the unpaid carer’s uplift from £151 to £196, which is the biggest uplift in carer’s allowance since the 1970s when the policy was brought in; hundreds of millions of pounds’ uplift in the disabled facilities grant; and groundbreaking legislation for a fair pay agreement for care workers. Those are just some of the immediate steps that we have taken. The first phase of the Casey review will report next year and we continue to work closely with Baroness Casey to deliver the reforms that are so desperately needed after 14 years of neglect, including a number of years when the Liberal Democrats were in government.

NHS and Care Volunteer Responders Service

Helen Morgan Excerpts

Monday 19th May 2025 Commons Chamber

[Mr Speaker]

I call the spokesperson for the Liberal Democrats.

[Helen Morgan (North Shropshire) (LD)]

I was a volunteer vaccination steward during the pandemic, and the Liberal Democrats are hugely grateful to the thousands of volunteers who have made a difference to the lives of patients and vulnerable people in their communities since the pandemic ended. Their compassion and commitment have been inspiring.

We are concerned that the end of the programme has been announced at extremely short notice; there will be no further shifts in just 12 days’ time. Will the Minister reassure the House that those currently receiving help from the volunteer scheme, such as collecting prescriptions or fetching shopping, will not be left high and dry after next Saturday? Has the Department conducted an impact assessment? If so, will it publish it? As with so many major decisions, such as dropping cross-party talks on social care or cutting funding for integrated care boards by 50%, it is concerning that the Government did not come to the House first to answer questions from hon. Members. Will the Minister reassure the House that these decisions will improve patient care and that they are not just a cost-cutting exercise dictated by the Treasury?

[Karin Smyth]

I thank the hon. Lady for her work volunteering and supporting the scheme during covid. The announcement is about NHS England. The organisation will continue to work with the NHS and voluntary organisations to ensure that where people are volunteering, that will continue, and that volunteers continue to be recruited, ahead of a fuller launch of the recruitment portal later this year. On her wider point, this Government are not dropping talks with other parties about social care, which is being taken forward by the independent commission under Louise Casey.