(1 day, 19 hours ago)
Westminster HallWestminster Hall is an alternative Chamber for MPs to hold debates, named after the adjoining Westminster Hall.
Each debate is chaired by an MP from the Panel of Chairs, rather than the Speaker or Deputy Speaker. A Government Minister will give the final speech, and no votes may be called on the debate topic.
This information is provided by Parallel Parliament and does not comprise part of the offical record
It is a pleasure to serve under your chairship, Mr Dowd. I thank the hon. Member for Ipswich (Jack Abbott) for securing this debate—the opportunity to raise the importance of this debilitating condition with the Minister today is extremely welcome. I welcome her to her place; I must say that the contributions today have all been excellent, and she has been given a significant to-do list, which I am sure she is equal to.
Endometriosis is estimated to affect 10% of women. It is a condition that brings chronic pain and worsening physical health and can pose a threat to fertility. It devastates lives and leaves many women excluded from education and employment.
Thanks to the tireless campaigning of groups such as Endometriosis UK, and of the women in the Public Gallery today—whom I welcome—many of us are increasingly aware of the condition. Despite those efforts, however, the average diagnosis time has steadily increased since 2020. As we have heard, it now takes an astounding nine years and four months on average for women just to get a diagnosis. That is unacceptable.
That shocking amount of time to get recognition of the condition is indicative of the wider issue of institutional misogyny and the dismissal of women’s pain. On average, endometriosis patients also wait three and a half years from first noticing symptoms before seeking medical help, largely due to the normalisation of severe period pain.
Awareness of endometriosis among the public and healthcare professionals is still too low. Some 82% of patients have reported being told by their healthcare practitioners, prior to diagnosis, that they were making a fuss, or that their symptoms were normal. That is a recurring theme in women’s health. When I was involved in the all-party parliamentary group on birth trauma in the previous Parliament, we heard appalling testimony from women who had suffered serious injury giving birth only to be told, when they went to their GP afterwards, “What do you expect? You have just had a baby.” Many of them were in fact seriously injured. That institutionalised acceptance that women should suffer is something we need to address. I hope the Government are going to take that seriously—I am sure they are.
The nationwide tales are echoed by cases that I have heard from my own constituents. Lucy first got in touch with me in 2024, having already experienced years of debilitating pain that was dismissed and left undiagnosed. It was eventually confirmed to be endometriosis, but she struggled to get appropriate support on the NHS. She has told me of the grave impact that the pain has had on her quality of life, including missing out on education. Following an exhausting journey of many healthcare appointments, she is still suffering and is instead learning to manage the pain herself—yet, inspiringly, although she still lives with debilitating problems, she has now returned to the university studies that were broken off six years ago due to the pain.
I want to mention the different but related condition of polycystic ovary syndrome. Another constituent, Bethany, was left waiting months for an appointment after being diagnosed with polycystic ovary syndrome at 18. Following scores of appointment cancellations and administrative errors, Bethany decided to take action herself, setting up the Cysters Circle, a group that regularly meets around the constituency to support women and girls with conditions such as endometriosis and polycystic ovary syndrome.
I commend the hard work and fortitude of women such as Bethany and Lucy in campaigning for awareness of these conditions and providing the space where women can support each other—but they have to do so because of the barriers and woeful lack of support they experienced from the healthcare system. We must do more to raise awareness of these conditions and transform the quality of women’s healthcare across the country.
The failure of endometriosis diagnoses in primary care settings is adding even more pressure to our hospitals and forcing women to suffer for longer than necessary. Women often have to present multiple times to NHS services before getting the help they need. Prior to diagnosis, more than half of women are forced to go to A&E due to their symptoms.
As well as investing in tackling NHS waiting times for gynaecological services, we urge the Government to implement public health messaging, awareness campaigns and greater training for primary healthcare professionals. They should work with regulators and professional bodies to strengthen expectations on endometriosis education and awareness. Existing NICE guidelines must be fully implemented to establish clear, standardised referral pathways when women arrive at their GP appointment.
The experience of women trying to access endometriosis services reflects how our NHS suffered under the Conservatives, leading to some appalling outcomes in women’s health. Most maternity units are not deemed sufficiently safe; thousands of women have suffered a miscarriage without referral to the appropriate NHS services; waits for breast, ovarian and other genealogical cancers are unacceptably high; and, as we have seen with endometriosis, millions of women continue to suffer in appalling pain as they languish on waiting lists.
It is alarming that, in the face of those issues, the Government have discarded the target of having a women’s health hub in every part of the country. That decision undermines the effectiveness of the women’s health strategy. I hope the Minister will recommit to implementing those health hubs. Women’s health services are often too fragmented and difficult to access; removing the requirement for those hubs could lead to closures that would hurt access for women in need of care, and shows the wrong priorities.
The Liberal Democrats would give everyone the right to see a GP within seven days, including access to a named GP for patients with long-term conditions to ensure continuity of care. That would ensure that women suffering from long-term gynaecological conditions were listened to and got the support that they need.
The normalisation of women’s pain must stop. We must ensure that our health system fully supports those suffering with long-term gynaecological conditions so that women such as Lucy and Bethany, and the women in the Public Gallery today, are not left to battle through pain alone.
(2 days, 19 hours ago)
Westminster HallWestminster Hall is an alternative Chamber for MPs to hold debates, named after the adjoining Westminster Hall.
Each debate is chaired by an MP from the Panel of Chairs, rather than the Speaker or Deputy Speaker. A Government Minister will give the final speech, and no votes may be called on the debate topic.
This information is provided by Parallel Parliament and does not comprise part of the offical record
It is a pleasure to serve with you in the Chair, Mr Mundell. I thank my hon. Friend the Member for Caithness, Sutherland and Easter Ross (Jamie Stone) for his opening speech, as well as the compassionate and balanced nature with which he introduced the debate.
Liberal Democrats have been arguing for many years that improved access to better specialist healthcare services for children and young people struggling with their gender identity is extremely important. These young people have been badly let down by low care standards, extremely long waiting lists and an unacceptably toxic public debate.
Up front, I want to be clear that my party’s position is that any treatment and the approval of a trial must always be led by clinical, expert evidence, and not by personal belief, however sincerely that belief is held. For these reasons, we welcomed and continue to welcome the call in the Cass review for a clinical trial.
Following the closure of the GIDS clinic, which was rated inadequate by the Care Quality Commission, it is clear that change is needed. Under the previous system, more than 5,000 young people were stuck on a waiting list for a single clinic, each waiting an average of three years for just their first appointment.
We have consistently campaigned for real action to tackle the shocking waiting times across the NHS, whether for cancer patients or mental health referrals, and the importance of cutting these wait times is equally pressing for gender identity services. We have been pressing for new services with more specialist clinicians who can provide children and young people with the appropriate and high-quality care that they need. Liberal Democrats welcome the NHS’s move to create new regional centres to offer this healthcare to the young people who need it. However, as far as I am aware, only two have opened so far—one in London and one in the north-west. We would like confirmation of when more centres will open.
Young people who are stuck on these waiting lists will still have to wait a very long time. At such a distressing point in their lives, the three-year average wait for someone to see a specialist must feel like an eternity—for them and their family. The Government must show true urgency in opening these services to prevent more children being further denied the care that they need.
It is right that treatment should first be based on talking therapies. That gives those receiving treatment and their families the time, space and clarity to make informed decisions about their future. However, young people must be able to start talking therapy when they need it as a matter of urgency, not after languishing for years on waiting lists.
Following the Cass review, the Secretary of State for Health and Social Care announced the launch of an NHS clinical trial to investigate the impact of puberty blockers, alongside an indefinite ban on puberty blockers as treatment for gender dysphoria or gender incongruence. That trial has now been paused. It is crucial that decisions on treatment are made by expert clinicians and based on the best possible evidence, but we need the NHS to build up that evidence base effectively and safely.
In that vein, we are supportive of the Secretary of State’s decision to pause the trial while the concerns raised by the MHRA are thoroughly assessed. I am calling on the Government to publish how the MHRA arrived at its decision to pause the trial, so there can be confidence that the decision was led by clinical evidence. As with any medical treatment, it is crucial that decisions are led by expert clinicians following the evidence on safety and effectiveness. Research should also take into account the personal experiences of those who have previously used these services.
This debate should not be an ideological one; it is a debate about the quality of healthcare we provide to people who are in desperate need. All trans and non-binary people should be able to access the high-quality healthcare they deserve. The Liberal Democrats call on the Government to make tackling the unacceptable waiting times a priority. To take the urgent action that is needed, the Government must commit to NHS trials and adult services for trans and non-binary people that will expand the timely provision of appropriate specialist healthcare.
The Government must ensure trans people can access high-quality healthcare in the manner we expect for all patients. Medical decisions should be made by patients and doctors together and informed by the best possible evidence. The Government must support research through effective and safe methods using international best practice to improve our evidence on the safety and efficacy of potential treatments.
One thing is certain: in a debate where the wellbeing of many young people is at risk, decisions should not be led by ideology. We cannot let a toxic public debate threaten the wellbeing of vulnerable individuals. The Government must prioritise clinical evidence and put the interests of patients at the heart of the decision-making process, as we do in all areas of healthcare.
(1 week, 2 days ago)
Written CorrectionsThe Minister is probably about to draw his remarks to a close, but can I press him again on the mental health investment standard, which should ensure that the proportion of NHS spending on mental health goes up every year? In the last year for which we have numbers, it had gone up as a proportion of ICB spend, but had fallen as a proportion of overall NHS spend. Can the Minister commit that the Department will not be abandoning that standard, and that we will see mental health spending go up each year?
Dr Ahmed
I can certainly commit to the hon. Lady that mental health spending in real terms will go up every single year. It went up by £688 million in real terms this year.
[Official Report, 26 February 2026; Vol. 781, c. 239WH.]
Written correction submitted by the Under-Secretary of State for Health and Social Care, the hon. Member for Glasgow South West (Dr Ahmed):
(3 weeks, 6 days ago)
Westminster HallWestminster Hall is an alternative Chamber for MPs to hold debates, named after the adjoining Westminster Hall.
Each debate is chaired by an MP from the Panel of Chairs, rather than the Speaker or Deputy Speaker. A Government Minister will give the final speech, and no votes may be called on the debate topic.
This information is provided by Parallel Parliament and does not comprise part of the offical record
It is a pleasure to serve with you in the Chair, Ms Vaz. I thank my hon. Friend the Member for Bath (Wera Hobhouse) for securing this debate and for her dogged campaigning, her tireless work as chair of the APPG on eating disorders and her excellent opening speech.
I welcome Eating Disorders Awareness Week, and the important role that it plays in drawing attention to one of the deadliest and most harrowing conditions. I recognise and draw attention to the eating disorder charity Beat, which offers invaluable support for those with eating disorders, and the carers and healthcare professionals who provide support that, in many cases, can be lifesaving.
Anyone with personal experience of eating disorders will know just how devastating they can be. They rob young people of the formative years of their life, put immense strain on families and carers, and have long-lasting physical and psychological impacts. I was shocked to learn that hospital admissions for eating disorders have doubled in the last decade. A development as stark as that demands robust action and investment. At the same time, over half of the country’s integrated care boards have cut children’s eating disorder services. Children and young people cannot be allowed to slip through the net because of underfunded services.
The National Audit of Eating Disorders found huge disparities in the levels of support available for children compared with adults who have eating disorders. Adult community teams face an 89% higher demand than teams that support children and young people, with adults waiting twice as long for assessment and over 10 times as long for treatment. For a condition that progresses devastatingly quickly, early intervention is crucial.
The Liberal Democrats welcome NHS England’s recent guidance on improving the design of eating disorder services and community-based support, but that support cannot fulfil its potential without investment and a meaningful strategy to tackle the problem. I add the calls of my party to those from the Members who have made excellent speeches in today’s debate.
In Shropshire, I was pleased to see recent improvements in waiting times for children and young people awaiting treatment for eating disorders, with 96% of patients seen within four weeks. That has come from a fairly low standard, so it is a huge improvement, and I congratulate everybody involved. However, a quarter of children and young people referred to mental health services as a whole did not receive contact within the four-week waiting standard, and 19% were not seen within 18 weeks. Those waiting times are unacceptable. Urgent mental health problems are exactly that: urgent. Time is of the essence when tackling an eating disorder, and delays in assessment and treatment carry serious dangers.
I know from constituents who have gone through the process of trying to access treatment for their children just how difficult it can be to get support on time, because services are underfunded, waiting lists are long and resources are stretched. I have heard from parents of daughters whose condition was not deemed serious enough for them to be referred to an eating disorder clinic, despite their having a dangerously low weight and BMI—they were told, essentially, that she needed to be thinner. I do not need to explain just how problematic it is to imply that someone’s condition must get significantly worse before they can be seen.
One mother’s tale of struggling to get support for her daughter is too harrowing to report in this debate, but her cry for help speaks volumes:
“Please help us…I am scared and desperate.”
When patients do access treatment, gain some weight and are discharged, many are not given the continued mental health support they need to prevent relapses of the condition. That cannot go on.
We must not underestimate the impact of eating disorders on entire families. Patients require around-the-clock care in many cases to ensure that they receive the support and nutrition they urgently need. One self-employed single mother who wrote to me about the delays and failures she had encountered when seeking support for her daughters had to forgo her income to care for them. We need far better support for unpaid family carers struggling to support their loved ones with eating disorders, and we must ensure they have the training and advice they need to be able to provide the help that is so urgent.
The Government’s primary course of action for easing this burden should be to provide patients with the support they need, when they need it. That is why the Liberal Democrats are calling for proper investment in community mental health services, prevention and specialist support for eating disorders. We are campaigning to establish mental health hubs for young people in every community and to have a dedicated mental health professional in every primary and secondary school and regular mental health check-ups for the most vulnerable.
Our Opposition day debate on Tuesday called for action to ensure that cinema-style age classification ratings are applied to social media sites to prevent children from being subjected to the worrying proliferation of harmful content promoting eating disorders, which, as we have heard, can be so pernicious and damaging. I urge other parties in this place to put aside the politics of that and to support our calls—as many children’s charities do—to ensure that an appropriate safeguarding regime is put in place for children’s use of social media.
The Government must improve early access to mental health services so that cases can be caught early, before they become critical. Can the Minister commit to preserving the mental health investment standard and reinstating targets for the treatment of mental health issues, especially for young people, so that we can do that? The stories we hear from families and patients of their experiences of eating disorders are heartbreaking. We must treat these conditions with the urgency they deserve.
Dr Ahmed
My hon. Friend is absolutely right. Being proactive and following the evidence should be our north star when we are formulating policy; I know that is true of my right hon. Friend the Secretary of State for Science, Innovation and Technology.
The Royal College of Psychiatrists has been explicit about eating disorders and end-of-life care. Anorexia nervosa is not a terminal illness in its own right. The college’s guidance on medical emergencies in eating disorders was developed precisely to ensure that preventable deaths become a thing of the past. NHS England is clear that no patient with an eating disorder should routinely be placed in palliative care. Our focus must always be on treatment and recovery, and underpinned by the hope of recovery.
We also share concerns about the accurate recordings of deaths where eating disorders may have been a contributing factor. The hon. Member for Bath outlined some of her frustrations regarding correspondence with the Ministry of Justice and I would be happy to take up that call on her behalf to make sure that she gets the correspondence that she is entitled to. The statutory medical examiner and coroner system provides a clear framework to ensure that deaths are properly investigated and recorded so that lessons are identified and patient safety is strengthened.
Although it is for the coroner to exercise independent judicial discretion to determine what is recorded as the medical cause of death, I can reassure hon. Members that the coroner’s office has been undergoing training to ensure that the recording of deaths associated with eating disorders is done more accurately and proactively. Accurate recording matters, and we will continue to work with our partners, including colleagues in the Ministry of Justice and clinicians, to ensure that not only are the statistics captured, but the learning underpinning those statistics is reflected in genuine improvements to care.
Eating disorders are serious and complex mental illnesses that can affect anyone at any age and in any community or family. They require timely treatment, skilled professionals and sustained support thereafter.
The Minister is probably about to draw his remarks to a close, but can I press him again on the mental health investment standard, which should ensure that the proportion of NHS spending on mental health goes up every year? In the last year for which we have numbers, it had gone up as a proportion of ICB spend, but had fallen as a proportion of overall NHS spend. Can the Minister commit that the Department will not be abandoning that standard, and that we will see mental health spending go up each year?
Dr Ahmed
I can certainly commit to the hon. Lady that mental health spending in real terms will go up every single year. It went up by £688 million in real terms this year. The good nature of this debate permits me to push back only gently against the hon. Member for Sleaford and North Hykeham, who talked about spending in the NHS, but I do feel I need to push back a little: one of the reasons why that percentage in statistical terms is lower, but the spend in real terms is higher is because we had to spend so much more money—the record £26 billion that was afforded in additional spend by the Chancellor in the Budget—in other parts of the health service to compensate for the decay and decline in the NHS over the last 14 years. But the hon. Member for North Shropshire (Helen Morgan) has my commitment to the overall philosophy that mental health spending will increase year on year.
As I was saying, eating disorders are serious and complex; over and above skilled professionals, they also require compassion, understanding and collective responsibility. Through the 10-year health plan, we are shifting care closer to home; strengthening early intervention; expanding the workforce where necessary, such as with community mental health workers; improving standards and investing in the community services that make recovery possible. We are also equipping staff with the right training, protecting young people online—while continuing to improve and explore the mechanisms through which we can do that—and working with experts and those with lived experience to ensure that the reform we are choosing to pursue delivers real and lasting change.
We know that the policy framework alone is never enough. Change also depends on the voices of campaigners, including many who join us here today, clinicians, families and those who have shared their lived experience. I can assure everyone that their advocacy continues to shape this Government’s approach, and it will continue to do so.
To those living with an eating disorder, and to the families supporting them, I want to say this: “You are not invisible. You are not alone.” This Government are committed to building a system that responds with urgency, expertise and compassion. Our task—across this House and beyond it—is to ensure that when someone reaches out for help, the system we create is ready to respond with urgency, expertise and, crucially, hope. I once again thank hon. Members for contributing to this debate and I look forward to continuing this work with colleagues from across the House.
(1 month ago)
Commons ChamberLast year in Shropshire, which is a fairly typical rural area, 158,000 patients waited more than a month for a GP appointment. That is not surprising, given that, like many other rural areas, we have 50 fewer qualified GPs than we did a decade ago. Meanwhile, already busy GPs are trying to develop integrated neighbourhood teams, but they report that they have not received any dedicated Government funding, and still do not have the model neighbourhood framework. Will the Secretary of State act to ensure that GPs have the resources and guidance that they need to develop those neighbourhood health teams, and ensure that everyone can access an appointment within seven days, or 24 hours if it is urgent, particularly in rural areas, where provision is poor?
We have 2,000 more GPs now than when Labour came into office, but the hon. Lady is right to say that we need to ensure that that provision and increased capacity are reflected throughout the country. Because general practices serving more deprived areas receive 10% less funding per needs-adjusted patient than those in wealthier parts of the country, we are reviewing and reforming the Carr-Hill formula to ensure that we can direct the right funding to the areas in greatest need, recognising that amid our rural communities, there is obviously not just plenty of affluence, but enormous pockets of disadvantage and deprivation. Whoever people are and whatever their background, the support and care that they need must be received in the right place and at the right time.
Everyone in this House knows that NHS dentistry was allowed to fall apart under the Conservatives, resulting in DIY tooth extractions, people being forced to go to A&E because they are in pain, and children suffering in every corner of the country. Last year, 38,000 children in Shropshire did not see a dentist. In Surrey, that number was 100,000 and in Sussex it was 133,000. That is a disgrace. The Government promised an extra 700,000 urgent appointments to fight this crisis, but that promise looks set to have been broken in the previous year. Will the Minister today highlight in black and white how many extra urgent appointments were actually delivered last year, rather than simply commissioned?
As I have just pointed out to the hon. Member for Waveney Valley (Adrian Ramsay), we have broadened the definition, because the clinical definition of “urgent” was simply not in line with the common-sense interpretation. People removing their own teeth in DIY dentistry were not fitting into the classification of “urgent”. We have changed that categorisation. As a result of that, I am pleased to confirm that we have delivered 1.8 million additional appointments and treatments this year compared with the same period last year—April to October 2025. We will continue to work on that basis of embedding urgent care into the contract, as I announced on 16 December, in the 2026 reforms that we are carrying out.
(1 month, 1 week ago)
Commons ChamberPharmacists play a crucial role in supporting the health service by reducing the pressure on overcrowded hospitals and GP surgeries. They also play a crucial role in local communities by providing access to treatment when appointments remain hard to come by elsewhere. But pressure on pharmacists is severe and has been getting worse, as shown by closures in my constituency and across the country. Those closures hit hardest in rural and coastal areas and in the most deprived areas, where they are most needed. This vital service needs to be supported and not undermined so that our constituents can rely on being able to access the medicines and treatment they need.
Has the Minister considered a new late payment mechanism to ensure that if contractors miss the deadline, they can still receive compensation for the work they have undertaken, especially in the interim as pharmacists adapt to the changes that have been introduced? What discussions has he had with NHSBSA to resolve the technical difficulties being experienced?
Dr Ahmed
I can assure the hon. Lady of our commitment to an effective primary care system up and down the country, in both rural and coastal communities. My hon. Friend the Minister for Care, whose portfolio includes pharmacy, takes his responsibilities seriously and is exploring all avenues to ensure equity of access and funding, including through the Carr-Hill formula.
The hon. Lady asks what mitigations can be employed to ensure that payments are made in extraordinary circumstances. I can assure her that I have had those discussions with my officials this morning, and they reassured me that there will be a degree of flexibility, particularly in circumstances outwith the control of individual pharmacies.
(1 month, 3 weeks ago)
Commons ChamberI am pleased to welcome this Bill, broadly. It seeks to prioritise graduates from UK and Irish medical schools for foundation and specialty training places. On this point, the Liberal Democrats support the Government, but we have some concerns about how that will be delivered, and about the real-world consequences for our NHS, patients and the doctors who keep our health service going.
Taxpayers invest around £4 billion every year in training young doctors, yet far too many are left competing for too few posts. In 2025, around 12,000 UK-trained doctors competed with 21,000 international doctors for just 9,500 specialty training positions. Many highly skilled young doctors, who were ready to serve in the NHS, were left without a pathway into specialist practice. That is clearly unfair and unsustainable. It is hardly surprising that so many doctors decide to leave the country altogether and seek opportunities elsewhere, where their training and wellbeing are valued. This is a tragedy for them and a tragedy for patients, so prioritisation is right, fair and long overdue.
However, reorganising a queue does not shorten it or make it move any faster. The reality is clear: the NHS has a deep workforce shortage, with crises in some specialties, and this Bill alone cannot solve it. A detailed long-term workforce plan, which ensures that training provides the skill mix that the NHS needs for the future, is required as soon as possible. I look forward to the Minister confirming when that will be delivered.
Shortly before Christmas, the Government committed to 4,000 additional specialty training places in their negotiations with the British Medical Association, including 1,000 that were brought forward, but following the collapse of those negotiations, it remains unclear whether those places will materialise. Patients cannot wait for certainty, and neither can exhausted staff. Will the Minister confirm those places, and go further by addressing other issues that have prevented doctors from working in the NHS, such as restrictive rotas, workplace violence and inflexible working? Dealing with such issues might prevent doctors who have secured specialty training places from moving abroad once their training is completed, ensuring that taxpayers’ money is not wasted, and that doctors with local, relevant experience remain in the NHS.
I turn to the details of the Bill. We have concerns about clause 7(1), which allows Ministers to change eligibility for prioritisation through the negative procedure. That will enable sweeping changes, without proper parliamentary scrutiny, to who can access training places. Given the scale and sensitivity of the NHS workforce pressures, such decisions must not be made behind closed doors, or at the whim of a future Health Secretary with less desirable motives than the current one. That is why the Liberal Democrats have tabled amendments that would require Parliament to approve any future changes through the positive procedure.
We are also troubled by the Government’s decision to apply the new rules part of the way through the 2026 specialty recruitment cycle. The Bill allows for prioritisation at the offer stage for medical specialty training places in 2026. I would like the Minister to clarify in her closing remarks whether this means that international doctors already working in our NHS—who have paid for exams, secured visas and maybe uprooted their life and their family—will suddenly be pushed to the back of the queue, mid-cycle. These doctors keep our hospitals running today. They entered the system in good faith, and it seems unfair to change the rules midway through the process.
I would also be grateful if, in the Minister’s closing remarks, she outlined the expected impact on NHS service provision if people who are deprioritised during the application process decide to leave en masse. Will she give my constituents in North Shropshire reassurance that patient safety and patient outcomes will not be impacted? The Liberal Democrats would prefer implementation to begin in 2027, at the interview stage; that would protect both fairness and patient safety.
Would the Minister elaborate on the impact of the Bill on universities that offer medical degrees elsewhere in the world? I think we have all been contacted by Queen Mary, University of London; the implications for the university may be serious if graduates, who have always been considered UK graduates, undertaking NHS training, and a UK medical qualification registered by the General Medical Council, suddenly have their expectations changed.
As I have mentioned, retention is just as critical as recruitment, but unfortunately it is outside the scope of this limited Bill. In the year to September 2023, 10.7% of NHS staff—about 154,000 people—left their role. Burnout is rife, morale is low and too many staff are working in buildings that are crumbling around them. We have been contacted by GP trainers who are worried that the doctors they are training plan to leave for Australia or Canada as soon as they qualify. The promised workforce plan must address this problem.
International comparisons lay bare the scale of the problem. England has just 3.2 doctors per 1,000 people, which is well below the OECD and EU average of 3.9. We would need 40,000 more doctors to meet that benchmark. Prioritising UK graduates is sensible, but it will not on its own deliver the workforce that patients urgently need. That is why the Liberal Democrats have tabled an amendment requiring a specialty by specialty workforce assessment. Shortages are acute in general practice, radiology, cancer care, mental health and more, and transparency is essential if training places are to be directed at where the need is greatest.
It is neither right nor remotely sustainable that, at a time when patients struggle to see a GP, qualified GPs are unemployed, yet that is happening now, with vacancy freezes and financial pressure creating an NHS in which shortages sit alongside unemployment. The Government’s decision to raise national insurance has only exacerbated the problem, forcing some practices into lay-offs or closure. In my North Shropshire constituency, several GP practices have told me that they cannot take on additional doctors because they are constrained by the outdated physical space in which they operate. The Liberal Democrats would fund 8,000 more GPs, ensuring that every patient could see a GP within seven days, or 24 hours if the need was urgent, because we cannot fix the NHS without fixing the front door.
NHS staff are the backbone of our health service, and they deserve better working conditions and a fair career path. We will continue fighting for an independent pay review body, for safe and modern buildings, for flexible working from day one, and for practical support, such as reduced parking charges, so that staff are not penalised for simply turning up to care for us. We will always stand up for our NHS and the people who make it work. While we support this Bill, we will push to ensure that its implementation strengthens our health service as much as possible.
(1 month, 3 weeks ago)
Commons ChamberThe amendments in my name raise concerns about the Bill’s impact on fairness, transparency and the smooth functioning of the NHS, notwithstanding the Liberal Democrats’ overall support for the Bill.
Clause 7(1) would allow Ministers to change who is eligible for prioritisation through the negative procedure, meaning that such changes could be made unilaterally, without meaningful scrutiny. In practice, that hands the Secretary of State the power to redraw the boundaries of opportunity, and to decide who gets prioritised for medical training places, without Parliament ever having a say. That is unacceptable for a decision that affects people’s lives and careers, as well as the future capability of our health service. While I do not doubt the intentions of the Secretary of State and the Front Bench team, it opens the door to the risk of political whim or prejudice influencing who gets access to career-defining opportunities in the future. That is why the Liberal Democrats have tabled amendments 2 to 5 to reverse this, and to ensure that any changes must be subject to full parliamentary consent.
On the timing of the Bill’s implementation, the Government intend to apply the new prioritisation rules midway through the 2026 specialty recruitment cycle. Let us reflect on what that means in practice. Doctors already working in the NHS have entered this cycle under one set of rules. They have paid for exams, secured visas, arranged travel, uprooted their families and committed themselves to the NHS. To change the rules halfway through the process would not only be potentially destabilising for services, but very unfair to those individuals, many of whom are plugging urgent staffing gaps right now.
We already face real workforce pressures, so the last thing our NHS needs is a wave of dedicated doctors forced out by uncertainty, or pushed to leave the country because the Government moved the goalposts after applications had already begun. For this reason, we believe that the Bill should come into force from 2027. We must protect frontline services and protect the integrity of the applications process. To address the problem directly, we have tabled amendments 6 and 7 to safeguard those already in the 2026 application cycle, ensuring that they are not deprioritised, because that is a simple matter of fairness.
We have also tabled amendments to improve the transparency and long-term impact of the Bill. Across the NHS, we face severe shortages, not just in general practice but in radiology, oncology, mental health services and many other specialities.
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?
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.
(2 months, 1 week ago)
Commons ChamberOrder. The question is about waiting lists, and I am sorry but we have got to stick to it. [Interruption.] Order. Mr Logan, I was very good in bringing you in, especially with health being devolved, so please let us not change the question before us. Helen Morgan will be a good example.
I always am, Mr Speaker; thank you very much. Recently, I have heard from Candice, who was interrupted while changing her stoma bag behind a curtain on the emergency ward; Lynne, who waited 17 hours for an ambulance after breaking several ribs; and Sandra, who has bladder cancer and spent 31 hours on a plastic chair in the “fit to sit” area. They all want to share their stories so others do not have to suffer like they did, in pain for hours and hours. Will the Secretary of State commit to ending the waits and back the Liberal Democrat call, welcomed by the Royal College of Emergency Medicine this morning, for a guarantee that no patient will have to wait for more than 12 hours in A&E?
We are striving towards meeting those standards, which were met so successfully under the last Labour Government. This Labour Government are having to pull out every stop to repair the enormous damage done by our predecessors. The Liberal Democrat spokesperson is right: safety, of course, is paramount, but so is dignity. When she describes those patients’ stories in those terms, it underscores the fact that behind the two words “corridor care” are countless stories of indignity and treatment in conditions that neither we, nor they as patients, nor staff want to see those people treated in. We are determined to put an end to it.
The social care crisis is piling pressure on hospitals, with beds taken up by patients who are fit enough to be discharged. It is also piling pressure on local councils such as Shropshire, where 80% of the budget goes to social care, yet the Government are shifting funding from counties to cities and dragging their heels on the social care crisis. Will the Secretary of State take action by reinstating the cross-party talks on social care as a priority, because we need to fix social care if we are going to fix councils, care and the NHS?
Cross-party working on social care has never been un-instated. I know there is much more to do, but we have been in government for 18 months and we have put in £4 billion of investment, legislated for the first ever fair pay agreements with £500 million committed to that, made significant additional investment in the disabled facilities grant and, in building the workforce plan for the future, we have commissioned Baroness Casey to do her work. She will be reporting soon and we look forward to taking that work forward.
(3 months, 1 week ago)
Commons ChamberUrgent Questions are proposed each morning by backbench MPs, and up to two may be selected each day by the Speaker. Chosen Urgent Questions are announced 30 minutes before Parliament sits each day.
Each Urgent Question requires a Government Minister to give a response on the debate topic.
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I call the Liberal Democrat spokesperson; you have one minute.
I hope that everyone in this House can agree that medical treatment should always follow the evidence on safety and effectiveness. It is right that expert clinicians are building this evidence base and therefore right that the Government are seeking to run this trial, because it should be led by evidence and not by ideology.
Given that the numbers on the trial will be very small and the waiting list for talking therapies, which are so important for children and their parents, is very long, with hundreds of thousands waiting, can the Secretary of State explain how he will increase access to NHS talking therapies so people can get the help they need and deserve? In a field with so little research, will he confirm if the pathways trial will look at international best practice in order to take learnings from abroad?