Glaucoma Awareness

Helen Morgan Excerpts
Wednesday 9th July 2025

(2 weeks, 3 days ago)

Westminster Hall
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Helen Morgan Portrait Helen Morgan (North Shropshire) (LD)
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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

(3 weeks, 2 days ago)

Commons Chamber
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Roger Gale Portrait Mr Deputy Speaker
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I call the Liberal Democrat spokesperson.

Helen Morgan Portrait Helen Morgan (North Shropshire) (LD)
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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 Portrait Wes Streeting
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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

(1 month ago)

Commons Chamber
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Helen Morgan Portrait Helen Morgan (North Shropshire) (LD)
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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

(1 month, 1 week ago)

Commons Chamber
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Helen Morgan Portrait Helen Morgan (North Shropshire) (LD)
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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.

Roger Gale Portrait Mr Deputy Speaker (Sir Roger Gale)
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I call the Opposition Front Bencher.

Oral Answers to Questions

Helen Morgan Excerpts
Tuesday 17th June 2025

(1 month, 1 week ago)

Commons Chamber
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Lindsay Hoyle Portrait Mr Speaker
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I call the Liberal Democrat spokesperson.

Helen Morgan Portrait Helen Morgan (North Shropshire) (LD)
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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 Portrait Karin Smyth
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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.

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Lindsay Hoyle Portrait Mr Speaker
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I call the Liberal Democrat spokesperson.

Helen Morgan Portrait Helen Morgan (North Shropshire) (LD)
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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 Portrait Stephen Kinnock
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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.

Helen Morgan Portrait Helen Morgan (North Shropshire) (LD)
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I welcome this piece of legislation, which I think is generally in a very good place. I have had a tragic situation in my constituency, where somebody who had been admitted to hospital in a suicidal state discharged themselves, after which, unfortunately, no follow-up care was provided, and they took their own life. It has been devastating for their family. Would the Secretary of State consider looking at how the community supports people experiencing a mental health crisis who might have discharged themselves, and how we can keep them safe in future?

Wes Streeting Portrait Wes Streeting
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I am very grateful to the hon. Lady for that intervention. The Bill deals to an extent with cases that would fall under the category she describes, in particular through reforms to community treatment orders. However, it would not necessarily cover the full extent of the sorts of people who might find themselves in that position, which is where I think we can use technology—which is not the answer to every problem in the health service, by the way. However, through better use of data, patient records and analytics, we will be better able in the future to predict risk and prevent tragedies as in the case the hon. Lady describes, which are a tragedy not just for those whose lives are cut needlessly short, but for those who live their lives with that intolerable grief and loss for the many years that follow.

It is a shameful truth about our society that people with a learning disability or autism are detained, sometimes for years, with little or no therapeutic benefit. The Bill will put an end to that injustice, limiting detentions so that people with a learning disability and autistic people are no longer detained beyond 28 days unless they have a co-occurring mental health condition that would benefit from treatment in hospital. This will require the necessary community provision in place to support people with a learning disability or autism, and we are working to set out what strong community services look like and on the resources required to implement them, so that there are robust alternatives to hospital care.

To help to plug the flow of inappropriate admissions to hospital, the Bill places a duty on integrated care boards to improve monitoring and support for people with a learning disability or autism who may be at risk of future detention. The Bill will introduce statutory care, education and treatment reviews to ensure that patients are safe and receiving the right care and treatment when detained, and that a plan to discharge them to the community is being worked up. We will also remove prison and police cells from the definition of “places of safety”. Police cells are for criminals, not patients in desperate need of medical help.

Throughout the development of these reforms, we have maintained the central purpose of the Mental Health Act—to keep individuals and the wider public safe. The vast majority of people with mental illness, including severe mental illness, present no risk to themselves or others, and, for the majority of people, treatment can be provided without compulsion. However, there are some people whose illness, when acute, can make them a risk to themselves, and sometimes to others.

No one knows this better than the families of Ian Coates, Barnaby Webber and Grace O’Malley-Kumar, the victims of Valdo Calocane’s violent rampage in Nottingham, whose campaign for justice and accountability has been truly awe-inspiring, or indeed the family of Valdo Calocane, with whom I have also spent time, listening to their experience of feeling badly let down by health services. As the independent investigation into the murders found, both he and his victims were failed by the health service, and their families have been left to live with the consequences with a level of pain the rest of us can scarcely imagine. I would like to place on the record my thanks to all four families for meeting me as my team and I worked on the Bill.

Thanks to the amendments that we are making to the Mental Health Act, decision makers will have to consider the risk of serious harm when making decisions to detain. That will ensure that any risks to the public and patients are considered as part of the assessment process. We will also introduce a new requirement for the responsible clinician to consult another person when deciding whether to discharge a patient, putting in place robust safeguards against the release of potentially dangerous people.

Finally, as I have said, legislation alone will not fix the wider issues of increasing mental health needs and long waiting times. To do that, the Government are investing in earlier intervention to meet patients’ needs and prevent them from reaching crisis point.

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Ian Sollom Portrait Ian Sollom (St Neots and Mid Cambridgeshire) (LD)
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I wish to draw the House’s attention to the appalling case of a young man who was very badly failed by mental health services and, indeed, tragically lost his life as a result. Today I am representing his family, my constituents Graeme, Sam and Kaitlyn, who have been campaigning to ensure that no other family has to go through the distress that they have endured and continue to endure.

Declan Morrison was 26 years old when he died. He had complex needs, and required some of the most specialist care and support throughout his life. He had autism, associated severe learning disabilities, bipolar disorder and attention deficit hyperactivity disorder. He was non-verbal and required 24-hour residential care, which he had needed and received since he was 11 years old. Declan’s behaviour could be challenging, and at times he would injure himself—and sometimes, latterly, staff members caring for him. That is why it is so important that he was supported by those who knew him well, and who were able to understand his behaviour and therefore provide, as best they could, for his needs. His family were unable to provide him with the care he needed in their home, and had to put their trust in the system and specialist carers to make sure that he was looked after. Sadly, their trust was broken, with the most devastating consequences.

Declan was moved into his final residential home in May 2021 after the previous placement had become unable to meet his needs, although in a subsequent independent safeguarding adult review following his death, that decision was called into question. For a brief period, Declan seemed to settle into his new placement, but quite quickly staff at the care home raised concerns that they could not safely care for him owing to his behaviour, which had become particularly challenging. However, attempts to find an alternative single-space home for him, which he needed, failed. There was nothing available, not a single appropriate placement, so he remained in that placement for a further 10 months, with his mental and physical health worsening. I will not describe here what life was like for Declan and his family at this time, because it is too distressing.

Helen Morgan Portrait Helen Morgan
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My hon. Friend is making an important point about lack of provision. Does he agree that the 10-year timescale for ensuring that that provision is available is critical? If the Government could speed that up, it would be extremely helpful in instances such as this.

Ian Sollom Portrait Ian Sollom
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I entirely agree, and I will come on to make that very point.

Needless to say, events took a very dark and ultimately heartbreaking turn. In March 2022, a serious incident occurred: Declan became very distressed, and assaulted some staff members. Police were called, and a number of officers assisted staff to restrain Declan. As a last resort, he was detained under section 136 of the Mental Health Act and taken to the section 136 suite at Fulbourn hospital. Some may not be aware that under the law, patients who are placed in a section 136 suite should be there for no more than 24 hours, or 36 hours in extreme circumstances. Declan was there for 10 days—10 days in an emergency suite that was entirely unsuitable for a person with his severe needs; 10 days while more than 100 places were contacted; 10 days during which not one bed in suitable accommodation could be found locally, regionally or nationally for him. Finally, he simply could not cope, and he banged his head repeatedly against a wall, inflicting a catastrophic head injury on himself. He was taken to hospital and operated on, but he died some days later in April 2022, when his family made the heart-wrenching decision to turn off his life support.

It is painfully relevant that we are debating the Mental Health Bill today, because clauses 3 and 4 specifically address the detention of people with autism and learning disabilities, like Declan. The Bill would limit detention for treatment under section 3 of the Act, but I must ask the Minister: would these provisions have been enough to prevent Declan’s tragedy? His case highlights the critical importance of having appropriate crisis provisions and suitable community placements available, not just in theory but in reality. The coroner’s report on Declan’s death and the independent care review found major failings in the system that was supposed to protect and care for him. He was acknowledged to have been in crisis for months. Ultimately there was, and there remains, an enormous shortage of available placements for someone with Declan’s complex needs, both in the community and within the NHS. As Declan’s father told me, in words that I hope will be heeded, the reliance on the section 136 suite to contain autistic individuals while they are in crisis is abhorrent, and must be seen as a breach of the Human Rights Act.

Declan’s sister, Kaitlyn, has called for specific crisis provisions to be funded and created for individuals with autism who need a designated place of safety when experiencing a severe mental health crisis. Such provisions would need appropriately trained and experienced staff. In fact, one was created in Cambridgeshire following Declan’s death. Sadly, the funding was pulled and it closed, but it operated at 90% capacity when it was open, showing the very real and immediate need for this kind of provision to exist permanently and across the country.

The Bill places new duties on integrated care boards and local authorities to provide community support for people with autism and learning disabilities, but how will the Government ensure that the duties it outlines translate into sustainable services that prevent cases like Declan’s from ever happening again? Duties without resources are merely words on paper. Although it is welcome that clause 49 removes police stations and prisons as places of safety, Declan’s case shows that even designated section 136 suites can be wholly inappropriate for individuals with complex needs. How will the Government ensure that appropriate alternatives are in place before the provisions commence?

I note with deep concern that the Government anticipate that full implementation of the Bill could take up to 10 years, which is too long for vulnerable people to continue to be at risk. In the light of the coroner’s findings in Declan’s case, will the Government commit to prioritising the provisions relating to autistic people and those with learning disabilities, particularly the development of appropriate crisis services, as outlined in the Bill?

On behalf of Graeme, Sam, Kaitlyn and all those people like Declan, I ask the Government whether they are satisfied that the provisions set out in the Bill will prevent tragedies like this one from ever happening again. If not, I urge them to make changes to ensure that it will. For Declan and all those with autism and learning disabilities, who deserve better from our mental health system, we must make sure that the Bill delivers the change they need—not in 10 years, but now. Their lives depend on it.

NHS and Care Volunteer Responders Service

Helen Morgan Excerpts
Monday 19th May 2025

(2 months, 1 week ago)

Commons Chamber
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Urgent 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.

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Lindsay Hoyle Portrait Mr Speaker
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I call the spokesperson for the Liberal Democrats.

Helen Morgan Portrait Helen Morgan (North Shropshire) (LD)
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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 Portrait Karin Smyth
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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.

Brain Tumours: Research and Treatment

Helen Morgan Excerpts
Thursday 8th May 2025

(2 months, 2 weeks ago)

Commons Chamber
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Helen Morgan Portrait Helen Morgan (North Shropshire) (LD)
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I thank the hon. Member for Mitcham and Morden (Dame Siobhain McDonagh) and my hon. Friend the Member for Witney (Charlie Maynard) for bringing forward this debate. It has been a privilege to sit through such excellent speeches on this very important topic. I am sure that the hon. Lady’s sister Margaret would be very proud of her, and I am sure that my hon. Friend’s sister is proud of him too.

As the hon. Lady and my hon. Friend have outlined, a brain tumour diagnosis can be utterly devastating and life-changing. Some 12,000 people a year are diagnosed with a primary tumour, while many others are diagnosed with a secondary tumour that has spread from elsewhere in their body. Primary tumours are largely unpreventable, and cause the death of more adults and children under 40 than any other type of cancer. As primary brain tumours do not spread around the body like other cancer types, they do not receive the same staging categorisation.

Current NHS programmes for diagnosing cancers earlier do not include brain tumours, as they focus on targets and improvements for catching more cancers in stages 1 and 2. Nearly half of people diagnosed—49%—are found to have a so-called benign tumour, a grade 1 or 2 tumour that grows more slowly. Those tumours are not technically cancerous, so they are not covered by previous cancer plans or initiatives for improving cancer care. However, the treatment and care for patients with a low-grade tumour has long-lasting impacts and can be life-altering.

I would like to mention the experience of my constituent Madi Ruby, who has tirelessly campaigned and fundraised on this issue. She has experienced both a grade 1 and a grade 2 tumour. She first experienced symptoms of a brain tumour in 1995 with numbness in her right arm, and went on to write backwards and develop headaches. She went for a CT scan when that numbness spread to her foot and she was involved in a minor car accident. Only then was she diagnosed with a grade 1 meningioma measuring 6 cm, which was removed—she was only 23 at the time.

Although that surgery was successful, Madi developed partial epilepsy. She was eventually discharged after five years of clear scans, but as we have heard, tumours still impact lives. She has had poor mental health and become depressed, and in 2013, her brain tumour returned. That tumour has also been removed, but she still deals with partial epilepsy, constant headaches and migraines, and suffers daily. She is also an inspirational person; she has bravely spoken out about her depression, trained to be a counsellor, and is now an associate dean responsible for nursing and allied health professionals at Wrexham Glyndŵr University.

I also want to mention my constituent Shaun Burgess, who raised more than £11,000 for the Brain Tumour Charity and the Meningioma Support Group by running 3,000 miles across Shropshire last year. He was raising money after his wife Mo was treated for a non-cancerous tumour, but not everyone diagnosed with a brain tumour gets that second chance; Shaun has lost a friend to a more aggressive brain tumour.

We must end the tragedy of people losing their lives because treatment for brain cancer took too long to start. As my hon. Friend the Member for Witney has outlined, progress on the treatment of brain tumours has not been good enough. The diagnosis and treatment of cancer should be a top priority for any Government, and the UK should be a global leader in cancer research and outcomes. I urge the Minister to listen to the pleas of Members from across the House on that point today.

For so many people, diagnosis and treatment are too difficult to access. My constituency is a typical example. The major hospitals in Shrewsbury and Telford face a number of challenges and regularly have some of the longest waiting times in the NHS for cancer screening and treatment. In December 2024, just 64% of patients were treated within the 62-day period, despite the target being 85%. The average across England was much better, but still poor at 71%.

Not only do too many people live in treatment deserts, but when they are finally offered the treatment they need, it is hard to access. Anyone living in rural North Shropshire would say that. Having waited anxiously for weeks or months for a scan and the result, they then, if the news is bad, have to travel extremely long distances for the treatment they need. Most of North Shropshire is an hour and a quarter away from a radiotherapy centre on public transport. For patients with brain tumours, public transport is fundamental if they can no longer drive. One of my constituents has faced exactly that problem, having had their driving licence suspended by the Driver and Vehicle Licensing Agency after being diagnosed with a tumour. Apparently that could be remedied if his consultant provided a BT1 form, but he has not been able to get through to the doctor. In the meantime, he is trapped without freedom in a constituency with some of the worst public transport in the country.

Ongoing funding issues, which we know are a huge challenge for the Government, continue to afflict brain tumour patients in a number of ways. Another constituent of mine told me their experience after being referred to a care navigator following their diagnosis. The care navigator’s job is to contact patients on a monthly basis, seeing whether they have any problems and concerns and guiding them through an experience that is extremely traumatic. However, the care navigator position has now been cut, and my constituent has been left in the dark, with growing anxiety and no one to speak to. No one should be going without treatment because there is not enough equipment, and no one should suffer because there are not enough staff to support them.

What would Liberal Democrats do? We would recruit more cancer nurses, so that every patient has a dedicated specialist supporting them throughout their treatment. For brain tumours, we would like to see an improvement in diagnosis, the care people receive and the range of treatment options available. Diagnosis targets need to reflect the fact that brain cancer does not occur in stages in the way that other cancers do—otherwise, we risk brain tumours falling through the cracks of NHS targets and objectives. Low-grade brain tumours, such as that suffered by Madi, need renewed attention, including in the upcoming cancer plan, which we look forward to seeing.

The Liberal Democrats have committed to boosting cancer survival rates more generally by passing a cancer survival research Act, which would require the Government to co-ordinate and ensure funding for research into the cancers with the lowest survival rates, such as brain tumours. We would halve the time for new treatments to reach patients by expanding the Medicines and Healthcare products Regulatory Agency’s capacity and ensuring that every patient starts their treatment for cancer within that 62-day urgent referral target. We would replace ageing radiotherapy machines and increase their number so that no one has to travel too far for treatment. Measures such as Margaret’s law, which the hon. Members who secured this debate have pressed for, would be an important step in the right direction to improve research in glioblastoma in particular, and I urge the Minister to consider that too.

Do the Government have any future plans for allocating support to research into vaccine treatment for brain tumours, which has reportedly shown remarkable progress against glioblastoma in recent studies? Too many patients with brain tumours have been let down by previous Governments over many years, and I hope that this Government will step up and make brain tumours, cancer and NHS care their No. 1 priority.

Judith Cummins Portrait Madam Deputy Speaker (Judith Cummins)
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I call the shadow Minister.

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Ashley Dalton Portrait The Parliamentary Under-Secretary of State for Health and Social Care (Ashley Dalton)
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I thank my hon. Friend the Member for Mitcham and Morden (Dame Siobhain McDonagh) and the hon. Member for Witney (Charlie Maynard) for securing this vitally important debate. They have both been powerful voices in this place for more research, greater care and better treatments for patients with brain tumours. My hon. Friend spoke so powerfully, as always, and in the name of her sister Margaret. I thank the hon. Member for Witney for sharing his sister’s story. I commend her for her fundraising activity and wish her the very best. The hon. Member asked three very clear questions, which I hope my response will cover.

I also thank other Members who made powerful contributions in what has been a very constructive debate. I hope my responses will answer their queries, but if not, I will endeavour to write to all Members following this debate about any gaps that are left. The hon. Member for Edinburgh West (Christine Jardine) spoke about disparity of drug access. My right hon. Friend the Member for Hayes and Harlington (John McDonnell) asked for zest, and spoke about the requirement for it. He expressed the frustrations of the APPG and others at the speed at which we are able to make progress. The hon. Member for Strangford (Jim Shannon) spoke about the importance of research, and my hon. Friend the Member for Bolton West (Phil Brickell) spoke about clinical trials. The hon. Member for Leicester South (Shockat Adam) brought his expertise on optometry to bear, and spoke about how useful an eye test can be. The hon. Member for North Shropshire (Helen Morgan), the Liberal Democrat spokesperson, talked about low-grade tumours. I commend her constituents, whom she spoke about, for their work.

I thank the shadow Minister, the hon. Member for Hinckley and Bosworth (Dr Evans), for sharing the story of Isla’s stones. What a powerful metaphor and a powerful remembrance. He also spoke about the acquired brain injury strategy. My remarks will focus on brain tumours, but I can confirm that the ABI strategy remains in play and in development. I will update the House on that as soon as possible. First, I pay tribute to some fantastic charities for their advocacy—the Brain Tumour Charity, Brain Tumour Research, Cancer Research UK and Tom’s Trust, to name just a few.

Innovative research is vital in our fight against this devastating disease if we are to offer people the most cutting-edge treatments and the highest-quality care. The Department of Health and Social Care, through the National Institute for Health and Care Research, invests over £1.6 billion per year in research. In the past financial year alone, it invested over £130 million specifically in cancer research. That has enabled 261 brain tumour studies to happen in the NHS, involving 11,400 people in potentially life-changing research over the past six years. Since 2018, the NIHR has directly invested almost £12 million in brain tumour research projects; it has also spent around £37.5 million on wider infrastructure investments in facilities, services and the research workforce, making research possible. In addition, over five years, between 2020 and 2024, the Medical Research Council committed more than £18.5 million to brain tumour research.

Our investments are having an impact. NIHR-funded research has shown that a new targeted drug combination treatment can give better outcomes for one of the most common types of paediatric brain cancer, but of course there is still so much more to do. Too little is known about how to prevent, diagnose and manage brain tumours, and they remain one of the hardest cancers to treat and a challenging area for research. That is why we are committed to furthering our investment in brain cancer research and have already taken some steps to stimulate scientific progress. I would like to offer the House just three examples from the past year.

First, in September, the NIHR announced a new package of funding opportunities for brain cancer research for both adults and children. Secondly, in December, the NIHR established a new national brain tumour research consortium. The consortium brings together research from a range of disciplines and institutions to drive faster scientific advancements in how we prevent, detect, manage and treat brain cancer. This complements the NIHR’s dedicated funding call on research into wraparound care, rehabilitation and quality of life for patients with brain tumours. It has received a high volume of applications, and those applications are under consideration by an independent expert peer review panel.

Thirdly, the Department is working actively as a member of the Tessa Jowell Brain Cancer Mission to fully support the vision of bringing the best care to all brain tumour patients in the UK. Together, we will work with the brain tumour community to accelerate research and bring new insights to the field. This summer, the mission will launch the Tessa Jowell allied health professional research fellowship to train early-career health professionals in conducting vital research on how we improve patients’ quality of life.

The commitment to spend at least £40 million on brain cancer remains in place. The limiting factor has not been restrictions on funding, or funds being spent elsewhere, and every research proposal assessed as being fundable has been funded. My Department is now focusing on how we grow the scientific community working on brain cancer to get more research funded. We are committed to increasing spending on brain cancer research, and the £40 million target is not a funding ceiling—it will not end there. However, it is important that only high-quality applications be funded, so that public funds are invested well and produce impactful and usable research evidence. We will continue to work hand in glove with partners who fund research on new scientific discoveries, such as Cancer Research UK, the Medical Research Council and brain tumour charities. We stand ready to translate these much-needed discoveries as quickly as possible into new treatments for patients via the NIHR.

My hon. Friend the Member for Mitcham and Morden raised the issue of partnerships with industry to develop treatments, and I can confirm that we are committed to working with the pharmaceutical industry and others with the common aim of creating a faster, more efficient, more accessible and innovative clinical treatment delivery system. We expect these efforts to attract more commercial investment in clinical research, and to yield a broad and diverse portfolio of clinical trials in the UK, so that we can provide innovative treatment options for patients, including those with glioblastoma. The new brain tumour research consortium, to which I have referred, will bring together people to work on that, and will work to detect, manage and treat rarer and less survivable cancers in children and adults.

Clinical trials are a crucial part of cancer research. They are the key to advanced medical progress, improved patient outcomes and more hope for the future. Britain is already one of the best destinations in the world for clinical trials, but we want to go further. On 7 April, the Prime Minister announced action to accelerate the set-up and delivery of clinical trials; the time taken to set up studies will be cut to 150 days by March next year, down from 250 days, according to the latest data, which was collected in 2022.

The Department of Health and Social Care is committed to being a world-leading destination for clinical trials. Work is ongoing to streamline and reform the set-up and delivery of clinical trials through digitalisation, and by reducing unnecessary bureaucracy. That is driving a “right research, right setting” initiative, and we are moving from reactive to proactive portfolio management, including by supporting the workforce and continuing to embed a research and innovation culture across the health and social care system.

The Government also support the private Member’s Bill on rare cancers, brought forward by my hon. Friend the Member for Edinburgh South West (Dr Arthur). The Bill will make it easier for clinical trials on rare cancers to take place in England by ensuring that the patient population can be easily contacted.

This Government are committed to backing innovative clinical research ecosystems in the UK, so that British patients can be among the first to benefit. We will bust bureaucracy, fast-track clinical trials and give patients improved access to cutting-edge treatments and technologies, including for brain tumours. “Be Part of Research” is our landmark service, allowing people from all walks of life across the UK to find and participate in research relevant to them, which could transform lives. I urge everybody watching at home to sign up to “Be Part of Research” and to get involved.

We have spoken about medicines repurposing, whereby medicines approved for a particular condition are used in new ways to treat different conditions. Repurposing drugs may have particular value for rare cancers, such as brain cancers, for which drug development has been limited. As my hon. Friend the Member for Mitcham and Morden noted, NHS England has suspended its medicines repurposing programme, but not because it is unimportant; it has shown that opportunities to use existing medicines in new ways can be delivered without the support of a formal repurposing programme, including, for example, through local off-label prescribing. This creates opportunities for NIHR and other funders to support proposals for clinical trials that use repurposed drugs for rare cancers. We will help researchers work with industry and clinicians to strengthen the evidence base for new drugs, and for new uses of drugs, so that we can find out how patients can best be helped.

Helen Morgan Portrait Helen Morgan
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How well will that work be co-ordinated if it is done on a local, sporadic basis, and how will the repurposing of drugs be co-ordinated centrally if NHS England is no longer undertaking that work?

Ashley Dalton Portrait Ashley Dalton
- Hansard - - - Excerpts

NHS England has found that creating that environment does not necessarily provide new and better ways of repurposing drugs, and that can be done far more efficiently and far less bureaucratically by using local off-label prescribing. We are looking at how we can incentivise researchers and clinical trials to explore repurposing drugs.

We are determined to make the NIHR and other funders grasp opportunities to support those proposals. We will help researchers work with industry and clinicians to strengthen the evidence base for new drugs.

The NHS is working hard to diagnose and treat cancers on time. There is more to do on early diagnosis and faster treatment, in order to improve patient experience and survival. The NHS is focused on improving diagnostic waiting times, and on providing MRI, CT and other tests to reduce cancer waits, because, as Lord Darzi’s investigation has shown, we face significant challenges if we are to bring this country’s cancer survival rates back up to the standard of the best in the world. We know that the best way to improve survival for those with brain tumours, and with all cancers, is to diagnose patients early and treat them quickly.

In our first six months, 80,000 more patients received a diagnosis or an all-clear within 28 days than did in the previous year, thanks to investment in cutting NHS waiting lists. In March, more than 80% of patients in England referred for cancer had it ruled out or diagnosed within 28 days—it is the first time that target has been met in years—but we must go further, and we will. Our reforms to cancer care will see more than 100,000 people diagnosed faster, and thousands more starting treatment within two months across the NHS.

There is no single solution to this complex challenge. That is why my right hon. Friend, the Secretary of State, has been clear that there will be a national cancer plan published later this year. This plan will ensure that rarer cancers, including brain cancers, will not be left behind. It is my absolute privilege, as a person with cancer, to be driving that cancer plan. I am delighted that we have so far received more than 11,000 representations as part of the call for evidence. I can assure my hon. Friend the Member for Mitcham and Morden that her contributions and all others will be taken seriously.

The Liberal Democrat spokesperson also talked about low-grade cancers. There is a difference between staging and grading, and it is important that we are clear about that. Low-grade brain tumours are considered non-cancerous, and they grow more slowly and are less likely to spread, but although low-grade brain tumours are generally non-cancerous, they can have similar serious symptoms, and require surgery or radiotherapy to treat them. The Government are investing in new life-saving and life-improving research to support people diagnosed with those cancers.

In closing, for those affected by this devastating disease, every discovery, every treatment and every moment matters. We recognise that more needs to be done to stimulate high-quality, high-impact research into brain tumours. Through our targeted package of support, that is what we will do. We completely understand the strength of feeling on this issue, not least because three Ministers in the Department of Health and Social Care are cancer survivors. We know how terrifying it is to receive a diagnosis. We have sat in waiting rooms, hoping for good news and fearing the worst—and we have heard the worst. We have had those difficult conversations with our loved ones and seen the devastating impact on their lives. That is why we are committed to making a real difference for patients with brain cancer. We will leave no stone unturned until they get the first-class care that they deserve. I look forward to further discussing how we can achieve this when I meet members of the all-party parliamentary group on brain tumours next week.

Oral Answers to Questions

Helen Morgan Excerpts
Tuesday 6th May 2025

(2 months, 2 weeks ago)

Commons Chamber
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Lindsay Hoyle Portrait Mr Speaker
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We now come to the Liberal Democrat spokesperson.

Helen Morgan Portrait Helen Morgan (North Shropshire) (LD)
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Too many families in Shropshire have suffered the agonising loss of a baby following the scandal at Shrewsbury and Telford hospital NHS trust. The Care Quality Commission rates 65% of trusts as inadequate or requiring improvement for maternity safety, and the taxpayer forked out a staggering £1.15 billion in compensation for maternity failings last year. With the £100 million put aside to deal with unsafe staffing no longer ringfenced, can the Minister reassure us that those safe staffing levels will remain on our maternity wards?

Karin Smyth Portrait Karin Smyth
- View Speech - Hansard - - - Excerpts

I know the Liberal Democrat spokesperson follows this issue very closely in her own local community. As she knows, we are committed to ensuring that the recommendations of the reviews are fully implemented as part of that three-year plan, but I gently say to her that the Liberal Democrat party has consistently opposed the extra £26 billion that this Government raised to support the wider health service. Without that extra funding and the decisions that the Chancellor has made, we would not be able to make the progress that we are now starting to see.

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Lindsay Hoyle Portrait Mr Speaker
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I call the Liberal Democrat spokesperson.

Helen Morgan Portrait Helen Morgan (North Shropshire) (LD)
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In his statement to the House just after Christmas, the Secretary of State acknowledged that cross-party consensus is essential to delivering meaningful social care reform. The Liberal Democrats support him in that endeavour, but we still do not have a date for those cross-party meetings, so will he give us one now?

Wes Streeting Portrait Wes Streeting
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Dates for meetings with the commission are now a matter for the independent commission.

Gender Incongruence: Puberty Suppressing Hormones

Helen Morgan Excerpts
Wednesday 30th April 2025

(2 months, 3 weeks ago)

Westminster Hall
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Helen Morgan Portrait Helen Morgan (North Shropshire) (LD)
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It is a pleasure to serve under your chairmanship, Ms Lewell. For too long, children and young people who are struggling with their gender identity have been badly let down by low standards of care, exceptionally long waiting lists and an unacceptably toxic public debate. That is why Liberal Democrats have been arguing for much better specialist healthcare services for children and young people who find themselves in this distressing situation. The old system, a single clinic, with a shockingly long waiting list and rated “inadequate” by the Care Quality Commission, was clearly failing vulnerable young people at the most difficult time in their lives. Before GIDS closed, more than 5,000 young people were stuck on the list and left waiting for an average of almost three years for a first appointment. For vulnerable teenagers and pre-teens, going through what are often incredibly difficult experiences, those three years must have felt like an eternity.

Liberal Democrats have consistently campaigned for action to tackle appallingly long wait times across the NHS, whether for cancer treatment or mental health, and it is right that we do so for gender identity services as well. It is clear that change is needed. That is why we have long been pressing the Government to establish new specialist services and recruit and train more specialist clinicians, so that children and young people can access the appropriate, high-quality healthcare that they need. The move to create multiple new regional centres is, therefore, a very welcome one, but only two are open now—in London and the North West—leaving those who have already been stuck on waiting lists for years to wait even longer. There is no sign yet of when the other centres will open. Would the Minister be able to give us an indication of when they might?

Unless the Government show far more urgency in getting these centres up and running properly, more and more children will be denied the care they need as they languish on those long waiting lists. While it is right that treatment is largely based on talking therapies for both the child and their parents to give all gender-questioning young people the time and space to make clear and informed decisions about their future, that has got to mean that people starting their talking therapy when they need it, not after years of delay.

Following the Cass review, the Secretary of State announced that the NHS would be conducting clinical trials on the impact of puberty blockers. That is due to begin very soon. I would appreciate clarification from the Minister about the current status of the trials and the terms of reference under which they will be conducted. The announcement of the trial came alongside an indefinite ban on the prescription of puberty blockers as a treatment for young people with gender incongruence or dysphoria, unless they are part of that trial. Numerous organisations, including the Council of Europe, have raised concerns about the potential ethical implications of only offering a treatment to a small group of patients taking part in a clinical trial. I believe that the Secretary of State confirmed at the Dispatch Box that the trial would be uncapped when he gave a statement on puberty blockers to the House in December 2024. Would the Minister confirm whether that is the case?

The ban has caused fear and anxiety for some young trans people and their families, who have been so badly let down for so many years. I have met with families in my own constituency who have highlighted the severe mental health impacts that uncertainty over treatment can have. It is crucial that any clinical decisions are made by expert clinicians based on the best possible evidence, not politicians with a point to make.

Tracy Gilbert Portrait Tracy Gilbert (Edinburgh North and Leith) (Lab)
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Are the Liberal Democrats supportive of the views in the Cass review? I do not think that that has been stated on the public record as yet.

Helen Morgan Portrait Helen Morgan
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I have met with Dr Cass. We have considered the Cass review, and we are in support of the clinical trial that she has recommended. That is why I am asking the Minister to clarify some of the points that have been made as that trial progresses.

When that decision was made to indefinitely ban puberty blockers, it obviously caused some concern and uncertainty for the families that are affected. Would the Minister commit to publishing the supporting evidence, including the results of the consultation, to give those families confidence in the decision to ban their prescription?

With any medical treatment, especially for children and young people, it is most important that the clinical professionals follow the evidence on safety and effectiveness. I welcome the Government’s support for the research to improve evidence on the safety and efficacy of potential treatments; that research must take into account the direct personal experiences of those who have used those services in the past. More broadly, Liberal Democrats believe that all trans and non-binary people should have access to the high-quality healthcare that they deserve, and that Government should prioritise tackling unacceptable waiting times by expanding the provision of appropriate and timely specialist healthcare through NHS child and adult services for trans and non-binary people, ensuring that trans people have access to high-quality healthcare on the same basis as we would expect for all patients, with medical decisions made by patients and doctors together, informed by the best possible evidence, and supporting research using international best practice to improve evidence on the safety and efficacy of potential treatments.

For puberty blockers specifically, it is for expert clinicians to build the evidence base and determine whether they are safe and effective. I do not think any politician, such as me, who does not have that clinical experience or evidence to hand should be making pronouncements on whether or not they are. We need the NHS to act on building up that evidence base, and for the Government to provide certainty that they will follow the evidence and expert advice when that is available.

Children and young people with gender incongruence are uniquely vulnerable, potentially facing an identity crisis, difficult relationships at home and social isolation at a very young age. It is extremely important that they are treated respectfully, safely, quickly and in the way that is best for their long-term health and personal development. It is unlikely that the same treatment will be appropriate for every individual in that situation, but when it comes to any individual medical interventions, Liberal Democrats believe it is right that those decisions are made by clinicians and patients together, informed by the best possible evidence, as is the case in all areas of healthcare.