Chronic Urinary Tract Infections

Jess Brown-Fuller Excerpts

Wednesday 21st May 2025 Westminster Hall

[Jess Brown-Fuller (Chichester) (LD)]

It is a pleasure to serve under your chairmanship, Sir Desmond. It is also a pleasure to see the Minister in her place. I thank my hon. Friend the Member for Sutton and Cheam (Luke Taylor) for securing today’s debate and for being a champion for both his constituents and the wider population suffering with UTIs. Although I will not mention all the contributions this morning, I must mention that of the hon. Member for Stoke-on-Trent South (Dr Gardner), whose speech was not only passionate, but well informed and very personal. It is the hardest thing to share a personal story, and I commend her for her bravery this morning.

Urinary tract infections are far more common than many realise and far more serious than many assume, and women are 30 times more likely to suffer from a UTI than men. They are agonising and can, in some cases, even be fatal. Between 2018 and 2023, 1.8 million hospital admissions in England involved UTIs, not to mention the no doubt countless GP appointments.

Chronic urinary tract infections, where symptoms do not go away, are a particularly distressing form of this condition. My hon. Friend the Member for Sutton and Cheam spoke about sufferers being in bedbound isolation and unbearable pain, preventing them from living their lives and often from attending important family events and moments that should be celebrated, because this condition can be so debilitating.

Short courses of antibiotics often fail, and urine tests can come back negative, even when the patient is in clear discomfort. That is because chronic UTIs can be caused by bacteria entering the lining of the bladder, which makes them much harder to detect and treat. The diagnostic tools available to us are simply not good enough. Midstream urine cultures are still considered the gold standard for diagnosing acute UTIs, but recent research shows that MSUs miss a wide range of bacteria, which leaves many sufferers undiagnosed, untreated and often feeling disbelieved.

Like most women, I am grateful that I do not suffer from regular UTIs, although I do remember the panic as a child when I was in absolute agony. I do not know whether this is oversharing, but I remember my mum running in with a milk bottle of cold water to pour on me while I went to the toilet, just to take an element of that pain away for me, as a young child experiencing something I did not understand.

I have seen how a UTI can be particularly debilitating for those living with dementia. I experienced that with my nana during her final years. She could not identify that she was experiencing pain, so it fell to us, as her family, to recognise the symptoms. Her carer would test her urine most days, as she became so prone to infections. Those can cause sudden and alarming changes in behaviour, known as delirium, which is often exhibited as confusion, agitation, hallucinations or sudden withdrawal.

My nana ended up being hospitalised for some severe UTIs in her final months. Her hallucinations were quite often enjoyed by the family, and I particularly remember one where she was very cross at me for coming to her hospital late at night with an entire choir, singing to her and waking up the whole ward. That obviously did not happen, but in her delirium she was absolutely convinced that I had not respected her sleep. Such symptoms are often mistaken for the progression of dementia, leading to the underlying UTI going uncured.

Social care has a key role to play in UTIs, but only 45% of care workers receive any sort of dementia-specific training. We were incredibly lucky that the carer we had for my nana was dementia-trained and recognised the signs of UTIs before they got too bad. Families are also vital in this process, especially when someone cannot advocate for themselves. As my hon. Friend the Member for Sutton and Cheam mentioned, when patients are so exhausted from having to fight a system that does not believe them, families often have to step in and be their advocates. People cannot do this alone.

Too often, UTIs are dismissed as short term or minor, but for many people, particularly those with underlying conditions, they are anything but. We welcome the NHS’s recognition of chronic UTIs as a legitimate condition since 2022, but too many people still suffer in silence or are dismissed, misdiagnosed and left without adequate support. That is why we urge the Government to explore ways to improve diagnosis, particularly for chronic UTIs. Further research is desperately needed.

The Liberal Democrats are calling for a significant expansion in the capacity of the Medicines and Healthcare products Regulatory Agency, and for a comprehensive agreement with the European Medicines Agency. We must ensure that new treatments can reach UK patients without delay, especially as we currently rely on three different strands of antibiotics to treat UTIs, as the hon. Member for Stoke-on-Trent South said. Those who suffer regularly are at risk of developing antimicrobial resistance, which then makes treatments less effective. If they are also allergic to certain strands, they are incredibly limited in the antibiotics they can receive. The hon. Member also mentioned that there is a UTI vaccine in other countries, which I am very interested in.

Continuity of care is equally important. Everyone with a long-term condition such as a chronic UTI should have access to a named GP. That would help to build understanding, avoid delays and improve outcomes, especially for those whose symptoms may be dismissed or misunderstood.

Lastly, I want to touch on the role of community pharmacies, which the hon. Member for Strangford (Jim Shannon) mentioned. The Pharmacy First scheme, which was introduced in England in January last year, has the potential to relieve pressure on GPs and to provide quicker treatment for uncomplicated UTIs, but many pharmacies are struggling to meet the consultation targets required to access funding. Ongoing financial and operational pressures are undermining the very service that we need to provide, and in the year to date we have lost the equivalent of four community pharmacies a week.

My questions to the Minister are as follows. What steps is her Department taking to support community pharmacies in delivering the Pharmacy First service, especially those struggling to meet the increase in consultation targets, and to ensure that patients with UTIs can access timely, local and effective care? Pharmacy First is currently available only for those with UTIs between the ages of 16 and 64. Is there a plan to widen that age range? Given the known limitations of current testing methods, will the Minister also outline what steps are being taken to ensure that better diagnostic tools are made available? Is there any plan to introduce a UTI vaccine? Finally, will chronic UTIs be included in the 10-year health plan, and is that still on track to be published in June?