Hughes Report: First Anniversary

Jess Brown-Fuller Excerpts

Thursday 27th March 2025 Westminster Hall

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

It is a pleasure to serve under your chairship, Ms Furniss. I congratulate the hon. Member for Washington and Gateshead South (Mrs Hodgson) on securing today’s timely and important debate on the first anniversary of the Hughes report. She has been a tireless champion for those harmed by pelvic mesh and for children born with birth defects as a result of sodium valproate. I commend her work as chair of the all-party parliamentary group on first do no harm, mesh, Primodos, valproate—that is a mouthful and could have been a bit shorter—of which I am also a member.

In 2024, the Patient Safety Commissioner estimated that at least 10,000 women in England have been harmed by vaginal mesh implants, some involving the mesh slicing into their bladder, bowels or vaginal wall, leaving them in permanent pain, sometimes unable to walk, work or have sex, leaving their lives changed profoundly. As multiple hon. Members have mentioned, including the right hon. Member for New Forest East (Sir Julian Lewis), the campaign group Sling the Mesh believes that the true number could be closer to 40,000 women.

When Dr Henrietta Hughes agreed to produce this report, she made one thing very clear: this was not to be another review that just gathers dust—this report must lead to action, not just words. We are now a year on and the people affected are still waiting.

The Hughes report makes the case plainly: there is a clear need for redress. These women were, in most cases, not failed by a single doctor or a one-off error. They were failed by the system, by healthcare structures, by regulators and by Governments who did not listen when they should have. The redress we need is not about blame but about restorative justice. It should be co-designed with the patients, and it should be distinct from adversarial court proceedings where, as other hon. Members have mentioned, women have to relive their experience and their trauma, time and again.

The Hughes report recommended establishing an independent redress agency. The lack of clarity on creating a bespoke redress scheme has left patients in limbo, which is deepening the harm—on that point, the right hon. Member for Salisbury (John Glen) shared his useful insight and learnings from the infected blood scandal. Several women in my constituency of Chichester have shared their stories with me: stories of being dismissed by clinicians, of medical records being incomplete, inaccessible or not reflecting the true circumstances that these women are in, and of suffering through chronic pain and ill health even after the mesh has been removed. I have met two of those women in person. I met one at her home because she is so profoundly injured and traumatised that she no longer leaves her property for any reason. With no access to social media or the outside world, my constituent had no idea that there were others like her, or that there is a national campaign for justice. She felt alone, embarrassed and broken by her circumstances, so I promised to stand by and with her, and with the thousands of others, up and down the country, who have been failed.

I take this opportunity to mention Paula Goss: a national campaigner, and a constituent of my hon. Friend the Member for Thornbury and Yate (Claire Young). Paula was affected by a mesh procedure that was not covered by the original Cumberlege review. The surgeon involved was found guilty of serious misconduct but only suspended for six months. Of the 462 patients harmed at the Spire private hospital and the Southmead hospital, just five were called as witnesses to the General Medical Council. When Paula tried to complain, she was—as many hon. Members, from both sides of the House, have noted in this debate—told that she was out of time, and that it was not in the public interest to waive the deadline. How can we call that justice? It is not justice or accountability. Cases like that of Paula, and those raised by my constituents in Chichester, are why we Liberal Democrats believe that the entire set of recommendations in the Cumberlege report must be implemented without further delay.

This scandal is not limited to mesh and sodium valproate. The same approach must be extended to other medical scandals, such as Primodos. We cannot continue to treat each crisis as an isolated issue, and need a system-wide approach to patient safety and accountability. That means a duty of candour on public officials. The Liberal Democrats would achieve that by establishing an office of the whistleblower so that safety concerns can be raised without fear or delay. It also means embedding patient voices in the heart of our healthcare system, not as an afterthought but as a fundamental principle. Earlier this year, 100 women secured a financial settlement from mesh manufacturers, but that is a drop in the ocean compared to the number of women who deserve redress. Every single woman affected by this scandal deserves proper compensation, not just those women able to pursue lengthy and difficult legal claims.

[Warinder Juss]

The Hughes report actually recommends that women affected by pelvic mesh should receive an initial interim payment of £25,000, followed by a main payment. Does the hon. Member agree that that interim payment would be of some comfort to the women she has mentioned, and mean that they could at least begin to try to get redress, and make some improvement in their lives?

[Jess Brown-Fuller]

The hon. Member says that from a place of experience and knowledge. Who am I to speak against anything he says as the expert in the room? I totally agree that that would provide those women some reassurance that their cases have been heard and recognised by the Government.

Finally, we are still waiting for a formal response from the Government to the Hughes report. In August, that response was promised “in due course”, but “due course” has come and gone. These women have waited long enough. People who have already suffered for years should not be forced to wait any longer for the compensation and recognition that they deserve. Let us end this culture of delay, disbelief and denial and do what we should have done years ago: listen, apologise and act.

Prevention of Drug Deaths

Jess Brown-Fuller Excerpts

Thursday 27th March 2025 Westminster Hall

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

I thank the hon. Member for Strangford (Jim Shannon) for bringing forward this important debate. I am particularly pleased to see the Minister in her place, which shows the Government’s recognition that this is a public health issue. Every drug-related death is a preventable tragedy. Every life lost represents not just statistics in a report, but families shattered, futures lost and communities left to pick up the pieces. As a Government and a society, we have a moral obligation to do better.

The reality is stark, and it has been laid out very well by Members across the House in the debate: drug-related deaths have reached record highs. They are not just the consequence of addiction but often the result of inadequate support, stigma—as has been mentioned by many hon. Members—and a failure to adopt evidence-based strategies. In 2023, more than 5,000 deaths related to drug poisoning were registered in England and Wales. That is the highest number since records began in 1993 and 11% higher than in the previous year. My local hospital, which is in Chichester, records hundreds of A&E attendances involving drug use.

For too long, the response to drug use has been focused on criminalisation rather than treatment. However, as hon. Members have said today, we cannot arrest our way out of the crisis. Those struggling with addiction need access to healthcare, not handcuffs. That means properly funding rehabilitation services, expanding mental health support and ensuring that no one seeking help is turned away due to lack of resources.

For me, it is personal. I have witnessed family members self-medicate with drugs when mental health support was unavailable to them. My own dear dad battled with alcohol addiction throughout his adult life. Although it was a related cancer that took him in the end, the addiction had taken him away long before that. In fact, one of the many reasons that I am proud to be a Liberal Democrat is that we pledged, in our general election manifesto, to provide mental health MOTs at key points in our lives when we are most vulnerable to a change in our mental health. I often wonder if my dad would still be here today had he ever had the opportunity to tell a professional that he was struggling.

Across the world, we have seen that harm reduction saves lives. I would like to acknowledge the role that hard-working GPs, nurses, community pharmacists and other health professionals play in supporting access to medication and safe consumption spaces, which is taking an evidence-based approach and using it to prevent deaths. In Glasgow, as many Members across the House have mentioned, where drug deaths are at crisis levels, pilots of safer consumption rooms are now under way. I was pleased to hear that my hon. Friend the Member for Mid Dunbartonshire (Susan Murray), as well as other colleagues from across the House, have visited those centres. We should be looking at those models with open minds, rather than relying on outdated ideologies, because the goal is simple: we need to keep people alive for long enough to access treatment and rebuild their lives. As the hon. Member for Warrington North (Charlotte Nichols) said, the savings that we find across health and justice far outweigh the investment needed in those centres.

We also need a joined-up approach across the country, which lays out the most effective pilot projects so that they can be rolled out to other areas. In its February 2024 report, the Public Accounts Committee identified that there were delays in allocating funding from the 2021 drugs strategy to local authorities, and a continued lack of understanding about what works to prevent people from using drugs. It is unacceptable that there was a 14% underspend in the funding allocated to the strategy in 2023-24, when it is clearly desperately needed across the country to prevent deaths.

Of course, prevention must also mean cutting off the supply of dangerous drugs at the source. We need stronger action to stop organised crime groups profiting from misery. That includes tackling county lines operations, which exploit vulnerable young people and push deadly substances into our communities. It is not a partisan issue; we must work together across the House to ensure that harm reduction, prevention and rehabilitation are at the heart of our national strategy. At the end of the day, it is not about politics; it is about people and ensuring that families do not have to endure the heartbreak of losing a loved one to drugs. At its core, it is about saving lives.

Oral Answers to Questions

Jess Brown-Fuller Excerpts

Tuesday 25th March 2025 Commons Chamber

[Karin Smyth]

I know that my hon. Friend and other Members representing that area have supported the trust and particularly the families who have been affected. As she highlights, my right hon. Friend the Health Secretary visited last week and was deeply moved by those stories, and has committed to visiting again. The Government are working through those recommendations and will update the House shortly.

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

Following on from the question asked by the hon. Member for Nottingham East (Nadia Whittome), I held a debate in Westminster Hall a few weeks ago on maternity services and spoke to families across the country who have experienced failures in the system that ultimately left them without their babies to take home. It was a devastating experience for all involved. The immediate and essential actions in the Ockenden review were supported by the previous Government, and the Secretary of State for Health has been vocal in his support for their implementation. However, those families want to know how quickly they will see real change in maternity services up and down the country so that families can confidently go to deliver their babies.

[Karin Smyth]

The hon. Lady is right to highlight the impact of the failures in maternity services on women and their families across the country. As she highlights, my right hon. Friend the Health Secretary takes this matter personally and is looking at it. We will continue to work closely with Donna Ockenden on those recommendations and will continue to update the House regularly. This is an important issue for Members across the House representing their constituents, whether in this Chamber or Westminster Hall, and we are very keen to ensure that we support staff, build that confidence for women and their families and give them a good experience of maternity services.

Down’s Syndrome

Jess Brown-Fuller Excerpts

Wednesday 19th March 2025 Westminster Hall

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

It is a pleasure to serve under your chairmanship, Mr Turner. I congratulate the right hon. Member for Beverley and Holderness (Graham Stuart) on securing this important and timely debate ahead of World Down Syndrome Day this Friday.

What a pleasure it was to take the opportunity before the debate, as we were slightly delayed, to chat to marvellous Millie, who is an incredible advocate for those who have been touched by Down syndrome.

In my constituency of Chichester we are fortunate to have an incredible charity, the Chichester and Arun Down Syndrome Support Group, which works tirelessly to fill the gaps left by failings in public service provision. Ahead of this debate, the charity highlighted to me many of the challenges that people with Down syndrome face, particularly in accessing the support they need throughout their education. One of its core initiatives as a charity is the bespoke schools outreach programme, which ensures that children with Down syndrome receive the tailored education they require. They require additional support throughout their education, yet many families struggle to obtain EHCPs from local authorities.

In West Sussex, the picture is stark: only 3.6% of EHCPs were issued within the statutory timeframe of 20 weeks in 2023, and the situation has not got much better. Those delays force children with Down syndrome to remain in unsuitable educational environments where their needs are not met, which hinders their opportunities. Most importantly, when an EHCP is issued, we need the accountability to see that that EHCP is delivered.

The charity also highlighted to me the cliff edge of support that people living with Down syndrome face at the age of 18, when they are no longer in an education provision. I was pleased to visit Together Our Community at its exciting new venue in Chichester, which is due to open next month. That will provide a space for TOC members and a public-facing café where adults with additional needs between the ages of 18 and 35 will have the chance to learn and develop essential skills. For people with Down syndrome, charitable organisations such as those provide vital support and services and give these incredible people the opportunity to thrive, not just survive.

The Down Syndrome Act recognised the needs of those living with Down syndrome and rightly acknowledged that public services must take those needs into account across health, social care, education and other local authority provisions. However, the Act must be properly resourced. The NHS website lists a range of specialists that a person with Down syndrome may need to see, including speech and language therapists, physiotherapists, opticians and occupational therapists. Yet local organisations consistently report a lack of those essential services, which undermines the opportunities for people with Down syndrome to live comfortably or independently. Three years on from Royal Assent, the Act is not supporting those who it was designed to support.

The Liberal Democrats have long called for all individuals with long-term conditions or disabilities to have access to a named doctor, which would shift care from the corridors of hospitals to local communities. That is especially crucial for people with Down syndrome, who not only have learning disabilities but are at a significantly higher risk of conditions such as dementia, seizures and leukaemia, as the hon. Member for Thurrock (Jen Craft) mentioned.

The impact of social care on people with Down syndrome cannot be overstated, which is why the Liberal Democrats are calling for a comprehensive overhaul of social care policy. While we welcome the cross-party commission to establish a long-term agreement on social care, we strongly believe that it can be concluded within one year, not three.

While the Down Syndrome Act was a step in the right direction, real change requires more than warm words; it demands proper funding and meaningful action. From healthcare and social care to employment and independent living, people with Down syndrome deserve better. As the right hon. Member for Beverley and Holderness stated, the guidance is where we are severely lacking at this moment in time. The Government must prioritise this issue, and we will continue to push for the improvements necessary to enhance quality of life for all.

Women’s Health

Jess Brown-Fuller Excerpts

Thursday 27th February 2025 Westminster Hall

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

It is lovely to see you in the Chair, Dr Huq, and I welcome the Minister to her place. I thank the hon. Member for Hastings and Rye (Helena Dollimore) for securing this important and timely debate, and for giving a passionate and well-informed opening speech.

Women’s health has been overlooked for far too long, and today’s discussion is an opportunity to highlight the urgent action needed to address the crisis in women’s health, with International Women’s Day due to be celebrated next week. The Fawcett Society found that nearly two thirds of women in the UK believe that their health concerns are not taken seriously, and more than half have had negative experiences with healthcare professionals. I start this speech feeling very frustrated, because during the debate I have had a message from one of my good friends who was ignored two years ago when she had pain in her leg, and she has just texted to tell me that she will now have to undergo a course of chemotherapy and extremely evasive treatment so that she can retain her ability to walk. My friend is in her early 20s—she was ignored, so I am very cross.

This is not just a health issue; it is an economic issue, as has been mentioned. The UK loses 150 million working days every year due to women’s poor health and inadequate support. If we want a healthier, more productive society, we must take action to close the gender gap in healthcare. During a drop-in surgery that I ran in my Chichester constituency, a woman told me that when her daughter started experiencing extremely painful periods, with pain outside of her period, all she could do was cry at the thought of her having to go through the same painful process with healthcare professionals that she had been through herself to get a diagnosis for endometriosis, which took that lady nine years.

Gynaecological waiting lists have more than doubled since 2020, which is the biggest increase of any medical speciality. At the end of last year, 755,000 women were waiting for treatment. Behind every number is a woman experiencing chronic pain, worsening mental health and a disrupted daily life. One in four women with a gynaecological condition will end up in A&E because they could not access the care that they needed in time, yet the NHS is failing to prioritise these urgent needs. The Royal College of Obstetricians and Gynaecologists has been clear: the system needs a complete overhaul so that gynaecological care is given the attention it deserves.

An example is St Richard’s hospital in my constituency, which does not have a specific gynaecological ward. That means that women who have gynaecological issues or have received treatment are placed across several other wards. That could negatively impact their treatment as it makes it more difficult for them to receive urgent specialised support in emergencies. Also, as the hon. Member for Luton North (Sarah Owen) said, clinicians do not have to do gynaecological training as part of their mandatory training.

Delays in female cancer care are alarming. Between April 2021 and March 2024, 2,980 people waited over 104 days to start treatment on the 62-day urgent suspected breast cancer referral route. My hon. Friend the Member for Bath (Wera Hobhouse) noted that younger women have a much worse prognosis, due to a lack of breast cancer screening before they are 50. For ovarian cancer, the average wait from GP referral to treatment is 69 days. That is one of the longest delays for any cancer. These prolonged waits are not just unacceptable—they have life-altering consequences.

For generations, women’s pain, particularly in maternity care, has been dismissed. That has created a crisis of confidence in NHS maternity services. Several investigations have revealed fundamental flaws in our maternity care and how it is delivered across England. A Care Quality Commission inspection of 131 maternity units found that 65% of them were not safe for a woman to give birth in, and studies show that one fifth of all causes of stillbirth are potentially preventable.

The CQC has also warned of a normalisation of serious harm in maternity care. That cannot continue. I held a debate on maternity services earlier this week, calling for the Government to fully implement the recommendations of the Ockenden report. That is urgently needed to reform the maternity care sector for the better.

In 2024, the Patient Safety Commissioner estimated that 10,000 women in England had experienced harm as a result of vaginal mesh implants, although campaigning groups argue that the true figure could actually be closer to 40,000. One woman in my constituency asked me to go to her home because she does not leave it; she is a victim of the mesh scandal and she is totally isolated from her community because of it.

I am a member of the First Do No Harm APPG, which builds support and raises awareness of the recommendations of the 2020 Independent Medicines and Medical Devices Safety Review, and I was really glad to hear the contribution from the hon. Member for Washington and Gateshead South (Mrs Hodgson), who talked about the women living in poverty, isolation and pain, who are so often dismissed by the professionals. The review found that those suffering adverse effects from medical treatments including vaginal mesh found a system that was

“disjointed, siloed, unresponsive and defensive.”

So many of those women are still waiting for compensation. It is a national scandal and a grave injustice. I appreciate all the work that the hon. Member is doing with the APPG.

The Liberal Democrats would ensure that medical scandals that have disproportionately harmed women in the past can never be repeated, including through the introduction of a statutory duty of candour for public officials. We believe that every woman deserves high-quality, safe and accessible healthcare. We would try to tackle the maternity care crisis by addressing chronic understaffing, improving retention and modernising outdated facilities. We will continue to press the Government to expand access to screening for conditions such as breast cancer and cervical cancer. We would also make a serious commitment to investing in women’s health research.

For too long, the gender gap in medical knowledge has left women without the answers or the treatments that they need. Faster diagnoses and better treatment pathways for women’s cancers and gynaecological conditions must be a priority for this Government, not an afterthought, because this is not just about healthcare; it is about basic dignity, fairness and justice. Women should not have to fight to be heard when it comes to their own bodies. It is time to put women’s health front and centre of the NHS.

Maternity Services

Jess Brown-Fuller Excerpts

Tuesday 25th February 2025 Westminster Hall

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

I beg to move,

That this House has considered maternity services.

It is an honour to serve under your chairmanship, Sir Christopher. I thank all the Members in attendance for their interest in this important topic and the Backbench Business Committee for allocating time to debate maternity services in England.

On average, a baby is born in England every 56 seconds, over 1,500 babies each day, most of them delivered in an NHS setting with the help and support of a maternity department or at home with an NHS community midwife by their side. That is over 500,000 babies every year. I contributed to that statistic in 2014 and 2019 when I gave birth to my children at St Richard’s hospital in Chichester. Two very different births that I will not spend my valuable time in this debate reflecting on, because there are far more important voices that need to be heard and considered. A person is at their most vulnerable moment when they or their partner go into labour. We put our health, safety, and the safety of our unborn child into the hands of professionals who work in that setting—the midwives, obstetricians, anaesthetists, and neonatologists—to support us in the safe delivery of our child and get us all home safe. And in the majority of births that is the case.

However, several investigations have revealed fundamental flaws in how maternity care is delivered across England. A Care Quality Commission inspection of 131 maternity units found that 65% were not safe for women to give birth in, with studies showing that one fifth of all causes of stillbirth are potentially preventable. The Ockenden report, led by Donna Ockenden, investigated the maternity services at the Shrewsbury and Telford Hospital NHS Trust, but it also highlighted the flaws in maternity care across England. The report laid out immediate and essential actions which are key to reforming maternity services and ensuring that every mother and baby receive the care they deserve and should expect. In her report Donna reflected that sometimes that spotlight can feel harsh to staff on the front line, who are doing their very best in what are often extremely challenging circumstances.

In conversation with midwives and others working in the maternity care sector, I recognise that each one I spoke to entered the profession as a the result of a calling, vocation, or passion for supporting mothers to bring their babies into the world. They are frontline NHS staff who often go above and beyond the call of duty to support and care for their patients in those extraordinary hours and days. Midwives in particular spend significant time with expectant mothers, supporting them through all stages of pregnancy and birth. They see women at their most vulnerable. They act as therapists, teachers, friends and maternal figures. Yet across the country, staffing levels are inadequate. In 2023, midwives and support workers worked over 100,000 hours of unpaid overtime every week. The pressure and stress on them is immense and this leads to burnout, absenteeism, high staff turnover and the loss of experienced professionals from the field, and that ultimately puts patient safety at risk.

[Jeremy Hunt (Godalming and Ash) (Con)]

I congratulate the hon. Lady on bringing forward this debate and the excellent and persuasive way that she is making her case. On burnout, does she agree that one of the biggest issues is that when a tragedy happens, midwives and obstetricians often feel that if they speak out the risk is that they or their institution will get sued, or that they could get fired from their jobs? Does she agree that litigation reform to try and change the rules of the game, so that people are able to be open when they think they have made a mistake and learn from those mistakes, is one of the most important ways that we could improve the record on patient safety, which is as much a concern to her as it is to me?

[Jess Brown-Fuller]

I agree wholeheartedly that we need to change the way that we do litigation, because NHS trusts often argue that they want to learn and grow from poor experiences, but the litigation system means that they rarely have the opportunity to do so, because everybody is so afraid to speak out. We need to change that culture within maternity services and the NHS as a whole.

As a country, we are training more midwives than ever before, yet retention remains a problem and the pandemic exacerbated an already difficult situation, with highly trained midwives with families or caring responsibilities leaving the profession too soon.

[Dr Al Pinkerton (Surrey Heath) (LD)]

I congratulate my hon. Friend on bringing this debate here today. Frimley Park hospital in my constituency received an outstanding report from the Care Quality Commission in 2023, but it none the less identified that inadequate staffing remains one of the highest risks on the maternity register. That has daily implications; many midwives reported, for example, that daily checks were often incomplete, handovers were interrupted and not standardised, and mandatory training was often not completed.

Does my hon. Friend agree that to ensure high-quality maternity care, from admission to discharge, requires not only stringent oversight by trust boards, but far greater care for staff in the setting of the hospital, providing safe spaces where conversations can be had, handovers can take place, and nurses can rest? In that way, we will both retain and also hopefully recruit more of our vital nursing staff.

[Jess Brown-Fuller]

My hon. Friend is absolutely right; the key to providing strong maternity services that benefit both the staff and the patients is making sure that there is a full workforce so that they can do not just the “need to haves”, but the “nice to haves” in a maternity department, which can make such a difference to patients’ experiences when they are going through that service.

The retention issue that we have directly impacts training. Newly qualified and inexperienced midwives need experienced mentors, but if seasoned professionals leave, the next generation lacks the support necessary to transition into leadership roles. Midwives and other maternity staff must train together at every level to be fully equipped for every situation, and ensure that concerns can be escalated effectively. That is why the Ockenden report and the Royal College of Midwives seek a commitment to including midwives in the long-term workforce plan.

In 2017, bursaries for student nurses and midwives were ended, with the Royal College of Midwives warning that that decision threatened the future of our maternity services in England. It has led to one third of midwifery students having debts exceeding £40,000, with 80% of them knowing someone who has dropped out of their course due to financial hardship. Many also take on additional jobs to afford their studies, which detracts from their vital training. To mitigate those pressures on trainee midwives, I encourage the Government to explore alternative routes to support midwifery and nursing students, which have been laid out by the Royal College of Midwives, through new funding options or a scheme where student debt is forgiven after a defined period of service in the NHS.

A similar funding issue affects apprenticeship schemes in midwifery. Despite receiving overwhelmingly positive feedback from trusts across the country regarding the apprenticeship route, many trusts cannot afford to offer those positions due to a lack of backfill funds, so trusts often hand back their apprenticeship levy, as the scheme is undeliverable. I hope the Minister will work with her colleagues in the Department for Education to address this fundamental flaw in the delivery of level 6 and level 7 apprenticeships, which have proven to deliver the midwives of the future.

In preparing for today’s debate, I was invited to my local maternity unit at St Richard’s hospital in Chichester, where as I mentioned I had both of my children. University Hospitals Sussex had its maternity services inspected by the CQC in September 2021, which found all hospitals across the trust to be inadequate or requiring improvement. Although there has not been a formal inspection since, the trust assures me that all actions from the CQC have been completed, with the majority of the Ockenden immediate and essential actions implemented. However, to fully implement all the IEAs will require funding, which currently the trust does not have.

St Richard’s hospital confidently tells me that it is now fully staffed for the first time in a long time, and the director of maternity services is keen to look at how she can further improve patient experience and communication. I know Members across the House are keen to work with their NHS trusts constructively to ensure the best outcomes possible for their constituents. I was reassured by the senior leadership team, those working in the department, and the new parents on the ward, who I had the pleasure of congratulating. Introducing tiny babies to the world was probably the best moment of my recess—it was very bizarre for those parents when the MP walked in and said, “Can I say hello?” I am pleased that the trust is taking seriously its responsibility to provide a much improved service.

It would be a missed opportunity if I, as the chair of the all-party parliamentary group for infant feeding, did not mention how we could do much more as a society to support mothers to breastfeed, if they choose to. The UK’s breastfeeding rates are among the lowest in the world. Only 1% of mothers exclusively breastfeed at six months, despite the World Health Organisation recommending exclusive breastfeeding for this period and continuation, alongside nutritious foods, for up to two years. Some 44% of mothers surveyed wished that they had breastfed for longer and would have done so if they had received better and more tailored support. New mothers need time, expertise and evidence-based information to make informed decisions on their feeding choices, and maternity services play a key role in establishing a feeding plan that works for mother and baby before they go home. But, across the country, community midwifery and health visiting services have been vaporised, so support is patchy and often delivered by volunteers or midwives in their spare time. I hope that the Government will support improved community services such as milk support groups, to give all women, regardless of their feeding choices, somewhere to turn when they need support.

I will take this opportunity, perhaps selfishly, to get on record the name of one of the coolest kids I ever met. Benedict Henry Goodfellow was an absolute dude—[Interruption.] I am not going to cry—and I am proud to call his mum, Steph, one of my close friends and the strongest woman I know. This debate is so important to me because Bendy needed 24-hour care since birth after a case of extreme birth trauma left him with devastating neurological damage. Bendy was loved by everyone who came into contact with him until he died, aged 10. The experience left Steph traumatised and profoundly changed. Bendy was born nearly 30 years ago and yet Steph and Ben’s story is just as relevant today. It should not be.

I am immensely grateful to Donna Ockenden for putting me in touch with families from across the country—including from Leeds, Nottingham, Shrewsbury and Sussex—ahead of this debate to hear their personal experiences of failures in maternity care.

[Katie White (Leeds North West) (Lab)]

As I am the Member for Leeds North West, the hon. Member may have spoken to my constituents, Dan and Fiona, who tragically lost their baby Aliona after only 27 minutes. Despite the fact that the inquest found a number of gross failings, the figures for Leeds, which came out only last night, are horrifying. Does the hon. Member agree that there are grounds for an independent review of maternity services in Leeds?

[Jess Brown-Fuller]

The hon. Member is absolutely right to raise the case of Dan and Fiona. I was lucky enough to have them give up their time to share their heartbreaking story with me. They are at the forefront of the fight for an independent inquiry in Leeds. The Secretary of State for Health and Social Care said that he would look at whether there is cause for an investigation but those families are still waiting to find out if that will go ahead.

I met with families like Dan and Fiona to ensure that the questions I ask the Minister today are the questions that those families would ask if they had the opportunity. I cannot begin to imagine how exhausting it is to relive the moments that their lives changed forever, over and over again, in the pursuit of better outcomes for the next family. I will include a number of their questions to the Minister in my closing remarks, but I reflect that the families who were able to share their experiences with me were, overwhelmingly, white, middle class, often highly educated and that many had medical backgrounds or academic careers before going through this trauma. Lord Darzi’s report found that black women are almost three times as likely to die in childbirth as white women and that neonatal mortality in the most deprived areas is more than double that in the least deprived. Who speaks up for those families? Who ensures transparency and accountability for those with a fundamental distrust of the medical profession, or those who have learning disabilities, or English as their second language, because those people are not supported in navigating the complex systems that are in place?

Negligence claims in obstetrics account for just 13% of the volume of litigation received by NHS Resolution in 2023-24 but cost over £1 billion every year—nearly 60% of the total cost of clinical negligence claims. Beyond financial costs, those failures carry a devastating human toll. If we truly invest in our maternity services, in both professionals and facilities, more than money is saved; lives are saved.

In conclusion, I would like to ask the following questions of the Minister. First, the previous Government were supportive of the Ockenden review, and previous health Ministers had made assurances that maternity services were going to get the support they desperately needed. I know the Secretary of State for Health is supportive of the Ockenden review and has met many bereaved parents since the general election. He has assured those parents that fixing maternity is a priority for the Government, and that actions would be outlined publicly before Christmas 2024. He came back shortly after Christmas saying they needed more time. That response is now two months overdue. Can the Minister assure me that those families will hear an update in the near future?

Do the Government support all the Ockenden report’s immediate and essential actions arising from the review into the Shrewsbury and Telford trust? How will the Government ensure that all integrated care boards and trusts across the UK implement all the actions? What support will be provided to the trusts to achieve that, and prevent a postcode lottery of maternity care?

If those IEAs are implemented, what will be the Government’s measure of success? We currently have no national data regarding preventable deaths. It is the charitable sector that has determined that more than 800 baby deaths a year could have been prevented. One of the IEAs is a long-term plan to secure a safe maternity workforce and improve training. Can we expect to see maternity care professionals, including neonatologists, obstetricians and anaesthetists, included alongside midwifery colleagues in the refresh of the 10-year workforce plan for the NHS?

An overriding theme in my conversations with bereaved parents was the CQC’s hesitancy to prosecute. Cases were often supported in the first instance, but families were then informed, just days before the three-year statute of limitations expired, that the CQC would no longer be seeking a prosecution, with the families having no time to appeal that decision. Does the Minister believe that a three-year statute of limitations is appropriate when families dealing with bereavement are often not even considering a case in the first 12 months?

Does the Minister have any concerns about the CQC’s ability as a regulator? Or does she agree with the parents that there is a reluctance to prosecute by the leadership of CQC when there have been failures in patient care? Does the Minister support calls from Sands and Tommy’s charities for all triage phonelines to be recorded, as currently they are not?

Finally, parents repeatedly reported to me that the bereavement care they received felt like a tick-box exercise, with a lot of focus on the mother and a lack of communication and support for the father, when both have suffered that bereavement. Does the Minister agree that communication could be vastly improved across maternity services in all cases, so that both parents have the opportunity to understand what happened in those most vulnerable hours?

I would like to finish by thanking every Member who has come to talk about this important issue. I also thank Donna Ockenden and all who contributed to the creation of the review. My greatest thanks go to all the families who gave up their time to share their stories with me, reminding me that those babies were people, not statistics. They are loved, they are missed, and they deserved better.

--- Later in debate ---

[Jess Brown-Fuller]

I thank all Members from across the House for their constructive approach to the debate. It is clearly an area where there is passion in all parts of the House. I thank the Minister for her replies to the questions, and I am sure that a lot of Members will be writing follow-up letters to Baroness Merron asking for further detail on particular areas. I will forgive the Minister for her “crack on and deliver” pun.

The Minister mentioned that lessons are learned from every tragic event. I will finish by saying that the parents I spoke to did not feel like lessons were being learned from their tragic events, because nobody was asking them what had happened. If just one thing comes out of this debate, let us send this message to all NHS trusts and ICBs: “When there are tragic events, please don’t cover them up. Please contact the parents, because they want to talk to you and they want to make it better for parents in the future and the babies that we lost too soon.”

Question put and agreed to.

Resolved,

That this House has considered maternity services.

National Cancer Plan

Jess Brown-Fuller Excerpts

Tuesday 4th February 2025 Commons Chamber

[Madam Deputy Speaker (Caroline Nokes)]

I call the Liberal Democrat spokesperson.

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

Nearly every family has a cancer story, whether it is a personal fight or that of a loved one. A 10-year plan from the Government is a welcome step, as the previous Government broke their promise to implement a 10-year cancer strategy that would have made a real difference to patients. We on the Liberal Democrat Benches are very proud that our cancer campaigner, my hon. Friend the Member for Wokingham (Clive Jones), secured from the Government a commitment to introduce such a plan.

Testing for cancer, diagnosing and starting treatment quickly reduces stress and anxiety. Also, if the cancer is caught early, it is more likely to be treated successfully. Yet the target of 85% of people receiving their diagnosis and starting treatment within 62 days of an urgent referral has not been met since December 2015. In my constituency, one third of cases fall short of that target and 1,000 families lose a loved one every year to this cruel disease.

Lord Darzi’s review laid out very clearly that the UK has appreciably higher cancer mortality rates than other countries and that more than 30% of patients are waiting longer than 31 days for radical radiotherapy. A quarter of England’s 280 radiotherapy machines are now operating beyond their recommended 10-year lifespan, and in some areas, such as West Sussex, there is no access to radiotherapy at all. That is why we welcomed the £70 million investment announced in October to start to replace the older radiotherapy machines.

Will the Minister confirm whether there will be further rounds of funding to keep pace with available radiotherapy technology? Will he look to support those at the mercy of a postcode lottery by ensuring that radiotherapy is available in all areas? What is the expected timeline for reversing the damage done by the previous Government, and when can all patients expect to start their treatment within the 62-day urgent referral target?

[Andrew Gwynne]

One reason we think a national cancer plan is so important is precisely to get the investment in the areas we need so that we can tackle those health inequalities. There are very real inequalities when it comes to the diagnosis of cancer and, more importantly, the treatment and therefore the outcomes. I am really keen that we focus on that in the plan, to ensure that all parts of the country achieve the best outcomes for people who have been diagnosed with cancer.

Part of the plan is the roll-out of community diagnostic centres so that we can get diagnosis much earlier. That then puts greater pressure on getting people through the front door for treatment, so that is why, as part of the recovery plan that the Prime Minister and the Health Secretary announced, we are seeking to get more people treated more quickly on those treatment pathways. Hopefully, that will get the desired outcomes we want. It is a commitment that we will seek to restore the national health service to its constitutional standards. That is a priority of this Government.

On radiotherapy machines, the £70 million investment will fund about 25 or so machines. The criteria for evaluating bids are the age of the machine, the proportion of machines aged over seven years, and the performance against the 31-day standard for radiotherapy, with poorer performers prioritised. On future rounds of funding, the cancer plan will feed into spending reviews and future Budgets. It is our priority to ensure that we reach the cancer targets, so hopefully we can make the case to the Treasury for future investment in further years.

Hospice and Palliative Care

Jess Brown-Fuller Excerpts

Monday 13th January 2025 Commons Chamber

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

I thank my hon. Friend the Member for Wimbledon (Mr Kohler) for securing today’s important debate, and all hon. Members for approaching the conversation with the compassion and thoughtfulness that this topic deserves.

Examples shared across the House show that hospices are a vital part of our healthcare system. They provide outstanding care for patients approaching the end of their lives, offering dignity, comfort and support to families, and they are often driven by hundreds of volunteers, alongside the paid staff. Hospices will play a key role in meeting this Government’s objective to move care from hospitals to the community. This debate is very timely, given that the front pages of the newspapers are reporting today that half a million people were left languishing on trolleys in A&E and in corridors in 2024 because there were not enough beds to admit them.

Hospices, such as the extraordinary St Wilfrid’s in my constituency of Chichester, are the cornerstone of community care. I was blown away during my recent visit to St Wilfrid’s, and I am not ashamed to admit that I was brought to tears by the accounts of the family members, patients and staff I met that day. I applaud the hon. Member for Stoke-on-Trent South (Dr Gardner) for her show of emotion, because it is an emotive topic. St Wilfrid’s provides comfort and compassion to patients and their families during life’s most challenging moments—both directly in the calm and idyllic surroundings of the hospice and out in the community, providing palliative care for 300 people in the comfort of their own homes. It is St Wilfrid’s belief that everybody should be afforded a good death, and it strives to ensure that there is beauty in every day for patients and their loved ones, yet its service is being crippled by rising costs and a lack of sufficient Government support.

Hospices are in the process of setting their upcoming budgets, and many are having to make difficult long-term decisions to cut palliative care because they lack a long-term solution to address the growing financial strain. As the hon. Member for North Herefordshire (Ellie Chowns) mentioned, it is all well and good being able to say you have a lovely car park when you do not have any nurses to park in it. Only 17% of the overall cost of St Wilfrid’s hospice is currently covered by NHS grant funding—well below the minimum requirement across the country.

One of the biggest components of hospice costs is the salary of their expert clinical and other staff. Hospices are trying to match NHS salary increases to ensure that staff can afford to stay with them, and to remain competitive. In addition, they are now burdened with paying increased national insurance contributions, whereas direct NHS providers are exempt. For St Wilfrid’s, the rise in national insurance contributions will cost an additional £210,000, which is a significant financial burden. Although we Liberal Democrats and hospices alike welcomed the capital investment announcement in December 2024, that funding does not address the challenges of day-to-day spend, so there is still a vast gulf between rising expenses and available income. As the hon. Member for Birmingham Erdington (Paulette Hamilton) said, the funding must be the start, not the end.

Hospice UK has warned that around 300 hospice in-patient beds—14% of the total—are currently closed or out of use due to a lack of funding and chronic staff shortages, meaning that fewer patients are able to access the end of life care that they need at one of the most vulnerable times in their lives.

My hon. Friend the Member for Twickenham (Munira Wilson) mentioned the Marie Curie report, as did other Members across the House, which stated that one in four people who need hospice care cannot currently get it. The term “bed blocking” is not one I am particularly comfortable with, but if adequate palliative care is unavailable in the community or in a hospice, those people will remain stuck in hospital, and those hospitals cannot provide the expert care that a hospice can. Our hospices are ready and willing to take on those patients, but they need the support of this Government to do so.

As my hon. Friend the Member for Wimbledon (Mr Kohler), who brought forward this debate, said, people do not want to die in hospital. They want to die at home or in a specialised setting such as a hospice. That is why the Liberal Democrats are calling for hospices to be exempted from the rise in national insurance contributions. This targeted measure would provide immediate relief for a sector that is struggling under the weight of rising costs, and prevent further reductions in capacity or even closures.

We must think long term. Hospices need a sustainable funding model that guarantees they can continue their vital work of providing care for patients, supporting families and easing the pressure on the NHS. Hospices must also be a part of the conversation in the Government’s upcoming 10-year plan for the NHS, and that must include sustainable hospice funding reform. Examples from across the House today showed a shared recognition of the importance of hospice care. Now we need the Government to match that recognition with action for the patients, for the families and for a health service that depends on hospices.

[Madam Deputy Speaker (Ms Nusrat Ghani)]

I call the shadow Minister.

Oral Answers to Questions

Jess Brown-Fuller Excerpts

Tuesday 7th January 2025 Commons Chamber

[Andrew Gwynne]

Attempting to exploit people with addictions is reprehensible. Free drug and alcohol treatment is available in every part of the country and I urge anyone who is struggling right now to visit the NHS addiction website. The Care Quality Commission has said that it could take legal action against companies misusing its logo, and Google has said it would remove search listings from these companies. I am more than happy to meet my hon. Friend to see what more we can do to stop this outrageous activity.

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

Social prescribing is one of the primary care services provided for drug and alcohol addiction, and it also supports the Government’s aim of moving from cure to prevention, which is why I was shocked to hear that a primary care network in my constituency is reviewing its social prescribing offering across the Chichester district and proposing to remove it entirely. Does the Minister agree that social prescribing is a key pillar of our primary care services, and does the money used need to be ringfenced to protect that service across the country?

[Andrew Gwynne]

Social prescribing is one of the tools, and it is an important one in addressing public health concerns in each of our constituencies. This Government are committed to ensuring that we get those shifts from sickness to prevention. We will be ensuring that local areas have public health funding in reasonable time. We are about to announce, in due course, this year’s allocations. We need to make sure that local systems maximise the use of their money, and that certainly includes social prescribing.

NHS Backlog

Jess Brown-Fuller Excerpts

Monday 6th January 2025 Commons Chamber

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

I thank my hon. Friend the Member for North Shropshire (Helen Morgan) for introducing this important debate on our first day back after Christmas. I also thank all hon. Members from across the House who have contributed to the debate, and specifically the hon. Members for Runnymede and Weybridge (Dr Spencer), for Ashford (Sojan Joseph) and for Bury St Edmunds and Stowmarket (Peter Prinsley), who always bring really valuable contributions because of their background and current professions; it is very much appreciated when talking about the NHS.

My hon. Friend the Member for North Shropshire highlighted in her opening remarks that backlogs are not just about NHS waiting lists, but that there are also problems with mental health backlogs, handover delays, A&E waits, poor access to dentistry, GP appointments, cancer treatment waiting times and staff that are being driven from the NHS because they cannot provide the care they want to give.

Our healthcare system remains the No. 1 issue that I am contacted about. It is not unreasonable for my constituents and people across the country to expect to receive the care they need when and where they need it. I doubt there are many people who have not been affected or know somebody who has been affected by NHS backlogs. Indeed my dad struggled for months to get a face-to-face GP appointment for what he believed was a return of a hiatus hernia. By the time he saw his GP and was referred, the oesophageal cancer that he had was so progressed that palliative care was the only option for him and he passed away shortly after being diagnosed in 2021.

When I asked my constituents to get in touch with examples of personal experiences of the NHS backlogs, I was inundated with emails from people across Chichester, and I will share some of those with the House.

I have Jane, who was at high risk of bowel cancer due to living with ulcerative colitis. She is meant to see her consultant every six months but has not had an appointment since 2019, despite her GP trying on her behalf on multiple occasions. She has no idea if the polyps discovered in 2017 have turned cancerous and is living in constant fear of her health deteriorating further.

Ian got in touch after waiting over a year to receive a scan after he experienced extreme chest pain. The scan revealed heart disease, but the lack of any follow-up appointments has left him anxious and uncertain about his health.

I will also mention a good friend of mine, Rylee, who noticed irregular bruising and a physical change on the back of their leg in 2021 and was finding it harder to walk. After visiting the GP, who sent an urgent referral to the hospital, Rylee waited for months only to discover when chasing the hospital that the referral had gone to the wrong place. They then got added to the waiting list and were told the wait would be between 40 and 50 weeks. We are four years on from the initial changes to Rylee’s leg, and they are finally being treated by leading specialists as Rylee can no longer walk unaided. Amputation of their leg is now being considered. If Rylee had been seen within the expected window of an urgent referral, they would not be facing the prospect of losing their leg in their mid-20s.

These are just a few examples of what is a much larger picture of the NHS, with caring and compassionate staff working within it who are overstretched and overburdened and, as my hon. Friend the Member for North Shropshire said, who cannot provide the care they desperately want to because of a system that cannot meet the demand.

The Liberal Democrats recognise that this is an inherited problem; indeed, the key NHS waiting times standards have not been met for some years. The number of patients waiting longer than four hours in A&E rose consistently between 2015 and 2020. The 62-day waiting time for standard cancer treatment has not been met in recent years, and the consultant-led treatment target in England of 18 weeks has not been met in 2016.

The last Conservative Government left emergency care in a deep crisis. The Darzi review stated that 800 working days were lost every day to handover delays in 2024. Last winter, ambulances across England collectively spent a total of 112 years waiting outside hospitals to hand patients over. In 2024, more than 1 million patients faced waits of more than 12 hours in A&E. The Liberal Democrats welcome new investment in the NHS, but instead of spending money firefighting crisis after crisis, we would invest to save taxpayers’ money in the long run. We would do that by investing in the front door and the back door: in primary care, with GPs and dentists, and by reforming social care.

Some of my constituents would like it noted that they will not be counted on any statistics regarding backlogs, because they cannot get a GP appointment to even get on the backlog list. That is why the Liberal Democrats are calling for everyone to have the right to see their GP within seven days, or 24 hours if it is urgent, with a 24/7 booking system to end the 8 am phone-call lottery to get an appointment. We would also ensure that everybody over the age of 70 and those with a long-term condition have access to a named GP.

We would fix the back door and address the social care crisis now, rather than spending another three years commissioning a report that will find out what we already know: social care is in urgent need of reform. The Darzi review showed that inadequate social care accounts for 13% of hospital bed occupancy, meaning that people who desperately want to get home cannot because of the lack of social care packages available and that others deteriorate at home, because they cannot access the social care they need. In the past year, more than half of all requests for social care were unsuccessful. We would strengthen our emergency services to reduce excessive handover delays by increasing the number of staffed hospital beds and calling for a qualified clinician in every A&E waiting room to ensure that any deteriorating conditions are picked up on to prevent tragic avoidable incidents.

I once again thank the hon. Friend the Member for North Shropshire for bringing forward this incredibly important debate, and I thank those Members who contributed to a conversation that matters to my constituents in Chichester and to people across the country.

[Madam Deputy Speaker (Judith Cummins)]

I call the shadow Minister.