Uckfield Community Hospital Surgical Unit

Jim Shannon Excerpts

Tuesday 25th November 2025 Commons Chamber

[Mims Davies (East Grinstead and Uckfield) (Con)]

I start by thanking, through you, Madam Deputy Speaker, Mr Speaker for granting me this Adjournment debate. I know that it is unusual to allocate Adjournment debates to members of the shadow Cabinet, so I am grateful. I am delighted to be raising this important matter on behalf of my constituents. I appreciate it, and I hope that you, Madam Deputy Speaker, as my constituency neighbour, will appreciate it too.

Since July 2024, Uckfield community hospital has been entrusted to me as part of my changed constituency. It is one of two small but vital community hospitals in my area, the other being the award-winning Queen Victoria hospital in East Grinstead, which is going from strength to strength. We look forward to the completion of the community diagnostic centre in 2026. It is a buzzing, specialist community facility with great ratings and a vibrantly bright future. I thank all NHS staff in the various hospitals that cover my area, and the wider frontline staff who are there for us in times of need. As we approach the festive season, we are especially grateful to them.

So why do we have what feels like a fragile moment for the Uckfield community hospital? It has the same caring NHS staff and high ratings, but services have been taken from the site, including the formal site manager. Those removals give a sense of great unease. I will give a little history of the site, which, Madam Deputy Speaker, you will already know. A local benefactor back in the 1980s—Mr Arthur Hughes, a generous local farmer—gave the land and £1 million. The League of Friends then raised a further £1 million, which was matched by the NHS, for the people of Uckfield and the surrounding villages to see the facility delivered. The hospital was officially opened in 1993 by Her Royal Highness Princess Margaret. The bequest has the vital inclusion of an operating theatre. This can be found in the associated covenants, and it was especially for the small surgical aspects of local day care.

I have visited this fairly new, fresh-feeling, beautifully set and well-maintained community hospital on several occasions, and the welcome has always been warm and caring—local NHS staff taking great pride in their roles to support and administer to the local community. The League of Friends has long played an active part, and frankly a huge financial part, and has been a practical supporter of Uckfield hospital and the resident trust over the past years. Two examples recently include funding X-ray equipment to the tune of £186,000, and ultrasound machines at £60,000. It has not only supported the hospital, but offered extra funding to local GP surgeries, as it is the League of Friends’ philosophy that such funding benefits all local people.

The League of Friends has delivered plans to help upgrade the busy minor injuries unit on site. However, with the surgical unit now mothballed—in reality, it feels like it is closing—the uncertainty is just too much for the Friends. That is reflected in the emails that I have received in the past few weeks and months—even today, ahead of this debate. Local people are worried about the site. I hope that their fears will be allayed tonight.

The wonderful Linda Kenwood, the secretary of the League of Friends, has said poignantly:

“To be treated in this way is very upsetting.”

[Jim Shannon (Strangford) (DUP)]

I commend the hon. Lady for bringing forward this debate. I spoke to her beforehand, and I share her concerns. We have similar concerns in my constituency, where the minor injuries unit closed. The unit was crucial for constituents, and its closure meant that they had to travel further—for almost an hour—to get to the nearest urgent care centre. Does the hon. Lady agree that any future decisions on any unit across this nation should be grounded in the needs of patients, the benefits of local access and the essential role that community hospitals play in delivering a resilient NHS?

[Mims Davies]

It is a pleasure to receive an intervention from the hon. Gentleman in an Adjournment debate, and I completely agree. That is exactly what tonight’s debate is about, and I thank him for adding to it.

Without a dedicated Uckfield hospital manager to pull it all together, the site has become fragmented—that is the feedback that I receive continually. I have repeatedly heard that none of the individual trusts seems to interact for the wider good of the hospital site and its patients. I have previously written to the Secretary of State for Health on this matter, as I am concerned that if any fire or substantial incident was found at the site, who ultimately would be responsible for the site as a whole and for ensuring health and safety for all?

Let me take you back, Madam Deputy Speaker. I visited the hospital on 4 October 2024 to meet Danielle Gearing, a staff nurse, to see for myself the services offered at the hospital and to find out what was actually happening on behalf of my constituents. Along with the minor injuries unit, there was a full and varied range of out-patient clinics, including oncology, rheumatology, chemical pathology, dermatology, vascular, oral and maxillofacial and neurology, to name a few. Most of these clinics did include the consultant, registrar and quite often a clinical nurse specialist.

Yet that list does not include the other service providers and facilities on the site, such as the health visiting team, diabetes nurses, diabetic eye screening, heart failure nurses, dietitians, cardiac rehab, Parkinson’s nurses and MS nurses. Macmillan is there. Bowel screening is there. There is hospice outreach and the AAA clinic—providing abdominal aortic aneurysm screening—and the list at Uckfield community hospital goes on.

Danielle confirmed that it is a very busy out-patient department, which we hope will continue. We should not forget that at that point the hospital also had a GP surgery, a pharmacy and a mental health facility on the site. The ambulance service also runs a site close to this facility, as you will know, Madam Deputy Speaker. I will say more on the pharmacy situation shortly.

Out of the blue, in August 2024, the League of Friends received the following in a letter from Dr James Evans, a consultant in critical care and anaesthetics and medical examiner at East Sussex Healthcare NHS trust:

“I am writing to yourselves as a Consultant within East Sussex Healthcare Trust, and Deputy Divisional director of DAS, and as a Clinical Lead for Day Surgery.

I am hoping you will be able to help, and would be grateful if you could take some time to consider this email.

One of my roles is Clinical Lead responsible for the newly built Sussex Surgical Centre (SSC), which is looking to be functional in March 2025. This will be a surgical Hub aiming to improve day case surgery provision across the whole region and hopefully benefiting patients and staff in East Sussex.

Part of my role is related to equipment for the SSC, both ensuring we have the right stuff in place, and sourcing any essential items within a tight budget. Whilst engaged in this task, I have been made aware of some equipment within Uckfield Hospital that was kindly purchased by yourselves over the years. Some of this equipment is expensive and specialist, and extremely useful for the surgeons and whole…surgery team.

I know that equipment purchased by The Friends is intended for use solely within their Hospital, but I was hoping you may be able to consider making an exception at this time.

All of the equipment you have purchased (including a microscope, ultrasound machine and ECG machine) are incredibly expensive, but vital for the successful running of a DSU, and we are struggling within the constraints of our budget to purchase all of the equipment. As you know, the trust is in a dire financial position, and any help would be greatly appreciated.

The items in Uckfield would go a long way to facilitating the above and would be used on a daily basis within the SSC.

I am aware that I am asking a great deal from yourselves at this time but wonder if you may be open to further discussion on the subject.”

This, Madam Deputy Speaker, is literally taking the family jewels in plain sight. Chris Macve, chairman of the League of Friends of Uckfield community hospital, said of their concerns about the possible removal of services from our day surgery unit that they “as yet have had no official communication from East Sussex healthcare NHS trust.” There are still various unhelpful rumours and deep concerns about what was received in this letter from James Evans, and frankly there is still no clarity for the staff, the Friends and my constituents—and your constituents, Madam Deputy Speaker. For clarity, the Friends have said—this is what they know—that they “have not been told that this unit is fully closing, but you can understand our disbelief at the insensitivity and the lack of respect at receiving the news in this way. We have a perfectly good operating theatre at Uckfield, fully equipped and staffed, just sitting there doing virtually nothing.”

After a number of rumours increased on 7 October 2024, the hospital staff in the surgical day unit were told unofficially that the integrated care board had agreed to a six-month closure and that they should expect a meeting at the end of October or early November in 2024. As Members can imagine, this was a real shock and morale took a massive tumble. The pilot—the mothballing—began on 2 December 2024, just before Christmas last year, and I brought to the House my worries and concerns for my constituents at that time.

As Joe Chadwick-Bell, chief executive officer of East Sussex healthcare NHS trust, wrote at the time of the announcement:

“Uckfield DSU cannot safely support general anaesthetic or overnight care, and does not carry out surgical procedures on patients with a higher risk of complications, such as those with complex needs, certain disabilities, significant frailty and/or certain concurrent illnesses. In those cases, even day case procedures must be carried out in an acute hospital environment where the full scope of supporting clinical services is on site. Uckfield theatre sessions are not currently well used. The reason is partly due to the safety criteria mentioned above, but also partly because some of the procedures that we previously carried out at Uckfield are no longer commissioned by the NHS. It is also because advances in care mean many of those procedures no longer need day theatres, so are delivered in normal treatment rooms.

Over the course of the pilot, we will evaluate the impact of the changes and consider options for the future of day surgery at Uckfield. It is in all our interests to make the best use possible of what is a valued asset for the NHS in Sussex.”

This pilot is so unfair. Frankly, the surgical unit in Uckfield was condemned to not stand a chance—with no staff, no anaesthetists and treatment figures already manoeuvred by the East Sussex healthcare trust. That is the view of staff. Another blow to the staff at the unit came at the start of 2025, when Kamsons Pharmacy closed—and left, I understand, with some clouds over the terms of its departure. Frankly, why has this happened?

One year on, my residents are not taking this lying down. They have got together a local petition, which at present stands at 6,366 signatures. But it is the uncertainty that is causing local residents a great deal of stress and panic. I will be building on this petition after this debate. People need local services. They need family and friends nearby to help with operations, getting to the hospital and out of hospital, and they need care in the community—all of which this Government are committed to. My residents need answers.

I have had meetings, after much pleading, with three recent chief executive officers of the integrated care board: Adam Doyle, who personally promised me and my casework team updates in early August; Mark Smith; and the newly appointed chief executive officer of NHS Sussex, Karen McDowell, who I had the most recent meeting with last week. NHS England reorganisation and staff changes have left me and my casework team in the dark, just like my constituents under this Government, who I know are committed to local community services just as I am.

I stress again how important the day surgery unit is to providing local care. Uckfield hospital is a vital facility. It must not slip through our fingers. Its staff—some of whom have now retired or left in upset, anger and frustration—are worried. The CEO has kindly written to me since we met and said:

“I clearly heard the commitment of you and the local people for Uckfield community hospital, and am speaking to our commissioning teams who have been working with East Sussex healthcare NHS trust around their pilot specifically on day surgery but also—and likely more importantly—our terms working to develop neighbourhood care, and the potential for this asset within its work.”

I thank her for this letter and share it gratefully.

To recap for the Minister, a thriving surgical day unit has been mothballed. The manager of the hospital has been taken away and not replaced. Anaesthetists have been moved elsewhere and are not accessible. Patients are now directed to other surgical sites. Staff heard out of the blue of a six-month mothballing and were given roles miles away from Uckfield. The League of Friends’ assets have been stripped from the site. A year later, we are still in the dark, with no decision taken and no ICB head willing to put their head above the parapet. We need to know what comes next.

My well-loved hospital is a vital community service. Our town and area are growing at a rapid rate, with a significant amount of housing being built and due to be built. There is difficulty involved in getting around a rural area and there is an impact from the public having to get to Eastbourne.

Lots of people have moved from the coast and from London and have taken the opportunity to work locally, and they expect NHS services on the doorstep. That is why I am grateful to be in the Chamber this evening to ask the Minister to look at this vital matter for me and my constituents and to do all that she can. We need this facility to thrive, with the community hospital and its wide-ranging services backed to the hilt. Crucially, we want the Uckfield day surgery back doing what it should: operating.

Unpaid Carers: Inequalities

Jim Shannon Excerpts

Thursday 20th November 2025 Westminster Hall

[Jim Shannon (Strangford) (DUP)]

It is a joy to serve under your chairship, Ms Vaz. I thank the hon. Member for Shipley (Anna Dixon) for championing the cause of unpaid carers so well, and congratulate her on how she has spent her time in this House. She is always making a name for herself on subjects important to her, such as carers—an issue that we all deal with every day. I also thank the hon. Member for Bexleyheath and Crayford (Daniel Francis) for telling us his personal story. Nothing illustrates a debate as well as a personal story, and the hon. Gentleman kindly and compassionately set the scene of what he and his wife do for their child.

This issue affects everybody in the United Kingdom of Great Britain and Northern Ireland. We are all aware that, without unpaid carers, our health and care system would collapse. If we had to pay for taxi services, all- night care and daytime care for those in need, we could never afford it.

The financial contribution made by unpaid carers in Northern Ireland is estimated to be some £5.8 billion annually, which is equivalent to 80% of the Department of Health’s budget. That is an increase of 42% over the last decade. Despite that massive economic value, many carers face significant financial hardship, with one in four living in poverty, rising to more than half for those not in paid employment. They are giving their lives to look after others, and they are living in poverty. Come on—that cannot be right. Juggling income and responsibility for care, their poverty is driven by the extra cost of caring and insufficient social security payments such as carer’s allowance.

Carer’s allowance is worth only £2 per hour—there is no way that could ever be a minimum wage—based on providing a minimum of 35 hours of care.

Young Lives vs Cancer has highlighted the fact that every year in the UK more than 4,200 children and young people aged under 25 are diagnosed with cancer—that is 12 per day—and sadly 10 of them die every week, making cancer the biggest killer by disease of children and young people in the UK.

In many cases, the parents or close family members of a child or young person who has been diagnosed with cancer will be their primary care giver throughout their illness and treatment—never mind the trauma that carers feel as they deal with someone who may not come out the other side. That is the reality of life. That is physically and mentally challenging for families, and the impacts of cancer and its treatment, along with the care needs, can last many years, given the nature of the disability.

The financial impacts of having a child with cancer include the loss of earnings. The families of children and young people with cancer face significant financial pressures and inequalities, which can start during the pre-diagnosis period but continue, and are most significant, following diagnosis. Many have to take time off or give up employment because of caring responsibilities. Seven in 10 households reported a loss of income and earnings because of having to take time to care for their child, or gave up work altogether because there was no other option. The average loss is around £6,000 a year, but for three in 10 households it is £10,000 a year. To try to meet caring needs, parents call on every source of leave and time off that they possibly can, frequently combining options until they are exhausted and, ultimately, the only option is unpaid time off or leaving employment.

The Minister is a kind Minister. I do not just say that; I mean it. We are all making a plea today on behalf of the carers. Yvonne in my office deals with benefits five days a week—sometimes five-and-a-half or six days a week—and the carer issue comes up all the time. We understand it well, and when we speak about it, we are speaking from experience.

In most cases, the carers of young cancer patients are eligible for carer’s allowance only once the child receives another form of benefit. For younger cancer patients, a young person receiving a personal independence payment or a child receiving disability living allowance is a gateway to their families receiving carer’s allowance. However, this leaves carers waiting months for support. There is a time period and a qualifying period, and I am asking that we get the money out as quick as possible. We should not drag our heels on this matter. A young person with cancer is eligible for PIP and DLA after being impacted by their condition for three months; this leaves the families of children and young people with cancer having to find and pay out nearly £5,000 extra in costs before their disability benefits are awarded.

Due to the immediate nature of the costs experienced by families, children and young people with cancer and their families should be entitled to access welfare benefits immediately. If we lose the unpaid care system, our NHS will collapse, and if we do not give families more support, they cannot sustain the situation. The choice seems clear: give more support and take away some of their financial problems and worries.

[Several hon. Members rose—]

--- Later in debate ---

[Stephen Kinnock]

As a ballpark figure, we are looking at 50,000 residents, but we will be open to developing multi-neighbourhood infrastructure that would cover closer to something like 250,000 residents. It will depend, to some extent, on how it works in the 43 pilot sites in our neighbourhood health implementation plan. We do not want to have too many top-down diktats like the disastrous 2012 Lansley reforms; this is much more about a bottom-up, organic approach to developing a neighbourhood health service. Approximately 50,000 residents will be the starting point.

[Jim Shannon]

What the Minister is referring to is very positive; as always, I have a quick ask. The policy he is outlining seems very plausible and workable, so can I ask him to share those thoughts with the Northern Ireland Assembly and the Health Minister, Mike Nesbitt? I think that the two Ministers are in regular contact, so it could be done through that.

[Stephen Kinnock]

I will be very happy to do that. We have launched the 43 sites, so I would be happy to share the documentation on how we launched them and the terms of reference. [Interruption.] I can see the representative from my private office is taking notes.

World COPD Day

Jim Shannon Excerpts

Thursday 20th November 2025 Westminster Hall

[Jim Shannon (Strangford) (DUP)]

I beg to move,

That this House has considered World COPD Day.

It is a pleasure to serve under your chairship, Mr Efford. I thank the Backbench Business Committee for making time for this debate. I am always pleased to see the Minister in her place—she knows that—and we look forward to her answers to our requests on behalf of our constituents. I am also pleased to have other colleagues here, including the shadow Ministers for the Conservatives and for the Lib Dems, the hon. Members for Farnham and Bordon (Gregory Stafford) and for North Shropshire (Helen Morgan), and also my good friend, the hon. Member for Surrey Heath (Dr Pinkerton).

I am glad to be able to raise the issue of chronic obstructive pulmonary disease. Yesterday was World COPD Day, so I pay tribute to the wonderful work carried out by so many organisations and individuals to draw attention to the illness. We had an event here last night, which was well attended. The people in the Gallery are those who do the hard work for the all-party parliamentary group for respiratory health, which I chair. We had a great event last night with many excellent speakers.

I want to reflect on the organisations and individuals that attended last night to draw attention to the illness. Hugh McKinney is going to look at me and say, “You mentioned that lady again”, because last night one of our special guests was Shirley Ballas of “Strictly Come Dancing”. I could not dance if my life depended on it—I have two left feet—but that lady can. Last night she was not there because she is a judge on “Strictly Come Dancing”. She was there to tell the story of how she cares for and looks after her mum, who has COPD. There are two sides to the lady—the side we see on TV and the caring side. The previous debate was about unpaid carers across the United Kingdom, in all constituencies, and the work that they do. It was a pleasure to take part in that debate and to see so many there.

As chair of the APPG for respiratory health, I will cover a number of issues today around COPD. I will frame my comments around the latest initiatives and also the current policy direction. Hopefully we can try to marry those two together so that we can have a focus and a target to do better. To make that happen, of course, we need Government and ministerial support.

As always, I am indebted to Sarah Sleet and her wonderful team at Asthma and Lung UK for their outstanding help and ongoing support. Without their enormous help to me and the APPG that I chair, we just could not manage as well as we do. I also want to say a special thanks to Jonathan Fuld, the national clinical director for respiratory disease, for his expert advice and counsel. I pay tribute to the ongoing work of our expert stakeholder groups, which comprise senior clinicians, industry, professional bodies and other experts. We have Zoom meetings because that is the best way for us to come together from all over the United Kingdom and it means people do not have to travel. When we have our Zoom meetings we have fantastic contributions from all over the United Kingdom of Great Britain and Northern Ireland, and sometimes further afield.

I want to begin with a general point on the modern service frameworks. There is much to be thankful for in what the Government are doing and we want to focus on that as well, but there are also things that we want to ask for. Although the APPG warmly welcomed the initiative of the modern service frameworks, the Minister will not be surprised that we were disappointed that respiratory health was not included in the first wave. Respiratory health is an ideal candidate, I believe, as do others inside and outside the Chamber, for the next wave. What can the Minister do to include respiratory health in the next wave of the Government’s 10-year plan for health, which we very much welcome and are encouraged by?

The outcomes of COPD are widespread and have a huge impact on the NHS. I will give some statistics to show that. Sometimes, people hear statistics and are sceptical. I always think about “lies, damned lies, and statistics”, but the stats are important because they set the scene. Many times when we are looking at the objectives and targets for the NHS, we need the statistics before us, because they indicate the policies that hopefully the Government will follow.

Lung conditions, including COPD, are the largest cause of emergency hospital admissions, especially in winter, when respiratory admissions can increase by some 80%. These figures are worrying; we are in that season now, and we could see that figure. The rate of emergency admissions to hospital for COPD in England increased by 9% in 2024 compared with 2023; unfortunately, they are increasing consistently. That represents some 121,129 A&E admissions—significantly higher than in the previous year. Worryingly, the trends are upwards. I hope that the Minister, when she responds to the debate, can give us some ideas about how the Government can reverse those trends and reduce that figure.

COPD is the second most common cause of emergency admission in the United Kingdom, and 1.7 million people in the UK have been diagnosed with it. In my office, when we meet constituents, we help them with their benefits forms and try to put them on the pathway to get some help to deal with their health conditions. I have known many people over the years who, unfortunately, are no longer here today because COPD has taken their life. Others are on oxygen, just trying to survive every day. Again, that is quite worrying.

It has been estimated that there could be around 600,000 more people in the UK who are living with undiagnosed and untreated COPD. What can we do to identify those people and ensure that they understand what is happening to them, so they can get some help with the life that they will now lead? Lost productivity due to COPD is estimated to cost around £1.7 billion per year. There is a cost to every disease, but there is a real cost to this disease, and if we can diagnose and catch it earlier, perhaps we can reduce that sum.

My last point is about something quite worrying. Each year, around 30,000 people in the UK die from COPD. That is the reality experienced by some of my constituents I have met over the years, but who are no longer with us. The disease progresses so fast that people’s life expectancy is reduced. Deaths caused by respiratory diseases are more strongly linked to deprivation than deaths caused by any other major disease. People living in the poorest areas of the United Kingdom are five times more likely to die from COPD than those living in the richest areas. That is a real disparity, whereby people in deprived areas are more susceptible to COPD and their life expectancy is also reduced. I have another ask of the Minister: how can the Government address deprivation and its impact on particular areas, specifically when it comes to COPD?

Research from Asthma and Lung UK shows that someone from the poorest 10% of households is over two and a half times more likely to have COPD than someone from the most affluent 10% of households. That is a real disparity. If someone lives in an affluent area, they have 10% less chance of getting COPD than someone living in a deprived area.

We hope that the transition from hospital to community under the 10-year plan for the NHS will transform COPD outcomes in the most deprived areas. A survey by Asthma and Lung UK found that almost a quarter of people with COPD wait five years or more for a diagnosis, with one in eight of people with COPD waiting for over 10 years. Again, I have another ask of the Minister. How can we shorten the wait for a diagnosis of COPD? If we catch it earlier, we can reduce the impact on life expectancy and help with life conditions and how to reach a better level of care.

The same survey showed that only 9% of people with COPD in the UK were receiving good basic care. That is worrying. Again, as chair of the respiratory health APPG, it is one of the things that we hope to address. While the statistics are stark, the APPG also acknowledges and welcomes a huge amount of work undertaken by NHS England ahead of the winter months to relieve the pressure on the NHS. We are all here to make lives better, and not to make them worse, but sometimes we need to have a better idea of what needs to be done. The NHS can do much, but it cannot perform miracles. It can only do the best it can, so how do we help it to do so, given all the pressures it is under?

We commend the urgent and emergency care delivery plan, and Exercise Aegis, which will devolve accountability for winter readiness to the integrated care boards—probably a good idea. Under Aegis, NHS England will stress test winter preparedness by running seven regionally-led exercises. I ask the Minister for some detail on that, on what it means and how it will work—no doubt we are to hear that shortly. The initiative is welcome and a well thought-out plan, I believe—I am sure others will comment —that promises to deliver the regional outcomes that will make a huge difference. Only in the past few days have we realised that winter is coming—anyone who has not felt the cold must be wearing a strong and heavy coat—so will the Minister update us on the outcomes of the regional exercises and how they feed into the winter preparedness strategy?

We are busy in the APPG—Hugh and the team clearly do that for us—and recently we held a roundtable on the winter pressures in partnership with the Centre for Applied Respiratory Research Innovation and Impact—CARRii, to abbreviate all those words—which gave an outstanding presentation. Early next year, we will produce a short report, taking the outcomes of that meeting and the data from this year into account. We are happy to share it with the Minister, because I think it will be helpful when drawing up a better way to do things.

Key themes of the roundtable included an increase in vaccination rates—more focus on that has been because of, unfortunately, a slight reluctance to take up vaccination —and how we encourage that. At the Tuesday morning roundtable, with Lord Bethell from the other place, we had an opportunity to discuss how best to do that with those in the NHS, and with other companies and people who have a deep interest in the subject matter. Some of the ideas will be helpful for the future.

We need better infection control. COPD exacerbations are mainly driven by infections. How can we address and target that in the system? We must implement fully the five fundamentals of COPD care by the National Institute for Health and Care Excellence, which outline what effective management of care looks like, such as vaccination, smoking cessation and pulmonary rehabilitation. Recent analysis has found that expanding access to PR services to all eligible patients could result in £142.6 million of direct NHS savings related to reduced exacerbations, as well as a reduction of 194,000 bed days, 66,000 of which would be saved over the winter period.

Those figures cannot be ignored—at the end of the day, the NHS has to work within the figures, the money, it has available. When we look at the savings and the reduction in bed days, in particular over the winter period, we must try to do better. The final fundamentals are personalising self-management planning and optimising treatment for co-morbidities. Will the Minister please assure us that the NICE fundamentals of COPD care are being implemented consistently across the country? The Minister will know, because she is very knowledgeable and responsive to these issues, that the APPG strongly supports the 10-year plan and the three shifts, which are ideally placed to transform respiratory care and outcomes. Community delivery, especially, promises a great deal for improved respiratory outcomes by placing facilities closer to home. That is a better way to do it.

We welcome the work already under way to place respiratory services in community settings and the introduction of spirometry in all CDCs and community health services. This a really positive way forward. There is, however, evidence to suggest that not all patients receive spirometry tests. If we are going to introduce spirometry, we need to ensure that all patients can receive those tests. Will the Minister make sure that these tests be undertaken on all eligible patients?

Will the Minister also please look at the waiting lists for diagnostic testing and see whether they can be prioritised to test those at the highest risk first? That is a lot of asks—I have given the Minister and the shadow Minister a copy of my speech, so hopefully the Minister had all my questions in advance. I hate to throw around 20-odd questions at her in the space of an hour and a half and expect answers right away, but hopefully we can get those answers—I know that the civil servants who are here will work very hard to ensure that happens. Although it might be too late for this winter, perhaps that provision could be in place for people for next year.

We are also looking forward to the upcoming NICE guidance on the biologic therapies for COPD, which will be a complicated process. We will keep an eye on the implementation of these drugs when they are approved. The advancements in medicine cannot be ignored; it is really good to have them, and it is encouraging that we are living that bit longer now. We can now extend and improve the lives of people with diseases that would previously have killed them fairly young.

Finally, we have been looking at the incidental findings from lung cancer health checks. According to recent data, around 100,000 people who have been assessed under the targeted lung health check programme have been diagnosed with emphysema or symptoms of no recognised disease to date. What can be done to help those 100,000 and perhaps others facing those circumstances who have not yet been diagnosed?

Lastly, there is no onward referral from the lung health checks, and I think there should be. It would be helpful to have an assurance about how that could be achieved. I know that this is a complex area—it always is—and that lung cancer health checks are carefully targeted, particularly for those in our most deprived communities, who are least likely to be well served, but this provision would seem to fit perfectly in a modern service framework for respiratory health. So, I end where I began: I hope that this will happen sooner rather than later. I have made a lot of requests, but we are fortunate to have a Minister who responds in a way that gives us all encouragement. We have a real problem with COPD, and this debate gives us the chance to highlight the issue for patients. The winter pressures are on. I am pleased to see my friend, the hon. Member for Blaydon and Consett (Liz Twist). She is the co-chair of the APPG, and she will hopefully speak next. I look forward to hearing all the contributions, including from the shadow Minister, the hon. Member for Farnham and Bordon, and, ultimately, the Minister.

--- Later in debate ---

[Jim Shannon]

I thank all hon. Members for their contributions. I particularly thank the hon. Member for Blaydon and Consett (Liz Twist). She and I have been friends for ages and ages—so far back that I maybe had hair at that time. She underlined two issues: access to public transport, and how difficult it is for people to return home from hospital. She was keen to welcome the progress on the Tobacco and Vapes Bill and on access to drugs. She is no longer a Parliamentary Private Secretary, so she can now be active on the APPG—we are very much looking forward to having her energy back.

The hon. Member for Surrey Heath (Dr Pinkerton) also set the scene very helpfully. COPD never goes away; it escalates, so how do we address it? He said that there were 200,000 admissions to hospital due to respiratory ill health in the last year. He also talked about access to data and to medical care for COPD. It is sometimes a postcode lottery in the United Kingdom, and that has to change.

The hon. Member for North Shropshire (Helen Morgan) talked about chronic bronchitis and rehabilitation. She said that early diagnosis reduces the cost to the NHS. Shortness of breath means that there should be more checks for COPD. She said that anyone over 35 should get checked. That is very wise—we should all take note of that. She also referred to the Lib Dem ambition to recruit another 8,000 GPs, and she spoke about vaccination.

The hon. Member for Farnham and Bordon (Gregory Stafford) made an excellent speech—it was a real pleasure to hear it. He referred to the inequality and deprivation across the United Kingdom, and talked about how to do spirometry tests better. The pressure on the NHS is enormous. He said that pulmonary rehabilitation treatment is a key way of responding, and we very much welcome that. He also referred to other COPD interventions, and said that this is a year-round emergency.

I am very pleased to have the Minister here to respond to our requests. Anyone listening to her speech would recognise that she is keen, eager and energetic in giving us the answers that we are looking for. I am conscious of the look that you are giving me, Mr Efford, so I will be very quick. She said that her mother has COPD, and therefore this is a personal issue for her. She is as keen as all of us to see results. She set out the case for the prevention of COPD, and said it is the next disease to be considered in the respiratory service framework—hopefully in the next phase. I am looking to her to see whether the Government can deliver on that.

Prevention is better than cure. We must work harder to introduce a vaccination programme. The hon. Member for Blaydon and Consett referred to housing and air quality. We need a pathway to work so that those with long-term illnesses can come back to work. The Minister set out lots of positive things. She referred to deprivation, which we all know about. She spoke about spirometry care from hospital to the community, pulmonary rehabilitation, which is key to reducing COPD, and lung cancer screening—all good stuff.

I want to put on the record a big thank you to all those who participated, to Hugh, Will and the team in the Public Gallery for all that they have done, to you, Mr Efford, for your patience, and to the civil servants—they are not often thanked, but let us thank them for what they do.

Question put and agreed to.

Resolved,

That this House has considered World COPD Day.

Access to Healthcare: Bracknell Forest

Jim Shannon Excerpts

Wednesday 19th November 2025 Westminster Hall

[Peter Swallow (Bracknell) (Lab)]

I beg to move,

That this House has considered access to healthcare in Bracknell Forest.

It is an honour to serve under your chairship, Mr Mundell. I thank the Minister for Secondary Care, my hon. Friend the Member for Bristol South (Karin Smyth), for her engagement on this important issue.

As local MPs, we all hear on the doorstep and at our coffee mornings about the importance of the ability to access timely, good-quality and local healthcare, and the impact not just on individuals, but on our communities more broadly, when the standard is not met. What those who work in our health and social care system do day in, day out touches all our lives and families. I thank those in Bracknell Forest and across the country who work in our NHS and wider health and care system for everything they do. I must declare an interest: my brother and sister-in-law are both NHS doctors.

These are challenging times for the NHS. Chronic under-resourcing after 14 years of Conservative austerity has left too many unable to access the care they need and has prevented the system from evolving to reflect the needs of today’s Britain. But although the NHS may be down, it is not out. While other parties threaten the very principle of the NHS—that care should be available to everyone and free at the point of use—the Government are investing in the NHS and putting in place the reforms we need. We have already seen those efforts bearing fruit, with the first cuts to waiting lists in 15 years, the recruitment of 2,500 more GPs and the creation of 5 million extra appointments.

[Jim Shannon (Strangford) (DUP)]

I commend the hon. Gentleman for securing this debate. He is right to underline the issue of GPs. Does he agree that access to healthcare must begin with access to the local GP surgery, and that the Government must prioritise training and retraining GPs to ensure that people can access their GP and do not head straight to emergency care at the local hospital when it is not necessary? GPs first—then, everybody else can do better.

[David Mundell (in the Chair)]

But primarily in Bracknell Forest.

Myalgic Encephalomyelitis

Jim Shannon Excerpts

Wednesday 19th November 2025 Westminster Hall

[Tessa Munt]

I accept my hon. Friend’s point. Most people I speak to say that ME has nothing to do with psychiatry. We now have evidence from Edinburgh, which I will go on to in a moment, to explain exactly why that is the case.

Our counterparts in Germany have grasped the importance and scale of the challenge. Just last week, the German Government announced a national decade against post-infectious diseases, with a particular focus on ME and long covid. In Germany, an estimated 1.5 million people are living with ME or long covid. The German Government have rightly recognised post-infectious diseases such as ME as one of the greatest public health challenges of the 21st century. Last week, they committed €500 million—around £440 million—over the next decade into research to understand the causes of post-infectious diseases and to develop treatments.

Will the Minister confirm whether Ministers in the Department of Health and Social Care have discussed that recent funding announcement and the logic behind it? I would love nothing more than to see the UK Government come up with a comparable level of commitment—or will the Government wait a decade for the German Government’s conclusions before taking action?

[Jim Shannon (Strangford) (DUP)]

I commend the hon. Lady on bringing this debate forward. In Northern Ireland, the figures for ME have unfortunately risen from 7,500 to 12,500 in the past few years. We have no clinical lead, no specialist services and no commission care pathways. We need research. Queen’s University Belfast is really good with research partnerships. Does the hon. Lady agree we should spend the money on research and find the cure? It has been said that the cure for cancer will come in 10 years’ time. The cure for ME could come too if research money were put into it.

[Tessa Munt]

I absolutely agree, and I thank the hon. Gentleman. The second area where I would urge the Government to go further is support for people with severe and very severe ME. It is estimated that around one in four people with ME are severely affected. ME is perhaps the only condition where the sicker someone becomes, the less care they receive from the NHS. The recent prevention of future deaths report focused on the tragic case of Maeve Boothby O’Neill, describing NHS care for severe ME as “non-existent”.

In my work on this issue, I have collaborated closely with #ThereForME, a campaign founded by two women, Karen and Emma, who are carers to partners with very severe ME. It can be difficult to comprehend the depth of suffering that ME can bring in its most extreme forms. With his permission, Karen has shared details with me about of her husband James’s day-to-day life.

Before developing ME, James, in his 30s, lived a full life and was a civil servant. Today he is completely bed-bound and spends 99% of his day alone in a dark room, unable to tolerate any noise, light or stimulation. He is hardly able to communicate and is so sensitive to touch that, despite his suffering, his wife Karen is unable to give him a hug or hold his hand. Despite an acute level of need, James is receiving next to no care from the NHS. Karen tells me that her biggest fear is that he deteriorates to the point of needing lifesaving care. She cannot feel confident that the NHS will provide it.

Suicide: Reducing the Stigma

Jim Shannon Excerpts

Wednesday 19th November 2025 Westminster Hall

[Jim Shannon (Strangford) (DUP)]

It is a pleasure to serve under your chairship, Mr Mundell. I thank the hon. Member for Richmond Park (Sarah Olney) for setting the scene, as she so often does. I know that this issue is very close to her heart; indeed, it is very close to all of us. I will give a couple of examples from Northern Ireland. They are never easy stories to tell, but both of them are solution-based. I will tell them without mentioning any names or specific details, so we can consider what steps we are taking to address the issue.

It is a real pleasure to see the Minister in his place—I wish him well in his role—and, as always, to see the shadow Minister, the hon. Member for Hinckley and Bosworth (Dr Evans). He and I seem to be tag-teaming all the time on health issues in Westminster Hall and the main Chamber.

When I thought about this issue, and I have given it a lot of thought because it is so real to all of us, I went back and forth in my mind about the title of this debate. The motion refers to “reducing the stigma associated with suicide”. I believe that we need to normalise talking about how we feel. I say that as a man, because men—myself included—seem to have some difficulty in understanding the issues that we face, especially the difficult aspects, relating them to others and acknowledging that we are not alone in having these thoughts. It is important that we recognise that, and that there is help for so many.

The hon. Member for York Outer (Mr Charters) is not here, but anyone who heard his Prime Minister’s question today will know that he lived the story that he told. We need to recognise what suicide truly is. He took us through his experience: he did us proud and did his family proud in how he dealt with the things he faced up to.

When I was first elected to this House back in 2010, the constituency of Strangford took in a new part, Ballynahinch. Around that time—in 2010, 2011 and certainly in 2012—there was a spate of suicides of young men in the area. It was horrendous. It was almost impossible to comprehend what was happening. However, a local Presbyterian minister, Rev. Mairisine Stanfield, galvanised the community in Ballynahinch to come together. What a lady she is! She organised all the churches and the individuals, who were all hurting and all wanted to know what to do. She was the prime mover: she created a hub in the area, which was a brand-new idea that gave young people and others a place to come together, talk about things, relate, socialise and have a chance. Alongside other things that were happening, the hub helped to reduce the suicides in that town, so I have never forgotten Rev. Mairisine. Indeed, I met her last Friday night at the mayor’s do over in Bangor. There she was, as bright as ever and with that wonderful smile. That lady motivated the people of the area, the community groups and others to come together and try to help, so I am always deeply indebted to her.

I remember that when I was younger—this goes back to the title of the debate—a stiff upper lip was expected. That was the demand of the day, but that approach is not helpful attitude to take to mental health. If we look at the cultural climate across most western countries, attitudes were shaped by fear, silence and, in some cases, religious views. This was not spoken about.

[Carla Lockhart (Upper Bann) (DUP)]

My hon. Friend will know that in Northern Ireland there are somewhere in the region of 200 suicides per year, which is deeply troubling and terrible for each family walking that difficult pathway. Online platforms and social media now play a huge part in some of those suicides. Does he agree that this Government need to go further in regard to platforms that are sharing information on how to commit suicide, and that we all need to play a role? Our mental health champion in Northern Ireland has said that by asking someone how they are, we are not likely to make the situation worse. There is a challenge for us all to reach out and ask people how they are, so that we can be more in tune with them and help them through difficult situations.

[Jim Shannon]

I thank my hon. Friend for her words of wisdom. I know that she has tried, before and during her time in this place, to address the issue of online access to information about how to commit suicide. I cannot conceive how that can be available; maybe I am from a different generation, but the availability today is scary. It is not the Minister’s responsibility, but I know that he will give us some ideas on how to tackle that.

People did not talk about mental health in the past. There was no awareness, and psychological conversations were not had day by day in the way they are today. We had a spate of suicides of young men in Newtownards a few years ago, and it was so tragic. There was a wee group of young boys who ran about together. One committed suicide, and unfortunately the other four or five all did the same. It is really difficult, sometimes, to deal with things.

The hon. Member for Ashford (Sojan Joseph) spoke about the suicide rate among farmers. This is not about pointing fingers—I do not want to do that—but I can say from the family farms that I know in Northern Ireland that the pressure on farmers today due to the family inheritance tax is incredibly worrying. I will leave it at that.

While any suicide is devastating, I would like to focus on the stats surrounding male mental health and suicide in Northern Ireland. The Northern Ireland Statistics and Research Agency revealed that there were 171 male suicides registered in Northern Ireland in 2023, which accounted for some 77.4% of all suicides. My goodness me! We men—that includes me and every one of us—need to have a look at how we deal with these things. Males in Northern Ireland are consistently three to four times more likely to die by suicide. It also noted that for males aged 15 to 49, such as those I referred to in Ballynahinch and Newtownards, suicide was the leading cause of death in 2023, followed by drug-related deaths.

Male suicide in Northern Ireland has been a painful and persistent issue for years, and the stigma around it can make things even harder for those who are struggling. The harsh reality is that men do not talk. We tend to be private about our health issues. There is a very strong cultural script back home that we just get on with it; we do not want to come across as weak or unable to cope, which is how we fear it would be perceived. Furthermore, for many men and their families, the pattern is passed down from our parents. To give a Northern Ireland perspective, our dads and grandads who suffered during the troubles were told to be silent at that time and swallow their feelings. Some of them had PTSD—we never knew what that was until the last few years, by the way. That has had a knock-on effect on how we deal with issues now.

We must do more to ensure that talking about mental health is as normal as talking about the weather or the news. That is how we will reduce the stigma. Transparency and openness is the way forward. First and foremost, we must ensure that help is accessible and available in this country. That is our responsibility.

Our mental health services are not where they need to be. More should be done to provide counselling services, as opposed to going to the GP and walking out with a prescription for anti-depressants. With great respect, they are not always the answer. I urge the Minister to tell us how the Government will do more to ensure that those services are properly funded so that we can help more people stop making that final decision, which some feel is the only way forward.

[Several hon. Members rose—]

Clive Treacey Safety Checklist

Jim Shannon Excerpts

Monday 17th November 2025 Commons Chamber

[Dave Robertson (Lichfield) (Lab)]

It is an honour and a privilege to lead this debate on Government support for the Clive Treacey safety checklist. I secured this debate in Clive’s name, and I want to start by telling the House a little bit about him. I did not have the pleasure of meeting Clive, so I am drawing here on the words of his family, who knew him best. Clive’s sister, and his father Michael, are in the Public Gallery this evening, and I am really glad that they are able to see proceedings. They have been tireless advocates for Clive, making sure that his voice is heard, and I hope that I can do their efforts justice tonight.

Clive was born in Lichfield, in my constituency, in 1969. He was soon diagnosed with a learning difficulty, and, between the ages of 8 and 10, with epilepsy. I will cover both those factors today. Sadly, they are important to understanding Clive’s death and the failures in care throughout his life, but they do not define what Clive’s life was. I want to ensure that the House hears who Clive was. Clive was a talented artist and gardener, gifted with a brush and able to make plants spring seemingly from nothing. He loved music, especially Elvis Presley, and was often singing and dancing—his family remember him as the life of the party. He wanted to work in a garden centre, helping to raise plants; to have his own home, close to family; to own a cat; to learn to drive; and to go on holiday to Blackpool and Somerset. Clive was as devoted to his family as they were to him. He was known as the family calendar, never forgetting a card for a birthday, Christmas, Easter or any other reason. Clive’s sister Elaine says that her brother was

“engaging, humorous, gentle, and loving”.

His parents, Pauline and Michael, have said his heart “knew no bounds”, and describe their son’s “magical qualities” throughout his life. In all the accounts of Clive, his love and optimism shine through.

Clive passed away in 2017 at just 47 years of age, after a seizure caused by his epilepsy brought on cardiac arrest. This is known as SUDEP—sudden unexpected death in epilepsy. Clive had been living in residential placements for years up until that point, moving often. Before he died, Clive’s family had become worried about his deteriorating health—and, tragically, so had Clive. He left a message on his dad’s phone, which was not received until some days after his death, saying that he was dying and needed an ambulance. Clive was not listened to, and his family were not listened to, and the consequences were devastating.

After that terrible event, Clive’s family had to fight hard for answers. They had to fight to secure an inquest into his death, and later to secure an independent review. When that review was completed in 2021, four years after Clive died, it confirmed what they had suspected all along: the independent review found that Clive’s care fell far short of what should be expected for somebody with drug-resistant epilepsy, and it identified multiple system-wide failures in delivering his care and treatment, which put him at greater risk. It found that his death was potentially avoidable, and that he had been failed both in life and in death.

What did that mean in practice? It meant that the management of Clive’s epilepsy was fragmented, and the link between his epilepsy and the sometimes challenging behaviours that he could exhibit when stressed, such as not taking his medication, withdrawing to his room, or not communicating, were often overstated. Those behaviours disproportionately impacted the generally held view that Clive required a hospital setting, and despite the fact that he had long expressed a wish to live in his own home, care in the community was discussed with him and his family only towards the end of his life. That is where Clive’s life was, and if we move on past his death, it is important to pay tribute to Clive’s family. Throughout all the suffering, they have been relentless in their focus on ensuring that other families do not go through what they had to. That is why we are here today, and for me, that is entirely what this debate is about.

[Jim Shannon (Strangford) (DUP)]

I congratulate and thank the hon. Gentleman for securing this debate. His choice of words, his tone, and the compassion in his voice are a real tribute to Clive Treacey, and to his family in the Gallery. The hon. Gentleman has paid a wonderful tribute to Clive, and it is right to put that on the record. I am an Elvis Presley fan as well; he could probably sing better than I can, but that is by the way. Does the hon. Gentleman agree that although nothing can bring back the life of this young man, his legacy can be life-changing for so many others? This checklist, rather than being best practice, must be rolled out as a recommended tool to each trust and area of this United Kingdom of Great Britain and Northern Ireland, as a tribute to Clive Treacey.

[Dave Robertson]

I thank the hon. Gentleman. That is my first intervention from him. He raises an important point, and when he asked that question, I thought back to a couple of weeks ago, when I was asked at a community event, “What gives you hope, Dave?”. I thought for a while. So often, we hear in this place stories of people who have gone through unimaginable hardship, but who somehow find the strength within themselves not to turn that into anger. They do not turn inwards; they turn outwards, and campaign to make sure that the same does not happen to other people. That is an example of what we have here. It is the very best testament to the human spirit that we see so many people who are able to do that.

Like a quarter of people with a learning disability, Clive had epilepsy. By contrast, one in 100 of the general population has epilepsy. Coupled with that, epilepsy is the second most frequently reported preventable cause of death for people with a learning disability, so not only are people with a learning disability more likely to have epilepsy, but the risks they face from their epilepsy are higher. The risk of SUDEP—that is what killed Clive—is more than three times higher for those with epilepsy and a learning disability than for those with epilepsy and no learning disability.

Tragically, Clive’s case is not an isolated example of these failures; this is a story that is far too common across the country, but there are things that we can do to change the story. Research suggests that annual health checks can significantly reduce the chance of premature death in people with a learning disability and autism who have epilepsy. Indeed, the chances of death were reduced by 84% for people with a learning disability and epilepsy who had a review of their epilepsy in the past 12 months.

That brings me to the Clive Treacey safety checklist. The checklist is a tool developed after Clive’s death, and an important part of his legacy. I place on record my thanks to Professor Mike Kerr and Professor Rohit Shankar for their work on the checklist, alongside the charity SUDEP Action, NHS England Midlands, and the Cornwall partnership NHS foundation trust.



The checklist was designed for commissioners and service providers, whether the care is provided in a specialist hospital setting or out in the community, and it outlines the steps that should be gone through annually, as well as whenever a patient moves between services or has a big change in their care, such as a new team looking after them. It recommends up-to-date health plans, genuine consultation with parents and families—not box ticking, but genuine consultation—and proper epilepsy training for staff. The Clive Treacey safety checklist is not a document that should be put in a drawer somewhere in an integrated care board, left alone and looked at once every so often when someone asks a question about it. It is a practical tool and the accompanying guidance, at just 24 pages long— for the NHS, a short story at best—is packed with information, and it is a document that can save lives.

Since Clive’s death, a number of NHS regions have reviewed the way that they care for patients with learning disabilities and epilepsy using the checklist. That includes the NHS in the midlands, where 11 integrated care systems carried out a detailed appraisal using the self-assessment tool developed by the charity Epilepsy Action, based on the work of Professor Shankar, to find the weaknesses in their services and take concrete steps to improve them. More recently, six integrated care boards in the north-west, north-east and North Yorkshire have done the same. It is detailed work, bringing health and care services together, and using joined-up thinking, which we do not hear enough about in Whitehall, to tackle the problem and normalise best practice. That best practice, like the Clive Treacey safety checklist, should be more widespread. I again pay tribute to Elaine and to Clive’s family more broadly for the work that they have done to drive this entire piece of work forward.

The problem is that we still have a postcode lottery. Different parts of the country do and do not follow the checklist; different parts of the country have and have not gone through that detailed work to update their practices. In this House, we cannot tolerate a situation where local outcomes are so varied, so I hope that we hear from the Minister what more we can do, both here in this place and through the Department of Health and Social Care, to ensure that people with learning disabilities are not dying of preventable causes, and to see the very best practice, as set out in the Clive Treacey safety checklist, adopted up and down the country, so that we can end this perverse postcode lottery.

Cross-border Healthcare

Jim Shannon Excerpts

Tuesday 4th November 2025 Westminster Hall

[Jim Shannon (Strangford) (DUP)]

It is a real pleasure to serve under your chairship, Mr Dowd, as always. On behalf of us all, I look forward to your deliberations. I thank the hon. Member for Brecon, Radnor and Cwm Tawe (David Chadwick)—I think I pronounced that right—for securing this debate. [Interruption.] Did I get it wrong? My apologies; the Northern Ireland accent gives it away nearly every time. While we are one United Kingdom, it is always important to remember the differences that we have in devolved matters, and in healthcare specifically—especially in Northern Ireland, where we have witnessed major disparities. It is a pleasure to make a contribution on that.

I want to talk about a cross-border health scheme that was used in Northern Ireland some years ago before our official exit from the European Union—although it appears that we never exited—and when we were all in the United Kingdom. The scheme meant that patients in Northern Ireland who had been on health and social care waiting lists for two years or more could apply to receive private treatment in the Republic of Ireland and claim reimbursement from the Northern Ireland Department of Health. When I was a member of the Northern Ireland Assembly and in my early years here at Westminster, I saw numerous examples of hip replacements, knee replacements and cataract operations being done down south because the patients had waited two years. The payment for the scheme then came from us in Northern Ireland. There are systems that work.

I thank the hon. Member for South Antrim (Robin Swann) for his contribution. He will probably be embarrassed by this, but I want to put on record that he was a great Health Minister when he was in the Northern Ireland Assembly, and I thank him for that. I never heard anyone say a bad word about him—and I talk to plenty of people, by the way—so I would say that he is an example of a Minister who really worked hard.

I know of a couple of constituents who availed themselves of the scheme and to say that their surgery was life-changing is an understatement. The hon. Member for South Antrim referred to his son. One of my constituents had a hip replacement and one had knee surgery. They could have been waiting up to 10 years for that surgery in Northern Ireland if they had not been able to avail themselves of the scheme with the Republic of Ireland. Those are some examples of how strategies like these work; I listened to hon. Members’ examples of similar processes in their constituencies.

I want to talk briefly about the importance of medical records. I spoke to the Minister about that beforehand, and others have referred to it. Through working closely with universities, I have witnessed a few examples where a young person lives in Northern Ireland and goes to Scotland or England for university. When they come back to Northern Ireland three or four years later, healthcare professionals cannot access their information as there is no shared provision for medical records. I hope that the Minister will forgive me, but it seems illogical not to have a system that takes that on board.

One of my staff members who went to Chester to study was in that exact scenario around 10 years ago. She had to travel back to England and pay £50 for a printout of her records to take to her GP back home. We must not forget that £50 was a lot of money for a student 10 years ago. It might be expected that the cost has now gone way beyond that.

This debate is really important, so I want to make sure that other hon. Members get their five minutes as well. There are clear examples of where cross-border health initiatives work and are beneficial to supporting people who are faced with extensive waiting lists and serious conditions that alter their day-to-day life. I look to the Minister—as I always do, because she answers us and listens to our requests—for a commitment to ensuring that our constituents have access to the care that they need, whether it be cross-border or within our healthcare systems in England, Scotland, Wales and Northern Ireland. Furthermore, hon. Members have shared experiences of the medical records issue within our constituencies. When so many people travel to different parts of this nation to study, more must be done to ensure that their records can flow smoothly and without hassle. My goodness, Mr Dowd, a life without hassle—it would be a miracle.

Moles: Histological Testing

Jim Shannon Excerpts

Thursday 30th October 2025 Westminster Hall

[Dr Danny Chambers (Winchester) (LD)]

It is an honour to serve under your chairpersonship, Ms Jardine. I congratulate the hon. Members for South Norfolk (Ben Goldsborough) and for Isle of Wight West (Mr Quigley) on securing this debate. I wish the hon. Member for South Norfolk all the best in his treatment. I have to say, it was hugely brave of him and emotive to hear him talk about the journey he is going through at the moment, and to hear him paying such tributes to all the staff involved in his care. I also thank Zoe’s family for coming here today, because it cannot be easy to hear people talk about this disease after everything they have been through.

Many of us will know, some from personal experience, how frightening it can be to face a possible or actual cancer diagnosis. When words such as “biopsy” or “diagnostic tests” enter the conversation, that provokes deep concern, and yet those tests, as everyone has been reiterating, are absolutely vital. Early diagnosis is the single most important factor in improving survival rates. The sooner any type of cancer is identified, the sooner treatment can begin, and the more likely the outcome will be favourable. The tests are very important for people’s mental health, because sometimes the test is clear: a person knows that, and knows there is no need to worry unnecessarily.

In an ideal world, someone who notices a suspicious mole or mark would call their GP; be seen within two weeks, as set out in the National Institute for Health and Care Excellence guidelines; if necessary, a biopsy would be taken; and, if cancer was confirmed, treatment would begin within 62 days. In an ideal world, that treatment would be available to everyone, regardless of their postcode.

We know that is not the reality for everyone, either in Winchester or the rest of the country. We know GP access is a growing concern. In Winchester, I regularly hear from my constituents that they are waiting weeks for appointments, which means we are falling at the first hurdle. The second hurdle—treatment within 62 days—is just as worrying. In Winchester, in July 2025, only 73.6% of cancer treatments began within 62 days, well below the operational standard of 85%.

The truth is that, at almost every stage of the process—from initial concern to diagnosis and treatment—we are letting too many people down. It is one of the reasons that the Liberal Democrats have been calling for a two-month cancer treatment guarantee for a long time now: a new target so that 100% of patients will start treatment within 62 days. We must also replace ageing radiotherapy machines and expand provision so no communities are left in what have rightly been called radiotherapy deserts. We do not want anyone to have to travel hours and miles when they are feeling ill for lifesaving care.

The last Government’s decision to close the National Cancer Research Institute, which had co-ordinated cancer research since 2001, was a grave mistake. One oncology professor compared this to

“turning off air traffic control and hoping the planes will be fine”.

We owe it to patients and their families to build confidence in the system, and that means faster access to GPs, earlier diagnosis, better treatment, proper investment in research and a comprehensive long-term plan to boost survival rates. I really welcome all the comments about regulating the private medical sector to ensure they are taking biopsies, as well as the regulation of sunbeds.

[Jim Shannon (Strangford) (DUP)]

I wanted to be here at the beginning, but unfortunately I could not because I had other things to do in the Chamber. I declare an interest—like the hon. Member for South Norfolk (Ben Goldsborough), I am going to get one of mine done very shortly, but in Northern Ireland the wait list is 56 weeks. If it is red-flagged, it is five weeks. There is anxiety and stress for everyone—not for me, but for all the others—because it is not about me but everyone else. Does he agree that the NHS, wherever it may be in this great United Kingdom of Great Britain and Northern Ireland, needs to ensure that those who have melanoma and a biopsy get the urgency that is absolutely critical? The Minister is in her place—there is no better person to answer these questions than her—and I look forward very much to what she says. Does the hon. Member for Winchester (Dr Chambers) agree that a concerted campaign across this great United Kingdom of Great Britain and Northern Ireland to address those issues might be a way forward?

[Dr Chambers]

I totally agree with those comments.

I will finish by paying tribute to one of my friends from vet school, Polly Birch. She was diagnosed with a melanoma in 2016 and had it removed, but in 2017, a few months after giving birth to her baby girl, Ada, she discovered it was metastatic, and she passed away. Her final post on social media was beautiful and moving. A couple of days before she passed away, she said:

“Appreciate the people around you, adventure with them, buy less stuff and go out and experience the world…and look after the bees.”

Finally, and perhaps most poignantly, I will quote Mary Schmich:

“If I could offer you only one tip for the future, sunscreen would be it.”

Ageing and End-of-life Care

Jim Shannon Excerpts

Thursday 30th October 2025 Commons Chamber

[Jim Shannon (Strangford) (DUP)]

I beg to move,

That this House has considered the ageing community and end of life care.

I thank the Backbench Business Committee for selecting this subject for debate. I declare an interest as the son of Mona Shannon, who is 94 years young and resides in a nursing home near Killyleagh in my constituency. Along with most other middle-aged sons or daughters—in my case, maybe a wee bit more than middle-aged—I am acutely aware that time is marching on and so are my mum’s needs.

The wee five-foot-nothing lady who kept three six-foot sons under control is no longer to live alone, but she is as sharp as a tack and I am thankful for the wisdom she gives me when I visit her twice weekly. Indeed, I suspect that every Friday and every Sunday I get a wee bit of wisdom—and maybe a wee bit of a telling off. She always likes to know what happens in this House and I am able to tell her that, but she will also give me her opinion, which I never ignore—indeed, I probably keep to it as much as I can.

Those visits to the nursing home, coupled with the focus on assisted dying, have highlighted to me with greater effect the changes that are needed in how we handle our older generation and their needs. I have spoken with representatives of both Sue Ryder and Marie Curie not simply to highlight the difficulties that most of us will be aware of, but to offer some ways that we can improve.

I am pleased to see the Under-Secretary of State for Health and Social Care, the hon. Member for Glasgow South West (Dr Ahmed), in his place. He and I are becoming a bit of a tag team, because on three days this week he has been the Minister responding to the debates that I have been involved in. The shadow Minister, the hon. Member for Hinckley and Bosworth (Dr Evans), has been there as well, so he should not be left out.

According to Marie Curie, in the next 25 years in Northern Ireland—I know it is not the Minister’s responsibility, but I want to give the stats, because they are important— there will be 20,500 people requiring this type of care, which is a rise of 32%. That includes a doubling of need by those aged over 85. It is also projected that the number of deaths in the community in Northern Ireland could rise by 74% during that time. Approximately 60% of the cost of care delivered through the independent hospice sector in Northern Ireland is reliant on charity. That is unsustainable. A new palliative care strategy for Northern Ireland that takes account of demographic changes and associated requirements for service transformation and investment is urgently needed.

That is what is happening in Northern Ireland, and in the mainland, things are very similar. Marie Curie has highlighted that as the population ages, more people will be living with and dying with multiple complex conditions. Every week in my office, when it comes to assisting those of my mum’s generation—and perhaps some of my own—with benefits, I see people with multiple complex needs more than ever. It is not just one thing that people are suffering from, but a multitude of things.

By 2050, the number of people in need of palliative and end-of-life care in the UK will rise by 147,000 to over 745,000 every year, and that increase will be driven by a growth in the number of people dying over the age of 85. These are really important stats, and we cannot ignore them; indeed, I believe the Minister will be focusing on them. Around 90% of the people who die each year need palliative care, but one in four of them is missing out. Older people, and particularly those with a non-cancer diagnosis, are at risk of missing out on the palliative care they need at the end of life. Research indicates that most people want to receive care at the end of their life and die at home. Elderly people tell me that all the time—they want to be at home.

[Sir Julian Lewis]

I am grateful to the hon. Member for giving way; I know he is pressed for time. The charity Together for Short Lives points out that where children’s palliative care is concerned, there is wide variation across different regions in the country. Is he afraid that this applies to the ageing population as well—that there is no consistency in the amount of palliative care available?

[Jim Shannon]

I thank the right hon. Member for his intervention and for the wisdom that he brings to all the debates he participates in. The Minister is listening, and he is a good Minister, so I know he will come back with the response we hope to have.

How often have we listened to family members who are past themselves with exhaustion and guilt about how they are caring for their loved one and who feel unprepared and yet unwilling to let them go into nursing care? With more support, their lives would be easier and their loved one’s life happier. This knowledge is why I was not surprised to learn that almost £12 billion of public funds was spent on healthcare for people in their last year of life, 81% of which was spent in hospital, with only 11% spent on primary and community care.

Access to a 24/7 palliative care advice and support telephone line has been recommended as a minimum service requirement for nearly two decades, but research shows that very little has happened, which underlines the issue that the right hon. Member for New Forest East (Sir Julian Lewis) raised. Only seven of the 42 integrated care boards in England said they have a dedicated 24/7 single point of access to palliative and end-of-life care advice, guidance and onward referral to other services, when needed—those are all important factors.

Despite the introduction of a new legal duty for ICBs to commission palliative care services in the Health and Care Act 2022, the urgency and importance of ensuring that everyone has the best possible care and support at the end of life has yet to be recognised as a national priority. I hope the Minister will be able to provide assurance on this, because that is what Marie Curie wants, it is what Sue Ryder wants, and it is what every mum, dad and family member wants as well.

[Lee Pitcher (Doncaster East and the Isle of Axholme) (Lab)]

The day I get to intervene on such an amazing Member is a remarkable day. I live in a very rural area where there are places with real socioeconomic deprivation. I know for a fact that there is huge inequality in those kinds of areas when it comes to palliative care. Does he agree that the Minister and the Government need to look at how to reduce that inequality over the next 10 years?

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[Jim Shannon]

The hon. Member is absolutely right. Politics aside, I want the Minister and the Government to do the job. It does not matter who the politician or the political party is; let us just give our people some hope. That is what I wish to see come out of this.

What assessment have the Government made of the need for a national strategy for palliative and end-of-life care? How will the Government ensure that palliative care specialists are included in neighbourhood health centres? What progress are the Government making on ensuring that every person with palliative care needs in the UK has access to a 24/7 support and advice line?

I believe that we can find a route towards an acceptable standard of life not simply for those who can afford private healthcare, but for all in our ageing communities. I understand that the Minister has a copy of my notes, and my seven points will be in there. To realise the 10-year plan objectives, which I have clearly said I support and want to see happen as soon as possible, palliative and end-of-life care must be recognised as a vital part of our health and social care system. Without making palliative and end-of-life care a priority for health reform, the Government will not achieve their bold ambition to provide more care in the community. I want the Government to achieve that ambition.

[Ms Julie Minns (Carlisle) (Lab)]

I spoke earlier to the hon. Gentleman to ask if he would take an intervention. When earlier this year my mum was placed on end-of-life care—she was put into the local hospital to receive that care—I had to repeatedly ask hospital staff to transfer her to our local, excellent Eden Valley hospice. It took three days for that request to be actioned. Does the hon. Gentleman agree that one change we could make is that, when someone in our hospitals is placed on end-of-life care, their families could be immediately apprised of the alternative provision that exists in our communities?

[Jim Shannon]

The hon. Lady is absolutely right—by the way, that is one of my seven points. We have spoken, but not exactly about that. The debate brings us together with our requests for the Minister and the Government; we are thankful for that.

Only 38% of those who died aged 85 or older received care from palliative care specialists, compared with 51.5% of those aged 65 to 84 and 59.3% of those aged 18 to 64. To the point made by the right hon. Member for New Forest East, most aged 18 to 64 spent most of their final months in a private home, but fewer than 50% of those aged 65 or older did so. One in seven people—15%—who died in hospital had been in there for less than 24 hours. When someone is coming to their last days, many complex needs are involved—there are also the problems for the family—but they will have to deal with two things in particular: pain, and probably breathlessness.

Almost two thirds of unpaid carers felt anxious most or all the time about the dying person’s illness or treatment. Shifting care from the hospital to the community would benefit older people, support the shift from hospital to community—analogue to digital—and prevent avoidable emergency care admissions. Those are all things that the Government must develop in a national strategy for palliative and end-of-life care.

The strategy must deliver on these seven points. First, an integrated whole-system approach is needed enabling patients at the end of life to move seamlessly through services as their health changes. Secondly, the Government must place palliative care at the centre of plans for neighbourhood health centres and ensure the inclusion of palliative care specialists. A key benefit of including palliative and end-of-life care in neighbourhood health centres will be the earlier identification of palliative care need and greater uptake of advance care planning.

Thirdly, the Government implement models of emergency and urgent care that can minimise avoidable accident and emergency visits. That would provide financial savings for the NHS as well as giving better care in a better system. That also comes to the input of the families, which is the very thing we all wish to see.

Fourthly, the Government need to strengthen the statutory guidance on the legal duty to commission palliative care services in the Health and Care Act 2022. Holding integrated care boards to account for the delivery of this duty must be part of that. Fifthly, we must introduce national quality standards for palliative and end-of-life care that must be met in all health and care settings. That would strengthen accountability while catalysing the 10-year health plan’s targeted shift from hospital to community for patients at the end of life. They must also support more equitable implementation of the vision set out in the ambitious national framework for local action.

Sixthly, there must be access to 24/7 support—the very thing being asked for—by creating a universal gateway to 24/7 specialist palliative and end-of-life care advice, guidance and support through NHS 111. In my constituency, we would say “yin, yin, yin.”

Seventhly, there must be a long-term, sustainable funding solution for palliative and end-of-life care that can reduce reliance on charitable fundraising and ensure parity of esteem for the NHS and non-NHS palliative care workforce. A transformation fund must also be created to invest in innovative and integrated models of care to meet different community needs. The Minister is probably saying, “My goodness, is it just seven points?”, but yes, I will stop at those seven, although I would like to comment on Sue Ryder if I may.

All of these stats can become figures on a page, but when I read them I think of the wee mummy lying on her bathroom floor after a fall, all night in tears; I think of my constituents who sob in my office, begging for help with their dying parent; I think of carers who are run ragged and know that a 15-minute call with that elderly person cannot possibly cater to their hygiene needs as well as feeding them; I think of district nurses who are late home because they would not leave their elderly patient upset after a wound change, and who made them a wee cup of tea and stayed for that comforting chat that time had not been allocated for.

Professor Jugdeep Dhesi, president of the British Geriatrics Society, said:

“Everyone should have access to high quality care until the end of their life, including palliative and end of life care when they need it. Sadly, this is not the case for many older people across the United Kingdom.”

Sue Ryder also asked me to highlight some issues. It is working to create a new ecosystem around palliative and end-of-life care, and to unlock hospital productivity through swiftly shifting care to the community in a progressive way that is sensitive to the resources available across the wider system, and focused on genuine collaboration at a local, place, and system level. The envisaged ecosystem would absorb patients from across the acute setting and increase referrals to community settings, helping our wonderful NHS to use its bed capacity more effectively, and relieving strain on the discharge system. The Sue Ryder model will shift care into the community by increasing hospice-at-home services and virtual wards, funded in line with national currencies and fast-track CHC reform. It is believed that this new approach to hospital care will develop dedicated care, alongside suites on NHS sites to provide compassionate, tailored care for those approaching the end of life, and to relieve pressure on hospital teams.

We must increase support for people in their own homes—that is what I want, what the hon. Member for Carlisle (Ms Minns) wants, and probably what we are all seeking. It is about expanding care in the community through partnerships, virtual wards, and increased hospice-at-home services to help more people die at home and reduce emergency admissions. We must aim to make full use of hospices’ expertise and space to support people with complex multi-morbidities and those in the last 1,000 days of life, preventing emergency admissions and helping people to live well.

I will keep to your timescale, Madam Deputy Speaker; I am coming to the end. The end of life is not a happy topic, but I believe it is a necessary conversation. We must open that conversation to ensure that people feel able to record their wishes for the end of life, so that more of their needs are met by the people involved in their care. We must ensure that there is information, and above all funding to deal with the growing pressure—the family issue that the hon. Member for Carlisle referred to—because how we treat the most vulnerable in our society is the measure that we will all be judged by.

I am no better than anybody else, but as elected representatives you and I, Madam Deputy Speaker, and everyone in the Chamber want to do the best for our people. Today we ask for the best for our people. I work alongside my mum to ensure that her last time on earth is the best we can make it, and I know I can safely say that it is the desire of this House and the Minister to provide that for every person in the United Kingdom of Great Britain and Northern Ireland. But we cannot do it without Government buy-in, or without help from the Minister, and from the Labour Government and those in power. The hospice sector is looking for a way to do things better, so I ask the Minister to join those who know this issue inside out, and find a route to help our ageing community and those in end-of-life care. That is also from Marie Curie, Sue Ryder and Professor Dhesi—all those people, and all of us as MPs on behalf our constituents.

Thank you for your time, Minister, and I look forward to your response.

[Several hon. Members rose—]

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[Jim Shannon]

I thank all Members who have taken part in the debate, including the right hon. Member for New Forest East (Sir Julian Lewis), and the hon. Members for Carlisle (Ms Minns) and for Doncaster East and the Isle of Axholme (Lee Pitcher). The hon. Member for Shipley (Anna Dixon) brought her knowledge to the Chamber, as did the hon. Member for Weston-super-Mare (Dan Aldridge) and I thank him for that.

It is good news that we are living longer, but there is a cost factor and we understand that. The hon. Member for Weston-super-Mare referred to hospices holding the community together, and he is absolutely right. They are always there and always available, and it is good to have that. The hon. Member for Epsom and Ewell (Helen Maguire) reminded us that there is better care in our latter days, and that is what we all need to see.

I am very pleased, as always, to see the shadow Minister, the hon. Member for Hinckley and Bosworth (Dr Evans), in his place. I always look forward to the contributions he makes in debates and enjoy his company. He spoke about cuts across all hospice services and the impact of that, which cannot be ignored. He made a comment about how end-of-life care is provided in Japan. There are lessons we can learn from other countries, which is an important point that I had not thought of.

I thank the Minister for his positive, heartfelt and honest response. He referred to moneys in his speech—some £100 million for hospices and some £26 million for children’s hospices, which the right hon. Member for New Forest East also mentioned. We are seeing palliative care and end-of-life care being central to the Government’s 10-year plan. Not one of us in this Chamber will not welcome that plan; if it brings forward what our people want, it is the right plan. With that in mind, I thank the Minister and I thank you, Madam Deputy Speaker, for your patience.

Question put and agreed to.

Resolved,

That this House has considered the ageing community and end of life care.