Terminally Ill Adults (End of Life) Bill (Money)

Jim Shannon Excerpts

Wednesday 22nd January 2025 Commons Chamber

[Dr Kieran Mullan (Bexhill and Battle) (Con)]

I am conscious of the limited time available and so will keep my remarks focused. I appreciate that it is not commonplace for Front Benchers to speak at length on money resolutions, but this is not commonplace legislation. I reiterate that His Majesty’s loyal Opposition have taken a neutral stance on the merits of the Bill, both in principle and in detail. The House has expressed its support for the introduction of assisted dying, and Members are currently considering the Bill in detail before it is presented back to the whole House for further consideration. The money resolution is a necessary part of associated legislation. Proponents of the Bill will welcome the Government bringing this forward, as it is not unheard of for Governments to withhold these resolutions in a manner that delays the progress of legislation.

[Jim Shannon (Strangford) (DUP)]

There are concerns from those of us who voted against the assisted dying Bill. I understand the process, and how it works with the money resolution coming forward, but on the day that this was finalised I asked a question, and the make-up of the Committee was 15 of those who voted for the Bill, and nine who voted against. A secrecy process has now been brought into the Bill, and we do not know what is happening. That is against the rules of this House. The second thing they have done is the issue of withdrawing the opinion of the judges, which is also out of order.

[Dr Mullan]

I hope that the hon. Member will appreciate that the money resolution is narrow in scope—I will perhaps bring the attention of the House to some tangentially related issues when it comes to the role of the Government in these proceedings.

As I said, proponents of the Bill will be glad of the progress that has been made, but this motion brings into sharp focus the fact that at some point the Government will need to fund, organise and provide assisted dying services to reflect any legislation that receives Royal Assent. As the Minister said, the money resolution will provide the legal basis for funding that service. I recognise that we are not yet at the stage when the Government can say with certainty what exactly those services and their associated funding will look like. There is time still for changes to be made, and we should not of course make an absolute assumption that any Bill will pass all its stages, as likely as that is, given the will of Parliament as expressed to date.

As the Bill proceeds, it will become increasingly important, and helpful to Members voting on future stages, to begin to have some idea of how the civil service and Ministers are envisioning enacting the legislation, not least in relation to the matter of resources before us today. The hon. Member for Spen Valley (Kim Leadbeater) estimated that up to 3% of adults may eventually choose assisted dying. In 2023 there were 577,620 adult deaths in England and Wales. If 3% of those were assisted dying cases, that would result in about 17,000 cases annually. Those are not insignificant numbers, and Members will recognise the considerable existing challenges with resources and personnel in the relevant areas of spending.

Although this is not a Government Bill, the Lord Chancellor has ultimate responsibility for ensuring the effective functioning of our legal system and judiciary, as does the Secretary of State for Health and Social Care for the delivery of this service, and how that will balance and interact with the other health services provided. I therefore have a small number of questions relating to resources, which I hope the Minister agrees will assist the House in better understanding how the Government are approaching such matters.

If information is not forthcoming today, it is crucial that the Minister sets out, in slightly more detail than he did earlier, at what point the Government will engage more fully with the detail of how they intend to resource the Bill, and start sharing their considerations. First, have the Government produced at the very least internal estimates of a potential range of the costs of delivering an assisted dying service, for both the NHS and the judiciary? If they have, will they share that with the House today? If they have not produced internal estimates, when do they anticipate doing so, and when do they intend to publish such estimates?

Secondly, have the Government identified potential sources of funding for the service? If they have, will that funding come from existing departmental budgets, or will it be allocated from outside currently allocated funding? In the latter case, where will those additional resources be drawn from? If the Government have not yet produced options for Ministers to consider on these questions, when will they do so, and when will they share them with the House?

Questions of resources relate to the impact on existing services of any decisions that the money resolution enables. The closer we come to the closing stages of the Bill, particularly ahead of any final parliamentary vote on a settled set of proposals, the more important it will be that Members get the benefit of answers to those questions, which can only come from the Government. It is important to say that it is perfectly legitimate for Members to decide that a better understanding of these issues is not an absolute necessity, and it will be for Members to decide whether they are happy to support legislation purely on principle. That may well be the position for many Members of the House, but I think most would agree that it would be preferable to be able to vote with, at very least, possible approaches and assessments of these matters, even if not definitive answers.

In conclusion, these are not merely procedural or technical issues. The Government’s tabling of this motion signals an acceptance that, should the Bill become law, the financial costs will need to be met, and that will not be a minor area of expenditure. This House has a duty to scrutinise every aspect of the Bill, and I urge the Government to provide a degree of clarity that only they can provide to assist Members in doing that. At this stage there has been a clearly expressed will of Parliament to introduce this service, and it is right for the Government to make legal provision for funding it in principle. However, the Government should enable Members to make decisions at future stages with as good an understanding as possible of how the legislation they may wish to support will translate into the real world.

--- Later in debate ---

[The Minister for Care (Stephen Kinnock)]

I thank Members for their continued contribution to the debate. The Government are of the view that the Bill is an issue of conscience for individual parliamentarians and it is rightly a matter for Parliament, not the Government, to decide. The money resolution allows the Bill to be debated in Committee, where its detail will continue to be scrutinised. As I have said, the Government will also be assessing the impact of the Bill and we expect to publish an impact assessment before MPs consider the Bill on Report. I therefore commend the money resolution to the House.

Question put and agreed to.

[Jim Shannon (Strangford) (DUP)]

On a point of order, Madam Deputy Speaker. The right hon. Member for North West Hampshire (Kit Malthouse) made a comment that I feel impinged upon my integrity. I have spoken to the right hon. Gentleman and he knows what I am referring to. I underlined and highlighted that the Terminally Ill Adults (End of Life) Bill Committee went into private session; some 15 Members, who support the Bill, voted for the private session and nine Members, who oppose the Bill, voted against the private session. The record must be corrected about what the right hon. Gentleman said about the comments I made about that. Facts are facts; they matter to me, as does my integrity.

[Madam Deputy Speaker (Ms Nusrat Ghani)]

Thank you, Mr Shannon, for letting me know you would be making a point of order. The Chair is not responsible for the content of Member’s speeches, but I remind the House of the advice in Erskine May on the importance of good temper and moderation in parliamentary language.

Auditory Verbal Therapy

Jim Shannon Excerpts

Tuesday 21st January 2025 Westminster Hall

[Jim Shannon (Strangford) (DUP)]

Thank you very much, Mr Western. I wish you well in your new role as Chair for Westminster Hall debates. I hope there will be many occasions on which you will call me to speak, although maybe not always first. It is a pleasure to see you in the Chair.

It is also a pleasure to see the Minister in his place, and I look forward to his response. I look forward to the contribution of the shadow Minister, who has a deep interest in health issues. I give special thanks to the hon. Member for Washington and Gateshead South (Mrs Hodgson) for bringing this important topic to Westminster Hall for debate, and for her compassionate introduction. She has a deep interest in the subject matter and in making lives better, which is of course why we are all here.

This issue affects children throughout this great United Kingdom of Great Britain and Northern Ireland. The information sent across by Auditory Verbal UK is a challenging read. It states:

“Deaf children in the UK currently face a lifetime of disadvantage without access to early and effective support to develop language and communication and less than 10% of deaf children who could benefit from Auditory Verbal therapy to learn to listen and talk can currently access it.”

That is the key issue and our key ask. This debate gives us the opportunity to raise awareness and make help available for all the deaf children who need support across this United Kingdom of Great Britain and Northern Ireland.

The fact that 90% of children who could benefit from this therapy to improve their lives, including their social, educational and future working lives—I suspect the Government are planning for children with deafness not just for today, but for their future engagement in working life—cannot access such help does not sit well with me or anybody else here. I know the Minister feels the same angst about the issue, which is why I very much look forward to his response to our requests.

It is clear that more must be done to facilitate access to auditory verbal therapy, which is why I am happy to support the hon. Member for Washington and Gateshead South and speak on behalf of the deaf children in my area and throughout Northern Ireland. The Consortium for Research in Deaf Education found that there were at least 1,428 deaf children in Northern Ireland. Some 77% of deaf school-age children attended mainstream schools, 1% attended mainstream schools with resource provisions—which there should be—and 21% attended special needs schools not specifically for deaf children.

This is a devolved matter, so the Minister does not have any responsibility for that, but those figures reflect what happens in the United Kingdom mainland. Some 36% of deaf children were recorded as having another additional special educational need; that has increased from 27% in 2021. The stats do not make good reading because they illustrate the shortfall and where there is need. My staff and my office have been in touch with the Department back home to chase up the matter.

An issue raised by the research was that the number of qualified teachers of the deaf in employment and working in a peripatetic role, in resource provision and/or in a special school or college not specifically for deaf children has decreased by 7% since 2022—just in the last two years—and by 40% since the survey started in 2011. There is a real need to train people to help to give young deaf children the opportunity to do better and get ready for employment in the future. I am keen to hear the Minister’s thoughts; perhaps there will be a role for an Education Minister in that work as well.

It is clear that there is a real need to focus on how we support these children, and that there is much more to be done. I suppose that is the ultimate reason for the debate. Some 80% of children who attend an auditory verbal therapy programme for at least two years achieve the same level of spoken language as their hearing peers—wow: that is why we need this; those are the results—rising to 97% of children without additional needs. They attain educational outcomes on a par with hearing children, and the majority attend mainstream schools. That truly speaks for itself.

With an investment of just over £2 million per year over the next 10 years, the Government could transform the landscape of auditory verbal provision and unlock £152 million of economic benefit. On the returns on investment, it is said that we have to speculate to accumulate; in reality, we have to spend time and money on the children to ensure that the economic benefit for all of us, but especially for them, rises to £11.7 billion within the next 50 years. We need to spend that money early and get the returns and, more importantly help people to prepare for life.

We must ensure that UK children have access to this most basic of support and that we give them the lifelong tools that are beneficial for them and for society as a whole. We are long past the days of believing that being born with a different ability means a different life; there are just too many success stories for us to believe that that is a death sentence for normality. I seek in this debate to ensure that young deaf children have the same opportunities as other young children. If we can manage that, I will be very pleased.

We know that a full life can be achieved, but the groundwork must be done in this place with sustained UK funding for auditory verbal therapy. I look forward to the Minister outlining how and when we can expect more for those who need it most. Has he had the opportunity, in the short time he has had, to make contact with the Health Minister in Northern Ireland and other responsible Ministers to see how we can exchange ideas, do it better together and raise awareness, which is very important?

Welfare of Doctors

Jim Shannon Excerpts

Tuesday 21st January 2025 Westminster Hall

[Peter Prinsley (Bury St Edmunds and Stowmarket) (Lab)]

I beg to move,

That this House has considered the welfare of doctors.

It is a pleasure to serve under your chairmanship, Sir John. Our NHS is described as “broken”. Gigantic waiting lists; ambulance delays; collapsed confidence that the NHS is there when we need it; poor access to general practice, dentistry and pharmacy; and, disgracefully, falling life expectancy in some places—these are all failures of the last Government, who could not look after the NHS despite record funding. Labour must mend the NHS; we have no choice. We invented the NHS. We fixed it before and we will fix it again.

In this debate, I speak about the people who work in the NHS. There are nearly 1.5 million of them, all contributing in their own way, but let me speak specifically about our doctors. Doctors in this country are in crisis. They are leaving the profession, retiring too soon and emigrating. Who is looking after our doctors? I come to this place as a surgeon. I am one of the very few surgeons ever elected to Parliament.

My dad was an RAF medic, who served in Aden in world war two before joining the newly invented NHS in 1948. He became a consultant physician in Teesside, where I grew up, and then a professor of geriatric medicine in Melbourne. He wrote an excellent account of his life called “New Ideas for Old Concerns”, which is full of fascinating accounts of his medical experiences during the war and later in the new NHS. It was a time of such hope and optimism, and I sincerely wish that we will be able to recreate that hope today.

[Jim Shannon (Strangford) (DUP)]

I spoke to the hon. Gentleman beforehand about bringing up an issue that I think is important. I commend him on securing this debate, as the welfare of doctors is so important. He will be aware that GPs in Northern Ireland pay the highest indemnity costs in the United Kingdom, and that adds to the primary workforce pressures. The Medical Defence Union is working with the Government in Northern Ireland to find a long-term solution. Does the hon. Gentleman agree that support would help the Northern Ireland Executive to address this issue and get our GPs and doctors in Northern Ireland on par with those here?

[Peter Prinsley]

I will speak of general practice shortly. My son is an A&E doctor here in London, and I am therefore one of three generations of doctors who have served the NHS continuously since it began; the welfare of doctors is personal for me. This Government have already done much for doctors, who are on the frontline and not the picket line for the first time in several years, but burnout, fatigue and stress are still very real problems that threaten to undermine the efficacy of our NHS.

Today’s new doctors graduate into the profession with debts of nearly £100,000. They immediately enter a lottery to be appointed to their first jobs as pre-registration doctors, sometimes ending up miles away from family and friends in places they have never visited before. Now that reminds me of another job that I just started. Young doctors are left immediately responsible for life-and-death decisions, sometimes with insufficient support. They are left scrabbling at the very last minute for somewhere to live—the on-call accommodation that my generation remembers has disappeared—and I have known several of them to sleep in their cars.

It has not escaped my notice that the new name for junior doctors is “resident doctors”. Resident doctors? That is the very last thing they are. If they are lucky, there is a place for them to rest, but many a time I have arrived to find a young doctor fast asleep from exhaustion at an office desk.

Obesity: Food and Diet

Jim Shannon Excerpts

Monday 20th January 2025 Commons Chamber

[Dr Opher]

Yes, I could not agree more. As I said in the debate on education, we should be careful about the food industry sponsoring school breakfasts. As I pointed out, there is no such thing as a free breakfast. Companies often make unhealthy and addictive food and get young people addicted to it, so we must be cautious.

I wanted a recipe to solve this crisis and what I am suggesting comes from evidence from Nesta and the House of Lords Select Committee. It should be mandatory that all stores report on the food healthiness of their sales. We need a fully independent Food Standards Agency. We should have a ban on advertising junk food, as has already been proposed, and there should be a watershed for children—that is incredibly important. As is planned in Scotland and Wales, there should be a ban on price promotions, particularly for unhealthy foods, ultra-processed foods and takeaways. We also need to put a lot more resource into breastfeeding and diet in pregnancies—remember the carrots—and we must regulate formula feeds.

One measure, which has worked with the drinks industry in reducing sugar, is a reformulation tax on foods that are high in sugar and salt. Supermarkets and food companies would reformulate their foods to avoid the tax, thereby making them healthier. My hon. Friend the Member for Slough (Mr Dhesi) mentioned breakfast clubs. There is a lot of evidence that free school meals and breakfast clubs reduce obesity. Where free school meals have been introduced in London, childhood obesity has been reduced by 11%. That is because the food is healthy and a healthy hot meal is really important, rather than high-calorie snacks, which are what a lot of packed lunches consist of. If we cannot have free school meals, because of financial problems, we should have auto-enrolment so that children who should be on free school meals actually get enrolled. That would benefit schools, too.

We must have mandatory front-of-packet labelling. I have never met a parent who does not want to buy healthy food for their children. The trouble is that they pick up a packet of cereal and it says, “High in iron and filled with vitamins,” and think it must be healthy. Nothing could be further from the truth, so we must have accurate labelling. Healthy school foods should be sourced locally. In Stroud, I have been working closely with local primary schools to encourage them to eat fresh, locally grown, highly nutritious food. I think the Government’s target is to procure at least 50% of food in schools from local sources.

Then there is the famous hospital food. I was recently in hospital with a relative, and I can tell the House that hospital food is not healthy. We had white-bread sandwiches and some crisps—that was our healthy snack. We must introduce healthy foods in hospitals.

Takeaways are another big barrier to healthy eating—there was a massive explosion in their use during the covid pandemic—and we need to include them in any regulation. As I have said, in Scotland and Wales a ban on takeaway price promotions has been proposed. On average, those in deprived areas order more takeaways than those in non-deprived areas. We certainly must not let takeaway outlets open near schools—that is a planning must.

I would also caution against the treatment of the obesity crisis with injections of drugs such as Ozempic, which could well turn out to be dangerous.

[Jim Shannon (Strangford) (DUP)]

According to today’s press, there is clear evidence of that. Apparently, 400 people across the United Kingdom who took Ozempic experienced poor health as a result. It is not for everyone, and the sooner that people know that, the better.

[Dr Opher]

The hon. Gentleman’s intervention reminds me of the GP I took over from—an old chap; very wise—who said, “Always be a few years out of date, Simon, because we never know what these new drugs are going to cause.” I think that is good advice—not that I am suggesting that doctors are out of date, of course.

Are we proposing the creation of a nanny state? That is the great fear of many people when they are confronted by controls of this kind, but let us look at what happened with the ban on smoking inside pubs. People—particularly in Ireland, but also in England—were saying, “This is crazy; it is never going to work”, but it worked fantastically well. We need to be aware of the vested interests of food companies, and we need to take radical steps.

--- Later in debate ---

[Jim Shannon (Strangford) (DUP)]

I thank everyone for their contributions so far. In particular, I thank the right hon. Member for Wetherby and Easingwold (Sir Alec Shelbrooke) for his contribution. It was a very personal story, and when we tell a personal story in this Chamber or anywhere else, it always carries more weight—that is not a pun, by the way. It carries a different focus, and I thank the right hon. Gentleman for sharing that story. We all thank him for sharing it, because it may inspire others outside this Chamber who find his words wise and helpful.

I am happy to speak in this debate. I declare an interest as a type 2 diabetic; my story of diabetes is personal to me, but it is one that many go through. I have experienced the health problems that a fast food diet brings. When I discovered I was a type 2 diabetic back in 2008, I weighed some 17 stone. I was in the Northern Ireland Assembly. We were at the Scottish Parliament in Edinburgh, and I had been to see my doctor, because I had some pains that men get in certain places and I had some concern over them. Dr Mageean phoned me in Edinburgh and said, “Jim, I’ve good news for you. Do you want the good news or the bad news?” I said, “Well, Dr Mageean, give me the good news first. That’ll get me on good form.” He said, “The good news is that you’ve got a heart like an ox. The bad news is that you’re a diabetic.”

Why had I become a diabetic? I did not recognise it, because I did not know what diabetes was. I was a diabetic probably a year before the doctor told me that day. I lived on Chinese meals five nights per week and two bottles of Coke. The sugar content was extreme, and I was 17 stone. Doctor Mageean told me, “Jim, it is up to you how you handle this.” His very wise words to me were, “Jim, it is up to you what you do, but if you do not do the right thing, it will progressively get worse.” I went on a diet that day, and I lost an extreme amount of weight. Along with that, I of course had fairly high stress levels.

I was able to make those changes and I lost 4 stone in weight, which kept me stable for a while. Then I went on to the Metformin tablets, the Linagliptin tablets, the Jardiance tablets and all the other ones. In the morning I start with nine tablets and I finish the day with five. Many others will do similar things, because that is how we keep alive and how we manage it. Coffee became a substitute. I drink copious cups a day. I used to drink 12 cups of coffee a day, and I have reduced that to six, mostly in the morning, with five before 11 o’clock. There are probably side effects from drinking too much coffee as well.

I tell all these stories to make the point that the right hon. Member for Wetherby and Easingwold made. He said that we have to do it ourselves, and we do. That is how it works, although I understand some people cannot. Over the years, I have helped numerous people with gastric band operations. They have all been successful, and it has helped those people. They had special circumstances, and they were able to lose weight. The hon. Member for Lagan Valley (Sorcha Eastwood) referred to food banks, and my food bank in Newtownards can give diabetic food to those who have diabetes, and those foods can help to manage diabetes.

I remember my mum telling me when I was a child, “Always eat your carrots, and your eyesight will never go astray.” Well, it did not work for me. It was not an issue for me, because I love carrots and I love vegetables. The carrots did not do me any good, but my mum did perhaps engrain in me the necessity to eat greens—the six a day, or five a day as it was. My lifestyle was unhealthy, which led to lifelong consequences. It also means that I understand how very easy it is for convenience and a lack of time to lead to an unhealthy option, which is why I would like to focus on how we can make healthy meals more accessible.

I am aware that it can be daunting as a parent with young children to try to work out healthy options that children will eat which are also affordable and do not take too long to make. It is clear that more work needs to be done to help young families, particularly to get the skills to cook and to create good eating patterns in families of all incomes. I am really pleased to see the Minister in his place and I look forward to his answers, because he is aways constructive in his answers. My son and daughter-in-law are staying with us and they have two children—Freya four and Ezra two and a half—and, as a grandfather, I have noticed that they had their children eating their vegetables from a very early age, which helps get that focus in place at an early stage.

One of my local residents associations, Scrabo residents association, in conjunction with Ards community network, have used funding to put on classes for families to learn how to cook in a cost-effective and healthy way. Their fun, innovative and informative classes helped with budgeting and planning, and they know they were successful. However, as so often, the Government funding for that process has no longer continued. There is therefore less of an incentive for those volunteer groups in the community network to do that, which is a problem. Can the Minister give any indication of whether he and his Department are prepared to target that area to help families understand that there is a way to save money on healthy food?

The latest data for Northern Ireland shows that 27% of adults and about one in 16 children, or some 6%, are living with obesity, and the development of obesity is strongly linked to deprivation. The hon. Member for Lagan Valley referred to deprivation, and it is so important for people to have a decent wage to buy the right food to look after themselves. Between 2011-12 and 2018-19, one in three or 36% of primary year 1 children living in the most deprived areas were more likely to be overweight or obese compared with those living in the least deprived areas. That represents a 12 percentage points increase since 2012, when the figure was 24%. It is now 36% of primary year 1 children, which is a real problem for us in Northern Ireland, although I am sure those figures are replicated on the mainland. Obesity also increases the risk of developing chronic diseases such as colon cancer, high blood pressure or type 2 diabetes, and it is linked to substantial direct and indirect costs estimated to be in the order of £370 million in Northern Ireland in 2009. What are those costs today?

I look to the Minister to consider the approaches that I have referred to. As he and others know, I always try to be constructive in my comments and in describing what we have done in Northern Ireland. What is available to help communities put on the training, and help people realise that healthy eating is not just for those who can afford to shop at wholefoods and organic groceries, but for all of us, and that it can be easier to cook such food in the daily struggle of feeding our families? Obesity is a ticking time bomb; we need to defuse it with a co-ordinated and joined-up approach, and funding is the foundation of that.

--- Later in debate ---

[The Parliamentary Under-Secretary of State for Health and Social Care (Andrew Gwynne)]

I am grateful to the Backbench Business Committee for ensuring that this debate took place, and I am particularly grateful to my hon. Friend the Member for Stroud (Dr Opher) for securing it in the first place. I am also grateful to all Members for their valuable contributions. We have heard speeches from across the House, including from my hon. Friends the Members for Bolton South and Walkden (Yasmin Qureshi), for Chelsea and Fulham (Ben Coleman), for Ilford South (Jas Athwal), for Swindon North (Will Stone), for Liverpool West Derby (Ian Byrne), for Washington and Gateshead South (Mrs Hodgson), for Worthing West (Dr Cooper), for Southend East and Rochford (Mr Alaba), for Blackpool South (Chris Webb), for Bathgate and Linlithgow (Kirsteen Sullivan), for Dudley (Sonia Kumar), for Dartford (Jim Dickson), for Mid Cheshire (Andrew Cooper) and for Bury St Edmunds and Stowmarket (Peter Prinsley).

On the Opposition Benches, we heard from the right hon. Member for Wetherby and Easingwold (Sir Alec Shelbrooke), who I have to say looks so healthy as a consequence of the medication he is taking. I remember what he looked like before—he is a shadow of his former self. We also heard from the hon. Members for Newbury (Mr Dillon), for Chester South and Eddisbury (Aphra Brandreth), for Caerfyrddin (Ann Davies), for Honiton and Sidmouth (Richard Foord), for Lagan Valley (Sorcha Eastwood), for Strangford (Jim Shannon) and for Stratford-on-Avon (Manuela Perteghella), and then obviously from the Opposition spokespeople for the Liberal Democrats and the official Opposition.

The United Kingdom has an obesity crisis. It poses serious challenges to our health, adds preventable pressure on the NHS, and restricts our economic productivity. I am reassured that none of us in the Chamber today underestimates the scale or importance of the task ahead, and we all recognise the need for action. I am proud that this Labour Government have already acted on manifesto commitments in several key areas, as I will outline, but I am also aware that much more needs to be done.

Over two thirds of adults are living with excess weight, and around 36% of children are living with obesity or are overweight by the time they leave primary school. That is appalling, but while it is shocking by itself, that average hides the deep inequalities we see in obesity. Children living in poorer areas are more than twice as likely to be living with obesity than those living in the least deprived areas. That has a huge impact on our lives, increasing the risk of many serious diseases—as we have heard—as well as exacerbating mental health issues and reducing the years that we and our loved ones can expect to live in good health. Almost 22% of all working-age people are economically inactive, and much of that is due to long-term health conditions caused or exacerbated by obesity. The cost of obesity-related conditions to the NHS now stands at £11.4 billion a year, and the cost to wider society is a staggering £74 billion every year.

I am so proud that we are committed to raising the healthiest generation of children ever. That means going further on prevention and tackling the drivers of obesity. Over recent decades in the UK, food and drink that is calorie dense, nutrient poor and less healthy has become cheaper. It is vital that we ensure our policies continue to drive companies to make food and drink healthier. That is why this Government took action to uprate the soft drinks industry levy in the October Budget. That levy has already taken thousands of tonnes of sugar out of the drinks we consume every day, and I give credit to George Osborne, the Conservative Chancellor in the coalition Government, who introduced that measure. Uprating the levy is a key part of keeping it effective and continuing to drive reformulation towards healthier products.

However, this is not just about what is in our food and drinks; less healthy foods are more heavily promoted, marketed and advertised than ever before. One third of the food industry’s advertising budget is spent on marketing confectionery, snacks, desserts and soft drinks, while only around 1% of that budget is spent on marketing fruit and vegetables. It is therefore not a surprise that our children want to eat those products. One study estimated that 6.4% of UK childhood obesity is attributable to junk food TV advertising. That is why this Government have already met our manifesto commitment to lay the secondary legislation required to ensure the ban on junk food ads targeting our kids comes in from October this year. This includes a 9 pm TV watershed for the advertising of less healthy food and drink products, and a restriction on paid-for online advertising of all these products.

[Jim Shannon]

The Minister is giving a very comprehensive response, and it is much appreciated. One of the things I asked for in my speech—I know he will do this, but I think we could probably do it better—is to look at initiatives in each of the regions of Scotland, Northern Ireland or Wales that could complement the policy driven from here. Is it the Minister’s intention to do that with the regional Administrations?

[Andrew Gwynne]

The advertising regulations of course cover the whole of the United Kingdom, but this Labour Government have a good working relationship with the devolved Governments in Northern Ireland, Scotland and Wales. We have the intergovernmental ministerial meetings, and we have been liaising closely on a whole range of public health measures, including the Tobacco and Vapes Bill, directly with ministerial counterparts in the devolved Governments. I want that relationship to deepen and mature because that is good governance across the whole United Kingdom.

We know that our chances of accessing healthy food depends on where people live. Children living in less affluent areas see five times more fast-food outlets on their high streets. That is why it is so important that strengthened the new national planning policy framework. Local authorities now have clearer powers to block fast-food outlets near schools, and also where children and young people congregate, to stop the relentless targeting of children and young people by the fast-food industry. Making the healthier choice the easier choice is a major part of achieving our shift to prevention. We will continue to look at ways to support people to make and sustain changes in their diet in line with the Government’s “Eatwell Guide”.

This may be a good point at which to clarify our position on ultra-processed foods. There are concerning associations between ultra-processed foods and negative health outcomes, including obesity. However, where the evidence is not yet clear is whether the negative health outcomes are due to processing or to these products tending to be high in calories, sugar, saturated fat and salt. I want to reassure hon. Members across the House that many ultra-processed foods are already captured by the existing healthy eating advice, policy actions and regulations relating to HFSS foods. Our scientific advisory committee on nutrition continues to monitor the evidence on ultra-processed foods, and we will commission further research where needed.

In my last few minutes, I will turn to a number of the issues that have been raised. First, just to reassure the shadow Minister, porridge oats will not be banned. The majority of porridge, muesli and granola products will not be affected by the restrictions, but some less healthy versions with added sugar, chocolate or syrup could be affected. To be in scope, products must fall within one of the categories of food and drink set out in the schedule to the advertising regulations and be defined as less healthy by the 2004-05 nutrient profiling model. For example, categories include but are not limited to soft drinks with added sugar, savoury snacks such as crisps, breakfast cereals, confectionery, ice cream and pizza. Despite recent media reports, the majority of porridge products will not be affected.

The right hon. Member for Wetherby and Easingwold made a really important point about stigma, and he is absolutely right that we really have to tackle stigma. Our genetics and our will power have not changed in the last 50 years. What has changed is the food environment and that we are bombarded with marketing for unhealthy foods. We already know that the issue is even worse in some of the poorer communities.

Finally, my hon. Friend the Member for Chelsea and Fulham and the hon. Member for Caerfyrddin mentioned accessibility to healthier affordable food. No child should live in poverty; that is why our ministerial taskforce is exploring all levers available across Government to give children the best start in life. We will tackle food insecurity by rolling out free breakfast clubs in every primary school and continuing to provide free healthy food during the holidays for children who receive free school meals. It is really important that we continue with that.

There is no silver bullet for obesity. This debate has shown that obesity is not just about health; it is about food, tax, education, business, employment, advertising and more. It is both a national challenge and a challenge within local communities. Our health mission is focused on shifting towards a more preventive approach which will benefit this agenda. In addition the Department for Environment, Food and Rural Affairs has announced an ambitious new cross-Government food strategy to work with the food industry to deliver on our goals for food security, health, affordability and the environment.

Obesity is a hugely complex challenge, but tackling it is a key part of achieving the change needed in this country. This Government are committed to taking effective action and I look forward to updating Members on what we do next.

Endometriosis: Women in the Workplace

Jim Shannon Excerpts

Wednesday 15th January 2025 Commons Chamber

[Gill Furniss (Sheffield Brightside and Hillsborough) (Lab)]

I am grateful for this opportunity to raise the plight of women with endometriosis and the everyday struggles they face in the workplace.

Endometriosis was first identified in 1860, but progress in improving the lives of women suffering from it has moved at a glacial pace since then. As the Women and Equalities Committee so accurately put it:

“Women and girls are missing out on their education, career opportunities, relationships, social lives and are having their fertility impacted because of neglected reproductive health conditions.”

This debate focuses on the impact of endometriosis on women in the workplace. I chose this specific focus of attention because an examination of all the issues facing women with this condition would far exceed the time constraints of an Adjournment debate; it would span an entire Parliament and more.

[Jim Shannon (Strangford) (DUP)]

I commend the hon. Lady for raising this massive issue. I have in my office a girl who joined as a 16-year-old and has been with me for almost 12 years. She got married on new year’s day. At the age of 28, she had menopause to try to help her endometriosis. As a caring employer, I obviously made sure that she had all the days off that she needed, but not every workplace will ensure that such women get the time off that they should. Does the hon. Lady agree that, although the debate will raise awareness, there is a role for the Government to ensure that there is training for businesses so that they understand their obligations?

[Gill Furniss]

I thank the hon. Member for that point.

The issue has been known about for a long time. The women’s health strategy, published in 2022, painted a picture of what workplaces should be like over the next 10 years, arguing that women should

“feel able to speak openly about their health and to be confident that they will be supported by their employer and workplace colleagues, with an end to taboos”

and that

“women experiencing women’s health issues such as period problems, endometriosis, fertility treatment, miscarriage and menopause”

must

“feel well supported in their workplaces.”

This is a far cry from the reality facing women in the workplace today.

Hospice and Palliative Care

Jim Shannon Excerpts

Monday 13th January 2025 Commons Chamber

[Mr Kohler]

I agree with the hon. Lady, and I will be coming to those points.

Today is not about rehashing the arguments made that Friday, but to allow Members time to discuss and reflect on this separate, but inextricably linked subject. It is not the last word on hospice and palliative care, but an important step in forging a consensus that I hope will unite us, no matter where we ultimately stand on assisted dying.

I began by referencing the crisis in hospice funding. Before I proceed further, I echo what the hon. Member for Spen Valley said and thank the Health Secretary for the £100 million in capital and digital moneys he announced last month. It will make a profound difference to the sector’s current financial position. I have been asked by individual hospices and Hospice UK to convey their genuine gratitude. In a similar vein, the Government’s recently announced commitment to extend the children’s hospice grant by a further year is deeply appreciated and equally vital to maintaining levels of service in this heartrending, but profoundly important part of the hospice movement. However, these are only short-term fixes and fail to provide the long-term funding and certainty critical to securing the future of the hospice movement.

Currently, only one third of hospice funding is provided by the Government, with the rest coming from charitable sources. That leaves hospices vulnerable to increased cost pressures, as can be seen in a recent Hospice UK survey, which found that at least 20% of hospices had cut services in the past year or were planning to do so. Becca Trower, the clinical director of the wonderful St Raphael’s hospice, which provides excellent care to residents in my Wimbledon constituency, was unambiguous when she told me:

“We have a funding crisis and we need to protect our hospice.”

Last year, that meant that St Raphael’s was forced to strip £1 million from its £6.5 million budget by ending its hospice at home service that provided vital care, advice and support to patients and carers in their own homes. It was a virtual ward, in fact, but not one that fitted within the NHS definition of such, which would have attracted the separate integrated care board funding available for such initiatives. In just one month, the cuts to the service directly impacted 26 patients, many of whom spent their last days taking up valuable hospital beds, dying in the one place they did not want to die and putting further pressure on the NHS. When the Government are aiming to move medicine into the community, it makes no sense for hospices to be forced into a position that achieves the opposite.

That contradiction is mirrored in the current funding settlement, where the Government have given with one hand and taken with the other by increasing employers’ national insurance contributions. The refusal to exempt charities will exacerbate the challenges confronting hospices. The amazing Shooting Star children’s hospice, for example, provides wonderful support for families in my constituency. It estimates that the change will add another £200,000 to next year’s cost base.

Hospices need certainty. Doubts over funding undermine morale and sap energy, making the recruitment and retention of staff another huge issue for the sector. To address these problems, the Government need to introduce a consistent, reliable funding mechanism that reflects the rising costs of care. Hospices consequently need to be included within the NHS’s much-anticipated 10-year health plan. In parallel, staffing needs must be addressed in the next NHS long-term workforce plan.

It should not be forgotten that hospices provide a variety of services in addition to palliative care, including emotional, psychological and spiritual support, as well as physio and occupational therapy, practical support, complementary therapies, respite care and bereavement services. Much of that is beyond the clinical, and not something that the NHS can be expected, nor can afford, to provide. That is why no one I spoke to in the hospice movement thought that hospices should be subsumed within the NHS. They provide a complementary service that extends well beyond the clinical, and to which a charitable funding model is more effective and appropriate.

[Jim Shannon (Strangford) (DUP)]

I commend the hon. Gentleman on setting the scene so well. One of the concerns that I and others in the Chamber have is the impact on the workers in hospices. It is not just about the financial implications, which are all part of the overall issue, but burnout. Staff are working long hours. They are volunteers in many cases, and they do that because it is what they are committed to. Does he share my concern that burnout in hospice care will have an impact on the NHS in the long term?

[Mr Kohler]

I agree with the hon. Member. We need more palliative care specialists and we need more training, and there is a real danger of burnout.

It is not just hospices that provide palliative care. When talking to specialists within and beyond the hospice sector, I have been struck by their commitment to giving patients a good death and their frustration that so many do not receive one. A palliative care doctor recently told The Guardian:

“I sometimes see patients…who come into hospital in unspeakable agony and want their lives to end. It is not because their pain cannot be prevented, but because they are not getting the care they need.”

A local oncologist told me:

“Demand for services is simply outstripping supply. The majority of patients are not getting their end of life care wishes met. The specialist palliative care teams are very good but there are not enough of them and they do not have adequate resources.”

Huge regional inequalities exist in the provision and quality of services due to the vagaries of the current funding model. The Health and Care Act 2022 included for the first time a statutory duty for ICBs to provide palliative care. However, it did not include a minimum standard of core provision, leaving it to what each ICB considers appropriate.

Freedom of information requests submitted by Hospice UK in 2023 found that adult hospice funding consequently ranged from just 23p to £10.33 per head of population across different ICBs. For children’s hospices, the variations were even starker. Research from the amazing charity Together for Short Lives found that spending per child with a life-limiting condition varied from an average of £531 in Norfolk and Waveney to just £28 in South Yorkshire.

--- Later in debate ---

[Jim Shannon (Strangford) (DUP)]

It is a pleasure to speak in the debate and to follow the hon. Member for Hartlepool (Mr Brash). I thank him for his personal story. Personal stories tell the story of the debate we have in front of us. During the last debate on assisted dying, the dire straits of our palliative care system were rightly put under the spotlight, so I am pleased to see this debate to address the system and the lack of funding.

I will refer to two charities in Northern Ireland that I have had contact with. One of them is Northern Ireland Hospice. It has highlighted that the Government fund approximately 30% of service costs, so the majority of its income relies on the good will and generosity of voluntary donations and other fundraising activities. That means 70% of the funding to provide its specialist palliative care for over 4,000 infants, children and adults with life-limiting conditions in Northern Ireland comes from the funding raised by volunteers. We owe a lot to Northern Ireland Hospice and its volunteers.

The people of Northern Ireland are incredibly generous when it comes to charitable giving, but when we take into account the cost of living crisis and the fact that it naturally reduces what people can give—it is a fact of life—we can see the concerns of the hospice sector. Indeed, when Northern Ireland Hospice believed that its funding would be cut by health trusts last year, it announced that it would have to cut the number of beds available in children’s hospices from seven beds all week round to six beds Monday to Friday and only three at the weekend, which represents a massive change in what it is able to do. That is not the news that we want to hear. It does not mean that fewer children need hospice facilities, but that costs have risen, the ability of fundraisers has decreased, and the Government have not enabled health trusts to make up the difference. Although I have underlined the situation in children’s hospices, the issue is replicated in adult care in every corner of the UK. The hon. Member for South Antrim (Robin Swann) is here. He is a former Health Minister of Northern Ireland, and whenever Northern Ireland Hospice needed help, he was able to allocate funding to get it over that hard patch. I thank him on the record for all that he did to make that happen.

Funding for palliative care is simply not sufficient. I referred to burnout when the hon. Member for Wimbledon (Mr Kohler) very kindly let me intervene earlier. Medical staff whose loyalty and passion for the job keeps them in post, doing overtime or working unpaid to provide cover, are exhausted and unable to carry on. Marie Curie says that one in four people will die without the right care and support. Far too many people are dying in avoidable pain, in poverty, and alone. By 2048, the need for end of life care will have risen by up to 25%, so the challenge for tomorrow is even greater than the challenge for today—over 730,000 people will need care every year. We know that that crisis is looming, and now is the time to make changes for our loved ones and our constituents. Like other Members, that is what I am asking the Minister to do.

--- Later in debate ---

[Stephen Kinnock]

The Government announced a commission on the future of adult social care. A separate commission was announced by my hon. Friend the Member for York Central (Rachael Maskell) on palliative care. We will certainly monitor the findings of that commission very closely.

We will set out details of the funding allocation and distribution mechanisms for both funding streams in the coming weeks.

[Jim Shannon]

In my contribution, I made the House aware that the Northern Ireland hospice has to cut its beds from seven to six for five days of the week, and at the weekend, there are only three. The Minister knows that I respect him greatly. It is all very well to have capital money available, but there has to be money to run the system and provide beds. Otherwise, we can buy beds, but might not be able to keep them and run a service. There must be something seriously wrong with what he is putting forward.

[Stephen Kinnock]

As I said in a previous answer, hospices face a range of pressures that financial contributions from the Government will help to ease. The funding will, of course, have a knock-on impact on hospices budgets in the round.

In spite of the record-breaking package that we have announced, we are certainly not complacent. There is more work to be done, and through the National Institute for Health and Care Research, the Department is investing £3 million in a policy research unit on palliative and end of life care. The unit launched in January 2024 and is building the evidence base that will inform our long-term strategy. A number of hon. Members requested a long-term strategy and plan, which is sorely missing after 14 years of Conservative neglect and incompetence. I agree that we need a long-term plan, and assure Members that conversations are taking place between my officials and NHS England. The research needs to be based on evidence and facts, which the unit will help us to get.

Oral Answers to Questions

Jim Shannon Excerpts

Tuesday 7th January 2025 Commons Chamber

[Andrew Gwynne]

My hon. Friend raises an important point. As part of the Government’s health mission, we are producing a five-point plan for prevention, and alcohol harms is one of those areas. I hope to be able to update her and the House in due course on the actions we will be taking to drive down the prevalence of alcohol harms and other addictions, because they are costing lives and causing misery in communities. That is why this Government are determined to tackle these public health problems.

[Jim Shannon (Strangford) (DUP)]

I thank the Minister for his answers. While there are community addiction services for those over the age of 18, worryingly, across this great United Kingdom, those under the age of 18 are succumbing to alcohol addiction, too. There does not seem to be any provision for them. May I ask the Minister genuinely and helpfully what provision there will be for those under the age of 18, because addiction problems are rising among the younger generation?

[Andrew Gwynne]

The hon. Gentleman raises an important point. This Government are committed to having the healthiest generation of children ever. That means we will have a concerted effort on a whole range of health issues that determine the health and wellbeing of young people, which will hopefully ensure that they become healthy adults as a consequence. Alcohol harms are certainly one of the considerations we will be looking at.

NHS Backlog

Jim Shannon Excerpts

Monday 6th January 2025 Commons Chamber

[Jim Shannon (Strangford) (DUP)]

I commend the hon. Lady on bringing forward this debate, and on being so consistent and assiduous on this issue. I understand that she will come on to the Lib Dem manifesto, which a lot of us in this Chamber, whether Lib Dem or not, can agree with. In Northern Ireland we have the health and social care board, which has been working on various strategies to reduce the backlog, but the scale is truly significant. Does the hon. Lady agree that, collectively, England, Scotland, Wales and Northern Ireland should look at all the recommendations and bring them together so that this great United Kingdom of Great Britain and Northern Ireland can benefit collectively?

[Helen Morgan]

The hon. Gentleman always makes an excellent contribution to our debates. He is right that we should look at best practice in Northern Ireland and the devolved nations, as well as in England, to get the right solutions for the problems that we face. I hope colleagues will forgive me as will not take any more interventions because we are tight on time and a lot of people want to speak.

We have reached a point where patients suffering heart attacks are being advised to find their own way to hospital. How can that be acceptable? Once patients get into A&E, they are confronted with the brutal reality of the backlogs. The reality means that only half of patients arriving at A&E in Shropshire were seen within four hours in November. The statistics are shocking, but individual people with serious problems suffer as a result—people such as my constituent with a pericardial effusion, who was deemed fit to sit and left in a chair for more than 24 hours before finally being taken on blue lights to receive the care she needed.

Staff in this situation are so overworked that the standard of care that they give is below what they would like to provide. The patient’s dignity is compromised, and staff are being driven from the service because they are unable to provide the care that they desperately want to. Until the Government put a plan in place to solve the workforce crisis, there is a risk that these scenes will continue to happen. In my local hospital trust alone, a total of 854,839 hours of nursing shifts went unfilled in the 12 months to October.

Liberal Democrats are calling for a qualified clinician in every A&E waiting room to ensure that anyone whose condition is deteriorating is treated more urgently. We are also calling on the Government to publish accessible localised reports of ambulance response times so that the delays that blight places such as North Shropshire and other rural areas can finally be addressed.

A key reason for the emergency backlog is that every day, around 12,000 hospital beds are filled with patients who could leave if they had a care package in place. That is the equivalent of around 26 hospitals being out of action every day. That is why Liberal Democrats have been banging the drum for social care. Without capacity in the care system, beds will remain blocked, A&Es will stay clogged and ambulances will continue queuing outside hospitals.

I am pleased that the Government have finally listened to our call for cross-party talks to fix a broken care system, and I look forward to constructively engaging with them throughout that process, but we cannot afford to wait three more years for this plan to be enacted. I hope that the Government will reconsider their timescale and get the review done as soon as possible, so that the care sector can see the long-term cross-party commitment to reform that it so drastically needs.

Part of solving this issue is supporting preventive measures, which stop people needing secondary care in the first place. I recently visited the North Shropshire charity Energize and saw the work of its Elevate programme, which works to improve fitness, balance and co-ordination in elderly and frail patients. It has had some amazing achievements: I met a gentleman suffering from Parkinson’s who had been falling five times a week before he started his programme, and who is now falling only once a week. Of course, it would be great if he did not fall at all, but I am sure everybody would agree that that is a huge improvement. It is estimated that for every £1 invested in that programme, £26 is saved, so it is an area where we can really make a difference to the crisis in the NHS.

Few backlogs have as much impact as those in cancer diagnosis and care. Nationally, the target of 85% of patients receiving treatment within 62 days has been missed every month since December 2015. At my local hospital trust, fewer than two thirds of patients began treatment within the 62-day target. Improving this situation is integral to increasing survival rates. It is also key to restoring patient faith in the NHS, stopping cases like that of my constituent, whose family felt completely failed by the NHS after he waited almost a year for treatment after first presenting with bowel cancer symptoms. Could the Minister clarify whether the Government remain committed to meeting the cancer waiting time targets this Parliament, as promised in their manifesto, and whether those targets will be included in their new national cancer strategy?

To achieve that improvement, we need to address key workforce issues, notably in radiology, where there is a 31% shortfall of consultants across the country. Again, in rural places such as Shropshire, it is recruitment and retention issues that have caused the sharpest problems. Throughout 2024, it became normal in Shropshire to wait months for cancer test and scan results, with patients in my constituency only receiving their results after their next scan was due to have happened. I am pleased to report that under new management, this backlog is now in the process of being cleared. However, that is happening due to overseas outsourcing, which is not a sustainable long-term solution for this country. We need to retain, recruit, and retrain more radiologists and ensure that enough modern equipment is in place across the country so that no one has to wait too long or travel too far to get the scans that they need. Will the Minister address whether that will also be part of the national cancer strategy?

We cannot talk about backlogs without talking about mental health. According to the Darzi review, 1 million people were waiting for mental health services by last April, over 340,000 of whom were children—children whom we as a nation need to protect, because they are our future. Waiting times for child and adolescent mental health services are shocking in every constituency in the country; from ADHD diagnoses to anxiety, depression and eating disorders, far too many people are not getting the urgent support that they need. A headteacher of a school in north Shropshire told me that in recent years, nine students at his school have lost a parent to suicide, yet there are no community mental health services in the town.

Along with the Government, Liberal Democrats would introduce a mental health professional in every school. However, we are also calling on the Government to improve early access to mental health services, and to cut mental health waits by establishing mental health hubs for young people in every community and introducing regular mental health check-ups at key points in people’s lives when they are accessing the NHS, so that we can pick up those problems and intervene early.

Meanwhile, GP surgeries are also struggling to handle the growing pressure being exerted on them. More than a million patients who tried to contact a GP last year could not get through. If patients cannot access primary care, they seek help elsewhere, or they do not seek help at all; in both cases, this creates further problems down the line. In Shropshire, we have lost 14.3% of fully qualified GPs in the past eight years. A young constituent of mine had to wait seven weeks just for a telephone consultation—a wait that would have been even longer if they had wanted an in-person meeting. Liberal Democrats would give everyone the right to see a GP within seven days, or within 24 hours if it was urgent, using 8,000 more GPs. If we can improve primary care, we can reduce backlogs across the health and care system.

Yet the Government have pledged to increase national insurance charges that could cost GP surgeries the equivalent of 2 million appointments a year. This hike will also hammer pharmacies, with more than a third of pharmacy owners now worried that their business may not survive the winter. If pharmacies close, backlogs will simply increase elsewhere. If we can keep them open and improve services such as Pharmacy First, we can reduce pressure across the system. We would like the Government to commit to removing the increase in employer national insurance contributions to support these crucial community services, so that fewer people end up in hospital and more people are treated in the community, where they will get better and quicker treatment.

Meanwhile, in dentistry, where practices will also be hit by the national insurance rise, there is not so much a backlog of care as an absence of care. Some 6 million adults in the UK are not registered with an NHS dentist and, in places like Shropshire, it is becoming almost impossible to find one, with increasing numbers of practices handing back contracts that have become unsustainable. One of my constituents has been trying to register with an NHS dentist for five years, while another pulled out his own tooth with a pair of pliers.

The Labour Government must show that they understand the problem better than the Conservative Government, whose solution was to introduce golden hello payments. They have been in place in Shropshire for years and they have not achieved the desired outcome. With that in mind, will the Minister outline the Government’s plans in relation to the new patient premium and offer assurances to dentists that any changes will be communicated, so that practices can plan and prepare to best serve their patients? NHS contracts need to be reformed so that we can end the use of the term “dental desert”, end DIY dentistry and guarantee access to people who are in pain.

In conclusion, the Liberal Democrats believe that people should be able to take control of their own lives and their own health. That means everyone should be able to access the care they need, where and when they need it. We welcome much of today’s announcement on elective care, and we welcome today’s announcement on social care, but we are concerned that the decision to hike employer NICs could worsen the crisis in the NHS. Hitting GPs, hospices, dentists and social care providers with higher taxes makes no sense. The Treasury is giving to the NHS with one hand, but taking away with the other. We also want much faster action on social care. As I said, I look forward to engaging constructively with the Minister to come up with the consensus we need, but we cannot afford to wait until 2028 for improvements to be made.

The Conservatives’ legacy on the NHS is that it is on its knees. The Liberal Democrats understand that there is no magic quick fix to change that, but to give people the care they need and deserve we must look at the measures needed for the whole service, giving equal priority to both heart attacks and hip replacements.

Health and Adult Social Care Reform

Jim Shannon Excerpts

Monday 6th January 2025 Commons Chamber

[Wes Streeting]

That is an excellent question. Having put in place funding to ensure that there are 1,000 more GPs on the frontline before April, and having announced just before Christmas a significant uplift for general practice, I hope that in the first six months of this Government, we have sent the strong message to people who aspire to long careers in medicine that general practice has a huge role to play in the NHS in the 21st century. It is an exciting place to be, but I recognise that we have to fix the front door to the NHS to make it more attractive. The situation is even worse than my hon. Friend has described, because when the Conservatives left government, there were qualified GPs unable to find jobs, at a time when patients were unable to find GPs. We got to work on that issue within weeks of taking office, and we will do more over the next 12 months.

[Jim Shannon (Strangford) (DUP)]

It is good to hear the latest announcements on overhauling the increasingly costly care for older and disabled people, and I very much welcome what the Secretary of State has said. I understand that this will happen through a three-year review, and that we will be clearer on the plan to introduce this in 2028. Health is devolved to Northern Ireland, but thousands of care packages in Northern Ireland are not fulfilled. What can he do to assist Northern Ireland in achieving its goals? Goals that are set here for England and the United Kingdom need to be in place in Northern Ireland as well.

[Wes Streeting]

The ministerial team and I have enjoyed working with counterparts in the devolved Governments over the last six months, and we will continue to do that. Thanks to the decisions that the Chancellor took in the Budget, we see significant investment in health and care services here in England, and the Barnett consequentials will create a rising tide that will lift all ships across England, Wales and Scotland. I might even say that all roads lead to Westminster. I say this to Scottish National party colleagues: down the road to Westminster lie the resources for the SNP Government, so they do not have an excuse not to act.

Hospice Funding

Jim Shannon Excerpts

Thursday 19th December 2024 Commons Chamber

[Karin Smyth]

As the hon. Gentleman knows, this Government have allocated an extra £12 billion in this year for the health and care sector. The full allocation to cover the entire area of health and social care will be announced in the new year.

[Jim Shannon (Strangford) (DUP)]

It would be churlish of anybody in this Chamber not to welcome the money that the Government are setting aside. I thank the Minister and the Government for that announcement, but what discussions has the Minister had with Cabinet colleagues to secure exemptions from national insurance contribution hikes for hospice workers? I think of Marie Curie—I spoke about that charity yesterday in Westminster Hall, and the Minister probably has a Marie Curie in her constituency. We know what that charity does. Unlike the mainstream NHS, it will not be exempted, yet it carries out the end of life care that the NHS simply cannot provide. Further, what help will be provided to carers in the community? The withdrawal of their service would leave the care system decimated.

[Karin Smyth]

The hon. Member makes an excellent point about carers and their support. We made announcements about that in the Budget, and we will make more general announcements about allocations in the new year.