Goods Trading: Great Britain and Northern Ireland

Jim Shannon Excerpts

Tuesday 15th September 2026 Westminster Hall

[Jim Shannon (Strangford) (DUP)]

I commend the hon. and learned Gentleman on introducing the debate. One of the greatest issues we all face is the crisis in the supply of veterinary medicines following Brexit. They continue to be subject to additional EU regulatory requirements, and farmers continue to face potentially serious consequences for animal welfare and the responsible management of antimicrobial resistance. Does the hon. and learned Gentleman therefore agree that Northern Ireland cannot continue to be economically cut off under the regulatory burdens placed on farmers and vets? Those burdens must be reduced.

[Jim Allister]

I think all that is self-evident, but sadly, we have a Government who are deaf to those issues, and sadly, the hon. Member’s party seems to have come to terms with them, because in Stormont, the DUP is now prepared to implement the Irish sea border and the Windsor framework, but let me be very clear: the integrity of our single market has been utterly destroyed.

Among the practical consequences of that are unimaginable levels of trade diversion. We were once a wholly integrated part of the United Kingdom. Once barriers are erected, trade is discouraged. Various surveys show that that has happened. From the Federation of Small Businesses survey, we know that 34% of GB companies that used to trade with Northern Ireland have ceased trading. Why? Because this paperwork and this checking is such a disincentive that it is not worth the bother.

This week, I received figures from the Department for Transport that I find quite astounding, and they make the point with great clarity of what it means to have had trade diversion. According to the Department for Transport, in 2022, 8.6 million tonnes of goods were distributed in Northern Ireland by GB-registered vehicles—in other words, GB haulage companies bringing goods into Northern Ireland. Last year, that figure fell to a staggering 2.2 million tonnes. In just four years, there has been a fall of 75% in the quantum of goods coming from GB to Northern Ireland by GB-registered vehicles.

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[The Minister for Science, Innovation and Investment (Chris McDonald)]

It is a pleasure to see you in the Chair, Dame Siobhain. I congratulate the hon. and learned Member for North Antrim (Jim Allister) on securing this important debate—its importance was reflected in the urgency and tone of his remarks. I thank him for his comments, particularly those on the importance of the Union, with which I agree.

That is why I would like to start by very much refuting the hon. and learned Member’s assertion that it is the policy of this Government to enable Northern Ireland to step out of the United Kingdom. I am sure that he does not fully mean that, although he is clearly very concerned about these issues of trade. I acknowledge those concerns, but the situation is more complex than his remarks have perhaps allowed for. Clearly, if there were a simple solution to this that would deliver all the benefits he has described for Northern Ireland, the Government would want to move to that solution, but it is more complex than that. Through my remarks, I will try to address the many points that he and other colleagues have raised, and I will perhaps be able to elaborate on some of that complexity.

First, I will address the hon. and learned Member’s point about unfettered access. The Government remain fully committed to unfettered access for qualifying Northern Ireland goods moving from Northern Ireland to Great Britain. I also want to be clear about the importance of the UK internal market and Northern Ireland’s place in that market. The Office for the Internal Market highlights the importance of the internal market and of the sales to the rest of the United Kingdom, equivalent to around a quarter of Northern Ireland’s economic output in 2021. In 2024, which is the last year for which we have published data, Great Britain accounted for 52% of Northern Ireland’s trade in goods, and that figure is broadly the same as it was in 2018, indicating the robustness of Northern Ireland’s place in the United Kingdom internal market.

[Jim Shannon]

Shops in Newtownards that have always bought their goods from a certain company across the water have been unable to do so because of the bureaucracy. By not being able to trade with that company directly, they are not able to offer the prices they once did. Nurseries and those that buy plants and seeds have also been restricted in what they do. DIY stores have been restricted by the bureaucracy and their ability to be competitive has been reduced. Has the Minister given any thought to that? I write to the Secretary of State for Northern Ireland regularly about these matters, although not to the Minister in particular, but has the Minister had a chance to understand the issues and problems that my businesses in Strangford are feeling?

[Chris McDonald]

I thank the hon. Gentleman for raising that. He raises concerns around bureaucracy and paperwork, essentially, for small businesses, and the hon. and learned Member for North Antrim mentioned our own House of Commons gift shop as well for low value items. I very much want to come on to this point in my speech, so I am grateful to the hon. Gentleman for raising it.

I will start by talking about the general performance of Northern Ireland trade with the rest of the United Kingdom. Northern Ireland’s goods exports within the UK and with the European Union have been strong. In fact, Northern Ireland’s exports to the European Union have outperformed the rest of the United Kingdom, increasing since 2019, whereas in the rest of the United Kingdom, exports have decreased in that period. It is therefore important to note that Northern Ireland does benefit from being a fundamental part of the UK internal market and having unique access to the EU single market. Of course, I do recognise—and the point was made by the hon. and learned Member for North Antrim—that this experience varies across sectors, companies and individual constituents, which is why this debate is so valuable. I will go on to talk more about that.

I understand the challenges around this, but public authorities have a statutory requirement to have special regard for Northern Ireland’s place in the United Kingdom internal market under section 46 of the United Kingdom Internal Market Act 2020. That guidance gives real statutory power to ensure that policymakers within the United Kingdom actively consider Northern Ireland’s place in the internal market when they are implementing the Windsor framework or making policy involving the movement of goods in the United Kingdom. Where that is the case, the statutory guidance ensures that those policymakers must have special regard for Northern Ireland’s place in the UK internal market.

Most importantly, one part of having special regard means the need to facilitate the free flow of goods between Great Britain and Northern Ireland, with the aim of streamlining trade between the two, and maintaining and strengthening the integrity and smooth operation of our internal market. The guidance ensures that policymakers must give that special regard considerable importance and weight above other factors in policymaking. That represents how this Government have implemented a key commitment in the “Safeguarding the Union” Command Paper published under the previous Government to ensure that proper process is in place to always consider both Northern Ireland’s place in the UK internal market and the flow of goods between Great Britain and Northern Ireland.

Members have spoken in detail about the Windsor framework and the challenges it brings. I would like to stress that the Government are wholly committed to the Windsor framework. The framework supports the peace and prosperity brought by the Good Friday agreement, one of the proudest achievements of our last Labour Government, and it plays a vital role in ensuring the smooth flow of goods between Great Britain and Northern Ireland, but of course I recognise the concerns raised by hon. Members.

It is clear that the Windsor framework is delivering benefits and smoothing the flow of goods between Great Britain and Northern Ireland. I have already noted how the Northern Ireland-Great Britain supply of goods has been maintained through the implementation of the framework. Over 15,000 traders are now signed up to the UK internal market scheme, and more than 1,100 operators are registered for the Northern Ireland retail movement scheme and the Northern Ireland plant health label. Northern Ireland traders are benefiting from these facilitations, and businesses are choosing to invest in the dual market access that Northern Ireland uniquely offers.

The hon. and learned Member for North Antrim is concerned about the level of investment and believes that businesses will not wish to invest in Northern Ireland for that reason. On my recent visit to Northern Ireland, however, I saw significant investment from Boeing, Airbus, Navantia and many other businesses. It is clear that this is not a uniform experience across all businesses, but it has been possible for Northern Ireland to attract significant inward investment.

Vascular Sector Reform

Jim Shannon Excerpts

Thursday 10th September 2026 Westminster Hall

[Jim Shannon (Strangford) (DUP)]

I beg to move,

That this House has considered the potential merits of reform of the vascular sector.

It is a real pleasure to serve under your chairship, Dr Huq. Last night, you were in the Adjournment debate, and today you are chairing a Westminster Hall debate. Your talents are incredible—well done to you. We appreciate all the efforts that you make for us in this House in all ways.

It is, too, a pleasure to introduce this debate on something I am particularly interested in. A number of people in the Public Gallery have much more medical talent than I have—I am interested in the subject, but in the Gallery are some of those who carry out some of the operations and so have a deep interest. I pay a special thanks to Roger Greer, who is the administrator for the all-party parliamentary group for vascular and venous disease, which I chair—I declare that interest. That gentleman and others with him make the effort on this subject matter, which I am interested in.

Back home, I have had the opportunity to visit the Royal Victoria hospital. On vascular health, unfortunately some of the statistics for Northern Ireland, which I will mention, are worrying. I suspect that they will illustrate where we are in Northern Ireland, and that what is happening there will be mirrored here on the mainland.

It is a real pleasure to see the Minister in his place. We had a wee chat beforehand, and I think—although I am not a prophet or the son of a prophet—we will all agree on the subject matter of this debate. I very much look forward to the Minister’s response, and to his encouragement in some of the responses that we need as we move forward.

I am speaking on an issue vital to thousands of families across our great nation, the United Kingdom of Great Britain and Northern Ireland, and yet one that too often remains hidden in the shadows of our health service. I just said that to the Minister before—this is one of the issues that is slightly hidden. We might not always know everything about it, unless we have a particular interest. I know that other Members present—I thank them for coming—will have a particular interest in the pressing need for comprehensive reform of lower limb vascular care.

This debate gives this Westminster Hall Chamber the opportunity to highlight an often forgotten health issue. Vascular disease affects the very network of life within us, the arteries and veins that carry blood around our bodies, and encompasses peripheral arterial disease, chronic limb-threatening ischaemia, venous disease and devastating diabetes-related foot complications. I declare an interest as a type 2 diabetic, although I Richard in the Gallery might say, “Well, after that cake you had the other day, perhaps you’re not as careful as you should be with your diabetes”—but I do try to be careful and look after it.

Those are not mere clinical terms; they represent real human suffering, unbearable pain, non-healing wounds, severe loss of mobility and, in far too many cases, major limb amputation and premature death. I will put a bit of focus on that for us in Northern Ireland, because some of the figures for amputations in Northern Ireland are scary. I think they are probably scary here on the mainland as well. We have seen inspiring progress in cardiac and stroke care, which is very much welcome, but outcomes for vascular patients have simply failed to keep pace. That is the issue I want to highlight, if I can.

The risk of developing PAD is four times higher among smokers than non-smokers, and two to four times higher among people with diabetes than people without diabetes. That is another reason for this debate and the importance of where we are. One in five people over the age of 60 is affected by PAD, and more than 80% of amputations among people with diabetes are preceded by a foot ulcer. People might say, “A foot ulcer? That is not too bad”, but it can well be. Often, it is the precipitation of a disorder in your blood, which ultimately could lead to amputation. That statistic clearly demonstrates the enormous opportunity we have in prevention and early intervention.

One of the main thrusts of my comments today will be about early intervention and how we do that. We have experts in the Chamber who will speak, and I thank all hon. Members for coming along to make their contributions.

Approximately 4,200 major lower-limb amputations are performed every single year due to PAD, each representing, I believe, a personal tragedy, and an average cost of £28,000 to the NHS. We have to consider the costs, because they are part of what the NHS has to look at. Managing CLTI alone costs our health service an estimated £244 million annually, while the overall bill for NHS wound care reached a staggering £8.3 billion in 2017-18. That included some £5.6 billion spent on wounds that failed to heal. That perhaps gives a clinical look at where we are.

The human toll, of course, is tragic. Patients suffering from CLTI with rest pain or tissue loss face a 60% risk of death within five years, a prognosis that is worse than for many end-stage cancers. Following an above-knee amputation, a quarter of patients die within 90 days, and median survival among diabetic patients is just 1.68 years. Those stats illustrate the extent of the problem and, I believe, confirm the importance of where we are.

[Dr Zubir Ahmed (Glasgow South West) (Lab)]

The statistics that the hon. Gentleman highlights should shock us all. If those were the statistics for dealing with any cancer, we would simply find them unacceptable. Does he agree that vascular disease, because it is not treated in the same way as cancer, in some cases ends up being treated as a “second-class” disease, and that we should be mindful of that?

[Jim Shannon]

I thank the hon. Gentleman for that intervention. He has rightly said that, when it comes to vascular disease, while it is equal with cancer in its severity and in the numbers who lose their lives, it is not treated the same. Today’s debate perhaps gives us a chance to illustrate that, and I am hopeful that the Minister responsible for answering can give us some encouragement in relation to it.

Furthermore, this crisis starkly reinforces health inequalities. Just as an example, among individuals aged 45 to 54, those in our most deprived communities face above-knee amputation rates nearly five times higher than those in the least deprived areas.

I thank the Library, as always, for the information that it made available to us. It said that

“gaps in vascular care are resulting in avoidable harm for patients. In particular, the report highlighted ‘delayed diagnosis, inconsistent referral pathways and variable access to specialist care’ for people with PAD, venous disease and diabetes-related foot complications. It said these problems are resulting in ‘thousands of avoidable lower-limb amputations each year.’”

If we were to achieve something from today’s debate, it would be first to ensure an improvement in vascular health, but secondly for the issue of amputations to be addressed through early diagnosis and looked at much more significantly and strongly than it has been.

As the Member for Strangford in Northern Ireland, I feel a particular responsibility to shine a light on how this national crisis presents itself in Northern Ireland. I do that because I think it will help add to the debate; I am ever mindful that the Minister here today has responsibility for the United Kingdom but not directly for Northern Ireland—I understand that—but I use the figures, stats and information from Northern Ireland as an illustration of the issue. What I want to see, and what I think the Minister will want to see as well, is an improvement in this across the United Kingdom and elsewhere.

My job is to shine a light on how the national crisis presents itself in Northern Ireland. While the briefing outlines the systemic challenges across the UK, the reality on the ground in our region underscores an even more acute urgency. Across Northern Ireland, hundreds of patients undergo limb amputations each year due to vascular complications and diabetes-related foot ulcers. In fact, diabetes prevalence in Northern Ireland continues to rise steadily, with local health trusts treating thousands of individuals at high risk of developing severe foot complications.

People sometimes think that diabetes is not that serious. I used to be almost 17 stone. I realised, when the doctor confirmed that I had diabetes some 18 years ago, that I had to lose weight. I lost 4 stone and I have kept it off, but I have to work hard to ensure I do not develop any other complications, which can quite often happen.

The stats in Northern Ireland reflect stark and unacceptable regional inequalities, and they are mirrored by the stats and figures from the mainland. On healthcare inequality, patients from the most socio-economically deprived communities in Northern Ireland face significantly higher amputation rates, nearing the alarming national trend here on the mainland, where deprivation increases the likelihood of a major amputation nearly fivefold.

Hopefully, when the Minister responds, he will tell us how the issue of higher levels of deprivation can be addressed, because it must be done. The lack of hospital bed capacity, dedicated wrapping access and community foot protection services forces vascular patients into prolonged, acute hospital stays. Managing severe vascular conditions and non-healing wounds accounts for millions of pounds annually across our health and social care costs. Those resources could be saved through early preventative community intervention. Again, that means early diagnosis, early community intervention and savings to the NHS, which can then be used in other parts of the health service.

Turning to survival rates, a patient in Northern Ireland who undergoes a major lower limb amputation faces a staggering mortality risk within their first year post surgery. It is the same across the UK. Preventative care is quite literally a matter of life and death. I could not express that any better than the hon. Member for Glasgow South West (Dr Ahmed), who underlined that in his intervention.

If we are to relieve pressure on local hospitals in the United Kingdom of Great Britain and, ultimately, in Northern Ireland and protect our most vulnerable citizens, we must ensure that any national reform framework, including the national foot attack pathway, and standardised waiting times are fully integrated across all HSC trusts, and we cannot allow postcode lotteries to dictate whether a patient keeps or loses her limb depending on where she lives.

I hope the Minister can address the issue of postcode lotteries, which seem to happen with unfortunate regularity. I know he will be keen to change that, and this House is keen to hear what he says. The cardiovascular disease modern service framework rightly focuses on shared risk factors and acknowledges PAD, but its immediate priorities lack the explicit, detailed pathways, treatment standards and outcome measures urgently required for lower limb vascular care.

To close that gap—because that is what we are trying to do—clinicians, patient representatives, professional bodies and NHS leaders across the vascular sector are coming together to publish a definitive best-practice document this autumn. I am sure that document will be made available to the Minister, hopefully in advance. I think that will be helpful for the Minister and others in this debate who want to make changes.

The APPG on vascular and venous disease has highlighted a practical programme for reform, which I endorse. Obviously, I would endorse it because I am its chairman, but it is a positive, focused vision for the future that, if delivered, could make a difference. It includes the national foot attack pathway, backed by public awareness; same day or next day triage for urgent foot issues; and a multidisciplinary foot protection service in every integrated care system linked directly to specialist arterial centres.

When I go for my diabetes test once or twice a year—I have one next Wednesday—they make me close my eyes and do that wee prick of my foot to see if I react and if I can feel it. I am glad to say that I always do. The point is that if someone cannot, that is a serious problem. That is an issue for diabetics, in particular, and it is really important that they are checked regularly, especially their feet.

Thirdly, there should be national maximum waiting times enforcing urgent vascular assessment within five days for in-patients and two weeks for out-patients. Setting a standard to be achieved and having a clear focus on outcomes that reward early diagnosis, fast healing and reduced amputations, are ultimately about patients having a better quality of life—a more normal life—without their health deteriorating. There should also be faster adoption of innovation, including community diagnostics, compression therapies and digital wound monitoring.

When it comes to research and development, the Minister is always very keen to know about advancements in vascular health and how the Government are helping. One of the people involved from one of the hospitals back home in Northern Ireland is with us today in the Public Gallery. She is clearly very aware of these issues and I thank her for her work. There is some great work being done in our hospitals, particularly in the Royal Victoria hospital back home, and in the rest of the Northern Ireland health service.

Will the Government ensure that the cardiovascular disease modern service framework includes distinct pathways and outcome measures for vascular conditions? Will the Minister support a national foot attack pathway and clear waiting time standards? With respect, standard rhetoric and warm words will not heal a failing wound; nor will they save a limb. Thousands of our fellow citizens face devastating, life-altering amputations—tragedies that are, in so many cases, entirely preventable if they are caught early enough.

As a type 2 diabetic myself, I know the personal anxiety that comes with those risks. I also know about early intervention. For me, that was losing 4 stone, taking the medication and being careful about what I eat. Cake became a once-a-week treat—my doctor told me we are allowed to have a wee treat now and again—and I am allowed to have a fry on Saturday morning, but the rest of the week it is best to abstain and not have any of those things. I know that early intervention, proper community pathways and timely care can work. They have worked for me and I know that they have worked for many others.

The Government have rightly pledged to shift the focus of the NHS from sickness to prevention and from treatment to early intervention. Today, I am asking the Government and the Minister to produce a clear and actionable blueprint to do precisely that. The vascular sector is coming forward this autumn with clear solutions, and I am very impressed by the sector’s ideas and suggestions about how to improve the strategy, including a national foot attack pathway, dedicated foot protection services and enforceable maximum waiting times, because we need to make sure that waiting times reflect the needs of those seeking help. The real test for the Minister is whether the Department can step up, grab this opportunity with both hands and deliver the system-wide reform that our patients deserve.

I thank all hon. Members for coming along to participate in the debate. I also thank those in the Public Gallery for being part of this work and for their expertise and input into the strategy. I think that the Minister will see that it can bring about the change that he and we all want.

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[Mr Frith]

I concur fully with my hon. Friend’s point. I noted his earlier remark about the commissioning of outcomes, and I think that one of the developing themes adjoining my own thinking and my brief is the need to get better at commissioning outcomes, considering whole populations, communities and places, and determining how we spend our money based on outcomes, not just activity. My hon. Friend makes a very powerful point with his question.

The hon. Member for Strangford and other members of the APPG feel strongly about the establishment of a national foot attack pathway. The Government’s ambition for integrated care boards to act as strategic commissioners focused on the needs of local populations is very much determined to assist that. The prevalence of vascular disease is not evenly distributed, as the hon. Member for North Shropshire (Helen Morgan) mentioned. ICBs are expected to use their nationally supported local commissioning power and their local data and intelligence, which includes user feedback and outcomes data, to develop a deep understanding of local need as well as local plans to develop and deliver.

[Jim Shannon]

I thank the Minister very much for that response; it is incredibly helpful. There seems to be a postcode lottery, where those who need care get it in some places but not in others. Does the Minister feel that his policy will ensure deliverability across all postcodes, not just in single places?

[Mr Frith]

That is a very fair and right challenge. This is not about endorsing patchwork provision; it is about understanding that, whether because of the physiological, social, environmental or behavioural differences that exist, care is not evenly distributed. We should have standards that we expect nationally, but we should also commission and empower local ICBs to commission, and we should hold them accountable through the frameworks and the work that we do in the Department.

[Mr Frith]

I hope that my further remarks will address that very point; I am happy to pick it up with the hon. Member in due course if they do not satisfy.

ICBs will use national modern service frameworks set by the Government and guidance to create the right services for their areas. That means local systems coming together to create neighbourhood services that reform the health and care system and are rooted in the needs of people and communities.

On the issue of maximum waiting times for vascular disease, this Government recognise that it is imperative that any patient requiring a vascular assessment receives that in a timeframe that reflects their condition and enables the best possible health outcome. The Government are committed to making progress on NHS waiting times, including returning by March ’29 to the NHS constitutional standard of 92% of elective care patients’ waiting times from referral to treatment being within 18 weeks. Of course, that includes those patients waiting for vascular services.

The NHS met the first interim target of 65% in March ’26, and we are now focused on driving improvements to achieve our second interim target of 70% by 2027. To help support the commitment to reduce waiting times, the podiatry workforce pipeline is currently being strengthened through NHS England’s focus programme for small and vulnerable professions, with the NHS workforce plan to be published shortly.

The health service also has clear guidance on what is required in delivering services for people with vascular disease or at risk of developing it. In March ’26, NHS England published guidance on standardising community health services. That guidance identifies podiatry, diabetes and tissue viability, and wound care as core components of ICB-funded community provision. People who need urgent wound assessment—for example, those with suspected infection, rapid deterioration, or diabetic foot ulcer—should be seen within 24 hours. The guidance also makes it clear that routine assessments should occur within five to seven working days, with data collected on healing and complications. The purpose and goal of community health services must be to support people as well as to avoid their needing to be admitted to hospital and, critically, the need for amputations.

[Jim Shannon]

I thank the Minister for his generosity in giving us a chance to ask questions. One of the areas that the APPG and we elected representatives have identified is that there are areas of deprivation where levels of vascular ill health and amputations are higher. What can be done to reduce that in areas of deprivation? I know I have them in my area. I am sure the hon. Member for Glasgow South West (Dr Ahmed) and others have them in theirs. I would like a focus on that, please, if the Minister does not mind.

[Mr Frith]

The hon. Member is absolutely right. We have to keep ICBs and their commissioning powers accountable to local jurisdictions. I will say a bit more on that in due course, but we are on the same page.

To facilitate faster assessments we also need to speed up and make earlier diagnoses, which is why the Government plan to open four new community diagnostic centres during ’26-27. That expanding capacity will help meet our March ’29 target that no more than 1% of patients should wait over six weeks for a diagnostic test.

On reforming commissioning to reward outcomes, as set out in the 10-year health plan, we want to develop new ways to pay healthcare providers based on clinical practice that maximises productivity and outcome, as my hon. Friend the Member for Glasgow South West mentioned. Under the best practice tariffs, providers receive payment when they follow agreed standards of care. On the adoption of proven innovation, the APPG report rightly identifies the importance of the NHS being able to quickly adopt new innovations.

As part of my responsibility to oversee further development and enhancement of the use and usability of the NHS app, one development coming through the House at the moment is the creation of the single patient record. The future exciting development of NHS online, or digital doctor, as I might yet call it, is about the digitisation of our NHS service—embracing innovation, personalising healthcare and responsive to individual need—as well as the innovator passport, delivered through a phased approach to accelerate access to and adoption of technologies.

The APPG’s report says that preventing vascular disease and its deterioration should be at the centre of the system, and I agree. Identifying people with vascular diseases and providing care centred on their needs is critical to ensuring vascular disease does not progress to the point where somebody needs incredibly serious interventions, such as a leg needing to be amputated. In this modern era, such amputations are wholly avoidable and should be prevented.

The distinction between the APPG’s report and the Government’s most recent announcement of the MSF has been mentioned. I was delighted to join the British Heart Foundation yesterday at the celebration event for the MSF ahead of the delivery plan later in the year. It is a reasonable challenge to ensure that we distinguish between conditions, a point made by the Opposition spokesperson, the hon. Member for Solihull West and Shirley. It was a point made to me—and a point I thought was likely to be raised with me—by stroke and diabetes charities at the event yesterday. We are on the same page on that. He made an excellent point and challenge on the distinction that is needed.

As hon. Members will know, prevention is at the heart of the Government’s health agenda—the prevention of health conditions and the prevention of them worsening. The cardiovascular disease modern service framework, which was published in July, sets a clear direction for how health and care systems should accelerate progress on the Government’s ambition to reduce premature mortality from heart disease and stroke by a quarter within a decade.

My hon. Friend the Member for Broxtowe (Juliet Campbell) talked about irregularity and different areas having different levels of heart failure, which she said was four times more likely in the area she represents. I would be very happy to have conversations about how we can embrace that insight and intervene. Prevention is fundamental to the Government’s efforts around an annual heart failure review, improving access to rapid diagnosis and embedding heart failure support in cardiac rehabilitation, as well as the wider Government goal to reduce premature mortality by a quarter within the next decade.

Central to the cardiovascular disease modern service framework is a holistic approach with a strong focus on reducing inequalities. The principles apply here, too: the missing millions; the need for healthy intervention and to understand the difference between the physiological, behavioural, environmental and social; an appreciation that living standards and the cost of living have as much impact as any knowledge of what to eat and when; and looking after each other. It is about commissioning for outputs, not just diktat, which means recognising that several conditions and risk factors share common causes and contribute to most heart attacks and strokes. Members have described them in their speeches: high blood pressure, smoking, diabetes, high cholesterol, unhealthy diet and lack of exercise.

At its core, the framework is about a fundamental shift towards proactive, whole-person, preventive care that is located in communities and neighbourhoods and makes better use of hybrid, traditional, in-person and digital models to increase uptake and treatment. Podiatry and related foot-health services align with the shift towards local community hub delivery. The framework’s approach is backed by wider Government, including the creation of the first smoke-free generation, which began under the Conservative Government.

[Mr Frith]

In the humblest of terms, I would be very happy to visit and speak to my Scottish counterparts to ensure that they take that opportunity, and that any development, whether on compatibility, operability, the learnings from the NHS app in how we then develop NHS Online—that sounds a bit too much like building a website; we have to be more ambitious and describe it as what it is, which is the digitalisation of our NHS—helps to ensure that our brothers and sisters in Scotland get the same level of digital access that we expect to deliver across the NHS in England.

[Jim Shannon]

The hon. Member for Glasgow South West (Dr Ahmed) has nabbed my request—it is not about green cheese, by the way, Minister. My request is that the kindness the Minister has extended in respect of the hon. Gentleman and the Scottish health service is also extended to us in Northern Ireland, because expertise gained here can be shared so that we can all benefit.

[Mr Frith]

I will take any excuse I can to come to Northern Ireland, and I hope my private office has noted that.

In closing, our approach to improving the treatment of vascular diseases is closely aligned with the reforms in the APPG report and the APPG’s ambitions. I know that, of course, there will be other areas in which the APPG, and the hon. Member for Strangford, will rightly continue to push for further progress. I thank hon. Members for their contributions, and I thank the APPG for its important work and report. I look forward to continued dialogue on this issue to improve the NHS, especially services for vascular disease.

[Jim Shannon]

I thank everyone for their contributions, including the hon. Member for Broxtowe (Juliet Campbell). It is perhaps disquieting to understand that the hon. Lady has four times the number of people with vascular health issues in her constituency compared with elsewhere. That indicates a level of deprivation that is seen in certain areas of my constituency, across Northern Ireland, and in Glasgow South West. I thank her for outlining those issues. The hon. Lady also said that investment needs to go further, and was very kind to share the experiences of her constituency.

We are pleased to have the hon. Member for Glasgow South West (Dr Ahmed) here. He brings vast knowledge. The great thing about these debates is that everybody brings their expertise. The hon. Gentleman has done that, and we are very pleased that he shared some of his lifetime of knowledge, which resonated with some of those in the Public Gallery. The hon. Gentleman learned the business, so to speak, and is now able to contribute to others along life’s way. That is incredibly helpful.

Glasgow has one of the largest hospitals in the country, and there is a need to ensure that some of the highest stats in Scotland are addressed, such as those relating to lower life expectancy, the diabetic foot protection service, vascular community waiting times and improvements, and pay for output and outcome. There was an incredible focus on all those things in the debate, and we thank the hon. Gentleman for that.

Over the past few days in the Chamber, the Liberal Democrat spokesperson, the hon. Member for North Shropshire (Helen Morgan), has made valuable contributions and proven herself be an expert on all health subjects when it comes to the Health Bill. Today, she referred to vascular disease as being as “common as cancer” and a “preventable disability”, and spoke about a “postcode lottery” of care, the issue of “delayed diagnosis” and how her county has one of the highest rates of lower-limb amputations. She also mentioned the issues of waiting times and care for those with long-term diseases.

We do not always think about the mental health impact of this issue—its impact on someone’s anxiety, depression or ability to cope with life. If someone is able to walk about and do things and then suddenly something happens and they lose a limb, their mental health will be affected.

The Conservative spokesperson, the hon. Member for Solihull West and Shirley (Dr Shastri-Hurst), also brings his interest to this place. We spoke about this in the morning and the other day. He referred to the treatment and the access for services. He referred to the five recommendations from the APPG—getting it right first time, the foot care teams and all those things. If ICBs’ budgets are to be reduced, how will the vascular and venous strategy be delivered? The Minister gave us some indication of how that was going to happen, and there is certainly a commitment to it. We appreciate that.

When will national waiting times be addressed? When will the needed national foot attack pathway be in place? Again, it is about better use of NHS resources.

I am very pleased to have a Minister who responds to us, takes the subject matter on board and gives us the reassurance that we seek. He focused on the APPG report and committed to a national foot attack pathway, with ICBs and neighbourhood services having accountability. The Government are on the same page. The Minister talked about deprivation of access, and we all see that it is harder for people in some areas to get the treatment that they need.

I welcome the four new diagnostic centres that the Minister referred to. There will be further development and enhancement. “Digital doctor” is becoming a common phrase. I suspect we will hear it very often—I might even use it the odd time myself. The Minister is embracing innovation, as we all have to do. He spoke about prevention policy, accelerating the progress, targets set by the Government, a holistic approach, sorting out the outputs, and ensuring that we have facts about risk factors.

The hon. Member for Glasgow South West talked about the reform of systems and leadership. It is really important that the APPG focuses on that.

The APPG would be very pleased to have a meeting with the Minister—I think he will agree to that, although I will not judge him—and other Members here who have brought their expertise. That would be a beneficial meeting, because we are all on the same page, trying to achieve the same goals. If we can help the Minister to do that, we would be very pleased to take that forward.

I again thank everyone for taking part. Thank you, Dr Huq, for having patience with a fella who was supposed to have only two minutes—I think you have given me five.

Question put and agreed to.

Resolved,

That this House has considered the potential merits of reform of the vascular sector.

Summer Health and Resilience

Jim Shannon Excerpts

Wednesday 9th September 2026 Commons Chamber

[Yvette Cooper]

The hon. Member is absolutely right to raise this issue. It is one of the first issues I raised with the Department of Health and Social Care teams during some of the first meetings I had after being appointed; at the height of some of the heatwaves, we were looking at what could be done to ensure that the right advice and requirements were going out to social care across the country. Many care homes did a phenomenal job, sometimes in difficult circumstances because of old buildings, but the hon. Member is absolutely right to point out areas where things did not happen in the way they needed to. We are looking further at this issue as part of the heat taskforce.

[Jim Shannon (Strangford) (DUP)]

I thank the Secretary of State very much for her statement, and welcome the commitment she has made. Strangford’s ageing population rely heavily on robust community care and swift access to their GPs, so can the Secretary of State outline what specific discussions she is having with her counterparts in the devolved Administrations—particularly in Northern Ireland—to ensure a UK-wide co-ordinated approach to summer resilience? What targeted support has been made available for community pharmacy networks, which so often act as the frontline of defence when GPs’ surgeries are stretched to capacity, as we prepare for the cold and flu season?

[Yvette Cooper]

I can reassure the hon. Member that regular meetings and discussions take place, involving not just Ministers but chief medical officers across the devolved Administrations, to ensure there is co-ordination. There are areas where we can learn from each other, but there are also areas where we need proper co-ordination, particularly on some of the public health and information issues and—as the hon. Member rightly says—some of the issues that link into our economic supply chains, including community pharmacies.

Pharmacies: Government Funding

Jim Shannon Excerpts

Wednesday 9th September 2026 Westminster Hall

[Jim Shannon (Strangford) (DUP)]

It is a pleasure to serve under your chairship, Mr Betts. I say a big thank you to the hon. Member for Leicester East (Shivani Raja) for bringing this subject to our attention.

As the DUP’s health spokesperson, I am particularly concerned about the amount of support available to our local pharmacies. As an indication of that, I used the opportunity of the first statement today, on summer health and resilience—the Minister was there, not to answer the question, but to support the Secretary of State—to ask the Secretary of State what discussions she is having with her counterparts in the devolved Administrations, particularly in Northern Ireland, to assure a UK-wide co-ordinated approach to summer resilience.

I also asked what targeted support has been made available for community pharmacy networks, which so often act as the first line of defence when GP surgeries are stretched to capacity as we prepare for the cold and flu season. To be fair to the Secretary of State, she answered my question very well and assured me that discussions are ongoing with the Minister back home in Northern Ireland, and that reassured me. That example underlines the importance of community pharmacies to me, those in my Strangford constituency and every one of us here.

Just last year, the National Pharmacy Association said that it was left with no choice but to recommend that its 6,000 members take collective action for the first time in its history, citing significant new costs and inadequate funding. About 90% of the work carried out by the average community pharmacy is funded by the NHS. This time last year, the National Pharmacy Association issued the stark warning that up to 63% of pharmacies were likely to close in 2026. We are still in 2026, so that threat hangs over all our heads. In response to a survey, 94% of pharmacies stated that the latest funding settlement did not provide stability to their finances. Those figures demonstrate the effect of persistent financial uncertainty on the sector.

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

The hon. Member mentions the closure of pharmacies, but this is also about the ending of some services. It is sometimes the things that are noticed the least that matter the most once they are gone. For example, people with neurological or mental health conditions rely on Nomads to have the right tablets on the right day, and that really important service is sometimes provided by our pharmacists. Does the hon. Member agree that we do not want the wonderful services that pharmacies provide free of charge to be lost because of financial pressures? They matter too much for the lives of our residents.

--- Later in debate ---

[Jim Shannon]

I thank the hon. Gentleman for giving me a chance to get a wee glass of water. His comments are incredibly important, and he is right to say that those services are almost impossible to bring back once they are lost.

Local pharmacies are under ever-increasing pressure. My particular concern is for small, independent pharmacies in rural constituencies such as my own. These businesses are facing rising costs, increasing workloads and the real risk of insolvency, and that is not to mention the personal toll on local pharmacy owners. The impact on those individuals and their health is sometimes forgotten.

[Shockat Adam]

I thank the hon. Member for making that point about how much stress is put on pharmacists and small business owners. In the last year, there was a 2.3% increase in items reimbursed by the NHS, a 17% increase in service volumes, a 3% increase in inflation, and increases in operating costs such as national insurance and business rates. That all adds to the pressure when pharmacists should be concentrating on providing a vital service to the community.

[Jim Shannon]

The hon. Gentleman is a Leicester City supporter, as I am; we do not have to seek our sorrows at this moment in time, but that is by the way. More importantly, his comments underline the issues for local independent pharmacy owners.

As the hon. Member for West Dorset (Edward Morello) said very clearly, at the heart of this issue are the patients—sometimes we need to remember that. Pharmacy closures are leaving many people, and particularly those in rural areas, with greater difficulty accessing their medication. Those concerns are felt deeply in Northern Ireland. The chief executive of Community Pharmacy Northern Ireland has warned officials that medicine shortages are having a greater impact on Northern Ireland because of systemic funding pressures, with pharmacies being forced to use their own money to bridge the gap in funding. That is the reality for these people, who have consciences, feel compassion and want to care for their patients and customers. The impact is clear, because almost 90% of pharmacies in Northern Ireland were unable to pay their wholesaler bill in January. Think about what that means for a second: that is real pressure. Further demonstrating the pressures is the number of pharmacies operating in Northern Ireland, which at 506 is the lowest ever recorded.

I know that the Minister is a compassionate lady who understands these issues incredibly well, and she will be aware that those figures raise serious concerns about the financial sustainability of our pharmacies and the security of the medicine supply throughout this United Kingdom of Great Britain and Northern Ireland. Our pharmacies need certainty about their funding arrangements. They need to know well in advance what support will be available to them, so that they can plan effectively, manage costs and pay their bills, and not be forced to close.

I have often highlighted the fact that pharmacies’ ability to provide first-line defence in the fight against minor injuries is not used enough. The right hon. Member for Richmond and Northallerton (Rishi Sunak) outlined some of the things that pharmacies do; they are frontline defence. These things are perhaps not seen by everyone, but they are seen by the patients and customers who come in. Every person who gets advice on treatment for warts, headlice, thrush or another ailment from the pharmacy rather than the GP is helping to ensure that GPs are not overwhelmed, and that A&Es are not overwhelmed by people who cannot see their GPs. We perhaps do not always see that, but it is very important.

Pharmacies are a vital cog in the health service, and we must fund them to do the job that they are able to do, yet are prevented from doing. I look to the Minister for that funding and for assurance. The Minister always tries to give us the reassurance we need and to answer the questions that we pose. These are hard times financially, but pharmacies are important for everyone. They produce savings for GPs and the NHS. Let us support them.

--- Later in debate ---

[Gregory Stafford]

I entirely agree with the hon. Gentleman. I think that we can use pharmacists and pharmacies much more creatively and in a manner that would in no way put patient safety at risk. In fact, it would allow patients more choice, and free up GPs and other health professionals to do other parts of their job, so he is right.

Community Pharmacy England’s 2026 pharmacy pressures survey makes the scale of the challenge facing pharmacies clear. Drawing on responses from nearly 4,000 pharmacy owners and staff members, it found that 75% of pharmacies are currently losing money, while only 14% reported being profitable. There is little value in providing additional funding for services without recognising the wider cost and workforce pressures facing the sector: 30% of pharmacies have reduced their opening hours and 76% report an impact on patient care, including longer waits and delays in accessing medicine.

That brings me—briefly—to the issue of business rates and the wider cumulative costs facing pharmacies. A pharmacy might occupy a storefront on a high street, but it is not simply another retailer; it is part of the national health service and is an essential provision in our community. As the hon. Member for Strangford (Jim Shannon) outlined, pharmacies are also part of our national resilience. The Government want pharmacies to take on more responsibility, but they face rising costs that have been caused by the Government.

Pharmacies need to be properly considered within the system and not treated simply as another high street retailer. The same issue applies when we consider national insurance increases, and indeed the national living wage. These cumulative increases are having a real impact. Unlike a high street retailer, a pharmacy has contractual obligations to the NHS and a moral responsibility to its patients, so it cannot just increase prices or stop providing a service like other businesses could. As my hon. Friend the Member for South West Hertfordshire (Mr Mohindra) rightly put it, the Government have to recognise the cumulative impact of these terrible decisions when considering future policy.

[Jim Shannon]

I want to underline a point I made in my speech: some of my community pharmacists back home are using their own money to subsidise their pharmacy and keep the business going—because of their compassion, their understanding and their concern for their customers and patients.

[Gregory Stafford]

The hon. Gentleman is entirely right, and his point goes to the heart of the debate. Pharmacies are businesses that must make a profit, and pharmacists must pay their staff and make sure that they can feed their own families, but they are also public servants. They are people who have decided to work in our national health service to provide for our patients, and the Government should recognise that.

The hon. Member for Leicester South (Shockat Adam) mentioned independent prescribing. If properly supported, it will give patients quicker access to treatment, but it brings greater clinical responsibility, greater governance requirements and greater pressure on pharmacists’ time. Given the limited capacity that we have already talked about, I want to ask the Minister three questions on independent prescribing. Does she believe the sector is ready? Does it have the workforce and the capacity to do it? What additional funding and support will be provided? We also need clarity on the timetable. Pharmacists have trained to prescribe, and they should be able to use that skill.

That brings me to the pharmacy workforce, because none of these reforms—independent prescribing, Pharmacy First or any other idea—will work without a sufficiently large and properly supported workforce. We have heard from right hon. and hon. Members about recruitment and retention pressures, including concerns about the number of full-time equivalent pharmacists. At the same time, the demands placed on existing staff are increasing. We cannot continue to add responsibilities to community pharmacy without considering whether there are enough people to deliver them safely and effectively.

The previous Conservative Government’s NHS long-term workforce plan included an ambition to increase pharmacist training places by 29%, taking them to around 4,300 by ’28-29. That ambition will clearly not be met under this Government, and we are still waiting for the long-promised NHS workforce plan. Despite my asking the then Secretary of State for Health, the right hon. Member for Ealing North (James Murray), in July when the plan was coming out, we still have no answer.

Finally, I will move on to medicines supply. Pharmacies are facing global supply chain disruption and rising medicine costs, with repeated price concessions adding further pressures. They cannot absorb these pressures indefinitely, so what are the Government doing to mitigate the impact of geopolitical disruption on medicine supply and prices, and what assessment has the Department made of the financial burden that these pressures are putting on community pharmacies? They are being felt by pharmacies across my constituency, including Vaughan James and Lalys in Farnham, Chase and Headley pharmacies and Day Lewis in Haslemere, and Grayshott pharmacy, all of which have contacted me about the issues that I have raised.

In conclusion, community pharmacy has a crucial role to play in the future of our NHS. We all want to see care delivered closer to people’s homes. Pharmacy First has shown what can happen when we give pharmacists greater responsibility and trust them to use their expertise, but ambition needs to be matched by capacity. The Government cannot say that community pharmacies are central to the future of neighbourhood healthcare while making it harder for those pharmacies to remain financially sustainable. I urge the Government to recognise the cumulative impacts of their policies on businesses, to look again at the treatment of business rates for community pharmacies, to ensure independent prescribing is properly supported, to protect the supply of medicines, and to provide clarity on when the NHS workforce plan will be published.

The fact is, we cannot ask pharmacies to take on more responsibility and deliver more NHS care while simultaneously making it harder for them to survive. The Conservative party believes that community pharmacy is absolutely central to the future of the NHS. If the Government agree, they must make sure that pharmacies have a future, too.

World Suicide Prevention Day

Jim Shannon Excerpts

Tuesday 8th September 2026 Westminster Hall

[Liz Twist (Blaydon and Consett) (Lab) [R]]

I beg to move,

That this House has considered World Suicide Prevention Day.

I am grateful for having secured this debate, Sir Christopher, and it is a pleasure to see you in the Chair for it. This Thursday is World Suicide Prevention Day, an event marked through the World Health Organisation. Each year, 10 September provides a moment for individuals, communities and Governments around the globe to unite behind one clear, unambiguous message: that suicides are preventable.

[Jim Shannon (Strangford) (DUP)]

I thank the hon. Lady for securing this debate on World Suicide Prevention Day. The Farm Safety Foundation has surveyed some 450 farmers under the age of 40, of whom 92% identified poor mental health as one of the leading hidden problems facing farmers today. Those challenges can be further compounded by stigma and reluctance to seek help, which are particularly prevalent in rural communities. Is the hon. Lady aware of the challenges people in rural farming communities face when trying to access mental health support? Does she agree that more must be done for that sector, who seem overwhelmingly to suffer isolation?

[Liz Twist]

I am indeed aware of that work and of the difficulties faced by the farming community, and it is important that we address those. This year, as in the last two years, the theme for World Suicide Prevention Day is “Changing the Narrative on Suicide”, accompanied by a direct call to action to start the conversation.

Health Bill

Jim Shannon Excerpts

Report stage
Monday 7th September 2026 Commons Chamber

[Helen Morgan (North Shropshire) (LD)]

I have tabled several amendments to the Bill, but I will hopefully keep my remarks focused so there is a good opportunity for other Members to make their speeches.

The Bill should be about fixing the front and back doors of the NHS. It offers the opportunity to bring in tangible changes for patients to address pressing problems and introduce desperately needed improvements to patient safety and experience. The primary care and social care crisis, in particular, are millstones around the neck of the NHS. But instead of addressing them, the Bill has focused on a top-down reorganisation, which risks diverting time and money away from those pressing issues, and it gives sweeping powers to the Secretary of State, which is not in itself without risk.

The Liberal Democrats would instead have put social care and general practice at the heart of the Bill—a move that would represent real reform of the health service. In particular, new clauses 54 and 56 tabled by my hon. Friend the Member for Mid Sussex (Alison Bennett) would together transform the rights of family carers through guaranteed respite care and reform of the carer’s allowance. They would put free personal care, and an end to catastrophic care costs, at the heart of social care reform.

New clause 53, tabled by my hon. Friend the Member for Epsom and Ewell (Helen Maguire), would ensure that everyone can see a GP within seven days, or 24 hours if urgent, and amendment 17 would introduce a primary care investment standard. Although general practice is the core of a patient’s relationship with the NHS, it has seen its funding decline as a share of NHS spending. Less than 10% of the NHS budget is spent on primary care, although that is estimated to constitute 90% of a patient’s direct experience with the NHS. A primary care investment standard would help to reverse that trend. Dentistry is another area of primary care that has been neglected, leading to dental deserts and dangerous DIY dentistry. New clause 18 would introduce a scheme to end dental deserts, and guarantee appointments for children and those most in need.

[Jim Shannon (Strangford) (DUP)]

New clause 82 refers to the family mental health pathway, but from diagnosis right through to treatment and, tragically for some, bereavement, mental health support for families cannot be an afterthought and must be a statutory proactive duty. Does the hon. Lady agree that the Government and the Minister should take that on board?

[Helen Morgan]

I broadly agree with the hon. Gentleman, and I am about to come to mental health. It is right to modernise the NHS and end some of the duplication that we see between NHS England and the Department of Health and Social Care, but the way it has been handled has been chaotic. It has been combined with 50% cuts to ICB budgets, unfunded redundancy payments, and chaos through the system. I was alarmed to read the report in The Times at the weekend about advice to the Secretary of State that the changes envisaged under the Bill are impossible to implement, given that the staff of NHS England are on different pay scales to those in the Department. Given those significant hurdles, I hope that in her closing remarks the Minister can provide some reassurance that abolishing NHS England in the way the Bill envisages is achievable.

We are particularly concerned that the functions of the Secretary of State under these reforms open the door to political capture, which is a huge risk given the unstable political climate we live in. Amendment 16 would create a firewall between the Secretary of State and operational decisions. These new powers are particularly worrying in the context of patient safety issues created by the Bill, which we will discuss in more detail tomorrow.

Beyond the Department, the Bill is complacent on taking seriously the vulnerability of our NHS to foreign interference and its implications for national security. That is why we tabled new clauses 2 to 5, which recognise and address the role of the NHS as part of our sovereignty, and the sensitivity of patient data. New clause 17 would require scrutiny in the House of the arrangement between the United States of America and the United Kingdom on pharmaceutical pricing. That deal, forced on us by Donald Trump with no say from the British people, will hike medicine prices in the coming years by billions of pounds, and deserves parliamentary scrutiny. All those shortcomings of the Bill attest to the fact that the NHS already spends far too much time and money responding to failure, rather than improving the safety and quality of services in the first place.

--- Later in debate ---

[Jen Craft (Thurrock) (Lab)]

I strongly welcome this landmark Bill, which will protect and strengthen our health service for decades to come, but for children with special educational needs and disabilities who are disproportionately impacted by not getting the healthcare that they need, I believe that it should go further. That is why I tabled new clause 85, which seeks to address the fundamental imbalance in the provision of health services for disabled children and young people. Currently, the statutory duty to deliver education, health and care plans—the legal mechanism by which children with special educational needs and disabilities can receive support—sits entirely with local authorities.

[Jim Shannon]

I commend the hon. Lady for all her endeavours in this regard. Does she share my concern that when a child is diagnosed with cancer, the parents are instantly overwhelmed by medical jargon, by appointments and by sheer panic? Does she agree that the Minister, and the Government, should accept the common-sense duty to ensure that no family faces those critical first two weeks completely alone?

[Jen Craft]

I do agree. The hon. Gentleman has made a very good point about the impact of childhood illness, not only on the child but on the family. I also agree that support for families is crucial. They are part of the care team for children when they are unwell, and that acknowledgment needs to be strengthened and acted on.

As I was saying, the statutory duty to deliver EHCPs sits solely with local authorities. In practice, that means that councils are the only bodies that can be held legally responsible for providing the service that a disabled child needs to access education, including health services such as occupational or speech and language therapy. Health bodies are not subject to the same requirement, and I know from my work as a member of the Health and Social Care Committee and a constituency MP, and as a parent of a disabled child, that that too often means that they are not at the table when it comes to delivering services for children with special educational needs and disabilities. There is a fundamental lack of accountability in the system. That, in practice, can force local authorities or families to procure privately, which can drive shortages in the NHS workforce or can mean that provision is substandard or non-existent.

My constituent’s son Haider, for example, has an EHCP which outlines his need for speech and language therapy to gain full access to education. Despite his mother Qaila’s relentless efforts, that support was not delivered for months. Qaila tells me that she has been forced to watch while Haider has become withdrawn, anxious and isolated. My constituent Elizabeth has a similar story. She has been fighting to get occupational and physical therapy for her son William, but significant delays in securing assessments from healthcare professionals have resulted in inaccurate, unhelpful support arrangements.

Surrogacy Law and Legal Parenthood

Jim Shannon Excerpts

Monday 7th September 2026 Westminster Hall

[Dave Robertson (Lichfield) (Lab)]

I beg to move,

That this House has considered e-petition 763161 relating to surrogacy law and legal parenthood.

It is always a pleasure to serve with you in the Chair, Mr Pritchard, and I am sure today will be no different. The petition calls for a change in the law so that the intended parents of babies born through surrogacy can be considered to be the legal parents from the moment of their child’s birth. Under current law, that is not possible. Intended parents must go through a months-long process in the courts and be visited by a social worker before they are considered to be the parents of the children in the eyes of the law.

Ahead of this debate, I met the petition’s creator, Adam, his fiancé, Jamie, and their daughter, Leven, who was born via surrogacy in Connecticut. I am pleased to say that Adam and Jamie have joined us in the Public Gallery today. Although baby Leven has not joined them, she made a cameo appearance on our call ahead of the debate. Adam and Jamie are listed as Leven’s parents on her birth certificate in the United States, but more than six months after her birth, they still are not recognised as her legal parents at home in the UK. That is what prompted Adam to create this petition. When we met, he said,

“We’re changing Leven’s nappies, we’re putting her to bed—we are her parents, we’re bringing her up”

and yet he says that babies like her are in “legal limbo” under current legislation.

My role today is to introduce the petition by setting out the petitioners’ views and framing the debate to follow. It is good to see so much interest from Members across the House. In preparation, as well as meeting Adam, I have drawn on the expertise of a range of organisations and individuals, with the expert support of the petitions team. They are often not thanked enough, so I place on record my thanks to the entire team for their support in preparing for the debate.

We met groups such as Surrogacy Concern, Stop Surrogacy Now UK and Brilliant Beginnings, and Dr Herjeet Marway of the University of Birmingham, who is the founding chairperson of SurrogacyUK’s ethics committee. We also met Professor Nick Hopkins of University College London, a former law commissioner for England and Wales, and Professor Gillian Black of the Scottish Law Commission and the University of Edinburgh. Together, they authored the joint Law Commission report on surrogacy reform, which was published in 2023. I will start with the current state of the law and the reforms proposed by that Law Commission report.

When a child is born to parents via surrogacy, whether in this country or abroad, as baby Leven was, the surrogate mother is considered the legal mother at birth under UK law. If she is married or in a civil partnership, her partner will automatically be the second parent on the birth certificate, irrespective of the child’s genetics. There are children out there today whose parents, as considered under UK law, have no genetic relationship to the child at all. That is because in UK law, the person who gives birth to a baby, and no one else, is considered the mother. That has led to a complicated reality in today’s world, where a growing share of babies are not born via natural conception.

If you give birth using a donor egg, you are considered to be the child’s mother in the eyes of the law. But if you cannot carry a baby, and if you and your partner have an embryo that is biologically yours carried by a surrogate, you are not considered to be the legal parents when your child is born. Intended parents and their surrogates can draft a surrogacy agreement setting out how they want parental rights to be arranged for the child, but those documents have no legal standing in the UK.

To become legal parents, intended parents must apply for a parental order through the courts. They have to make that application between six weeks and six months after the baby’s birth. Organisations that specialise in assisting intended parents say that the process normally takes between six and 12 months to complete. In that time, the baby will almost invariably be living with the intended parents, but legally, they are strangers to that child.

[Jim Shannon (Strangford) (DUP)]

The hon. Gentleman is putting the case very well. There are also very practical hurdles, such as registering the child with a GP, the child’s medical circumstances and applying for a passport. The whole thing is illogical. The practicalities add to the timescale, and it is time that the Government address the issue.

[Dave Robertson]

It is always a pleasure to see the hon. Member for Strangford (Jim Shannon) in his place in this Chamber. I will touch on health later, so I ask him to hold fire.

--- Later in debate ---

[Jim Shannon (Strangford) (DUP)]

It is a real pleasure to serve under your chairship, Mr Pritchard. I thank the hon. Member for Lichfield (Dave Robertson) for introducing the debate on this petition on behalf of the Petitions Committee. As the DUP’s health spokesperson, I am particularly interested in advocating for the protection of the women and children at the heart of this process. Although health and social care are devolved, surrogacy policy is a reserved matter and is decided by Westminster. The thrust of my concern and contribution to this debate is more about urging caution to ensure that, while we need to legislate for the new scenarios that we face in modern life, protection is in place and the legislation is thoroughly considered. I think that reflects the opinion of most of us who are putting forward points in the debate.

I recognise that surrogacy can be a lifeline for those struggling with infertility or who are unable to have children themselves. Surrogacy can no doubt represent an extraordinary act of kindness where a woman chooses to help a friend or family member to fulfil their dream of becoming a parent. However, I must stress that I have significant concerns about the increasing commercialisation of surrogacy. I have spoken on this issue in a separate debate in Westminster Hall and I want to reiterate the concerns that I expressed then. An important distinction must be made between the women who voluntarily agree to carry a child for someone they know, perhaps with reasonable expenses being covered, and the wholly exploitative system whereby a woman’s womb becomes a service that can be bought. That concerns me greatly.

The background information that we got from the House of Commons Library—we always thank the Library for its contributions—refers to the international and regional human rights relevant to surrogacy: the right to respect for family life, the rights of the child, women’s rights, the right to equality and non-discrimination, the right to dignity, and protection from human trafficking. A number of issues were outlined in the background information that we got from the Library. We must tread very carefully to not contribute to a market that preys on the financially vulnerable and pressures them to use their bodies for the benefit of others. Compensation for genuine expenses incurred in carrying a baby is one thing; paying a woman for carrying a baby is quite another. The distinction becomes increasingly blurred—the hon. Members for Leicester East (Shivani Raja) and for South West Devon (Rebecca Smith) both made contributions on this, and I would echo them—when payments for carrying a child are disguised as expenses. There must be no room for ambiguity in this process. I should have welcomed the Minister to her place. We wish her well in the role that she now plays, and we look forward to her responses to our concerns.

In my intervention on the hon. Member for Lichfield, I referred to the practical hurdles, such as registering the child with a GP, making critical medical decisions for a child who may have complex medical needs, and applying for a passport. Prolonged uncertainty is not in the best interests of the child, nor is it fair to the families who have planned for, prayed for and loved that baby from the beginning. Does the Minister not agree that access to these scientific advances means that we must regulate well for them? That is the thrust of what I am putting forward.

I must also raise my wider concerns about the rapidly growing fertility market, as young women are being encouraged to donate their eggs in return for compensation. In fact, it is the clinics themselves that profit most substantially from the donation, and clinics take advantage —I say this with respect—of those who may be in financial difficulties or who need the money. I would argue that sufficient information is not being provided to these women about the potential long-term health consequences of egg retrieval. I am deeply grieved by any idea that promotes fertility as something that can be bought and sold. That is wrong, and I put that on the record.

The concerns that I have outlined become even more significant when we look internationally. Commercial surrogacy is illegal in the UK but permitted in some countries abroad, leading many UK couples to circumvent the law by using a surrogate abroad. That leaves room for exploitation, as the UK Government cannot control the protections available to those surrogate mothers. I ask the Minister what is being done to close those loopholes. We should legislate, if necessary, to ensure that protection is in place. Will any Government action extend to Northern Ireland? I understand that it will, because the matter is not devolved from Westminster. Therefore, if the Government take a decision here, it will apply to us, but I am keen to have that confirmed.

That brings me to the petition, which calls for the intended parents to become the legal parents of the child from birth, rather than having to go through a parental order process. In the Strangford constituency, 131 people have signed the petition. They did so for a simple reason—because they have concerns. I want to reflect their opinion on this process. I can understand why some families may want to simplify the process, and there is perhaps a balance to be achieved. However, does the Minister agree that any reforms cannot be allowed to come at the expense of safeguards for surrogate mothers and the children themselves? The Minister is a compassionate lady—I say that in all honesty and know it to be the case. In my dealings with her over the years, I have always found her to be of that opinion, but we need some reassurance.

Surrogacy should remain an incredible act of generosity. It cannot be anything else—not a commercial transaction that risks exploiting vulnerable women and commodifying their children. That can never happen. With that in mind, I look forward to the Minister’s answers.

--- Later in debate ---

[Dr Neil Shastri-Hurst (Solihull West and Shirley) (Con)]

It is a pleasure to serve under your chairmanship this afternoon, Mr Pritchard. I start by declaring an interest in this debate as a former member of the appeals panel of the Human Fertilisation and Embryology Authority.

I pay tribute to the hon. Member for Lichfield (Dave Robertson) for the tone in which he opened the debate, and I recognise the more than 113,000 people who have signed this petition. Behind many of their signatures will be personal experience of infertility and loss, and a long-held wish to start a family. For intended parents, surrogacy is not simply a legal process; it is about getting a family they never thought they could have, and in many cases, it comes at the end of a long and difficult journey.

Nobody doubts the love that such parents have for their children. Families formed through surrogacy deserve dignity, certainty and respect. However, our job in this House is to consider more than the wishes of the adults involved. We must speak for the child who cannot speak for themselves. We must also protect the woman who carries and gives birth to that child.

The issue for us to consider is whether legal parenthood should pass automatically at birth, before the state has considered the child’s welfare, the surrogate mother’s consent and the circumstances in which the arrangement was made. As a starting-point, any reform to the legislation must do three things: first, and most importantly, it must protect the child; secondly, it must preserve the free and continuing consent of the woman who gives birth; and thirdly, it must address the safeguarding concerns arising from the increase in international commercial surrogacy.

First, on protecting the child, the petition describes the upset and strain of months of court proceedings and visits from social services workers before the intended parents are legally recognised. I understand why that process might feel intrusive and unsettling. Intended parents have planned for the child and cared for them from birth, and already see themselves as a family. However, a parental order is not merely words on a piece of paper; it is the legal means by which parenthood is transferred from one person to another. That is a serious act, with lifelong consequences for the child.

The process, as it currently stands, allows a court to consider the child’s welfare, establish that the surrogate mother has freely consented, examine any payments that have been made either through expenses or cash, and consider the circumstances in which the child will be raised. CAFCASS provides an independent assessment, so that the decision is not based only on what the adults expected or agreed before the child was born.

It is argued by some people that those checks are unnecessary because the overwhelming majority of applications are approved. I simply do not accept that. The fact that a system usually finds that everything is in order does not mean that the checks serve no purpose at all. Their existence helps to ensure that proper standards are followed. If the process is too cumbersome, it should be made more intuitive; if families receive inconsistent advice, that advice should be made clearer; and if the courts or CAFCASS lack the resources to deal with applications promptly, the Government should address that. Delays should be reduced, but that does not warrant the underlying protections’ being diminished. I ask the Minister whether the Government remain committed to the parental order process, and what they will do to reduce unnecessary delays while retaining independent welfare assessments.

My second point concerns the woman who gives birth. Under the present law, the woman who carries and gives birth to a child is the child’s legal mother. Legal parenthood is transferred only after she has given valid consent following the birth. It would be ill-judged to dismiss that as an outdated legal technicality, as it recognises the physical, medical and emotional consequences of pregnancy and childbirth. The law normally prevents consent from being given until six weeks after the child is born. That period of time is necessary: a decision made before childbirth cannot fully account for the experience of giving birth, the mother’s health afterwards or how she may feel when the child is born.

If intended parents became legal parents automatically, that protection would be reversed. The woman who carried and delivered the child would instead have to take legal action if she wished to withdraw her consent or assert her own rights. That should concern us all, particularly where there is a financial or social imbalance between the surrogate mother and the intended parents. A system that depends on someone’s having the knowledge, confidence and money to begin legal proceedings may offer very little protection in practice.

Compassion for intended parents cannot require Parliament to treat the woman who gives birth as a temporary party to somebody else’s story, nor should this be presented as a contest between traditional and modern families. Recognising different kinds of family does not require us to reduce the rights of the woman who carries the child. If the Government are considering recognising intended parents from birth, I ask the Minister to set out what protection would remain for a surrogate mother who changed her mind after giving birth.

The third issue is of growing concern: the increase in international commercial surrogacy. The majority of parental order applications now concern children born overseas. Applications relating to children born internationally reportedly rose from 215 in 2021 to 509 in 2025; in that same year, there were 150 applications relating to children born in the United Kingdom. That marks a significant change in surrogacy in this country. International arrangements may involve large differences in wealth and power, commercial contracts that would not be enforceable here, complicated payment arrangements made through intermediaries and serious doubts about whether consent was properly informed and freely given.

[Jim Shannon]

I should have said this in my earlier contribution, but I refer the hon. Gentleman to page 31 of the Library’s “Surrogacy in the UK” briefing, where it refers to some physical circumstances and risks that came up in a Canadian population-based surrogacy study that I think are incredibly important. It says:

“Some research suggests that using an egg from a relative may reduce these risks”.

Does the hon. Gentleman agree that we need to consider the Canadian perspective and the surrogacy study that they did?

[Dr Shastri-Hurst]

The hon. Member always comes to these debates well prepared and well briefed. I think the point he is making, which we can all agree on, is that this is an incredibly complex area that we cannot rush to legislate on, nor should we seek to water down the clear protections that currently exist.

Vaccination Rates: England

Jim Shannon Excerpts

Thursday 3rd September 2026 Westminster Hall

[Jim Shannon (Strangford) (DUP)]

As always, it is a pleasure to serve under your chairship, Mrs Barker—you are certainly earning your money, because you were here yesterday and are back again today. I congratulate the hon. Member for Uxbridge and South Ruislip (Danny Beales) on introducing this debate, and I thank him for setting the scene incredibly well. As the Democratic Unionist party’s spokesperson on health, I am particularly interested in this topic and how it affects those in Northern Ireland. It is good to see the Minister in her place again, and I wish her well in her role. I know that her answers will encourage us—no pressure!

Vaccines have saved millions of lives, protecting our children from serious illnesses and life-changing complications. However, over the last decade, vaccination uptake has declined across the United Kingdom. In 2021, data showed that none of the routine childhood vaccinations had reached the World Health Organisation’s recommended 95% coverage target. That trend reveals a significant risk to public health, which we have already seen with localised outbreaks of measles and whooping cough in areas across the United Kingdom. Research published in August also showed further falls in UK-wide uptake among 12-month-old children of vaccines including pneumococcal conjugate, rotavirus and MenB. If vaccines are not done, it can lead to serious illnesses including pneumonia, meningitis and other life-threatening infections.

I will briefly comment on Northern Ireland, and then I have some asks of the Minister. In Northern Ireland, for children aged 24 months, coverage was above 84% for all reported vaccines. In 2024, the Department of Health warned that a measles outbreak was likely unless urgent action was taken to increase MMR vaccine uptake in Northern Ireland.

New parents must have access to clear, accurate and reassuring information that addresses uncertainty and maintains confidence in the safety of these vaccines. However, my biggest concern is related to practical barriers, which I want to ask about. Research from the Royal College of Paediatrics and Child Health has emphasised that vaccine confidence remains generally high across the UK, while practical issues in accessing vaccination services are far more likely to contribute to declining uptake. Practical barriers are largely faced by those living in deprived areas, for example, or those living in rural areas who do not have access to transport.

Can the Minister comment on those who are prevented from accessing vaccines by lack of transport? Will she have discussions with the relevant Minister in the Northern Ireland Executive on vaccination uptake in Northern Ireland? We must get the correct messaging across social media and into schools with a non-condescending approach. Vaccination is in all of our best interests, but an educational approach must be the way forward. With great respect, this should not be a stick with which to beat parents who believe they are doing the best for their children.

Sudden Cardiac Death: Young People

Jim Shannon Excerpts

Tuesday 1st September 2026 Commons Chamber

[Greg Smith (Mid Buckinghamshire) (Con)]

I have initiated this Adjournment debate on behalf of my late constituent and his family. It concerns a tragic case that raises serious questions about emergency response, clinical training, information sharing, and whether the systems meant to save young lives are fit for purpose.

On 31 January 2024, Adam Ankers, aged just 17, collapsed while playing football for the Wycombe Wanderers Foundation’s under-19 development team. He was a much-loved son, brother, friend and team-mate. He dreamed of a career in professional football, and on the captain’s armband that he was wearing that day he had written the words “strength, inspiration, leader, desire.” Despite the presence of first-aid-trained coaches, despite a defibrillator being brought straight to the pitch, and despite multiple calls to 999, no one recognised that Adam was in sudden cardiac arrest. No cardiopulmonary resuscitation was started.

The coroner found that Adam’s brain had been was starved of oxygen for about eight minutes because no one had attempted CPR, and heard evidence that for every minute without CPR, the chances of survival decrease by 10%. South Central Ambulance Service’s serious incident review reached the same conclusion independently, acknowledging an eight-minute period in which CPR should have started and did not. The ambulance arrived within 11 minutes of the first 999 call, at 2.31 pm, but by then the critical window in which to act, having been led by telephone, had already been missed.

[Jim Shannon (Strangford) (DUP)]

The hon. Member has raised a heart-rending and very difficult case, and I congratulate him on that.

The British Heart Foundation estimates that in Northern Ireland one person under the age of 35 dies every month from an undiagnosed heart condition. In view of that, does the hon. Member agree that more must be done to ensure that the public are equipped to perform effective CPR and to use a defibrillator, and are confident about carrying out bystander CPR?

[Greg Smith]

I do agree with the hon. Gentleman, and I will explore many of those issues later in my speech.

When paramedics arrived, they found Adam cold, blue, not breathing, and without a pulse. They immediately started CPR, and took him to Harefield hospital, with the support of Thames Valley Air Ambulance. Despite the best efforts of clinicians, Adam was declared brain-stem dead on 4 February—in law, that was the moment of his death—and his heart stopped for the final time on 5 February, when life support was withdrawn. His parents, Alastair Ankers and Naomi Wakefield, both work in healthcare. Through devastating experience, they came to the conclusion that Adam’s death could have been prevented.

Adam’s parents fought for more than two years for a proper, in-depth inquest, rather than the four-hour online hearing first offered. They were represented by a single barrister, paid for by remortgaging their house, against an array of solicitors and counsel for the NHS bodies and the Football Association. That is not a fair fight. The underlying condition was arrhythmogenic right ventricular cardiomyopathy—ARVC, a genetic heart disease, the first sign of which can be sudden cardiac arrest. This was a failure to identify a life-threatening emergency in real time, and it is why recognition, escalation and response matter so much.

The inquest raised serious concerns about the handling of 999 calls and the ability of call handlers to recognise abnormal breathing and cardiac arrest. Ambulance services in England use one of two systems: MPDS—the medical priority dispatch system—and NHS Pathways. NHS Pathways is used by just over half of 999 services and by all 111 services in England, and it was the system used on the call that day. The inquest heard expert evidence from paramedic David Davis—not the one of this parish—who told the court,

“I am unable to say that NHS Pathways as is currently configured can always properly support members of the public to identify agonal or ineffective breathing. I am also uncertain as to whether NHS Pathways can adequately identify potential out-of-hospital cardiac arrest where there is seizure-like activity at the outset.”

That is about as serious a warning as an expert witness can give. If the system cannot reliably recognise the signs of cardiac arrest, people are being put in danger, and if the public are left uncertain about whether to follow the advice they are given or to act on instinct, that is a public safety problem.

The coroner issued a five-point prevention of future deaths report on 16 April this year. It was addressed to 13 bodies, including NHS England, the Department of Health and Social Care, the Football Association, South Central Ambulance Service, the UK National Screening Committee and Cardiac Risk in the Young. Responses were due by 11 June. There is a pattern in those responses: every organisation expressed sympathy and described some work under way, but almost none attached a date to anything. NHS England says that a genetic service specification is “currently being revised”, but with no timetable. Staff at Resuscitation Council UK say that responsibility sits with NHS England and the Department of Health and Social Care, not them. The Association of Ambulance Chief Executives says that it is

“not constituted to mandate or instruct ambulance services”.

Everybody has pointed to somebody else, and there have been warnings for years about call handlers and cardiac arrest, sepsis and other conditions, with no clear public evidence of improvement. Why?

I therefore ask the Minister to instruct the Care Quality Commission to urgently and regularly assess ambulance services on call-handler skill in detecting and managing abnormal breathing and suspected cardiac arrest. A CQC inspection of South Central Ambulance Service before Adam’s death had already found call handlers struggling to recognise abnormal breathing, with serious incidents leading to patient harm as a result—this is not new information to the trust. South Central Ambulance Service’s own response to the coroner’s report suggests that the public should understand that call handlers follow a fixed script, and that callers may need to act independently of the advice given. If it is genuinely the Government’s position that people in the worst moment of their life should second-guess the emergency services, the public deserve to hear that plainly, not discover it buried in a filing after a child has died.

Training alone will not be enough. NHS Pathways plays a central role in how millions of emergency and urgent care calls are handled every year, yet there is strikingly little publicly available data on its safety and effectiveness. That is not good enough. Will the Minister commit to a fully independent review of the effectiveness and the culture of NHS Pathways—not simply a restatement that the National Clinical Assurance Group already provides oversight? That body assures the clinical safety of dispositions; it does not examine culture. Its terms of reference are set by NHS England and it reports to NHS England, which is the body that runs NHS Pathways.

I want to press further on one other point, because it speaks to whether the Government can even get the basic facts right in responding to a dead child’s inquest. NHS England’s own prevention of future death response states that Adam was triaged through “Protocol 12, Convulsions/Fitting”—an MPDS reference. However, the coroner’s findings state that NHS Pathways, a different system owned and run by NHS England itself, was used as the script for that call. Why did NHS England’s response point to the wrong system entirely, rather than confront the failings of the system it actually runs? Did national leadership check its own response against the coroner’s findings before sending it? Will it now formally correct the record and explain how that error ever happened?

Moving on, there is the question of how genetic risk is communicated within families. Distant relatives in Scotland had known since 2018 that a genetic variant, PKP2, which is associated with ARVC, ran in the family, but that was not passed to Adam’s immediate family in full until after his death, and only then because Adam’s parents themselves had to go back to that distant relative and ask directly whether there was a letter he had not shared. There was. Once the risk was confirmed, the genetic service’s answer for cascading that information further to the wider family was a brown paper envelope containing 10 photocopied letters, which the family were left to hand round themselves—a grieving family doing the NHS’s job of tracing and warning their own relatives, with no support offered.

Adam’s grandmother had, in fact, raised the family history with her cardiologist at Papworth hospital, who accepted that it was recorded in three places in her notes but said he had not seen it. A 2022 referral from the GP was read by this doctor but never followed up due to an administrative error. Separately, NHS Greater Glasgow and Clyde, which held the original genetic records, refused to disclose them to the English coroner’s inquest as it fell outside its jurisdiction. The coroner considered applying to the Scottish High Court to compel co-operation, but decided against as it was not a proportionate use of public funds. No family should be told that it is not proportionate to pursue the truth about their son’s death across a devolved border. I ask the Minister to raise this issue with counterparts in the devolved health systems, so that no hospital anywhere in this United Kingdom refuses to co-operate with an inquest into a child’s death ever again.

Lobular Breast Cancer: Moon Shot Project

Jim Shannon Excerpts

Thursday 9th July 2026 Westminster Hall

[John Milne (Horsham) (LD)]

I beg to move,

That this House has considered Government support for the Lobular Moon Shot Project.

It is a pleasure to serve under your chairship, Mrs Hobhouse. MPs from across the House are here today to mark the anniversary of the death of my constituent Dr Susan Michaelis, founder of the Lobular Moon Shot Project. I thank the Backbench Business Committee for finding time at very short notice in the parliamentary schedule for this debate. Unfortunately, that short notice has prevented many MPs who would have liked to have spoken today from joining us. Unfortunately, that was a necessity.

Today is a sad moment because Susan is no longer with us, but it is also a time to celebrate what she has achieved. Susan was a remarkable woman. She was warm but incredibly stoic. At no time was that clearer than on her last trip to Parliament in the summer of last year, oxygen tank in tow. Determined but evidently suffering, Susan stood for 22 minutes in a silent vigil outside No. 10 Downing Street with fellow campaigners and lobular ladies around her. We all understood that Susan was in her last days or weeks, so to watch her husband, campaigners and fellow lobular ladies rallying around her, literally supporting her, was a sight to behold.

In her haste to deliver her petition to No. 10 that day, Susan had forgotten her ID. She was distraught. All that effort would be wasted, as the rules were clear: no ID, no entry. But that, of course, was not Susan’s way. Susan, with our support, blagged her way past security. Susan was never one to take no for an answer. Not long after, Susan died—just days after her meeting with the then Health Secretary.

It might seem odd to say, given that I met Susan when she was already very ill with the lobular cancer that she was campaigning to prevent, but I feel that I met her in her prime. It was immediately clear to me that this was a person with an unparalleled commitment to her cause. Despite her illness, Susan never looked for the sympathy vote. She was always calm and matter of fact. She led by example. It is a reminder that her cause, while not yet complete, is a worthy one, and with a champion to match.

Susan’s first campaign was in fact not lobular breast cancer; it was aviation safety. She flew commercial aircraft in the Australian outback, one of the few female pilots to take up this challenge, and piloted the first all-female crewed Qantas flight. This was before contaminated cabin air ended her flying career in 1997. She spent the following decades building the evidence base on aircraft cabin air contamination, with a PhD, an MSc, peer-reviewed research and a leading role in her home country’s Senate inquiry into cabin air quality. Her focus in her final years was on lobular breast cancer, and it is on this endeavour that I was pleased to support her as her local MP.

Susan was diagnosed with invasive lobular breast cancer in 2013. It was a one millimetre mark—no lump, no pain. Two mammograms and two ultrasounds told her that there was nothing to worry about. An MRI scan found 2.5 cm and surgery then confirmed 7 cm. That gap between what standard imaging can see and what is actually there is the heart of why lobular breast cancer needs its own research programme. It behaves differently. It is missed because it is different and it is currently treated exactly the same as the most common form of the disease, because the underlying biology has never been properly funded.

In May 2023, with her husband Tristan, Susan launched the Lobular Moon Shot Project in Horsham. She built it from nothing into a campaign that has cross-party support in this House, a partnership with the Manchester Breast Centre and a research plan costing £20 million over five years.

In June 2025, Susan travelled to Manchester to help launch the scientific programme that she had spent years fighting for. It was a programme that, of course, she knew she would never benefit from herself. Nine days later, Susan died. She never received a reply from No. 10 and never got a chance to make her case to the then Health Secretary. So today, I will again make the case to the Government on behalf of Susan, the 22 patients a day who are diagnosed with lobular breast cancer, and the 463 MPs who have publicly supported her campaign so far, which I believe is the highest number of MPs to publicly support any individual campaign.

Every day, 22 women in this country are told that they have lobular breast cancer—that is over 8,000 a year. This is not a rare disease; in fact, it is the sixth most prevalent cancer in women.

[Jim Shannon (Strangford) (DUP)]

I commend the hon. Gentleman for securing this debate. He has been very vocal on this subject matter and we all support him. I apologise to him, to you, Mrs Hobhouse, and to the ladies in the Public Gallery today, because I have an early flight home so I cannot be here to make a longer contribution to the debate.

This debate is not just about the women the hon. Gentleman has referred to. Alongside Northern Ireland’s Health Minister, Mike Nesbitt, I have met women in Northern Ireland who have lobular cancer. Some of them will not have a long time in this world and I was very moved by what they told us. Does the hon. Gentleman feel that now is the time for the Minister and the Government to ensure that the small amount of money that is needed to help to alleviate the health issues for women with lobular breast cancer is made available, as well as the money that is needed for research? If that happens, the ladies who are here today and my constituents in Northern Ireland can get the help they need.

[John Milne]

I thank the hon. Member for his contribution and I very much agree. I also note that the right hon. Member for Makerfield (Andy Burnham), who is potentially our next Prime Minister, comes from Manchester, has visited the clinic and is already familiar with the campaign, so I am hopeful.

As I was saying, lobular breast cancer is the sixth most prevalent cancer in women. That puts it ahead of melanoma cancer, ovarian cancer, brain cancer, kidney cancer and pancreatic cancer combined. Incredibly, there is still no specific treatment.

Breast cancer as a whole costs this country over £3 billion a year. It takes around 11,200 lives annually, or the lives of roughly 31 women a day. Many of these are lobular cases, yet lobular breast cancer receives none of the targeted treatment that drives down mortality for other forms of this disease. Every woman who is diagnosed with lobular breast cancer is given the same drugs, the same protocols and the same guidelines as someone with an entirely different cancer. That is because the basic biology of lobular has never been established.

It is this gap that the Lobular Moon Shot Project exists to close. We need £20 million over five years, which is just £4 million a year to crack the biology of this disease. That is not speculative research; it is a certain outcome. Other researchers in the UK and around the world can then take things forward to find targeted treatments, because this is a world problem and the world can find the solutions. Of course, there are many demands on Government funding and the national budget is always under pressure, but I think we would be hard pushed to find another project with such a relatively small need for such a big reward. This is a precise unfunded gap, and we already have a delivery partner in the shape of the Manchester Breast Centre, which is ready to begin this work.

I will conclude by quoting Susan’s husband, Tristan, who is sitting behind me in the Gallery—it is strange that I have to speak these words rather than him, but that is the procedure of the House. He said:

“The last overseas holiday Susan and I took together was to Easter Island, one of the most remote places on earth. Like so many people, I had always imagined the island’s famous stone statues—the moai—looking out across the Pacific Ocean. But when we arrived, we discovered something rather beautiful. Most of them face inland. We were told that they were positioned that way because they watch over their people rather than looking out to sea. Whether that is history, tradition or simply one interpretation, it touched us both deeply.

Before we left, Susan found a beautifully carved wooden replica of one of the moai. We brought it home together, and today it sits in our house. Every time I look at it, I think of Susan. It reminds me that although she is no longer physically with me, her love, her courage and everything she stood for remain with me every single day. In my heart, I like to think she is still watching over me, just as those remarkable statues have watched over their people for generations.

If Susan could stand in Westminster Hall today, she would not ask Members to remember her. She would instead ask you to remember the thousands of women diagnosed with invasive lobular breast cancer every year who still have no treatments designed specifically for their disease. That is why this debate matters. That is why the Lobular Moon Shot project matters. And that is why Susan’s legacy deserves not only our admiration, but our action.

As Susan’s husband, I know she would have been deeply humbled that Members from every corner of this House have come together today to honour her life. She never sought recognition for herself. She simply wanted to leave the world a little safer, a little fairer and a little kinder than she found it. My sincere hope is that history will remember this debate not simply as a tribute to one remarkable woman, but as the day Parliament chose to transform admiration into action for future generations of women diagnosed with invasive lobular breast cancer. That would have been the greatest tribute we could ever have paid to Dr Susan Michaelis.”