Major Trauma Centres: Helipads

Jim Shannon Excerpts

Thursday 29th October 2026 Westminster Hall

[Jim Shannon (Strangford) (DUP)]

I beg to move,

That this House has considered the potential merits of mandatory safeguarded 24/7 helipads at major trauma centres.

It is a pleasure, as always, to serve under your chairship, Sir Alec, and I say a big thank you to all the hon. Members for coming along today. I particularly thank the Minister, the right hon. Member for Kingston upon Hull North and Cottingham (Dame Diana Johnson), who has kindly agreed to step in and answer the debate, the subject of which is not her direct responsibility.

What always unites us is the fact that we come together on things that we see as good and necessary, and I am sure that everyone here would say the same. I thank the Backbench Business Committee for allowing us to debate this important issue relating to our urgent and emergency care system—hospital helipads, the barriers that can prevent them from being used when needed, and the case for a strategic national policy. The Minister already knows that I have three asks, but the main one is to have a strategic national policy. I welcome the Government’s 10-year health plan, and I hope that such a policy will be part of it.

[Perran Moon (Camborne and Redruth) (Ind)]

Cornwall Air Ambulance undertook almost 1,000 missions last year, many in my Camborne, Redruth and Hayle constituency. The front helipad directly outside the emergency department at Treliske hospital, which is the only general hospital in Cornwall, was closed in March 2023 and patients have since faced longer transfers, despite assurances that the rear helipad would be upgraded. Does the hon. Member agree that the Government must accelerate a permanent solution so that lives are not put at risk by avoidable delays?

[Jim Shannon]

The hon. Gentleman is right to underline that issue. I understand that he has a very dispersed community, and an air ambulance in that location can shorten journey times—I will mention this in my speech in relation to an issue back home. A journey that maybe takes an hour and a half by road can be done in 15 minutes in an air ambulance. That 15 minutes can save lives. An hour and a half in an ambulance fighting to save the person in the back sometimes just does not work.

I thank the Members who are here to support this debate. I also thank the all-party parliamentary group for air ambulances for bringing this important issue to Parliament in the past, and I am happy we can have this debate today for them. I acknowledge the work of Air Ambulances UK, which provides the APPG’s secretariat, the HELP Appeal and the University of Liverpool’s flight science and technology group in developing the evidence underpinning this work, alongside the UK’s 21 air ambulance charities and the wider group of stakeholders who have contributed their expertise and support. I also thank Air Ambulance Northern Ireland for what it does. I can vouch for the air ambulances and the lives that they have saved. As I will explain later, I know people who live today because of AANI and the quick response of staff.

When someone is critically ill or seriously injured and needs specialist hospital care, can we be confident that the receiving hospital has the facilities they need that will be available when required? The same question applies during a major incident, as we have seen on several occasions this summer in my constituency and across this great United Kingdom of Great Britain and Northern Ireland, when hospitals needed to respond to a sudden surge in demand. For too many hospitals, that cannot be taken for granted.

Air ambulances across the UK play a vital role alongside the NHS in bringing specialist clinical teams to patients and helping transport them to the hospitals that are best equipped to treat them. That relates to an ask I have of the Minster, and I have shared that ask with other Members of the same mind. Across the United Kingdom, air ambulance charities attend an average 137 missions each day. For 365 days of the year, that is what they do. An estimated 23,248 helicopter missions take place annually, at an average cost of £4,748 per mission. That gives us an idea of the work they do, but there is also a cost factor, which is an important part of the debate. Those 137 missions, 365 days a year, represent around £110 million in annual costs.

Behind those figures are patients, families, clinicians and crews working in extremely difficult circumstances, but it is also important to recognise how these services are funded, and that is part of this debate. The UK’s 21 air ambulance charities operate independently of the NHS and receive no day-to-day Government funding, but the people of this great United Kingdom of Great Britain and Northern Ireland are incredibly generous. The charities rely on some £200 million in public donations each year to provide lifesaving pre-hospital care.

Despite that fact, public understanding of the independence of air ambulance charities remains limited. Research done in 2025 by Air Ambulances UK found that 53% of the public did not know that these charities operate independently of the NHS. However, they still depend on reliable NHS infrastructure, including hospital helipads, to transfer patients to the care they need. Their ability to deliver a consistent service is therefore affected by NHS infrastructure and operational arrangements beyond their direct control.

This is the thrust of the debate: when a helipad is unavailable, has restricted operating hours or cannot operate safely, additional challenges can arise in getting patients to the right place at the right time for treatment to save their lives. In some cases, staffing arrangements or restrictions outside normal operating hours can limit access even when a helipad already exists. This is an urgent and emergency care issue that requires co-ordinated leadership from the Government and the NHS.

I want to be clear that this is not a call for every hospital to have a 24/7 on-site helipad. I recognise that in Northern Ireland. I was asked by one of the officials whether we want a helipad in every hospital. No, we do not, but we want one at the Royal Victoria hospital in Belfast because that is the No.1 accident and emergency hospital. It has the surgeons, doctors and care available, and from a regional point of view, that is what I am after. Decisions must reflect clinical evidence and operational requirements. We need national leadership and a consistent policy framework to support safe, reliable, 24/7 on-site hospital helipad access whenever there is a clear clinical and operational need, which must be informed by evidence.

I will focus on three practical areas: a national policy and implementation framework, or road map, to address inconsistent provision and establish a data-led approach to safe, reliable, 24/7 on-site access; clearer NHS standards and stronger planning safeguards; and a national emergency hospital helipad infrastructure contingency fund to support urgent infrastructure needs that cannot be met through charitable funding alone.

The APPG for air ambulances has launched a report, and I have no doubt that the Minister has had a chance to look at its recommendations. I commend the APPG members, some of whom are present, for what they have done in outlining the case for safeguarded, 24/7 on-site hospital helipads at major trauma centres and specialist hospitals.

Some hospitals need infrastructure improvements, and hon. Members will speak to that. Others face restrictions in operating hours, while some require further assessment of their clinical and operational needs. Although solutions may differ for the helipads in each hospital, they should be considered within a consistent national framework. One thing we hope to come from this debate is a national framework within the NHS 10-year plan, which I very much welcome—indeed, everyone in the Chamber does. Although the report provides an initial assessment of major trauma centres and specialist hospitals, the need for a national approach extends well beyond those sites.

Air Ambulances UK’s assessment of 47 major hospital sites, updated on 10 September 2026—about six weeks ago —illustrates the scale of the issue. Six sites, or 13%, require priority action, while 16 sites, or 34%, require further action or monitoring, and 25 sites, or 53%, were assessed as being in a good position. That means that 22 of the 47 sites assessed were identified as requiring priority action, further action or monitoring. That is the target that we hope to achieve. The wider picture should be considered as the national policy develops. Air Ambulances UK’s 2026 public survey found that 83% of respondents supported a national policy to ensure that major hospitals can receive air ambulance patients at any time via an on-site helipad.

I will tell the story about my introduction to Air Ambulance NI and the wonderful people who work there. I live in a village called Portaferry at the bottom of the Ards peninsula, where the AANI service is the thin line between life and death. If a child in Portaferry suffers a critical trauma or a sudden, life-threatening medical emergency, a blue-light ambulance land journey to the Royal Belfast hospital for sick children takes well over an hour, done safely and in the best road conditions, with no cars in front or behind. In a paediatric emergency, when every single second dictates a child’s survival and long-term recovery, a 60-minute delay on a winding rural road is a luxury that those families simply do not have. I know some of the families in the Ards peninsula whose children’s lives have been saved by the presence and response of Air Ambulance NI. When it comes to transferring a vulnerable child to the regional trauma centre in less than 15 minutes, they can do it—an ambulance on the road cannot.

We cannot allow this lifeline to be taken for granted. Securing robust, long-term funding for the air ambulance service is not a bureaucratic policy debate or something that will divide us in this Chamber. It is a moral imperative to protect the lives of our children in the most rural corners of Strangford. It is not just somebody being injured on a farm or having a road traffic accident; that can happen, but it could be a boating accident where the air ambulance comes to the rescue. Some of the air ambulance team are in the Gallery, and I thank them for all their information and comments.

I will refer next to Bristol. Given Bristol royal infirmary’s role as a regional paediatric major trauma centre and a specialist children’s hospital, the case for operating its helipad 24 hours a day, 365 days a year, should be properly assessed against clinical and operational need. That is important for all of us in the United Kingdom of Great Britain and Northern Ireland. Any policy must recognise the particular needs of major trauma centres and specialist hospitals while taking a broader view of the hospital helipad network across the United Kingdom.

Many other hospitals have helipads that support emergency transfers and wider patient pathways. A national policy must recognise their contribution and ensure that their operational requirements are not overlooked. The framework should provide a consistent way to assess clinical and operational need, taking account of each hospital’s role, local circumstances and the consequences of restricted access. That means identifying where clinical and operational need justifies 24/7 access and understanding the barriers that prevent it, whether that relates to infrastructure, restricted operating hours, staffing or out-of-hours arrangements. Sometimes, it can be about planning issues relating to the safety of the helicopter coming to the helipad in the hospital. That may impact on the situation.

Decisions should be based on robust data. That would allow the Government and NHS partners to prioritise action proportionately, rather than adopting a blanket requirement for every hospital. The policy should identify where new infrastructure is required, where existing facilities need improvements, where operating arrangements create barriers, and where facilities need stronger protection from surrounding development, as I was saying. In England, the NHS 10-year health plan and the medium-term planning framework of 2026-27 to 2028-29 set out ambitions to improve care, reduce delays, strengthen productivity and support more integrated services. I welcome that—it is good news, and how could anybody not welcome it? That is the sort of programme and strategy that we want, but the new hospital programme and the UK’s 10-year infrastructure strategy also provide a wider context for modernising and planning resilient infrastructure.

[Tessa Munt (Wells and Mendip Hills) (LD)]

Thank you for chairing this debate, Sir Alec. I benefit from Dorset and Somerset Air Ambulance and the Great Western Air Ambulance. They are both fantastic, but they have raised concerns with me about existing helipads that they may not be able to use in future. Will the Minister—I ask him through the hon. Member for Strangford— consider whether there needs to be some protection and development of the town and country planning direction 2002 so that flight paths are protected from development and infrastructure? It is not just the new hospitals that we need to be concerned about; we need to make absolutely certain that existing helipads can be accessed by the air ambulances.

[Jim Shannon]

The hon. Lady is right; that is the thrust of my contribution. I know that others will make contributions on that issue, including my colleague on my left, the hon. Member for North Cornwall (Ben Maguire).

Helipad provision should be considered as part of delivering on wider ambitions. Reliable access could support more direct transfers to appropriate special care, help to avoid unnecessary additional road journeys and ensure that hospital infrastructure reflects clinical and operational needs. As the hon. Lady mentioned, being operational means that helicopters need a free and safe path to where the helipads are. That is particularly relevant for major trauma networks, but also for the wider network of hospitals that receive air ambulance patients and contribute to emergency care.

I am conscious that other Members want to speak, and I want to ensure they have ample time to do so. I have three asks of the Minister. Will the Government commit to working with NHS partners and Air Ambulances UK to develop a national policy and implementation roadmap for hospital helipads, using clinical and operational evidence to identify where safe, reliable, 24/7 on-site access is needed, and address the inconsistencies in provision that we unfortunately have across the United Kingdom? We all know that the purpose of this debate is to come up with solutions, so we look to the Minister to help us to achieve our collective goals.

The Bristol example demonstrates that having a helipad does not necessarily mean that patients can access it at all times. Improvement is needed. Operational arrangements must be considered alongside the physical infrastructure. Where 24/7 on-site access is clinically and operationally necessary, we should expect the practical arrangements required to deliver it, including staffing, safe operating procedures and out-of-hours availability. That would help to ensure that the presence of a helipad translates into reliable access where patients need it.

There is also a need to protect existing and planned helipads from surrounding developments that could compromise safe operations. The planning around helipads and the flight paths for helicopters is an integral part of that. The Government should work with NHS England and the Ministry of Housing, Communities and Local Government to review whether current planning arrangements provide sufficient protection and whether stronger safeguards are needed. That should include considerations to change the town and country planning direction 2002. That is not the Minister’s responsibility; as so often happens, other Departments need to feed into this issue.

This is not about preventing development; it is about making sure that development can proceed in a way that does not impact unfavourably on air ambulances and helipads. It is about ensuring that planning decisions properly consider the operational requirements of hospital helipads and their role in supporting emergency care. Planning authorities and Departments should help to protect those facilities and provide greater certainty for hospitals that are planning for the future.

My second ask is: will the Government work with the NHS and MHCLG to establish clear expectations for hospital helipad provision and availability in the NHS estates standards and commissioning arrangements? That includes addressing staffing, restricted operating hours and out-of-hours barriers where 24/7 on-site access is clinically and operationally necessary, and strengthening planning safeguards to protect existing and planned helipads.

The Helicopter Emergency Landing Pads Appeal provides charitable funding for the vast majority of local hospital helipad projects and has made a vital contribution to developing and improving infrastructure. However, charitable funding cannot be expected to meet every urgent or emerging requirement. Charities should not be left to address every infrastructure gap through fundraising alone. The Government must—hopefully they will—consider establishing a national emergency hospital helipad infrastructure contingency fund, which would enable air ambulances to make the health delivered in the NHS even better. The funding could help projects that address barriers to safe, reliable, 24/7 on-site access where that access is clinically and operationally necessary. The fund should complement the HELP Appeal’s work, not replace charitable investment.

Thirdly, will the Government consider establishing a national emergency hospital helipad infrastructure contingency fund to support urgent, evidence-based infrastructure requirements, including essential upgrades or new facilities, where safe and reliable 24/7 on-site access is clinically and operationally necessary, but where charitable funding cannot meet the need? The Government do not need to start this work from scratch; the APPG has done much of the hard work already. Its report and recommendations have established an initial national picture of provision at major trauma centres and specialist hospitals, and have identified areas requiring further action. The Government’s next stage can build on that evidence and help to form a broader national approach that also considers other hospitals with helipads.

Lots of the spade work has been done. Air Ambulances UK represents and supports the UK’s 21 air ambulance charities. The HELP Appeal also brings considerable experience of supporting hospital helipad projects and understanding infrastructure funding requirements. Both should be involved alongside NHS organisations. They all want to do the same thing and have the same objective, so we should bring them all together—they are all singing from the same hymn sheet. I believe that there is an opportunity to do this collectively. They should be involved alongside the relevant Government Departments to ensure that the resulting policy is evidence-led, proportionate and capable of being implemented and monitored. The objective should be a practical framework that recognises the difference between hospitals, identifies where action is needed and ensures that the contribution of the wider hospital helipad network is not overlooked.

While major trauma centres and specialist hospitals are a clear priority, the wider network of hospitals with helipads must not be overlooked either. The UK’s 21 air ambulance charities provided lifesaving care through public donations, but their ability to transfer patients depends on NHS infrastructure, which they do not control. There is a wider emergency care issue that requires Government and NHS leadership, and we need a data-led national policy to identify where safe, reliable, 24/7 on-site access is clinically and operationally necessary. It needs to address the gaps in provision, strengthen the NHS standards and planning safeguards, and support urgent infrastructure needs where charitable funding cannot meet the need.

In conclusion, this sector has provided substantial evidence and stands ready to help. I thank the Minister for all that she does for health and the campaigns that she has led over the years, which I have been honoured to support. I urge her to work with the NHS, Air Ambulances UK and the HELP Appeal to turn this debate into a practical, sustainable policy and implementation roadmap. I look forward to hearing other Members’ speeches and the Minister’s response.

--- Later in debate ---

[The Minister for Public Health and Patient Safety (Dame Diana Johnson)]

As always, it is a pleasure to serve under your chairmanship, Sir Alec.

I am grateful to the hon. Member for Strangford (Jim Shannon) for securing the debate—he must contribute to more debates than any parliamentarian I have ever come across—and for giving us the opportunity to discuss the important role that hospital helipads play in supporting urgent and specialist care. My hon. Friend the Minister for Secondary Care, who has responsibility for this policy area, is always happy to meet Members, in particular the hon. Member for Strangford, and I know she will look at Hansard to read the contributions of other right hon. and hon. Members.

The hon. Member for Strangford is a long-standing supporter of air ambulance services. He has regularly talked about their importance, particularly for rural and coastal communities, where the geography can make it harder to reach patients quickly. In his excellent opening speech, he paid tribute to the important and vital work of the air ambulance service in Northern Ireland. I too recognise its invaluable work.

I also recognise the work of the air ambulance charities around and across the United Kingdom, which provide a vital service helping seriously ill or injured people. Across England, air ambulance charities carry out more than 50,000 missions each year. I am very grateful to everyone who works and volunteers in the sector, and to the communities that support them. As a Yorkshire MP, I have to give a shout-out to my local air ambulance—Yorkshire Air Ambulance—for its brilliant work.

I thank all Members who contributed to the debate. My hon. Friend the Member for Camborne and Redruth (Perran Moon) asked about the Royal Cornwall hospital. Although decisions on capital investment are a matter for local NHS systems, I understand that work is under way to look at options to improve the air ambulance access at the hospital. I also understand that the hospital is investigating alternative options so that coastguard helicopters can land safely.

My hon. Friend the Member for Truro and Falmouth (Jayne Kirkham) talked about the necessity of the service in rural and coastal areas. She and a number of other Members raised fuel resilience. We routinely engage with air ambulance charities on contingency planning, and as part of that we have addressed fuel resilience. The Government will continue to work with fuel suppliers to make sure that essential services are supported.

The hon. Member for North Cornwall (Ben Maguire) said that Cornwall Air Ambulance is based in his constituency. He brought the whole debate to life when he talked about 15-year-old Lewie, who suffered horrific injuries, and about how the service saved his life. He also talked about how important the service was when three-year-old Mia had a seizure. I send my best wishes to them both—I am sure all Members would like to do the same—and I hope they have made good recoveries.

My hon. Friend the Member for Cannock Chase (Josh Newbury) gave the example of a family member—I think it was his niece—who needed an air ambulance. I was pleased to hear that she is now 21, and hopefully she is in good health. There were some very good contributions to the debate. I heard what the hon. Member for Chelmsford (Marie Goldman) said about Essex & Herts Air Ambulance, and the issues with the local hospital. I will relay those points to the Minister for Secondary Care.

I recognise the concerns raised by hon. Members and the all-party parliamentary group for air ambulances. The points are well made. In June, the APPG published its report making the case for safeguarded 24/7 on-site hospital helipads at major trauma centres and specialist hospitals, which is a very good piece of work.

We all accept that getting seriously ill or injured patients to the hospital quickly matters. Air ambulance teams work alongside NHS ambulance service and hospitals to provide specialist care at the scene and help patients to reach specialist treatment quickly. We also need to think about what happens when the aircraft reaches the hospital. If direct landing is not available, a patient may need an onward transfer by road ambulance, which can add time to the journey and place additional demand on ambulance vehicles and crews.

Alternative landing sites are an important part of resilience when a hospital helipad is unavailable, so clear local arrangements are needed to minimise delays. Hospital helipads therefore have an important role to play, but the current picture is not the same everywhere. Helipad provision has developed locally, over many years. There has not been a single national approach setting out where helipads should be provided, what the provision should look like and how it should be funded.

Currently, responsibility for hospital helipads sits with local NHS organisations, working with planning, aviation and local authority partners. Decisions about investment, including improvements to allow night-time operation, are generally made locally, as part of a wider NHS estates and capital planning programme. But I recognise the arguments made today that we need to look again at whether those arrangements remain right for the future.

NHS England has identified challenges, including changing aircraft and aviation standards, secondary ambulance transfers, and differences in landing infrastructure. Work has also started to strengthen safety arrangements. Following the tragic incident at Derriford hospital, NHS England worked with His Majesty’s Coastguard, the Department for Transport and the Civil Aviation Authority to strengthen assurance. Sites are now required to have a named accountable manager, a site-specific risk assessment and a helipad operating manual. Chief executives have been asked to confirm that appropriate safety standards are being met.

NHS England continues to work with the air ambulance sector and regularly meets the DFT and Air Ambulances UK. It also takes part, when needed, in the onshore surface landing group, which brings together organisations including the Civil Aviation Authority, the DFT and the devolved nations.

I want to be clear about what we are doing next. I am pleased to announce that the Minister for Secondary Care has instructed the Department of Health and Social Care and NHS England to scope a strategic review of air ambulance resilience, including hospital helipads and landing sites. That work is starting, and I do not want to pre-empt what it may find or any recommendations that it may come up with. It will give us the opportunity to look at current landing facilities, onward transfers, future clinical and aircraft requirements, and the condition of existing infrastructure.

The hon. Member for Strangford rightly recognised that different hospitals have different clinical needs, geography, landing arrangements and planning constraints, and that the same solution will not be right for every site. I agree that any future approach needs to be proportionate and informed by clinical and operational need.

Let me turn to the concerns, raised by a number of hon. Members and the APPG, about the impact of the planning system—

[Jim Shannon]

I want to clarify one wee matter. First, I very much welcome the national review that the Minister has described. On some occasions, there are issues with planning. Will the national review be able to address specific issues and ensure that, where there may be planning objections, there can be an arrangement to ensure that helicopters can safely access helipads? We would not want to see planning holding that up.

[Dame Diana Johnson]

I will set out the position on planning. The Government share the concerns about the potential impact of new developments on the operation of hospital helipads. That is why our new national planning policy framework, published in August, makes it clear that existing public services should not face unreasonable restrictions on their operation because of development that takes place around them.

The framework is clear that where a new development could be affected by an existing activity nearby, the impacts should be identified and suitable steps taken to address them. It also gives substantial weight to the benefits of new or improved public service infrastructure, including healthcare facilities. Work is happening on that now, and I am sure that if the hon. Gentleman wants to discuss it further, we will be able to facilitate that.

Work is happening on aviation standards, too. The CAA’s civil aviation publication 1264 provides guidance on the design and operation of hospital helicopter landing sites. This matters, because safe access depends not just on having a landing site but on whether an aircraft can use it safely. The guidance is not currently mandatory, but the DFT and the Civil Aviation Authority are working towards the formal regulation of hospital landing sites, which is currently expected around 2028.

NHS England and the DFT are also working to build a clearer picture of which hospital landing sites comply with the existing guidance. Currently, helicopter operators make their own decisions about where they can safely land. That can depend on things such as the aircraft being used, the weather and the obstacles around a landing site. The DFT is working with NHS England, the CAA, the air ambulance sector and His Majesty’s Coastguard on those issues. There is obviously much more work to do, and I absolutely recognise the concerns raised in the debate and through the APPG report.

The Opposition spokesperson, the right hon. Member for East Hampshire (Damian Hinds), asked about capital spend in previous years, and I will have to write to him about that. On his comment about announcements in the Budget, our contribution to the defence investment plan, including at the extended level set out yesterday, will avoid impact on frontline NHS services, patient safety, investment in technology and the delivery of the new hospital programme.

--- Later in debate ---

[Jim Shannon]

I thank all right hon. and hon. Members for their contributions.

The hon. Member for Camborne and Redruth (Perran Moon) set the ball going with his contribution. He referred to the 600,000 people in and around his constituency and the need to have the helicopter and air ambulance available. The Minister was kindly in her positive response to that intervention.

The hon. Member for Wells and Mendip Hills (Tessa Munt) referred to safe routes for air ambulances coming into helipads. She rightly set the marker down in raising the impact of future development. Again, the Minister responded to that point, and we thank her for that.

I thank the hon. Member for Truro and Falmouth (Jayne Kirkham) for her contribution. She shared personal knowledge of how her local air ambulance is an essential part of the NHS, and spoke about quality of access, planning and development.

The hon. Member for North Cornwall (Ben Maguire) referred to the air ambulance headquarters in his constituency. He is doing extremely well for the air ambulance. He spoke of access to uneven terrain, clifftops and dispersed moorland, and described it as the “flying doctor service”. That is what it is.

The hon. Gentleman also gave two supreme examples of how the air ambulance saved young 15-year-old Lewie and three-year-old Mia. My goodness, if we ever need a story to illustrate the case, it is the examples Members give from their constituents. Those are lives saved. I could give similar examples of my own constituents —all Members probably could—because we all know people who are alive and walking around the streets in our constituencies today, still with their families. I thank the hon. Gentleman for that. He also referred to better NHS and air ambulance co-ordination, with partnership structures in place. All those things are incredibly helpful.

The hon. Member for Cannock Chase (Josh Newbury) shared examples from his own life, including the supreme example of his niece, who is alive and well today because of the air ambulance. Examples like that convince us all of why we are here and the importance of these debates. He also referred to country roads, how different hospitals have different needs, how we need clearer approval for helipads and how trusts need to work together with the air ambulance.

The hon. Member for Chelmsford (Marie Goldman) shared the problems she is having with her own trust. She said that the NHS should work better with the air ambulance. I always say that it is our job to find solutions, and the hon. Lady referred to solutions. Helicopters need helipads. It can often be a problem for an ambulance to reach an incident safely by road, but there would be no need for that if there were a helipad. The hon. Lady gave the figures for that too.

The shadow Minister, the right hon. Member for East Hampshire (Damian Hinds), is always very kind with his comments. We are all here for the same purpose: to try to help our people. His air ambulance service has flown 907 missions this year, including eight times in one day. My goodness, them guys are on overtime, if there is any in the air ambulance, though there probably is not. The right hon. Gentleman illustrated the cost of running the service in his constituency. We need a plan for helipad funding in the next year. To be fair, the Minister gave the shadow Minister some of the answers he sought. We appreciate that. He also requested a clear standard and financial support.

I will move on to my conclusion, Sir Alec. I am mindful that although I have 14 minutes to speak, usually we only get two minutes to wind up no matter how long is left, so you have been very kind. I thank the Minister incredibly much for her positive response. I do not want to give her a big head, but she always tries to encourage us all. We come here as MPs to fight battles on behalf of our constituents. That is the job that they task us with. I am always at peace whenever a Minister gives us some of the answers that we sought, and today, the right hon. Lady did that.

The Minister referred to the importance of air ambulance charities across England, and the 50,000 missions flown each year. She also referred to fuel resilience for air ambulances, and the ongoing discussions among air ambulances and the NHS. On air ambulance access to helipads and the national approach, work has started to address some of the outstanding improvements. The Minister then gave us the one that we really hoped for: the national review of air ambulance services, their resilience and helipads. We thank her for that.

The Minister referred to the new planning policy framework, and the hon. Member for North Cornwall sought the timescale; although not responsible for that, I know that the Minister will seek to get a timescale. Whenever I go to a meeting, whether it be with the roads service or hospitals, they always tell me what they are going to do and I say, “When will it happen?” That is the question. Today, we ask, “When will it happen?” but we have been very privileged to have had such a responsive Minister. I thank all right hon. and hon. Members for their contributions. As always, I thank the civil servants who keep the Ministers right, and I thank the Hansard Reporters for their patience with this boy from Northern Ireland who speaks at 100 miles an hour.

Question put and agreed to.

Resolved,

That this House has considered the potential merits of mandatory safeguarded 24/7 helipads at major trauma centres.

HCRG Care Group: Performance in the South-west

Jim Shannon Excerpts

Wednesday 28th October 2026 Westminster Hall

[Sarah Gibson]

I absolutely agree with my hon. Friend and will come to that point. The biggest concern for staff is patient safety, which they have clearly highlighted to us. One Chippenham resident told me they waited an hour to get through to the single point of access, only to be told to expect a callback, which did not arrive until the following day. A constituent from Calne described spending a week making calls, leaving messages and sending emails simply to secure a podiatry appointment. I understand that, in the end, he was so desperate that he just went into the offices, but not everyone can do that. I appreciate that the integrated care board, the commissioner, has the single point of access under surveillance. But as I will return to later, being under surveillance is just not enough for our residents.

Many of the concerns raised with me have come not only from patients but from staff. I have heard concerns about growing caseloads, vacancies, the loss of experienced staff and, as my hon. Friend the Member for Melksham and Devizes (Brian Mathew) mentioned, the reduction of administrative support.

One nurse reported that what had previously been 10 visits per day had increased to approximately 15. Another described seeing 14 patients during a shift that overran by 90 minutes. Staff speak of chronic understaffing, excessive workloads, and concerns about the impact that the pressures are having on patients and the workforce.

[Jim Shannon (Strangford) (DUP)]

I commend the hon. Lady for securing this debate. The HCRG took over a substantial NHS contract to run the community health service in the south-west of England. I share her concerns about the long delays faced by patients: similar issues have come up in my constituency in Northern Ireland, where the group struggles to provide services due to worker shortages and lack of funding. Does the hon. Lady agree that the ability of private care providers to deliver NHS-contracted services effectively and reliably must be more thoroughly assessed before the contracts are handed out?

[Sarah Gibson]

The hon. Member is quite right. We are seeing promises not being delivered; whether that is because HCRG is a private service or because of the management of the system is not for me to say. I hope that the Minister will be able to look into the matter.

I personally spend a lot of time in the NHS—not out of choice, but as a patient and a carer for my husband. The frontline staff are fabulous. They go above and beyond to support the patient, regardless of whether that patient happens to be their MP. But as their MP, I do find that the staff tend to approach me in confidence to say that they fear using the formal channels for feedback. Patients and staff working across the community-based healthcare system are raising the same issues with me: delays, difficulty navigating the referral pathway and concerns about whether requests always reach the right clinical team. I think Ministers have a responsibility to take those concerns as seriously as the Members sitting next to me.

Patient safety is my chief concern since HCRG took over. One community nurse described families contacting nursing teams because a loved one approaching the end of life was experiencing severe pain despite being told that help would be available. The nurse reported instances of when no referral appeared to have reached the community nursing team at all. Visits were eventually arranged, but the patient spent several hours without adequate pain relief. A former community nurse separately described trying to obtain additional medication for palliative patients and not being able to get it. Nobody approaching the end of their life should spend hours in avoidable pain because the system is inadequate.

I have also heard concerns about delayed wound care, time-critical medication and urgent catheter issues. One district nurse described attending a patient whose leg wounds had leaked through his dressing. His daughter had contacted the service twice over the weekend without receiving assistance. By the time the nurse arrived, the patient had resorted to wrapping plastic bags around his legs—and I understand that the same problem occurred the following weekend.

The concerns I have received are not limited to community nursing. A physiotherapist working in Chippenham hospital described concerns about the introduction of the new referral system. According to the information, staff noticed that referrals were dropping dramatically under the new system. But when those delayed referrals were eventually identified and processed, clinicians faced a sudden influx of cases, including urgent post-operative patients.

We are talking about knee replacements not being seen in a timely manner, in which case they will end up being re-done. That is a cost for no reason. Clinicians describe patients waiting around eight weeks after knee replacement surgeries, despite the treatment being expected much sooner. The concerns raised are not simply about waiting times, but about the possibility of avoidable deterioration and long-term impacts on recovery. They are not simply administrative inconveniences; they are potentially about patient safety.

I want to touch briefly on wheelchair services. I understand that Wiltshire currently has one wheelchair technician, although it had originally been intended to have four. One constituent from Calne told me that she was supplied with an unsuitable wheelchair without being properly measured. She raised concerns about the difficulty, her safety and the fact that she could not get on to the bus. Despite repeated attempts over months to resolve the matter, she is getting nowhere. Another constituent reported from Chippenham that their replacement battery and updated seating did not arrive, which meant that they were unable to get to college. When repair and maintenance services are not functioning as they should, the consequences for the patient are immediate and profound.

Something that particularly troubled me was a comment made to me by some patients who were no longer bothering to complain because they had become accustomed to the delays and difficulties. Sometimes, the absence of formal complaints reflects a loss of confidence rather than anything else. That is particularly concerning when we think about older patients, disabled patients and those already struggling to navigate a complex health system. The people who find it the hardest to access services are often the people least likely to make their voices heard. That is why scrutiny and transparency matter.

When constituents raise concerns about HCRG services, they expect clear, simple answers. Who is responsible? We have an ICBC contract oversight group that reports to the ICBC collaborative oversight forum. We have the BSW community delivery group, which oversees transformation across the system. We have joint contract oversight groups, quality boards and safeguarding groups that all scrutinise performance, but many of the same organisations sit across multiple levels of that oversight. The integrated care board, the local authority commissions and the HCRG itself are involved throughout that governance structure. The organisations commissioning the contract and managing the contract are also scrutinising the contract—all of them seem to be on the same table. Frankly, even we elected representatives struggle to work out who is accountable.

When everyone is involved in the oversight, it can be remarkably difficult to identify who is responsible for acting when problems emerge. There is a risk that organisations end up marking their own homework, with concerns passing between governance groups rather than being subject to genuinely independent challenge. Patients deserve a system in which responsibility is visible, understandable and transparent from the outset. Where persistent concerns are being raised about access to care, referral pathways and patient safety, it is entirely reasonable to ask whether the Care Quality Commission should take a closer look. We should not worry about independent scrutiny; we should welcome it, because it will lead to improvements.

I would be grateful if the Minister addressed two specific points. First, will she ask BSW’s ICB and the HCRG to publish some comparable pre-transformation and post-transformation performance data that includes call waiting times, callback performance, referral processing times, complaints and patient outcome, broken down where possible to a local level? In that way, patients and parliamentarians will be able to see whether the promised improvements have actually been delivered a year and a half into the contract, despite the fact that the group had six months before the contract started to provide for the transition.

Secondly, will the Minister engage with the Care Quality Commission about a case for further independent scrutiny of HCRG’s Wiltshire services and clarify what further regulatory action may be available if the persistent concerns about access, referrals and patient safety continue, as was referenced by my hon. Friend the Member for Melksham and Devizes?

Patients do not really care how many committees or meetings are called; they want answers. Their concern is whether they are getting the care they need, when they need it.

Covid-19 Inquiry Module 4 Report: Government Response

Jim Shannon Excerpts

Tuesday 27th October 2026 Westminster Hall

[Sir Christopher Chope (Christchurch) (Con)]

I beg to move,

That this House has considered the Government response to the Covid-19 Inquiry Module 4 Report.

It is refreshing to see the Public Health Minister in this debate. If anybody will be empathetic on this topic it must be the right hon. Lady, as she has campaigned fearlessly on behalf of another group of victims: the victims of contaminated blood scandals. Although I do not want to overdo the comparison between the victims of contaminated blood and victims of vaccine damage, the responses of successive Governments to those tragedies have had a similar pattern: total denial of responsibility to start with, then recognition that people have suffered but not because of anything for which the Government were responsible, and then eventually conceding the cause and effect of the damage but still stalling on providing any effective redress.

It is that stalling on which I wish to concentrate. The Hallett inquiry made clear recommendations in April this year. Recommendation 5 stated:

“The UK government must reform the Vaccine Damage Payment Scheme as soon as possible. The reform should include as a minimum: increasing the £120,000 payment, at least in line with inflation to date; subsequently applying annual increases in line with inflation; introducing multiple levels of payment, commensurate with the degree of injury suffered; and any transitional arrangements necessary to provide for fairness between applicants to the existing scheme and applicants to the revised scheme.”

The Government’s response, published earlier this month, is inadequate. That may be because the Minister has been in post for only three months; it may be because Government officials have not done the review work that for the last several years they have assured me and others that they were doing. We will hear from the Minister in due course. I hope she will be able to say that the Government agree to increase the £120,000 payment, that they will apply annual increases in line with inflation, that they will introduce multiple levels of payment, commensurate with the degree of injury, and so on.

[Jim Shannon (Strangford) (DUP)]

I commend the hon. Member for being stalwart in his campaign on this issue; it has been very well done. For too long a small minority of families who suffered severe adverse outcomes have been left stranded by administrative failures and the lack of fair support. Does the hon. Member agree that the promised reforms must be designed in direct collaboration with the vaccine-injured and their families, to ensure that they are treated with the dignity, speed and fairness that they deserve?

[Sir Christopher Chope]

I absolutely agree with the hon. Member. It is fair to remind everybody that he participated in the first debate I had on this subject, on Friday 10 September 2021. That was the occasion on which I moved the Second Reading of a private Member’s Bill and, in so doing, drew attention to what were then 1,632 yellow card reports of deaths having taken place shortly after vaccination.

I also drew attention then to the public petition that had been put to Parliament, and the Government’s response. The petition called for improved support for those injured or bereaved through covid-19 vaccines. The Government response stated:

“Once more is known about the possible links between the vaccine and potential side effects, it will be considered whether a wider review of the VDPS is needed.”

Well, that was more than five years ago. We have now had that review, had the public inquiry and had the outcome, yet we have not had the Government’s acceptance of the clear recommendations to which I have already referred.

Back in September 2021, I requested that the then Secretary of State establish an independent review of disablement caused by covid-19 vaccines and the adequacy of the compensation awarded. I was not requesting a mammoth public inquiry, but only a short, judge-led inquiry into how we should most fairly compensate those who suffered adverse consequences. I also contrasted the Government’s pessimistic view with the World Health Organisation’s COVAX scheme, which, as the Minister will know, indemnifies claims for vaccine damage in third-world countries. We, the British taxpayers, pay for that, but we do not have an equivalent scheme in our own jurisdiction.

On 2 March 2022, I raised the specific subject of the Vaccine Damage Payments Act 1979 in an Adjournment debate. In that debate, I referred to Kate Scott, whose husband, a fit 44-year-old software engineer, spent 124 days in hospital following a severe brain injury caused by the vaccine. Boris Johnson, the then Prime Minister, had written to Kate Scott and her family back in August 2021, stating:

“You’re not a statistic, and must not be ignored.”

He said that the Government would—I use the word again—consider Kate’s suggestions for reform of the scheme.

In concluding my speech on that occasion, I referred to what David Ennals, Labour’s Secretary of State for Social Services, had said back on 5 February 1979, when introducing the legislation. He said:

“For most people, vaccination is a beneficial procedure, and it is right for the community to give financial aid and support to those who suffer as the result of vaccinations given as part of the public policy programme.”—[Official Report, 5 February 1979; Vol. 962, c. 32.]

That was the rationale for the vaccine damage payment scheme, a scheme introduced by the then Labour Government in their dying days. I will not criticise them for having made that a priority at the end of their term of office.

In responding to my Adjournment debate in March 2022, the then Minister, Maria Caulfield, refused even to accept any causality. She said that there had been 920 claims by then, but:

“The work currently going on is establishing whether there is a causal link between the vaccine and the adverse events that people have been suffering.”—[Official Report, 2 March 2022; Vol. 709, c. 1151.]

Fast forward to today, and we see that we have the findings, to which I have already referred, and then the Government response:

“The government…accepts that there is a need for reform of the Vaccine Damage Payment Scheme, and is committed to reviewing the scheme to ensure it is fit for purpose and delivered effectively.”

That implied that it was a review that would start after the inquiry had reported; however, when I and other people campaigning on behalf of the victims met the then Public Health Minister, the hon. Member for West Lancashire (Ashley Dalton), probably about a year ago, she told us that the Government were already reviewing the scheme. We asked her in what respect they were reviewing the scheme, but she said she could not say, although she conceded that they were reviewing it. It now seems as though the Government are starting afresh, saying they are

“committed to reviewing the scheme…we will work closely with the vaccine injured and their families as we consider how the scheme could be strengthened in the future.”

That is a long way from the specific, clear and strong recommendations made by Baroness Hallett. Let us think about what the Prime Minister, Boris Johnson, said to Kate Scott in in August 2021: he said he would review it. Has the review not already taken place? I assume it must have.

There is another issue here. We now know that, as of 30 June, 264 claims had been successful and 582 claims under the scheme had been rejected where causation had been established but the claimant did not meet the 60% disability threshold. On my calculation, that means that about £32 million has been paid out in compensation, yet in answer to a question I asked, which was answered on 3 September, I found out that over four years the costs of the staffing, the non-staffing, the medical assessment and payments to health care bodies is no less than £82 million. All that public money was spent on bureaucracy to try to block people who have suffered damage—in some cases, bereavement—as a result of doing the right thing and taking the vaccines. That is just unacceptable.

I hope that the Minister will include within her response an explanation of what the Government are going to do to simplify the scheme, stop blocking legitimate claims through technical measures, and ensure that instead of spending another £82 million over the next four years on bureaucracy, we actually use some of that money to compensate the people who have suffered as a result of the vaccine programme.

I can help the Minister because I anticipated this debate, in a sense, when we had the private Members’ Bill ballot. I put in a number of presentation Bills, one of which is the Vaccine Damage Payment Scheme (UK Covid-19 Inquiry) Bill. That is set for Second Reading on 15 January 2027, so it is ideally timed to be able to incorporate any recommendations that the Minister comes forward with in this debate. The long title of the Bill is:

“A Bill to require the Secretary of State to publish proposals for the implementation of Recommendation 5 of Module 4 of the UK Covid-19 Inquiry, relating to the Vaccine Damage Payment Scheme; and for connected purposes.”

The Bill represents a legislative opportunity for the Government, and I hope that they will take advantage of it.

In the meantime, during this Session, the Government have been blocking my Covid-19 Vaccine Damage Payments Bill. It has already been published, and the explanatory notes to the Bill set out a number of suggested reforms, including looking at the benefits of having a system that does not cost the Government anything but would ensure that people got recompense. That would be done by introducing a scheme similar to that which covers motor insurance, for example—the Motor Insurers’ Bureau scheme or the Financial Services Compensation Scheme—where the industry pays for the costs of the compensation arising from problems with the way in which those schemes have operated. What could be more equitable than that?

Instead of doing that, both the previous Government and the current Government are indemnifying big pharma against any costs associated with vaccines that do not work properly, which is intolerable. My Bill has a number of recommendations and suggestions. I hope that the Minister will be able to engage with me on them, if not in this debate then privately afterwards.

Jarrow Crusade

Jim Shannon Excerpts

Thursday 22nd October 2026 Westminster Hall

[Jim Shannon (Strangford) (DUP)]

It is always a real pleasure to serve under your chairship, Mrs Hobhouse. I thank the hon. Member for Jarrow and Gateshead East (Kate Osborne) for setting the scene incredibly well.

It is no secret that I love history, but I love the history of social politics as well, and this story is a great example of that key issue. The nature of my life, and I suspect the life of most of us here, is to look out for those who are less well off. Our job, and my privilege and honour as the MP for Strangford, is to chase the bread-and-butter issues. Having read this story over the years, I am pleased that the hon. Lady has brought it forward. It is not just a significant historical moment for her constituency; it holds immense importance for workers across this great United Kingdom of Great Britain and Northern Ireland. I will mention this later in my speech, but the shipworkers at Harland & Wolff in Northern Ireland were of a similar mind and made a similar protest to that of the men from Jarrow.

I am pleased to see the Minister in his place; I have absolutely no doubt that we will get an encouraging response to our requests. I am also pleased to see the shadow Minister, the hon. Member for Bromley and Biggin Hill (Peter Fortune), and the Liberal Democrat spokesperson, the hon. Member for Richmond Park (Sarah Olney). It is incredibly encouraging to hear that, 90 years after the Jarrow crusade, the men’s descendants were invited to Downing Street. That is a real privilege. It is an acknowledgment of the significance of their work—those 200 men marching some 300 miles—that they were recognised centrally in Government by our Prime Minister. It endorses that campaign of many years ago. That has offered a sense a closure for many whose ancestors have passed on, as the difficulties that their families faced have finally been formally acknowledged.

The determination of those formidable men who marched almost 300 miles to make their case for employment was admirable. We must remember that they did not take the train, a vehicle or a horse and carriage; they walked 300 miles, because they believed in the campaign. As someone who loves history, I love the idea that people thought so much of the campaign that they did that. Although they probably returned from London feeling dejected because they had not achieved their goal, I want to make a point about what they did achieve. They achieved the establishment of some social reforms. They achieved the right to have work. They were perhaps the first people to see the NHS and the welfare system introduced, as it was later by the Labour Government. Those were the key social issues that they were chasing way back then. They may have felt dejected some 90 years ago, but the Jarrow crusaders can claim that their walk introduced some of those social reforms. It introduced the issues to which the hon. Member for Jarrow and Gateshead East referred: better housing, the right to better working conditions and the right to secure work.

Shipbuilding is an industry that Northern Ireland shares with the north-east of England, and both have experienced the consequences of industrial decline. When the Jarrow men were marching some 90 years ago, men in Belfast were doing something similar—maybe not as far as 300 miles, but they were out protesting in support of the Jarrow men. Both communities have experienced the consequences of industrial decline, striking or taking action over job losses and increasing poverty. Poverty was as rife in Jarrow as it was in Belfast and in other parts of the United Kingdom. However, we must never be tempted to write off shipbuilding and engineering as industries of the past. With the recent investment in defence, there is an opportunity to rebuild industry in the United Kingdom of Great Britain and Northern Ireland and support job creation.

In his response to our requests, the Minister will undoubtedly tell us about the progress that the Government are making. I can see that progress in Belfast with Harland & Wolff: the Government are handing out contracts to ensure that Harland & Wolff can recruit in Belfast again—not like it did when there were 25,000-odd workers, but 1,000 or 2,000—and establish itself at the forefront of modern shipbuilding. That is good news for Northern Ireland, for the shipyard in Belfast and for my constituents in Strangford, who are only 15 or 20 minutes away from possible employment.

I want to make a plea, if I can. Today, too many young people across the United Kingdom feel, as the men who took part in the Jarrow crusade did, that their efforts are being ignored. As elected representatives, we always encourage our constituents—especially our young people—to apply for jobs, but some young people say to me, “I’ve made application after application, and I haven’t even had a letter of response from the employers,” so many of them despair. I am really encouraged by the Prime Minister’s commitment to try to help young people. He is saying the right things, but the right words mean something only when they become the reality. He said that young people today face

“an economic catastrophe and a moral failure”,

and he and the Government have indicated that that must be righted.

I will tell a quick story about my youngest son. He is a young man now, married with two children, but I remember that when he first applied for a job he made something like 70 applications. Unfortunately, not one was successful and he did not get one reply—that was even more discouraging. If someone writes you a letter, you might not agree with them, but for goodness’s sake, you should write back and tell them that.

It was disappointing, but then a part-time job came up. It was only four hours—this was when he was just 18, 19 or 20—and he said, “What should I do?” I said, “You take the job, mate, and I tell you what: make sure you are 15 minutes early and stay 15 minutes later.” He did, and then the job was eight hours, then 16 hours, then 24 hours, then 36 hours and then 40 hours. Then he became the deputy manager of the shop, then the manager and then the manager of another shop. Those are the things that give our young people encouragement.

In the Prime Minister’s commitment, I see an opportunity to encourage our young people and give them hope for the future. Not that I am better than anybody else, but when the Prime Minister came here to take his oath, I saw him beforehand. I remember him from when he was last here in 2015. I shook his hand, gave him a hug and wished him well. I said, “Prime Minister, our people need hope. Our people need encouragement. That’s what I ask you to do for our people.” The Prime Minister’s word has been “hope”, not because I said it to him, but because he appreciated—perhaps we both appreciated—what the word was to be.

The concern must be acted upon. I call on the Government to grow British industry and invest in job creation to ensure that our young people are supported into employment. The 200 men who marched from Jarrow some 90 years ago should never have had to walk to London to make their demands, but they did, and they perhaps changed a part of history. That encourages us all as we look forward. Similarly, young people today should not feel that they have to go to extreme lengths to be heard by the Government. Like the Prime Minister, I hope for a change that makes a difference, encourages our young people, lifts this nation and makes us more united so that we can do better for our people and young people of the future. To the hon. Member for Jarrow and Gateshead East, I again say well done.

--- Later in debate ---

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

It is a pleasure to serve under your chairship, Mrs Hobhouse. I thank my hon. Friend the Member for Jarrow and Gateshead East (Kate Osborne) for securing this debate. She follows in the proud footsteps of her predecessor Ellen Wilkinson, who was the MP for both Jarrow and Middlesbrough.

As we have heard, there is an incredible history of the Jarrow march. For anyone interested, I can strongly recommend Ellen Wilkinson’s book, “The Town that was Murdered”. My own copy is at home on my bookshelf, so I have borrowed the House of Commons Library’s copy. I will be returning it later today, so Members may wish to take it out and study more about the social conditions in Jarrow at the time.

As we have heard, in October 1936, around 200 unemployed men set out from Jarrow and walked almost 300 miles to London asking for the opportunity to work. They carried with them the hopes of a community and a petition signed by 12,000 of their neighbours, but they were ignored by the Government of the day. Those men and their community will not be ignored by history, nor by this Government.

The story of the Jarrow crusade cannot be separated from the story of British industry and shipbuilding. Today, we recognise the UK’s civil maritime sector as it should have been recognised then, as a strategic national asset underpinning prosperity, resilience and security. Shipbuilding ended in Jarrow, but the wider Tyneside retains ship repair capability at Hebburn—a yard recently acquired by Balaena Tyne during my tenure as the shipbuilding Minister. I am pleased to offer reassurance to my hon. Friend the Member for Jarrow and Gateshead East that as Minister for Investment, I am concerned with ensuring that we continue to attract investment into British shipyards. I am working with ministerial colleagues to maximise the opportunity of Government procurement, including opportunities for Hebburn.

Those areas where modern shipbuilding, ship repair and marine fabrication continue benefit from highly skilled, well-paid industrial jobs, and they are often areas of the country that are otherwise lacking in alternatives. That contributes to the growth in every postcode scheme that the Prime Minister has committed to across the whole of our United Kingdom. When I was the shipbuilding Minister, I was pleased to visit Harland & Wolff in Belfast and learn from the managing director. When I asked him, “What is your greatest concern?” he said, “The lack of space,” which is quite remarkable at Harland & Wolff. It shows the strength of British shipbuilding and the opportunity for new orders.

The pride in skill that we saw in Jarrow and that I have seen in British shipyards was demonstrated during the Upper Clyde Shipbuilders dispute of 1971 to 1972. Faced with liquidation and threatened job losses, shop stewards representing 8,000 workers staged a disciplined work-in: they kept the yards operating and continued to build ships under contract. The campaign helped to secure Government investment and preserve shipbuilding employment on the upper Clyde.

A firm tradition of shipbuilding continues today. The sector supports more than 38,000 skilled jobs across the country. The Government are expanding the role of the National Shipbuilding Office to oversee civil shipbuilding decisions and to use procurement more strategically to give British yards and supply chains a clearer pipeline. The forthcoming shipbuilding and maritime technology action plan will seek to align procurement, innovation and industrial capability, to improve pipeline visibility, to accelerate technology adoption, and to strengthen UK supply chains across defence and civil maritime markets. The Government are investing £440 million in UK Shipping Office for Reducing Emissions research and development between 2026 and 2030: the largest Government investment yet in the UK commercial maritime sector, including £150 million for zero emission infrastructure and vessels, and £120 million for clean maritime demonstration projects.

The tragedy at Jarrow—for it was a tragedy—was that the shipbuilding industry and the community that depended on it were left at the mercy of the market, not to improve efficiency or productivity but to effect consolidation that would raise prices. For shipbuilding, a project-based industry with high fixed costs and high economies of scale, that was a disaster.

The community in Jarrow understood the need for industrial transition; they had already transitioned from mining to shipbuilding. They were asking for a transition from shipbuilding to steel. The Government of 1936 took a free market approach; this Government take a different approach: supporting a transition. Alongside our plans for shipbuilding we are reindustrialising the UK, building on our industrial strategy. Reindustrialisation is creating more, better, well-paid jobs in manufacturing and industry, including in those sectors critical to the UK’s resilience. It is bringing back jobs, pride and decency to the places that deindustrialisation most badly affected.

But saying what we will do is not enough; we also know how we will address the situation. The jobs plans that we have set out will ensure that workers have the opportunity to develop the skills they need for the jobs in growing areas, and there are opportunities across the whole country. We have published job plans for digital and technologies, clean energy, life sciences, financial services, construction, and professional and business services. They set out practical actions to tackle workforce and skills challenges.

The jobs plans for professional and business services and for construction were published on Monday and will support 22,500 new under-25 apprenticeships a year in businesses such as accountancy, legal services and consultancy. That comes alongside 40,000 construction placements annually, as part of a previously announced construction industry ambition to create 100,000 jobs a year. Over the next year, the Government will further cut industrial energy costs, roll out further jobs plans in partnership with employers, see our new apprenticeship units and technical excellence colleges train people for growing industries, and strip back unnecessary administrative costs to businesses.

The shadow Minister, the hon. Member for Bromley and Biggin Hill (Peter Fortune), was generous in his remarks, particularly those relating to the Prime Minister, and in his criticism of Stanley Baldwin, but it has been nearly a century so I do not think he is going to get any comeback from that. He also expressed his concern about deindustrialisation in the UK, so I remind him that under the previous Government we lost around 50% of our automotive output, 30% of our chemicals output, 50% of our steel output, and around 30% of our ceramics output.

This Government have made efforts to support those industries, to reinvest and to reindustrialise. Last year, as Industry Minister, I announced a £350 million chemicals resilience fund, a ceramics support scheme, £2.5 billion of support for the steel industry through the steel strategy, the critical minerals strategy, and of course the nationalisation of British Steel. This Government remain committed to supporting the growth of and investment in our industry.

The Liberal Democrat spokesperson, the hon. Member for Richmond Park (Sarah Olney) mentioned the issues affecting young people and their employment. That was also a great concern for those who marched in Jarrow. The social conditions in Jarrow were quite appalling and were the sort of social conditions that can be found today in parts of the country where there are high levels of unemployment. Unemployment and poverty also result in cramped and squalid housing conditions, such as those found in Jarrow at the time. There were high levels of ill health among young people, particularly tuberculosis, and there was a shortage of food, as was noted at the time by the very low consumption of milk by children in the local area. This was compounded by the inability of the local council to raise local taxes sufficiently high enough to provide relief for local people—a product of the inequality of land values in places like Jarrow compared with other parts of the country. In fact, Ellen Wilkinson, in her book, makes a direct comparison with the property taxes that were able to be raised in Westminster, a comparison that my hon. Friend the Member for Hartlepool (Mr Brash) made in his own area, so the problem persists until this day.

What the town council in Jarrow did do with the resources that it had available was always put education first because it knew, as we know, the success of our country and industry depends on the next generation of people who will build, design and operate the industries of the future. I know my hon. Friend the Member for Jarrow and Gateshead East has made a particular point during this anniversary of working to include young people in the commemorations of the Jarrow Crusade. It is vital that our young people have the opportunity to understand the histories and values of their forebears. I do hope that Elise and Imogen had a very memorable meeting with the Prime Minister at Downing Street.

It is also important that we support our young people to access work opportunities, which they were asking for, but were rejected, in 1936. With around 1 million young people not in education, employment and training, this Government will not leave an entire generation of young people behind. Our measures are helping more young people take their first step into work. Since announcing an additional £2.5 billion to create up to 500,000 opportunities to earn and learn by 2029, we have begun rolling out youth guarantees across Great Britain. The youth guarantee gateway is now available in jobcentres. We are expanding youth hubs. We have launched the £3,000 youth jobs grant and are rolling out the jobs guarantee. Youth hubs are a crucial part of our youth guarantee. They bring together the employment skills and wider support that young people need to move into work, training or education. By expanding the network to over 360 locations across the country, more young people will be able to access personalised and wraparound support in their local community.

[Jim Shannon]

I commend the Minister for his comprehensive and helpful response to the things that we have asked. He is outlining the programme, strategy and focus here in the mainland, which I certainly encourage. There are lots of good things in the Administrations in Scotland, Wales and Northern Ireland that we could all learn from. I know the Minister has been to Harland & Wolff in Belfast. He was keen to go; I remember him telling me he was going there. Has he had a chance to discuss strategies so that we can maybe develop them ourselves and try to work more consistently across all the nations to improve opportunities for young people, wherever they may be?

[Chris McDonald]

The hon. Member makes an important point. The solutions that will help young people get into work are understood well in local communities, because they need to respond both to the needs of that local community and the needs of local industry. There are, both in Northern Ireland and in many places around the country, excellent collaborations between industry and local colleges, particularly in Northern Ireland with the work being done around the Short Brothers aerospace location, where there are excellent opportunities for young people and close working with local further education colleges, for instance. I am sure there are lessons there that could be learned in other parts of the country, too, so I thank him for making that point.

We commissioned Alan Milburn to independently review the crisis of young people not in employment, education or training, and we will consider the findings in the interim report to continue to build our reforms. We look forward to the final recommendations being received shortly.

We remember not only the men who marched, but, as the shadow Minister said, the people who provided them with support and assistance along the way. Those working people showed solidarity, offering shelter, food and medical supplies. Just like the marchers in 1936 and all the people from around the country who supported them, this Government recognise the value of secure work, fair pay and opportunities to progress. Employment laws have not kept pace with modern working patterns. Too many workers lack the protections that they need at work, and responsible businesses face unfair competition from those willing to exploit gaps in outdated employment laws.

That is why this Government came up with our plan to make work pay, which will modernise employment rights to respond to a changing labour market and create a fairer, more secure economy for workers and business. Evidence drawn from UK and international research, alongside economic modelling, suggests that the Employment Rights Act can support a better-functioning labour market, more secure work, better job quality, improved productivity and fairer competition, and will have a positive, direct impact on economic growth.

More than 18 million employees are expected to benefit from the new protections, with lower-paid workers in sectors such as social care, hospitality and retail seeing the biggest gains. Analysis suggests that the north-east is likely to be one of the UK regions that benefits the most from the measures in the Employment Rights Act.

Many of our reforms are already making a difference for workers. Employees now have access to family-friendly rights from day one of employment, up to 1.3 million more people are eligible for statutory sick pay, and we have made it easier for workers to connect with trade unions. We also created the Fair Work Agency, bringing the enforcement functions of three predecessor bodies together so that employment rights can be enforced more effectively and efficiently. Together, our reforms ensure that economic progress is shared by the people and communities who create it.

Ninety years ago, the men of Jarrow walked to demand something fundamental: the chance to work, to contribute and to build a better future for their families. Their journey stands as a reminder not only of the consequences of economic decline, but of the resilience, determination and solidarity of working people. I share that belief in the dignity of work, as do all working-class communities. As we commemorate the Jarrow crusade, we have the responsibility both to remember their story and to learn from it. Through investment in industry, support for skills, stronger workers’ rights and renewed opportunities for young people, we will build an economy in which every community can succeed.

University Hospital of North Tees

Jim Shannon Excerpts

Wednesday 21st October 2026 Westminster Hall

[Matt Vickers (Stockton West) (Con)]

I beg to move,

That this House has considered the future of University Hospital of North Tees.

It is a pleasure to serve under your chairmanship, Mr Stringer. I am grateful to the Minister for being here to respond to the debate.

I was born in North Tees hospital. So were tens of thousands of my constituents and many of their children and grandchildren. For nearly 60 years, it has been where Stockton goes when something goes wrong. It is where we are stitched up after an accident, welcome our children into the world and sit beside our parents in their final days. There are very few families in our town whose story does not run through North Tees at some point.

I want to begin by thanking the incredible people who work at North Tees: the doctors, nurses, porters, cleaners and everyone who keeps our hospital going day and night. I have seen for myself their dedication and the challenges they face in a building that makes an already difficult job harder. They deserve decent facilities. Their patients deserve them, too. I have to tell the Minister plainly that the building they work in is running out of time.

When my party was in government, I campaigned for a new diagnostic centre in Stockton. Thousands of residents signed my petition and backed that campaign. Around £25 million was secured, with a further £8.4 million from the community diagnostic fund, to bring scans and tests into the heart of our town. For somebody waiting to find out whether they have cancer, that means answers and that treatment can begin. Alongside that came £3 million for the new mental health hub at Brook House, a new respiratory unit, upgrades to the urgent care centre, and a £4.3 million robotic and emergency maternity theatre, where a woman who needs urgent surgery in labour can now get it next door to the delivery suite. That is what investment can achieve, but we cannot keep bolting 21st-century medicine on to a 1960s frame forever.

[Jim Shannon (Strangford) (DUP)]

I commend the hon. Gentleman for securing this debate, which is not specific to one corner of the mainland; as an example, our South Eastern health and social care trust has to find savings of £50.7 million. Does he acknowledge that the capital and resource crises across our United Kingdom are interconnected and that patient safety should always be paramount? Ensuring the availability of the resources it needs to keep patients safe should be the NHS’s priority at all times.

Smoke-free UK

Jim Shannon Excerpts

Thursday 15th October 2026 Westminster Hall

[Jim Shannon (Strangford) (DUP)]

It is always a pleasure to serve under your chairship, Ms Vaz. I thank the hon. Members for Harrow East (Bob Blackman) and for City of Durham (Mary Kelly Foy) for introducing the debate. Both their contributions set the scene incredibly well on an issue that concerns the health of people across the United Kingdom of Great Britain and Northern Ireland.

The information published by the Library ahead of the debate reminded us that the Conservative party published a Green Paper on this topic in 2019 and that the Labour party has committed to the smoke-free by 2030 ambition. The major political parties and all of us in this Chamber want the same thing: to achieve a smoke-free UK. The introduction of the Tobacco and Vapes Act 2026 has made possible what is hoped to be a smoke-free generation, by prohibiting the sale of tobacco to anyone born on or after 1 January 2009. That will undoubtedly contribute to the continuing decline in the number of adult smokers.

I only ever had a cigarette once. I tell the story because I was only about six years old. You know the way, when you are small, you look at your granda? He was not a big man, but he was my hero because he was my granda. Granda smoked the cigarettes. They were Gallaher’s, and I do not think there was any filter on them. I looked at my granda and said, “Granda, you’re always smoking cigarettes—can I have one?” My granda says, “Yes, you can. Take that there and then take a really deep breath.” And I did—with no filter. Those of a certain generation will remember whenever the po was under the bed; well, I went green and I was violently sick into the po. I always remember that introduction, from my granda—that was a cigarette. Never, ever have I wished to smoke a cigarette, all my life. The Government do not have to worry about me; it will never happen. Nor, I am glad to say, did it happen to any of my children. That is a story with, perhaps, a poignancy—a reminder of what it was like years ago.

In 2024, those aged 45 to 54 had the highest proportion of current smokers, at 12.4% UK-wide. Many of that age group are addicted beyond their control, and deterrence measures alone are likely to be a bigger challenge and potentially less successful. The hon. Member for Harrow East referred to the mother—it is not a condemnation; it is a fact—who would buy a cigarette before getting food on the table. We must recognise that smoking is a serious addiction and acknowledge that many in that age group began smoking without fully understanding the long-term health consequences. Our focus must extend beyond prevention. We must advocate for accessible addiction treatment and practical support for those who want to quit smoking but are struggling to do so.

I understand that the consultation on the tobacco and vapes regulations ended on 2 October. Will the Minister give us some indication of the timescale for the release of the responses to the consultation, and the timescale to take action on those responses? I should have welcomed the Minister to her place; it is always a pleasure to see her and we wish her well in her role.

It was estimated that in 2024 smoking contributed to 15% of all deaths in Northern Ireland, and the costs of treating smoking-related illnesses was estimated at £218 million annually. Those figures are worrying. They indicate that if we achieve a smoke-free United Kingdom of Great Britain and Northern Ireland, it will clearly reduce the financial impacts on the NHS. The same report reflected UK-wide concerns regarding young people vaping, estimating that in Northern Ireland alone 9% of 11 to 16-year-olds use e-cigarettes. Although e-cigarettes may help some adult smokers to move away from tobacco, it is increasingly the case that young people who have never smoked are becoming addicted to vaping. There is a real need to address that in the Government’s consultation on vaping.

I call on the Government to take further action to reduce the appeal of e-cigarettes to children by introducing controls on flavouring and advertising. Alongside stronger enforcement against the illegal sale of e-cigarettes to those under 18, that will contribute to a smoke-free United Kingdom of Great Britain and Northern Ireland, which will ease pressure on our already burdened health service and ensure that the next generation—the ones who come after us—will grow up free from the harms that we have seen smoking cause.

Unpaid Carers

Jim Shannon Excerpts

Thursday 15th October 2026 Westminster Hall

[Jim Shannon (Strangford) (DUP)]

It is always a pleasure to serve under your chairship, Mrs Barker. You always have a wonderful smile and you give us encouragement when we come along. That helps us to talk about subjects that are sometimes quite difficult to talk about—this is one of them. It is also a pleasure to see the Minister in his place. I look forward, as we all do, to his response to the debate.

Over my years as an elected representative—it has been a long time—I have met some young carers and unpaid carers. I have to start my contribution by paying tribute to them—those who quietly, tirelessly and selflessly dedicate their lives to looking after loved ones. What have I seen? I have seen the profound exhaustion. I have seen the absolute devotion. I have seen the immense financial and emotional toll. It is a fundamental truth that unpaid carers are filling a massive breach that the state simply cannot afford to fill. Without them, our health and social care system would collapse overnight.

I always give a Northern Ireland perspective. I wish I could say that it would not be replicated in what others will say today, but on this it is the very same. We have some 220,000 carers providing vital support to sick, elderly or disabled family members and friends. That is roughly one in eight adults. It breaks my heart to note that we also have roughly 17,500 children and young adult carers in Northern Ireland carrying a physical and emotional burden that no young shoulder should ever have to bear, but they are bearing it.

The latest research from Carers NI reveals that unpaid carers save the Northern Ireland Executive an astronomical £5.8 billion every single year. That is because if staff were doing that work, it would cost £16 million every single day, or more than £660,000 every single hour. That is equivalent to 80% of the entire day-to-day Department of Health budget.

In my Strangford constituency, in the Ards and North Down area, the local reality hits even closer to home. We have some 18,000 unpaid carers in our local communities, from the streets of Newtownards and Comber right down to the most isolated parts of the Ards peninsula. They are ordinary people doing extraordinary things. They are the partners, the parents and the children who have stepped into the breach because their love for their family overrides everything else.

How do we reward—I say “we”, but it is not us personally; it is government—that immense contribution? We reward them with poverty. We reward them with isolation and institutional neglect. The poverty rate among young carers in Northern Ireland stands at a shocking 28%. For those trying to survive on carer’s allowance, the situation is dire. The cost of living crisis has pushed them to the absolute brink, with more than half struggling to pay basic utility bills and over a third being forced to skip meals just so that they can look after their loved ones.

More than 52% of carers in Northern Ireland report that their physical health has suffered due to their responsibilities. Their days have a sense of fear and dread. Our carers in Northern Ireland do not even have the statutory baseline of protection. They are forced to reduce their hours or leave the workforce entirely, with nearly 30% of local carers having to give up their jobs to care. The impact on the carers is massive; poverty, for 28% of carers in Northern Ireland, is extreme.

This is the responsibility of the DWP, not the Minister, but every week in my office, sometimes more than once, my staff and I have to take on the case of someone who has had an overpayment. Sometimes they are a carer, and we have to intervene and help to get a repayment system that they can cope with, and it is all because of a mistake that was made. I am not talking about those who blatantly take advantage of the DWP system; I am talking about the ones who come to me—and probably to you, too, Mrs Barker—on a regular basis, who have to repay a statutory payment. It is a disgrace that we penalise those who want to work a few extra hours while managing their care duties. Does the Minister agree that it is high time that we stop treating unpaid carers as a free resource to prop up a failing social care system?

I welcome the fact that the Prime Minister says he will address this, but my goodness me, do it not just in England but in Northern Ireland. Will the Government commit to a comprehensive cross-departmental review of carer’s allowance thresholds and work closely with the Stormont Executive to deliver a ringfenced financial package and proper respite care, to ensure that those who care for our society are finally cared for themselves? That is what I want; I think it is what everybody wants.

Burnout is a real thing. Without support, we risk carers not only being unable to care for their loved ones but needing care themselves. That is what the ones I meet tell me. All we need to do is look at them. I am not better than anybody else, but when I engage with them, I can quickly understand how things are. This precarious house of cards around carers must be sheltered from the wind, and the Government must do that or pay an ultimate, unfathomable cost.

--- Later in debate ---

[Helen Maguire]

Absolutely. I referred to that, and the care also affects their career prospects.

The care that unpaid carers provide is worth an estimated £152 billion annually, which is equivalent to the annual NHS budget. The 2021 census also found that in England and Wales, women are more likely to provide unpaid care than men, with women accounting for 59% of unpaid carers.

The number of unpaid carers has risen by 70% in the past two decades, according to the Institute for Public Policy Research, and 1.7 million of the 5.8 million unpaid carers provide 50 or more hours of care every single week. In England and Wales, women aged between 75 and 79 are most likely to provide 50 or more hours of care a week, while among men it is those aged between 85 and 89.

The sacrifice to step up and work as an unpaid carer is not without significant impact. Evidence consistently shows that unpaid carers experience worse health outcomes than non-carers. The 2021 census in England and Wales found that around one in four carers reported “not good” health, compared with fewer than one in five non-carers. The GP patient survey in 2025 found that 72% of carers said they had a physical or mental health condition or illness. An academic study that analysed the GP patient survey data found that for those providing care for 50 or more hours a week, the health impact of being a carer is equivalent to their losing 18 days of full health each year.

The economic and employment prospects of unpaid carers are also heavily impacted. Census data shows that nearly 3 million people in the UK balance unpaid care with paid employment. Polling by Carers UK suggests that the number could actually be much higher, with one in five workers, or 6.7 million people, providing unpaid care. In addition, 69% of carers who are employees report not having focused on their career as much as they would have liked to, 61% said that caring has impacted the type of employment they have taken on and 21% said that they had taken on a lower paid or more junior role that better fitted with their caring responsibilities.

This polling also found that in the past two years 1.1 million people have left employment to provide care. That is equivalent to around 1,500 people leaving the workforce every single day, which is an increase of 150% compared with polling in 2019 that showed the figure was 600 a day.

[Jim Shannon]

I thank the hon. Lady for her contribution to the debate. She is focusing clearly on those in work. I was sitting there thinking about the young carers I first met, who were between 11 to 17 years old. The impact on them is clear and graphic. Their work and their education suffers. When they go home from school they have to do their homework and have to look after their mum, dad or siblings, so the impact on them is even greater than normal. Does the hon. Lady agree that for those in education, there is a big impact as well?

[Helen Maguire]

I absolutely agree.

WPI Economics research found that being out of work is the single strongest quantitative predictor of poverty for unpaid carers. Those negative impacts of caring are particularly felt among under-represented groups. Ethnic minority carers are more likely to be struggling financially and have concerns around services not meeting their needs in comparison with white British carers. Similarly, LGBT+ carers are more likely to be struggling financially and more likely to say that caring has impacted on their mental health in comparison with their heterosexual counterparts.

The Liberal Democrats have always been the party of carers. We have campaigned to ensure that they have the financial resources, training, support, rights, respite and access to services that they need to live their own lives to the fullest and look after their loved ones. We are proud of the successes that we have had so far in helping unpaid carers, including introducing the Carer’s Leave Act 2023 and securing increasing carer’s allowance in 2024.

However, much more must be done. We are happy to see that social care has moved up the agenda under the new Labour leadership, and we look forward to continuing to work constructively with the Prime Minister on this topic. However, the failure in social care is devastating family finances, forcing thousands to sell their homes, crippling the NHS with delayed discharges and unnecessary admissions and bankrupting local authorities. We will make sure that unpaid family carers are not overlooked as the whole system is reformed. They cannot continue to be seen as a never-ending source of labour that will always be there to cover the shortcomings of state support.

Our first test of Labour’s social care reforms will be whether family carers are front and centre with guaranteed rights. Those must include respite care and a full replacement of the broken carer’s allowance so that families can afford the care. Could the Minister clarify whether working-age adults will also be in scope for the national care service?

The Liberal Democrats will ensure that unpaid carers have a fair deal by increasing the carer’s allowance by £20 a week and expanding the eligibility for it; introducing a statutory guarantee of regular respite breaks for unpaid carers; establishing paid carers leave and building on the entitlement to unpaid leave previously secured by the Liberal Democrats; creating a carer support service in every hospital to support carers before, during and after a loved one leaves hospital and to involve them in their discharge planning; making caring a protected characteristic under the Equality Act 2010; and requiring employers to make reasonable adjustments to enable employees with caring responsibilities to provide that care and launching a young carers pupil premium as part of an education guarantee for young carers. We also want to see the NHS do more to identify and support unpaid carers, including by promoting the health and wellbeing of carers as part of integrated care board plans.

We are also calling on the Government to establish a new £75 million a year national scheme that would fund guaranteed respite care in every part of the country. That would alleviate the burden on carers and prevent hospital admissions due to carers becoming too exhausted to look after their loved ones. Unpaid carers deserve the right to a break. Many are overwhelmed and at breaking point because of their caring role. Being able to take a break is often described by carers as the No. 1 way to prevent burnout and in turn reduce pressure on our health services. That is particularly important as one in three NHS workers are unpaid carers themselves, and 65% of us will become unpaid carers at some point in our lives.

I urge the Minister to reflect on all the contributions and calls made by myself and other Members here today. We cannot let this crucial opportunity to strengthen support for those who provide essential care to others and reduce the risk of burnout among the millions of unpaid carers on whom our health and care system depend pass by. We must ensure that unpaid carers and the people that they care for receive the long-overdue support that they truly deserve.

Underperforming NHS Trusts: Government Oversight

Jim Shannon Excerpts

Wednesday 14th October 2026 Westminster Hall

[Jim Shannon (Strangford) (DUP)]

It is a real pleasure to serve under your chairship, Mr Stuart. I thank the hon. Member for Chelmsford (Marie Goldman) for raising this issue and giving us a chance to participate in this debate.

The new intensive recovery programme has identified several NHS trusts in England that are underperforming as a result of waiting lists, persistent financial difficulties and leadership instability. The trusts identified include North Cumbria, Mid and South Essex, Hull, North Lincolnshire and Goole, and East Kent. Performance across those trusts and beyond has raised serious questions about whether patients in England are receiving consistent access to cancer treatment.

I want to focus on cancer treatment in particular. The NHS has a long-standing target that 85% of patients should get treatment within 62 days of an urgent referral for suspected cancer. However, the performance at many trusts is substantially beneath that, and it is having serious consequences on patient outcomes. For example, in 2023, the death of a patient admitted to Mid and South Essex was linked to the trust’s failure to meet any of NHS England’s cancer waiting time targets. At that trust, only 47.7% of patients began treatment within 62 days, and by 2025 the number had further declined—in other words, it was getting worse.

At the County Durham and Darlington trust, which the hon. Member for Darlington (Lola McEvoy) referred to, the situation is similar. Significant failings were identified in breast cancer care, as she illustrated very well. A review of the care received by women between 2023 and 2025 found that 32 women had undergone unnecessary surgery, 20 had experienced a late diagnosis and a further 78 patients were found to have suffered moderate or severe harm. A review has been committed to, demonstrating that the true scale of the issue is likely much bigger than we know.

Analysis of NHS cancer waiting time performance found that nearly every English NHS trust missed cancer targets. In Northern Ireland, we have also experienced serious concerns regarding cancer care. For example, recently there has been a call for a public inquiry into urology services at the Southern Health and Social Care trust, where it was identified that cervical screening services had reported some results incorrectly. Patients were told their scan was clear, and then shortly afterwards told it was not. That is an absolute scandal, and it caused patients and families considerable distress. Northern Ireland’s waiting time statistics further illustrate the pressure on cancer services. Some 30% of patients began treatment within 62 days, and that percentage has been on a downward decline.

I know the Minister has no responsibility for Northern Ireland, but she has responsibility for the trusts here. I look to her to ensure the promotion of effective oversight and accountability in all our trusts. Underperformance is widespread and must be addressed. These failures are undermining public confidence in the health service. A suspected cancer diagnosis is already a distressing experience, and patient outcomes are not being helped by lack of clarity and reassurance.

[Graham Stuart (in the Chair)]

Last but not least from the Back Benches, I call Adam Dance.

--- Later in debate ---

[Helen Morgan]

I do agree, and I echo my hon. Friend’s call. The estate that people work in is part of the fundamental problem that we are trying to tackle across the NHS.

I hope all the Members here who have made excellent speeches highlighting shocking failures in their own trusts can take heart from the fact that it is possible to tackle the issues in underperforming trusts. In my time as the MP for North Shropshire, I have seen meaningful changes for my constituents. From 2018 to 2023, Shrewsbury and Telford hospital trust was obviously underperforming, with CQC inspections consistently rating it as inadequate. That included inadequate levels of safety and services—reflected in the horrifying stories received at the time in my inbox and those of the other Shropshire MPs, and on doorsteps—and a churn in the management team that led to constant uncertainty about what was going to happen there. The human consequence of those stories was devastating.

When I was first elected, the overwhelming issue was the abysmal ambulance waiting times, related to poor handover times, as the hon. Member for Stoke-on-Trent South (Dr Gardner) highlighted. I will never forget the letter I received from a headteacher: after a pupil dislocated his knee playing football, he and the teachers waited so long for an ambulance in the dark and cold on a winter night that he was at risk of developing hypothermia by the time the ambulance arrived. We heard countless devastating stories, including ones where the ambulance had taken so long to arrive that it was too late, and the outcome was fatal.

Following a targeted campaign, which included me joining the West Midlands ambulance service team for an eye-opening shift, wait times have significantly improved, and we see far fewer of these cases in our inboxes. But challenges remain, not least in corridor care in the accident and emergency department, which has at times been rated one of the worst in the country.

A constituent told me of the shocking experience of her aunt Cath during this period, who was admitted to Royal Shrewsbury hospital following a serious stroke. One night, Cath fell out of her hospital bed and broke her hip after staff had failed to put up the necessary guardrails. She spent nearly half an hour trying to attract the attention of staff on the ward with the alert bell, but they were so overworked that they did not respond, and in the end she was forced to dial 999 from the floor of the ward. She was left in the ridiculous position of explaining to the call centre staff that she was actually on the floor of a ward in Royal Shrewsbury hospital before the staff reached her. That cannot be right. We heard of many heartbreaking situations where cancer patients’ scans could not take place because waiting lists had meant that they were booked in the wrong order and of fatally long waits for diagnosis in some cases, with the trust failing to hit key targets across the board.

Finally, the 2022 Ockenden report shook my community with its devastating finding of over 200 preventable deaths of babies and unimaginable harm done to families. Campaigning and voicing justified anger, which everyone has done today, and working with Ministers on the failings can bring about change. That was essential in Shropshire, and though things are not perfect, it is encouraging to see the improvements that have been made so far. It has been a really difficult environment for staff to work in. I pay tribute to them and the new leadership team for all the hard work that they have put into turning this extremely difficult situation around. The trust’s CQC rating has recently been upgraded, although it still requires improvement, with emergency department waiting times and understaffing as key focuses. However, there is much to be pleased with. Reviews have noted a positive culture, and the trust has recently been shortlisted for several awards for its performance improvements.

We must celebrate the many trusts in the UK that provide high levels of care and innovation, and support those making significant improvements. For underperforming trusts, it is our duty to our patients and constituents to ensure that we campaign to bring them up to good standards, and I congratulate everyone here today on doing just that. However, if conditions for care are stretched and staff are expected to deliver the impossible with limited time and resources, it is patients who suffer. How can we transform patient safety? To start, we need to hold failing leaders to account, as I have discussed. Reports have pointed to a culture of unaccountability among NHS leaders, which has accompanied recent scandals and undermines public confidence. Failing trusts need to be held to account, and our amendments to the Health Bill would help do that by retaining the necessary structures for accountability.

First, we must retain the independent patient voice, Healthwatch, which was established in the wake of the Mid Staffordshire scandal. Although still in its infancy, HSSIB, the Health Services Safety Investigations Body, should also be retained because it promises to improve the patient safety environment. Our amendments would also introduce duties and a standardised framework for the reporting of suspected health system failings and medical malpractice by coroners, medical examiners and members of ICB and NHS trust boards.

Whistleblowing routes to the CQC, the Department of Health and Social Care, HSSIB and the police would be accompanied by statutory protections. We would also place a corresponding duty on senior leadership to escalate any concerns they have about safety or malpractice to the relevant boards. My colleagues in the other place will be re-tabling those amendments at the next stage of the Health Bill, and I urge the Government to accept them.

[Jim Shannon]

The hon. Lady referred to whistleblowing, as did the hon. Member for South Basildon and East Thurrock (James McMurdock) before her. Does she agree that there should be more encouragement for those who want to blow the whistle, but also protection for their jobs?

[Helen Morgan]

I fully agree, and that is why HSSIB has a role to play, because it provides a safe space for people to raise concerns without fearing for their jobs. The National Guardian’s Office, which is also being removed by the Health Bill, enables and encourages safe whistleblowing across the NHS, and it is important that we retain it.

The Thirlwall inquiry highlighted constant reorganisation as a problem as well. I received a notification in my inbox this week that Shropshire, Telford and Wrekin ICB had clustered with Staffordshire and Stoke-on-Trent ICB to get ready for a merger, but that it is all on hold now because it does not line up with local government reorganisation. It is really problematic for local health services when their management teams do not know whether they are coming or going from one month to the next. I urge the Minister to deal with that problem as well.

It is clear that urgent action is needed to turn around underperforming trusts for the safety of their patients, the welfare of their staff and the value delivered for the taxpayer. I hope the Government will look at the measures we have outlined and accept some of them in the Health Bill as it passes through the House of Lords, so that we can really affect people’s lives and put back their confidence that the NHS will be there for them when they need it most.

Bone and Joint Health

Jim Shannon Excerpts

Tuesday 13th October 2026 Commons Chamber

[David Reed (Exmouth and Exeter East) (Con)]

It is a real pleasure to lead this evening’s debate during Bone and Joint Week, raising awareness of an issue that affects millions of people, but receives nowhere near the attention it deserves. I start by thanking Arthritis UK and the Arthritis and Musculoskeletal Alliance, known as ARMA, for their work raising awareness of these conditions, for the information they have provided ahead of this debate and for the parliamentary event they put on today.

Musculoskeletal conditions or MSK conditions affect our bones and joints and the muscles and tissues that hold them together. They include arthritis, osteoporosis, chronic back pain and joint injuries. For some, these conditions are manageable. For others, they are utterly debilitating, leaving people struggling to walk, to work or to carry out basic everyday tasks.

More than 20 million people in the UK live with an MSK condition. Some 10 million have arthritis, including an estimated 15,000 people in my constituency. Such conditions are the single biggest cause of pain and disability in this country, accounting for around one in seven GP consultations, yet I fear that we underestimate their seriousness, perhaps because they are rarely immediately life-threatening. While they may not kill people, however, they can slowly rob them of their mobility, independence, ability to work and quality of life.

I want to explain why this issue matters to me personally. Six years ago this month, my life changed significantly, although I did not know it at the time. It is something that I have avoided talking about publicly, and if I am honest, I have struggled to accept it. However, I believe we should draw on personal experience in this place, particularly when it might help improve our country.

In October 2020, I was an extremely fit and physically robust former regular Royal Marine with multiple operational tours behind me. I was also competing at the highest level of wingsuit skydiving as a member of the Team GB squad. I can see Members thinking that those activities and MSK injuries are natural bedfellows, and they are probably right, but nothing prepared me for the debilitating consequences of what happened that October.

On a grey and windy day in Devon, I decided to go parachuting, which was a near weekly occurrence. As a reservist member of the Royal Navy parachute display team, I needed to keep current for the following season. I had completed around 700 jumps, and I was not frightened—this was like any other day—but I had something far more dangerous: complacency. The winds were strong and the parachute centre had restricted jumping to experienced parachutists only. I was practising precision landings and convinced myself that it would be good training. I also chose to wear trainers, rather than my usual military boots that provided ankle support. The plane took off and we climbed to 15,000 feet. The green light came on and I jumped.

Everything went to plan until the landing. Rather than landing in the middle of a muddy field away from obstacles, I decided to land closer to where I would be picked up. It was a lazy decision, and it was a stupid one. As I approached the ground, gusting winds caught my parachute, lifted me and slammed me into the side of an aircraft hangar. My left foot took the initial impact, before the rest of my body smashed into the building. My parachute went over the roof, leaving me dangling from the hangar. Fortunately, I remained conscious, managed to release my harness and fell the remaining 5 feet or so to the ground. I remember lying there in shock, checking everything was still attached. Then came the searing pain in my left ankle. My wife came and picked me up and drove me straight to accident and emergency. After examinations and scans, I was told that I had suffered a severe sprain. I was advised to get the ankle moving and seek physiotherapy, because timely NHS support was unlikely to be available. Having had little experience of the NHS, I trusted that advice.

Over the following months I worked hard at rehabilitation. Gradually, I regained strength, but I remained in considerable pain. I took the classic Royal Marine approach: crack on and hope it gets better. Having served alongside men who lost limbs in Afghanistan, I considered myself lucky, and I certainly was not going to complain about a sore ankle, but six months later, something was clearly wrong.

My physiotherapist recommended an MRI scan, which I paid for privately—again, I was advised that the NHS process would take too long—and, when the results came back, I had to catch my breath: my ankle had been broken the entire time. The fracture had been missed at A&E and I had spent six months rehabilitating an injury that had never been properly diagnosed.

I was advised to see a private consultant—again, because of the time it would take to access specialist help through the NHS. This is where I was incredibly fortunate. By complete chance, the consultant whom I went to see happened to be ex-forces himself. Having discussed my injury and background, he suggested that I see him through his NHS practice, where he could continue to oversee my treatment, and I am enormously grateful to him for doing so. After months of uncertainty, pain and frustration, I finally felt that someone understood the problem and could help me to work out what came next. I want to make an important point here: my experience has left me deeply frustrated with parts of the NHS and particularly with the difficulties in accessing timely diagnosis and treatment, but it has also shown me that there are some outstanding people working within it who go above and beyond for their patients.

[Jim Shannon (Strangford) (DUP)]

I commend the hon. Gentleman for raising this issue. I spoke to him this morning to ensure that it would be okay for me to intervene in the debate.

Arthritis UK has said that there is an “escalating musculoskeletal health crisis”. In Northern Ireland, some 550, 000 people—nearly a third of the population—are now living with arthritis or a similar condition. Those living in chronic pain face long, painful waits—the very thing the hon. Gentleman referred to—with some reporting having to wait for up to eight years for a rheumatology appointment. Many are unable to work or live independently as a result, and almost 80% report that their mental health has deteriorated significantly, so it is not just a physical problem. Does the hon. Gentleman agree that while more must be done to reduce waiting lists, we must also ensure that, in the interim, patients living with chronic pain have timely access to appropriate mental health support?

[David Reed]

I will come on to the points that the hon. Gentleman has made, but he is completely right. We must look at these problems in the round, because this is an issue of not just physical but mental health. People who were once fit lose that fitness, both physically and mentally, and then they become a bigger burden on the state.

Let me return to the subject of the surgeon who helped me out. I have been fortunate to benefit from that care, but I recognise that I was lucky. At the time, I had the means to access private treatment, and through that process happened to find a consultant who could help me back into the NHS system. That should not be a matter of luck, and it certainly should not depend on someone’s ability to pay.

Six years on, despite the excellent care that I now receive, I am left with osteoarthritis that can, at times, be severely debilitating. I can no longer run. I avoid activities that cause my arthritis to flare up, and I face the prospect of eventually having the bones in my ankle surgically fused. For the first few years I held on to the hope that I would recover and return to the active life that I once had, but I have now accepted that it is likely that I will not. That is difficult when physical fitness and independence have been such an important part of one’s life. At times, it has been an incredibly lonely journey. My current NHS consultant gives me hope that advances in medical technology may offer better options, but because I limp, other bones and joints are now beginning to suffer. I know that I am likely to place increasing demands on the NHS in the decades ahead.

My experience has shown me a health service that can be brilliant at dealing with life-threatening emergencies, but pretty poor when it comes to conditions considered less serious, even when they fundamentally change someone’s life. I was fortunate enough to be able to afford private care, but millions of people cannot. They are left waiting, living with pain and sometimes watching manageable conditions develop into lifelong disabilities. That brings me to the wider purpose of this debate. People living with musculoskeletal conditions are about one and a half times more likely to experience mental health problems, and I understand why. When pain becomes part of everyday life and you can no longer do the things that you enjoy, it takes a toll. However, there is another dimension that we must urgently address in the House: the economic cost of doing nothing.

In 2024 alone, 26.5 million working days were lost to musculoskeletal conditions. Arthritis UK estimates that working days lost to osteoarthritis and rheumatoid arthritis cost £2.58 billion in 2017, with the figure projected to reach £3.43 billion by 2030. About 646,000 working-age people claiming sickness or disability benefits cite a musculoskeletal condition as their primary reason. I am not suggesting that they can all return to work, or that every disability is preventable, but I do believe that too many people deteriorate when early intervention might have kept them healthy, independent and economically active.

Let us consider someone working in construction, hospitality or healthcare. They develop a back problem or knee injury but cannot access timely treatment, so they carry on through the pain. Eventually, they cannot carry on. They fall out of work, their health deteriorates and they become increasingly dependent on public services. The taxpayer potentially picks up the bill several times over through NHS treatment, welfare payments and lost tax revenue, and the individual pays an even greater price. We focus too much on the immediate cost of treatment, without considering the potentially much greater cost of failing to treat someone early. Surely that is economically illiterate. If timely physiotherapy, imaging or specialist intervention can prevent lifelong disability or someone losing their job, we should see it as an investment, not simply another NHS cost.

However, it is not all doom and gloom, and there is reason for optimism. In my constituency, the Royal Devon University healthcare NHS foundation trust held its first MSK community appointment day in Exmouth. More than 100 people attended, accessing clinical assessments, rehabilitation advice and community support together. Patients particularly valued being listened to, and early results suggested fewer unnecessary follow-ups. One pilot does not provide all the answers, but it does show what can happen when services are organised differently and patients receive joined-up support.

That brings me to my questions for the Minister. First, where is the national leadership on MSK health? The previous Government recognised MSK as one of six major conditions in their major conditions strategy, yet we have not received a firm commitment that the current Government will develop a dedicated modern service framework. Will the Minister commit to establishing such a framework, with clear accountability and measurable outcomes? Will the Minister also commit to a national approach, with clear responsibility and measurable outcomes, and meet the Arthritis and Musculoskeletal Alliance to discuss it? I thank the shadow Health Minister, my hon. Friend the Member for Sleaford and North Hykeham (Dr Johnson), for tabling an amendment to the recent Health Bill that calls for just such a framework.

Secondly, what more can be done to improve early diagnosis and timely access to rehabilitation to prevent avoidable deterioration while patients wait? Thirdly, will the Government work across the Department of Health and Social Care, the Department for Work and Pensions, and the Treasury to properly assess the economic case for early intervention?

Lastly, as a veteran, I want to raise veteran issues. MSK injuries are a major reason for medical discharge from the armed forces, and their consequences can follow people long after they leave service. Will the Minister work with Defence colleagues to improve access to rehabilitation for veterans, and examine whether the armed forces covenant properly addresses their long-term MSK needs? It cannot make sense for any one part of Government to save money by delaying treatment, only for another part to spend considerably more in dealing with the consequences.

I will finish where I began. Six years ago, I was able to soldier. I could run for miles, jump out of aircraft and represent my country in sports. Today, I have to think about every physical activity and the associated cost in pain. I do not share that to seek sympathy; I share it because I understand how profoundly an MSK condition can alter someone’s life. Millions of people across this country are living with far worse circumstances than mine.

[The Parliamentary Under-Secretary of State for Health and Social Care (Mr James Frith)]

I start by congratulating the hon. Member for Exmouth and Exeter East (David Reed) not just on bringing this debate on bone and joint health to the Floor of the House during Bone and Joint Week, but on sharing his personal insights and testimony. I thank him for his service and give him an assurance that I am very happy to talk about veterans, about the specifics and about his insights into how we can deliver on the armed forces covenant. I signed Bury’s first armed forces covenant when I was an armed forces champion, and although it was not the service level that he was accustomed to, I take very seriously our need as a country to pay our respects to the men and women who have put themselves in harm’s way or given the ultimate sacrifice in service to their country, so I thank the hon. Gentleman.

[Jim Shannon]

I was trying to intervene before the hon. Member for Exmouth and Exeter East (David Reed) sat down. While one door closed when he had his injury, another door opened. The door that opened was to be an MP coming here to represent his constituents, so he has an opportunity to speak up for all those who have such injuries, and that is a voice he has now.

[Mr Frith]

As ever, the hon. Member sees the upside—the glass half full—of all life’s experiences.

I thank and pay tribute to the charities, clinicians, researchers, carers and campaigners who support patients and refuse to let these conditions be overlooked. Bone and joint conditions are too often overlooked or dismissed as an inevitable part of ageing or frailty, but they are not; nor should we accept them as such. Arthritis, osteoporosis, fragility fractures and other musculoskeletal conditions can mean relentless pain, lost mobility, lost confidence, lost work and lost independence.

In 2024, almost one in five adults in England reported a long-term MSK condition. This is not a niche issue; it is a national challenge. Our task is clear: diagnose earlier, treat faster, prevent more illness, and help people remain active and independent. The Government’s 10-year health plan is built around three decisive shifts: hospital to community, analogue to digital and sickness to prevention. For people with MSK conditions, that means simpler access and the ability to refer themselves through the NHS app to services, including physiotherapy, pain management and orthopaedics.

The hon. Member for Exmouth and Exeter East sought advice on how we educate sooner and inform sooner, but the work we are doing with the single patient record, the new iteration of the NHS app and the development of NHS online—or the digital doctor, as I am calling it internally—is about providing that useful information in a timely manner. It should be as accessible as we have become accustomed to for information we consume online, whether through retail or consumer habits. That is the level of expectation we should have for services such as this, which can give future patients the certainty and knowledge they need, when otherwise they may endure pain while waiting to access services at a later point. That is an important distinction.

On osteoporosis, we are acting before the fracture, not merely after it. This March, the Government invested £2.6 million in 20 new DEXA scanners across England, following £1.9 million for 13 scanners last year. Earlier scans mean earlier treatment and fewer painful life-changing fractures, especially for older people and women. Patients must also benefit from effective medicines. Since 2022, the National Institute for Health and Care Excellence has recommended Eladynos and Evenity for osteoporosis in post-menopausal women—an important distinction within the debate—both of which strengthen bones and reduce fracture risk. The UK National Screening Committee is reviewing the case for screening women for osteoporosis. Its consultation closed last week, and we will consider its independent recommendation carefully when it reports.

We must be frank: community waiting lists for MSK remain the longest of any community service. Every delay can mean more pain, less mobility and a greater risk that somebody leaves work or loses independence. I agree with the hon. Gentleman’s point about having a cross-departmental approach to ensure that support is timely to prevent people going off work and losing their income, identity, self-esteem and worth, and everything that we understand comes with a forced departure from work. That is why the Getting It Right First Time MSK community delivery programme is backed by about £6 million in 2026-27. It is redesigning services, improving referrals and connecting patients to wider support. The first cohort saw waits of over 18 weeks fall by about 20% in participating systems. That is real progress and we must spread it.

We are also expanding MSK physical activity hubs. They use the skills of the leisure and fitness workforce to improve mobility, reduce pain and fatigue, and help people stay in or return to work. The principle is simple: care should come to people, not force people to navigate the maze. Throughout neighbourhood health, community MSK services, physiotherapy and occupational therapy will support recovery, protect mobility and manage long-term conditions closer to home. We have set a clear national ambition that by 2028-29, at least 80% of community health services activity should take place within 18 weeks. National guidance will define a consistent core offer and bear down on unacceptable variation or postcode lottery.

General practice is often the front door. We are increasing capacity so that patients are seen sooner and urgent cases are directed to the right care on the same day. Elective recovery matters. We remain committed to meeting the constitutional standard by March 2029: 92% of patients treated within 18 weeks. For bone and joint conditions, that means stronger links between primary, community and hospital care, and faster access to specialist advice.

Women’s health must be central to this argument as well, not peripheral. Menopause-related hormonal changes raise the risk of osteoporosis and frailty. The renewed women’s health strategy therefore focuses on earlier recognition, easier access, better treatment and practical support at work.

Bone and joint health is an inequalities issue as well. Chronic MSK conditions are a major cause of poor health and work limitation, often occurring alongside mental ill health—as the hon. Member for Exmouth and Exeter East described—and obesity, which is often concentrated in poorer communities. A postcode must not determine whether pain is relieved, mobility restored or independence protected. Reducing delays and unwarranted variation is not an optional extra; it is a matter of principle and fairness.

In conclusion, let us reject the idea that these conditions are simply to be endured. Pain is not inevitable. Disability is not inevitable. A life-changing fracture is not always inevitable. Earlier identification, effective treatment, rehabilitation and prevention all change lives and save the NHS the greater cost of acting too late.

I again thank the hon. Member for his service and for securing this debate, and all those working through Bone and Joint Week. The Government will work with the NHS, local government, clinicians, charities and patients to turn ambition into action: fewer fractures, shorter waits, better mobility and more people living independently for longer.

Question put and agreed to.

Youth Suicide Prevention and Mental Health Support

Jim Shannon Excerpts

Tuesday 13th October 2026 Westminster Hall

[Jim Shannon (Strangford) (DUP)]

It is a pleasure to serve under your chairship, Mr Wishart. A big thank you to the hon. Member for Blaydon and Consett (Liz Twist) for setting the scene so incredibly well. This profound and heartbreaking crisis touches almost every community, school and street across the United Kingdom of Great Britain and Northern Ireland.

When we talk about the mental health of our young people, we are talking about our future. The world our young people have inherited is one of intense and inescapable pressure: social media follows them everywhere, there is no place to hide from cyber-bullying, and the continuous distortion of self-worth is pulling our youth into dark, isolated corners. In Northern Ireland, one in 10 have engaged in self-harm, and we have lost 290 to suicide in a single year. Every one of them represents an empty chair at a family table, a shattered home and a life of potential cut tragically short.

Regional figures from Ards and North Down council indicate that the number of suicides in Ards and North Down increased by a shocking 40% over the last four years. Our local youth services and schools are overwhelmed. Grassroots groups are doing an angelic job, but they are fighting an uphill battle against rising demand and unstable funding.

Our young people in Comber and Newtownards, and right down the Ards peninsula, which I represent and where I live, deserve better than a system in which they have to wait months on end just to speak to a mental health professional. That is not satisfactory. Early intervention is not a luxury; it is a life-saving necessity.

[Pete Wishart (in the Chair)]

Order. I am going to have to reduce the time limit to a minute and a half to try to get everybody in.