Bone and Joint Health

Debate between Jim Shannon and James Frith

Tuesday 13th October 2026 Commons Chamber

[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.

Vascular Sector Reform

Debate between Jim Shannon and James Frith

Thursday 10th September 2026 Westminster Hall

[Mr Frith]

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

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

[Jim Shannon]

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

[Mr Frith]

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

[Mr Frith]

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

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

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

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

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

[Jim Shannon]

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

[Mr Frith]

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

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

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

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

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

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

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

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

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

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

[Mr Frith]

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

[Jim Shannon]

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

[Mr Frith]

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

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

UK Politics: Pro-Israel Influence

Debate between Jim Shannon and James Frith

Monday 22nd June 2026 Westminster Hall

[Mr Frith]

I will make some progress.

The premise of the debate veers into the unhealthy territory of antisemitic tropes and conspiracy theories: the double standard towards the only Jewish state, questioning the legitimacy of a democratic state’s existence that is not applied to other countries, including those with authoritarian regimes.

The Government are clear that antisemitism is unacceptable in all its forms and that British Jews must never be held responsible for the actions of the Israeli Government.

[Jim Shannon]

I commend the Minister on his honest, truthful and forthright stand. He deserves credit for that, and he is right to underline the issue. The Prime Minister deserves credit for all he has done to change attitudes in the Labour party. He is about to depart, but we should put our thanks to him on the record for what he did to change attitudes and make sure that antisemitism was frowned upon.

[Mr Frith]

I thank the hon. Member for his comments. The record will show his support, and I concur with it.

We have all seen the harm caused by the abhorrent rise in antisemitism, which was raised by my hon. Friend the Member for Stoke-on-Trent Central (Gareth Snell). Antisemitism in the UK has been on the rise, and it has no place in our society. Since the appalling 7 October terror attacks, there has been an increase in antisemitic attacks in the UK, including in Heaton Park, near my constituency. That is just one example of the shocking fear, prejudice and anger directed towards the Jewish community.

The attacks cannot be divorced from the nature of the debate. We should condemn the readiness, ease and tendency to hold 300,000 British Jews collectively accountable for the actions of the Israeli Government. That standard is never applied to other communities in relation to foreign Governments.