Unpaid Carers: Inequalities

Jonathan Davies Excerpts

Thursday 20th November 2025 Westminster Hall

[Jonathan Davies (Mid Derbyshire) (Lab)]

It is a pleasure to serve under your chairmanship, Ms Vaz. I thank my hon. Friend the Member for Shipley (Anna Dixon) for securing this important debate and colleagues for sharing their powerful personal insights. I fully acknowledge the work carried out by unpaid carers across my constituency and throughout the country more generally. Their dedication keeps families safe, our social security system afloat and our society humane. Their work—including that of children who are, unfortunately, carers too—deserves not only recognition but support from the Government.

Earlier this year, I met local unpaid carers, as well as the Derbyshire All-Age Carers Support Service and Healthwatch Derbyshire, to listen and learn about the issues that matter to unpaid carers in my Mid Derbyshire constituency. I met a woman who is caring for her mother. She told me there is a gulf between policy and reality when it comes to working carers. Carer’s leave exists, but it is not adequate for people who are already struggling financially, and too many carers do not even know that it is available. Those who do often forgo it because it does not cover their pay or because they are worried about their job security. Instead, they use annual leave or their limited number of sick days. That just is not right. This lady was the primary carer for her mother in a virtual ward during the pandemic, when she repeatedly faced security checks that treated her as an outsider rather than as a partner in care. We need systems that support this vital work rather than obstruct it.

Another woman I spoke to is an NHS worker who has been providing unpaid care for over 20 years. She told me that the NHS, an organisation with care as its very purpose, is itself inconsistent in the support it provides to staff with caring responsibilities outside their main work. I understand that as many as one in three NHS staff may be unpaid carers, yet career progression and role flexibility are not guaranteed for them. Too often they depend on the service in which they happen to work to get the allowances they need to undertake their caring responsibilities. That can be disruptive for managers but is essential for the person they care for.

Finally, I heard from another long-term carer. He has overcome many challenges, including faulty equipment, particularly catheters; an unresponsive district nurse team who did not always recognise his important role; and ambiguity about responsibilities when the dependant and the carer fall into different authority areas. He has not been able to take a holiday in 10 years, although that is a sacrifice about which he felt no regret—I found that particularly inspiring.

I came away from that meeting earlier this year in awe of the contributions that these people make day after day, often with no complaint. But they are in dire need of greater support and recognition.

I welcome the progress the Government made in increasing the carer’s allowance last April but, despite the very difficult circumstances the country finds itself in, I believe we should go further. I am also looking for the Government to lead us in clearer integration with local authorities and the wider care system. Carers would like employers to understand their work more consistently, and we can work on that across Departments. I would also like the Government to ensure more public visibility and recognition of unpaid carers, and a renewed focus on identifying unpaid carers. We need more information about the help available to them.

I again thank my hon. Friend the Member for Shipley for being a champion in this place for unpaid carers and her constituents, and for her excellent work in Parliament on this issue. I look forward to reconvening the constituents I met earlier this year, along with Healthwatch Derbyshire and the Derbyshire All-Age Carers Support Service, to report back what the Minister says today about their important work.

--- Later in debate ---

[Stuart Andrew]

It just shows how, when Parliament works well, it works exceptionally well.

I want to repeat some of the comments that have been made. The Government have launched a review of the potential benefits of paid carer’s leave, with the conclusions coming at the end of the year, I believe. As others have said, that is welcome, but I am sure that carers would hope that there will be clarity and no delays.

I look forward to hearing the Minister’s response to some of the issues that have been raised in this debate, and to hearing whether the Government are genuinely open to acting on the review’s findings. A fair point has been made about the length of time that people have to contribute to that consultation, given the responsibilities that they have. We must ensure that the consultation is accessible. I was a critic of this when we were in government, but doing just online consultations means that those who are not digitally savvy can be excluded. It is important we make sure that is not happening.

As other hon. Members have said, the financial pressures on carers remain severe, with one in four unpaid carers living in poverty. The employment rate among carers is just 50%, compared with 75% across the general population, but with the right support an estimated half a million carers could return to work. That would not only strengthen their security but contribute to the economy, which is what we all want to see.

In fairness, it is not just the Government who have to act; there is a responsibility on employers, too. I saw in the hospices that some businesses took on our young adults despite their life-limiting conditions. The employers told us that what they got from those individuals was utterly amazing, and that they were really dedicated to their work.

The recent increase to the carer’s allowance earnings limit is a step in the right direction, for which I thank the Government. However, the Carers Trust has rightly called for a full review of carer’s allowance and the wider support system. I am keen to hear whether that is something the Government are considering.

I am also concerned that the level of respite support has been falling, and has dropped by 6% in local authorities in the last year alone. I am concerned about, and pay tribute to, the charities that offer so much respite support. I know, from my consultations with charities, that the rise in national insurance contributions has had an impact, and that they have had to reduce and scale back their staffing. That is a concern, and I hope we recognise the size of their contribution.

At the hospices at which I worked, it was not just about end-of-life care. Some of the most important care they provided was respite stays. Either the child came on their own so that the family might go on holiday, or the whole family came together, which gave them the opportunity to be a family again. The child who needed care was being looked after by the care team, which meant the parents could be parents again to the siblings, who often miss out in such situations.

[Jonathan Davies]

The shadow Minister is making a very powerful speech. He raises the issue of national insurance, and I know that change was very difficult in the last Budget, but it was to get over £20 billion into the NHS, which I hope will improve respite care. We saw huge cuts to local authorities under the last Government, and we are paying for that in different ways, including in Derbyshire. I hope we will be able to move beyond the national insurance thing and get better public services. Hopefully, we will even be able to reduce national insurance in the future, but it is right to contextualise that in the circumstances in which we find ourselves.

[Stuart Andrew]

This has been a really good debate so far, and I do not want to get into party politics, but the rise in national insurance contributions is having an impact on charities—it really is. The cost is about £1.4 billion. Charities have been a cornerstone of respite provision, and without them we would not have as many respite places as we need.

The other point I want to make is about the social care review. I went to those cross-party talks, and I was encouraged by the first meeting—it felt like all of us, representing our political parties, wanted the talks to succeed—but it is disappointing that we have not had another meeting since. I am concerned. Baroness Casey is an exceptional person. She has a huge amount to contribute, and she certainly left me with the impression that she is absolutely determined to find solutions to some of the issues in social care, but I am anxious that she has responsibilities for other issues, all of great enormity.

I hope the Minister can update us on when we might have another meeting. As the hon. Member for North Herefordshire (Dr Chowns) said, we do not have to be invited by Baroness Casey; we can be invited by the Secretary of State. I know that Baroness Casey is doing an enormous amount of work on this issue, but it is important that, politically, we try to find where we can agree. If we can introduce things earlier, that would be to the benefit of everybody in the country who needs care.

I say that because I want to be constructive in opposition. I recognise that some of these things are not easy to deliver. They are difficult issues, but they demand more than our sympathy—they demand action. I do not claim that we got everything right in government, but I am clear that carers need to know that we are all listening and are keen to respond and deliver when we can. Unpaid carers do not seek praise; they just want systems that they can rely on, policies that reflect their worth and services that offer real support.

Finally, this is not about just one Department—it is not just the Department of Health and Social Care. There are many other Departments. Having been a Minister, I know the structure of Government means that working cross-departmentally can sometimes be a challenge. Can the Minister update us on how that is going? I know it is a challenge, and I wish him well in any cross-departmental work that is happening.

Unpaid carers deserve fairness, support and action. I finish by saying to every single one of them: thank you for the amazing contribution you make every day, looking after others and being the backbone I mentioned at the beginning.

Jhoots Pharmacy

Jonathan Davies Excerpts

Wednesday 15th October 2025 Commons Chamber

[Stephen Kinnock]

I know that my colleague the Minister of State for Health is working hard on the drafting process for the Bill. I cannot give the hon. Member the exact date of its introduction, but I would be very happy to write to him with confirmation of the expected introduction date.

[Jonathan Davies (Mid Derbyshire) (Lab)]

I am pleased that this urgent question has been secured, because I have written to the Minister about this company. I am also grateful to my hon. Friend the Member for North Somerset (Sadik Al-Hassan), who has given me advice in the matter. I am pleased that the Government are taking regulatory action in respect of the quality, safety and availability of the service, but I was horrified to hear that several of my constituents working for this company have gone unpaid for several weeks. Please could the Minister reach out to the relevant Minister within the Department for Business and Trade to see what else we can do for those people, because it is simply not right that they are out of pocket?

[Stephen Kinnock]

That is an excellent suggestion; I will do that. We are hearing colleague after colleague say that staff are not being paid, and if there is clear evidence of a breach of employment law, we absolutely need to look at that. I will follow up on my hon. Friend’s suggestion.

Terminally Ill Adults (End of Life) Bill

Jonathan Davies Excerpts

Report stage
Friday 13th June 2025 Commons Chamber

[Dame Caroline Dinenage]

Thank you, Madam Deputy Speaker. I am addressing new clause 13, which provides the strict regulation of life-ending substances and self-administering devices. That means there will be transparency about what substances are used and how they are stored, prescribed and delivered. We owe it to patients, clinicians and the public to ensure that every part of the process is governed by clinical standards and ethical safeguards. For those physically unable to swallow or self-ingest, the new clause ensures that devices to support self-administration can be safely used. Without that, we risk creating a system that excludes some of the very people it is meant to support.

While we must regulate the system properly, we must also reject amendments that would undermine or stall the Bill’s delivery. Amendment 19 proposes adding suicide prevention, the Mental Health Act and deprivation of liberty safeguards to the code of practice. As the Minister who put much of that legislation through, those are really important topics for me, but this is not the legislation to address them. Let us keep the code focused on the Bill’s core function of ensuring a safe, consistent and compassionate assisted dying process.

Amendment 20 would allow non-adherence to the code to be used in civil or criminal proceedings. That is not appropriate. Guidance is meant to help professionals navigate difficult decisions, not become a legal trap. If clinicians act negligently, existing law already applies. We should not be creating new liabilities for those acting in good faith in very difficult conditions.

I also oppose amendments 97 and 27, which would require the MHRA to license drugs specifically for assisted dying and the National Institute for Health and Care Excellence to recommend them. That would make the Bill unworkable.

[Jonathan Davies (Mid Derbyshire) (Lab)]

Does the hon. Member share my concern that the impact assessment associated with the Bill says:

“The safety and efficacy of those substances used for assisted dying is currently difficult to assess”?

[Dame Caroline Dinenage]

I am not entirely sure that I agree with that.

However, I want to talk about the MHRA, which is just not set up to license drugs for ending life. Clinical trials to support such a licence and MHRA requirement would be impossible. However, the substances likely to be used are already tried and tested in other jurisdictions and are MHRA approved for other purposes. New clause 13 already provides us with the strict regulation that we need, without putting prohibitive hurdles along the path to a compassionate and painless death.

Amendment 42 would remove the backstop date for implementation, giving the Government indefinite discretion over when or whether to put this law into effect. That cannot be right. If Parliament passes the Bill, there must be a clear and reasonable timeframe for implementation. The four-year backstop already gives Government more than enough time to get this right. Removing it simply invites delay.

This is a moment to show that we can be both compassionate and competent, and that we can bring an end to the quiet suffering caused by an unjust status quo and replace it with a system that is safe, fair and accountable. Let us support new clause 13, let us reject amendments that would add red tape or stall the Bill’s progress, and let us show dying people that we are ready to treat them with the dignity and trust that they deserve.

--- Later in debate ---

[Ellie Chowns]

I thank the hon. Member for raising that issue and giving me the opportunity to speak about the detailed evidence given by my constituent Emeritus Professor Sam Ahmedzai, with whom I spoke at length yesterday about precisely this detail. I have reviewed a number of tables of data about this. Any substance has side effects but, as the comments made today have indicated, in reality those substances are being held to a far higher standard than substances routinely used in palliative care.

We have to recognise that there is a huge amount of evidence about the efficacy of the substances that are talked about in relation to assisted dying. There is a huge amount of published, peer-reviewed evidence about the effectiveness of those substances, and people like Professor Ahmedzai, who has 40 years of experience and is a global expert in this area, point out that we know how to assist people to have a peaceful, compassionate death effectively, and that is what the Bill is about: helping people who are terminally ill to die with dignity and to face those final moments with the support, love and care of their family around them; not in agony, but in whatever degree of peace is possible when facing death.

As the hon. Member for West Worcestershire (Dame Harriett Baldwin) said, new clause 14, which relates to advertising, has been developed in consultation, as a result of concerns raised by opponents to the Bill, to try to ensure the crucial fact that assisted dying is not an advertised service. There is a crucial distinction between advertising and information, and this new clause will ensure that assisted dying remains a careful, clinical process and not something that would be promoted commercially. It is a balanced, cross-party safeguard supported by people on all sides of this debate.

[Jonathan Davies]

Will the hon. Lady give way?

[Ellie Chowns]

I am very short of time, so I think I had better continue.

Turning to new clause 15, which relates to the role of coroners, if the Bill is passed, assisted dying would be a very strictly regulated process—the choice of an individual; not a death caused by others, but by the individual themselves. As Aneez Esmail has pointed out, this would be the most scrutinised type of death in the country, and it therefore makes no sense to require another legal process at the end when there have already been multiple layers of scrutiny before the death.

--- Later in debate ---

[Patricia Ferguson]

I rise to speak to my amendment 13, which concerns the appointment of the voluntary assisted dying commissioner. In Committee, it was decided that the Prime Minister would appoint the voluntary assisted dying commissioner, and that the appointee would serve for five years and be responsible for appointing the assisted dying review panels. The commissioner would also oversee the training of panel members, give them guidance on the procedures to be used and, crucially, decide when a case that a panel has refused should be referred to another panel for reconsideration. According to the Bill, the commissioner will not be acting as a judge, but they must be a current or former senior judge of the Supreme Court, Court of Appeal or High Court. However, they are not required to have any expertise in medicine or healthcare.

Importantly, following our considerations in Committee, the Bill no longer requires that the chief medical officer be responsible for monitoring whether or not the assisted dying regime complies with the law. That responsibility has now been transferred to the voluntary assisted dying commissioner, so the person in charge of overseeing the process and setting up the panels will also be the person deciding whether the Act is being administered correctly.

[Jonathan Davies]

Given the scandals we have seen in healthcare over many years, from infected blood and medicines that should not have been prescribed to what happened at Mid Staffs hospital, it is clear that having that independent, robust oversight from the chief medical officer is a good way forward if people are going to be able to trust this legislation, if it comes into law.

Obesity: Food and Diet

Jonathan Davies Excerpts

Monday 20th January 2025 Commons Chamber

[Ben Coleman]

I am grateful for the right hon. Gentleman’s comments. I was not attempting to put together the whole puzzle, but additives are an extremely important part of the puzzle. We do ourselves a disservice if we pretend that sugar, salt and fats—eaten in the quantities they are today—and the ready food that can be bought so cheaply are not poisonous, and not huge problems that we need to address.

I am not wild about the term “obese” because of the negative, pejorative connotations that can make people feel awful about themselves, as has been said, but it is the best term we have at the moment. Over a fifth of children in this country—22.1%—are obese. The figure is even higher in my constituency, which contains some of the country’s richest people, as well as many residents living in poverty. In the London borough of Kensington and Chelsea, 23.4% of reception pupils, aged four to five, are obese. In the borough of Hammersmith and Fulham, 22.4% of reception pupils are classified as obese. This is a problem everywhere, not just in the poorest parts of the country. It is therefore hugely good news that the Government have identified a shift from ill health to prevention as one of the three major objectives of their health mission.

It is even better news that a cross-Government national food strategy is being developed. What would I like to see in that national food strategy? What should be done? I would like us to start by realising that it is time to stop placing excessive emphasis on individual responsibility. That may be hard to swallow for some people, but the Lords report makes it clear that 30 years of policies that rely solely on personal choice, rather than tackling the underlying drivers of unhealthy diets, have failed to shift the dial. Sadly, under successive Governments, these policies have contributed to widening health inequalities.

As my hon. Friend the Member for Bolton South and Walkden (Yasmin Qureshi) noted, the Lords report rightly praised the last Government’s sugar tax on soft drinks. Officially called the soft drinks industry levy, it was a significant public health success—people are consuming less sugar. While obesity remains an overall problem, it has fallen to an extent, particularly among girls aged 10 and 11 in the most deprived areas. Fewer children are having to go to hospital to have their decayed teeth pulled out. That brings me to the lack of dentists after 14 years of Conservative Government, but I will not go there now. The sugar tax has saved millions, possibly billions, of pounds in healthcare costs, as well as a lot of misery. It is a pretty good example to follow, so I support the call by my hon. Friend the Member for Stroud for the levy to be extended to more food products and for similar action to be taken on salt and fats.

I am glad that the Government are delivering on their manifesto pledge to give children the best and healthiest start in life by banning the targeting of junk food at children. Just as advertising restrictions contributed to a decline in the number of smokers, I hope that restricting the advertising of unhealthy foods will contribute to a decline in childhood obesity. I also agree that labelling food better, to distinguish between healthy and less healthy products, is essential. It already works, as allergy sufferers are benefiting from Natasha’s law, which requires food businesses to fully label their ingredients.

However, targeting unhealthy food is not enough. Even unhealthy food is better than no food, for those who cannot afford healthy ingredients, for those who cannot find healthy ingredients or for those who do not know how to cook them. I am not arguing that we should make crap food so expensive that people are forced to go elsewhere to buy even more expensive alternatives. As the hon. Member for Newbury (Mr Dillon) said, it is of fundamental importance that healthy food should be affordable to everyone and widely available wherever they live. At the moment, it is far from either. It is no good badgering people to eat five pieces of fruit and veg a day if they cannot afford to do so or if it is not available locally—that is just patronising.

[Jonathan Davies (Mid Derbyshire) (Lab)]

I am surprised that no one has mentioned the rise of food banks. Does my hon. Friend share my view that, although well-meaning people give produce to food banks, it is often tinned products or ready meals that people need to cook at home, which may be an inadvertent driver of this issue?

[Ben Coleman]

That is a very good point. The poverty in this country now and the cost of energy is causing people in my constituency to go to food banks and ask for foods that they do not have to cook. We are offering people food that might not always be of the best quality, and food banks tell me that a lot of healthy, fresh fruit and veg goes to waste because people are either worried about the cost of energy or simply do not know how to cook. These are addressable problems; these are things that we can do something about if we want to do so.

I strongly back the House of Lords report’s recommendation that the revenue from a salt and sugar reformulation tax should be used to make healthier food cheaper, particularly for those on low incomes. I would like some of the revenue to go to organisations such as Alexandra Rose, a charity operating in my constituency. It makes healthy food affordable and accessible to families on low incomes by handing out vouchers so that pregnant women and the families of children under five can buy fresh fruit and veg at local markets or independent shops.

In the heart of Fulham, 376 families and 587 children have enjoyed £85,200-worth of fresh fruit and veg from our wonderful North End Road market, which has operated since late Victorian times. Alexandra Rose tells me that, six months after starting the project, 64% of children are meeting their five-a-day target, compared with just 7% when it began. As the Government develop their food strategy, I encourage them to consider supporting such charities to extend their work through national action.

Another issue is the accessibility of food, and I do not think this point is addressed enough. Many parts of this country are healthy food deserts. In his annual report, Professor Sir Chris Whitty, the chief medical officer, said that

“families in inner-city areas are less likely to have access to healthy, affordable food options”

and as a result they will have shorter and unhealthier lives. We have to ensure that good food is available at an affordable price. I hope the food strategy will look at that, as well as at teaching basic cookery in schools—that is another important point.

Change will take time, but it can be done. It just needs the political will. I hope we will reach a position where, if Mr Horniman could come back to see us, he would be delighted. After all, we must remember that he took immense pride in the tea his family produced; it was one of the very few to be declared free of chemicals and safe to drink in the 1850s. Let us hope we can say the same about our food in the future.

Puberty-suppressing Hormones

Jonathan Davies Excerpts

Wednesday 11th December 2024 Commons Chamber

[Wes Streeting]

I thank the hon. Member for her question. On the cases of young people who have been on a gender identity pathway and later regret those interventions, whatever those interventions may have been, they are small in number, but they are addressed in the Cass review. It is important that we do not lose sight of those young adults and older adults who may well need the support of health services if they feel they were inappropriately placed on a gender identity pathway or undertook medical interventions that they have later come to regret. We will keep that and other evidence under close review.

[Jonathan Davies (Mid Derbyshire) (Lab)]

I thank the Secretary of State for his statement and the sensitive way in which he has approached this issue, because nothing is more important than our children and young people’s health. A lack of an evidence-based approach may have taken us into a space where some children and young people have received puberty blockers as an appropriate intervention, but others have received that medication when it was not right for them, so can I ask him or his officials to look at how we got ourselves into that space? There may be lessons for us to learn not just about this issue, but about healthcare more generally. Sometimes when we have rushed into things in the past, we have found what appears to be a panacea for an issue, but it has turned out not to be the right thing at all.

[Wes Streeting]

I am grateful to my hon. Friend for his question. This lies at the heart of the dilemma that has plagued clinical leaders and political leaders, particularly since the scandal at the Tavistock clinic was brought into the public eye. There are many people in our country—young people, and young and older adults—who will say, and some have certainly told me in my office, that having access to puberty-suppressing hormones has been completely life-changing and affirming, and has led to a positive outcome for them. Yet we know that the prescription of that medication to this particular group of patients for this particular medical need has not been supported by underpinning evidence in the way that the use of other drugs has been underpinned by effective trials and an evidence base.

That has been the challenge: people with a lived experience saying that this has been positive, while none the less—at the Tavistock clinic, in particular—not only puberty blockers but a whole range of medical interventions were delivered with the best of intentions, but in ways that were inappropriate and clinically unsound. That was the genesis of the Cass review, and it is why I think it is so important that we proceed in an evidence-based way. To do the contrary risks real harm to people and also a lack of trust in the medical profession that will be damaging for our entire country, and particularly for this group of patients.

Tobacco and Vapes Bill

Jonathan Davies Excerpts

2nd reading
Tuesday 26th November 2024 Commons Chamber

[Wes Streeting]

I am grateful for the intervention, because I anticipate that there will be similar arguments made from the Opposition Benches, particularly from a right-wing libertarian perspective. I want to engage seriously with those arguments.

[Jonathan Davies (Mid Derbyshire) (Lab)]

Will my right hon. Friend give way?

[Wes Streeting]

I will just respond to the point made by the hon. Member for Romford (Andrew Rosindell).

There is no liberty in addiction; there is no freedom in addiction. The logical extension of the libertarian argument the hon. Gentleman puts forward would be the end of the ban on indoor smoking. If we should take a live and let live approach, why not legalise cannabis? Why not legalise cocaine? We prescribe certain harmful substances, and there is, I think, an unanswerable case on tobacco because it is uniquely addictive and uniquely harmful. That is why we will take a tougher approach with this harmful substance than we would with something such as alcohol, or other harms such as gambling.

[Jonathan Davies]

The Secretary of State stole my line when he said that there is no freedom in addiction. I just want to thank him for his pragmatic approach to the hospitality industry, which has made representations to me on this matter. May I also impress on him that vapes are a valuable quitting aid for many adults, but many young people are now taking to vaping when they have never actually smoked at all? Can he say a little bit more about how we will address that?

[Wes Streeting]

I will certainly come on to the action that we are taking on vaping, and the case for it. I welcome the contribution that my hon. Friend has made in his first few months as a Member of this House. He brings enormous expertise and experience, particularly on health, which we very much value here in the Chamber.

One choice would be to continue paying an ever heavier price for failure. That is the road that we were heading down, under the previous Government. Our NHS already takes £4 for every £10 spent by the Government day to day. We are on course to go from being a nation with a national health service to a health service with a nation attached to it. It is projected that by the end of this Parliament, 4.3 million people will be on sickness benefit if we fail to act. Smoking could cause 300,000 patients to be diagnosed with cancer over the next five years, including 3,000 for whom that is the result of exposure to second-hand smoke. That is what happens if we only ever treat the symptoms of ill health. We end up spending more on the NHS than ever before, but with worse care for patients, a ballooning welfare bill due to more and more people being out of work, stagnant economic growth, and the heaviest tax burden in 70 years. In short, we will be paying more, but getting less.

Britain is like a ship with a hole. We are constantly battling to chuck enough water overboard to keep us afloat, as more and more floods in. We must break out of this cycle. Britain can break out of this cycle, but only if we are serious about tackling the causes of ill health, and shift our focus from treating the symptoms to preventing them. Plugging the hole in the ship is how we get back to growth, how we reduce the burden of taxation, and how we ensure that this Government can intrude more lightly on people’s lives.