Health Bill

Judith Cummins Excerpts

2nd reading
Monday 1st June 2026 Commons Chamber

[James Murray]

I am going to make more progress.

Alongside the removal of confusion and duplication at a national level, the Bill also gives those with local expertise the power, resources and flexibility they need to design and deliver health and care services for their area. The Bill will empower them to innovate, drive progress and do what is in the best interests of the patients they serve.

Under the Bill, ICBs will have more direct responsibility for their services than ever before. They will be at the heart of integrating health and social care, and they will include those people responsible for housing, transport and jobs, so that we can tackle the root causes of ill health, which is better both for patients and for the NHS.

The NHS gave me a second chance at life, and so as Health Secretary I will fight for the NHS every day with the strength it has given me back. The Tories ran down the NHS through 14 years of neglect, and the Lib Dems enabled them. Reform wants to abolish the NHS altogether and replace it with an insurance-based system. The Greens seem intent on ignoring clinical advice and have no practical solutions for the health service. Only Labour has a plan to get the NHS back on its feet. Only Labour is determined to both invest in and fundamentally transform the NHS for the future. Only Labour is showing that change is possible.

We promised to cut waiting lists—we delivered the biggest annual fall in 16 years. We promised an extra 1,000 GPs in our first year—we delivered twice that number. We promised 8,500 more mental health staff by 2029—we have delivered them three years early. We promised 700,000 more NHS dentistry appointments—we have delivered an extra 1.8 million already.

We promised to transform the NHS for the future, and that is what this Bill will do. We are already boosting investment in the NHS where it needs more. We have begun stripping out bureaucracy from the NHS where it needs less. And now we will build a truly modern NHS that will be there for generations to come. The Bill is the next crucial step in our mission, and I commend it to the House.

[Madam Deputy Speaker (Judith Cummins)]

I call the shadow Secretary of State.

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[Several hon. Members rose—]

[Madam Deputy Speaker (Judith Cummins)]

Members will have noticed that about 50 Members want to speak in the debate, so with the exception of Front Benchers I will be starting with an immediate six-minute time limit.

[Andy McDonald (Middlesbrough and Thornaby East) (Lab)]

May I begin by welcoming the Secretary of State to his place and wishing him well in the responsibilities that he carries on behalf of patients, NHS staff and communities across the country? I welcome the Bill and its intention to improve patient care through investment, modernisation and better integration across the health service.

It is right to acknowledge the progress made on waiting times and waiting lists since Labour returned to government, with the overall waiting list falling significantly and long waits continuing to come down, but may I add my voice to those of others about the appointment of a chair for the Tees, Esk and Wear Valley inquiry? My right hon. Friend the Member for Ilford North (Wes Streeting) gave that commitment, which we were pleased to hear, but we have yet to see that chair appointed. If that could be given attention, we would be most grateful.

I remain concerned about the continuing impact of historic private finance initiative costs on NHS trust budgets, including the pressures facing South Tees hospitals NHS foundation trust in my patch. Too much money is still being diverted from frontline care. I regret that this issue remains unresolved.

The principal reason I rise today is as chair of the all-party parliamentary group on spinal cord injury. Last summer, the APPG’s inquiry into spinal cord injury services reached a clear conclusion: the evidence points to the need for more national co-ordination, not less. Spinal cord injury is a low-volume but highly complex condition requiring specialist pathways, lifelong rehabilitation and co-ordinated support, yet the inquiry heard repeated evidence of fragmented services, postcode variation, delayed rehabilitation and patients being lost within the system. The APPG therefore called for a national strategy and a modern service framework for spinal cord injury care. As we intend to hold a lived experience roundtable shortly, I invite the Health Secretary to come and meet people with spinal cord injury to hear their concerns about the proposed changes to commissioning.

We welcome the excellent constructive engagement from the Under-Secretary of State for Health and Social Care, my hon. Friend the Member for Washington and Gateshead South (Mrs Hodgson), and NHS England officials, but we remain deeply concerned about proposals to transfer spinal cord injury commissioning from national oversight to integrated care boards. Indeed, NHS England’s own evidence to the inquiry emphasised national standards, national quality metrics and nationally co-ordinated pathways, quality measures and oversight. If national consistency has not yet been achieved under national commissioning, what evidence demonstrates that transferring responsibility to multiple ICBs will improve outcomes or equity?

What is at stake is not abstract. When somebody sustains a spinal cord injury, their life changes overnight. They may require specialist rehabilitation, housing support, benefits advice, mental health support and long-term clinical care. Patients and families should not be left to navigate a fragmented system alone. That is why I welcome the ambition behind the single patient record and Diagnosis Connect.

Connecting newly diagnosed patients directly to specialist support reflects one of the APPG’s recommendations. Organisations such as the Spinal Injuries Association help people rebuild their lives after life-changing injury. I hope that Ministers will consider including spinal cord injury within the early phases of Diagnosis Connect.

The question is not whether structures change on paper; it is whether people living with spinal cord injury will experience safer, more equitable, more co-ordinated care. I hope that the Secretary of State will answer some straightforward questions. If NHS England accepts that national consistency has not yet been achieved, what evidence shows that localised commissioning will improve it? How will national standards, benchmarking and quality oversight remain coherent under a fragmented arrangement? Do the Government accept that spinal cord injury differs fundamentally from standard population health commissioning because of its low volume, high complexity and cross-boundary nature? What safeguards will prevent widening regional inequity, if accountability is dispersed across multiple ICBs?

The APPG’s inquiry concluded that spinal cord injury services require stronger national co-ordination and oversight, not greater fragmentation, and I hope the Government will reflect carefully on that evidence. This country led the world in spinal cord injury provision under the leadership of Professor Ludwig Guttmann after the second world war, with the remarkable work that he achieved. We need to return to those days of being pioneering and world-class. As a lawyer who previously practised in this area, I am afraid that over the past several decades services have deteriorated and gone backwards. We must restore those services and bring trust to people who so desperately want reassurance that there is a national system for them to rely on that will address their needs. We are currently not in that place at all. The Bill is an opportunity to address that, and I trust the Minister will take that on board.

[Madam Deputy Speaker (Judith Cummins)]

I call the Liberal Democrat spokesperson.

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[Wes Streeting (Ilford North) (Lab)]

That was a characteristically thoughtful speech by the hon. Member for Runnymede and Weybridge (Dr Spencer). It is also a particular pleasure to follow my hon. Friend the Member for Glasgow South West (Dr Ahmed), who was an outstanding Minister in the Department of Health and Social Care and has demonstrated again today why his expertise and integrity are highly valued on the Government side of the House.

I strongly supported the speech made by the Secretary of State. He has hit the ground running, and he knows that he has my full-throated and wholehearted support. He does not need a predecessor being a back-seat driver—something that I am sure the Prime Minister feels about one or two of his predecessors after recent days. I also thank the Minister of State for Health, my hon. Friend the Member for Bristol South (Karin Smyth), for her leadership on the Bill, and the brilliant team of officials, who have worked exceptionally hard to prepare the Bill for its introduction.

It will come as no surprise to anyone that I strongly support the Bill. The latest NHS waiting list figures show the biggest cut to NHS waiting lists for 17 years, and as we heard from the Tories today, they cannot stand it. They cannot stand that within less than two years we have done something that they failed to achieve in 14: lowered waiting lists. Waiting lists are shorter than when we came in—lots done, and lots more to do, but the numbers are there. Despite record levels of demand and strike action by the British Medical Association, we delivered record levels of activity and waiting lists are falling. That is the difference that a Labour Government make.

To understand how and why this happened is to understand why the Bill matters. Those who claim that recent improvements in NHS performance are simply the result of more money are making exactly the same mistake that held the NHS back for years under the Conservatives. Investment matters—of course it does—but, as the Secretary of State outlined, we are combining investment with reform. We are embracing technology, cutting bureaucracy, improving productivity and changing how care is delivered—from cutting £1 billion from spend on agency staff to funding GPs to treat more patients in the community, equipping NHS staff with the latest AI tools, and sending crack teams of top clinicians to bust the backlogs in hospitals with the most patients off work sick. Every single change has been opposed by vested interests, but that is why we are seeing more patients treated and better value for taxpayers. That is the difference between managing decline and delivering change.

For all our progress, we know that there is so much more to do. Too many people are still waiting too long. Too many staff are working against systems that make their jobs harder, not easier. Too many patients have to tell their story over and over again. Too much money is trapped in bureaucracy when it should be reaching the frontline. Too often, accountability is blurred between two different headquarters or two different boards, bodies and acronyms that the public do not know and cannot hold to account. This Bill is the NHS modernisation Bill, and it addresses every single one of those challenges, giving expression to the principle that the NHS should be run for the patient, not the other way around.

The Leader of the Opposition recently claimed that we have not kept our promise to abolish NHS England. In fact, we have already started: 7,000 posts removed from ICBs, and 4,500 more posts going from NHS England and the Department of Health and Social Care. I know that those changes are not easy for the people affected, and I never treated them lightly, but abolishing NHS England is about cutting duplication, reducing bureaucracy and putting responsibility for the NHS where it belongs: with elected Ministers who are accountable to the public.

Every pound wasted on administration is a pound that could be spent on patient care. That is why we are stripping out unnecessary layers and directing more resources to the frontline. Hearing the opposition from Conservative Front Benchers, it is no wonder that they presided over such a bloated bureaucracy. This Bill will save money, but they never once asked how much it would cost to pile on layer after layer of bureaucracy, saddling the NHS with top-heavy management, which frustrated patients and really frustrated staff.

Some will say that there is a contradiction: that centralising accountability and giving patients more control over their own data pull in opposite directions. But that is precisely the point. For too long, power in the NHS has sat in a no man’s land—an accountability sink, too distant from patients and citizens to be meaningful and just far enough away from Ministers that there is plausible deniability when things go wrong. The Bill takes back power in order to give it away: accountability for Ministers where it belongs, and power for the patient where it belongs, too.

The Government must face down powerful producer interests on patient data. Our health data is precious. Two things matter above all else: that our data is held securely and that it is used ethically. However, the single patient record is one of the most important reforms of the NHS for decades. It is frankly unsafe, as well as absurd, that patients are still being asked to repeat their medical history every time they access a different service. We also have to take on the producer interest of those who think patient data belongs to them rather than to patients. Our health, our data, our NHS—patients should control who can access their data, and they should control their own data.

By all means let us scrutinise the Bill and suggest improvements, but do not slow it down. The NHS does not have time to waste. The NHS is on the road to recovery, and this Bill puts the foot down on the accelerator.

[Madam Deputy Speaker (Judith Cummins)]

I call the Chair of the Health and Social Care Committee, after whose speech there will be a four-minute time limit.

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[Paulette Hamilton (Birmingham Erdington) (Lab)]

As someone who has worked in the NHS for 25 years as a district nurse and who has been involved in integrated care systems in Birmingham and Solihull since the very beginning, I will focus my contributions on three areas of the Bill: health inequalities, patient voice and integrated care boards.

Let me start by saying that I support the principles of the Bill. My constituents want services that work better. They want care that is easier to access closer to home and properly joined up, and parts of the Bill help to support that ambition. I want a focus on neighbourhood health plans and shifting more care into communities. Some of the best healthcare happens in people’s homes, in clinics and through early intervention before problems become a crisis. That is why the investment in Stockland Green health centre in my constituency in Birmingham matters so much to my residents and to me. It represents the right ambitions: shifting care into the heart of the community, bringing services together locally and making healthcare more accessible for residents in Birmingham Erdington. The principle of that is absolutely right.

My concern is that parts of the Bill risk moving us away from the original purpose of integrated care. Integrated care systems were created because health is shaped by far more than hospitals alone. I am concerned that the Bill risks moving us away from that local collaborative model and towards something far more centralised. As a former cabinet member on Birmingham city council with governance responsibility for health and social care and public health, and as the chair of Birmingham health and wellbeing board, I know how important local government involvement is in these decisions, yet under these proposals, somebody in that position would not automatically have a seat around the table—they would have to compete for it.

I believe the Bill should protect three things in relation to ICBs: genuine local partnership, a combined focus on health inequalities and prevention, and a strong focus on place, reflecting the needs of local communities like mine. One of my biggest concerns about the Bill is the reduction in independent patient representation, including the abolition of Healthwatch structures. If patient voice is weakened at the same time that local representation is reduced, there is a real risk that health inequalities become even less visible within the system, and we cannot allow that to happen.

The ambition to improve joined-up care and strengthen community healthcare is the right direction of travel. I simply ask the Government to keep a close watch on local representation and patient voice as these changes are implemented. Patient voice must not be lost and health inequalities must not increase. ICBs should not be used as a vehicle to reorganise NHS management structures.

[Madam Deputy Speaker (Judith Cummins)]

I will call a Member on the Opposition Benches, and then I will reduce the time limit to three minutes.

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[Gideon Amos (Taunton and Wellington) (LD)]

This Bill contains welcome elements, such as creating a single patient record and enabling integrated care boards to become commissioners across a wider area. However, I cannot support the weakening of patient voices, nor removing local authorities from oversight of health trusts. I pay tribute to Gill Keniston-Goble and her team at Somerset Healthwatch for all the fantastic work they have done.

In moving to a single patient record, we need to prioritise privacy and rethink putting the American firm Palantir in charge of our data, with its founders such as Thiel opposing democracy and denigrating our NHS as part of a “Stockholm syndrome”. My constituent, whose family member was brutally murdered, is rightly horrified that victims’ NHS records were shared unlawfully online with NHS workers—she called it “repugnant voyeurism”, and she was right to do so. I hope the Minister will echo the apology of the trust and condemn that kind of behaviour.

However, none of the reforms in the Bill will have a positive impact on patients or staff in Taunton and Wellington who use the maternity and paediatric department until and unless the promised new unit is brought forward. One of my constituents, Jeff, told me of their grandson Ryan, who was admitted to the ward a couple of weeks ago. The lack of air conditioning meant that temperatures there exceeded 30°C over the past week—no wonder medical staff have fainted in the heat while looking after mothers and children who are baking in single-storey flat-roof buildings—buildings that were put up for the United States army as a temporary measure during the second world war and never replaced.

As Jeff put it,

“Walking down the corridor of the old building is an embarrassment. There are literally sheets of plastic attached to the leaking ceilings running into guttering in the corridor”.

I do not need my architectural training to know that guttering should be on the outside of the building, not the inside. It is therefore unsurprising that the previous Secretary of State, the right hon. Member for Ilford North (Wes Streeting), when challenged on BBC Radio Somerset only a month ago, promised that he would speed up the Musgrove Park hospital project if he could. I hope the new Secretary of State will honour his predecessor’s promise to meet me to discuss that.

The Bill is based, at least in part, on the mission to move from treatment to prevention, which is of course the right ambition. Because of its major teaching hospital status, Taunton has a big medical community who know a thing or two about prevention, and I will highlight two areas in which this Bill should be going further on prevention. On prostate cancer, I hope the Government do not decide to hold back from widespread screening, as a recommendation to do so is before them. As a member of a family in my constituency recently hit by that disease told me,

“I am a recently retired doctor and I do not believe the statistics that have been published, with the emphasis being placed on over-investigating patients and the distress this causes. This pales into insignificance compared to a missed diagnosis.”

Finally, more should be done to reform the dental contract. Unless the Bill leads to more NHS dentists, social care reform and better prevention—

[Madam Deputy Speaker (Judith Cummins)]

Order.

Allied Health Professionals

Judith Cummins Excerpts

Thursday 23rd April 2026 Commons Chamber

[Relevant documents: Oral evidence taken before the Health and Social Care Committee on 26 November 2025, on Delivering the Neighbourhood Health Service: Workforce, HC 1527; and correspondence from the Health and Social Care Committee to the Minister of State for Health, on the NHS 10 Year Workforce Plan and Neighbourhood Health, reported to the House on 7 January.]

[Madam Deputy Speaker (Judith Cummins)]

I call Jen Craft, who will speak for up to 15 minutes.

GP Contract

Judith Cummins Excerpts

Monday 16th March 2026 Commons Chamber

[The Minister for Care (Stephen Kinnock)]

When we came into office, we found GP services in an appalling state—underfunded, understaffed and in crisis. Since July 2024, this Government have been fixing the front door to the NHS, investing more than £100 million to fix up GP surgeries this year, making online booking available to patients across the country and recruiting 2,000 more GPs who are now serving patients on the frontline. Following investment in advice and guidance, we have seen 1.3 million diverted referrals since April 2025. Those are people who would have otherwise been added to the electives waiting list. A lot has been done, but there is a lot more still to do. We are determined to make the system fairer for coastal communities and deprived areas, so we have launched a review into the Carr-Hill formula to close the gap on health disparities and ensure that funding is targeted on the basis of need. We will shortly update the House in the usual way on our Carr-Hill review.

Last year’s GP contract saw the biggest cash increase in more than a decade, and this year we are investing an additional £485 million, taking the total investment made through the contract to more than £13.8 billion this financial year. Investment must always be combined with reform, so the new contract will improve access for patients by requiring that all clinically urgent requests are dealt with on the same day. It will provide a mechanism to hire even more GPs via a new practice-level reimbursement scheme, and it will support the shift from treatment to prevention, as set out in our 10-year plan, through incentives to boost childhood vaccination rates, better care for patients living with obesity and requiring GPs to share data with the lung cancer screening programme.

These ideas were not cooked up by someone sat behind a desk in Whitehall. What is happening is that we are taking the best of the NHS to the rest of the NHS, working with pioneering practices that have been doing these things for a long time. Today we can see that our policies are working, and after years of decline in general practice, we are getting the front door back on its hinges. Patient satisfaction with general practice is finally moving in the right direction. According to the Office for National Statistics, almost 77% of people described contacting their GP as easy in January this year, up from just 60%, where it was languishing in July 2024. I know that when he gets up, the hon. Member for Hinckley and Bosworth (Dr Evans) will hugely welcome, as will his hon. Friends, the progress that we are making.

[Madam Deputy Speaker (Judith Cummins)]

I call the shadow Minister.

[Dr Evans]

The Health Secretary and his team have perfected the sales pitch for NHS reform. The problem is that the detail never seems to arrive. We have seen a 10-year health plan with no delivery chapter, and a plan for the abolition of NHS England with no price tag; the Health Secretary has announced 10 new “straight to test” referral pathways, but could not name a single one; and now we are seeing a new GP contract with more questions than answers.

Calling something modernisation does not make it reform. If the rules and the delivery are unclear, it is simply confusion with branding. “Advice and guidance”, for example, appears in practice to create a single point of access for referrals. GPs will no longer be able to refer patients directly to a consultant, even when they believe that it is clinically appropriate. Will the Government publish the clinical evidence supporting that approach? Who will carry the legal responsibility if, in a GP’s professional judgment, a patient needs to see a consultant but must first go through “advice and guidance”? If advice and guidance becomes mandatory as an extra layer before referral, are the Government not, in essence, managing the waiting list by keeping patients in primary care rather than treating them in secondary care? Waiting lists will look shorter on paper, but patients are simply waiting elsewhere in the system. Can the Minister clarify exactly where those patients will appear in the official waiting list figures? The contract also requires patients whose cases are deemed “clinically urgent” to be dealt with on the same day, but it does not define “urgent” or explain what “dealt with” means, and that really matters.

Let me therefore ask the Minister three clear questions. First, when will the Government publish the clinical definition of “urgent”—a patient’s sick note is urgent for the patient, but not clinically urgent—and what counts as a patient’s being “dealt with” on the same day? Secondly, the Minister has talked about access, but how can practices guarantee same-day responses when demand is uncapped and definitions are not published? Finally, with advice and guidance being required as a mandate beforehand, how will we ensure that patients are protected, and where will they appear on the waiting lists?

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[Stephen Kinnock]

The Carr-Hill review is happening as we speak, and I expect to get a submission from officials on the first round of analysis that is being conducted by the National Institute for Health and Care Research. That will be the first step towards agreeing on how we make the formula work, with a view to implementing the new Carr-Hill formula from 1 April 2027.

[Madam Deputy Speaker]

I call the Liberal Democrat spokesperson.

[Helen Maguire (Epsom and Ewell) (LD)]

I welcome the fact that the Government have adopted our policy of seeing clinically urgent patients on the same day, but patient safety has been put at risk by increasing workloads, according to members of the Royal College of General Practitioners. One in five patients has been forced to wait at least two weeks for an appointment. Although the Government’s funding of 1,600 new GPs is welcome, it is insufficient to deliver the required shift to community care. The Health Foundation says that an additional 6,500 GPs will be needed by 2031, and the Liberal Democrats would provide 8,000. What is the Minister doing to address the shortfall? Residents in Epsom and Ewell, who already struggle to get a GP appointment, are concerned that increased housing will make it even harder. What is the Minister doing to ensure that there is funding for GP buildings, as well as GPs?

I welcome the Government’s focus on the obesity crisis, but it does not fix the root cause. Aside from the junk food ban, what steps are the Government taking to encourage children and young people to create active and healthy habits for life from an early age?

National Cancer Plan

Judith Cummins Excerpts

Thursday 5th February 2026 Commons Chamber

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

With permission, I will make a statement on the Government’s national cancer plan for England.

A cancer diagnosis changes you forever. When I was diagnosed with metastatic breast cancer 18 months ago, I did not know whether I would be alive today, never mind standing at this Dispatch Box announcing a national cancer plan, but one year ago almost to the day, the Prime Minister asked me to do just that. Since the Government took office, over 212,000 more people are getting a cancer diagnosis on time, over 36,000 more are starting treatment on time, and rates of early diagnosis are hitting record highs. Despite those vital signs of recovery, though, the NHS is still failing far too many cancer patients and their families. That is why first and foremost, this plan is a break with the failure of the past 15 years.

In 2011, the coalition Government published “Improving Outcomes: A Strategy for Cancer”. That strategy was followed in 2016 by “Achieving world-class cancer outcomes: a strategy for England”. In 2019, the long-term health plan for England made cancer a priority and included a headline ambition to diagnose 75% of cancers at stages 1 and 2. However well-intentioned they were, not one of those strategies has lived up to its promises. Cancer mortality rates in the UK are much higher than in other, comparable countries, while survival rates are much lower. Cancer incidence is around 15% higher than when the 62 day standard was last met, and working-class communities are being failed most of all. The most deprived areas, including rural and coastal communities, often have fewer cancer consultants, leaving patients waiting longer. This all adds up to the chilling fact that someone living in Blackpool is almost twice as likely to die young from cancer than someone living in Harrow. Wherever in our country a person lives, they deserve the same shot at survival and quality of life as everyone else. Wealth should not dictate their health, and neither should their postcode.

Behind these statistics are real people. I have heard from those whose care lacked empathy and dignity, from those whose cancer was missed or whose test results were lost, from those who were passed from pillar to post and kept in the dark about their condition, and from those whose loved ones died before their turn came for surgery because the wait was too long. Those experiences are unacceptable—they are devastating. From day one, I was determined to put their voices front and centre of our plan. Over the past year, we have listened to and learned from cancer charities, clinicians and, most importantly, patients and their families. Every action is a response to someone’s lived experience. Every commitment is a promise to transform someone else’s life. Their stories have become the blueprint to make the biggest improvement in cancer outcomes in a generation.

Three major themes stood out from the 11,000 responses to our call for evidence, some 9,000 of which came from patients and their carers: core performance standards, improved survival, and quality of life after diagnosis. Those are not radical ideas, but unlike previous strategies, this plan is not limited to incremental improvement. Instead, it is an ambitious, bold plan to save 320,000 more lives by 2035, which will be the fastest rate of improvement this century. We will do that by modernising the NHS, harnessing the power of science and technology, putting our patients at the front of the queue for the latest medicines, and helping them to live well after diagnosis, not least for people diagnosed with stage 4, metastatic and incurable cancers—people like me.

How do we get there? We are placing big bets on genomics, data and artificial intelligence, as set out in our 10-year plan for health. We will hardwire the three shifts of our 10-year plan into cancer pathways. First, on moving from analogue to digital, we heard from patients about the importance of clinical trials, so we will make the UK one of the best places in the world to run a trial with a new cancer trials accelerator. We will start people’s care earlier using liquid biopsy tests, which can return results up to two weeks faster than conventional testing. We will harness AI to read scans, plan radiotherapy and identify the right path for each patient. We will harness genomics so that every eligible patient has access to precision medicines. We will harness data to make sure that all metastatic disease is counted properly—starting with breast cancer—so that people with incurable cancer are properly recognised and supported. When people are not counted, they feel like they do not count, but we will end that.

Innovation will also help us fight inequalities and make the shift from sickness to prevention. We will turn the NHS app into a gateway for cancer care. By 2028, it will host a dashboard for cancer prevention, with access to tests and self-referral. By 2035, it will bring together genomic and lifestyle data with the single patient record to advise every patient according to their risk. That will benefit people in rural and coastal communities who can find it difficult to access specialist care simply due to geography.

Finally, we will use the neighbourhood health service to make the shift from hospital to community. That will mean more care, from prehabilitation to recovery support, delivered closer to home. We will help people live well with cancer through tailored support closer to home. People will be given personal cancer plans, named neighbourhood care leads and clear end-of-treatment summaries so that no one feels abandoned after their treatment.

For too long, those with rarer cancers have seen little to no progress for many of their conditions. They told us we need a special focus on these cancers, and our plan sets out how they will benefit from the deployment of genomics, early detection and the development of new treatments. That was asked for by patients and will be delivered by this Government. I pay tribute to my hon. Friend the Member for Mitcham and Morden (Dame Siobhain McDonagh) for her campaigning in memory of her late sister Margaret. We should also remember that the late Tessa Jowell raised this issue in 2018, and her family have campaigned ever since.

Our plan also gives pride of place for children and young people. We will improve their experience of care at every level, from hospital food to youth worker support and play support. I pay tribute to my hon. Friend the Member for Leyton and Wanstead (Mr Bailey) for his campaigning on that point. Our children and young people cancer taskforce asked for support with travel costs, because when someone’s child has cancer, the last thing they should worry about is how they will pay for their train ticket. Today, I can announce that we will fund those travel costs.

Alongside rare and less common cancers, we will make research for children and young people a national priority. I take this moment to thank the children, young people and families who made up our children and young people cancer taskforce. It was a pleasure and a privilege to meet them earlier this week. I thank the many families and loved ones of people lost too soon who continue to fight to make change for others. I am so grateful to them, and I want people to hear their voices as they read the plan, because it is rooted in the voices of patients, families, clinicians and charities. It will turn cancer from one of this country’s biggest killers into a chronic condition that is treatable and manageable for three in four patients. It delivers the ambition of the 10-year health plan, embodies this Government’s three shifts and sets a clear path towards earlier diagnosis, faster treatment and world-leading survival rates by 2035.

This plan does not belong to the NHS, and it does not belong to the Government; it belongs to us all. We all must play a part in making it work. Over the past year, I have met the patients, families, carers, clinicians, researchers, cancer charities and voluntary groups who all contributed to our plan. This Government is on their side. We wrote this with them, and we cannot deliver it without them. Let us do it together. I commend this statement to the House.

[Madam Deputy Speaker (Judith Cummins)]

I call the shadow Secretary of State.

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[Ashley Dalton]

I thank my hon. Friend for his question, for his expertise and for all that he has shared from his experience to help us develop this plan. I note how important specialist nurses are, but we are also doing more to help people navigate the NHS. I know exactly what it is like; I think I have in my Filofax—I am that retro!—about 38 email addresses and phone numbers of the various people I have to contact in order to project manage my treatment. We are going further and ensuring that the NHS app can handle all that information. Cancer patients will have the ability in their hands, or in their pockets, to manage scans, appointments and test results directly through the NHS app.

I am delighted to say that my hon. Friend the Minister for Technology, Innovation and Life Sciences is already looking at the issues that my hon. Friend the Member for Sheffield South East (Mr Betts) raises around blood products and donations, and is working with the Anthony Nolan trust on those. I will be more than happy to work with my hon. Friend further on those issues.

[Madam Deputy Speaker (Judith Cummins)]

I call the Liberal Democrat spokesperson.

[Helen Maguire (Epsom and Ewell) (LD)]

I thank the Minister for advance sight of the statement and for her personal experience that has gone into this plan. After the Conservatives failed to invest in our NHS, it is no surprise that cancer survival in the UK is still around 10 to 15 years behind leading countries, with worse survival rates for some cancers than Romania and Poland. I am therefore pleased that this Government listened to my hon. Friend the Member for Wokingham (Clive Jones) and brought this national cancer plan to life, because cancer touches everyone.

One of my residents, a mum with a young family, discovered a lump in her breast. Despite attending the one stop breast clinic on four separate occasions, it took two horrendous years for her to be diagnosed with breast cancer. When she was finally diagnosed, the cancer was aggressive and required a mastectomy, chemotherapy and radiation therapy. That is why I welcome the Government’s target on meeting all cancer wait time standards by 2029, but the aim to halve the backlog in three years’ time is not ambitious enough. Will the Minister go further and back a Liberal Democrat plan to write into law a guarantee for all cancer patients to start treatment within 62 days from urgent referral?

The focus on ending delays in cancer care is a step forward, but funding 28 new radiotherapy machines is not enough when the treatment is so cost effective and successful. We need to end radiotherapy deserts, so will the Minister extend her ambition to 200 extra radiotherapy machines?

The Minister says that the plan will turn the NHS app into a gateway for cancer care, but how will she support older people and the digitally excluded? The plan promises to drive up productivity, end the postcode lottery, expand NHS diagnostic capacity, introduce personalised cancer plans and more. That is optimistic and will require more investment to increase NHS capacity, but without clear funding and capacity building plans, is it realistic?

Labour was right to put patients at the heart of this plan and incorporate the Liberal Democrat’s calls for a specialist cancer nurse for every patient. We costed for 3,000 extra cancer nurses; how many additional cancer nurses does the Minister believe are needed?

Finally, will the Minister confirm that the plan’s annual summary of progress will be reported in the House for Members to scrutinise?

--- Later in debate ---

[Several hon. Members rose—]

[Madam Deputy Speaker (Judith Cummins)]

Order. Members will know that this statement is on a very important, sensitive and sometimes personal subject, but I remind them that after this we have two debates that are also important, so please keep questions short.

[Martin Vickers (Brigg and Immingham) (Con)]

Further to the exchanges about radiotherapy, I understand that the national figure for access to radiotherapy is 53%, which itself does not seem particularly high. However, the figure for my Brigg and Immingham constituency, which falls in the Yorkshire and the Humber region, is only 35%. Could the Minister give some assurance to my constituents about progress on increasing that figure, and when does she think we can reach the national average?

Medical Training (Prioritisation) Bill

Judith Cummins Excerpts

Committee of the whole House
Tuesday 27th January 2026 Commons Chamber

[Judith Cummins in the Chair]

[The First Deputy Chairman of Ways and Means (Judith Cummins)]

I remind Members that in Committee they should not address the Chair as “Deputy Speaker”. Please use our names. Madam Chair, Chair or Madam Chairman are also acceptable.

Clause 1

UK Foundation Programme

Question proposed, That the clause stand part of the Bill.

[The First Deputy Chairman]

With this it will be convenient to consider:

Amendment 6, in clause 2, page 1, line 16, at end insert—

“(e) persons within subsection (3),”.

This is a paving amendment for amendment 7.

Amendment 7, page 2, line 6, at end insert—

“(3) A person is within this subsection if they—

(a) were actively employed as a doctor in the NHS or Health and Social Care Northern Ireland on 13 January 2026; and

(b) had submitted a valid application for a UK specialty training programme for a start date in 2026 before the day on which this section comes into force.

(4) For the purposes of subsection (3), “actively employed” includes, but is not limited to, persons on fixed-term Trust Grade, Clinical Fellow or Staff, Associate Specialist and Specialty Doctor contracts.”

This amendment would require applications to specialty medical training in 2026 from those already employed in the NHS to be prioritised.

Clause 2 stand part.

Clause 3 stand part.

Amendment 10, in clause 4, page 3, line 2, at end insert—

“unless that time was spent outside the British Islands as part of a posting with the UK armed forces.”

This amendment would include within the definition of a UK medical graduate anyone who spent all or part of their training on a military posting outside the British Islands.

Amendment 9, page 3, line 3, after “are” insert

“a British citizen or are”.

This amendment would require British citizens to be prioritised for places on UK Foundation programmes and for interviews and places on speciality training programmes from 2027 onwards.

Clause 4 stand part.

Amendment 8, in clause 5, page 3, line 30, at end insert

“,provided that the majority of training for the programme takes place in the United Kingdom.”

This amendment would require a UK Foundation Programme to be a programme for which the majority of training takes place inside the United Kingdom.

Clause 5 stand part.

Clause 6 stand part.

Amendment 2, in clause 7, page 5, line 1, leave out paragraph (a).

This amendment, taken together with amendment 4, would provide that regulations made under Clause 3 are subject to the affirmative procedure.

Amendment 3, page 5, line 24, leave out “section 3 or”.

This amendment is consequential on amendments 2 and 4, which provide that regulations made under Clause 3 are subject to the affirmative procedure.

Amendment 4, page 5, line 40, after “under” insert—

“section 3 (regulations describing persons who may be prioritised for specialty training programmes from 2027 onwards)”.

This amendment, taken together with amendment 2, would provide that regulations made under Clause 3 are subject to the affirmative procedure.

Amendment 5, page 6, line 19, at end insert—

“(6) Before laying before Parliament a draft statutory instrument containing regulations under section 3 the Secretary of State must obtain the consent of—

(a) the Welsh Ministers, if the draft regulations contain provision which would be within the legislative competence of Senedd Cymru if it were contained in an Act of the Senedd;

(b) the Scottish Ministers, if the draft regulations contain provision which would be within the legislative competence of the Scottish Parliament if it were contained in an Act of the Scottish Parliament;

(c) the Department of Health in Northern Ireland, if the draft regulations contain provision which—

(i) would be within the legislative competence of the Northern Ireland Assembly if it were contained in an Act of that Assembly, and

(ii) would not, if it were contained in a Bill for an Act of the Northern Ireland Assembly, result in the Bill requiring the consent of the Secretary of State.”

This amendment would require the Secretary of State to obtain the consent of the relevant devolved government before laying draft regulations under section 3. It is consequential on amendments 2 and 4.

Clause 7 stand part.

Amendment 1, in clause 8, page 6, line 23, leave out from “on” to the end of line 24 and insert

“the day on which it is passed”.

This amendment would bring the Act into force on the day on which it receives Royal Assent.

Clause 8 stand part.

New clause 1—Report on impact—

“(1) The Secretary of State must lay before Parliament an annual report on the impact of the provisions of this Act.

(2) A report under this section must include—

(a) an assessment of the impact of the provisions of this Act on the number of applications for places on—

(i) UK Foundation Programmes, and

(ii) UK speciality training programmes, and

(b) if the assessment under paragraph (a) concludes that there has been a decrease in the total number of applications attributable to the provisions of this Act, an analysis of the potential impact of that decrease on the number of fully qualified doctors working in the NHS and Health and Social Care Northern Ireland, including specific analysis of the impact on the number of general practitioners and on each medical specialism.

(3) The first report under this section must be laid before 31 December 2029.”

New clause 2—Allocation of individual places on merit—

“(1) This section applies to the allocation of individual candidates to specific places on a UK Foundation Programme or a UK specialty training programme, whether that allocation takes place in the course of deciding offers of places or otherwise.

(2) A person who has a function of allocating places on a UK Foundation Programme or a UK specialty training programme must ensure that, once the prioritisation requirements set out in sections 1 to 3 of this Act have been applied, those allocations are based on an assessment of the applicants’ merits.

(3) For the purposes of the assessment of the applicants’ merits, a person may take into account—

(a) the candidates’ educational achievements,

(b) the candidates’ clinical performance,

(c) structured assessments of relevant skills and knowledge,

(d) the candidates’ research, leadership, management, quality improvement, and teaching skills, and

(e) the candidates’ knowledge relating to the place being allocated.”

This new clause would require the allocation of candidates to specific training places to be decided on an assessment of the candidates’ merits, after the prioritisation requirements in clauses 1 to 3 of the Bill have been met.

New clause 3—International students—

“(1) The Secretary of State must report annually to Parliament on the impact of the provisions of this Act on the numbers of international students at UK medical schools.

(2) This report must include an assessment of the financial impact on medical schools.”

This new clause would require the Secretary of State to report to Parliament annually on the impact of the measures in this Act on the numbers of international students studying at UK medical schools.

[The Minister for Secondary Care (Karin Smyth)]

In the interests of time, I will address the amendments at the end of proceedings, when I have heard from them—I think we have the gist of most of those issues. I restate our firm commitment to the Bill and all clauses.

Let me turn to clause 4 and clarify how we are defining “UK medical graduate” and “the priority group” for the purposes of the Bill. “UK medical graduate” in this context excludes those who have spent all or the majority of their time training for their medical qualification outside the British isles. This means that if a person has obtained a primary UK qualification but has studied mainly overseas, they will not be eligible for prioritisation as a UK medical graduate unless they fall into another group that is to be prioritised under the Bill. While internationally educated graduates from overseas remain an important part of the workforce and can continue to be recruited under the Bill, we are committed to growing home-grown talent, who are more likely to work in the NHS for longer, and to be better equipped to deliver healthcare tailored to the UK’s population.

Clause 8 sets out the territorial extent of the Bill and deals with commencement. The Bill extends to England, Wales, Scotland and Northern Ireland, and we have worked closely with the devolved Governments to ensure that it meets all needs and provides consistency. We are grateful to them for their support in bringing these measures forward so quickly. The Bill will engage the legislative consent motion process, and the devolved Governments have committed to commence this process in their Parliaments.

To ensure that the systems, planning and operational capacity required for successful implementation are in place, the Bill will be commenced

“on such day or days as the Secretary of State may by regulations appoint.”

As the Secretary of State outlined on Second Reading, this is an important fail-safe to ensure that we are not in a position in which a law is enacted that we cannot implement effectively at the time. I am happy to expand on that after we have discussed the amendments, but the key issue is the ability of the NHS and training providers to deliver the measure. That is why we have a fail-safe; we first need to be very clear that the NHS is in a position to deliver. Members have talked about the strikes. Those would be one consideration, and there are many others. We are asking the NHS and training providers to do something very difficult very quickly, and in order to ensure that they have the capacity and capability to do it safely, we are reserving the right to commence the Bill at a later date, rather than at the end of this Session. I will come back to the amendments when I close the debate.

[The First Deputy Chairman of Ways and Means (Judith Cummins)]

I call the shadow Minister.

[Dr Caroline Johnson (Sleaford and North Hykeham) (Con)]

I will speak to the amendments tabled by the Opposition. First, amendment 9 would require that from 2027, priority is given to British citizens on UK foundation programmes, and that they are prioritised for interviews and places on specialty training programmes. Clause 4 defines a UK medical graduate as a

“a person who holds a primary United Kingdom qualification within the meaning of the Medical Act 1983 (see section 4(3) of that Act)”.

However, it does not include

“a person who spent all or a majority of their time training for that qualification outside the British Islands.”

The Secretary of State has stated his intention to prioritise UK medical graduates, but he has failed to protect all British citizens in doing so. Our amendment would ensure that British citizens who study on an eligible medical course overseas were still prioritised in the Bill. There are many scenarios in which we may need to ensure that we protect British citizens. Consider, for example, a spouse, partner or child of a serving member of the UK armed forces who completes relevant training overseas while their relative is posted in Cyprus; a student at Queen Mary University of London who has completed the bachelor of medicine and bachelor of surgery course at its Malta campus but received a UK medical degree; a young British citizen who has studied in the US or France, owing to a family relocation; or, given that the largest bottleneck is not in training places but in getting a place in medical school at all in some cases, a British student who has gone to study overseas because of their fervent desire to become a doctor.

Those are all entirely possible and plausible scenarios in which British citizens have completed their relevant training, and wish to bring their skills back and to relocate in their homeland for the rest of their career, but may not be covered by the Government’s prioritisation model. The Government’s prioritisation model is based on where the degree was taken, rather than also considering who did it. The Secretary of State must ensure that we do not overlook our own citizens if we are to fairly address the competitive landscape for training posts. The Opposition therefore urge the Government to accept amendment 9.

Amendment 10 is a probing amendment to explore the effects of the Bill on military personnel. As a Member of Parliament representing an area with a large armed forces community, I know that medical trainees are an integral part of our serving community. The world is becoming an increasingly dangerous place, and junior trainees may be sent abroad earlier in their career than is currently the case. It is clearly wrong to penalise people who are doing brave work caring for our armed forces. They ought to be provided with optimal opportunities, and the Secretary of State has a duty to ensure that they are not overlooked. I would be grateful if the Minister covered that in her response.

New clause 3 would require the Government to make an annual report to Parliament about the Bill’s impact on the number of international students at UK medical schools, and the financial impact on UK medical schools. We talked about the bottleneck, and the balance between UK and international students training at UK medical schools; clearly, becoming a UK graduate will now come with a significant premium. What impact will that have on British children getting to make their choices and become doctors if they want to? What incentives does it provide to universities to increase the number of international students, and what effect will that have overall on UK medical schools?

New clause 2, tabled by my hon. Friend the Member for Runnymede and Weybridge (Dr Spencer), is about places for UK foundation and speciality training programmes, and the importance of allocation on merit, because we all want the very best doctors. When I became a doctor—believe it or not, it was 25 years ago this year, Madam Deputy Speaker—I applied for a job as a junior house officer, as it was called then. I applied for the jobs I wanted, I was interviewed by the consultants who would have been supervising my training, and then I was offered the jobs.

The experience of students today is very different. They are allowed to put in a preference and say which deanery or foundation area they would like to work in, but that is all. After that, the application goes into a computer system, which gives them a single rank that is not based not on anything they have done at university, or on whether they got good results or worked hard, or anything like that. The computer system will do a first pass, and if the first choice is available, it will give the student their first choice. If it is not available because by the time its gets to that student those places have gone, the computer system will miss the student and go on to the next one. When it has completed its full pass of the list, it will start again, and when it comes to that student next time, it will give them the highest preference that is still available.

Once the student has been allocated a foundation deanery, the process starts again within the locality, and I mean “locality” in the loosest possible sense. Take those applying for the Trent rotation; they could be posted in Lincoln, Boston, Nottingham, Derby or Burton. The doctor has no control over where they will go, and very little ability to express a preference. My hon. Friend the Member for Weald of Kent (Katie Lam) spoke about a student in her locality who had not been able to get a place, despite being at the top—third, I think—of their university class. It is clearly not fair to give people no opportunity to control their future. By the way, there is no right of appeal, so having been given their place, the choice for the student is: that place or no place.

The hon. Member for Sunderland Central (Lewis Atkinson) spoke about ordinary children from the north-east. Having once been an ordinary child from the north-east, I agree that it is important that people have opportunity, but it is equality of opportunity, not equality of outcome, that matters. I worry that the system creates equality of outcome. We therefore support new clause 2, tabled by my hon. Friend the Member for Runnymede and Weybridge.

Amendment 1 would require the Bill to take effect on the date of Royal Assent, as opposed to a date at the discretion of the Secretary of State for Health and Social Care. The Bill is deemed necessary emergency Government legislation to prioritise medical graduates in the United Kingdom for places on medical training programmes. When he announced the Bill in an attempt to avert industrial action by resident doctors in December, the Secretary of State told the House that he had been working intensively with his team to

“to see how quickly we could introduce legislation”—[Official Report, 10 December 2025; Vol. 777, c. 430.]

However, the Bill does not commit to a date when these measures will be enacted. Instead, the power lies in the hands of the Secretary of State, giving him a clear bargaining chip for future negotiations. It is clear that the Government intend to pass this legislation urgently, as they have said. However, without a commencement date, there are clear concerns that the Bill is just a negotiating tactic to prevent industrial action by resident doctors, and can be scrapped at a later date. There remains the prospect of further industrial action, despite the legislation being introduced. The Secretary of State should not be asking Parliament to pass a Bill that he has no intention of enacting if the British Medical Association plays ball and holds off on strikes. Either the Secretary of State thinks that this is emergency legislation that we need to get on with and enact, or he does not.

It is vital that the legislation is enacted straight away, because students are due to be given their training programme places now, and they need to decide where they are going to live. They cannot put their life on hold, and measures to prioritise UK doctors cannot be held off, until the Secretary of State has finished dangling a carrot in front of the British Medical Association. The Opposition are clear: while we are supportive of the principles of the Bill, it must be used for offers made this year.

Amendment 8 would clarify that under clause 5, a UK foundation programme is a programme where the majority of training takes place inside the United Kingdom. A foundation programme is defined as

“an acceptable programme for provisionally registered doctors”

in section 10A of the Medical Act 1983. It is vital to clarify that a UK foundation programme is a programme where a majority of training takes place inside the United Kingdom. That is because the General Medical Council can approve foundation programmes overseas. If it is not explicit that a foundation programme needs to be in the United Kingdom, a loophole is created whereby a foundation programme could be approved overseas, creating a back way into the system and circumventing the measures that the Government have tried to put in place. I encourage the Minister to look at that carefully as the Bill progresses.

In summary, we support the Bill, but we have concerns about some of the clauses, so we have tabled amendments that we hope the Government will look at carefully.

[The First Deputy Chairman]

I call the Liberal Democrat spokesperson.

[Helen Morgan (North Shropshire) (LD)]

The amendments in my name raise concerns about the Bill’s impact on fairness, transparency and the smooth functioning of the NHS, notwithstanding the Liberal Democrats’ overall support for the Bill.

Clause 7(1) would allow Ministers to change who is eligible for prioritisation through the negative procedure, meaning that such changes could be made unilaterally, without meaningful scrutiny. In practice, that hands the Secretary of State the power to redraw the boundaries of opportunity, and to decide who gets prioritised for medical training places, without Parliament ever having a say. That is unacceptable for a decision that affects people’s lives and careers, as well as the future capability of our health service. While I do not doubt the intentions of the Secretary of State and the Front Bench team, it opens the door to the risk of political whim or prejudice influencing who gets access to career-defining opportunities in the future. That is why the Liberal Democrats have tabled amendments 2 to 5 to reverse this, and to ensure that any changes must be subject to full parliamentary consent.

On the timing of the Bill’s implementation, the Government intend to apply the new prioritisation rules midway through the 2026 specialty recruitment cycle. Let us reflect on what that means in practice. Doctors already working in the NHS have entered this cycle under one set of rules. They have paid for exams, secured visas, arranged travel, uprooted their families and committed themselves to the NHS. To change the rules halfway through the process would not only be potentially destabilising for services, but very unfair to those individuals, many of whom are plugging urgent staffing gaps right now.

We already face real workforce pressures, so the last thing our NHS needs is a wave of dedicated doctors forced out by uncertainty, or pushed to leave the country because the Government moved the goalposts after applications had already begun. For this reason, we believe that the Bill should come into force from 2027. We must protect frontline services and protect the integrity of the applications process. To address the problem directly, we have tabled amendments 6 and 7 to safeguard those already in the 2026 application cycle, ensuring that they are not deprioritised, because that is a simple matter of fairness.

We have also tabled amendments to improve the transparency and long-term impact of the Bill. Across the NHS, we face severe shortages, not just in general practice but in radiology, oncology, mental health services and many other specialities.

Medical Training (Prioritisation) Bill

Judith Cummins Excerpts

2nd reading
Tuesday 27th January 2026 Commons Chamber

[Madam Deputy Speaker (Judith Cummins)]

I call the shadow Secretary of State.

--- Later in debate ---

[Preet Kaur Gill]

I am not the Chair of the Select Committee, and I think that the Secretary of State set out his position. This is really important. This is about UK taxpayers’ money being invested in training doctors, and we must ensure that UK trainees are able to secure training places once they graduate. That is the issue that we are discussing.

Let me be clear: this is not a criticism of international staff. The NHS would not and could not function without the dedication, skill and compassion of people from around the world, and we should say that plainly and with gratitude. Every day, they hold our system together. However, a mature, confident country can value that contribution while also saying that we cannot replace long-term workforce planning with a permanent reliance on overseas recruitment. That is not fair on British trainees, not fair on source countries, and not fair on the NHS. As we heard from the Secretary of State, the World Health Organisation has estimated that by 2030, there will be an 11 million shortfall in health workers, as every country competes for the same limited workforce. This Government understand that putting British workers first is not something for which we will apologise. It is what the public expect.

The Prime Minister has been clear: a serious Labour Government must align migration, skills and training policy with the national interest. We cannot simply be passive; we must shape our domestic workforce to ensure that the NHS can continue to function. The same principle should apply wherever we are overly dependent on skilled migration because domestic training was neglected for 14 years under the Conservatives. Investing in people in the UK, and expecting that investment to strengthen Britain, is not ideological; it is responsible government.

The powers conferred to the Secretary of State in this Bill are important. The Royal College of Radiologists’ 2024 census found that 83% of cancer centre heads of service in the west midlands were concerned about patient safety as a result of workforce shortfalls. In 2024, only 19% of clinical oncology training places in the west midlands were filled. Will the Secretary of State outline how he intends to use the powers in this Bill and work with the integrated care boards to ensure that access to training matches regional workforce needs and health demands?

Above all, this Bill is about respect—respect for the taxpayer, respect for the NHS workforce, and respect for a health service that must be planned for the long term, not patched up year on year. This is exactly the kind of reform that the public expect from a Labour Government who are serious about work, contribution and the future of our NHS.

[Madam Deputy Speaker (Judith Cummins)]

I call the Liberal Democrat spokesperson.

--- Later in debate ---

[Ms Julie Minns (Carlisle) (Lab)]

I would like to place on record my interest as the mother of an NHS nurse.

It is a privilege to speak in today’s debate and to do so on behalf of my Carlisle constituency, which I am proud to say has recently taken a transformative step with regard to medical training, with the opening of the Pears Cumbria School of Medicine. This new graduate school of medicine is being jointly pioneered by Imperial College London and the University of Cumbria, and I put on record my thanks to Professor Martin Lupton, Professor Mary Morrell and Professor Brian Webster-Henderson, whose vision the medical school is, and to Sir Trevor Pears and the Pears Foundation, whose generosity has made their vision a reality.

As with the Medical Training (Prioritisation) Bill before us today, the Pears Cumbria School of Medicine purposefully prioritises home-grown talent. The school also seeks applications from students from non-traditional backgrounds, encouraging applications from groups that are less well represented in medicine. As part of the school’s commitment to widening access, the four-year graduate programme has no GCSE or A-level requirements. The reason for this approach is simple: it provides the best chance, year in, year out and generation after generation, for Carlisle and Cumbria to produce our own doctors. These doctors will often come from the surrounding communities and, in part because of where they are trained, will be deeply committed to the local area and its people.

In geographically remote areas such as ours, the ability to train and retain our own doctors is critical. It matters enormously. Cumbria faces some of the most entrenched health inequalities in the country. We have struggled for years with recruitment and retention across both primary and secondary care, and our hospital trust relies heavily on locums. We know all too well that the traditional model of medical education, centred on large metropolitan teaching hospitals, simply does not produce or attract the workforce that rural areas such as mine need.

That brings me back to the Bill before us today. The Government are right to prioritise UK graduates for foundation and specialty training places. The Bill represents a significant and welcome step towards restoring confidence in the training pipeline, addressing the growing mismatch between the number of medical graduates and the number of available posts, and ensuring that those who have invested years of training in our NHS are not left without a route on which to progress. It is a sensible, fair-minded reform that will bring much-needed stability to a system that has been under real strain.

For Carlisle and Cumbria, however, the issue is not only who gets priority but where the training posts are located. At present, although foundation training can be delivered locally, it can be delivered only where accredited F1 and F2 posts exist. In Cumbria, the number of those posts is limited. The North Cumbria integrated care trust is able to provide places for some foundation trainees, and others will find F1 and F2 posts in primary and community care settings, but further accredited places will be required at foundation level. I ask the Minister to explain, in her response, not just how the new powers will prioritise UK medical graduates and members of the priority group, but how the powers might be used to widen the availability of accredited F1 and F2 posts in areas such as Cumbria, where there is a shortage of doctors.

Even if we successfully retain Pears medical school doctors in Cumbria for their foundation programme training, the risk of losing them when they come to their specialty training programme is even greater, because doctors will overwhelmingly choose to settle near to where they complete their training, particularly their specialist training, and Cumbria will never be able to provide every specialty training pathway within the county to retain our home-grown talent. We simply do not have the population size or the case mix to deliver all specialisms in our trusts. However, that does not mean that we cannot design a system that keeps trainees connected to Cumbria throughout their training. I therefore urge the Minister to consider how the regulation-making powers granted by the Bill can address that issue.

Pears medical school believes that a new approach to specialist training is the way forward. I recently wrote to the Secretary of State seeking a meeting between him and representatives of the medical school to explore that approach, and I very much hope that he will soon accept that meeting. I also ask Ministers to consider seriously how specialty training can be structured so that trainees who complete F2 in Cumbria are supported to remain based in the region, even if their specialist rotations take them elsewhere for short periods. That could mean funded return-to-base arrangements, rotational models anchored in Cumbria, or formal partnerships between specialist centres in UK cities and community providers in Cumbria. In other words, we need a training pathway that allows people to specialise with Cumbria, not away from it, because if we allow the system to pull trainees out of Carlisle at the very moment they are beginning to put down roots, we will simply recreate and repeat the cycle that has left rural areas like mine short of doctors for too long.

The Pears Cumbria School of Medicine is a once-in-a-generation opportunity to reshape the medical workforce in Cumbria, but it will fully succeed only if training programmes are aligned with its purpose. In welcoming the Bill, I urge Ministers to ensure that its implementation meets the requirements and needs of remote communities. Prioritisation is important, but place matters too.

[Madam Deputy Speaker (Judith Cummins)]

I call the Chair of the Health and Social Care Committee.

Resident Doctors: Industrial Action

Judith Cummins Excerpts

Wednesday 10th December 2025 Commons Chamber

[The Secretary of State for Health and Social Care (Wes Streeting)]

With permission, Madam Speaker Deputy, I shall make a statement on industrial action by resident doctors. I thank you, Mr Speaker, business managers and the official Opposition for facilitating this evening’s statement.

As we head into winter, our hospitals are running hot and the pressures on the NHS are enormous. Flu season has come earlier, with a sharp rise in cases and the peak still to come, and this year’s strain is more likely to affect older people more severely. Already, the number of patients in hospital in England with flu is the highest on record at this point in the year. It is 50% higher than this time last year and 10 times higher than in 2023. Some 95% of hospital beds are occupied, growing numbers of staff are off sick and we are already seeing the pressure in our A&E departments. It is against that backdrop that the British Medical Association is threatening to douse the NHS in petrol, light a match and march its members out on strike. This represents a different magnitude of risk to previous industrial action.

The BMA resident doctors committee is in dispute on two issues: pay and jobs. On pay, resident doctors have already received a 28.9% pay rise—the highest in the public sector. For a first-year resident doctor, that is the equivalent of a £9,400 pay rise. I have been consistent, honest and up front with resident doctors that we cannot go further on pay this year. There is a gap between what the BMA is demanding and what the country can afford. Nor would further movement on pay be fair to other NHS staff, for whom I am also responsible and many of whom will never in their careers earn as much as the lowest-paid doctor. As I have made clear to the BMA and other trade unions, I am open to discussing multi-year pay deals with any trade union if we stand a chance of bridging the gap between affordability and expectations.

On jobs, I have much more sympathy with the BMA’s demands. I have heard the very real fears that resident doctors across the country have about their futures; it is a legitimate grievance that I agree with. My Conservative predecessors created training bottlenecks that threatened to leave huge numbers of resident doctors without a job. In 2019, there were around 12,000 applicants for 9,000 specialty training places. This year, that number has soared to nearly 40,000 applications for 10,000 places.

It used to be the case that UK graduates competed among themselves for specialty roles; now, they are competing against the world’s doctors. That is a direct result of the visa and immigration changes made by the previous Conservative Government post-Brexit, and it is compounded by the Conservatives’ decision to increase the number of medical students without also increasing the number of specialty training places.

Taxpayers spend £4 billion training medics every year—we then treat them poorly, and some leave to work abroad or in the private sector. It is time that we protect our investment and give bright, hard-working UK medical graduates a path to becoming the next generation of NHS doctors. Our 10-year plan for health set out our commitment to provide that path. It pledged to introduce 1,000 extra specialty training places and prioritisation of medical graduates from the UK and Ireland.

Today, in an offer to resident doctors, I can announce that I am able to go further. I want to thank Sir Jim Mackey, the chief executive of the NHS, and his team, who have been going trust by trust to see how many extra places can be funded and are needed. Thanks to their hard work, I am in a position today to be able to offer 4,000 specialty places for resident doctors, starting with an additional 1,000 for those applying this year.

In the Department of Health and Social Care, we have been working intensively on UK graduate prioritisation. The barriers have been legal ones, so I have been working intensively with my team to see how quickly we could introduce legislation. Thanks to their efforts, the co-operation of colleagues across Government, and my counterparts in Wales, Scotland and Northern Ireland, I can notify the House tonight that, subject to the agreement of resident doctors, we intend to introduce urgent primary legislation in the form of a Bill to be presented to Parliament in the new year.

The legislation will prioritise graduates from UK medical schools over applicants from overseas during the current application round and in all subsequent years. The reforms will also prioritise doctors who have worked in the NHS for a significant period for specialty training. This will not exclude international talent, who will still be able to apply to roles and continue to bring new and vital skills to our NHS, but it will return us to the fair terms on which home-grown medics competed before Brexit. The impact of these changes is that instead of four doctors competing for every training post, it will now be fewer than two doctors for every place. That is a good deal for doctors.

Following discussions with the BMA, we are also addressing the specific costs faced by resident doctors that do not apply to other NHS staff. Although I cannot go further on pay this year, I am able to offer today to put money back in resident doctors’ pockets by reimbursing royal college portfolio, membership and exam fees, with the latter backdated to April. The allowance for less-than-full-time resident doctors—many of whom are parents and carers—will be increased by 50% to £1,500, helping to close the gender pay gap.

In recent days, I formally made this offer to the BMA resident doctors committee. The BMA will now survey its members in the coming days on whether to accept this offer and end its dispute with the Government. The BMA told us that it will survey its members quickly and give us less than 48 hours’ notice of whether the strikes are going ahead. That presents serious operational challenges for NHS leaders, who need certainty now as to whether they are cancelling patient appointments and cancelling staff annual leave to cover strikes.

In my determination to prevent the havoc that strikes would cause this Christmas, I therefore made one more offer to the BMA, which I will now share with the House, the country and frontline doctors. So that the BMA could run a genuine ballot of its members and call off next week’s strikes while that ballot ran, I offered to extend its strike mandate. This would have allowed enough time for the BMA to reschedule next week’s strikes for the end of January, were the offer to resident doctors rejected in a ballot. It would have avoided the chaos that looming strike action threatens at the most dangerous time of year by removing the spectre of strikes next week. I knew that extending the BMA’s strike mandate would leave me open to attack from political opponents; that was a risk I was willing to take to stop the Christmas strikes going ahead. Madam Deputy Speaker, I must report to the House that the BMA’s leadership said no.

In the coming days, as the NHS prepares for strike action that may or may not happen, there are patients whose operations will be cancelled. There are NHS staff who will have to tell their families that they will not be home for Christmas because they have to cover for their resident doctor colleagues. This was entirely avoidable—no one should be in any doubt that the BMA has chosen to play politics with people’s lives this Christmas, and to continue holding the spectre of strikes over the NHS. I ask resident doctors to bear that in mind when they cast their votes.

The power to end these strikes now lies in the hands of doctors. Resident doctors face a choice: to continue the damaging industrial action in which everyone loses, or to choose more jobs, better career progression, more money in their pockets and an end to strikes. The deal that is on offer would mean emergency legislation to put our own home-grown talent first; to increase the number of extra specialty training places from 1,000 to 4,000, with a quarter of those places delivered now; to reduce the competition for training places from around four to one to less than two to one; to put more money in doctors’ pockets by funding royal college exam fees, portfolio fees and membership fees, with exam fees backdated to April; and to increase the less-than-full-time allowance by 50% to £1,500. It is a chance for a fresh start, to end this dispute and look ahead to the future with hope and optimism—a chance to rebuild resident doctors’ working conditions and rebuild our NHS. I urge every resident doctor to vote for this deal, and I commend this statement to the House.

[Madam Deputy Speaker (Judith Cummins)]

I call the shadow Health Secretary.

--- Later in debate ---

[Wes Streeting]

I agree entirely with my hon. Friend. She brings considerable frontline experience to this House, having worked in the NHS and dedicated her life to it. I am pretty sure that as well as speaking for her constituents, she speaks for so many other NHS staff. I do not want to see nurse pitted against doctor, or NHS staff pitted against each other. I do not want to see people resenting each other at a time when we should be pulling together to get the NHS back on its feet, and to make sure that it is well down the road to recovery. That is why, even at this late stage, I urge the BMA to think again. There is nothing to stop me extending the strike mandate tomorrow and giving Jim Mackey and NHS leaders the opportunity to stand down planning for strikes next week, even at this late stage. It would be an extraordinary gesture of good will, and it would be a Christmas present for the country. It would benefit doctors, resident or otherwise, and all NHS staff. Most importantly of all, it would benefit patients. I hope that message is heard in good faith by the BMA, even now.

[Madam Deputy Speaker]

I call the Liberal Democrat spokesperson.

[Dr Danny Chambers (Winchester) (LD)]

I thank the Secretary of State for his statement. People will be hugely alarmed at the threat of more industrial action right before Christmas, and we cannot forget how we got here. We know that the previous Government under-resourced the NHS. It was overburdened, people felt underappreciated, and the whole system was being held together by the good will of the staff.

Having said that, the timing is terrible, because we have the worst winter flu outbreak in decades, right before Christmas. We have to urge the BMA to work constructively to resolve this dispute in a way that is fair for both patients and taxpayers. Given that resident doctors received a 29% pay rise last year, I think most of the public feel that pushing for another 28.9% this year is unaffordable and unreasonable.

The Secretary of State touched on resident doctors’ legitimate concerns. The previous Government increased medical school places without increasing the facilities to deliver the necessary specialist training placements, so this was a predictable bottleneck that we are now up against. Waiting lists are long, we need more doctors, and we have doctors who have been trained largely at the taxpayer’s expense struggling to find work. We very much welcome the extra 4,000 placements that were announced today, which are hugely necessary. Can we ensure that they will address the acute shortages in general practice and psychiatry? To put those 4,000 places in context, 10,000 doctors applied for 500 psychiatric training places last year, and the Secretary of State said that about 40,000 doctors have applied for 10,000 places this year. Is there work to try to increase places as quickly as possible in the next few months and years?

At Winchester hospital, one in five beds is taken up by people who do not have any social care packages. That is not good for them, because they are stuck in the hospital, and we want to get them home for Christmas, but it will also affect the flow through the hospital right now, during a winter flu crisis.

We welcome this action and urge the BMA to call off the strikes, but can we address the legitimate grievances that the Secretary of State has mentioned?

--- Later in debate ---

[Wes Streeting]

I wholeheartedly agree with my hon. Friend. I was about to say that it is always a disappointment when Reform and Green Members do not appear in the Chamber, but I would not want to be accused of misleading the House. I am sure they had a better offer, and there is a Christmas party up the road.

In all seriousness, my hon. Friend is absolutely right. The tragedy of the past couple of rounds of industrial action is that each round costs about a quarter of a billion pounds. Each round, despite the best efforts of NHS leaders and frontline staff, does cause disruption, and we all lose when that happens. One of the things that is really hard for staff is that they are also confronted in a very real way with the impact of the state of the NHS on their patients. They are not in it for themselves, but because they believe in public service and want to improve the health of our nation. We are so much better able to achieve our shared goals if we work together, and we can grasp that opportunity if doctors vote for this deal, we draw a line under this dispute, and we try to reset the relationship between me and this Government on one hand, and the BMA’s leadership on the other.

[Madam Deputy Speaker (Judith Cummins)]

I call the Chair of the Health and Social Care Committee.

[Layla Moran (Oxford West and Abingdon) (LD)]

This is just not the time for a strike. As much as we have huge sympathy with many of the grievances of resident doctors, we understand that the next few weeks will be critical for how the next few months will be for the NHS, so I echo calls for the BMA to listen to reason. However, I spare a thought, and I hope the Secretary of State does, for the overseas doctors we rely on so heavily, because there is an acute workforce shortage. How, through this plan and this legislation, will the Secretary of State avoid creating a two-tier system that risks undervaluing the critical work that overseas doctors do to prop up our NHS?

--- Later in debate ---

[Several hon. Members rose—]

[Madam Deputy Speaker (Judith Cummins)]

I do want to finish this statement shortly, so could Members keep their questions and answers short? I call Andrew George.

[Andrew George (St Ives) (LD)]

I welcome the Secretary of State’s statement and the manner in which he has been handling the issue. However, I want to ask him about the way he summarised the position at the end of his statement. He presented it as a choice between striking and having more jobs and the other parts of the offer. I seek clarity on the matter. Is he genuinely saying that he is going to withdraw that? Was that purely for oratorical effect, or is that his negotiating position?

Budget Resolutions

Judith Cummins Excerpts

Tuesday 2nd December 2025 Commons Chamber

And it is declared that it is expedient in the public interest that this Resolution should have statutory effect under the provisions of the Provisional Collection of Taxes Act 1968.

[Madam Deputy Speaker (Judith Cummins)]

I draw the House’s attention to two minor corrections that have been made to the text of resolution 59 and the title of resolution 98. A revised version of the resolutions paper is available in the Vote Office and online. It includes a note setting out the corrections that have been made.

With the exception of Front Bench speeches, there will be an immediate four-minute time limit. I call the Secretary of State.

--- Later in debate ---

[Wes Streeting]

My hon. Friend is absolutely right. Of course, we want to ensure that investment is deprivation linked. We want to reverse the damage the Conservatives did when they pursued what I would characterise as the Royal Tunbridge Wells strategy, when our former Prime Minister, the right hon. Member for Richmond and Northallerton (Rishi Sunak), declared with pride to Conservative party activists that he had taken funding from the poorest communities in the country and funnelled it to the richest. There could be no shorter or clearer exposition of Conservative party values and politics in action than that claim.

To my hon. Friend’s point, he is absolutely right that within many affluent communities there are also pockets of deprivation, and we have to ensure that the NHS is there for everyone in every part of the country. We are dealing with enormous undercapitalisation in the NHS, totalling some £37 billion as identified by the noble Lord Darzi. It will take time to address that challenge, but I think my hon. Friend’s constituents know from his assiduous hard work and visible campaigning as a constituency MP that he will ensure that their needs and interests are not forgotten or overlooked by this Government.

Of course, as we improve the health of our health service, we also need to address the health of our nation. Children in England face some of the poorest health outcomes in Europe. Obesity in four and five-year-olds is reaching record levels—a health time bomb that leaves them at greater risk from cancer and heart disease later in life. What kind of start in life are we giving our children, and if we allow it to continue, what kind of future are we leaving to them? Our children will lead shorter, less healthy lives; our NHS will buckle under a tidal wave of chronic conditions; and our economy will suffer because businesses will be denied the potential of the next generation.

This Labour Government are tackling the sickness in our society. Whether it is the extension of the soft drinks industry levy, free school meals, a warm home discount that reaches millions more, the generational ban on smoking, Awaab’s law, cutting pollution and cleaning up the air that our children breathe, we are combating the drivers of ill health in children’s lives: poor diets, damp homes, dirty air and a lack of opportunity. In short, we are tackling poverty, because every child deserves a healthy start in life, and prevention is better than cure.

The leader of Reform, the hon. Member for Clacton, says we should instead be educating people to make healthier choices—I assume that he will not be leading from the front on that campaign. But we know that Reform and the Conservatives oppose our agenda to improve public health. They oppose our investment in the NHS. They should just be honest and admit that they now oppose the NHS itself. [Interruption.] Conservative Members do not like it, but I challenge them to dispute a single claim I just read. Let me repeat the charge sheet for their benefit: they oppose our investment in the NHS. Have they not opposed every budget spending review since Labour came to office? [Interruption.] Honestly, from a sedentary position, the hon. Member for Kingswinford and South Staffordshire (Mike Wood), who does not want to intervene because I think he knows he is leading with his chin on this, wants to suggest that somehow the Conservative party left a legacy that they could be proud of. They inherited the shortest waiting times and the highest patient satisfaction in history. They left us the longest waiting lists and lowest patient satisfaction on record. No wonder so few of them have turned up to defend that shoddy record.

The Conservatives oppose our public health agenda, do they not? I thought this was an area where we had built consensus, but not under their present leadership. I have already quoted what their leader, the right hon. Member for North West Essex (Mrs Badenoch), has said. Maybe they were not listening—the country certainly is not. I would have thought, though, that their own side would at least listen to what she said. She says she wants a debate about charging for healthcare. I do not know whether they have heard that or whether they stand by it. Maybe we could just see a simple show of hands—how many of her own side want to see charging for healthcare in the NHS? Not a single hand has gone up. That does not bode well for the future of the Leader of the Opposition, but let’s leave the Conservative party to revel in its irrelevance.

In fact, I was probably one of the few people who paid any attention to what the shadow Health Secretary, the right hon. Member for Daventry (Stuart Andrew), said at the Conservative party conference. I noticed that he did not mention a single policy. I say to the Conservatives: if we are doing such a bad job, why would they not do anything differently? Would they cut the £26 billion this Labour Government are investing in the NHS, and if not, if they oppose this Budget, how would they pay for it? The Conservatives seem to think that the British people are so stupid that they will forget which party wrecked the NHS and led it to the worst crisis in its history.

To conclude, this is a Government who are cutting waiting lists, giving children a healthier start in life and lifting 500,000 children out of poverty. In doing so, we are restating the case for universal healthcare that is publicly owned, publicly funded and free at the point of use. We are showing that progress is possible after 14 years of decline, that things can get better. Abolishing the two-child limit is not a handout, it is a hand up. Our country cannot prosper while 6 million people languish on waiting lists, 4.5 million children grow up in poverty and 1 million young people are not in education, employment or training. But if we protect people’s health, give them the opportunities to put their talents to use and give them a strong foundation, they will build a good life for themselves and a better Britain for all, and we can fulfil the lost promise that tomorrow will be better than today.

[Madam Deputy Speaker (Judith Cummins)]

I remind all Members that the courtesies of this House require Members to inform other Members if they intend to name them in the Chamber.

I call the shadow Secretary of State.

International Men’s Day

Judith Cummins Excerpts

Thursday 20th November 2025 Commons Chamber

[Madam Deputy Speaker (Judith Cummins)]

I call Josh Newbury, who will speak for around 15 minutes.

--- Later in debate ---

[Several hon. Members rose—]

[Madam Deputy Speaker (Judith Cummins)]

Order. I will impose an immediate four-minute time limit.

--- Later in debate ---

[Chris Bloore]

You’re welcome! [Laughter.]

[Madam Deputy Speaker (Judith Cummins)]

I call the Liberal Democrat spokesperson.

[Susan Murray (Mid Dunbartonshire) (LD)]

I thank the hon. Member for Cannock Chase (Josh Newbury) for bringing forward this debate, but also for sharing his experience.

I am the mother of two young men, and I am very proud of the way they tackle the challenges that life has put in their way with kindness and resilience. Before the debate, I took the time to sit down with some more young men, and we talked about their experience of living as young men in the UK today. They are successful individuals, university graduates with good jobs and what, from the outside, look like steady lives, yet their outlook was shockingly bleak. They talked about their belief that, without support or systemic change, they would never own a house. They are resentful about their opportunity to build up a good pension. They talked about how the cost of living is reaching a point where even basic leisure activities, such as sport after work, are becoming unaffordable. Most worryingly of all, they talked about how younger men are being radicalised by this. They said they are increasingly seeing boys and young men being pushed into far-right and hateful echo chambers while searching for an alternative path.

It is clear that we are failing young people as a whole, and young men in particular. Buying a house is a distant dream for most young people, and even renting is, by the Government’s own assessment, unaffordable. Mental ill health services are inaccessible, and male suicide is now the biggest killer of men under 50. Young men are falling behind young women in education and earnings, which at a time when traditional expectations are shifting, is challenging their sense of identity and place in society. This is not about dismissing the struggles faced by women, many of which are the same; it is about recognising the nuance in the ways these pressures affect men differently and how many men cope with them differently.

Too often this debate swings between two extremes: those who wish to dismiss men’s concerns altogether; and those who wish to capitalise on male disillusionment to sow division and hatred. That is why we welcome the Government’s new men’s health strategy, and applaud the campaigners and organisations that fought so hard to bring it to us at this moment. It is right that the Government finally recognise the specific ways in which men are suffering—from suicide to substance abuse and prostate cancer—but we need to go further. Many of the steps are still modest, especially on suicide. I have been directly affected by the suicide of a young man, who had his full future ahead of him. As we have heard, this is the greatest killer of men under 50, but the Government have scrapped the suicide prevention grant—a £10 million lifeline—and the new measures barely replace it. With thousands of people dying by suicide every year, we have to be more ambitious. That means restoring the suicide prevention grant in full, introducing regular mental health checks at key points in life and tackling the wider determinants of health, including ending rough sleeping, which disproportionately affects men.

Beyond mental health, we must also address the deep sense of hopelessness felt by so many young men. We must acknowledge that men are now 14% less likely to attend university than women, and we need to provide respected alternative routes into good work through apprenticeships and skills programmes. We must also confront the housing crisis more quickly. Investment in housing will not only ease pressure on the market, but create long-term jobs in construction and engineering. This is deeply important because, ultimately, we can invest in mental health support, but without job prospects, a home to build a life in and a future to believe in, young men will continue to feel hopeless, and when young men feel hopeless, they will continue to look for answers from those on the extremes. So while I welcome the men’s health strategy, this is just the first step of many.

[Madam Deputy Speaker (Judith Cummins)]

I call the shadow Secretary of State.

Ageing and End-of-life Care

Judith Cummins Excerpts

Thursday 30th October 2025 Commons Chamber

[Several hon. Members rose—]

[Madam Deputy Speaker (Judith Cummins)]

Order. Before I call the first speaker, Members will have noticed that we are pushed-ish for time, so I ask them to keep their comments to around eight minutes.

--- Later in debate ---

[Dan Aldridge (Weston-super-Mare) (Lab)]

I thank the hon. Member for Strangford (Jim Shannon) for securing this debate. It has been a pleasure to see his passion for his community and for the people of Northern Ireland, especially as a member of the Northern Ireland Affairs Committee.

Care at the end of life and ensuring dignity, compassion and community in every chapter of life is so incredibly important. I pay tribute to Weston Hospicecare, and particularly to Paul Winspear and his amazing team, who are an extraordinary example of what compassionate, community-based care can achieve. Their current director of patient services, John Bailey, retires in December after 30 years of dedicated services. Paul, the chief exec, describes John as a “truly exceptional” person, and I absolutely agree.

Founded in 1989, Weston Hospicecare supports more than 1,000 patients and families each year, serving a population of around 225,000 people from Clevedon to Burnham-on-Sea and from Cheddar to Weston-super-Mare, Worle and the villages that surround my constituency. It is hard to find somebody in my town whose life has not been touched by Weston Hospicecare’s dedicated team; my family is no exception. Weston Hospicecare helped us during some of our darkest times. I have a personal mission to help safeguard the future of this important facility. Its dedicated team provides in-patient, day hospice and community nursing services alongside physiotherapy, counselling and bereavement support, all free of charge.

Weston Hospicecare truly embodies the spirit of my home town—caring, community-minded and determined to do the right thing—but it is important to acknowledge the pressures that it faces daily. Weston Hospicecare receives only around 18% of its operating costs from the NHS, compared with a national average closer to 29%. The rest must be raised through community fundraising, shops and donations. The generosity of our community is remarkable, but it is being stretched to its limit, despite some of the most innovative approaches to fundraising that I have witnessed. I am genuinely, truly impressed by what Weston Hospicecare has been able to achieve.

Over recent years, hospice funding increases have fallen well behind inflation. The national living wage increase has rightly lifted incomes, and I am entirely in favour of it, but that and other factors have increased staffing costs for many hospices. Weston Hospicecare faces an annual deficit of £500,000—roughly 10% of its £6 million budget—and it has had to dip into reserves, which now stand at less than six months’ cover. For such vital services that mean so much to my community and to the communities around us, we must find a better way.

Despite that, Weston Hospicecare continues to deliver outstanding value. It provides care for patients with complex, multi-morbid conditions who would otherwise occupy hospital beds or require costly community nursing, and it is relieving pressure on the NHS in my town. Weston Hospicecare saves the health system money while delivering really outstanding outcomes for patients and families.

The Government’s recent £75 million capital investment in hospices has been so important. Weston Hospicecare has benefited from it, and is particularly grateful for it, as am I, but we all recognise that while one-off capital investment is welcome, it cannot by itself secure the future. We need a sustainable commissioning model and fair funding for the essential, specialist care that hospices provide, while allowing them to continue raising community funds for services that are so often seen as optional, but which are in reality vital, such as family support, bereavement care and the holistic and therapeutic services that help people to live and die well.

This issue is also about the wider fabric of our communities. In coastal towns such as Weston-super-Mare, where we have higher proportions of older residents, fewer large employers and sometimes higher levels of isolation, hospices—in particular my hospice—are part of what hold our communities together. They offer not just care and employment, but training, volunteering and opportunities for young people to build meaningful careers in care. One of my best friends, John Williams, has been a carer his whole life. All too often, what I consider to be a vocation—a profession—is undervalued. That is something that we must change.

When we talk about ageing and end-of-life care, we must see it not as a burden, but as a mark of who we are—a society that values every life at every stage, and sees worth in all human life. Weston Hospicecare is a beacon of that principle, and with the right long-term funding framework, I believe it and other providers like it across the country can continue to serve our communities for decades to come.

[Madam Deputy Speaker (Judith Cummins)]

I call the Liberal Democrat spokesperson.

[Helen Maguire (Epsom and Ewell) (LD)]

I congratulate the hon. Member for Strangford (Jim Shannon) on securing this important debate.

It is well known that our population is ageing, with the latest census showing that people aged 65 and over account for 19.1% of the total population in Surrey. That figure is predicted to increase to 25% by 2047. In my constituency of Epsom and Ewell, there are brilliant charities working to support the older population, including Age Concern, which empowers older people to live the most fulfilling lives they can while providing services, including advice, medical transport, social support and befriending. Organisations such as Age Concern are a vital lifeline for many, especially following the Conservatives’ failure to fix social care and invest in preventive measures that support older people to stay in good health.

Our older and ageing communities also need to be able to access public services, including GP provision. According to Age UK, the number of full-time equivalent GPs, including trainees, increased by just 2.5% between 2023 and 2024, which is not keeping pace with the population growth of older people aged 75 and over. Many GPs are heading towards retirement, leaving an even bigger gap, so the Government must go further with plans for recruitment. There needs to be a concerted effort to build a strong, resilient GP workforce that prioritises retention and delivers services that stop older people from ending up in hospital due to delays in primary care.

Along with GP provision, access to social care services is vital. With an ageing population, we are seeing more and more older and frail carers supporting their spouses, putting a further strain on the carer’s own health. We need to do more to support, protect and empower older people, so will the Minister commit to reversing the Conservatives’ cuts to public health funding and facilitate a social care system that is accessible to older people, encourages preventive care, and tackles key issues such as loneliness and frailty?

As our population ages, more people will be living with—and dying with—multiple complex conditions. Marie Curie reports that by 2050, the number of people in need of palliative and end-of-life care will rise to over 745,000 people per year, which is 147,000 more than at present. One local family in Epsom and Ewell have shared their experience of struggling to access hospice care for a loved one with a terminal illness. Despite their efforts, no hospice place was available, and delays in pain relief made their loved one’s final days distressing, something that could have been alleviated by better funding and co-ordination of end-of-life services.

Funding cuts and years of neglect under the previous Conservative Government have led to reduced services, which has a direct impact on patients and their families, who deserve dignity and support in their final days. The Liberal Democrats have proposed exempting health and care providers from increases in employer’s national insurance contributions, yet the Government have ignored that proposal and have not provided much-needed support to the social care sector. In a further damning development, a report released just this week by the National Audit Office revealed that nearly two thirds of independent hospices in England reported a deficit in 2023-24. As a result, services have been slashed and hospices have been forced to cut the number of beds available, due to a lack of Government funding.

With hospices and care services under strain, people desperately need support, and families often have no place to turn. There have been a number of successful and ongoing pilots by local NHS trusts of dedicated phone lines for palliative and end-of-life care needs. The Thames Valley pilot advice line led to a reduction in ambulance conveyances, a 35% reduction in referrals to out-of-hours primary care, and a fourfold increase in calls closed with no further intervention required. NHS 111 is a brilliant service, but it is not always appropriate. Access to a specialised palliative care expert can alleviate patient anxiety, streamline support and facilitate better care. That is something that I urge the Minister to investigate.

Will the Minister commit to ending the postcode lottery of funding for palliative care, create a dedicated hospice workforce plan, expand carer’s allowance, and provide guaranteed respite care before end-of-life care eligibility begins? As we manage the ageing population and navigate end-of-life care, this Government must put patients first and prevent a devastating erosion of public services, tackle dangerous understaffing, and support people to age well in their community.

[Madam Deputy Speaker (Judith Cummins)]

I call the shadow Minister.