Palliative Care

Julian Lewis Excerpts

Thursday 5th March 2026 Commons Chamber

[Sir Julian Lewis (New Forest East) (Con)]

I begin by congratulating the hon. Member for York Central (Rachael Maskell) most warmly on her exemplary record in campaigning for better palliative care. I will address just one segment of her panoramic presentation, namely the work done by the charity that she briefly mentioned, Together for Short Lives. It provided me with a detailed briefing and I apologise in advance if I make some points that others, who may have received the same briefing, anticipate making.

Children’s palliative care enables babies, children and young people with life-limiting conditions, life-shortening conditions or severe medical complexity to live as well as possible until they die. Palliative care for children and young people is defined by the charity as

“an active and total approach to care, from the point of diagnosis throughout the child’s life, death and beyond.”

By embracing physical, emotional, social and spiritual elements, children’s palliative care helps to achieve the best possible quality of life and care for every child with a life-limiting or life-threatening condition and their family.

Giving families an opportunity to set out what they need and want is key to this approach. Children’s palliative care is holistic and is provided by a network of services in hospitals, homes and children’s hospices by the NHS and the voluntary sector, including children’s hospices. These services should be planned, funded and provided in a way that enables children and families to access them when and where they need them.

The key problem is the one that I am about to set out:

“In England, integrated care boards have a legal duty to commission palliative care for children, young people and adults that it considers necessary.

Across England and the wider UK, there is huge variance in the extent to which palliative and end of life care for seriously ill children and young people is being formally planned, funded and provided in ways that meet national and regional standards.

Of particular concern is children and families’ access to end of life care at home”—

we heard this from the hon. Member for Taunton and Wellington (Gideon Amos)—

“24 hours a day, seven days a week, provided by nurses and supported by advice from consultant paediatricians who have completed sub-specialty training in paediatric palliative medicine (also known as GRID training).

Despite some improvements, freedom of information…requests published in March 2025 have revealed that less than a fifth…of ICBs currently commission these services on a formal basis. Meanwhile, over a third…are still failing to meet this established national standard.

As a result, many families feel abandoned by a complex system which should support them to provide care once their child is diagnosed.”

I have been asked by the charity to raise a rather large number of questions, which I am going to cut down to just six, if I can manage to squeeze them in. The charity stresses the fact that the Government’s decision to allocate up to £80 million in ringfenced NHS funding for children’s hospices in England over the next three years is very welcome, but many challenges remain.

These are the six questions that I have picked out of more than a dozen and a half that I was presented with. First, will the Minister confirm that the modern service framework for palliative and end-of-life care, which we heard about from the hon. Member for York Central, will explicitly acknowledge the difference between adult and children’s palliative care and ensure that the needs of seriously ill children are not overlooked?

Secondly, can the Minister confirm that the framework will take a holistic approach and address the wide-ranging needs of seriously ill children and their families, including medical, emotional, social, psychological and practical needs?

Thirdly, will the Minister commit to using the upcoming 10-year workforce plan to examine how the existing children’s palliative care workforce can be used as equitably as possible, organising services into NHS-commissioned children’s palliative care operational delivery networks, such as I gather are used in neonatal care services, in order to help to achieve that?

Fourthly, can the Minister commit to increasing investment in specialist paediatric palliative medicine training by £2.4 million annually to address the funding gap identified by the charity Together for Short Lives?

Fifthly, do the Government support the call of the Royal College of Nursing for nurse-to-patient ratios in all health and care settings? Will they commit to tackling the shortage in NHS community children’s nurses?

Finally, with ICB funding for children’s hospices varying significantly across England, how is the Minister ensuring that every seriously ill child and their family, regardless of where they live, has equitable access to palliative care?

Oral Answers to Questions

Julian Lewis Excerpts

Tuesday 24th February 2026 Commons Chamber

[Dr Ahmed]

I am grateful for my hon. Friend’s invitation. She is right: we need to think of innovative ways of attacking the mental health issues that face our country, and particularly our young people. Those include digital and face-to-face therapies, both of which we are expanding at a rapid pace. I am delighted to pass on her invitation to the Minister for Mental Health.

[Sir Julian Lewis (New Forest East) (Con)]

Has the Minister had any opportunity to form conclusions about whether excessive involvement with social media and other online potential harms has contributed to an apparent significant increase in the levels of mental health disorders?

[Dr Ahmed]

The right hon. Gentleman is right to highlight this very live issue. As a doctor, a parent and a Minister, it is live in my mind, as it is in the minds of hon. Members across the House. It is important that we follow the evidence, and act safely and proportionately in response to that evidence. The right hon. Gentleman will know this Government’s ambition, and the direction that we want to set to ensure that young people are kept safe online.

Hughes Report: Second Anniversary

Julian Lewis Excerpts

Wednesday 11th February 2026 Westminster Hall

[Sir Julian Lewis (New Forest East) (Con)]

I will try to add something new to the excellent start to the debate by both the previous speakers, who showed a great command of the overall situation, by quoting my constituent Emma, who got in touch with me yesterday after learning that the debate would take place. I will briefly summarise her concerns, which she set out in the following way:

“In the main, the point is that so many have been injured, left on NHS waiting lists, paying for prescriptions and transport to and from appointments. Not being able to work—or restricted working hours. Limited access to PIP…Very little support for those who had mortgages due to the benefit system not supporting mortgage costs”

and

“loss of pension contributions, as none of us is getting any younger.”

This lady is exceptionally strong. Despite the injuries she suffered personally, she has been a rock and a leader for other mesh-injured women in or near my constituency. I hold her in the highest esteem; in fact, I salute her courage. What she has to say is, in a sense, an argument that has already been won. The Cumberlege report won that argument, and the Hughes report wanted to recommend what should happen next. I am delighted to see Henrietta Hughes in the Gallery—and seemingly acknowledging that I am right about that difference between the two reports.

Let me briefly quote from Henrietta Hughes’s admirably concise list of 10 recommendations. Recommendation 1 was:

“The government has a responsibility to create an ex-gratia redress scheme providing financial and non-financial redress for those harmed by valproate and pelvic mesh. This scheme should be based on the principles of restorative practice and be co-designed with harmed patients.”

Recommendation 3 was:

“The government should create a two-stage financial redress scheme comprising an Interim Scheme and a Main Scheme.”

Recommendation 4 was:

“The Interim Scheme should award directly harmed patients a fixed sum by way of financial redress. These payments should start during 2025.”

Recommendation 8 was:

“Both the Interim Scheme and the Main Scheme should be administered by an independent body which commands the confidence of patients.”

What is the point of an interim scheme? It is to recognise that there will be tremendous complexity in individual cases, but at least these mesh-injured ladies would get a minimum of help—I think £25,000 has been suggested—straightaway, while the more complex calculations can be done later. Yet despite that being the very point of an interim scheme—that we can do this quickly and work on the harder parts subsequently—we have seen no progress.

What does that remind us of? It reminds me of the Post Office. It reminds me of the infected blood scandal. What do all those things have in common? A large number of people who have been injured in some way or another—either physically, or with their character or freedom damaged, often beyond repair—and who are owed very large sums of money by way of redress or compensation. We know what happens in the end: there is enough public protest to ensure that there is action. I hope that the level of public awareness is no less for this cause than it is for other, similar scandals because all the victims were women. That would be even more disgraceful than that this all happened in the first place.

--- Later in debate ---

[Karin Smyth]

I want to address the main concerns and, as I said, the Under-Secretary of State is very keen to talk with Members and campaigners.

We remain committed to working alongside Dr Hughes and her team to better support patients and ensure that steps are taken to prevent similar harm in the future, both in this area and across the wider patient safety landscape. That is obviously crucial. Many Members mentioned the importance of women’s voices being heard in this area, and many of us were involved in the campaign in the previous Parliament. We must make sure that women’s voices are better heard in the health system. As my hon. Friend the Member for Morecambe and Lunesdale (Lizzi Collinge) said, the campaigners are doing that, and I pay tribute, as she did, to In-FACT, as well as Sling the Mesh and the very many other patient groups that have raised this on behalf of women. They should not have to, but I commend their work.

I assure Members and people listening to the debate that we remain committed to advancing this work across Government and to looking at lessons from any cases in which patient safety has been affected. I fully understand why colleagues are asking for an official response to the Hughes report here and now. It is important that we get it right, and we need to carefully consider all options and the associated costs before coming to a decision on the report’s specific recommendations. I am sure that many Members have seen the letter that my hon. Friend the Under-Secretary of State wrote to the Patient Safety Commissioner in November, and I reconfirm, as he wrote, that that work includes looking at the costs.

We must take forward the lessons learned from this work—including, as the right hon. Member for New Forest East (Sir Julian Lewis) and my hon. Friend the Member for Ellesmere Port and Bromborough (Justin Madders) highlighted, work on similar areas—and the Government are doing that. We must ensure that our approach provides meaningful, often ongoing support to those who have been so profoundly affected.

The Government have to consider options for financial redress collectively, with input from a number of Departments, and we started that work immediately. As was mentioned, the previous Government did not respond to the report when it was published, but we have picked up that work. Initially, Baroness Merron was the lead Minister, and it is now the Under-Secretary of State, my hon. Friend the Member for Glasgow South West.

I assure the hon. Members for Strangford (Jim Shannon) and for Aberdeenshire North and Moray East (Seamus Logan) that my hon. Friend recently met the devolved Government Health Ministers to discuss their respective positions further. He will continue to do so across all devolved Government areas; as Members have said, patients there are affected too. We have to proceed with care to ensure the correct approach. We are committed to providing updates at the earliest opportunity, once all relevant advice and implications are considered.

[Sir Julian Lewis]

Will the Minister give way?

[Karin Smyth]

I will continue, if I may.

On non-financial redress, the Department is committed to meeting the needs of current patients with clinical requirements via three principal avenues. The first is improving clinical services and treatment to patients, and the second is commissioning further research and development programmes on sodium valproate and pelvic mesh to address the remaining knowledge gaps. I commend my hon. Friend the Member for Bexleyheath and Crayford (Daniel Francis) for sharing again his personal experiences and for laying bare the deep complexity and the need for more research and development, to which my hon. Friend the Under-Secretary of State is committed. The hon. Member for Leicester South (Shockat Adam), with his clinical knowledge, also added useful experience to the debate. That is absolutely what my hon. Friend will be taking forward. The third avenue is initiating longer-term preventive measures that will help ensure that the system can pick up on adverse trends in patient care and act more quickly in the future.

I will take each avenue in turn. On improvement of clinical services, although the number of women up to the age of 54 who have been prescribed sodium valproate has nearly halved since 2018, there is a significant group of patients already affected who have complex and varied needs, and the health system has to ensure that that cohort receives high-quality and tailored care. NHS England has committed to a pilot project on foetal exposure to medicine in the north of England, involving multiple clinical specialties and a wide range of clinical experts, that will undertake a comprehensive review of the service. Eighty patients have been seen as part of the pilot, representing 560 appointments and 650 clinical hours. We have received feedback from patients on the value for their quality of life of being seen by clinical experts and wider multidisciplinary teams. We are considering options to commission this service further nationwide.

NHS England has also completed an internal review of mesh centres across England. Mesh centres undoubtedly offer a valuable and impactful service, with nearly 3,000 patients now seen since their introduction. However, as a relatively new service, distinct areas for improvement remain, and we will look closely at the results of the internal review and promptly deliver the necessary improvements.

With regard to further research and development, the National Institute for Health and Care Research has been commissioned for a £1.56 million study to develop patient-reported outcome measures for prolapse, incontinence and mesh-complication surgery. In the longer term, those measures will be integrated into the pelvic floor registry, which monitors and improves the safety of mesh patients. Further research is also taking place in this area, and we will ensure that future work takes into account the recommendations of the pilot project and of the mesh centre audit.

On longer-term prevention work, recent discussions with NHS England and the Medicines and Healthcare products Regulatory Agency indicate that longer-term improvements in digitisation will help position the UK as a world leader in reducing valproate-exposed births and applying the insights to other teratogenic medicines. The Department will explore increasing centralisation and visibility of the annual risk acknowledgment form across care settings, as highlighted in the Hughes report, and may consider expanding the medicines and pregnancy registry to better link data with research outcomes.

--- Later in debate ---

[Karin Smyth]

I am happy to answer that at the end of my comments, but first I will take the intervention from the right hon. Member for New Forest East.

[Sir Julian Lewis]

I appreciate that the Minister does not have primary responsibility for this area, but it worries me that we are hearing an awful lot about process. What I fear is really going on is that Ministers have been told at the highest possible level, by the Chancellor or a Treasury Minister, that the money for redress will not be made available and they have to take that as their starting point. She may not be able to confirm this now, but I would like an answer as to whether a conversation of that sort has taken place.

[Karin Smyth]

I thank both Members for their comments. Experienced parliamentarians will know what I will be able to say. As my hon. Friend the Under-Secretary of State, the hon. Member for Glasgow South West, outlined in his letter, costs—I think that is what the hon. Member for Aberdeenshire North and Moray East was alluding to—are part of the overall consideration, along with the complexity, in the work that he is leading on behalf of the Department across all Government Departments.

Puberty Suppressants Trial

Julian Lewis Excerpts

Wednesday 17th December 2025 Commons Chamber

[Wes Streeting]

I will try to do that, Madam Deputy Speaker.

We will ensure that young people get good access to wider evidence-led support. I have had to wrestle with the fact that some trans people enter adulthood without ever receiving any sort of healthcare, and I have been heavily criticised by those people in particular for some of the decisions that I have taken. We are working to reduce waiting times, as I have described.

My hon. Friend says that puberty blockers are reversible. We hear contrary views about that from Members across the House, some of whom say that puberty blockers are irreversible. The truth is that the evidence in this area is mixed, which is why we need to build a stronger evidence base.

[Sir Julian Lewis (New Forest East) (Con)]

The Secretary of State deserves our sympathy for having to negotiate such an ethical minefield. Will he tell us whether the data exists from all the people who had puberty blockers under the old regime? He mentioned having met one person for whom they had worked well and one person for whom they were a disaster. Surely it should be possible to do a systematic survey of the dozens, if not hundreds, of people who went through that. Might that be a more constructive and less dangerous way forward?

[Wes Streeting]

The right hon. Member is right that we need that data linkage study. That will happen, but it will not produce the same evidence base as a clinical trial, and that is the distinction between the two. It is frankly a disgrace that people have sought to withhold that kind of data and it is really important that we get this right.

I appreciate the right hon. Member’s sympathy. I have wrestled with this issue probably more than any other ethical decision that I have had to make in this office. I do not seek any pity or sympathy for doing so—it is the job that I signed up to and a job that I love doing. I have taken great care and sensitivity in this area because of the particular vulnerability of this group of children and young people.

NHS: Winter Preparedness

Julian Lewis Excerpts

Monday 15th December 2025 Commons Chamber

[Sir Julian Lewis (New Forest East) (Con)]

I hope that the Secretary of State will give a little more consideration to the rather important point raised by the hon. Member for Walthamstow (Ms Creasy) about 16 and 17-year-olds not being able to be vaccinated.

If any junior doctor—whether or not a member of the BMA, but particularly if a member of the BMA—decides on ethical grounds to go into work during the period of the strike, and then faces sanctions from the BMA, will the Government protect them?

[Wes Streeting]

Two things: first, we will certainly give serious consideration to the point made by my hon. Friend the Member for Walthamstow (Ms Creasy)—the JCVI will do that in the usual way, and we follow its advice —and secondly, resident doctors have been to work in previous rounds of strikes, and I have not been made aware of bullying or intimidation of them. Of course, that should not be happening, and if it does, my priority will be protecting doctors who are doing the right thing. My expectation is that no one will be intimidated for making the moral and ethical judgment that going to work is the right thing to do by patients, by their colleagues and by the NHS this Christmas.

Resident Doctors: Industrial Action

Julian Lewis Excerpts

Wednesday 10th December 2025 Commons Chamber

[Wes Streeting]

My hon. Friend is absolutely right. I do wish the BMA would take yes for an answer sometimes; I would like it even more if the BMA gave yes as an answer to me once a while, but that has not happened in a little while. He is right to talk about the need for workforce planning. The workforce plan, which is in production, is all about making sure we have the right people in the right place at the right time. He mentioned mental health specifically. Our manifesto committed to 8,500 extra mental health workers over the course of this Parliament, and I am happy to report that we have already delivered well over 6,500. There is lots done, but more to do.

[Sir Julian Lewis (New Forest East) (Con)]

I find it rather shocking that when the Secretary of State for Health has offered the BMA leadership an opportunity to strike a few weeks later, they have turned it down, presumably because they prefer to strike at Christmas, when, frankly, lives will be lost as a result. Am I missing something here? Why is it, according to the Secretary of State, that the BMA leaders seem to be so determinedly militant? Does he think that in reality, they simply do not represent the views of their own membership?

[Wes Streeting]

I will say to the right hon. Gentleman that we are doing everything we can to mitigate against harm during the proposed strike dates, but I cannot in all honesty and integrity assure him that no patient will come to harm next week should the strikes go ahead, because the situation is so dire. I really urge the BMA to reflect on that overnight and into tomorrow and to ask themselves—perhaps their members will also ask this of their reps—whether it is really necessary to strike next week, given the offer of an extension to mandate.

To the right hon. Gentleman’s final point, when I was the president of the National Union of Students, I was once asked by a Labour member of a Select Committee that I was appearing before whether I was speaking for my members or for my activists. There is sometimes a difference between the two. I know that lots of people have campaigned hard for pay restoration and that many people are involved in the Doctors Vote campaign in pursuit of that aim. I think there are many doctors, however, who recognise that there has been real progress on pay and that what we are putting forward now is meaningful progress on jobs, too. I say to all members of the BMA: do not let the perfect be the enemy of good, especially when the stakes are so high.

Ageing and End-of-life Care

Julian Lewis Excerpts

Thursday 30th October 2025 Commons Chamber

[Jim Shannon (Strangford) (DUP)]

I beg to move,

That this House has considered the ageing community and end of life care.

I thank the Backbench Business Committee for selecting this subject for debate. I declare an interest as the son of Mona Shannon, who is 94 years young and resides in a nursing home near Killyleagh in my constituency. Along with most other middle-aged sons or daughters—in my case, maybe a wee bit more than middle-aged—I am acutely aware that time is marching on and so are my mum’s needs.

The wee five-foot-nothing lady who kept three six-foot sons under control is no longer to live alone, but she is as sharp as a tack and I am thankful for the wisdom she gives me when I visit her twice weekly. Indeed, I suspect that every Friday and every Sunday I get a wee bit of wisdom—and maybe a wee bit of a telling off. She always likes to know what happens in this House and I am able to tell her that, but she will also give me her opinion, which I never ignore—indeed, I probably keep to it as much as I can.

Those visits to the nursing home, coupled with the focus on assisted dying, have highlighted to me with greater effect the changes that are needed in how we handle our older generation and their needs. I have spoken with representatives of both Sue Ryder and Marie Curie not simply to highlight the difficulties that most of us will be aware of, but to offer some ways that we can improve.

I am pleased to see the Under-Secretary of State for Health and Social Care, the hon. Member for Glasgow South West (Dr Ahmed), in his place. He and I are becoming a bit of a tag team, because on three days this week he has been the Minister responding to the debates that I have been involved in. The shadow Minister, the hon. Member for Hinckley and Bosworth (Dr Evans), has been there as well, so he should not be left out.

According to Marie Curie, in the next 25 years in Northern Ireland—I know it is not the Minister’s responsibility, but I want to give the stats, because they are important— there will be 20,500 people requiring this type of care, which is a rise of 32%. That includes a doubling of need by those aged over 85. It is also projected that the number of deaths in the community in Northern Ireland could rise by 74% during that time. Approximately 60% of the cost of care delivered through the independent hospice sector in Northern Ireland is reliant on charity. That is unsustainable. A new palliative care strategy for Northern Ireland that takes account of demographic changes and associated requirements for service transformation and investment is urgently needed.

That is what is happening in Northern Ireland, and in the mainland, things are very similar. Marie Curie has highlighted that as the population ages, more people will be living with and dying with multiple complex conditions. Every week in my office, when it comes to assisting those of my mum’s generation—and perhaps some of my own—with benefits, I see people with multiple complex needs more than ever. It is not just one thing that people are suffering from, but a multitude of things.

By 2050, the number of people in need of palliative and end-of-life care in the UK will rise by 147,000 to over 745,000 every year, and that increase will be driven by a growth in the number of people dying over the age of 85. These are really important stats, and we cannot ignore them; indeed, I believe the Minister will be focusing on them. Around 90% of the people who die each year need palliative care, but one in four of them is missing out. Older people, and particularly those with a non-cancer diagnosis, are at risk of missing out on the palliative care they need at the end of life. Research indicates that most people want to receive care at the end of their life and die at home. Elderly people tell me that all the time—they want to be at home.

[Sir Julian Lewis]

I am grateful to the hon. Member for giving way; I know he is pressed for time. The charity Together for Short Lives points out that where children’s palliative care is concerned, there is wide variation across different regions in the country. Is he afraid that this applies to the ageing population as well—that there is no consistency in the amount of palliative care available?

[Jim Shannon]

I thank the right hon. Member for his intervention and for the wisdom that he brings to all the debates he participates in. The Minister is listening, and he is a good Minister, so I know he will come back with the response we hope to have.

How often have we listened to family members who are past themselves with exhaustion and guilt about how they are caring for their loved one and who feel unprepared and yet unwilling to let them go into nursing care? With more support, their lives would be easier and their loved one’s life happier. This knowledge is why I was not surprised to learn that almost £12 billion of public funds was spent on healthcare for people in their last year of life, 81% of which was spent in hospital, with only 11% spent on primary and community care.

Access to a 24/7 palliative care advice and support telephone line has been recommended as a minimum service requirement for nearly two decades, but research shows that very little has happened, which underlines the issue that the right hon. Member for New Forest East (Sir Julian Lewis) raised. Only seven of the 42 integrated care boards in England said they have a dedicated 24/7 single point of access to palliative and end-of-life care advice, guidance and onward referral to other services, when needed—those are all important factors.

Despite the introduction of a new legal duty for ICBs to commission palliative care services in the Health and Care Act 2022, the urgency and importance of ensuring that everyone has the best possible care and support at the end of life has yet to be recognised as a national priority. I hope the Minister will be able to provide assurance on this, because that is what Marie Curie wants, it is what Sue Ryder wants, and it is what every mum, dad and family member wants as well.

NHS 10-Year Plan

Julian Lewis Excerpts

Thursday 3rd July 2025 Commons Chamber

[Sir Julian Lewis (New Forest East) (Con)]

Does the NHS 10-year plan include an assisted dying scheme? If the present private Member’s Bill runs out of time at the end of this parliamentary Session, and thus falls, will the Secretary of State reintroduce the legislation as a Government Bill in the next parliamentary Session?

[Wes Streeting]

I am grateful to the right hon. Gentleman for that question—[Laughter.] Given that the Bill is still passing through Parliament, assisted dying is not referred to in this 10-year-plan, but I assure both this House and the other place that regardless of different views among Ministers and across the House, we will abide by the law of the land. We will abide by the will of this House and the other place. If the Bill times out in the other place, I have no doubt that someone else will bring it back. I suspect it will not be a Government Bill.

It is important that we have the debate and that we scrutinise the legislation well. I am proud of the way the House has conducted the debate. My hon. Friend the Minister for Care, who is not in his place now, along with the Minister of State, Ministry of Justice, my hon. and learned Friend the Member for Finchley and Golders Green (Sarah Sackman), have done an exemplary job in supporting people on both sides of the debate to give the Bill the detailed scrutiny that it had here and that it will no doubt have in the other place. That is a credit to this House.

Spending Review: Health and Social Care

Julian Lewis Excerpts

Thursday 12th June 2025 Commons Chamber

[Karin Smyth]

I thank my hon. Friend for the excellent role she plays as a clinician. Her expertise is really welcome; we want to hear from a wide variety of experts in this House—that is very valuable. She understands from her professional background, as well as from her constituency, how important it is to look at the entire pathway of care for patients, and to ensure that they have the best possible care as close to home as possible. We think that is better not just for patients, but for clinical outcomes, and it is more efficient and better use of taxpayers’ money. The move from hospitals to communities is front and centre of our 10-year plan, as is delivering neighbourhood health services.

[Sir Julian Lewis (New Forest East) (Con)]

The Minister will be well aware of Sir Andrew Dilnot’s ambitious plan to put a cap of £86,000 on the cost of the social care that any family would ever have to pay. It was never going to be easy to implement that. Previous Governments postponed the plan, and the Chancellor effectively scrapped it completely. May I appeal to the Minister to work across party lines, and to focus on the crippling debt that hits hard-working families when they come to the end of their working lives and need the support of the state?

[Karin Smyth]

I agree that this issue absolutely needs to be resolved. There was agreement previously, under the coalition, and it is so disappointing that it was so unceremoniously dumped when I came to this place in 2015; that was one of the first things that the subsequent Tory Government did. It was a great disappointment to many people across the country, particularly those who were responsible for supporting an older person or a disabled person. We have ensured that we will address this issue, and have appointed Louise Casey to lead the interim report. I know that she will continue to work with everybody, and that all hon. Members will take an active interest in that work.

Access to NHS Dentistry

Julian Lewis Excerpts

Thursday 22nd May 2025 Commons Chamber

[Sir Julian Lewis (New Forest East) (Con)]

Thank you, Madam Deputy Speaker, for that no-pressure introduction. I congratulate the hon. Member for Great Grimsby and Cleethorpes (Melanie Onn) on her speech and I agree with every part of it. I was hoping to quote from individual cases raised by constituents and from the local Women’s Institute, but all that will have to go by the board.

I have a wonderful briefing from the British Dental Association and, in the remaining two and a half minutes, I would like to make one pertinent observation, from which everything else flows. Dentistry is a highly skilled profession in which practitioners can charge colossal sums of money in private practice, which gives them a financial incentive to steer clear of working for the NHS. That is the root of the problem.

On 13 March, I put a question to the Secretary of State for Health and Social Care about a point made by the Darzi report, last September, which says:

“There are enough dentists in England, just not enough dentists willing to do enough NHS work, which impacts provision for the poorest in society.”

I was pleasantly surprised when his reply was:

“NHS dentistry is in a terrible state and, in fact, in many parts of the country it barely exists. There are lots of reasons for that, and it is a source of constant astonishment to me that the dentistry budget was underspent year after year despite that situation.”—[Official Report, 13 March 2025; Vol. 763, c. 1298.]

In reality, as the BDA points out, the reason why that budget is underspent is not because of the lack of demand, but because NHS practices cannot fill vacancies and are unable to meet contractual commitments. Therefore, those who do work with and for the NHS are having to deliver dental care at a loss. There is a fundamental requirement for a rewritten constitution and contract by which it becomes worthwhile for people to practice dentistry in the NHS, because otherwise we will see a two-tier society, in which only the rich can get the dental care that people so desperately need.