Sepsis Awareness Month

Julie Minns Excerpts

Tuesday 15th September 2026 Commons Chamber

[Ms Julie Minns (Carlisle) (Lab)]

I am grateful for the opportunity to contribute to this very important debate during Sepsis Awareness Month; I pay tribute to the hon. Members for Kingswinford and South Staffordshire (Mike Wood) and for Ashfield (Lee Anderson) and my hon. Friend the Member for Dartford (Jim Dickson) for securing it.

The danger posed by sepsis cannot be overestimated. As we have heard, five people lose their lives to sepsis every single hour, and my mother was one of those it claimed last year. Deaths from sepsis rise sharply in the over-65s. Older people are more vulnerable to sepsis because ageing weakens the immune system, increases the likelihood of chronic illness and infection, and reduces the body’s ability to recover from severe infection, making sepsis more likely to become life-threatening.

I am acutely aware at my age that one of my significant organs is visually fading and failing, and that is my skin. The serious point is that, as our skin fails, the increased risk of cuts, tears and the formation of ulcers becomes ever more prevalent, all bringing with them the attendant risk of infection. That, sadly, was the case for my mother. That sepsis is the second biggest killer after cardiovascular disease is evidence of why awareness is so important. The earlier sepsis is recognised and appropriate help sought, the better the chance of preventing a devastating outcome.

I want to use this debate to share the experience of one of my Carlisle constituents, Kelly Pattison. Kelly developed biliary sepsis in December last year. She describes how she did not know she had it until she woke up on a ward, having spent three days in intensive care. Kelly’s story is an important reminder of just how unpredictable and unexpected sepsis can be. What she particularly wanted me to emphasise today is that there is no one single experience of sepsis; it can affect people in very different ways, and the seriousness of what is happening may not always be immediately obvious.

[Sureena Brackenridge (Wolverhampton North East) (Lab)]

There is really good practice across other countries, including Australia, which has a national sepsis standard, standardised clinical pathways and a public awareness campaign, similar to ours, which is aligned with the simple question: “Could it be sepsis?” Work that has reduced sepsis mortality has been happening around the globe, so does my hon. Friend agree that it is worth looking beyond our borders?

[Ms Minns]

My hon. Friend raises an important point, and I agree that the more best practice available elsewhere that we can bring to our country, the better.

Awareness cannot stop at the point of diagnosis. Surviving sepsis can be a major event in someone’s life, and the effects can continue well beyond the immediate illness. Patients and their families may need information, support and help as they recover. That is why I welcome the Government’s sepsis modern service framework. It represents an important step forward in how we approach this condition, setting out a long-term plan to improve sepsis care across prevention, recognition, diagnosis, treatment and recovery, with the ambition of reducing deaths, life-threatening complications and the long-term effects of sepsis by at least 25% by 2035. That ambition is significant. The success of the framework will be measured in earlier recognition, prompt treatment and ongoing support for survivors who need it.

The framework’s focus on better data, research and innovation is particularly welcome. Improving how we identify sepsis, developing faster and more accurate diagnosis and learning from patients’ experiences can all help clinicians to intervene earlier and improve outcomes. I hope that through the sepsis modern service framework we can ensure that when people do seek help, they are heard, sepsis is recognised as early as possible, and they receive the care and support that they need.

Neuropsychiatric Conditions: PANS and PANDAS

Julie Minns Excerpts

Thursday 25th June 2026 Commons Chamber

[Ms Julie Minns (Carlisle) (Lab)]

I thank the hon. Member for North East Fife (Wendy Chamberlain) for introducing the debate so well. It is always a pleasure in this place when I discover that I have something in common with Members from across the House. In recent months, the hon. Lady and I have discovered that we share an interest and passion for Jane Austen and hard agree that the BBC 1995 production of “Persuasion” is by far the superior, but more importantly, that we share an interest and desire to improve the diagnosis, understanding and clinical treatment of people of all ages who are living with PANS/PANDAS.

I first became aware of PANS/PANDAS when my constituent Joanne came to see me about her son Jake shortly after my election. Jake has lived with PANS/PANDAS for more than six years. For a period of time, treatment was effective, and NHS continuing healthcare funding enabled Jake to access the care of a specialist immunologist. However, despite the progress that had been made, the family have since faced repeated challenges in securing the treatment and funding, resulting in uncertainty, stress and significant personal expense. I therefore appeal to North East and North Cumbria integrated care board to please help urgently resolve these issues, and I have an outstanding query with the ICB on exactly this point. Joanne has worked tirelessly to advocate for her son, yet she continues to encounter delays, poor communication, a lack of clarity, and uncertainty about funding—a story all too typical of families trying to support a family member living with PANS/PANDAS.

While this case is deeply personal, it also highlights the wider challenges faced by these families. Too often, parents like Joanne find themselves navigating complex systems, spending years seeking access to appropriate care and treatment, all while battling for recognition of their child’s condition. It was thanks to Joanne that I had the privilege of meeting members of the PANS PANDAS youth board when they visited Parliament in April. As has been said, they shared their personal stories with me and other parliamentarians. I welcome them again in Parliament today.

I welcome the Government’s work with the royal colleges, specialist clinical bodies and PANS PANDAS UK on the development of clinical guidelines. In her remarks, will the Minister indicate when the Government expect to publish the first UK clinical guidelines for PANS and PANDAS? The guidelines should, I hope, result in a clearer and more consistent framework and recording of these conditions. Without an official diagnostic pathway and reliable data collection, it is difficult to understand how many children and young people are affected, the scale of the unmet need, or to ensure that appropriate services are available. Better recognition and data would therefore not only support future research and service planning, but help ensure that families like Jake’s receive timely, co-ordinated and compassionate care.

Community Pharmacies

Julie Minns Excerpts

Tuesday 2nd June 2026 Westminster Hall

[Ms Julie Minns (Carlisle) (Lab)]

It is a pleasure to serve under your chairship, Ms Jardine. I thank the hon. Member for Tiverton and Minehead (Rachel Gilmour) for securing this important debate. I also thank the staff at community pharmacies across my constituency, particularly the staff at the Well pharmacy in Denton Holme who have given exceptional care and support to my family for many years.

Pharmacies and their staff provide a vital accessible health hub in our communities. However, this year Community Pharmacy England has reported that 55% of pharmacy staff experience abuse, often triggered by medicine shortages, prescription delays, long queues and other issues entirely outside their control. I am sure all hon. Members will agree that, whatever the prompt, abuse of that nature is completely unacceptable. I will therefore be grateful if the Minister can briefly outline what action the Government are taking to protect pharmacy workers from abuse.

Sadly, under the previous Government too many community pharmacies were lost. Between 2019 and 2024, 1,633 community pharmacies closed. In the same period, about 400 opened: just one for every four that was closed. In communities such as Carlisle, the closure of a pharmacy has a significant knock-on effect on the remaining pharmacies. Two pharmacies in the Harraby area of Carlisle have closed in recent years, placing additional pressure on the sole remaining pharmacy, on Central Avenue, and resulting in longer waits for prescription collections. It is therefore doubly frustrating that efforts to open a new pharmacy in the same community have so far come to nothing because the premises’ landlord, the Riverside housing association, has failed to respond to representations from both the prospective pharmacist and me since last October.

[Sadik Al-Hassan]

Shame!

[Ms Minns]

In the meantime, ironically, the shop next door, a former pharmacy, has been refurbed and opened as yet another barber’s and mini-mart. It is simply not good enough. That is why I very much welcome this Government’s prescription for our community pharmacies: not just £3.6 billion in funding for community pharmacies, but the Government’s high street strategy, the recently announced crackdown on dodgy vape shops and mini-marts and the plans to integrate community pharmacies as key local healthcare hubs. These actions are not just vital for the health of local people; they are vital for the health of our high streets, too.

Health Bill

Julie Minns Excerpts

2nd reading
Monday 1st June 2026 Commons Chamber

[James Murray]

When the data is held by a GP surgery or an NHS hospital trust, for instance, the relevant bodies will remain the information controllers. Where that information is then shared through the single patient record, the Department of Health and the Secretary of State will take on a role as data controller as well. That will all be governed in the way that data protection currently applies across the NHS, through existing forms of data security. Fundamentally, it will reorientate the NHS to be a service that revolves around patients, rather than patients having to revolve around the NHS.

[Ms Julie Minns (Carlisle) (Lab)]

Just before my right hon. Friend moves away from the single patient record, may I highlight the challenge remaining in cross-border communities such as mine in Cumbria? My constituents in Carlisle often register with a GP across the border in Scotland. Unfortunately, at present that means that their single patient record will not necessarily flow with them. Will he work at pace with his colleagues in Scotland —and Wales; I can see my hon. Friend the Member for Clwyd East (Becky Gittins) nodding in front of me—to ensure that we get this right for anyone, regardless of where they live?

[James Murray]

My hon. Friend is absolutely right that the single patient record applies to the NHS in England, but my colleagues in the ministerial team have regular conversations with our counterparts in Scotland and in other devolved Governments to ensure that we are working on such cross-border issues wherever we can.

Tobacco and Vapes Bill

Julie Minns Excerpts

Consideration of Lords amendments
Monday 23rd March 2026 Commons Chamber

[Jim Dickson (Dartford) (Lab)]

It is a pleasure to have this Bill back before us today. During the many great speeches tonight, but also on Second and Third Reading, the great majority of people have agreed that we should feel proud of this world-leading piece of legislation. It will create that elusive thing: a smokefree generation in this country.

As a former smoker and as vice-chair of the all-party parliamentary group on smoking and health, I am grateful to have been able to speak regularly in the debates on this Bill, including spending many hours in the Bill Committee going through it line by line. As the hon. Member for Winchester (Dr Chambers) said, there is a feeling of veterans of the Bill gathering round to see it finally get over the line, and that is a wonderful thing.

As vice-chair of the APPG on smoking and health, I want to put on record my thanks to my hon. Friend the Member for City of Durham (Mary Kelly Foy) and the hon. Member for Harrow East (Bob Blackman) for their great work over the years leading that APPG to the point where we now have legislation that embodies the APPG’s ambitions.

Before I get into the detail, I will offer my thanks to Ministers and officials here and across the four nations of the United Kingdom for the work that they have done to create a Bill that will apply across our entire nation. I welcome the new Minister for public health, my hon. Friend the Member for Washington and Gateshead South (Mrs Hodgson), to her place. It is brilliant to have a champion for public health over many years as the new Minister. She was a very able public health spokesperson for this party while in opposition.

Just under a year ago, I tabled an amendment on Report that would have introduced a ban on all cigarette filters, regardless of whether they contain plastic. I tabled it in recognition of the fact that there are no health benefits at all to cigarette filters, despite the hon. Member for Windsor (Jack Rankin) seeming to be of the view that there are. Filters were developed by the tobacco industry following evidence that smoking caused lung cancer, in order to give a false sense of reassurance to smokers. The passage of this Bill has also seen discussions of the merits of what have been described as biodegradable filters. As Dr Bas Boots, ecologist and senior lecturer at Anglia Ruskin University—he spoke last year to the APPG on smoking and health—has said:

“All cigarette filters are harmful to the environment. Research from Anglia Ruskin shows the extent of this, with filters leaching toxic chemicals into soils and waterways causing harm to plants and animals.”

Although the Government did not accept my amendment, I am pleased to see other amendments—including Lords amendments 37 to 45—to ensure that regulatory powers in the Bill can apply to filters, and I understand from Action on Smoking and Health that if the UK were to ban filters, we would be the first country in the world to do so. I hope that the Minister, when she sums up the debate, will be able to tell us when a call for evidence related to cigarette filters will be launched.

In Committee, we discussed at length whether the changes in the Bill should extend to vape vending machines in mental health settings. I am grateful to the Government for considering that carefully and altering the Bill, via Lords amendments 3 and 4, to exempt vending machines in such settings from the overall, and very sensible, ban on them elsewhere in the light of their obvious role in helping often vulnerable people to stay smokefree.

The addition of a Government commitment, via Lords amendment 80, to review the implementation of the Bill within four to seven years is really sensible. It is important for us to look at how it is working, and to share any lessons learned with other countries that may be pursuing similar legislation—we know that a number of countries are doing so.

I also support Lords amendments 89, 90 and 91, which will ensure that a comprehensive definition of “tobacco” will apply from Royal Assent, as it should. That will end the practice of illegally marketing heated tobacco products, and will enable the Government to use powers in the Bill to specify that devices used for the consumption of tobacco cannot be promoted.

Finally, I want to reflect on the key impact of the Bill. When the age of sale restrictions for tobacco come into force on 1 January 2027, we will create a smokefree generation, with those born on or after 1 January 2009 turning 18 and never being able to purchase tobacco legally. As this century progresses, millions of UK lives will be saved, and we will genuinely be on the road to a smokefree Britain.

[Ms Julie Minns (Carlisle) (Lab)]

Before I begin my brief speech, may I say how good it is to see my hon. Friend the Member for West Lancashire (Ashley Dalton) in the Chamber? We owe her a debt of gratitude for both introducing the Bill and piloting it through the House. She leaves behind—I was going to say large shoes, but that seems a bit rude—significant shoes to be filled, but I know they are shoes that the Under-Secretary of State for Health and Social Care, my hon. Friend the Member for Washington and Gateshead South (Mrs Hodgson), is more than capable of filling, and I am very glad to see her in her place this evening.

I wish to speak briefly about Lords amendments 11 and 61, which, as we heard from my hon. Friend the Member for Falkirk (Euan Stainbank), clarify what we mean by a “relevant enforcement authority” and, in particular, clarify the duty that will be placed on that relevant enforcement authority to consider annually whether it is appropriate to carry out a programme of enforcement action. As has been said, we acknowledge, and know, that vaping can support adults who want to move away from smoking, but we nevertheless cannot ignore the rapid rise in youth vaping and the growing presence of illegal, non-compliant and counterfeit vapes and cigarettes in all our communities. That is why a robust, mandatory licensing framework is so urgently needed. The Bill will give the Government the power to introduce such a framework, and that can only be strengthened by a requirement for licensing authorities to consider annually the programme of enforcement.

Contrary to what the hon. Member for Windsor (Jack Rankin) seemed to suggest, one of the strongest arguments for licensing is its ability to combat the sale of illegal cigarettes and vapes on our high streets. Local authorities and enforcement bodies have warned repeatedly that rogue sellers are flooding the market with untested, high-nicotine, incorrectly labelled or counterfeit products, and my constituency is no exception. Just a few weeks ago, Cumberland council trading standards seized 6,000 illegal cigarettes in raids, and that was in addition to the £20,000-worth of illegal tobacco and vapes seized last summer. The introduction of on-the-spot fines of up to £2,500 and the ability to revoke retailers’ licences entirely are therefore welcome.

Mandatory licensing will also make it much easier to shut down dodgy shops that knowingly stock or distribute illegal vapes and cigarettes. Under the new framework, any premises found storing, displaying or supplying unregulated products will lose their licences, because licensing applies not just to the act of selling, but to the possession of regulated products for retail purposes. This means that enforcement officers will no longer have to rely on repeated seizures or warnings; they will have a fast, lawful route to closing down problem retailers for good.

In short, mandatory licensing is not just another layer of regulation; it is a powerful tool to crack down on illegal vapes, remove bad actors from our high streets, and support safer and more responsible retailing. More important, it will give local authorities the powers they need to shut down dodgy shops quickly, decisively and permanently. I therefore welcome both the Lords amendments and the Bill as a step forward to cleaning up our high streets and ensuring that we have a healthier, happier country.

[Mrs Hodgson]

With the leave of the House, Madam Deputy Speaker, I would like to place on the record my sincere thanks to all Members who have contributed to this thoughtful and constructive debate, and throughout the Bill’s passage in this House. It has been a real privilege to take it through this stage, following in the elegant and tiny footsteps but great ability of my hon. Friend the Member for West Lancashire (Ashley Dalton), who, along with our colleague Lady Merron in the other place, has done sterling work.

I am so grateful for the engagement of colleagues across the House, and for the shared commitment to improving public health and protecting future generations. As Members are aware, smoking remains the leading preventable cause of death, disability and ill health in this country. Despite significant progress, 5.3 million adults were still smoking cigarettes in 2024, and while tobacco remains the greatest threat, owing to its unique harms, we are also seeing a rapid rise in the use of vapes and other nicotine products, particularly among young people, creating a new generation at risk of harm and addiction. That is why this Bill matters, and why the action that we are taking today is so important.

Let me now turn to the points raised by hon. Members, who were small in number but mighty in their contributions. The shadow Minister, the hon. Member for Hinckley and Bosworth (Dr Evans), made an excellent speech, and I enjoyed hearing his thoughts—but he is not listening while I am talking about him.

Palliative Care

Julie Minns Excerpts

Thursday 5th March 2026 Commons Chamber

[Tom Collins (Worcester) (Lab)]

I thank my hon. Friend the Member for York Central (Rachael Maskell) for leading on this topic.

I have seen palliative care fail. My mum, Alison, had ovarian cancer. She died lonely and in dreadful indignity in a hospital ward intended for recovering liver and kidney patients. She felt a burden to a nursing team who were used to people getting better. She was waiting for a hospice bed, but, as it turned out, the waiting time was longer than she had.

In my constituency, we have hospices with superb facilities. Both Acorns children’s hospice and St Richard’s hospice are beloved institutions in our city, but they are struggling and it is vital that we support them. Clearly, we need more hospice capacity, but the deficiencies in palliative care are vast, and my lurking, uneasy suspicion is that many of them are not hospice-shaped, but reflect deeper deficits across our NHS.

[Ms Julie Minns (Carlisle) (Lab)]

My hon. Friend raises an important point about the NHS. In my limited but painful experience of hospices, one problem is that even when there is a hospice bed available, NHS staff do not refer end-of-life patients to the hospice because the palliative team is 9 to 5, Monday to Friday. Does he agree that we have to get to a point where palliative support in our NHS is available 24/7 so that those referrals can take place?

[Tom Collins]

My hon. Friend is entirely right. We need far better integration across those services. I was heartbroken to see that the palliative care that my mother was receiving seemed to have been outsourced to charities, and was not being provided by the NHS at all. That specialist care ought to be something that is native to our NHS.

I was recently talking to a couple of GPs in Worcester. Speaking with them is a refreshing change. While their work is in diagnosing and treating illness and, to a good extent, preventing it and promoting healthy lives, for them, palliative care is not an exception; it’s a Monday. With an ageing population, end-of-life care is really an emerging flavour in medical care. Bodies do not last forever, and the balance of benefits of treatment versus the very human costs of pain, inconvenience and indignity starts to change.

Medics dealing with palliative care understand that our bodies are intermingled, complex systems, and that they are one part of what we are: complex, intermingled physical, psychological, social and spiritual beings with rich tapestries of relationships, values, perspectives and experiences. “See the problem, name the problem, fix the problem” just does not cut it as an approach. We must treat the whole person, or we risk mistreating them. Sadly, our urgent and acute systems of diagnosis and treatment are simply not designed for this approach. Palliative care is by and large out of mind and out of scope. Care is siloed into specialties, patients become units of flow and relationships are substituted out for transactions.

This is reflected in the stories I hear from constituents in Worcester: stories from people with multiple complex conditions who are locked in the flip-flop between specialisms, where alternately one gets managed well and the other slips into neglect; stories of people who feel unheard, unvalued and anonymously shipped to different hospitals in different areas under different trusts; and stories of people who, when their wellness takes a dip, do everything they can to avoid calling an ambulance and the inevitable prodding, poking and a long, cold night in A&E corridors that follows. This has to change.

Addressing our gaps in palliative care demands a fundamental shift in the way our NHS thinks and works. Here and there, there will be a place for the cut-and-shut quick surgical procedure, a course of antibiotics, or a cast, a sling and a suggestion not to do it again, but the primary role of healthcare needs to be one that sees the human being and works in relationship for their wellbeing. In fact, best practice in palliative care is often remarkably similar to treatment for recovery: setting small, achievable goals and working with patients to fulfil them. An NHS informed by this approach would most likely be more effective across the board. With that foundation, the opportunities for a better, more holistic and properly resourced approach to palliative care can start to open up.

I would like to touch on the topic of assisted dying. I found debate on the Bill difficult to navigate, largely for the reasons I have discussed. The overwhelming message I have heard from medical professionals is that we need to improve the way we navigate the end of life as things stand today, break the taboo of death and develop care that meets the practical, physical, psychological, spiritual and social needs of patients and their families, and make that available to all.

As we do that, treatments that shorten but enhance life would undoubtedly play a role, but they must sit at the apex of a well-developed practice in end-of-life care that we do not yet have. This should be a major and urgent priority for us, not least because the drive towards excellent palliative care can only improve our systems and approaches overall, enabling us to deal better with complex needs, putting patients’ perspectives at the centre of system design, and plugging gaps so that patients are no longer able to fall through them. By taking proper ownership of palliative care, we can end experiences like my mum’s, and in doing so, we will also make a better NHS.

Oral Answers to Questions

Julie Minns Excerpts

Tuesday 24th February 2026 Commons Chamber

[Ashley Dalton]

As the hon. Gentleman is probably aware, this Government’s cancer plan, which I launched just over a week ago, is the first ever cancer plan to have a section on children and young people with cancer and to commit to supporting children holistically throughout their cancer journey. I am more than happy to have a conversation with him about the issues that he has raised.

[Ms Julie Minns (Carlisle) (Lab)]

T7. A resident in my constituency was initially told to take a round trip of almost 200 miles to receive hospital treatment in Glasgow because he was registered with his nearest GP, which happened to be in Scotland. Can the Minister tell the House what progress is being made in reviewing and updating cross-border healthcare guidance?

[Dr Ahmed]

Glasgow is a great place to get medical care—I can attest to that—but people should not have to travel 200 miles to get medical care. My hon. Friend and I have had many discussions on this topic, and I am very glad to continue those discussions. She knows that treatment along the border is subject to service-level agreements in both English trusts and Scottish health boards, but it should be much more porous and accommodating than it is. I am happy to take these discussions with her further later.

National Cancer Plan

Julie Minns Excerpts

Thursday 5th February 2026 Commons Chamber

[Ashley Dalton]

I can assure the hon. Member that we are working with our Welsh counterparts to make sure that there is equity of access to resources and to information, and we will continue to do so.

[Ms Julie Minns (Carlisle) (Lab)]

The reality is that if someone lives in a big city with access to a university teaching hospital, their access to cancer treatment will be different from those who live in a town or small city like Carlisle, where we face challenges in recruiting and retaining specialist consultants. Does the Minister agree that this plan, combined with the pioneering approach to training doctors at the new Pears Cumbria School of Medicine, will begin to fix those inequalities that my constituents experience?

[Ashley Dalton]

That is absolutely the case. This plan will support people in my hon. Friend’s constituency by expanding access to community diagnostic centres and personalised neighbourhood-based cancer care. We are also focusing on recruiting more cancer specialists for rural and coastal areas, and are supporting that through the workforce plan.

Medical Training (Prioritisation) Bill

Julie Minns Excerpts

2nd reading
Tuesday 27th January 2026 Commons Chamber

[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.

Cross-border Healthcare

Julie Minns Excerpts

Tuesday 4th November 2025 Westminster Hall

[Ms Julie Minns (Carlisle) (Lab)]

It is a pleasure to serve under your chairship Mr Dowd. I congratulate the hon. Member for Brecon, Radnor and Cwm Tawe (David Chadwick) on securing this important debate.

As the Member of Parliament for Carlisle and north Cumbria, I represent a region where the realities of geography often challenge the neat lines that we find on maps, and those drawn by policy and practice. For example, earlier this year, during a prolonged power cut that affected the village of Kershopefoot, to the north-east of Carlisle, staff at ScottishPower Energy Networks were somewhat surprised to discover, after I contacted them, that they served customers in England who had a Scottish postcode.

When it comes to health, my constituents quite often face more serious issues. For some, their nearest GP might be in Scotland, but the nearest hospital is in England—in my case, the Cumberland infirmary. This can and does lead to issues.

I acknowledge the Government’s excellent work to improve healthcare access across the UK and in my constituency. In Carlisle and north Cumbria we have seen real progress: waiting lists have been cut and the urgent dental centre that opened last year is beginning to address many of the challenges we experience with NHS dental care. Those meaningful steps forward were made possible by this Government, but progress must be matched by policy that works for everyone, and especially those who live on the edge of systems, maps and borders.

One of my constituents, who lives in the northernmost part of the constituency, found himself facing a deeply troubling situation when he became very ill. He is geographically closer to Scotland and therefore registered with a Scottish GP. However, when he needed hospital care he was told he could not be treated at his local hospital in England—in Carlisle—because he was registered with a Scottish GP. Instead, he was advised to travel to Glasgow, a round trip of over 200 miles, rather than take the 40-mile trip to Carlisle.

This is a man who lives in England, pays his taxes here and has his bins collected by an English local authority, and whose nearest hospital is in England, but he was told to travel to Glasgow for care—not because of clinical need or even capacity, but because of outdated guidance. Thankfully, after the intervention of his GP and other dedicated health professionals, he was able to receive the treatment that he needed locally, but his case should not have required such extraordinary effort. It should never have required the negotiation it took and should not have required escalation. It should have been common sense.

The English guidance does not adequately cover cross-border scenarios, and I am told the Scottish guidance predates the creation of the integrated care boards altogether. I am very grateful to the Minister for Care for giving me his time a few weeks ago to discuss this issue. I know he recognises that this needs to be urgently resolved. I would welcome any update that I can share from the Minister today on whether the guidance is now to be reviewed and improvements are under way. We must ensure that all relevant healthcare providers are equipped with clear, up-to-date information, because we all want the same thing: a system that works for patients, wherever they live.

This is not a question of politics, as we can see from the cross-party presence at this debate—although the absence of the SNP is notable. I am pleased to see my constituency neighbour, the hon. Member for Berwickshire, Roxburgh and Selkirk (John Lamont), in his place. This is a question of practicality, compassion and, as the hon. Gentleman said, common sense. We must ensure that our healthcare system reflects the lived realities of our constituents, and not the lines on a map. I urge the Minister to take this issue forward with urgency. I stand ready to support any efforts to improve cross-border healthcare.