Oral Answers to Questions

Karin Smyth Excerpts

Tuesday 22nd July 2025 Commons Chamber

[Laura Kyrke-Smith (Aylesbury) (Lab)]

3. What assessment he has made of the potential impact of the 10-year health plan for England on perinatal mental health.

[The Minister for Secondary Care (Karin Smyth)]

The 10-year health plan sets out ambitious plans to boost mental health support across the country, including for women during the perinatal period. During the year to April 2025, a record 64,805 women accessed maternal mental health services or specialist community perinatal mental health services, such as those at the Whiteleaf centre in Aylesbury. The Department for Education is also investing £500 million to roll out Best Start family hubs to all local authorities in England, which will also support new mums.

[Laura Kyrke-Smith]

I am really grateful to the Minister for her answer and for her focus on this. I would like to ask about midwives, who do incredible work supporting parents and babies, including identifying and supporting women who are facing mental health challenges. We desperately need more of them, yet the Royal College of Midwives has found that eight out of 10 student midwives who are due to qualify this year are not confident that they will find jobs. What steps is the Minister taking to ensure that newly qualified midwives are able to find work?

[Karin Smyth]

I recognise my hon. Friend’s great work in this place to support women on this issue. We recognise that newly qualified midwives are experiencing challenges in gaining that first role. That is partly due to the record number of midwives in post and to better retention rates. NHS England is working with employers, universities and regional midwifery leads to help midwives find those roles after qualification and to transition into workforce, and we will keep a close eye on that with them.

[Alex Easton (North Down) (Ind)]

In assessing the impact of the 10-year plan on perinatal health for England, can the Minister assure us that the lessons learned will be shared across the rest of the United Kingdom, to enhance care quality and reduce regional disparities, especially in Northern Ireland?

[Karin Smyth]

The hon. Gentleman makes an excellent point about the important need to share the learning across the United Kingdom, and I will make sure that we do indeed make efforts to do that.

[Mr Speaker]

I call the Liberal Democrat spokesperson.

[Jess Brown-Fuller (Chichester) (LD)]

Over the weekend, The Guardian reported that the number of women dying in the perinatal period had risen sharply since 2015. Families that have been failed, and health professionals feel that whether it is perinatal depression or unsafe births, lessons are not being learned and the same errors are repeated in review after review. Alongside the inquiry that the Secretary of State has launched, will the Government immediately implement every action from the Ockenden review and put an end to this national scandal in maternity service?

[Karin Smyth]

The hon. Lady has raised a really important issue. She highlights the work that the Secretary of State is putting in place to address these issues and finally bring all that together to produce a plan that will assure people, and we are working at pace to ensure that those recommendations are implemented.

[Greg Smith (Mid Buckinghamshire) (Con)]

4. If he will make an assessment of the potential merits of siting a neighbourhood health centre in Long Crendon, Buckinghamshire, as part of the 10-year health plan for England.

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[Gareth Snell (Stoke-on-Trent Central) (Lab/Co-op)]

7. What steps his Department is taking to improve electronic patient record systems in the NHS.

[The Minister for Secondary Care (Karin Smyth)]

My hon. Friend will know that trusts have responsibility for securing—using the approved procurement framework—an appropriate electronic patient record system that delivers all the core capabilities set out in the digital capabilities framework. Since 2022, £1.9 billion has been invested in digital transformation, including in the roll-out of EPRs to NHS trusts that do not have one and in support to optimise existing ones.

[Gareth Snell]

The Minister will be aware that my hon. Friend the Member for Stafford (Leigh Ingham) and I have been working on a replacement system for the University Hospitals of North Midlands NHS Trust in north Staffordshire, which would improve public and patient experience, and productivity, at those hospitals. Will the Minister meet us so that we can consider how further to unlock that funding to improve productivity and patient experience in good time?

[Karin Smyth]

I commend my hon. Friend, and our hon. Friend the Member for Stafford (Leigh Ingham), for their diligent work with their trust and local system. Progress is being made on that EPR, which will have huge benefits. I will ensure that he has a clear outline of progress to the final planned operating of the go-live date for that issue. I am happy to meet him.

[Mike Martin (Tunbridge Wells) (LD)]

Blocked beds cost Pembury hospital £18,000 every night, yet discharge teams have to manually phone care homes to place people there. My constituent Debbie has created a dashboard—it is basically like Skyscanner—to accelerate discharges by matching discharged patients to care beds. It has already received seed funding of £200,000 from Kent county council, and could save up to £7 million a year in Pembury alone. Will the Minister meet me and Debbie to discuss that idea?

[Karin Smyth]

The hon. Gentleman highlights the serious problem of staff operating in an analogue age in the NHS, which we keenly highlighted in the 10-year plan. We want to move the system into a more digital age. We would be very happy to hear more about the scheme that he outlines and the great work that staff are doing to get over some of the problems that they are working with.

[Ms Julie Minns (Carlisle) (Lab)]

My constituent Lee Armstrong contacted 111 when he was suffering from an Addisonian crisis. Lee and his partner provided full details about his condition to 111, and when his condition worsened, they called 999, but what neither Lee nor his partner knew was that the electronic record details given to 111 would not be available to 999, and neither would his patient records. As a result, the ambulance was not dispatched with the urgency required and Lee died. Will the Minister set out how the improvements in the digitisation of electronic records will cover the integration of the 111 and 999 services so that lives like Lee’s can be saved?

[Karin Smyth]

My hon. Friend outlines a horrific case in her constituency, where she has been a fantastic campaigner since last year. Information sharing between 111 and 999 already exists in many places. We want standards in place to ensure that that happens safely across the country. That is a key part of what we are trying to do in our 10-year plan by bringing together single patient records and records within systems. I am very happy to follow up with her in more detail on the case she mentions, if that would be helpful.

[Edward Morello (West Dorset) (LD)]

Many GPs say that their buildings are not fit for purpose and lack digital infrastructure. Without fully integrated electronic patient records and better systems, including the electronic prescription service across all hospitals and community trusts, we risk wasting time and money while increasing pressure on frontline staff. Will the Minister outline the steps being taken to full integrate the electronic prescription service across all settings in Dorset?

[Karin Smyth]

The hon. Member highlights the importance of getting this right not only from hospital to discharge but, crucially, in primary care, where 90% of patient contacts happen across the system. That is why a central plank of our 10-year plan has been moving the entire system from the analogue to the digital age. We have allocated £10 billion, particularly in this spending review, to address this issue and make sure we get this right for the system and for patients.

[Kate Osamor (Edmonton and Winchmore Hill) (Lab/Co-op)]

8. What assessment he has made of the potential impact of the 10-year health plan for England on the prevention of ill health.

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[Josh Babarinde (Eastbourne) (LD)]

10. What steps his Department is taking to improve car parking provision at NHS hospitals.

[The Minister for Secondary Care (Karin Smyth)]

The Department has published guidance that trusts are expected to follow to manage the provision of car-parking spaces for patients, hospital users and staff. Responsibility for hospital car parks lies with each individual trust, and provision must be managed alongside the existing policy, providing free parking for those in the greatest need.

[Josh Babarinde]

Parking at Eastbourne district general hospital, where I was born, is woefully inadequate. The car park is often full, so patients have to park way away up the Rodmill hill, and car park services are crumbling. More than that, lower-banded NHS staff now face a near doubling of car parking charges to cover the cost. Given that the Government have delayed investment in our new hospital and, therefore, in a new car park until the 2040s, what support will they provide in the meantime to upgrade our DGH car parking facilities without our NHS heroes being expected to foot the bill?

[Karin Smyth]

As the hon. Gentleman knows, the discussions about any advanced works arising from the new hospital programme are ongoing. I am very happy for the Department to continue to discuss with the trust how future investment can best meet the needs of the future.

[Rachel Taylor (North Warwickshire and Bedworth) (Lab)]

University hospital Coventry and Warwickshire suffers from really poor car parking facilities. I have had to take both my parents there over recent years to use its specialist cardiology services. The poor quality of those car parking facilities causes additional stress for patients visiting those services, which they can ill afford when they have suffered strokes or heart attacks. It is becoming extremely vital that something is done, so will the Minister meet me and other local MPs to discuss the crisis in car parking at the hospital?

[Karin Smyth]

The provision of car parking remains an issue for trusts. I recognise the stress caused by trying to get patients to hospital, particularly if they have mobility problems. I commend the many hospitals across the country that have really good active travel plans and are working with their local communities to resolve some of these issues. We need to hear more from the trust about what provision it is putting in place to serve my hon. Friend’s constituents.

[Perran Moon (Camborne and Redruth) (Lab)]

11. What steps his Department is taking to tackle health inequalities across the country.

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[Dr Ben Spencer (Runnymede and Weybridge) (Con)]

Eight years ago, Weybridge community hospital burned down. After a long journey, the replacement finally received planning consent last week; all it needs now is for the Secretary of State to sign the cheque on the dotted line. Will he do so as soon as possible?

[The Minister for Secondary Care (Karin Smyth)]

The business case for the rebuild of the health centre has been submitted to NHS England for review, and NHS Property Services will in parallel be asked to approve the capital funding. Subject to those approvals, a new health centre will be fully completed in 2027.

[Will Stone (Swindon North) (Lab)]

Phlebotomists across the country play a vital role in our NHS. Will the Minister consider making the job role band 3 across the nation to ensure that everybody is paid fairly?

[Karin Smyth]

Phlebotomists are paid on an “Agenda for Change” pay scale, which is underpinned by the job evaluation scheme. It is something the Secretary of State and I discussed with the trade union Unison last week; I should declare that I am a member of Unison. It is working closely with the trust in question, but I am happy to discuss the matter with my hon. Friend further.

[Dr Danny Chambers (Winchester) (LD)]

Many carers have told me how much they rely on respite care to protect their own physical and mental health so that they can continue to care for their loved ones day in, day out. The wonderful Chesil Lodge day centre in Winchester has recently been threatened with closure, and I have been fighting alongside constituents to keep it open. How will the Department ensure that respite services such as those at Chesil Lodge are consistently available and are not subject to a postcode lottery? Can I also—

Regulation of NHS Managers: Consultation Response

Karin Smyth Excerpts

Monday 21st July 2025 Written Statements

[The Minister for Secondary Care (Karin Smyth)]

Ensuring strong and accountable NHS leadership will be critical to delivering our plan for change and building an NHS fit for the future.

We know the important role that high-quality leadership plays in fostering a compassionate and transparent culture within the NHS and we want a healthcare system where staff feel confident to speak up, with a positive and open workplace culture.

The vast majority of NHS managers do an excellent job. They are also responsible for hugely significant decisions that affect patient care, and the Government believe that they should be held to the same high standards of accountability as the healthcare professionals who work in the NHS.

Too often, tragic cases and high-profile reviews have shown repeated instances where leaders have failed to act appropriately and have not been held to account for their actions. The Government are committed to ensuring NHS leadership is transparent and accountable. Today, the Department of Health and Social Care has published its response to the 12-week consultation on options for the regulation of NHS managers. This important development forms part of a programme of work to meet the Government manifesto commitment to introduce professional standards for, and regulation of, NHS managers.

Regulating managers will strengthen their professional accountability by providing a consistent and fair means of addressing concerns about conduct or performance, protecting the public by removing those from the profession whose conduct is unacceptable.

The consultation had a high level of engagement, with 4,924 responses, over 100 of which were from organisations. I would like to put on record my sincere gratitude to everyone who took the time to share their views on this pivotal piece of work.

Having considered these views, the Government will be bringing forward legislation to provide the health and care professions council with the powers to run a statutory barring system for NHS board level leaders and their direct reports so that those who commit serious misconduct or silence whistleblowers will not be able to practise in senior roles in the NHS. We will explore what further steps can be taken so that those barred from working in the NHS are not employed in equivalent roles in social care.

It is equally essential that managers and leaders are supported with the skills they need to deliver transformation in the NHS and that they can access development opportunities that enable them to meet the high standards that will be expected of them. This is why today’s consultation response builds on our wider programme of leadership and management development that will ensure patient, public and professional confidence in NHS leadership and equip the NHS with the leaders needed to deliver our 10-year health plan. This programme of leadership reform, designed to strengthen the capability, confidence and accountability of NHS managers includes the establishment of the college of executive and clinical leadership. As part of our work to develop the college, we will work with stakeholders to consider whether there are forms of accreditation that could be implemented to recognise the professionalism of NHS managers and leaders. This will be complemented by wider work to strengthen NHS leadership, including NHS England’s leadership and management framework, the NHS very senior manager pay framework, and the implementation of General Sir Gordon Messenger’s recommendations to establish a national and regional strategic approach to talent management in the NHS.

The consultation also asked about the introduction of a professional duty of candour for NHS leaders, if leaders should be under a duty to ensure that the existing statutory (organisational) duty is correctly followed in their organisation and about the responsibility of leaders to respond to patient safety concerns.

These issues have been highlighted in previous reviews and inquiries including the 2019 Kark review, the 2024 infected blood inquiry and the Thirlwall inquiry into events at the Countess of Chester hospital. This consultation response reinforces the responsibility of leaders and managers in relation to candour and patient safety. As we implement regulation of managers, take forward recommendations from the IBI and consider the implications of the Cabinet Office’s proposed Hillsborough law, we will consider what further sanctions may be required in relation to failing to uphold the principle of candour.

Next steps

Department officials will prepare draft legislation to provide the HCPC with the powers to implement a statutory disbarring regime for NHS managers. When parliamentary time allows, we intend to bring forward this legislation, which will be subject to a further public consultation. We will continue to engage with stakeholders throughout and we will work closely with NHS England to ensure alignment with the wider work under way to develop and professionalise NHS managers and leaders.

[HCWS873]

NHS Pensions: Frontline Patient Care

Karin Smyth Excerpts

Thursday 17th July 2025 Commons Chamber

[Dr Luke Evans (Hinckley and Bosworth) (Con)]

(Urgent Question): To ask the Secretary of State for Health and Social Care if he will make a statement on NHS pensions and the impact of administrative delays on frontline patient care.

[The Minister for Secondary Care (Karin Smyth)]

As the House knows, the NHS pension scheme is administered by the NHS Business Services Authority, which is facing challenges, as are all public sector pension schemes, as a result of the coalition Government’s public sector pension reforms in 2015, which in 2018 were found to have been discriminatory—known as the McCloud remedy. The work to remedy that is complex, and much of that I have already detailed in a written ministerial statement on 31 March and a subsequent urgent question. It is complex, technical work, and as the NHSBSA began to produce individual statements, it became clear that its initial estimate of the time needed for each one was too low. My written statement of 1 July updated the House that the NHSBSA did not meet its deadline to deliver statements to certain classes of member by that date and set out the actions that I was taking.

Let me be clear that this Government remain absolutely committed to providing affected members with their statements at the earliest opportunity, and that is what we are doing. The authority is developing a revised plan, and I will hold it to account against the new deadlines. I met the chief executive of the authority and was very clear about my disappointment in the progress, my expectation for the authority to remedy the situation for members, and the need to have a more robust assessment of the delivery plan. I also ensured that the independent chair of the NHS pension board is ready to set up an independent review of the delivery plans. I met her yesterday and was clear that I expect a thorough review of the process and a realistic assessment of delivery, and to hear her initial assessment. She will give her full report after the summer recess.

I will set new deadlines, including for members who are expecting statements this month. I will update the House as soon as possible, of course, both on the progress with the assessment and on the revised deadlines. Let me be clear that members will not face further financial detriment as a consequence of remediable service statement delays, interest on related pension arrears will be paid at 8%, and my Department and the authority have already put in place compensation arrangements for direct financial losses that members may have incurred.

People who have served in our NHS deserve their dues, and we will prioritise members based on need. Let me end by reassuring the House that there will be no direct impact on frontline care. I will continue to update the House.

[Dr Evans]

I declare an interest, for myself and on behalf of the shadow Front-Bench team, as we all have NHS pensions.

In April, Mr Speaker granted us an urgent question because the Government have no real plan for NHS pension statements. Today we return because the Government have now admitted in writing that a new plan is failing— deadlines were missed, then pushed back, and now we have no idea what they are. Just 1,359 statements have been issued out of a required total of 381,920—just 0.35%. Further still, there is no comment on the remediable pension savings statements. Has the Government’s own delayed deadline of July been met or discussed?

This matters. Hundreds of thousands of frontline doctors are not getting their pension statements. The British Medical Association is clear that senior doctors are stepping back from extra work for fear of unexpected tax liabilities. In short, taking on extra work risks an extra tax bill of thousands of pounds. When I raised this in April, the Minister retorted that I could have asked about the impact on services of cancelling the strikes. Well, I will do so now, as the strikes are back on. It will be the senior doctors who have to pick up the slack—the very doctors who are avoiding extra shifts for fear of the tax. If they will not take on the extra work for fear of the heavy tax burden, we have a huge problem.

This should be a priority for the Government, especially as we plan for winter pressures. What will the Minister do to remedy the situation with RSS? What will she do regarding RPSS? Ministers cannot just announce new deadlines and then miss them, so would she be kind enough to publish a delivery plan? Finally, she said that the Government have faith in the NHS Business Services Authority. Is that still the case? Will she demand that the Pensions Regulator steps up and expedites its investigation, given that the referral was made in December 2024? In the end, doctors are counting on her, and so are their patients.

[Karin Smyth]

As I outlined in my initial response and further to the written ministerial statement, we have asked for an independent review of the process and will report back as soon as possible with a realistic deadline for that. With regard to the strikes, we will continue to be open to discussing the avoidance of those strikes, and I hope that the Opposition will support us in that.

[John Slinger (Rugby) (Lab)]

Given that the summer recess is imminent, will the Minister use this opportunity to update the House on the number of additional appointments and, more importantly, the number by which the NHS waiting lists have fallen under this Government? Does she agree that it would be very nice if the Conservative party addressed the crisis in which they left our NHS? It is a mess that this Labour Government are proud to be clearing up.

[Karin Smyth]

I thank my hon. Friend, who is a superb advocate for his constituents. I met him again yesterday as he advocated for services in his constituency—that is the focus of Labour Members. He is absolutely right; as I said in my statement, this is part of the overall mess that we inherited from the Conservatives. As I said in my previous response on this issue, the problems outlined by Lord Darzi are wide and deep. It is still shocking, after a year in government, to be faced with the level of disaster that was left to us after a complete abdication of responsibility for sorting out the problems. We will continue to focus on getting more of the appointments that people so need and on reducing waiting lists, which is what our constituents expect.

[Madam Deputy Speaker (Ms Nusrat Ghani)]

I call the Liberal Democrat spokesperson.

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[Jess Brown-Fuller (Chichester) (LD)]

I thank the Minister for coming to the House to answer this urgent question. These administrative delays are deeply worrying. They make financial planning for those affected very difficult and, more importantly, stop doctors taking on additional work for the NHS as they could face large and unknown tax penalties. That was highlighted at the start of the year, when 4,000 NHS staff missed out on pension tax compensation after administrative failings.

This is having a direct impact on patient care, so how will the Minister reassure NHS staff regarding their pension entitlements, and when can they expect to see the compensation the Minister mentioned to encourage them back into the workforce? Can she assure the House that the Government are taking steps to prevent doctors with missing pension records from being unfairly penalised? Can she tell us how the Government will address the 156,000 years of missing pension data for GPs? Finally, will the major reorganisation of the NHS—especially the 50% cut to the organisations that oversee local health services—potentially compound this problem?

[Karin Smyth]

I thank the hon. Lady for those questions. She highlights a number of important issues regarding the complexity for the NHS Business Services Authority of dealing with this. There is a large number of high earners in this scheme. With regard to tax liabilities, that makes the system complex, as does the movement of doctors throughout the system in their career.

One issue I discussed with the independent reviewer yesterday is the need to ensure there is a technical look at solutions to issues such as missing years. The hon. Lady is right to highlight that changes make a difference to following people’s careers through the system. There are wider lessons, which I have already started to discuss with the reviewer, about how we make the best use of technology so that we can track people through their careers and give confidence to the current workforce that we are addressing this not just for the cohort who have immediate issues but for the future. That is the sort of action this Government are taking. We do not do sticking plasters. We are looking at this very seriously.

[Dame Harriett Baldwin (West Worcestershire) (Con)]

I declare an interest, as a trustee of the parliamentary contributory pension fund.. Many people in the public sector receive a significant pension contribution, but they are not aware of its value. The Pension Schemes Bill currently going through Parliament presents an opportunity to place on someone’s pay cheque and pay offer the annual value of that incredibly important contribution to a public sector pension fund. That is something that very few people in the private sector are now able to enjoy, and it feels like it is undervalued by those who benefit from it. Will she consider taking that opportunity?

[Karin Smyth]

I thank the hon. Lady for that really constructive suggestion. In my discussions with the NHSBSA, the reviewer and officials at the Department, I have raised similar issues. I am a member of the NHS pension scheme and the parliamentary pension scheme. I tell my young people that this is a really valuable asset, and I encourage my constituents who are looking for jobs in the NHS to consider the pension scheme, because people sometimes do not look at it immediately. We should look at ways to encourage people to take part in the pension scheme—particularly for lower earners, it is a really valuable and stable contribution—and the value of it from the public purse should be well known.

I am not across the detail of the hon. Lady’s point on the Pension Schemes Bill, but I will talk with my colleagues across Government about how we can look to do that and come back to her, because I agree that it is a really valuable thing—it rewards the contribution of public service, and we should make the most of it.

[Tom Gordon (Harrogate and Knaresborough) (LD)]

I would like to take this opportunity to put my thanks on the record to the Minister. I have spoken to her outside this place about the money we have secured for removing reinforced autoclaved aerated concrete at Harrogate district hospital, which I have been campaigning on for years.

It is great having state-of-the-art hospital facilities, but if we do not have the staff there, it is all a bit moot. I want to press the Minister on the concerns raised by colleagues that people might not come back or take on additional hours in the NHS as a result of this issue. Will she commit to updating Members throughout the recess on progress on this matter?

[Karin Smyth]

I congratulate the hon. Gentleman on, yet again, shoehorning in a reference to his local hospital, for which he does a great job.

People are determined to work in and support the national health service. We take remedying confidence in pensions seriously. I will not give further deadlines before we hear from the assessor. I have asked her to come back and make a very clear statement as soon as possible after the summer recess. I will then be happy to update the House.

Coming forward to work in the NHS is a matter of choice for individuals, and we particularly want to work with consultants to ensure that their career progression is the best it can be. We very much value their work in the service.

[James Wild (North West Norfolk) (Con)]

With the British Medical Association set to strike, and with the Health Secretary reduced to pleading with it not to, thousands of patients are set to have their appointments cancelled. Can the Minister assure the House that she will grip this issue so that senior doctors do not also reduce their hours? And will she rule out bonuses for NHS Business Services Authority executives?

[Karin Smyth]

We are working very closely to ensure that resident doctors do not go on strike. We are very clear that we cannot negotiate on pay this year, but we will work with everybody to improve conditions. Some of those conditions are shocking, and we want to work constructively with them to avoid disruptive strike action.

[Robbie Moore (Keighley and Ilkley) (Con)]

The Daily Telegraph reported in April that a quarter of doctors have reduced their overtime to avoid potential five-figure tax bills, and NHS capacity has been reduced by about 10% as a result. This has been raised many times when I have been out and about door-knocking across Keighley and Ilkley. What steps will the Government take to rectify this absurd situation, which is preventing doctors from working more to reduce waiting lists?

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[Karin Smyth]

The hon. Gentleman highlights yet another mess that we inherited due to his party’s lack of proper engagement with the workforce over the last decade to resolve the disincentives to making the system work more effectively.

Making the system work more efficiently and more effectively is a key part of our 10-year plan announced, I think, only last week—the days keep rolling by. We not only involved the public in those conversations but had valuable conversations and received insights from all staff groups. There is a real spirit of optimism that everyone wants to pull together to ensure that the incentives are right for staff at all levels—over 1.5 million of them—to make the NHS fit for the future, and that is what we are focused on.

[Blake Stephenson (Mid Bedfordshire) (Con)]

The Minister knows that I have a keen interest in NHS reorganisation and the impact on frontline services, particularly in Mid Bedfordshire. Given the failures of NHSBSA, has consideration been given to reorganising that authority? I also repeat the question asked by my hon. Friend the Member for North West Norfolk (James Wild): given the failures, will the Minister rule out bonuses for the NHSBSA’s leadership?

[Karin Smyth]

I am totally focused on remedying this situation and learning from the mistakes. If further action is required, I will happily update the House at that point. My absolute focus at the moment is on getting everybody in that organisation and the independent review focused on sorting out the pension situation for those who have already lost out.

[Jim Shannon (Strangford) (DUP)]

As always, I thank the Minister very much for her answers. I recently read an article that referred to the mechanism of the NHS pension scheme as a “Ponzi scheme”, which gives me great concern about the scheme’s ability to cope in 20 years’ time. How do the Government and the Minister intend to convert the transitional arrangement in place since 2019—of topping up pensions from another source—into permanent and transparent arrangements so that we can stop robbing Peter to pay Paul and ensure that those who are working 70 hours a week in 2025 have a real pension and retirement fund in 2065?

[Karin Smyth]

The hon. Gentleman tempts me to stray further from the urgent question, but he raises an important point, further to the one raised by the hon. Member for West Worcestershire (Dame Harriett Baldwin), who is a trustee of the parliamentary contributory pension fund.

The NHS pension scheme is an extremely important part of the reward package that NHS staff at all levels absolutely deserve. We want to ensure that it, like the rest of the NHS, is fit for the future. If hon. Members have suggestions for how to make it work better, as part of ongoing discussions, I am happy to hear them.

Women and Girls with Autism: Mental Health Support

Karin Smyth Excerpts

Tuesday 15th July 2025 Westminster Hall

[The Minister for Secondary Care (Karin Smyth)]

It is a pleasure to serve under your chairmanship, Sir Edward. I am grateful to my hon. Friend the Member for Bournemouth West (Jessica Toale) for securing this debate and raising this extremely important topic. We know that, sadly, autistic people are at the wrong end of statistics on a range of mental health conditions: 70% to 80% of autistic people will experience mental health problems during their lives, and tragically many are more likely to die by suicide.

We have heard the devastating impact that can have on individuals and families. I pass my heartfelt condolences to my hon. Friend’s constituent, Ms Bridges, on the loss of her daughter. My hon. Friend spoke of the campaign for Lolly’s law, and I commend her for her tireless work to ensure that autistic people get the mental health support and treatment they deserve. As my hon. Friend said, that is exhausting, and too many parents are forced into campaigning roles. As she rightly said, Lauren should still be here.

It is clear that the number of autistic people and those with a learning disability who are in mental health hospitals is unacceptable. There are still too many people being detained who could be supported to live well in their communities. We want to ensure that people get the support they need in the community, improving care and keeping people out of hospital. The Mental Health Bill, currently before Parliament, would limit the scope to detain autistic people and those with a learning disability, so that they can be detained under part 2 section 3 only if they have a co-occurring mental disorder that requires hospital treatment.

The Bill would also introduce a package of measures to improve community support for autistic people and those with a learning disability. It is also critical, however, that when autistic people do need to be admitted to mental health in-patient settings, due to a co-occurring mental health condition, they receive the right care and support.

[Alison Bennett (Mid Sussex) (LD)]

My constituent, Annabel, who is a teenager, has parallel experiences to Lolly, as set out by the hon. Member for Bournemouth West (Jessica Toale). She also had a terrible experience being detained in a secure unit, which her parents did not think was safe. Does the Minister agree that when teenagers—children—are detained in secure units, more needs to be done to ensure that they are safe and fit for purpose to protect those children’s welfare?

[Karin Smyth]

The hon. Lady raises another terrible case concerning a teenager on behalf of her constituent. We must of course be mindful of that provision for children and young people. My hon. Friend the Member for Bournemouth West spoke of her constituent’s campaign to retrain mental health staff, to improve understanding and acceptance of autistic women and girls. As we have heard, we know there can be differences in how autism presents in males and females, which can make autism harder to identify in girls.

[Rachael Maskell (York Central) (Lab/Co-op)]

I am grateful to my hon. Friend the Member for Bournemouth West (Jessica Toale) for securing the debate. Will the Minister ensure that mental health trusts and integrated care boards do not put people waiting for an autism assessment through a process of filling in a pro forma, only to be left languishing on a list, perhaps never having an assessment? We know the predominance of young women on those lists, yet the right support in the right way never comes. Will the Minister ensure that that process is brought to a conclusion?

[Karin Smyth]

I will come on to talk about what we expect local providers to do, but obviously no one should languish on a list as she describes.

[Dr Lauren Sullivan (Gravesham) (Lab)]

In the new training regimen, can we please ensure that parents are believed? Young women and young girls often mask very well in schools where all the professionals are, but then at home they can explode and have meltdowns. Some parents are not believed at that stage. Will that also be included in the new training guidelines?

[Karin Smyth]

My hon. Friend makes an excellent point about carers. We should address that. She made an excellent point about support for parents wanting to support their own children. With regards to training, we are taking action to increase awareness and understanding of autism in health and adult social care services. Under the Health and Care Act 2022, providers registered with the Care Quality Commission are required to ensure that their staff receive specific training on learning disability and autism appropriate to their role.

To support that, we have been rolling out the Oliver McGowan mandatory training on learning disability and autism to the health and adult social care workforce. The first part of the training has now been completed by more than 3 million people. NHS England has also rolled out additional training across mental health services, and 5,000 trainers have been trained as part of the national autism trainer programme. That training covers autism representation in women and girls, as well as exploring misdiagnoses, including of personality disorders, for example. These trainers will cascade their training to teams across mental health services. NHS England also commissioned the Royal College of Psychiatrists to deliver the national autism training programme for psychiatrists, with over 300 psychiatrists having been trained in the past three years.

My hon. Friend the Member for Bournemouth West spoke about her constituent’s campaign on suicide prevention. We have committed as a Government to tackling suicide through the suicide prevention strategy for England. It identifies autistic people as one of a number of groups for tailored or targeted action at a national level. To support that, the Department, through the National Institute for Health and Care Research, has commissioned a review to understand what is known about the effectiveness, cost-effectiveness and experience of interventions to reduce suicide among autistic people.

More broadly, we also know that autistic people can face challenges in accessing mental health services. While it is the responsibility of local NHS bodies to ensure services meet the needs of their local populations, we are taking actions to support them to address the challenges that autistic people face. In addition to the training I have outlined, NHS England has published guidance on how to improve the quality, accessibility and acceptability of care and support for autistic adults to meet their mental health needs, as well as taking guidance on adaptation of NHS talking therapies for autistic people.

NHS England has also developed a reasonable adjustment digital flag, which enables the recording of key information about a patient and their reasonable adjustment needs to ensure that health support can be tailored appropriately. We are taking action to support early intervention and improve access to mental health services more broadly. Through the 10-year health plan, we will continue to roll out mental health support teams in schools and colleges to reach full national coverage by ’29-30. We will also ensure that support for the mental health of children and young people is embedded in the new young futures hubs, alongside a wellbeing offer to ensure that there is no wrong front door for young people seeking help.

[Afzal Khan]

Clearly, there are issues on the school side. Without tailored support, accessible information and properly funded SEND pathways, too many girls are being left behind, often resulting in mental health difficulties and poor educational outcomes. Does the Minister agree that urgent investment in SEND support in schools is needed, alongside reforms that recognise the different ways that autism presents in girls?

[Karin Smyth]

I understand that the previous debate was on SEND; I am sure my hon. Friend will pick up that point with the relevant Minister. As I have said, we are rolling out more support into schools, so that should join up to support those young people.

We are also transforming mental health services through the 24/7 neighbourhood mental health centres, to support our ambition to shift care from hospitals to communities. People will also get better direct access to mental health support and advice 24 hours a day, seven days a week through the NHS app, without needing a GP appointment. Our ambition is that, through improving access to mental health support in the community, we will prevent the escalation of mental health needs for all people, including autistic people.

My hon. Friend the Member for Bournemouth West asked a number of questions that I hope I have largely addressed. Regarding anti-ligature doors and specialist suicide prevention for in-patient units, I know that she has received a letter from the Department. I will make sure that officials provide a more thorough answer on the issues outlined in that request. She also raised the issue of the transformation programme, and support for and work with families. We have committed to developing a new national autism strategy to help support the direction of local systems to include families. I will ask officials to consider the specific issues that my hon. Friend raised, and make sure that she gets an answer.

I also assure my hon. Friend that, on out-of-area placements, ICBs have published plans to localise in-patient care under the national in-patient commissioning framework. To support that, we have allocated £75 million in this financial year to help stop mental health patients being sent far away for treatment. I know from my own constituency work that that is an issue of great concern. We will make sure that we are focused on it.

I am happy to request that the Minister responsible for this policy area, my hon. Friend the Member for Aberafan Maesteg (Stephen Kinnock), meet my hon. Friend the Member for Bournemouth West and her constituent. I know that he wanted to attend this debate, but could not do so for family reasons. We will get that meeting in train.

I again thank my hon. Friend for raising such an important issue, and recognise the tireless efforts of her and her constituent to raise awareness of mental health needs, and the need for support for autistic women and girls. I also thank all hon. Members in this debate who raised issues on behalf of their constituents. This is a really important issue for many of us, and I hope that my comments have gone some way to assure people that we take it very seriously, and are committed to working with them to make life better for people.

Question put and agreed to.

NHS Pensions: McCloud Remedy Implementation

Karin Smyth Excerpts

Tuesday 1st July 2025 Written Statements

[The Minister for Secondary Care (Karin Smyth)]

On 31 March 2025, I issued a written statement on the delivery of remediable service statements to NHS pension scheme members affected by the discrimination identified by the McCloud judgment. In it, I set out the extended deadlines by which the NHS Business Services Authority, which acts for the Secretary of State as the administrator of the NHS pension scheme, must provide affected members with remediable service statements.

Those deadlines were informed by a delivery plan put forward by the authority. However, as statements have been produced, it has become clear that the resource required to implement that plan was significantly underestimated.

I regret to inform the House that the NHS Business Services Authority will not be able to meet a number of these deadlines, including for those members who were due to receive a statement by 1 July 2025. The authority has begun issuing these statements, and enacting members’ consequential decisions, and as of 27 June 2025, 1,359 have been issued.

I stated on 31 March 2025 that I will hold NHS Business Services Authority to account against those extended deadlines for the delivery of remediable service statements. I will be meeting with the chief executive of the NHS Business Services Authority this week to express my disappointment with the progress that has been made and will be asking the recently-appointed independent chair of the NHS Pension Board to review the capacity, capability and delivery plans of the authority’s McCloud remedy functions and report to me before recess. The NHS pension scheme is a key part of the reward package for NHS staff who should expect an excellent service.

When I have agreed a revised delivery plan with the authority, one which is endorsed by the authority’s board, I intend to set new deadlines, including for those members who were expecting a statement by 1 July 2025, and will update the House as soon as possible. It is important to me that members have realistic timeframes for when they will receive their statements, and that the Government fulfil their obligations to them at the very earliest possible opportunity.

I know this will be disappointing news to affected members and the organisations that represent them. I want to assure them that we will continue to prioritise members based on their likelihood of facing financial detriment, that the authority are continuing to issue statements while a revised delivery plan is developed, and that they will receive 8% interest on pension arrears they are owed following receipt of their statement and enactment of their choice.

[HCWS766]

IVF Egg Donation: Young Women

Karin Smyth Excerpts

Thursday 26th June 2025 Westminster Hall

[The Minister for Secondary Care (Karin Smyth)]

It is a pleasure to serve under your chairmanship, Mr Efford. I thank the hon. Member for Strangford (Jim Shannon) for securing this debate on egg donation in young women. He raises a number of important points, which the Government take seriously. I absolutely assure him that there are rules and regulations around egg donation in this country. Hon. Members in this debate have talked about the potential concerns of the long-term impact of egg retrieval, and the potential incentive of the compensation offered for egg donation, particularly for young women on low incomes. I hope to address those points in my remarks.

For people who are struggling to conceive, which may be for a variety of reasons, receiving donor eggs can be life-changing—as we have heard in this debate—and enable them to start a family of their own. Donating eggs should be a purely altruistic act, and choosing to become a donor is a complex decision. In the UK, the average egg donor is between 31 and 32 years of age. That average has remained stable since records began in 1991. Egg donors are typically UK-based, with around 3% of donor eggs imported from abroad. There were around 3,800 IVF cycles using donor eggs in 2023, which is an increase from around 3,600 in 2019. Those donors support around 2,000 to 3,000 people a year who would otherwise not be able to have a baby. I recognise their generosity, although, as my hon. Friend the Member for Newcastle upon Tyne East and Wallsend (Mary Glindon) said, we also recognise that egg donation procedures come with risks, and they should not be undertaken lightly.

The HFEA ensures that licensed fertility clinics are following law and guidance in relation to egg donation. The Government agree with the point made in this debate that young women should be fully informed of any risks when making the decision to donate their eggs, and that clinics must ensure that women are fully informed and supported throughout the egg donation process. It is mandatory for clinics to provide counselling to women before egg donation to ensure that they understand all the potential risks, and legal and social implications, of donation. Donating eggs is generally very safe, and most women do not experience any health problems beyond discomfort during the stimulation of the ovaries and the egg collection procedure.

I do not want to minimise that experience of discomfort, but where women wish to donate eggs, the HFEA and the Government are committed to making it as safe and accessible as possible. In the short term, there is a potential risk of having a reaction to the fertility drugs used for the donation procedure. If that happens, the effects are normally mild, and can include headaches, nausea or feeling bloated. Donors are advised to let their clinic know if they experience any of those side effects.

In some very rare cases, as we have heard, women develop OHSS. It is a serious and potentially fatal reaction to fertility drugs, which happens about a week after eggs have been collected. Fortunately, it is rare, occurring in less than 0.1% of cycles. Because of the serious nature of OHSS, all severe or critical cases must be reported to the HFEA within 24 hours by the patient’s clinic. They are categorised by the HFEA as grade B incidents. A grade B incident involves serious harm to one person, or moderate harm to many. The HFEA’s latest “State of the fertility sector” report found that fewer OHSS incidents were reported in 2023-24, with 53 severe and critical cases reported by UK clinics.

In recent years, there has been widespread interest in donation, and figures show that the number of egg donors is rising. We heard from my hon. Friend the Member for Newcastle upon Tyne East and Wallsend and the Opposition spokesperson, the hon. Member for Sleaford and North Hykeham (Dr Johnson), about the importance of having conversations and asking questions about the long-term impact on women’s health, which is generally an under-researched area. The Government recognise that and would welcome studies in this area. If there is anything I can add to that following this debate, I will follow up with hon. Members on the opportunities for understanding the wider long-term implications for women’s health in this area.

At the public board meeting last year, the HFEA discussed the rates of compensation offered to egg and sperm donors. Since 1 October 2024, egg donors have received £985, which is up from £750. That increase in donor compensation was the first since 2011, and reflects the rise in inflation. The compensation offered to them is intended to reflect their time and the nature of the procedure, rather than being an attempt to monetise donation in the UK.

I want to address some of the points raised by Members to do with the variability of access to fertility services more broadly. Infertility affects one in six women of reproductive age worldwide. It is a serious condition that impacts wider family, relationships and mental health, as we heard from the Liberal Democrat spokes- person, the hon. Member for Chichester (Jess Brown-Fuller). I congratulate her friends, Lottie and Marvin, on the arrival of their child.

This Government expect integrated care boards to commission fertility services in line with the National Institute for Health and Care Excellence guidelines. NICE is currently reviewing the fertility guidelines, and will consider whether the current recommendations for access to NHS-funded treatment are still appropriate. I look forward to the guidelines being published; we will work with integrated care boards to determine how best to improve their local offer and ensure equity of access for affected couples.

[Jim Shannon]

I thank the Minister for her very comprehensive review. I have three quick questions. First, will the Government commit to undertaking a long-term study into the long-term health outcomes of women? That is one of the things I hope to see happen when it comes to egg retrieval. Secondly, will the Government review the safety of offering £985 per donation, which is sometimes said to be compensation? Thirdly—I hope I am not pressing the Minister too hard; I am quite happy for her to come back to us on this—everyone who has participated in the debate has expressed concern about the adverts, so we are keen to hear her thoughts on banning those.

[Karin Smyth]

I have addressed the issue of compensation. It rose in response to inflation, for the first time since 2011. We have no further plans to start a study specifically on health. As I said in my remarks to others, we understand that broader outcomes in women’s health is an under-researched area. Bringing forward trials is the usual response. If we need to add anything else to that, I will make sure we do so, but there are no other plans currently.

Advertising is governed in this country by the Advertising Standards Authority, which issued a joint enforcement notice in 2021 with the HFEA to ensure that fertility clinics and others were aware of the advertising rules and treating customers fairly. I am afraid I cannot comment on Scotland, where I understand there has been a large advertising campaign. That is not in my ken, although it is covered by the HFEA, which is a UK-wide body, so that is a bit of a complication. If there is anything to report back on with regard to Scotland, without me stepping on devolved issues, I will make sure we do so.

I again thank hon. Members for securing the debate and acknowledging the altruism of the women who choose to donate their eggs and help to give others a much longed-for baby. I assure Members that this Government will monitor the issues raised this afternoon. Women’s health and tackling inequalities are central to the priorities that we will take forward in the 10-year plan.

Department of Health and Social Care

Karin Smyth Excerpts

Tuesday 24th June 2025 Commons Chamber

[The Minister for Secondary Care (Karin Smyth)]

I thank the interim Chair of the Health and Social Care Committee, my hon. Friend the Member for Birmingham Erdington (Paulette Hamilton), for securing this debate, and all colleagues for taking part. I have been asked to condense my comments, so I hope that I can address her questions, but if I do not cover them, we will of course make sure that she has a written response.

We are honest about the challenges facing the health service, and we are serious about solving them. That is why we published the independent review led by Lord Darzi, which provided a full and frank assessment of the state in which the nation’s health service was left by the Conservatives after 14 years of government, aided in the first five years by Liberal Democrat colleagues. That investigation highlighted the critical challenges facing the NHS, and we have heard about more of them today. They include a significant increase in people living with multiple long-term conditions, and growing demands for mental health services, particularly among children and young people. That is why we are taking the steps that we are taking.

The investment we are already making in 2025-26, the outcome of the recent spending review and the forthcoming 10-year health plan will address these root causes by delivering our plan for change commitments, investing in preventive health care and modernising NHS infrastructure, so that we radically reform the NHS. We will deliver three shifts to ensure that the health service can tackle the problems of today—caused by the Conservatives—and of tomorrow. They are: shifting care from hospitals to community; shifting from analogue to digital; and shifting from sickness to prevention.

My hon. Friend the Member for Birmingham Erdington said that there were highly optimistic assumptions in the planning process, and that robust, detailed plans and efficiency savings were needed if we are to deliver on those assumptions. I agree. I am optimistic about our ability to deliver, but I am also realistic and very focused on delivery. Like my hon. Friend the Member for Chelsea and Fulham (Ben Coleman), I am already seeing improvements, as are most Members in their constituencies. May I wish him a happy birthday for July, while we are here? My hon. Friend the Member for Altrincham and Sale West (Mr Rand) rightly said that the Labour Government did this before, and we will do it again.

The estimates set the Department of Health and Social Care a resource spending budget of £208.1 billion and a capital DEL—departmental expenditure limit—budget of £13.6 billion, an increase from the 2024-25 supplementary estimates budget of £9.6 billion and £2 billion respectively. On capital, we have, as my hon. Friend the Member for Shipley (Anna Dixon) said, reversed the shocking decision by previous Governments to keep raiding capital budgets in order to keep the revenue going. That is why NHS buildings across our constituencies are in the state that they are in, and why we do not have the infrastructure that we need. I was pleased to visit Airedale hospital recently to see the work being done to repair it. On digital and tech, my hon. Friend the Member for Birmingham Erdington will notice that we have a £10 billion dedicated spend for the issues that she quite rightly raised.

The Department covers a wider family of organisations, and I can assure the House that we are focused on all parts of the departmental family to make sure that taxpayers’ money is spent as efficiently and effectively as possible. Everybody here has raised particular issues to do with the NHS, so I will briefly remind Members of the outcome of the spending review that my right hon. Friend the Chancellor recently announced. The spending review includes £29 billion more day-to-day funding in real terms than in 2023-24 and the largest-ever capital health budget; there will be a £2.3 billion real-terms increase in capital spending over the spending review period. That is our commitment to the British public. My hon. Friend the Member for Sunderland Central (Lewis Atkinson), with his great experience of the health service, said that we need to make sure that we have good public administration. The multi-year settlements can help the system to plan much better.

This record investment puts the NHS on a sustainable footing to deliver for the British people. We will cut waiting lists so that, by the end of the Parliament, 92% of patients will start consultant-led treatment for non-urgent health conditions within 18 weeks, delivering on the Prime Minister’s plan for change commitment to prioritise people’s health. We will support the shift from analogue to digital with the investment of £10 billion in NHS technology and transformation between 2026-27 and 2028-29—an increase of almost 50% from 2025-26. We will repair the NHS estate, continuing to deliver the 25 hospitals, with £30 billion over the next five years for day-to-day maintenance and critical safety risks, including the eradication of RAAC. None of that happened under the Conservatives.

We will enable 2% productivity growth per year, unlocking £17 billion of savings to be reinvested in frontline services. As well as delivery, the British people rightly expect us to ensure value from this huge investment in the health service. The Secretary of State has marked 2025-26 as a financial reset year with the publication of this year’s planning guidance. He has been clear that all systems must live within their means, exhausting all opportunities to improve productivity, tackle waste and take decisions on how to prioritise resources to best meet the health needs of their local population.

All systems are now planning to achieve a balanced financial position in 2025-26, recognising that £2.2 billion of deficit support has already been provided. We will therefore close the £4.4 billion initial gap in full. Financial plans support the delivery of key operational performance targets for elective, cancer, and urgent and emergency care at a national level set out in the guidance. We are working closely with NHS England on key aspects of delivering that. I assure the Chair of the Select Committee that I meet colleagues from across the Department of Health and Social Care and NHS England weekly to go through those plans in a robust manner.

There is a lot to get through, so I am sorry that we have lost a lot of time to respond to colleagues. We are particularly looking at productivity and efficiency targets. We are ensuring that the financial performance and improvement programme for 2025-26 learns the lessons of the past. We will focus on cost variation and on upskilling finance teams and wider leadership to ensure that there is good governance in our reporting practice. We will issue the NHS performance assessment framework and have a targeted approach to recovery because the current model does not work. We are looking at ICB reform, as has been discussed. We want to ensure there is a reduction in the variation of cost across the system so that we can get more care and support to the frontline. We are focusing much more on medium-term planning to have a long-term financially sustainable system for systems and providers.

Thanks to this Government’s record investment, we are taking steps towards fixing the foundations of our NHS to make it fit for the future. We will set out more details on our plans shortly in the forthcoming 10-year plan, which will lead the NHS to meet the challenges set out in the plan for change and build an NHS fit for the future.

Incontinence

Karin Smyth Excerpts

Thursday 19th June 2025 Commons Chamber

[The Minister for Secondary Care (Karin Smyth)]

It is a pleasure to see you in the Chair, Mr Deputy Speaker; you have done an excellent job of making sure that all Back Benchers get to contribute to this afternoon’s important debate. I will have to cut some of my comments, but hopefully I will get to address everybody’s points. We are having this debate during World Continence Week, and I congratulate my hon. Friend the Member for Dudley (Sonia Kumar) on securing it. There could not be a more appropriate time to raise awareness of this issue.

Millions of men, women, young people and children are living with bowel and bladder problems. Incontinence is an issue that robs people of their dignity, as we heard from my hon. Friends the Members for Chelsea and Fulham (Ben Coleman) and for Harlow (Chris Vince), and too many suffer in silence. As my hon. Friend the Member for Dudley rightly says, this subject is taboo, and I congratulate her on securing her first debate in the Chamber. It is great to have her expertise in this area.

All continence problems can be debilitating and life-changing. They affect a wide range of care groups, and can be a particular concern for older people. In recent years, public discussion and awareness has opened up. The advertising of products has become slightly more commonplace, helping people to normalise these issues, with which so many people live from day to day. However, we are still a very long way from being a society that supports people with incontinence to live without stigma.

As these issues affect people of all ages, we need to recognise that different approaches are required. We heard an excellent contribution from the hon. Member for Dumfries and Galloway (John Cooper), who raised that point, as did the hon. Member for Farnham and Bordon (Gregory Stafford). The hon. Member for Strangford (Jim Shannon) talked about children, and my hon. Friend the Member for Nuneaton (Jodie Gosling) talked passionately about people with learning disabilities.

There is no one-size-fits-all approach to managing incontinence, but dignity and compassion must be at the heart of the care provided. That is why we are introducing reforms to put the patient at the heart of the care pathway and the decision-making process around it. The 10-year health plan, and its focus on the three shifts needed to deliver a modern NHS—moving from hospital to community, from analogue to digital, and from sickness to prevention—will benefit people at risk of developing incontinence and those already living with it. For example, preventing type 2 diabetes or helping people into remission will help to reduce the number of people who develop continence problems as they go through life.

We have heard many contributions about women’s health. NHS England has established a perinatal pelvic health service, which focuses on the prevention, identification and timely treatment of a range of issues antenatally and for at least 12 months after birth. The initiative aims to support women who experienced trauma during childbirth, including conditions such as urinary incontinence and pelvic organ prolapse, as noted by my hon. Friend the Member for Gravesham (Dr Sullivan).

In addition to perinatal pelvic health services, continence services are provided more widely via women’s health hubs, and the core specification outlines that incontinence care is a key consideration for local organisations when establishing hubs. I commend my hon. Friend the Member for Wolverhampton West (Warinder Juss) for bringing his expertise and experience to this debate, and for supporting so many women. I know that in the last Parliament many Members of this House supported women through the horrors of mesh implants, and we are moving that issue forward.

By moving from sickness to prevention, the Government want to shorten the amount of time people spend in ill health and to prevent illnesses before they happen. Although prevention is extremely important, we must also ensure that those living with incontinence receive the best possible care, wherever they live. A key part of that involves the NHS providing high-quality guidance on how to care for people living with incontinence. The National Institute for Health and Care Excellence has published five guidelines on the management of urinary and faecal incontinence, which cover the management of urinary incontinence in people with neurological disease, the prevention and management of pelvic floor dysfunction, and pelvic organ prolapse in women. NICE has also published advice on a further 14 products for urinary incontinence, and on 12 products for faecal incontinence.

My Department has commissioned NICE to produce late-stage assessment guidance on one-piece closed bags for colostomies, and on intermittent urethral catheters for chronic incomplete bladder emptying in adults. These late-stage assessments will gather the views of clinical experts and patients to help NICE assess and compare the value of products in widespread use across the NHS. In addition to NICE’s guidance, the NHS must have regard to the “Excellence in Continence Care” guidance, published in 2018.

NHS England has also produced guidance on safer bowel care for patients at risk of autonomic dysreflexia, a serious medical condition that can affect people with spinal cord injuries. The guidance offers resources to support safer bowel care practice, and highlights the importance of implementing the excellent incontinence framework. In addition, the Nursing and Midwifery Council has professional standards relating to bladder and bowel nursing care. Its code places a strong emphasis on the principle of prioritising people, setting out the expectation that registrants should always respond to individual patient needs. NHS England is also developing a best practice catheter care pathway across all settings, which is to be completed by the end of this year.

The provision of suitable care, with the products necessary to deliver that care, is essential for minimising the physical harm related to complications and treatments for continence problems, which can lead to admission to hospital for extended lengths of stay. The NHS will commission pathways of care that ensure early assessment and effective management of incontinence, along with other bladder and bowel problems. These pathways will take account of the impact of urinary tract infections on social, physical and mental wellbeing to reduce expensive pad usage, high-cost complications, and unnecessary hospital and care home admissions.

As we have heard, our focus on the shift from hospital to community will drive more joint working in neighbourhoods between primary care, pharmacies, community healthcare and social care to help people manage incontinence at home. This will help them to access the right self-care and the right professional support so they are not passed from service provider to service provider. It will also reduce their need for emergency hospital admissions, as we heard from my hon. Friend the Member for Nuneaton.

My hon. Friend the Member for Penrith and Solway (Markus Campbell-Savours) made some excellent points about access to facilities, and I know he will keep pressing my hon. Friends in the Ministry of Housing, Communities and Local Government about that issue. His points were echoed by my hon. Friend the Member for Colchester (Pam Cox).

As I stated at the outset, shifting care into community settings is one of our three shifts, and we will shortly be publishing the 10-year plan. Once again, I thank my hon. Friend the Member for Dudley for bringing forward this debate to raise awareness of this important but often overlooked issue.

Prostate Cancer Treatment

Karin Smyth Excerpts

Tuesday 17th June 2025 Commons Chamber

[The Minister for Secondary Care (Karin Smyth)]

I thank my hon. Friend the Member for Ealing Central and Acton (Dr Huq) for securing the debate, and I thank the other Members who have spoken.

As my hon. Friend has said, more than 50,000 men are diagnosed with prostate cancer every year, and one in eight will be diagnosed with it during their lifetime. I commend her for raising an issue that I know is very personal to her, as she has articulated so well. I am sure that her late father is watching her carefully. She was also right to support her constituent Peter by raising this issue, which affects so many men, and to highlight the number of black and minority ethnic men presenting with the disease. That is something on which we have all campaigned very strongly.

Timely and equitable diagnosis and access to innovative medicines for the treatment of prostate cancer are of the utmost importance. To support faster diagnosis, NHS England has redesigned pathways to maximise capacity. We are also aware of very early-stage trials of the use of artificial intelligence in prostate cancer detection, and we look forward to a formal report on those trials, so that the evidence can be considered carefully.

[Carla Lockhart (Upper Bann) (DUP)]

The effects of prostate cancer have been well noted tonight, as has the number of men who are affected. About 12,000 die from it each year, more than 300 of them in Northern Ireland. Does the Minister agree that Northern Ireland should be included in the commissioning, and will she undertake to speak to the Health Minister in Northern Ireland about the issue? Does she also agree that this needs to sit alongside a UK-wide prostate cancer screening programme, targeting in particular people with a family history of the disease?

[Karin Smyth]

We talk regularly with our colleagues in Northern Ireland, and I am always happy to do so. As the hon. Lady knows, this matter is devolved, so it is a matter for Northern Ireland, and we respect the devolution settlement.

Our elective reform plan, published in January 2025, builds on the investments already made with an ambitious vision for the future of diagnostic testing. This will include more straight-to-test pathways, increasing and expanding community diagnostic centres, and better use of technology. With nearly 170 community diagnostic centres up and running, they can take on more of the growing diagnostic demand in elective and cancer care. We will also deliver additional capacity in 2025-26 by expanding some existing centres and building up to five new ones. We will address the challenges in diagnostic waiting times, providing the CT, MRI and other tests that are needed to reduce the elective and cancer waits.

Members know that the National Institute for Health and Care Excellence—we have heard a little about it this evening—is an independent body responsible for assessing whether new licensed medicines can be recommended for routine use in England, based on a thorough assessment of their clinical and cost effectiveness. The NHS is legally required to fund NICE recommended medicines, ensuring consistency of access for NHS patients wherever they live in England.

NICE is able to recommend promising new cancer medicines for use through the cancer drugs funds, which supports patient access while real-world evidence is generated to address clinical uncertainties. Through the cancer drugs fund, NHS patients also benefit from access to cancer medicines from the point of positive draft NICE guidance, accelerating access to clinically and cost effective medicines by up to five months. Through this process, many thousands of patients, including patients with prostate cancer, have been able to benefit from effective new treatments at prices that represent value to the NHS.

The drug that is the subject of this debate, abiraterone, is licensed, as my hon. Friend the Member for Ealing Central and Acton said. It is recommended by NICE for use in the treatment of certain types of metastatic prostate cancer, and it is now routinely available to NHS patients in England in line with the NICE recommendation. NHS England has recently put in place an interim commissioning policy that makes abiraterone available for men with high-risk, hormone-sensitive metastatic prostate cancer, pending the outcome of NICE’s update of its negative guidance. I am pleased that this approach was agreed between NICE and NHS England late last year to ensure uninterrupted access to abiraterone for men leaving the STAMPEDE trial.

My hon. Friend raised particular concerns about access to this drug for men with non-metastatic prostate cancer. First, it is important to note that abiraterone is not licensed by the MHRA for use in this indication, and it is therefore off-label. NICE does not evaluate the off-label uses of medicines, and the drug is also now off-patent and available generically, which means there is no single manufacturer that could sponsor an MHRA licence application or NICE evaluation. It is therefore for NHS organisations to take decisions on funding based on the available evidence.

NHS England considered abiraterone for the treatment of non-metastatic prostate cancer through its clinical prioritisation process last year. Through this process, NHS England concluded that evidence supported the routine commissioning of the drug in this indication. Approximately 7,000 men per year could be eligible for this drug, and it is estimated that it would cost an additional £20 million per year to fund that.

While, as my hon. Friend said, there may be some cost savings in the pathway from preventing the disease’s progression, these are unlikely to materialise for about five years and would not impact the up-front costs of the £20 million per year for the additional out-patient monitoring and drug cost. I had not heard the figures she outlined, but I will get back to her on some of the questions she asked, and it would be helpful to know where those figures are from.

Unfortunately, it has not been possible to identify the necessary current funding to support the commissioning of abiraterone for this purpose or any other treatments in this prioritisation round. I know that is disappointing for those affected, and I want to acknowledge that this is a really difficult and unusual situation. However, I want to assure my hon. Friend and other hon. Members that the funding position for this treatment does not mean that there are no treatment options. The NICE guideline on prostate cancer recommends the treatment of non-metastatic prostate cancer with surgery and radiotherapy.

I want to assure hon. Members that NHS England is keeping this position under review, and would reconsider funding for abiraterone for non-metastatic prostate cancer if the funding position changes. Earlier this month, NHS England met Prostate Cancer UK, which shared its financial model of the expected cost impacts. NHS England is reviewing this in more detail, and I encourage it to continue those discussions.

In closing, I recognise how hard it is when patients want access to effective treatments. I also recognise the distress and worry it causes not only for patients, but for their families and friends. The Government are committed to ensuring that we provide access to the most innovative and effective medicines, but it has to be in a way that is sustainable and affordable for the NHS. It is right that NHS England continues to engage with Prostate Cancer UK, and I know that my hon. Friend and other Members will keep an eye on this and similar issues with drugs coming forward. The national cancer plan will seek to improve every aspect of cancer care, to better the experience and outcomes of people with cancer. Our goal is to reduce the number of lives lost to cancer over the next 10 years. I am grateful for the opportunity to respond to the debate this evening.

Question put and agreed to.

Oral Answers to Questions

Karin Smyth Excerpts

Tuesday 17th June 2025 Commons Chamber

[Sadik Al-Hassan (North Somerset) (Lab)]

3. If he will undertake a review of the potential impact of medicine supply chain shortages on community pharmacies.

[The Minister for Secondary Care (Karin Smyth)]

Increasing the resilience of the UK medical supply chain is a key priority. I regularly meet the team to routinely take action to mitigate supply issues, including requesting additional stock, identifying alternative global sources and issuing management advice. Although the Department has no plans to conduct a specific review, we constantly work to identify and take forward further actions to reduce the impact of medicine shortages, including targeted winter monitoring.

[Sadik Al-Hassan]

Having worked in community pharmacies for nearly 20 years, I have witnessed at first hand the pain that medicine shortages can cause North Somerset patients and their loved ones. Will the Minister meet me, along with my hon. Friend the Member for Exeter (Steve Race) and other members of the all-party parliamentary group on pharmacy, to discuss the outcome of our inquiry into these shortages?

[Karin Smyth]

I congratulate my hon. Friend and constituency neighbour on his dedicated career in community pharmacy, and thank him for the expertise that he brings to the work of the all-party parliamentary group to help Members understand the impact of this issue on patients and pharmacies. I am planning to hold a parliamentary event on the subject in the autumn, and I am keen to work with the APPG to make it a success for all Members.

[Mr Richard Holden (Basildon and Billericay) (Con)]

Supply chain problems are just one of the many issues that are having an impact on community pharmacies. My local pharmacy in Noak Bridge is one of them, but it is also being hammered with national insurance increases, and the combination of these issues means that its long-term viability is at stake. Will the review that the Minister has mentioned include all the impacts on community pharmacies that are affecting their long-term viability?

[Karin Smyth]

The long-term viability of pharmacies and, indeed, the whole NHS was under threat from the right hon. Gentleman and his party, but thanks to this Government, it is being made fit for the future. This is a serious issue for all our constituents, and we want to make the system work better. The right hon. Gentleman will see from the 10-year plan that we will make the NHS fit for his constituents, mine and those of every other Member.

[Mr Speaker]

I call the Liberal Democrat spokesperson.

[Helen Morgan (North Shropshire) (LD)]

Across the country, community pharmacies struggle not only with supply chain problems but with dispensing some of the critical medicines for our constituents at a loss. I was concerned to read that higher prices for United States pharmaceuticals are on the table for the next stage of trade negotiations with Donald Trump, because an additional £1.5 billion would cost both the NHS and our community pharmacies dear. What steps is the Department taking to ensure that the NHS, and the vital medicine supply on which we rely, will not be used as a bargaining chip in a trade deal with a highly unreliable US President?

[Karin Smyth]

The hon. Lady has asked an important question about the pharmaceutical industry, which is key to the country’s growth mission and to supporting all our constituents and the entire country. As we know, my right hon. Friend the Prime Minister is currently attending the G7 summit. We have good relationships with America, and the Department is working closely across Government to ensure that the same stability of supply remains for our constituents.

[Naushabah Khan (Gillingham and Rainham) (Lab)]

4. Whether he has made an assessment of the potential merits of expanding the additional roles reimbursement scheme to include GPs.

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[Olivia Blake (Sheffield Hallam) (Lab)]

11. Whether his Department has made an assessment of the effectiveness of the ban on the use of sunbeds by under-18s.

[The Minister for Secondary Care (Karin Smyth)]

The Sunbeds (Regulation) Act 2010 banned the use of commercial sunbeds for under-18s, requiring businesses to prevent under-age use. The Department has commissioned the Committee on Medical Aspects of Radiation in the Environment to review the Act, including the effectiveness of the under-18 ban.

[Olivia Blake]

According to Cancer Research UK, 86% of melanoma skin cancer cases are preventable. My constituent Charlotte, who has stage 4 melanoma, is leading a campaign alongside Melanoma Focus to get better enforcement for the ban on sunbeds for under-18s and to stop the use of harmful melanotan II products such as tanning nasal sprays and injections. For under-35s, just one session on the sunbed is enough UV exposure to increase the risk of melanoma to 59%. Prevention is better than cure. Will the Minister meet us to discuss the effectiveness of the ban and preventive measures such as access to free sunscreen at events?

[Karin Smyth]

As someone who was diagnosed myself with an earlier stage melanoma, I really commend the work of my hon. Friend’s constituent. I never used sunbeds and I spent holidays in my youth in Ireland, so I never saw much sun either—sorry to the Irish tourism board. As my hon. Friend says, it is an overwhelmingly preventable cancer, including by using sunscreen, better clothing, shading and no sunbeds. It is up to event organisers to provide sunscreen at events, but my hon. Friend is right. I want to personally thank Melanoma Focus for the support it gave me during my diagnosis. There are great charities out there to support people. I am sure a Minister will be in contact with my hon. Friend and her constituent soon to highlight the prevention aspects of this disease.

[Cameron Thomas (Tewkesbury) (LD)]

Until his recent death, my constituent Luke Webster had lived with alternating hemiplegia of childhood. His life was short and he spent much of it being moved between different care facilities, to the frustration of his family. At one such facility, Luke was abused. Will the Minister meet me and Luke’s mother to discuss improved safeguards—

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[Mike Martin (Tunbridge Wells) (LD)]

12. What steps he is taking to reduce waiting times for biopsy results.

[The Minister for Secondary Care (Karin Smyth)]

More patients are now getting world-leading testing technology in the NHS as part of our mission to revolutionise cancer care in this country. The Government are spending £600 million a year in capital on diagnostics, including for the first time funding for the automation of histopathology laboratories to improve productivity. We are also funding pathology networks to reach digital maturity by 2026, which will reduce unnecessary waits and repeated tests.

[Mike Martin]

My constituent Julian noticed that he had a mole on his chest that was growing and bleeding. Members of his family had died from skin cancer, so he was very concerned and went to his GP. He was referred to the Kent integrated dermatology service and was told that the results would come back in four weeks. They came back in 17 weeks. I know that this issue is of personal concern to the Minister, so would she please investigate what happened and write to me?

[Karin Smyth]

The hon. Member raises an awful case on behalf of his constituent. Of course, our targeting of waiting lists includes diagnostics. What happened in that case should not happen anywhere, and I will ensure that he gets a response as soon as possible.

[Mr Bayo Alaba (Southend East and Rochford) (Lab)]

13. What steps his Department is taking to reduce the time taken for cancer diagnoses.

[Paulette Hamilton (Birmingham Erdington) (Lab)]

20. What steps his Department is taking to reduce the time taken for cancer diagnoses.

[The Minister for Secondary Care (Karin Smyth)]

Reducing waiting times for cancer diagnosis remains a key priority. Under this Government, an extra 99,000 patients have had cancer diagnosed or ruled out. This has been supported by investment, including in Cancer 360—a digital innovation that brings patient data into one central platform—and in NHS England’s cancer innovation open call to fast-track cutting-edge interventions into practice. Our forthcoming national cancer plan will set out how we will speed up cancer diagnosis even further.

[Mr Alaba]

Our Labour Government have recently invested in a new state-of-the-art linear accelerator machine in Southend hospital. The machine is the first of its type in the country and will drastically improve cancer treatments. Please can the Minister outline how record levels of investment, such as in the LINAC machine and as announced at the spending review, will finally mean that the NHS will be there when we need it?

[Karin Smyth]

I am delighted that my hon. Friend’s constituents will benefit from the £70 million investment. These machines are game changing and will reduce the number of visits for his constituents. They are also more reliable, which gives more capacity to the system. That is better for staff, as there will be less appointment cancellations. That is exactly the sort of thing we want to see more of, and we are delivering that under this Government. It is the result of our drive to reduce long waits and treat more people quicker. That was reinforced in last week’s spending review, and it is exactly what his constituents deserve.

[Paulette Hamilton]

Early diagnosis of less survivable cancers is vital if survival rates are to improve. What assessment has the Department made of the report by the all-party parliamentary group on less survivable cancers that looks at earlier detection and faster diagnosis, and what steps are the Department taking to deliver on this?

[Karin Smyth]

My hon. Friend is right to highlight that issue. I commend her great work not just on the APPG but on leading the Health and Social Care Committee on behalf of its Chair, the hon. Member for Oxford West and Abingdon (Layla Moran). She is right to highlight that it is a priority for the Government to diagnose cancers earlier and improve survival rates. That is particularly important for the group of people with rare cancers. The APPG’s report will inform the development of our national cancer plan, which will seek to include all aspects of care throughout the entirety of the cancer pathway.

[Alison Bennett (Mid Sussex) (LD)]

Part of a successful cancer journey is swift cancer treatment as well as swift diagnosis. My constituent Catherine was diagnosed last year with stage 3 breast cancer. She had a mastectomy and went through chemotherapy. She was then meant to begin a course of radiotherapy in December, but as of May that still had not begun. What can the Department do to ensure that those unacceptable delays do not happen and lives can be saved?

[Karin Smyth]

Many hon. Members across the House rightly highlight the actual experience of people throughout the entire pathway. We have heard about the investment we are making in machines and in staff to ensure, on exactly this point, that people get not just that faster diagnosis—that is so important, particularly if cancer is ruled out—but faster care across the entire pathway. The majority of people on waiting lists are on them for diagnostics, which is exactly why we are investing more in capital and investing in staff to ensure that the process is quicker and better for patients. If the hon. Member wants to write to me about any particular issues, I will obviously respond to her.

[Tom Gordon (Harrogate and Knaresborough) (LD)]

Every 17 minutes, someone in Yorkshire is told that they have cancer. Tomorrow, I will be launching a report for Yorkshire Cancer Research, which is based in my constituency, that will set out key recommendations. Will the Minister meet us to talk about how we can feed them into the national cancer plan?

[Karin Smyth]

The work that the hon. Member is doing locally with that group is essential. I will ensure that we have a good response for him, whether it is meeting me or a colleague.

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[Daniel Francis (Bexleyheath and Crayford) (Lab)]

T5. It is 16 months since the publication of the Hughes report, but those patients harmed by sodium valproate continue to await the outcome on the redress that the Government will provide. Will the Secretary of State please provide an update on when they can expect an announcement on the redress that will be made available to them?

[The Minister for Secondary Care (Karin Smyth)]

I thank my hon. Friend for that important question. The Government are carefully considering the work of the patient safety commissioner and her report, which sets out the options for redress. This is a complex issue involving input from different Government Departments. We will provide a further update on the commissioner’s report soon.

[Graham Leadbitter (Moray West, Nairn and Strathspey) (SNP)]

My constituency, in Scotland, has a significant shortage of health and social care workers, despite extensive efforts to advertise recruitment to get people in, as replicated in parts of England, Wales and Northern Ireland. The rug has been pulled out from under that by the changes to immigration policy and visas for that sector. Will the Secretary of State commit to pushing this harder in Cabinet to ensure that we can have more geographic and sectoral visas?

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[Peter Lamb (Crawley) (Lab)]

T7. What steps is the Secretary of State taking to enable access to non-hormonal, non-steroidal oral contraceptives?

[Karin Smyth]

Such contraceptives are an emerging technology that will be subject to clinical and other relevant assessment before being considered for use in England. The Government remain committed to ensuring that women can access their preferred method in a timely manner. A range of contraception is available free of charge from a range of settings. That includes a copper coil, which is a non-hormonal, non-steroidal contraceptive device.

[Sarah Bool (South Northamptonshire) (Con)]

In Prime Minister’s questions last week, I raised the need for a universal national screening programme for type 1 diabetes. Will the Secretary of State agree to meet me to discuss this, so that it could form part of the 10-year plan, given that it fits so neatly into prevention of issues such as diabetic ketoacidosis over treatment?

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[Alice Macdonald (Norwich North) (Lab/Co-op)]

Infertility is a medical condition that affects one in six couples in the UK, but access to NHS treatment is a postcode lottery, with less than 10% of ICBs in England offering the recommended three cycles of IVF. Does the Minister agree that we need to end that postcode lottery, and will she meet me and campaigners such as Fertility Action to discuss how we can end it for good?

[Karin Smyth]

In the light of the broader pressures and changes in the NHS, we have been considering the ambitions on fertility services and fairness for all couples. The National Institute for Health and Care Excellence is reviewing its fertility guidelines, which will be the clinical standard for the future. I know that my hon. Friend will ensure that she and the group she talks about keep an eye on that, and that she will work with them. I am happy to keep working with her on how we best support ICBs to improve their local offer.

[Mr Joshua Reynolds (Maidenhead) (LD)]

I have raised with Ministers before my concerns about the closure of St Mark’s walk-in urgent care centre in Maidenhead. Frimley ICB has confirmed yet again that it will not reopen the centre, against the will of the majority of Maidenhead residents. Will the Secretary of State meet me and local campaigners to see how we can finally get St Mark’s walk-in centre back open after five years of closure?

[Will Stone (Swindon North) (Lab)]

Will the Minister look into minimising the pain of patients going through hysteroscopy and biopsy procedures by requesting that medical professionals fully brief them on anaesthetics and pain relief in advance of procedures to ensure that they can plan accordingly?

[Karin Smyth]

My hon. Friend raises an important question. We are committed to improving women’s experience of gynaecological procedures, including hysteroscopies. Women should be provided with information prior to their procedure so that they can make an informed decision about the procedure and pain relief options, including local or general anaesthetic. He will probably make further representations, which we will certainly look at.

[Lincoln Jopp (Spelthorne) (Con)]

One of the ways in which the Secretary of State has reduced the waiting list is by turbocharging the use of the private sector since January, meaning that half a million people have been treated in irreducible spare capacity. Has that experience elicited any learnings that the Secretary of State is able to take into the wider reform agenda for the NHS?