National Cancer Plan

Lewis Atkinson Excerpts

Thursday 5th February 2026 Commons Chamber

[Ashley Dalton]

As I have set out, we have already invested £70 million in the new LINAC machines, and we are using AI to support oncologists to use those machines more effectively. Through the spending review, we are providing £15 billion in operational capital for local priorities. It is down to local ICBs and local trusts to identify what they need and what they want to purchase in their areas, but we are providing the support and guidance to help them do that.

[Lewis Atkinson (Sunderland Central) (Lab)]

I wish to thank NHS cancer teams in Sunderland for doing such incredible work in my constituency. Other Members have mentioned the unacceptable variation in NHS performance against waiting times, and I commend the Minister’s focus on that. Can she say a little about the variation in waiting times by tumour site? In November last year, 82% of skin cancers were tret within 62 days, but for gynaecological cancers, the figure was only 58%.

[Ashley Dalton]

This is a key issue. Some cancers are an awful lot easier to get at, and so they are a lot easier to diagnose sooner. We are looking at how we can roll out screening wherever appropriate and increase access to tests such as liquid biopsies, which I talked about in the statement, so that people can get their diagnoses sooner.

Medical Training (Prioritisation) Bill

Lewis Atkinson Excerpts

2nd reading
Tuesday 27th January 2026 Commons Chamber

[Lewis Atkinson (Sunderland Central) (Lab)]

I welcome the Government bringing forward this legislation, and not just in response to the significant concerns that doctors currently have about access to training places, but as an important part of a reset, with a longer-term approach, to ensure that we have an NHS workforce that is fit for the future.

I am going to go off script and respond to some comments that the shadow Secretary of State, the right hon. Member for Daventry (Stuart Andrew), made. He rightly pointed out that the Bill is about prioritisation, not immediate capacity. However, in week one or two of NHS manager school, one of the core techniques that is taught is about capacity and demand modelling. A fundamental assumption about the capacity of our workforce going forward is retention—how long they will work over the course of their careers. The GMC is absolutely clear that an international medical graduate will, on average, work for a shorter period of time in the UK than a UK medical graduate—they are more likely to leave.

I suggest that it is entirely sensible that the Government are bringing in the legislation now, in advance of their NHS workforce planning, because the Bill fixes a core assumption of that plan. To give an example, I have managed cancer waiting lists and, knowing that I have a list of patients I am responsible for, feared that the lower gastrointestinal oncologist who is getting on will announce their retirement without a clear succession plan, as lower GI oncologists are in short supply. This Bill is not just the right thing to do but provides the absolute clarity around medical capacity that will allow the Government to do the proper demand work that is necessary to build the NHS of the future.

Turning to the immediate situation, I have heard the views clearly expressed by medical graduates in Sunderland and across the country about the bottlenecks they face when trying to secure foundation and specialty training places. Many are left in prolonged periods of uncertainty, unable to progress despite years of study.

When we talk about trainees, we risk giving the impression that the contribution made by these talented young people will all be in the future, but of course, in reality, people in training positions provide a huge contribution of direct service to the NHS today, forming the core of the medical workforce in hospitals up and down the country. When I was an NHS operational manager, I had to get to know the new rotation of core, foundation and specialty training doctors every time as they rotated around. Meeting those inspiring and motivated young people was not just a lovely thing to do but a hugely important one, as the day-to-day care of the patients in the specialties I was responsible for was largely provided by the people on those training courses.

That experience also highlighted to me how, over a decade under the previous Government, there was a total failure to put in place a proper care framework for those foundation and specialty doctors, which left UK-trained doctors competing in increasingly crowded pools. We have heard some of the numbers already from the Secretary of State: in 2025, there were more than 30,000 doctors competing for just 9,500 training posts. That is not a system that shows proper regard for the commitment of medical graduates or for their wellbeing, let alone a system that is designed to meet the future needs of the country or the NHS. We invest hundreds of thousands of pounds training each medical student, but too often we fail to retain them. That represents a loss not only of talent, but of public investment.

However, I think it is important, as others have done, to put on the record our recognition of the enormous benefit brought by medical professionals who have chosen to come to the United Kingdom and dedicate their careers to the NHS. I know that will continue even after this legislation is passed. As I always say, healthcare is a team sport, and in my experience, when a team is working together under significant operational pressure, the commitment of everyone in going the extra mile, no matter which country they trained in and what nationality they are, is always exemplary. That is the case throughout the NHS that I know.

The contribution of international medical and wider clinical staff to our NHS is invaluable, and it must never be diminished or forgotten. I know that will continue. It is important, therefore, that the discussion of the Bill is not interpreted as a slight on their contribution or commitment.

In aggregate, as I have said, the GMC has been clear that while international graduates are essential to the functioning of our health services, they are statistically more likely to leave the UK workforce within six years of joining compared with those who train here. That reality makes clear the risk of overreliance on a system that is unpredictable and, ultimately, unsustainable. This Bill is about balance, not exclusion; it is about ensuring that the significant public investment we are making in training doctors in this country translates into a stable and sustainable workforce for the years ahead.

[Jim Shannon (Strangford) (DUP)]

As others will know, I have raised this matter a number of times in the Chamber. In Wales, for example, the health service pays students’ fees and trains them, and students then have an obligation to stay with the Welsh health service for a period of time. One of my constituents, whom I know well, did just that. She went there, received training and stayed there. What happened, of course, is that she met someone in Wales who she fell in love with, and now she wants to stay there, so we will lose her in Northern Ireland. The point I want to make is this: if paying the fees retains the staff in Wales, should we not also do that in Northern Ireland, Scotland and England? We could do so in this Bill.

[Lewis Atkinson]

There is some merit in the hon. Gentleman’s proposal, not just for medical training but across the clinical workforce. As Members have acknowledged, we pay significant sums of public money training clinical staff, but the graduates incur significant student debt. If a UK-trained undergraduate student decides to work abroad, the UK taxpayer will have invested a significant amount in their training, and that is then lost. It strikes me that there is an opportunity for the Government to think about the sort of incentive that the hon. Gentleman describes as part of wider workforce planning.

That is pertinent to my next point about the importance of the medical workforce reflecting our wider society, particularly the working class communities of the north-east of England. I want to ensure that a young person doing well at a state school in Sunderland has as much encouragement and access as anyone else in the country to study medicine and, crucially, progress through the ranks to the highest grades. We have heard some talk of international medical schools, but I can absolutely assure Members that there are not state school-educated kids in Sunderland thinking that they will pay privately to study in Grenada or anywhere else.

As the Secretary of State rightly pointed out, there have been welcome improvements on diversity in the NHS, but we often fail to consider socioeconomic background in that. The first line of the NHS constitution states:

“The NHS belongs to the people.”

But sometimes it can feel like it is staffed by a pretty unrepresentative slice of the people, particularly in medical roles.

In that spirit, I recognise the excellent work of the University of Sunderland medical school, which has placed widening access at the heart of its mission. Building on a 100-year history of wider clinical training, the school opened in 2019, shortly before the covid-19 pandemic—a period that starkly exposed our over-reliance on overseas recruitment and underlined the importance of growing our own workforce. By 2022, 47% of the University of Sunderland’s intake were local students, and it now ranks sixth in the UK for student satisfaction.

However, it is no good universities like Sunderland in my constituency doing excellent work on widening participation at recruitment stage if when we get to foundation training and specialty training those students are disadvantaged in competition. In my view, the Bill will help to ensure that talent nurtured by institutions like the University of Sunderland is retained and prioritised for the benefit of our NHS.

I highlight that medical schools such as Sunderland are increasingly placing a huge emphasis on training their medical students in a multidisciplinary environment alongside the trainee nurses and trainee pharmacists of the day, so that they are prepared to work in the multidisciplinary environment that our NHS rightly demands. I am not sure that all international undergraduate courses are always so advanced, so it is right to prioritise this UK-based training approach for the multidisciplinary ethos of the NHS in the future.

Other Members have mentioned the wide variation in specialist training fill rates, and GP recruitment has been mentioned as part of that. It is also worth saying that the national statistics about specialty training mask significant regional variations. The GP specialty training fill rate has been as low as 62% in the north-east of England, and as we have heard, over 73% of applicants for GP specialty training in 2023 were international. That has a disproportionate effect in regions like mine. My constituents want to have the confidence that there will be a stable GP workforce as part of our community for the long term. I cannot tell them in all candour that the status quo delivers that, so we must make changes of the type that the Bill sets out.

I hope that by introducing effective, regulated training pathways, the Bill will improve retention and strengthen workforce planning in our communities, including in areas such as women’s health, where training provision has not kept pace with rising demand. When I look at the shape of the NHS elective waiting list, it is no coincidence that some of the trickiest waiting time problems are in specialties such as gynae, where we have had recruitment and training challenges in recent years.

To close my remarks, I re-emphasise the link between capacity and demand, which I hope the Minister will touch on in advance of the workforce plan. Will she also say a little about the medical training review and the phase 1 report for NHS England and how the Government will work with that?

Resident Doctors: Industrial Action

Lewis Atkinson Excerpts

Wednesday 10th December 2025 Commons Chamber

[Wes Streeting]

My hon. Friend is absolutely right. It also costs us roughly a quarter of a million pounds each time the BMA does this, and we cannot afford to keep paying that. It may say, “Well, then just do a deal with us and you will not have to fork out,” but then why would the rest of the NHS workforce, or the entire public sector or the entire economy, not go on strike? That is not constructive, and it is not going to get the NHS or Britain out of the enormous hole it was left in by the Conservatives. We are making real progress together, and I thank resident doctors for that. We will make more if we work together.

[Lewis Atkinson (Sunderland Central) (Lab)]

The coming weeks are always the most dangerous time of year for the NHS, and it is important to note that the patient safety risks arising from the strike will be present not just during the strike period but in the weeks following it. Some of my most daunting, and indeed scary, times in the NHS involved working alongside resident doctors, nurses and others in the early hours of the morning in January and late December to try to ensure that ambulances could still be offloaded under the most difficult circumstances. In that spirit of one team working for patient safety, I urge the resident doctors to accept the offer that the Secretary of State has set out. Will he confirm that NHS England and local NHS leaders will have his full support in taking the difficult decisions that they need to take to keep patient flow going and emergency care going during this period if strikes do take place?

[Wes Streeting]

I thank my hon. Friend for what he says and for the experience he brings to bear. I hope his urging is heeded by the BMA. I can give him that assurance. I think its operational leaders will face some fiendish choices in the coming days and weeks if strike action goes ahead. They will have my full backing. Myself, the Minister for Health and the Minister for Care are working closely with both the NHS and the social care sector, but this will be extremely challenging, and that is why I urge the BMA to adopt that “one team, one NHS” approach that he urges them to adopt.

Mental Health Bill [Lords]

Lewis Atkinson Excerpts

Report stage
Tuesday 14th October 2025 Commons Chamber

[Zöe Franklin]

I am honoured to open today’s debate on Report and to have served in Committee, where it was clear that Members on both sides of the House shared a commitment to high-quality mental health care for those in crisis. I thank my colleagues who also served in Committee; it was an informative and moving discussion. It is that commitment to high-quality mental health care that underpins new clause 2. It addresses a critical issue: the inconsistency and inadequacy of care in mental health units across England.

I am sure we have all heard distressing accounts of vulnerable individuals being placed in units that are understaffed, unsafe and ill equipped for recovery. Families entrust the system with their loved ones during moments of crisis, only to find that trust undermined—not by a lack of compassion, but by a lack of national direction. New clause 2 seeks to change that by establishing a national strategy and annual reporting to ensure that every mental health unit is safe, well-staffed and fit for purpose.

In my Guildford constituency, a family recently shared with me their experience of a loved one’s stay in a mental health facility. The unit was understaffed from the outset and wards were mixed in age and illness, with little therapeutic structure. There was no clear advocate or caseworker, and the family did not know whom to contact. They described a system that, in their words,

“dishes out drugs without improving mental health or wellbeing.”

The setting was so short-staffed that their loved one was able to self-harm—an unacceptable failure in any care setting. New clause 2 aims to prevent such failures from recurring.

The Care Quality Commission has repeatedly raised concerns about the safety of mental health wards, citing staff shortages, poor infrastructure and environments that are unfit for therapeutic care. In 2023, the King’s Fund reported that 40% of NHS mental health providers were rated “requires improvement” or “inadequate” on safety—figures that would be intolerable elsewhere in the health system. The Health Services Safety Investigations Body has identified systematic risks in in-patient mental health care, including delayed responses to distress, inappropriate use of restraint and a lack of therapeutic staffing models. Perhaps most starkly, the British Medical Journal reported over 17,000 serious incidents in mental health services between April 2022 and March 2023. Each one was a moment when care went seriously wrong. These are not just statistics; they represent real people who deserve better.

New clause 2 would require the Secretary of State to publish a national strategy within 12 months to ensure that all mental health units meet or exceed “good” safety standards under the CQC framework, and to report annually to Parliament. It focuses on three key areas: recruitment, retention and training of staff; safe staffing levels and patient-to-staff ratios, especially during nights and peak times; and ongoing accountability through public reporting. The new clause would make patient safety a national obligation, not a postcode lottery. It is about responsibility and transparency.

Although the Bill modernises detention criteria and patients’ rights, it does not explicitly require the Secretary of State to guarantee basic safety and staffing standards, and new clause 2 would fill that gap. Some may worry that it would be too prescriptive or add bureaucracy, but it would not replace local management; it would support it. It would build on the CQC’s role by ensuring that action is taken when failings persist, and it would turn inspection findings into a driver of national improvement.

On cost, unsafe care is already expensive. It leads to readmissions, litigation, staff burnout and the loss of public trust. A national strategy would allow for smarter investment, preventing failures rather than paying for them later. We have had decades of guidance and reviews, but what we have not had is statutory accountability. My new clause would deliver that.

New clause 2 is focused, deliverable and urgently needed. It complements the Bill by ensuring that the rights it enshrines are backed by safe, well-staffed and properly regulated environments. Without it, we risk legislating for rights in theory while leaving patients unsafe in practice. By supporting it, we affirm that mental health care deserves the same national standards as any other branch of healthcare. I urge Members to support new clause 2 and make safety, dignity and accountability a permanent part of our mental health law, and I look forward to the debate in this House today.

[Lewis Atkinson (Sunderland Central) (Lab)]

Many Sunderland families, including mine, share stories of Cherry Knowle, the Sunderland borough asylum in my constituency, which opened in 1895. Severe mental illness has always been a feature of society. Thankfully, the legislative framework and services have developed somewhat since 1895, but arguably they have not developed fast enough, particularly over the 42 years since the Mental Health Act 1983 was passed. At the start of my NHS career, I spent time shadowing staff on the wards of the then Cherry Knowle, which in 2014 was replaced by a much better facility in Hopewood Park in Ryhope in my constituency. To this day, 2,825 adults are detained under the Mental Health Act in Sunderland Central as a result of that facility.

--- Later in debate ---

[Sojan Joseph (Ashford) (Lab)]

Similarly, a community service called Mental Health Together has been introduced in my area. Does my hon. Friend agree that the whole mental health system is so complex, with different practices in different parts of the country, and that not having continuity and a standard across the country is a big issue for mental health?

[Lewis Atkinson]

My hon. Friend is absolutely right and I thank him for his intervention. Part of the issue around poorly reported waiting times is that it is less easy to see that differential access than it would perhaps be in physical health services. Indeed, over the years when specialist teams have been set up—for example the early intervention and psychosis teams and assertive outreach teams, which I know my hon. Friend knows well given his professional background—they have been introduced with very good intentions and to target specific needs, but they sometimes make it more difficult for patients to get overall care rather than very specialist care for individual conditions.

I will not take any more time, Madam Deputy Speaker, but I will just say that the mantra of investment and reform applies to mental health services, as it should apply to all our health services. For us to make further progress in pursuing parity of esteem between mental health and physical health, we not only need to consider these amendments today and pass the Bill to modernise the legislation, but ensure the Government have sufficient political priority on producing and improving mental health services.

[Several hon. Members rose—]

Oral Answers to Questions

Lewis Atkinson Excerpts

Tuesday 22nd July 2025 Commons Chamber

[Wes Streeting]

Once again, the House is speaking with one voice, and I hope that the BMA understands the strength of feeling on both sides of the House about the unnecessary and irresponsible nature of the proposed strike action this week. Discussions in recent days have been constructive, and I hope that gives grounds for the postponement of strike action so that we can work together to avert it—not just this week, but altogether.

[Lewis Atkinson (Sunderland Central) (Lab)]

T1. If he will make a statement on his departmental responsibilities.

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

Under this Government, waiting lists have fallen by more than a quarter of a million in our first year, but strike action puts that hard-won progress at risk. If strikes do go ahead, we will do everything we can to minimise the disruption to patients, who will bear the brunt of cancellations. We continue to work with the BMA resident doctors committee in the hope that its members will do the right thing and call off the strikes. None the less, if they go ahead, we stand ready, responsive and resolute.

[Lewis Atkinson]

There were 5,448 drug-related deaths in 2023—the highest figure ever—and an 84% increase from the number that led the previous Government to publish their drugs strategy, which was supposed to save lives. Does the Secretary of State agree that the existing drugs strategy is not fit for purpose, and will he urgently start work on replacing it with a public health-led drugs strategy to tackle this public health emergency?

[Wes Streeting]

I am extremely grateful to my hon. Friend for his question. The number of drug-related deaths remains far too high, and we are committed to saving lives through access to high-quality treatment. For 2025-26, my Department is providing £310 million in addition to the public health grant to deliver the recommendations from Dame Carol Black’s independent review, but there is much more to do. We look forward to working with my hon. Friend to achieve success.

Resident Doctors: Industrial Action

Lewis Atkinson Excerpts

Thursday 10th July 2025 Commons Chamber

[Wes Streeting]

I thank the right hon. Gentleman for his question. He is that rare beast: a Tory trade unionist. He raises the serious point of the consequences of strike action. I will, of course, keep the House updated, but I want to reassure the House that we are taking every step possible to mitigate the disruption that these strikes will cause. That will come at a financial cost and a cost to patients because of the disruption that will follow. It will also come at a cost to other staff, many of whom are paid less than resident doctors, who will be left at work with more pressure and in harder conditions, picking up the pieces because of the actions of their colleagues who were given a higher pay rise, but who will be stood outside protesting the 28.9% pay rise that they received.

I assure the House that we will do everything we can to mitigate the impact of the strikes on patients and the disruption that will follow. What I cannot say to the House, however, is that we can offset or cancel the impact or detriment felt by patients. We will look carefully at the data on the experience and impact of the strikes that occurred during the previous round of negotiations. I will ensure that that information is published so that the House can see the impact of the previous strikes, so that we can brace ourselves for what may lie ahead.

[Lewis Atkinson (Sunderland Central) (Lab)]

Anyone who has ever worked in healthcare knows that it is a team sport and that delivering excellent care requires a range of staff across the allied health professions including nurses, doctors, administrative staff and estate staff. Does the Secretary of State agree that it is therefore essential that all NHS staff groups have confidence that their pay is being set fairly, and that going beyond the independent pay review body’s recommendations for one set of staff would undermine the “one NHS” team ethos that so many have worked to build?

NHS 10-Year Plan

Lewis Atkinson Excerpts

Thursday 3rd July 2025 Commons Chamber

[Wes Streeting]

Absolutely, and the people of Watford can see the difference a Labour Government can make, thanks to their sending a Labour MP to the House. They saw what happened when they sent a Tory, and they cannot send a Liberal Democrat to this place and trust them to deliver. They need a Labour Government to deliver Labour change. I am delighted that my hon. Friend is here, and we are making a real difference together. Thanks to the engagement events he held with his constituents in Watford, their ideas are reflected in this plan. That is thanks to their hard work and his advocacy.

[Lewis Atkinson (Sunderland Central) (Lab)]

It falls on each Labour Government to reform and renew the NHS in the service of patients, and that includes mental health patients; from my consultations, I know that they are a key priority for the people of Sunderland Central. I welcome the plan’s emphasis on empowering patients by providing them with information and choice through the NHS app, including on waiting times, but the Secretary of State will know that information about mental health waiting times is often poor, as are the waiting times themselves. In the 10-year plan, will he commit to making sure that empowerment applies equally to people seeking mental health services and those seeking physical health services?

[Wes Streeting]

My hon. Friend is absolutely right. We in this place are so lucky to have his expertise and his leadership of the Back-Bench health and social care committee of the parliamentary Labour party. Sunlight is the best disinfectant, and I am concerned that we do not give enough profile to paediatric waits and mental health waits. With more transparency, information and access, we will be able to demonstrate improvements over the course of this Parliament and the next decade.

Department of Health and Social Care

Lewis Atkinson Excerpts

Tuesday 24th June 2025 Commons Chamber

[Lewis Atkinson (Sunderland Central) (Lab)]

I welcome the estimates and the CSR settlement from the Government —a record settlement for the Department of Health and Social Care and the NHS. Given the time constraints, I will focus on three key points: financial management, underlying demand and the prioritisation of spend in the estimates.

We rightly focus on the headline settlements in estimates such as these, but what we do not talk about enough is the importance of good public administration in the Department. In the 19 years that I spent in the NHS before coming to this place, I saw how the previous Government had a sticking-plaster approach not just to politics, but to public administration. Budgets were confirmed at the last minute and planning guidance was outlined at the very last moment of the financial year, meaning that there was no opportunity for NHS leaders and health leaders to plan appropriately for resource spending. I particularly welcome the emphasis the Secretary of State for Health and the new chief executive of NHS England have put on restoring accountability through the foundation trust model and multi-year settlements that mean that, although I am sure NHS colleagues would like more, they at least know and can plan investment and spend-to-save decisions over that period.

Secondly, Members have queried why the NHS seemingly continues to require increases. I draw the House’s attention to the Nuffield Trust’s work showing that this is about not health inflation but underlying health demand. The Nuffield Trust estimates that, as a result of population changes—mainly the ageing of the population—there is a 1.1% increase in demand every year. In addition, advances in technology add a further 1.8% increase in healthcare demand, so there is already a 2.9% increase in underlying demand before inflation, which highlights that the Government’s emphasis on reform accompanying investment is critical.

Finally, to deliver that reform, the investment going in must be very carefully targeted. The evidence base is clear that investment in primary care—and we are fortunate in this country to have a world-leading gatekeeper system of healthcare through general practice—represents the best return on investment in health. Work done by Michael Wood and the NHS Confederation confirms that. Alongside investment in mental health services and wider public health, this creates the best chance for the health system to live within these estimates and to meet our constituents’ expectations.

NHS Pensions

Lewis Atkinson Excerpts

Tuesday 1st April 2025 Commons Chamber

[Karin Smyth]

I understand that point. Obviously, it is a source of much discussion. The change came about during the pandemic to encourage people to return to work, and it is a complex issue. We want to continue to use the skills of doctors at all stages of their careers, and we shall continue to work with them, the British Medical Association and others to make sure that there is no detriment to their returning to service in the NHS.

[Lewis Atkinson (Sunderland Central) (Lab)]

I declare an interest as a member of the NHS pension scheme. Can the Minister confirm that this issue arose only because the previous Government carried out their NHS pension reforms in a way that was found to be age discriminatory? More widely, does she agree that giving NHS staff the terms and conditions and the reward and recognition that they deserve also requires prompt action each year on agreeing the NHS pay award, which the Conservative party routinely failed to do when in Government?

[Karin Smyth]

My hon. Friend makes an excellent point on our commitment to staff to be clear on their terms and conditions, and our commitment to honouring that reward. That is why we acted promptly when we came into office. We have issued statements and provided answers to parliamentary questions to make sure that people are clear about the system and that we are transparent.

Prevention of Drug Deaths

Lewis Atkinson Excerpts

Thursday 27th March 2025 Westminster Hall

[Lewis Atkinson (Sunderland Central) (Lab)]

It is a pleasure to serve under you, Dr Murrison. I pay tribute to the hon. Member for Strangford (Jim Shannon) for securing this debate.

As colleagues have said, 5,448 drug-related deaths in England and Wales is truly a public health crisis, and we need a response that meets the urgency of that crisis. When the last Labour Government came into power, we were approaching 2,000 drug-related deaths a year, and that was considered serious enough at the time to implement a new national drug strategy, with funding, and to set up a national treatment agency to provide evidence-based treatment. That was at almost 2,000 deaths a year.

The effect of that intervention was that drug-related deaths, which had been inexorably rising for a decade or more, levelled out and stopped rising. Thousands of lives were saved and improved. I know a little bit about that, because it was the privilege of my NHS career to manage NHS drug treatment services in the north-east of England for three years when that strategy and system were in place. A harm-reduction approach was key to treatment, as other colleagues have said.

Drug deaths are horrific, and so are the wider harms, including the impact on crime. The amount of acquisitive crime in this country that is driven by addiction is really significant. The Government are focused rightly on tackling crime as well as wider health themes. This is an intervention that meets a lot of the Government’s missions. The harms around children are also significant. Many children are taken into care as a result of parental drug use. A prevention approach would reduce costs for the state by ensuring appropriate drug treatment.

Treatment, particularly for opiate use, must focus on substitution therapies. It was disappointing that in the last decade ideology against opiate-substitution treatment trumped the evidence base for it. There are people who could still be alive today if it were not for that ideology. The scale of the treatment gap is significant. In Sunderland, in my constituency, adult mortality from drug causes is about twice the average in England, but around 60% of opiate and crack users are not in treatment today. That must change, and I look forward to hearing the Minister’s response on that.

Under the last Labour Government, the policy and health landscape was rather different. As well as the policy urgency, there were clear national levers to pull, with a primary one being the National Treatment Agency for Substance Misuse. Since then, we have moved to a more diffuse system that is not at the centre of Government but commissioned by each council individually through the public health grant. The provider landscape has fragmented. Whereas NHS treatment services used to be the norm, now there is a significant pattern of commissioning—in some cases there is competitive tendering every few years. That has not helped to tackle this issue with the urgency it needs.

I look forward to hearing from the Minister. I do not think legislation is required to improve treatment. This issue requires clear political will and focus, and I hope we will hear a lot more of that from the Government today and in the coming months.