Spinal Muscular Atrophy: Newborn Screening Test

Lewis Atkinson Excerpts

Monday 22nd June 2026 Westminster Hall

[Lewis Atkinson (Sunderland Central) (Lab)]

I beg to move,

That this House has considered e-petition 755980 relating to spinal muscular atrophy and the newborn screening test.

It is a pleasure to serve with you in the Chair, Mr Mundell, and a privilege to open the debate as a member of the Petitions Committee. I want to begin with two little girls. In May last year, twin daughters were born prematurely to the petitioner, Jesy Nelson, who is a constituent of the hon. Member for Broxbourne (Lewis Cocking). Several months later, they were diagnosed with spinal muscular atrophy type 1, which is the most severe form. Their mother was told that they would, in her words, “probably never walk”.

In January of this year, Jesy chose to share that diagnosis publicly, saying that it would be

“selfish to keep this to myself and not potentially save a child’s life.”

This petition is the result, and I pay tribute to her for the way that she has courageously told her story, using her own unique reach. As a result, the petition was signed by 149,692 people, including 225 of my constituents in Sunderland Central. I was grateful to meet Jesy earlier in Westminster Hall, and I thank her and every family who has turned the hardest experience imaginable into a campaign for other people’s children.

In preparing for this debate, I also met Giles Lomax of SMA UK, Muscular Dystrophy UK, and Professor Francesco Muntoni of the Neuromuscular Centre at Great Ormond Street. I thank all of them for their time, and I also thank the Petitions Committee staff for their help as I prepared for this debate.

SMA is a rare genetic condition that attacks the motor neurones, causing progressive muscle weakness. Around 1,500 people in the UK live with it and about 48 babies are born with it each year—roughly one a week. With type 1 SMA, symptoms appear within the first six months and the effects are profound. Children cannot hold up their heads or sit unsupported; they may be tube-fed and need help to breathe. Until recently, up to 90% of untreated babies either died before the age of two or required permanent ventilation.

I used the past tense there deliberately and happily, because the important fact in this debate is that SMA is no longer untreatable. There are now three disease-modifying therapies in this country, including a one-time gene therapy that did not exist a decade ago. They are approved by the National Institute for Health and Care Excellence, and funded by the NHS. A condition that was too often a death sentence for babies is now one that we can treat.

[Jim Shannon (Strangford) (DUP)]

I commend the hon. Gentleman for, as he often does, leading this debate on a petition that has generated a lot of interest. I understand that the one of the life-altering gene therapies for SMA, Zolgensma—I hope that I have pronounced it correctly—is available on the NHS, but such gene therapies only work if they are administered before irreversible nerve damage and muscle wasting occur. My hon. Friend the Member for Upper Bann (Carla Lockhart) has been at the forefront on this issue. Does the hon. Gentleman agree that perhaps what we really need is a UK-wide purchasing power for these heel-prick testing kits to be fully extended to all local health trusts without delay? That would make sure that those who have SMA are caught in time.

[Lewis Atkinson]

The hon. Gentleman is absolutely right and I will come on to talk about screening in just a minute.

[Mark Sewards (Leeds South West and Morley) (Lab)]

It is a pleasure to serve under you, Mr Mundell. My hon. Friend is talking about lifesaving treatments. One of my constituents has a niece who was born with SMA type 1 and previously would have been at risk of dying. My constituent was told that her niece was unlikely to live past the age of two, but because of the advances in treatment that my hon. Friend has just spoken about, she has just celebrated her ninth birthday. However, she did have to be fed through a stomach pump. Does my hon. Friend agree that for £3.1 million we can get full coverage across England, Wales and Northern Ireland, and ensure that all babies are tested, so that those with SMA can be treated as early as possible?

[Lewis Atkinson]

I agree with my hon. Friend, though I think the issue is not mainly financial; I will come on to that in a minute.

As other Members have said, the key point is that treatments are dramatically more effective the earlier they are given: before symptoms appear and before irreversible damage is done. Once motor neurones are lost they do not come back.

[Munira Wilson (Twickenham) (LD)]

I congratulate the hon. Member on his speech. I join him in paying tribute to Jesy Nelson and her campaigning. I also pay tribute to the parents of little Charlie in my constituency. In the words of his mother, he was

“very lucky to celebrate his first birthday last August.”

He was treated with gene therapy after being diagnosed and following symptoms. He is now living his life, but in a wheelchair. Had he been screened at birth he might have had treatment sooner and he might be walking right now.

[Lewis Atkinson]

The hon. Lady is entirely right and I have heard a number of those heart-wrenching stories; she does well to speak so movingly on behalf of her constituent. That is a testament to the key intervention of getting a diagnosis as soon after birth as possible. Today, a baby with type 1 SMA is typically not diagnosed until around six months of age. By then, for many the window when treatment would have had the most impact has closed.

There is an alternative; screening at birth through the existing NHS heel-prick test, which is routinely done on day five of a baby’s life. That already screens for 10 different serious conditions.

[Amanda Martin (Portsmouth North) (Lab)]

Thank you, Mr Mundell, for your chairmanship. I, too, pay tribute to the determination of Jesy Nelson and all the parents and young people who have been campaigning for this. I was alarmed to discover from parents this weekend that Portsmouth will not be included in the roll-out of the SMA screening this October. That means that babies born in my city will miss that early diagnosis and will face potentially devastating conditions that early treatment might well have saved them from. My hon. Friend the Member for Portsmouth South (Stephen Morgan) and I have written to our integrated care board to find out why Portsmouth is not included and whether it will change its mind.

[Lewis Atkinson]

My hon. Friend is absolutely right, and I will come on to talk about the potential postcode lottery. I do not believe it is a decision for individual ICBs to make, but a national decision that includes the UK National Screening Committee, which I will come on to.

The screening that I have described is already in place in dozens of countries. Across Europe, 75% of children are screened at birth and since 2024, every newborn in the United States and Canada has been screened. Ukraine managed to begin newborn screening for SMA in the midst of a full-scale Russian invasion. Given that, the petitioners simply ask, “Why is this screening not in place universally here too?”

[Jim Shannon]

On 23 March, Scotland rightly introduced routine screening. In October, babies born in England will benefit from the in-service evaluation framework. Yet families in Northern Ireland do not qualify whatsoever. Does the hon. Member agree that the Government must commit to working across jurisdictions with the Northern Ireland Department of Health to ensure that the evaluation framework is immediately extended to Northern Ireland so that a child’s chances of walking, breathing and surviving are not dictated by the part of the United Kingdom that they are from?

[Lewis Atkinson]

I thank the hon. Member for making one of his excellent interventions. Clearly health is a devolved matter in Northern Ireland and Wales, where screening is also not available, but the hon. Member is absolutely right. It would be difficult to explain to parents anywhere in the UK why this screening is increasingly standard practice internationally but is not available in every nation of the United Kingdom.

The petitioners are clear that all the conditions necessary to begin screening have been met. The test exists, the treatments exist and the evidence tells us that screening would save both lives and money. In the UK, screening is overseen by the independent UK National Screening Committee, which gives recommendations to Ministers. I was unable to meet with the committee in preparation for the debate, but I am sure that the Minister has had the benefit of its advice.

I recognise, as we all must, that the committee’s independence matters. However, its decision making and the way in which it balances risk, evidence and benefit must be subject to ministerial oversight. In this case in particular, there are questions about how those three elements have been balanced, and specifically about how far the committee seemingly required NHS-specific evidence when significant international evidence already exists.

When the National Screening Committee reviewed SMA for potential inclusion in the screening programme in 2018, the committee did not recommend screening, but campaigners like SMA UK did not walk away; they kept on doing the work. New cost-effectiveness modelling commissioned by the screening committee and published last year finds that screening for SMA is likely to be lifesaving and cost-effective.

[Peter Dowd (Bootle) (Lab)]

I congratulate my hon. Friend on introducing this debate and welcome your chairmanship of it, Mr Mundell. My hon. Friend referred earlier to 90% of children who are untreated potentially dying before their second birthday. That is a sobering statistic, but it is not a statistic; it is the reality of the lives of children, families and parents. Does my hon. Friend agree that we need to go faster sooner to roll out a comprehensive programme, as so many other countries have managed to do?

[Lewis Atkinson]

My hon. Friend is absolutely right. This is a matter of pace and of asking, “When?” not “If?” or “How?” because both those questions have already been answered.

I turn to the Government’s response. The previous Secretary of State for Health, my right hon. Friend the Member for Ilford North (Wes Streeting), met Jesy Nelson, the petitioner, in January. The Government accepted the case for an in-service evaluation and brought the date for that live NHS trial forward from January 2027 to October this year, when screening will begin to be rolled out. I, the petitioners and others welcome that, though there is a sadness that it has taken so long to get to that point.

We must, however, be honest about where that decision leaves us. As my hon. Friend the Member for Bootle (Peter Dowd) alludes to, the real argument now is about pace and fairness. The evaluation is funded. It will run at seven of England’s 13 screening laboratories, covering around 72% of births. The remaining six sites, which include the site that covers the constituents of my hon. Friend the Member for Portsmouth North (Amanda Martin), and which account for the remaining 28% of babies born in the UK every year, are not at present in the plan. That does not seem to be an accident but the design.

Put in human terms, of the 48 babies born with SMA in England each year around 35 would be diagnosed by the introduction of SMA screening in this evaluation but 13 would not: there would be 13 babies a year born with the same condition but on the wrong side of an arbitrary line that they did not choose who will go undiagnosed until damage is done. A baby born in one postcode will be screened, treated early and may walk, but a baby born in another postcode in the same week will not, and by the time anyone knows it may be too late. That is the postcode lottery that Jesy told me about, and which deeply concerns her, in its starkest form.

It is not about a difference in waiting times but about whether a child walks, breathes unaided or feeds normally for life. That is why Professor Muntoni’s assessment needs to be heard. He asked me specifically to put this on the record: he described a trial that deliberately leaves some babies unscreened to serve as a comparison group as—his word—“unethical”. We are withholding from some children a diagnosis that we are fully capable of making and that we know will help to shape their lives in order to gather data on something that Professor Muntoni considers already internationally proven. That is the view of not just one eminent clinician, I am told, but the wider SMA clinical community.

[Amanda Martin]

rose—

[Munira Wilson]

rose—

[Lewis Atkinson]

I will make a little progress and finish my point; I can see the time getting away and I want to make sure that other Members can speak.

The question is why, when so much of the world has acted, the United Kingdom is moving so slowly. That caution sits oddly with the Government’s welcome ambition elsewhere. The generation study is sequencing the whole genome of 100,000 newborns for more than 200 rare conditions, and the Government have committed to offering whole genome sequencing to every newborn within a decade, which is a welcome part of their 10-year health plan. That is a world-leading vision, and I welcome it, but there is some irony in promising to read every baby’s entire genome within 10 years while not rolling out today across the whole of England one well-established, internationally proven test for a single treatable condition.

Screening decisions must, of course, be taken with care. A national programme that affects 650,000 babies a year must be safe, accurate and deliverable across many laboratories. I recognise that the therapies are relatively new and therefore their lifespan impacts require ongoing evaluation. There are legitimate grounds for further research, but the evidence that we have now on its impact should sharpen our urgency, not dull it. I am told that the research the screening committee commissioned estimates that each year, screening could prevent around two babies needing permanent ventilation, prevent around three early deaths and allow around 37 babies to live relatively normal lives.

The economics are striking, too: the typical direct costs of caring for a child severely disabled by SMA—not the drugs costs, but the care costs—are around £450,000 per year. Most of that would be avoidable through diagnosis and treatment at birth. Here, the compassionate course and the fiscally responsible course point the same way.

I gently raise the point—the hon. Member for Strangford (Jim Shannon) has already made it—that there is a geographical discrepancy across the United Kingdom on this matter. Let us welcome the fact that, in Scotland, screening is now being rolled out for every newborn, though that is not the case, and there are no plans that I am aware of, in Northern Ireland or Wales.

I began my speech with two little girls—Jesy’s girls—and I return to them now. The delays to their diagnosis were not inevitable. Had the UK adopted screening on a timetable comparable to that of other countries, Jesy’s twins might have been diagnosed before symptoms appeared. We cannot change that, but we can stop it being true for the next family.

SMA is only the first of many rare genetic conditions where an early, treatable diagnosis will likely become possible in the coming years. If we cannot move at a reasonable pace on screening for SMA, which is proven, costed and adopted across the world, what does that say for the children with other rare genetic diseases, the screening tests for which will be developed in the coming years?

I put the following questions to the Minister, and I hope—and I know the petitioner hopes—for answers that are as specific as she is able to give. First, will the Minister push for conclusions to be drawn more quickly from the in-service evaluation than the 18 months that are currently planned? Every month of delay in roll-out to the 28% of the population not covered by the evaluation will likely delay the diagnosis of one baby, with serious consequences.

Secondly, what does the Minister say to the families of the 13 babies a year who, on the current plans, will be born outside the evaluation’s reach? Are there any interim safeguards against a delayed or missed diagnosis? Thirdly, will the Minister respond directly to the concern shared across the SMA clinical community that knowingly leaving some babies unscreened when the test and treatments already exist raises serious ethical concerns?

Finally, will the Government commit to ensuring that every baby in England is screened for SMA as quickly as possible? Will they continue to roll that out to all remaining screening centres, even if that is on a provisional basis while we wait for the in-service evaluation? By what date can that be achieved?

I conclude with a reflection that, as it stands, the science on this disease has changed faster than our health system has. The condition was, within living memory, untreatable, but now a test at birth can make the difference between a wheelchair and a childhood spent running around. The petitioners are not asking us to abandon evidence or caution; they are asking us to act with the urgency that international evidence now permits, and to make sure that no baby is left behind simply because of where they are born. I look forward to contributions from other Members and to the Minister’s response.

[Several hon. Members rose—]

--- Later in debate ---

[Lewis Atkinson]

I thank the Minister for her remarks. As others have said, she is a diligent Minister, and I know that she will push this carefully with the Department. Would she consider meeting me, Jesy and SMA UK after she has had a chance to push some of those points? I thank all Members for their contributions today.

Most of all, I thank Jesy for bringing this petition to life, telling the story of her twin girls, being so clear and rightly challenging us about the fact that there should not be a postcode lottery in the UK. We should have screening provision as good as anywhere else in the world.

Oral Answers to Questions

Lewis Atkinson Excerpts

Tuesday 9th June 2026 Commons Chamber

[Lewis Atkinson (Sunderland Central) (Lab)]

I commend the Minister for her work in reducing waiting lists for GP referral to first treatment, and they are genuinely coming down. She will be aware, however, that that statistic does not capture the entire picture, particularly for people who require subsequent follow-up care—for example, women with endometriosis or women waiting for breast reconstruction following mastectomies. Could she say a little about any plans she has to capture those waiting lists?

[Karin Smyth]

My hon. Friend is someone who does understand the way waiting lists are managed and so on. We do not have any plans to add any new targets to those to which we have already committed to give confidence to the British public that we can fix the NHS and get waiting lists down. However, he raises an important point about how we support patients to understand where they are in the system and where their care will be provided. Part of our commitment in the elective reform plan, which we outlined last year, is that patients are kept up to date about where they are being treated and why they are being referred to perhaps a more local service, and we will continue to try to do that.

Health Bill

Lewis Atkinson Excerpts

2nd reading
Monday 1st June 2026 Commons Chamber

[Lewis Atkinson (Sunderland Central) (Lab)]

The history of the NHS shows that there is no one way of securing improvement or accountability, and that a range of different mechanisms have a role. Patient voice, patient choice, performance management—including centralised performance management—planning, democratic challenge, competition and collaboration all have a place, and it is for the Government of the day to make a judgment about the right blend of mechanisms with which to pursue their objectives. Overall, I think that the Bill represents a good attempt to do that, given the NHS that this Government inherited and their ambitions, as set out in the NHS plan. There was undoubtedly duplication between the DHSC and NHSE, and returning to the situation before 2012, when there was direct departmental oversight of the NHS, is not a radical step.

There are, of course, costs to this transition. Unfortunately, in terms of morale, I think that these costs were somewhat exacerbated by the regretful manner in which the original announcement about NHSE abolition and ICB changes were made, which did not do justice to the commitment and professionalism of impacted staff. But that does not change the fact that the Government’s overall diagnosis is correct: since the 2012 reforms, accountability has been muddied, and a total reset of regulation is required to empower NHS providers to meet the urgent health needs of the population with the resources available. However, I agree that there are significant questions about the role of HSSIB, and I hope that this issue can be resolved in Committee.

The Government have been clear that they see the future role of ICBs as strategic commissioners. That capability needs to be developed, and I echo the point made by my hon. Friend the Member for Middlesbrough and Thornaby East (Andy McDonald) that it needs to be done with particular care in relation to specialist services. There also needs to be a resolution of how the development of neighbourhood health services will be strategically led. ICBs must retain the capacity to work at place level, and I join others in questioning the proposal to remove local authority representation on ICBs. Combined authority representation does not suitably replace that. Mayors’ responsibilities are entirely different and do not include anything to do with social care or public health that rightly sits with councils, and we need that to be hardwired into ICB membership.

I want to end on an area of healthcare that is the subject of a manifesto commitment that is not currently in the Bill: delivering parity of esteem for mental health. It is unconscionable that waits for NHS mental health services are significantly longer than physical health waits and that, as yet, there is no specific commitment to bring them down. The Health and Care Act 2022 introduced a duty on the Secretary of State to report annually to Parliament on NHS mental health spend. I wonder whether, as part of this Bill, there is scope to widen that duty to include reporting on the different waiting times for physical and mental health, and to make some progress on the very welcome cross-Government mental health strategy that has recently been announced.

Oral Answers to Questions

Lewis Atkinson Excerpts

Tuesday 24th February 2026 Commons Chamber

[Dr Ahmed]

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

[Lewis Atkinson (Sunderland Central) (Lab)]

Analysis by Rethink Mental Illness of the latest NHS waiting time statistics shows that people are eight times more likely to wait over 18 months for mental health treatment than physical health treatment. Does the Minister agree that waiting 18 months for such treatment is totally unacceptable? What steps will the Government take to cut adult mental health waiting times?

[Dr Ahmed]

Absolutely; it is unacceptable that there is still a disparity between mental and physical health when it comes to investigation, diagnosis and treatment. That is why this Government are proud to put record amounts of funding for mental health into the NHS. We are also making available £473 million of capital funding for encouraging and establishing 24/7 mental health centres, alongside other capital priorities, so that people can get the right support at the right time, closer to home.

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?