Oral Answers to Questions

Lindsay Hoyle Excerpts

Tuesday 17th June 2025 Commons Chamber

[Stephen Kinnock]

My hon. Friend is absolutely right, and I commend him for the work he is doing in his constituency, including with pharmacies. In many ways, what we want to see is a culture change, because the interface between general practice and community pharmacy is not where it should be. We believe that pharmacists have a huge amount more to offer, but that requires a better digital interface and better information sharing—a single patient record. That sort of vehicle will be really important for delivering some of those reforms.

[Mr Speaker]

I call the shadow Minister.

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

I am pleased to hear the Minister speak about Pharmacy First, which was brought forward by the previous Government and welcomed by communities, the public and the pharmacists. Although I am pleased to see the Government continue it, why have they decided to cap the number of consultations that a pharmacist may do?

--- Later in debate ---

[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?

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[Stephen Kinnock]

My hon. Friend will know that when we came into Government we inherited the absurd situation where the additional roles reimbursement scheme was weighed down by red tape and it was not actually possible to recruit GPs. We changed that. We invested an extra £82 million and as a result we have well over 1,000 more GPs on the frontline, but that is just the beginning. We have contract reform and £889 million of additional investment in general practice, and we are moving forward with an online booking system, which will be obligatory by 1 October. We have much more work to do—for example, around the interface with pharmacy; we are working hard on that. There is a lot more to do, but my hon. Friend is right that the first step up the mountain has been taken.

[Mr Speaker]

I call the shadow Minister.

[Dr Caroline Johnson (Sleaford and North Hykeham) (Con)]

Last health questions, I asked about delays to crucial medications in A&E and the Secretary of State said he was interested to hear more, but his office said he would delegate it to a Minister and we still have not been offered a date, so could I encourage him to look into that, please? The U-turn on winter fuel will help the elderly to stay warm and healthy this winter, but another way to help elderly people would be to protect them from the respiratory syncytial virus. Will the Government extend the vaccination to the over-80s?

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[Wes Streeting]

I think the hon. Gentleman will find that, since this Government came to power, we have reduced the size of NHS waiting lists by a quarter of a million. NHS waiting lists are coming down—latest figures show that this is the first time in 17 years that waiting lists have fallen in the month of April—so we are making progress, not least thanks to the investment that we are putting into community diagnostic centres. The hon. Gentleman has some brass neck to complain about NHS services under this Government, when we are cleaning up the mess that the previous Government left behind.

[Mr Speaker]

It would also help to extend the hours at Chorley A&E.

[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.

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[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—

[Mr Speaker]

Order. I do not think this is relevant to sun tanning. Let us move on.

--- Later in debate ---

[Stephen Kinnock]

I have to correct the hon. Lady: the commission is up and running, Baroness Casey has started meetings and she had a roundtable just a few weeks ago with people who have lived experience. The hon. Lady is therefore not correct on that point and I am sure that she will want to correct the record.

On the point about delayed discharge, the hon. Lady is absolutely right. We are reforming the better care fund to get much better interface between hospitals, care and local authorities. That system and those relationships can and should work much better, but there are pressing, long-term challenges. We are conscious of that and are working at pace with Baroness Casey to ensure that those reforms are delivered.

[Mr Speaker]

I call the Liberal Democrat spokesperson.

[Helen Morgan (North Shropshire) (LD)]

As we have just heard, it is widely acknowledged that the crisis in social care is a cause of dangerously high occupancy rates in hospitals that lead to the horrors of corridor care, the dreadful ambulance waiting times that we have seen and a knock-on effect on the community. When I was contacted by the family of a terminally ill man in Wem in my constituency last month, I was reminded that not only is care often provided in the wrong place, but it is often not available at all. Will the Government bring forward the timeline for the horribly delayed Casey review to report back, get it done this year and heed Liberal Democrat calls for cross-party talks so that we can agree on a long-term solution for the crisis?

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[Wes Streeting]

I absolutely agree with my hon. Friend. It is thanks to the fact that his constituents sent him to this House of Commons that we have a Labour Government able to deliver, with him, for his community.

[Mr Speaker]

I call the shadow Secretary of State.

[Edward Argar (Melton and Syston) (Con)]

May I, through the Secretary of State, pass on my best wishes to the Under-Secretary of State for Health and Social Care, the hon. Member for West Lancashire (Ashley Dalton)? In front of the Health and Social Care Committee in January, NHS England’s then chief financial officer set out that pretty much all the additional funding to the NHS last year would be absorbed by pay rises, national insurance contributions and inflation. What proportion of the latest additional funding will be absorbed in the same way?

--- Later in debate ---

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

A couple of weeks ago at my constituency surgery, though tears my constituent Amy explained how, following a hip operation in 2008, she suffered progressive nerve damage due to repeated failures in diagnosis, referral and treatment. Despite raising concerns for years, she was told that her pain was common. A nerve test in 2015 confirmed damage, and further tests last year showed a significant deterioration. After 17 years she has only now been offered surgery. All Amy wants to know is what steps are being taken to ensure that no other patient is left permanently disabled due to such prolonged and systemic failure—

[Mr Speaker]

Order. That is very important, but why does the hon. Member not want others to get in?

[Wes Streeting]

First, on behalf of the NHS I apologise to my hon. Friend’s constituent. That is an intolerable situation, but sadly not rare or exceptional. There is too much of that happening, and a culture of cover-up and covering reputations, rather than being honest with patients about failures. We are changing the culture. Safety is at the heart of the 10-year plan, and I would be delighted to talk to my hon. Friend further about his constituent’s case.

Terminally Ill Adults (End of Life) Bill

Lindsay Hoyle Excerpts

Report stage
Friday 13th June 2025 Commons Chamber

Further consideration of Bill, as amended in the Public Bill Committee.

[Mr Speaker]

Before we begin, I would like to say a few words about today’s proceedings.

We will begin at the point we ended on Friday 16 May, with the decisions to be taken after debate on the first group of amendments. I will put the necessary questions without further debate. After that, debate on the second group of new clauses and amendments can begin. I remind hon. Members that the scope of that debate will be the amendments and new clauses in that group.

Nearly 60 Members have indicated that they wish to speak in the debate. Not all hon. Members will be called. It is not customary to impose a time limit on speeches on a private Member’s Bill, but I hope that Member in charge of the Bill, and the speakers after her, will restrict themselves in the early part of the debate, including in taking interventions. The Chair will keep time limits under review as the debate progresses. If the Chair feels that people are taking advantage of the Chamber, a time limit will be imposed, but I hope we do not have to do that. I do not expect to call the Front Benchers to speak until at least 1.15 pm.

I can also confirm that I have provisionally selected for separate decision all of the propositions in the name of Kim Leadbeater, the Member in Charge of the Bill. I have also provisionally selected the following for separate decision on new clauses: amendment (b) to new clause 14, new clause 1, new clause 2 and new clause 16. I will make further announcements on selection for separate decision on amendments at an appropriate point. We will begin with the question that new clause 10 will be added to the Bill, which was debated on Friday 16 May.

New Clause 10

No obligation to provide assistance etc

“(1) No person is under any duty to participate in the provision of assistance in accordance with this Act.

(2) No registered medical practitioner is under any duty to become—

(a) the coordinating doctor in relation to any person, or

(b) the independent doctor in relation to any person.

(3) No registered medical practitioner, other than the coordinating doctor or the independent doctor, is under any duty to perform any function under or in connection with this Act other than—

(a) a function relating to the giving of notifications, or

(b) a function relating to the recording of matters in a person’s medical records.

(4) No health professional or social care professional is under any duty to respond when consulted under section 11(3)(b) (requirement for assessing doctor to consult professional with relevant qualifications or experience).

(5) No registered pharmacist or registered pharmacy technician is under any duty to participate in the supply of an approved substance to a registered medical practitioner for use in accordance with section 23.

(6) No person is under any duty to—

(a) act as a witness under this Act, or

(b) act as a proxy under this Act.

(7) Nothing in this section affects—

(a) any duty relating to the giving of notifications under this Act or the recording of matters in a person’s medical records,

(b) any duty relating to a requirement to keep records or to provide information, or

(c) any duty of a professional to respond to enquiries made under section 11(2)(b) (enquiries by assessing doctor) relating to health or social care the professional is providing, or has recently provided, to a person seeking assistance under this Act.

(8) Schedule (Protection from detriment) amends the Employment Rights Act 1996 to make provision to protect employees and other workers from being subjected to any detriment for—

(a) exercising (or proposing to exercise) a right under this section not to participate in an activity or perform a function, or

(b) participating in the provision of assistance in accordance with this Act or performing any other function under this Act.

(9) In this section—

(a) a reference to a duty includes any duty, whether arising from any contract, statute or otherwise;

(b) “registered pharmacist” and “registered pharmacy technician” have the same meaning as in the Pharmacy Order 2010 (S.I. 2010/231) (see article 3 of that Order).”—(Kim Leadbeater.)

This new clause, intended to replace clause 28, expands the protection currently provided by that clause by broadening the persons to whom it applies and the functions to which it relates; and it introduces NS1 which makes provision for enforcement of the right not be subject to detriment in connection with the Bill

Question put, That the clause be added to the Bill.

Question agreed to.

New clause 10 accordingly added to the Bill.

New Clause 11

Replacing the coordinating or independent doctor where unable or unwilling to continue to act

“(1) This section applies where—

(a) after a first declaration has been witnessed by the coordinating doctor, that doctor is unable or unwilling to continue to carry out the functions of the coordinating doctor, or

(b) after a referral is made under section 9(3)(c) (including a referral to which section 12(4) applies), but before a report under section 10 has been made by virtue of that referral, the independent doctor is unable or unwilling to continue to carry out the functions of the independent doctor,

and in this section such a coordinating or independent doctor is referred to as “the outgoing doctor”.

(2) The outgoing doctor must as soon as practicable give written notice of their inability or unwillingness to continue to carry out their functions under this Act to—

(a) the person seeking assistance,

(b) the Commissioner, and

(c) if the outgoing doctor is the independent doctor, the coordinating doctor.

(3) Any duty or power of the outgoing doctor under this Act that arose in consequence of the declaration or referral mentioned in subsection (1) ceases to have effect from the time the outgoing doctor complies with subsection (2); but this does not apply to any duty under subsection (8) or (9).

(4) The Secretary of State may by regulations make provision relating to the appointment, with the agreement of the person seeking assistance, of a replacement coordinating doctor who meets the requirements of section 7(5) and who is able and willing to carry out the functions of the coordinating doctor.

(5) Regulations under subsection (4) may, in particular, make provision to ensure continuity of care for the person seeking assistance despite the change in the coordinating doctor.

(6) Where the independent doctor gives a notice under subsection (2)—

(a) a further referral may be made—

(i) under section 9(3)(c) (if section 12 does not apply), or

(ii) where section 12 applies, under subsection (2) of that section, and

(b) the registered medical practitioner to whom that referral is made becomes the independent doctor (replacing the outgoing doctor) and sections 10 to 12 (and this section) apply accordingly.

(7) Subsections (8) and (9) apply where the coordinating doctor—

(a) gives a notice under subsection (2) to the person seeking assistance, or

(b) receives a notice under that subsection given by the independent doctor in relation to the person seeking assistance.

(8) Where the coordinating doctor is a practitioner with the person’s GP practice, the coordinating doctor must, as soon as practicable, record the giving of the notice in the person’s medical records.

(9) In any other case—

(a) the coordinating doctor must, as soon as practicable, notify a registered medical practitioner with that practice of the giving of the notice, and

(b) the practitioner notified under paragraph (a) must, as soon as practicable, record the giving of the notice in the person’s medical records.”—(Kim Leadbeater.)

This new clause makes provision about the replacement of the coordinating doctor or the independent doctor where the doctor is unable or unwilling to continue to carry out their functions under the Bill.

Brought up, read the First and Second time, and added to the Bill.

New Clause 12

Report where assistance not provided because coordinating doctor not satisfied of all relevant matters

“(1) This section applies where a person is not provided with assistance under section 23 because the coordinating doctor is not satisfied as to all of the matters mentioned in section 23(5).

(2) The coordinating doctor must make a report which—

(a) sets out the matters as to which they are not satisfied, and

(b) contains an explanation of why they are not satisfied of those matters.

(3) The Secretary of State may by regulations make provision about the content or form of the report.

(4) The coordinating doctor must give a copy of the report to—

(a) the person,

(b) if the coordinating doctor is not a practitioner with the person’s GP’s practice, a registered medical practitioner with that practice, and

(c) the Commissioner.”—(Kim Leadbeater.)

This new clause (intended to be inserted after Clause 27) requires the coordinating doctor to produce a report where assistance is not provided because they are not satisfied of all of the matters mentioned in Clause 23(5).

Brought up, read the First and Second time, and added to the Bill.

New Clause 13

Regulation of approved substances and devices for self-administration

“(1) The Secretary of State must by regulations make provision about approved substances.

(2) The regulations must make provision about—

(a) the supply or offer for supply, or administration, of approved substances;

(b) the transportation, storage, handling and disposal of approved substances;

(c) the keeping of records of matters relating to approved substances.

(3) The regulations may in particular make provision—

(a) about the manufacture, importation, preparation or assembly of approved substances;

(b) for or in connection with the monitoring of matters relating to approved substances;

(c) requiring persons specified in the regulations, in specified cases, to give information to the Secretary of State.

(4) The regulations may in particular—

(a) make provision relating to approved substances that is similar to, or that corresponds to, any provision of the Human Medicines Regulations 2012 (S.I. 2012/1916);

(b) make provision applying any provision of those Regulations, with or without modifications, in relation to approved substances.

(The regulations may also amend the Human Medicines Regulations 2012.)

(5) The Secretary of State may by regulations make provision about devices made for use or used for, or in connection with, the self-administration of approved substances.

(6) Regulations under this section must make provision about enforcement (which must include, but need not be limited to, provision imposing civil penalties).

(7) Regulations under this section may make any provision that could be made by an Act of Parliament; but they may not amend this Act.

(8) In this section “device” includes information in electronic form for use in connection with a device.”—(Kim Leadbeater.)

This new clause (which is intended to replace clause 34) imposes a duty to make regulations about approved substances, and a power to make regulations about devices intended for use, or used, in connection with the self-administration of approved substances.

Brought up, and read the First time.

[Kim Leadbeater (Spen Valley) (Lab)]

I beg to move, That the clause be read a Second time.

[Mr Speaker]

With this it will be convenient to discuss the following:

Amendment (b) to new clause 13, at end insert—

“(5A) The Secretary of State may only approve a device under subsection (5) if the Medicines and Healthcare products Regulatory Agency has approved the device for that purpose.

(5B) Before making any regulations under this section, the Secretary of State must consult the Medicines and Healthcare products Regulatory Agency.”

This amendment requires that the Medicines and Healthcare products Regulatory Agency be consulted before making regulations and that medical devices can only be approved for self-administration if they have been approved by the MHRA.

Amendment (c) to new clause 13, at end insert—

“(5A) Regulations under subsection (5) must forbid the use of any device used for the self-administration of a gas.”

This requires the Secretary of State to forbid the use of medical devices which cause death by the administration of a gas.

Amendment (a) to new clause 13, leave out subsection (7).

This removes the power to make regulations that may make any provision that could be made by an Act of Parliament (known as Henry VIII power) from this new clause.

New clause 14—Prohibition on advertising—

“(1) The Secretary of State must by regulations make provision prohibiting—

(a) the publication, printing, distribution or designing (anywhere) of advertisements whose purpose or effect is to promote a voluntary assisted dying service;

(b) causing the publication, printing, distribution or designing of such advertisements.

(2) The regulations may contain exceptions (for example, for the provision of certain information to users or providers of services).

(3) Regulations under this section may make any provision that could be made by an Act of Parliament.

(4) But regulations under this section—

(a) may not amend this Act, and

(b) must provide that any offence created by the regulations is punishable with a fine.

(5) In this section “voluntary assisted dying service” means—

(a) any service for or in connection with the provision of assistance to a person to end their own life in accordance with this Act, or

(b) any other service provided for the purposes of any of sections 5 to 27.”

This clause imposes a duty to make regulations prohibiting advertisements to promote services relating to voluntary assisted dying under the Bill.

Amendment (b) to new clause 14, in subsection (2), leave out from “exceptions” to the end of subsection (3) and insert—

“( ) for the following—

communication made in reply to a particular request by an individual for information about a voluntary assisted dying service;

(b) communication which is—

(i) intended for health professionals or providers of voluntary assisted dying services, and

(ii) made in a manner and form unlikely to be seen by potential service users.

(3) Regulations under this section may make provision that could be made by an Act of Parliament, but may not amend this Act or the Suicide Act 1961.”

This amendment would limit the exceptions that can be created to the advertising ban set out in NC14 and also provides that regulations cannot amend the Suicide Act 1961, which includes the offence of assisting and encouraging suicide.

Amendment (a) to new clause 14, leave out subsection (3).

This removes the power to make regulations that may make any provision that could be made by an Act of Parliament (known as Henry VIII power) from this new clause.

New clause 15—Investigation of deaths etc—

“(1) In section 1 of the Coroners and Justice Act 2009 (duty to investigate certain deaths), after subsection (7) insert—

“(7A) In this Chapter a reference to an “unnatural death” does not include a death caused by the self-administration by the deceased of an approved substance, within the meaning of the Terminally Ill Adults (End of Life) Act 2025, that was provided to the deceased in accordance with that Act.”

(2) In section 20 of that Act (medical certificate of cause of death), after subsection (4) insert—

“(4A) Regulations under subsection (1) may make, in respect of cases where assistance was provided or purportedly provided to the deceased under the Terminally Ill Adults (End of Life) Act 2025—

(a) such provision that is similar to, or that corresponds to, provision mentioned in subsection (1) as the Secretary of State considers appropriate;

(b) such further provision as the Secretary of State considers appropriate.

(4B) Regulations under subsection (1) must provide that in cases where the cause of death appears, to the best of the knowledge and belief of the person issuing a certificate under the regulations, to be the self-administration by the deceased of an approved substance (within the meaning of the Terminally Ill Adults (End of Life) Act 2025) that was provided to the deceased in accordance with that Act, the certificate must—

(a) state the cause of death to be “assisted death”, and

(b) contain a record of the illness or disease which caused the person to be terminally ill within the meaning of that Act.”

(3) In Schedule 1 to that Act (suspension of investigations etc), in the definition in paragraph 1(6) of “homicide offence”, after paragraph (d) insert—

“(e) an offence under section 31, 32 or 33 of the Terminally Ill Adults (End of Life) Act 2025;”.”

This new clause provides that references in Chapter 1 of the Coroners and Justice Act 2009 (investigations into deaths) to unnatural deaths do not include deaths caused by self-administration of approved substances provided in accordance with the Bill. It makes offences under clauses 31 to 33 “homicide offences” for the purposes of that Act. It also amends the powers in that Act in respect of medical certificates of cause of death.

Amendment (a) to new clause 15, in subsection (1), leave out from “section” to “(medical” in subsection (2) and insert

“20 of the Coroners and Justice Act 2009”

This amendment ensures that deaths from assisted dying will still fall within the coroner’s duty to investigate deaths under section 1 of the Coroners and Justice Act 2009.

New clause 20—Guidance about operation of Act—

“(1) The Secretary of State must issue guidance relating to the operation of this Act.

(2) The guidance need not (but may) relate to matters about which the Welsh Ministers may issue guidance under subsection (4) (“Welsh devolved matters”).

(3) Before issuing guidance under subsection (1), the Secretary of State must consult—

(a) the Chief Medical Officer for England,

(b) the Chief Medical Officer for Wales,

(c) such persons with learning disabilities and other persons who have protected characteristics as the Secretary of State considers appropriate,

(d) such persons appearing to represent providers of health or care services, including providers of palliative or end of life care, as the Secretary of State considers appropriate,

(e) if any part of the guidance relates to Welsh devolved matters, the Welsh Ministers, and

(f) such other persons as the Secretary of State considers appropriate.

(4) The Welsh Ministers may issue guidance relating to the operation of this Act in Wales, but the guidance must only be about matters within devolved competence.

(5) For this purpose, a matter is “within devolved competence” if provision about it would be within the legislative competence of Senedd Cymru if it were contained in an Act of the Senedd.

(6) Before issuing guidance under subsection (4), the Welsh Ministers must consult—

(a) the Chief Medical Officer for Wales,

(b) the Secretary of State,

(c) such persons with learning disabilities and other persons who have protected characteristics as the Welsh Ministers consider appropriate,

(d) such persons appearing to represent providers of health or care services, including providers of palliative or end of life care, as the Welsh Ministers consider appropriate, and

(e) such other persons as the Welsh Ministers consider appropriate.

(7) When preparing guidance under this section, an appropriate national authority must have regard to the need to provide practical and accessible information, advice and guidance to—

(a) persons (including persons with learning disabilities) requesting or considering requesting assistance to end their own lives;

(b) the next of kin and families of such persons;

(c) the general public.

(8) An appropriate national authority must publish any guidance issued under this section.

(9) In this section—

“appropriate national authority” means the Secretary of State or the Welsh Ministers;

“protected characteristics” has the same meaning as in Part 2 of the Equality Act 2010 (see section 4 of that Act).”

This new clause (which is intended to replace clause 37) makes provision about guidance relating to the operation of the Bill.

New clause 21—Provision about the Welsh language—

“(1) In this section “relevant person” means a person in Wales who wishes to be provided with assistance to end their own life in accordance with this Act.

(2) Subsection (3) applies where the Welsh Ministers make regulations under section 39 (voluntary assisted dying services: Wales).

(3) Regulations under that section must make such provision as the Welsh Ministers consider appropriate for the purpose of ensuring that, where a relevant person indicates that they wish to communicate in Welsh, all reasonable steps are taken to secure that—

(a) communications made by a person providing a voluntary assisted dying service to the relevant person are in Welsh, and

(b) any report about the first or second assessment of the relevant person is in Welsh.

(4) Where a relevant person informs the Commissioner that they wish to communicate in Welsh, the Commissioner must take all reasonable steps to secure that—

(a) communications made by the Commissioner to the relevant person are in Welsh,

(b) each member of the panel to which the relevant person’s case is referred speaks Welsh, and

(c) communications made by that panel to the relevant person are in Welsh,

and any certificate of eligibility issued by that panel must be in Welsh.

(5) Regulations under section 7, 9, 10, 17 or 26 that specify the form of—

(a) a first or second declaration,

(b) a report about the first or second assessment of a person, or

(c) a final statement,

must make provision for the forms to be in Welsh (as well as in English).

(6) Before making regulations in pursuance of subsection (5), the Secretary of State must consult the Welsh Ministers.

(7) In this section—

“panel” and “referred” have the meaning given by paragraph 1 of Schedule 2;

“voluntary assisted dying service” has the meaning given by section 38.”

This new clause (which is intended to replace Clause 47) makes provision about the use of the Welsh language.

New clause 4—Monitoring by Chief Medical Officer—

“(1) The relevant Chief Medical Officer must—

(a) monitor the operation of the Act, including compliance with its provisions and any regulations or code of practice made under it,

(b) investigate, and report to the appropriate national authority on, any matter connected with the operation of the Act which the relevant national authority refers to the relevant Chief Medical Officer, and

(c) submit an annual report to the appropriate national authority on the operation of the Act.

(2) The relevant Chief Medical Officer’s report must include information about the occasions when—

(a) a report about the first assessment of a person does not contain a statement indicating that the coordinating doctor is satisfied as to all of the matters mentioned in section 9(2)(a) to (h),

(b) a report about the second assessment of a person does not contain a statement indicating that the independent doctor is satisfied as to all of the matters mentioned in section 10(2)(a) to (e),

(c) a panel has refused to grant a certificate of eligibility,

(d) the coordinating doctor has refused to make a statement under section 17(6).

(3) An annual report must include information about the application of the Act in relation to—

(a) persons who have protected characteristics, and

(b) any other description of persons specified in regulations made by the Secretary of State.

(4) When preparing an annual report, the relevant Chief Medical Officer must consult—

(a) The Commissioner, and

(b) such persons appearing to the relevant Chief Medical Officer to represent the interests of persons who have protected characteristics as the relevant Chief Medical Officer considers appropriate.

(5) An appropriate national authority must—

(a) publish any report received under this section,

(b) prepare and publish a response to any such report, and

(c) lay before Parliament or Senedd Cymru (as the case may be) a copy of the report and response.

(6) In this section “appropriate national authority” means the Secretary of State or the Welsh Ministers.

(7) In this section “protected characteristics” has the same meaning as in Part 2 of the Equality Act 2010 (see section 4 of that Act).

(8) In this section “relevant Chief Medical Officer” has the meaning given by section 37(5).”

This new clause would require the monitoring, investigation and reporting functions set out in the Bill to be carried out by the Chief Medical Officer instead of the Voluntary Assisted Dying Commissioner.

New clause 5—Implications for civil procedure rules and probate proceedings—

“(1) The Secretary of State must, within six months of the passing of this Act, publish a report setting out the implications of this Act on—

(a) the civil procedure rules, and

(b) probate proceedings.

(2) The report in subsection (1) must include an analysis of likely consequential changes to the civil procedure rules and probate proceedings in consequence of this Act.”

New clause 6—Board to consult communities—

“(1) The Commissioner must, within six months of being appointed under this Act, appoint a consultation board.

(2) The role of the board is to consult communities in order to report to the Commissioner on the impact of the Act on those communities.

(3) The Board must report to the Commissioner and the Secretary of State every 12 months from its appointment on its findings.

(4) The communities that the Board must consult include people from Black, Asian and Minority Ethnic communities.

(5) The Board may consult other groups in addition to those listed in subsection (4) as it considers appropriate.

(6) The Secretary of State must, within 3 months of receiving a report under subsection (3), lay that report before both Houses of Parliament.”

New clause 19—Collection of statistics—

“(1) The Voluntary Assisted Dying Commissioner must ensure that the statistics specified in Schedule (Statistics to be collected) are collected.

(2) The Commissioner must publish a yearly report setting out those statistics.

(3) The Secretary of State may, by regulation, vary the contents of Schedule (Statistics to be collected).”

Amendment 13, in clause 4, page 2, line 22, at end insert—

“(2A) A person may not be appointed under subsection (2) unless the appointment has the consent of the Health and Social Care Select Committee of the House of Commons.

(2B) In this section, references to the Health and Social Care Committee shall—

(a) if the name of that Committee is changed, be taken (subject to paragraph (b)) to be references to the Committee by its new name;

(b) if the functions of that Committee at the passing of this Act with respect to matters relating to the provision of assistance under this Act become functions of a different committee of the House of Commons, be taken to be references to the committee by whom the functions for the time being exercisable.”

Amendment 96, in clause 25, page 21, line 5, at end insert—

“(1A) A drug or other substance may only be approved under this Act if the Secretary of State is reasonably of the opinion that there is a scientific consensus that this drug (or other substance) or combination of drugs (or other substances), is effective at ending someone’s life without causing pain or other significant adverse side effects.”

This amendment ensures that drugs can only be approved if the Secretary of State is reasonably of the opinion that there is a scientific consensus that the drug is effective at ending someone’s life without causing pain or other significant adverse side effects.

Amendment 97, page 21, line 5, at end insert—

“(1A) A drug or other substance may only be approved under this Act if it has been licensed by the Medicines and Healthcare products Regulatory Agency for that purpose.”

This amendment ensures that drugs can only be approved for this purpose if the MHRA has licensed those drugs for that purpose.

Amendment 98, page 21, line 5, at end insert—

“(1A) Nothing in subsection (1) requires the Secretary of State to approve any drugs or other substance if they conclude that there are no appropriate drugs or other substances to approve.”

If the Secretary of State concludes that no drugs or substance is appropriate to be used, then the Secretary of State is not required by subclause 25(1) to approve any.

Amendment 27, page 21, line 7, at end insert—

“(2A) The doses and types of lethal drugs specified in any regulations made under subsection (1) must be licensed by the Medicines and Healthcare products Regulatory Agency.

(2B) The doses and types of lethal drugs to bring about the person’s death must be recommended by the guidelines of either—

(a) the National Institute of Clinical Excellence, or

(b) the All Wales Medicines Strategy Group in Wales, as appropriate, prior to licensing.”

This amendment will require the doses and types of lethal drugs to be licensed by the Medicines and Healthcare products Regulatory Agency and to be recommended by either the National Institute of Clinical Excellence or the All Wales Medicines Strategy Group in Wales as appropriate prior to licensing.

Amendment 99, page 21, line 7, at end insert—

“(2A) The Secretary of State may not lay a draft statutory instrument containing (whether alone or with other provision) regulations under subsection (1) before both Houses of Parliament unless they also lay before both Houses a report setting out all relevant information on the likely time to death, complications (including pain) and likely side effect.”

This amendment requires that a report be provided to Parliament setting out the information available on the proposed drugs, including time to death, complications (including pain) and likely side effects. Such a report is required before Parliament votes to approve the drugs or substance. See consequential Amendment 100.

Amendment 69, page 21, line 8, leave out subsection (3) and insert—

“(3) See section (Regulation of approved substances and devices for self-administration) for powers to make provision about—

(a) approved substances, and

(b) devices for use or used in connection with the self-administration of approved substances.”

This is consequential on NC13.

Amendment 53, line 24, leave out clause 34

This amendment is consequential on NC13.

Amendment 54, line 34, leave out clause 35

This amendment is consequential on NC15.

Amendment 19, in clause 36, page 27, line 17, at end insert—

“(ba) how the provisions of this Act relate to the operation of—

(i) the Government’s strategy on suicide prevention,

(ii) the duties on clinicians and others to secure the right to life, including of those at risk of suicide, under paragraphs 1 and 2 of Article 2 (Right to Life) set out in Schedule 1 of the Human Rights Act 1998,

(iii) the Mental Health Act 1983,

(iv) deprivation of liberty safeguards as set out in Schedule A1 to the Mental Capacity Act 2005, and

(v) liberty protection safeguards as set out in Schedule AA1 to the Mental Capacity Act 2005.”

Amendment 70, page 27, line 20, at end insert—

“(ca) ensuring effective communication in connection with persons seeking assistance under this Act to end their own lives, including the use of interpreters;”

This amendment provides that a code of practice must be issued covering ensuring effective communication in connection with persons seeking assistance under the Bill.

Amendment 108, page 27, line 31, at end insert—

“(h) how the provisions of this Act, including but not limited to section 23, interact with the provisions of the Abortion Act 1967.”

Amendment 71, page 27, line 35, leave out subsection (3).

This amendment is consequential on amendment 70.

Amendment 20, page 28, line 5, leave out subsection (8) and insert—

“(8) If it appears to a court or tribunal conducting any criminal or civil proceedings that—

(a) a provision of a code, or

(b) a failure to comply with a code,

is relevant to a question arising in the proceedings, the provision or failure must be taken into account in deciding the question.”

Amendment 89, page 28, line 7, leave out clause 37.

This amendment is consequential on NC20.

Amendment 34, in clause 37, page 28, line 14, at end insert—

“(ii) persons from Black, Asian and Minority Ethnic communities and advocate groups representing those communities, and

(iii) representatives of the healthcare sector, including persons who work in hospices.”

Amendment 12, clause 38, page 28, line 36, leave out subsections (4) and (5) and insert—

“(4A) Regulations under subsection (1) may not amend, modify or repeal section 1 of the National Health Service Act 2006.”

This amendment would prevent section 1 of the National Health Service Act 2006, which sets out the purposes of the NHS, from being amended by regulations. Its effect would be to require changes to be made by an Act of Parliament instead.

Amendment 105, page 29, line 4, leave out subsection (6).

Amendment 15, page 29, line 5, at end insert—

“(6A) Regulations under this section must provide that, where a body other than a public authority provides voluntary assisted dying services under subsection (1), that body must publish an annual statement that includes information on the following—

(a) the number of persons to whom the body has provided a preliminary discussion under section 5(3);

(b) the number of to persons whom the body has assessed under section 9(1);

(c) the number of persons whom the body has assessed under section 10(1);

(d) the number of persons to whom assistance has been provided under section 23(2);

(e) the cost and revenue associated with providing such assistance; and

(f) any other matter that the Secretary of State may specify.”

This amendment would require private providers of the services permitted under the Act to publish annual statements of the numbers of people to whom they have provided those services. It would also require them to disclose their associated costs and revenue.

Amendment 92, in clause 39, page 29, line 13, leave out from “Wales” to end of line 14.

Amendment 106, page 29, line 16, leave out subsection (2)(a).

Amendment 107, page 29, line 22, leave out subsection (4)(a).

This amendment and amendment 93 ensure that the power under subsection (3) also covers provision securing that arrangements are made for the provision of services, so far as such provision is outside the legislative competence of the Senedd.

Amendment 93, page 29, line 27, at end insert—

“(b) a reference to provision about voluntary assisted dying services includes in particular provision securing that arrangements are made for the provision of such services.”

See the statement for Amendment 92.

Amendment 29, in clause 40, page 30, line 5, at end insert—

“(5) Any notification to the Commissioner made pursuant to regulations under this section must be forwarded by the Commissioner to the relevant Chief Medical Officer.

(6) The relevant Chief Medical Officer may exercise any power granted to the Commissioner under subsection (2).

(7) In this section “relevant Chief Medical Officer” has the meaning given by section 37(5).”

Amendment 21, in clause 43, page 31, line 15, at end insert—

“(4) For the first reporting period referred to under subsection (2) (a) the report must set out an assessment of the state of health services to persons with palliative and end of life care needs and the implications of this Act on those services.

(5) The report under subsection (4) must, in particular, include an assessment of the availability, quality and distribution of appropriate health services to persons with palliative and end of life care needs, including—

(a) pain and symptom management;

(b) psychological support for those persons and their families;

(c) information about palliative care and how to access it.”

This amendment would require the Secretary of State for Health and Social Care to prepare and publish an assessment of the availability, quality and distribution of palliative and end of life care services as part of the first report on implementation of the Act (to be undertaken within 1 year of the Act being passed). This would mirror the assessment already required as part of the 5 year review of the act.

Amendment 28, page 31, line 32, leave out clause 45.

This amendment is linked to NC4.

Amendment 35, clause 45, page 32, line 20, after “characteristics” insert

“, including persons representing Black, Asian and Minority Ethnic communities,”.

Amendment 36, in clause 46, page 33, line 11, after “disabilities” insert

“, and

(ii) persons from Black, Asian and Minority Ethnic communities”.

Amendment 90, page 33, line 18, leave out clause 47.

This amendment is consequential on NC21.

Amendment 39, in clause 47, page 33, line 19, after “provided” insert “in Wales”.

This amendment specifies that this section applies only to services provided in Wales.

Amendment 40, page 33, line 24, at end insert—

“(2A) Any entity providing a service or fulfilling a function under this Act must take all reasonable steps to ensure the particular health professionals providing a service or fulfilling a function under sections 5, 9,10, 12, 15, and 23 have fluent proficiency in the Welsh language, if the services are to be provided to a person in Welsh under subsection (1).

(2B) For the purposes of subsection (2A), “fluent” includes speaking fluent Welsh in order to enable conversations with the person in Welsh.

(2C) The Commissioner must take all reasonable steps to ensure members of Assisted Dying Panels will, if the person to whom the referral relates has asked for services to be provided in Welsh, when hearing from or questioning that person under section 15(4)(b), do so in Welsh.”

Amendment 103, in clause 50, page 34, line 24, leave out from “under” to end of line 29 and insert

“any provision of this Act unless a draft of the instrument has been laid before, and approved by a resolution of, each House of Parliament.”

This amendment would require all statutory instruments in the Act, except commencement orders, to be made by the draft affirmative procedure. It is linked with Amendment 104 which creates the power for the Secretary of State to use the made affirmative procedure in cases of emergency.

Amendment 72, page 34, line 24, after “10(9)”, insert—

“(Regulation of approved substances and devices for self-administration),”.

This amendment provides that regulations under NC13 are subject to the draft affirmative procedure.

Amendment 50, page 34, line 24, after “10(9),” insert “(Doctor independence)”.

This amendment makes regulations under NC7 [Doctor independence] subject to the affirmative procedure.

Amendment 100, page 34, line 24, after “10(9),” insert “25(1)”.

This amendment makes regulations under clause 25(1) subject to the draft affirmative procedure. It is consequential on Amendment 99.

Amendment 73, page 34, line 25, leave out “or 39” and insert—

“39, or (prohibition on advertising)”.

This amendment provides that regulations under NC14 are subject to the draft affirmative procedure.

Amendment 88, page 34, line 25, after “39” insert “or (Collection of statistics)”.

This amendment provides that the changes to NS2 should be made by affirmative regulations, and is consequential to NS2.

Amendment 104, page 34, line 32, at end insert—

“(5A) If they reasonably consider it urgent and necessary for the protection of others, the Secretary of State or the Welsh Ministers may dispense with the requirement to lay a draft statutory instrument.”

This amendment is linked with Amendment 103. It creates the power for the Secretary of State to use the made affirmative procedure in cases of emergency (this means that it would come into effect straight away but there would be a vote afterwards).

Amendment 76, in clause 53, page 36, line 12, at beginning insert “Subject as follows,”.

This amendment is consequential on amendment 77.

Amendment 77, page 36, line 12, at end insert “only.

(2) Sections (Regulation of approved substances and devices for self-administration), (Prohibition on advertising), 50 and 52, this section, and sections 54 and 55 extend to England and Wales, Scotland and Northern Ireland.

(3) Section (No obligation to provide assistance etc)(8) and Schedule (Protection from detriment) extend to England and Wales and Scotland.”

This amendment provides for NC13 (regulation of approved substances etc) and NC14 (prohibition on advertising), and the general provisions of the Bill, to extend to each part of the United Kingdom; and for NC10 (no obligation to provide assistance etc) and NS1 (protection from detriment) to extend to England and Wales and Scotland.

Amendment (a) to amendment 77, in subsection (2), leave out

“(Regulation of approved substances and devices for self-administration),”.

This would provide that NC13 (regulation of approved substances etc…) does not extend to each part of the United Kingdom and only applies, like most of this Bill, to England and Wales.

Amendment (b) to amendment 77, in subsection (3), leave out “and Scotland”.

This amendment would provide that subsection (8) of NC10 (no obligation to provide assistance) and NS1 (protection from detriment) only extend to England and Wales.

Amendment 42, in clause 54, page 36, line 16, leave out subsections (2) to (5) and insert—

“(2) In relation to England, the provisions of this Act not brought into force by subsection (1) come into force on such day or days as the Secretary of State may by regulations appoint.”

This amendment will mean that, except as provided by subsection (1), provisions of the Bill will only commence in England when the Secretary of State makes a commencement order, and not automatically.

Amendment 37, in clause 54, page 36, line 21, leave out subsection (4) and insert—

“(4) Regulations under this section cannot be made unless the Secretary of State has previously—

(a) made a statement to the effect that in their view the provisions of the Act are compatible with the Convention rights; or

(b) made a statement to the effect that although they are unable to make a statement under subsection (4)(a), the Government nevertheless wishes to proceed with commencing provisions of the Act.

(4A) The statement required by subsection (4) must be laid before both Houses of Parliament.

(4B) A statement under subsection (4)(b) must include the steps the Government plans to take to resolve any incompatibility.”

Amendment 3, page 36, line 22, leave out “four” and insert “three”.

Amendment 94, page 36, line 25, leave out “Wales” and insert—

“sections 39(1) and (2) and (Provision about the Welsh language)(2) and (3) which come into force on such day as the Welsh Ministers may by regulations appoint.”

This amendment provides that the Welsh Ministers have power to commence clauses 39(1) and (2) and NC21(2) and (3), and that other provisions of the Bill come into force in accordance with subsections (1) to (4) of this clause.

Amendment 95, page 36, line 26, leave out subsection (6).

This amendment is consequential on Amendment 94.

New schedule 2—Statistics to be collected—

“Characteristics

1 The Voluntary Assisted Dying Commissioner must collect the following information about persons requesting assisted dying—

(a) sex,

(b) age,

(c) self-reported ethnicity,

(d) level of education,

(e) Index of Multiple Deprivation based on postcode,

(f) region of residence,

(g) marital status,

(h) living status (alone, with others, in a care home etc),

(i) main condition leading to “terminal illness” fulfilment,

(j) other medical conditions,

(k) other psychiatric / mental health conditions,

(l) presence of physical disability, and

(m) presence of intellectual disability.

Health and Care Support

2 The Commissioner must collect statistics on the following information about health and care support—

(a) whether the person was, before the request—

(i) under a specialist palliative care team, and

(ii) under a psychiatry team,

(b) whether following the request there has been—

(i) referral to specialist palliative care team, and

(ii) referral to psychiatry team following request.

Information about requests

3 The Commissioner must collect statistics on the following information about the requests for assistance—

(a) the main reason for requesting assisted dying,

(b) any other subsidiary reason for requesting assisted dying,

(c) any previous requests for assisted dying from that patient,

(d) time between first request and subsequent request(s),

(e) number of times a second opinion was requested under section 10, and

(f) number of times the second opinion disagreed with the first.

Information about refused requests

4 The Commissioner must collect statistics following information about requests that are refused—

(a) at what stage of the process was the request refused, and

(b) reasons for refusal.

Information about the process

5 The Commissioner must collect statistics on the following information about the process—

(a) time from initial discussion to first declaration,

(b) time from first declaration to first doctor’s assessment,

(c) time from first doctor’s assessment to second doctor’s assessment,

(d) time from second doctor’s assessment to panel approval,

(e) time from panel approval to second declaration,

(f) time from second declaration to provision of assistance to self-administer lethal drugs,

(g) time from panel approval to death (whether by lethal drug or natural causes),

(h) duration of relationship between patient and coordinating doctor at first request, and

(i) use of a proxy and reason for using proxy.

Information about clinicians and pharmacies

6 The Commissioner must collect statistics on the following information about clinicians and pharmacies—

(a) number of clinicians participating, their speciality, and number of assisted deaths each carries out per year, and

(b) number of participating pharmacies; number of times assisted dying drugs are dispensed.

Information about Assisted Dying Panel processes

7 The Commissioner must collect statistics on the following information about Assisted Dying Panel process—

(a) number of applications made,

(b) number of applications granted and rejected,

(c) reasons for rejection,

(d) whether family members informed of proceedings,

(e) whether family members took part in proceedings,

(f) number of requests for reconsideration made,

(g) number of reconsideration requests granted and rejected, and

(h) reasons for granting requests.

Information on approved substances

8 The Commissioner must collect statistics on the following information about the approved substances—

(a) name of drug(s) used for the assisted death,

(b) whether intravenous or oral self-administration is used,

(c) presence and nature of complications following self-administration of drugs (vomiting, regurgitation, seizures, regained consciousness, other),

(d) time from self-administration to loss of consciousness,

(e) time from self-administration to death,

(f) whether emergency services called at any time following self-administration of drugs,

(g) location of death,

(h) health care professionals present at self-administration,

(i) non-professionals present at self-administration,

(j) health care professionals present at death,

(k) non-professionals present at death.”

Amendment 82, in schedule 2, page 41, line 18, leave out sub-paragraph (1) and insert—

“(1) The Judicial Appointments Commission must make arrangements for the appointments to a list of persons eligible to sit as members of panels.”

This amendment requires that panel members be appointed by the Judicial Appointments Commission. It is linked with Amendments 83, 84, 85 and 86.

Amendment 83, page 41, leave out lines 23 to 26 and insert—

“but has not reached the age specified in section 11 (Tenure of office of judges of Senior Courts) of the Senior Courts Act 1981.”

This amendment requires that the legal member of the Panel is someone who holds high judicial office or has held high judicial office but not yet reached the mandatory retirement age. It is linked with Amendments 83, 84, 85, and 86.

Amendment 41, page 41, line 34, at end insert—

“(2A) In Wales, the Commissioner must take all reasonable steps to ensure each member of a panel has fluent proficiency in the Welsh language if services or functions in the Act are to be provided to an individual in Welsh under section 47(1).

(2B) For the purposes of subsection (2A), “fluent” includes speaking fluent Welsh.”

Amendment 84, page 42, line 2, leave out “or deputy judge”.

This amendment ensures that only High Court judges, and not deputy High Court judges, can chair the panel. It is linked with Amendments 83, 84, 85 and 86.

Amendment 85, page 42, line 2, at end insert—

“(4) All judges of the High Court are automatically on the list and will remain so for the duration of their appointment to the High Court.

(5) If they have not already, all persons on the list (whether as a legal member, psychiatrist member, or social care member) must take the judicial oath.”

This amendment makes all High Court judges automatically eligible to chair panels without needing further application and it requires that the non-legal members take the judicial oath before they can sit. It is linked with Amendments 83, 84, 85 and 86.

Amendment 86, page 43, line 5, at end insert—

“(3) Panels shall have the same powers, privileges and authority as the High Court.”

This amendment gives the panel the same powers as the High Court. It is linked with Amendments 83, 84, 85 and 86.

[Kim Leadbeater]

It is a privilege to open today’s debate and to present to the House the amendments tabled in my name, a number of which relate to issues that I promised to return to when they were raised in Committee. All amendments in my name have been drafted with technical advice and expertise from civil servants from the Department of Health and Social Care and the Ministry of Justice, along with the brilliant Government Legal Department and the Office of the Parliamentary Counsel, in order to make the Bill workable and to give coherence to the statute book, as confirmed by the Minister for Care, my hon. Friend the Member for Aberafan Maesteg (Stephen Kinnock), and the Minister for Courts and Legal Services, my hon. and learned Friend the Member for Finchley and Golders Green (Sarah Sackman), in their recent letter to MPs. Some are technical and drafting amendments, and all are there to strengthen the Bill, so I hope that colleagues will be able to support them, wherever they stand on the principle of assisted dying.

I know that many colleagues wish to speak today, so I will endeavour to speak with brevity. I will speak first to the new clauses that stand in my name, starting with new clause 13. This important new clause and the related amendments would create a regulatory framework and safeguards around the approved substances referred to in the Bill by imposing a duty to make regulations about those substances and a power to make regulations about devices for use in connection with their self-administration.

Amendment 72 provides that the regulations relating to approved substances would be subject to the affirmative procedure, meaning that they must be laid before Parliament and approved by resolution of both Houses, providing important parliamentary oversight. These measures ensure that the substances used in assisted dying are subject to a specific and appropriate regulatory regime.

--- Later in debate ---

[Dr Jeevun Sandher (Loughborough) (Lab)]

Thank you, Mr Speaker, for allowing me to rise to speak to new clause 6, which proposes a special representative for ethnic minorities. I am not white, as some Members may have noticed. The fact that my presence in this House is unremarkable is in and of itself remarkable. That did not happen by chance; it happened because of those who came before me.

The Mother of the House, my right hon. Friend the Member for Hackney North and Stoke Newington (Ms Abbott), has spoked powerfully in this debate, and I know that my unremarkable presence here is due to her remarkable achievements. We may not always hold the same opinions, but we have always shared the same Labour values. She will never know how grateful we all are to her. I may be part of the last generation of MPs who can say this to her while she is in the House: thank you.

My hon. Friend the Member for Vauxhall and Camberwell Green (Florence Eshalomi) has spoken powerfully in this debate, and my right hon. Friend the Member for Walsall and Bloxwich (Valerie Vaz) has tabled new clause 6. I know I stand on their shoulders too, and I do not doubt their good intentions, but this Bill has nothing to do with the colour of my skin. New clause 6 proposes a special representative for ethnic minorities. I disagree with the new clause, because the colour of my skin has no bearing here and no special place in this debate. Equalities data will be reported through the Equality and Human Rights Commission, as set out in clause 51, and the Secretary of State can already consult community representatives. For every person of every skin colour, this Bill gives those already dying a choice to end their suffering—

[Mr Speaker]

Order. We need to make sure that contributions are tied to the amendments. We are not debating the general points of the Bill—we have gone past that. The hon. Gentleman is making more of a Third Reading speech, which he might want to save.

[Dr Sandher]

It is to the point of where we are—

[Mr Speaker]

Order. I will make that decision. Please do not challenge the Chair.

[Dr Sandher]

I do apologise, Mr Speaker.

What I meant to say is that new clause 6 would introduce a special representative for ethnic minorities, and I am trying to explore why we do not need one. A duty to consult is already included in clause 51.

--- Later in debate ---

[Several hon. Members rose—]

[Mr Speaker]

May I informally suggest that we aim for speeches of around six minutes? I call Paul Waugh to provide a good example.

[Paul Waugh (Rochdale) (Lab/Co-op)]

I rise to speak in support of the amendment in my name, which seeks to strengthen new clause 14 tabled by my hon. Friend the Member for Spen Valley (Kim Leadbeater). Why do we want to restrict advertising about assisted dying? It is not just because such adverts could appear crass or insensitive, or because we worry that private companies could profiteer from death, but because advertisers know that they influence choices. The issue of choice, whether it is informed choice, skewed choice, self-coercion or coercive control, as has already been mentioned, is, in many ways, at the heart of the Bill and whether its safeguards are sufficient.

My brother works in advertising and he knows its power. It is why companies spend billions of pounds on it, why Google is the giant that it is, why we see lots of adverts at Westminster tube station trying to influence every single one of us, and why X is full of ads. Advertising works because we human beings are suggestible, and prone to messaging, visual cues and hints. Older people are bombarded with adverts for everything from stairlifts to care homes. One person’s advert, though, is another person’s public information campaign. It is not impossible to imagine a future Secretary of State, who passionately believes in the merits of assisted dying, authorising such a campaign. It could be a Government-approved plotline in a soap opera, or an ad read out by a podcaster that ever so subtly sounds like a news item, or even their own opinion. Many in this House rightly try to protect teenagers from online harms, but the online harm of an ad for a website about assisted dying shared on TikTok could be a reality without the tighter safeguards in my amendment.

NHS and Care Volunteer Responders Service

Lindsay Hoyle Excerpts

Monday 19th May 2025 Commons Chamber

[Karin Smyth]

I am happy to give my hon. Friend an absolute assurance. Volunteers support and complement the existing workforce; they do not replace it. Including volunteers signals a recognition of the important role they play in supporting staff, services and patients. Many hon. Members are volunteers and we have all seen how those volunteers can support the wider system. However, it is important that we keep our staff and respect their important roles.

[Mr Speaker]

I call the spokesperson for the Liberal Democrats.

[Helen Morgan (North Shropshire) (LD)]

I was a volunteer vaccination steward during the pandemic, and the Liberal Democrats are hugely grateful to the thousands of volunteers who have made a difference to the lives of patients and vulnerable people in their communities since the pandemic ended. Their compassion and commitment have been inspiring.

We are concerned that the end of the programme has been announced at extremely short notice; there will be no further shifts in just 12 days’ time. Will the Minister reassure the House that those currently receiving help from the volunteer scheme, such as collecting prescriptions or fetching shopping, will not be left high and dry after next Saturday? Has the Department conducted an impact assessment? If so, will it publish it? As with so many major decisions, such as dropping cross-party talks on social care or cutting funding for integrated care boards by 50%, it is concerning that the Government did not come to the House first to answer questions from hon. Members. Will the Minister reassure the House that these decisions will improve patient care and that they are not just a cost-cutting exercise dictated by the Treasury?

--- Later in debate ---

[Dr Caroline Johnson (Sleaford and North Hykeham) (Con)]

On a point of order, Mr Speaker. Notwithstanding the response to the urgent question that you were kind enough to grant, we still have no idea how long the gap in the service will last, or what will happen to the most vulnerable people who are using it. What other parliamentary mechanisms could I use to secure the answers to these questions?

[Mr Speaker]

I think that, in fairness, I cannot allow the debate to continue, which is what I think the hon. Lady is trying to tempt me towards. What I would say, however, is that I am sure that the good offices around her will give some very strong advice. I am sure that the Table Office and others will be able to advise her on how she can pursue this matter, and I am sure that those on the Front Bench have heard her point of order.

Brain Tumours: Research and Treatment

Lindsay Hoyle Excerpts

Thursday 8th May 2025 Commons Chamber

On resuming—

[Mr Speaker]

I believe we are now coming to the statement.

[The Minister for Trade Policy and Economic Security (Mr Douglas Alexander)]

On a point of order, Mr Speaker. It had been the intention of the Government to make a statement to the House this afternoon immediately following the scheduled press conference by the US President and the words of our own Prime Minister. Both of those sets of remarks were delayed, with the result that, at this relatively late hour, the Government would now suggest respectfully to you that it would be more courteous to the House to be able to provide all Members with the opportunity for a full statement on Monday. If that does not—

[Mr Speaker]

Order. The Government have to come forward with a statement. They converted an urgent question to a statement this morning, so a statement has to be made. What the Minister says cannot be done on a point of order, as that would be unfair. I understand that people were going around telling Members to go home as there would be no statement, because Downing Street had decided that. We do not do business like this: it is totally wrong. To give him the benefit of the doubt, I am sure he would like to update the House on the position now, and I would of course expect the details to come on Monday.

[Mr Alexander]

I am grateful to you, Mr Speaker, and I of course defer to your judgment and will issue the statement—

[Mr Speaker]

Order. It is not my judgment; these are the rules of the House. An urgent question was put in, and it was converted by the Government into a statement, so it is for the Government now to come forward with the statement.

Oral Answers to Questions

Lindsay Hoyle Excerpts

Tuesday 6th May 2025 Commons Chamber

[Karin Smyth]

My hon. Friend is absolutely right to highlight that point, which has been found in all the reviews that have been undertaken. It is completely unacceptable. That is why the Secretary of State has continued to meet families and hear their experiences to ensure that we learn from them, continue to support the implementation of those recommendations and, crucially, ensure that women’s voices are taken forward as part of our 10-year plan.

[Mr Speaker]

I call the shadow Secretary of State.

[Edward Argar (Melton and Syston) (Con)]

I fear that many will have found the Minister’s answer to my hon. Friend the Member for Windsor (Jack Rankin) disappointing. He highlighted that the previous Government committed to the headline recommendation of the cross-party birth trauma inquiry led by the hon. Member for Canterbury (Rosie Duffield) and the former Member for Stafford, Theo Clarke, who has recently written about her experiences in a book, and in the Daily Mail called for a national maternity improvement strategy. No equivalent commitment has been made by this Government. Let us try again: will the Minister commit without any equivocation to implementing the inquiry’s recommendation to produce a national maternity improvement strategy?

[Karin Smyth]

To be clear for the shadow Secretary of State, the Secretary of State is continuing to look at all those recommendations and consider how best to respond.

[Mr Speaker]

We now come to the Liberal Democrat spokesperson.

[Helen Morgan (North Shropshire) (LD)]

Too many families in Shropshire have suffered the agonising loss of a baby following the scandal at Shrewsbury and Telford hospital NHS trust. The Care Quality Commission rates 65% of trusts as inadequate or requiring improvement for maternity safety, and the taxpayer forked out a staggering £1.15 billion in compensation for maternity failings last year. With the £100 million put aside to deal with unsafe staffing no longer ringfenced, can the Minister reassure us that those safe staffing levels will remain on our maternity wards?

--- Later in debate ---

[Wes Streeting]

I wholeheartedly join my hon. Friend in thanking Pam and everyone at Compassion in Action for the work that they do. At the heart of our approach to health is a recognition that Government action is essential for improving health outcomes in the country, and that Government acting alone will not be sufficient. That is why working with the voluntary sector, employers, trade unions, community groups and all of us as individual citizens is vital for tackling health inequalities and improving care in our country. I would be delighted to ensure that one of the team pays a visit to the charity as soon as possible.

[Mr Speaker]

Stuart Anderson, welcome back.

[Stuart Anderson (South Shropshire) (Con)]

Community hospitals can reduce pressure on major hospitals, especially in rural communities such as mine. Will the Secretary of State lay out his plans to support community hospitals in South Shropshire?

--- Later in debate ---

[Wes Streeting]

Thanks to the decisions taken by this Chancellor, we are putting £26 billion more into health and social care. Thanks to the decisions taken by this Chancellor, the spending power of local authorities has risen. Thanks to the decisions taken by this Chancellor, we have delivered the biggest expansion of carer’s allowance since the 1970s. Thanks to the decisions taken by this Chancellor, we have significantly increased the disabled facilities grant, not just last year but this year. That is the investment delivered by a Labour Government, and opposed by the Conservatives and Reform, and it shows that only Labour can be trusted with our NHS.

[Mr Speaker]

You will have another chance in a minute! I call the shadow Minister.

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

This Government have been in power for 10 months. Two months ago, Labour postponed the cross-party talks on social care. When will they be rescheduled?

--- Later in debate ---

[Alex Brewer (North East Hampshire) (LD)]

A piece of technology that already exists that can prevent hydrocephalus is the humble tape measure. The Secretary of State said that he would ask the National Institute for Health and Care Excellence to conduct a review of the frequency with which infants’ heads should be measured to allow us to detect hydrocephalus early. The charity Harry’s HAT—Hydrocephalus Awareness Trust—based in my constituency says that this review is not necessary, and that the evidence is already there. Will the Minister meet me and the charity to discuss this further, so that more infants’ lives can be saved?

[Mr Speaker]

In fairness, the Secretary of State did meet them.

[Ashley Dalton]

And he has just sold me on what a wonderful charity it is. I would be more than happy to make sure that the relevant Minister meets the hon. Member to discuss the matter.

--- Later in debate ---

[Wes Streeting]

My hon. Friend has huge experience in this area, and she is absolutely right. What we saw under the Conservatives was bloated bureaucracy—layer upon layer of checkers, when we need more doers. That is why frontline staff, patients and provider leaders all welcome the changes that we are making, so that we can invest more into our frontline.

[Mr Speaker]

I call the shadow Secretary of State.

[Edward Argar (Melton and Syston) (Con)]

The Health Service Journal reports that officials have acknowledged that the first draft of a high-level plan for merging NHS England and DHSC has been delayed. When we ask any written question about the merger, the standard answer seems to be:

“Ministers and senior Department officials will work with the new transformation team at the top of NHS England, led by Sir Jim Mackey, to determine the structure and requirements needed to support the creation of a new centre for health and care.”

Even when we ask a question specifically about the size of the transformation team, the answer is virtually identical. The Government either wilfully decide not to answer, or simply do not know. As with so many things, the Government go for the headline-grabbing announcement and talk the talk on reform, without having done the actual work to deliver it. My question to the Secretary of State is simple: when will that first high-level plan for the merger, with a full assessment of costs and savings, be published?

--- Later in debate ---

[Wes Streeting]

I would be delighted to do so. Since we came into government, we have made this announcement today, put £889 million into general practice and agreed a contract with GPs, including reform for patient access and services. We are fixing the front door to the NHS, but of course that will take time. We recruited 1,500 more GPs by the end of March, but day by day, week by week, month by month and year by year, people should see improvements in their GP services thanks to Labour.

[Mr Speaker]

I call the shadow Minister.

[Dr Caroline Johnson (Sleaford and North Hykeham) (Con)]

Taking medicines on time is important, especially for those with conditions such as diabetes and epilepsy. Dr Acheson, an A&E consultant who has time-critical medicines for his own Parkinson’s disease, understands that well. He has been running a quality improvement programme to ensure that time-critical medicines are given on time in A&E. Will the Secretary of State lend that project his support and commit to reviewing how time-critical medicines are delivered on wards?

--- Later in debate ---

[The Parliamentary Under-Secretary of State for Health and Social Care (Ashley Dalton)]

I add my heartfelt condolences to Arlo’s family. In September, we launched a new series of funding opportunities designed to improve brain cancer research for both adults and children. We are committed to furthering our investment and support for high-quality brain tumour research, ensuring that funding is used in the most meaningful and impactful way. Hon. Members will note that there is a debate on Thursday on brain tumours, and I will be attending the all-party parliamentary group on brain tumours next week.

[Mr Speaker]

I call the Liberal Democrat spokesperson.

[Helen Morgan (North Shropshire) (LD)]

In his statement to the House just after Christmas, the Secretary of State acknowledged that cross-party consensus is essential to delivering meaningful social care reform. The Liberal Democrats support him in that endeavour, but we still do not have a date for those cross-party meetings, so will he give us one now?

--- Later in debate ---

[Jim Dickson (Dartford) (Lab)]

T9. Far too many promises made by the last Government—promises that care would be moved out of hospitals and into the community—turned out to be hollow. From speaking to residents in Dartford, I know that hospital and community services have struggled to keep pace with new housing developments in the constituency. I am pleased to say that later this year in Dartford we will be seeing an expansion of our state-of-the-art community diagnostic centre, taking care closer to where people live. Does the Secretary of State agree that this is the start of Labour getting on with finally delivering that big shift, and will he visit Dartford with me—

[Mr Speaker]

Order. I think Ministers have got the message. If they have not by this stage, I would be surprised. Who is answering?

[The Minister for Secondary Care (Karin Smyth)]

My hon. Friend is absolutely right that this is exactly the sort of thing that is being rolled out across the country, and that we are committed to delivering care closer to where his residents live.

Hospitals

Lindsay Hoyle Excerpts

Wednesday 23rd April 2025 Commons Chamber

[Mr Speaker]

I inform the House that I have selected the amendment in the name of the Prime Minister.

--- Later in debate ---

[Helen Morgan]

No. I have been very generous with my time and I am going to make some progress.

We are also campaigning for a review of outdated Government finance rules that prevent NHS trusts from investing the funds that they have raised into their own buildings. Even NHS managers struggle to access common-sense investment in their facilities due to overly complex rules and glacial processes. Trusts are prevented from using unspent funds on improving their buildings. We need root-and-branch reform, combined with our 10-year programme of investment, to bring our local health facilities up to scratch.

In conclusion, the recent history of the NHS is one of short-term decision making and of the failure of successive Governments to grasp the nettle of long-term sustained investment in the things that matter: hospital buildings, GP services, dentistry, pharmacy and, crucially, the unspoken crisis of social care. The outcome is an organisation that is spending millions of pounds to go backwards. It truly is a false economy.

This Government have spoken warmly of the need to reform the NHS and improve productivity, and we support them in that, but we cannot expect to retain staff and provide high-quality care when so many doctors and nurses are negotiating leaking roofs and sewage backing up on the wards. Dealing with the new hospital programme is a matter of urgency, and I urge the Secretary of State to, at long last, grasp the nettle.

[Mr Speaker]

I call Stephen Kinnock—is it?—to move the amendment; I have a different name in front of me.

Eating Disorder Awareness

Lindsay Hoyle Excerpts

Tuesday 1st April 2025 Westminster Hall

[Mr Luke Charters (York Outer) (Lab)]

It is a pleasure to speak with you in the Chair, Mr Stuart. I pay tribute to the hon. Member for Bath (Wera Hobhouse) for securing this debate, and of course my hon. Friend the Member for Camborne and Redruth (Perran Moon); he is an inspirational dad with an inspirational daughter, and we all wish his family well.

I will speak about eating disorders affecting young men and boys. We need to focus on online influencers and the impact they can have on eating disorders, so of course I must mention the TV show “Adolescence”. An under-discussed theme of the series was the 13-year-old boy’s concern about his own body image, driven by social media. Recent research shows that eating disorders are growing at a faster rate in young men—a concerning trend.

Over the last few years we have seen toxic influencers drive false expectations about what young men should look like, and some young boys are being diagnosed with a lesser condition called bigorexia or muscle dysmorphia. Bigorexia drives boys to engage in extreme behaviours such as excessive weightlifting for their age, steroid use and excessive dieting and supplement intakes, all in pursuit of a totally unattainable ideal.

“Gym bros” and fitness influencers are giving impressionable young men and boys a false sense of security about many products. Paediatric science is uncertain about the effects of the intake of those products in children, and there are dangerous mental health scenarios as children clamour for them. Such products are often marketed with cheap deals and attractive flavours, such as blazing berry or creatine candy.

Another issue is the lack of advertising regulation. Ever-younger children are having that content pushed their way, resulting in a detrimental impact on their lives as they chase an unrealistic body type. This week I am writing to Ofcom and the Advertising Standards Authority, requesting that they review the current guidelines for advertising creatine supplements, low-carb diets and more, all of which I believe are harmful for children.

However, we also need positive role models and influencers, particularly in those sport, who can reach the young male demographics most at risk. There should be more airtime for Gareth Southgate than for Andrew Tate.

As my son grows up, I say to him, “Being a man in modern Britain is about how you behave, not how you’re built; how you express yourself, not what you eat, and how you support others, not how you suppress your emotions.” Whether we are grandparents, parents, aunties, uncles or anything else, we all want to see the next generation make misogyny extinct, so I make one final request today: it would be fantastic if the Minister could meet me to discuss my campaign to stop the selling of supplements and creatine to children.

I have a second son on the way this summer, and I want my boys to grow up to be respectful of women and confident and comfortable in themselves.

[Graham Stuart (in the Chair)]

The winding-up speeches begin with Jess Brown-Fuller.

Oral Answers to Questions

Lindsay Hoyle Excerpts

Tuesday 25th March 2025 Commons Chamber

[Stephen Kinnock]

I thank the hon. Gentleman for that question. I have met hon. Members from the area and made it clear that in principle we support any creation of new teaching capacity for dentistry. What I have also set out is that, before we can give an instruction to the Office for Students to go ahead with that work, we have to have the settlement of the comprehensive spending review, so we know what our financial envelope is. We will not have that until June, but certainly we will be looking at that as and when we know whether the funding will be available.

[Mr Speaker]

I call Jim Shannon.

[Hon. Members]

Hear, hear!

--- Later in debate ---

[Liz Jarvis (Eastleigh) (LD)]

The inquest into the tragic death of a young woman who lived in Eastleigh has highlighted the importance of continuity of specialist care for vulnerable people who move home. My constituent, Alex, is still waiting for an appointment for ongoing specialist care three years after moving to Eastleigh. Will the Minister meet me to discuss the provision of mental healthcare in my constituency?

[Mr Speaker]

This question is about sex and gender. Do not worry; I am sure that the Secretary of State has the message.

I now call the shadow Minister.

[Dr Caroline Johnson (Sleaford and North Hykeham) (Con)]

Given the findings of the Sullivan review on patient and health safety, which came about as a result of inaccurate and poor data collection, can the right hon. Gentleman confirm what meetings he has had with Secretary of State for Science, Innovation and Technology to discuss the reliability of the data on sex that is intended to be used by the digital verification platform in the Data (Use and Access) Bill?

--- Later in debate ---

[Wes Streeting]

That sounds like an invitation to commit a criminal offence, and I think I will resist the temptation. I am sure that the ICB has heard the hon. Gentleman’s forceful representations, and we will make inquiries to get him an update.

[Mr Speaker]

I call the Liberal Democrat spokesperson.

[Helen Morgan (North Shropshire) (LD)]

Shrewsbury and Telford hospital trust has some of the longest waiting lists in the country for cancer and A&E, among other areas. It has been receiving national mandated support from NHS England’s recovery support programme. NHS England also provides support to hospital trusts that are struggling with excessive waiting lists through its Getting It Right First Time programme. Given the announcement to abolish NHS England, will the Secretary of State reassure my constituents that there will be continued support for hospital trusts such as Shrewsbury and Telford with unacceptable waiting times, and a clear pathway to improvements for patients who deserve better?

--- Later in debate ---

[Stephen Kinnock]

The right hon. Gentleman is right that a big part of the Government’s shift from hospital to community is the pivotal role that community pharmacies will play in that process. We are committed to the Pharmacy First model of enabling community pharmacies to do more clinical work, such as the type that he just described. That is at the heart of our 10-year plan.

[Mr Speaker]

I call the shadow Minister.

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

Now that the Secretary of State is abolishing NHS England, will he listen to the calls from the National Pharmacy Association and the Independent Pharmacies Association, and publish immediately the independent report commissioned by NHS England on pharmacies’ finances?

--- Later in debate ---

[Wes Streeting]

I am very sorry to hear of June’s experience. It illustrates why our determination to end the 8 am scramble for appointments is so necessary, starting with a new requirement for practices to make online appointment requests available through core hours, as well as the big uplift we have invested into general practice. I hope that will start to see improvements so that people like June will not be left queuing outside in the cold.

[Mr Speaker]

I call the shadow Secretary of State.

[Edward Argar (Melton and Syston) (Con)]

May I take this opportunity to thank the Secretary of State for his kindness following the death of my father earlier this month? It was very much appreciated.

I welcome the moves to streamline decision making and improve efficiency in the context of the Secretary of State’s NHS England announcement, if he genuinely drives decentralisation to integrated care boards. However, in a written answer on 21 March, the Minister for Secondary Care said:

“We recognise there may be some short-term upfront costs as we undertake the integration of NHS England and the Department”.

For clarity, can the Secretary of State confirm what the quantum of those reorganisation costs will be and the date by which they will have been recouped?

--- Later in debate ---

[Wes Streeting]

As my hon. Friend says, we have brought NHS waiting lists down five months in a row, including during the peak winter pressures. We have delivered the 2 million more appointments we promised seven months early, and we published our elective reform plan at the beginning of the new year with the Prime Minister, which sets out the combination of measures, the investment and the reform that will ensure that we deliver the shorter waiting times and the faster access to treatment that my hon. Friend’s constituents and people right across the country deserve. I look forward to keeping him updated.

[Mr Speaker]

We are not going to get everyone in unless we pick up the pace. The Liberal Democrat spokesperson will set a good example.

[Helen Morgan (North Shropshire) (LD)]

In last night’s “Panorama” programme, the Secretary of State was reported to have said that he did not need to wait for a review to put more money into social care, which we agree with. If that is the case, will he explain why the Casey commission will take three years, and will he instead commit to getting it done this year in order to fix the social care crisis straightaway?

--- Later in debate ---

[Wes Streeting]

I am grateful to the hon. Gentleman for his question, as it gives me the chance to pay tribute to the late great Baroness Jowell, as well as to the work taking place in her name through the Tessa Jowell Brain Cancer Mission. There have been frustrating delays in getting funding out the door for the purpose for which it is intended. Ministers are looking carefully at this issue, and we want to make more progress more quickly, to ensure that families do not receive the same death sentence that our late friend did.

[Mr Speaker]

That concludes Question Time.

[Dr Evans]

On a point of order, Mr Speaker. Since 14 January, I have tabled 15 named day written parliamentary questions to the Department of Health and Social Care. Fourteen have received a holding response, meaning that just one was answered on time. To give a simple example, I asked how many times the Minister had met Community Pharmacy England. Four days later, I received a standard holding answer, which stated that

“it will not be possible to answer this question within the usual time period.”

It then took five days for an answer to come, which stated:

“Ministers meet regularly with external stakeholders on a variety of topics, including, but not limited to, pharmacy.”

May I ask your advice, Mr Speaker? What mechanisms are in place to ensure that named day questions are answered on time? If they continue not to be answered on time, how can I escalate the matter further?

[Mr Speaker]

First, I am disappointed that questions are not being answered, but I am not responsible for ministerial answers. I hope that those on the Treasury Bench, including the Secretary of State, have taken on board the importance of replying. Named day questions are called that because they are meant to be answered on the day that is named. I am very disappointed. The Department may be overworked; if that is the case, perhaps we ought to bring in staff from other Departments to ensure that questions are answered on time. I know that the Secretary of State will have immediately made a note to ensure that those questions are answered.

Oral Answers to Questions

Lindsay Hoyle Excerpts

Tuesday 11th February 2025 Commons Chamber

[Adam Jogee (Newcastle-under-Lyme) (Lab)]

1. What steps he has taken to improve access to patient care for people with Parkinson’s disease in Newcastle-under-Lyme constituency.

[Mr Speaker]

I welcome the Minister to her place.

[The Parliamentary Under-Secretary of State for Health and Social Care (Ashley Dalton)]

I thank my hon. Friend for his continued support for people with Parkinson’s disease, a condition that I know is close to his family. This Government inherited long waits for neurology services, with only 53.4% of patients, including those with Parkinson’s, waiting less than 18 weeks for a referral in June. Our elective reform plan will free up over 1 million appointments each year for those who really need them, including patients with Parkinson’s, and NHS England’s Getting It Right First Time programme continues to work with 27 specialised centres in England, including at University Hospitals of North Midlands.

--- Later in debate ---

[Stephen Kinnock]

After the disastrous 14 years that we have had, we are facing a very serious situation in terms of mental health provision. It will take some time to get the workforce in place, but we have a clear commitment to having a specialist in every school. The appointment and training of those specialists will take some time. We are also rolling out open-access Young Futures hubs in every community. I am confident that the combination of those two interventions will get us back to having mental health services that this country can be truly proud of.

[Mr Speaker]

I call the Chair of the Health and Social Care Committee.

[Layla Moran (Oxford West and Abingdon) (LD)]

I welcome the Under-Secretary of State for Health and Social Care, the hon. Member for West Lancashire (Ashley Dalton), to her place. I look forward to working with her, as I do with other Ministers.

As the Minister for Care will know, 20% of the burden on the NHS is due to mental health, yet only 10% of the budget is allocated towards it. The mental health investment standard has been a welcome maintenance under this Government. However, the Select Committee heard from Amanda Pritchard the other day that the standard is guaranteed for only the next two years. Does the Minister agree that the standard has had a positive effect on mental health community services, and would he commit to protecting it?

--- Later in debate ---

[Stephen Kinnock]

We in this Chamber should, whenever possible, pay tribute to the people providing those frontline services, who every day work heroically in very difficult circumstances. My hon. Friend is absolutely right about the pressures on the workforce—we are very conscious of that. We will bring forward a workforce plan in the summer, and we are working at pace to recruit the 8,500 mental health workers.

[Mr Speaker]

I call the Liberal Democrat spokesperson.

[Helen Morgan (North Shropshire) (LD)]

Last week, the Secretary of State issued a new mandate for the NHS in which a number of mental health targets were dropped. I accept that targets that drive perverse behaviours should be dropped and that some sharpened focus is necessary, but mental health waiting lists are at a record high, huge numbers of people are not at work because of poor mental health, and our young people are being let down badly by CAMHS, not least in my constituency of North Shropshire. Does the Secretary of State accept that mental health targets should be reinstated and that mental health should be treated with equal priority to physical health?

--- Later in debate ---

[Wes Streeting]

The hon. Member raises an important point. I know that my ministerial colleagues in the Foreign, Commonwealth and Development Office are looking at the investment cases for Gavi and the Global Fund as part of the spending review. I will ensure that her representations are relayed to the FCDO, and she is very welcome to make those points during oral questions to that Department.

[Mr Speaker]

I call the shadow Minister.

[Dr Caroline Johnson (Sleaford and North Hykeham) (Con)]

There were almost 67,000 cases of serious antimicrobial-resistant infections in the United Kingdom in 2023. War is increasing such infections globally; 80% of patients in one Kyiv hospital in Ukraine are said to have such infections. The Conservative Government had a plan to tackle that. Do the Labour Government plan to follow that plan, are they on track to meet those targets, and if not, what will the Secretary of State do about it?

--- Later in debate ---

[Wes Streeting]

I wholeheartedly agree with my hon. Friend. As we know from the Greens’ experience in local government, they cannot clear the bins, let alone the waiting lists.

[Mr Speaker]

I call the shadow Minister.

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

The Labour Government’s elective reform plan says that there are plans for 10 straight-to-test pathways. Can the Secretary of State name them, or give one example?

--- Later in debate ---

[Wes Streeting]

I am a product of the welfare state, and I remember the benefit system putting food in the fridge and money in the electric meter. I also know from lived experience that people who are trapped in the benefits system want to escape. The best way out of poverty is not through social security, important though that is, but through fair, decent work that pays. That is the Government’s agenda.

[Mr Speaker]

Just a reminder that we are on topicals, folks.

[Edward Argar (Melton and Syston) (Con)]

I congratulate the hon. Member for West Lancashire (Ashley Dalton) on her promotion to the Front Bench.

Eating disorders affect over 1.25 million people, and this is the last Health and Social Care Question Time before Eating Disorders Awareness Week, which starts later this month. The Secretary of State will be aware of the amazing work done by the eating disorder charity Beat, which I met a few months ago, and to which I pay tribute. Will he back Beat’s call for broader access to intensive community and day treatment for those with eating disorders—there are limited places currently—and set out a timetable in which that will be delivered?

--- Later in debate ---

[The Minister for Secondary Care (Karin Smyth)]

I holidayed in my hon. Friend’s constituency this summer—it is a very beautiful part of the world—so I understand some of the rural challenges. It is a matter for local integrated care boards how they organise ambulance services. There are many problems that we want to resolve, and I would of course be very happy to meet him.

[Mr Speaker]

I call the Liberal Democrat spokesperson.

Oral Answers to Questions

Lindsay Hoyle Excerpts

Tuesday 7th January 2025 Commons Chamber

[Stephen Kinnock]

There is a pattern here. The Conservatives welcome the additional investment in health and care but oppose the choices that we have made to raise the revenue. They need to tell us which services they would cut or which taxes they would raise instead.

[Mr Speaker]

I call the Liberal Democrat spokesperson.

[Helen Morgan (North Shropshire) (LD)]

Coverage Care, a not-for-profit adult social care provider in North Shropshire that operates 11 care homes and employs around 1,000 local staff, has been in touch to say that it expects the impact of the increase in national insurance contributions to be £840,000 in the first full year of implementation. Given that there are huge numbers of vacancies across adult social care in North Shropshire, will the Secretary of State consider exempting social care providers from the national insurance increase? Otherwise we are putting money into social care with one hand and taking it away with the other.

--- Later in debate ---

[Nesil Caliskan]

I thank the Secretary of State for his answer on the critical issue of access to GPs in primary healthcare. My constituency of Barking is woefully under-served by primary healthcare, and especially by GPs. On average, each GP looks after 2,000 patients; the national average is 1,600. In particular, the area of Barking Riverside has no GP services. Will the Secretary of State meet me to discuss this matter, so that the thousands of homes that are being built will also have a primary healthcare facility on site?

[Mr Speaker]

Order. I remind Members to look towards the Chair, because I cannot hear what is being said. I call the Secretary of State—I hope he heard the question.

[Wes Streeting]

Thank you, Mr Speaker. I would be delighted for my hon. Friend to meet me or the relevant Minister. The NHS has a statutory duty to ensure sufficient services in each local area, including general practice, and it is vital that we also take into account population growth and demographic changes. I strongly support the Deputy Prime Minister’s commitment to delivering 1.5 million new homes, and she and I know that that must be accompanied by local healthcare facilities. We are working together to achieve just that.

--- Later in debate ---

[Wes Streeting]

I am grateful to the hon. Member for that question. I am incredibly sorry about the awful conditions in which staff in that practice are having to see patients and in which the patients it serves are having to be seen—that is the epitome of the broken general practice system that we inherited. Thanks to the decisions taken by the Chancellor in the Budget, we are able to invest in the capital estate need in the NHS. That will take time, and we would be delighted to hear more about that individual case to see how the ICB and the NHS can assist.

[Mr Speaker]

I call the Chair of the Select Committee.

[Layla Moran (Oxford West and Abingdon) (LD)]

Following the theme raised by my hon. Friend and neighbour, the hon. Member for Bicester and Woodstock (Calum Miller), may I make a plea for Summertown health centre? They are my doctors, by the way, so I declare an interest. They operate in an old Victorian building and are desperate to move to new premises. That health centre was at the top of the priority list, but the ICB says that there is no money, and the doctors say that there is no pot that they can bid into in order to get this seen to. Will the Secretary of State meet me as well? Clearly, £102 million spread across 50 projects in the country is not going to be sufficient. Can we get creative about how we can get new premises built for Summertown health centre?

--- Later in debate ---

[Wes Streeting]

That was a rare admission of failure in this House by the SNP. I am very sorry to hear that general practice in Scotland is in such a sorry state, because here in England we are investing £889 million in general practice, the biggest uplift in years. That is in addition to the funding I have found to employ 1,000 more GPs on the frontline before April, because we are prioritising general practice. As for the decisions the Chancellor took in the Budget, as I said before the election, all roads lead to Westminster. Thanks to the decision a Labour Chancellor has made here in Westminster, coming down that road from Westminster to Holyrood are the resources the SNP Government need to deliver the priorities of the Scottish people. If they cannot, Anas Sarwar and Jackie Baillie stand ready to deliver.

[Mr Speaker]

I call the shadow Minister.

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

To improve access, the Government have announced a planned expansion of advice and guidance, and GPs will be paid £20 per advice and guidance request they make for further expert advice from consultants. How do the Government expect this expansion to take place? Will they be mandating it given that the current position of the British Medical Association, under its collective action, is that GPs should

“Stop engaging with the e-Referral Advice & Guidance pathway”?

--- Later in debate ---

[Wes Streeting]

First, as the shadow Minister has said, advice and guidance happens in general practice, and we want to see more of it. We have to give GPs the tools to do the job, and that is what we are doing. My hon. Friend the Minister for Care will be talking to the BMA shortly in the context of contract negotiations in the usual way. What the shadow Minister neglects to mention is that these reforms and improvements to general practice are made possible thanks to the £889 million we are putting in, which is investment that he and his party oppose.

[Mr Speaker]

I call the Liberal Democrat spokesperson.

[Helen Morgan (North Shropshire) (LD)]

Dentistry is a key part of primary care, yet an estimated 5 million people in England have been left without an NHS dentist. That is why today a petition is being handed in at Downing Street signed by more than a quarter of a million people. We have moved on from the election, but we do not yet have a timetable for when the negotiations for a new NHS dental contract will begin and when another 700,000 extra urgent appointments will be rolled out. Can the Secretary of State confirm the timetable for those improvements? What specifically are the Government’s plans for the new patient premium, and will he offer assurances to dentists that any changes to the current model will be outlined in detail to them as soon as possible?

--- Later in debate ---

[Wes Streeting]

I thank the hon. Member for that question. I agree with him about the need for clarity as well as consistency. We undertook the review into the new hospital programme because the previous Government’s timetable was a work of fiction and the money was not there. I hope to report to him and to the House shortly on that, with the undertaking that the timetable we publish and the funding provided by the Chancellor in the Budget and at the spending review will mean that we will provide not just clarity but consistency, which is important for NHS leaders, important for patients and important for the construction industry partners we need to work with.

[Mr Speaker]

I call the shadow Minister.

[Dr Caroline Johnson (Sleaford and North Hykeham) (Con)]

Thank you, Mr Deputy Speaker. [Interruption.] I am sorry—that is the last time I will get called. Thank you, Mr Speaker.

Yesterday, in relation to the elective backlog, the Secretary of State said:

“Where we can treat working people faster, we will, and we make no apology for doing so.”—[Official Report, 6 January 2025; Vol. 759, c. 597.]

Labour politicians have struggled to define what they mean by working people, but his words have caused anxiety. Will he reassure those with disabilities that prevent them from working and retired elderly people who have worked all their lives that they will not be pushed to the back of the queue and that treatment will continue to be provided in the NHS on the basis of clinical need?

[Wes Streeting]

Of course, clinical need is paramount and must always drive decision making about who to treat when and the order in which people are treated. That is why I find the question posed so deeply disingenuous. [Interruption.] We inherited NHS waiting lists at record levels and waiting times that are frankly shameful. The shadow Minister should be apologising for her party’s record, and she should also apologise for the two-tier healthcare system that sees those who can afford it paying to go private and those who cannot afford it—working-class people—being left behind. That is the two-tier system that the Government are determined to end.

[Mr Speaker]

Order. Can we be a bit careful with the language we are using?

[Dr Johnson]

The Secretary of State needs to be careful with the words he uses, as you said, Mr Speaker, because his words did cause anxiety among people. It was not a disingenuous question; it was a genuine question to make sure that people are reassured.

It will not have escaped the Secretary of State’s notice that it is cold outside. Removal of the winter fuel allowance has reduced elderly people’s ability to follow the advice that he gave last week, which was to turn the heating on. What assessment has he made of the number of additional admissions caused by his removal of the winter fuel allowance? What effect is that having on the Government’s ability to deliver their reduction in elective backlogs?

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[Wes Streeting]

I am grateful to the hon. Member for that question. With our fair pay agreements, we will be bringing together government, public and private sector employers and staff trade unions to negotiate the future for fair pay agreements that will benefit care workers across the system and give them the professional status and career progression they deserve. The Chancellor, through the Budget, also took steps to ensure that we could invest in our social care services. I am deeply saddened that the Conservative party has not supported that investment.

[Mr Speaker]

I call Dame Emily Thornberry—congratulations!

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[The Parliamentary Under-Secretary of State for Health and Social Care (Andrew Gwynne)]

In September the Secretary of State and I met the families of people who had suffered harm following the covid-19 vaccination, including my hon. Friend’s constituent Sheila Ward, and they raised the need for reform of the vaccination damage scheme. We listened closely to their descriptions of what they had been through and agreed to look at a number of options, noting that cross-cutting Government decisions might be necessary. We are also working with the NHS Business Services Authority to improve claimants’ experiences of the scheme, and to ensure that claims are processed quickly.

[Mr Speaker]

Order. May I remind Members not to walk past when the Minister is replying to a question? Please have regard for each other; this sets a bad example.

I call the shadow Secretary of State.

[Edward Argar (Melton and Syston) (Con)]

The Prime Minister’s announcement yesterday of his elective recovery plan mirrored that of Sir Saijd Javid in 2022, but one aspect was different. Our plan explicitly recognised the importance of the workforce being in place to deliver the 9 million extra tests and interpret the results, and it set out proposals to increase that workforce further. What plans has the Secretary of State to boost the workforce in community diagnostic centres specifically, over and above the plans that he inherited from us, to ensure that his elective recovery plan is deliverable?

[Wes Streeting]

The shadow Secretary of State is right to say that we need staff in place to do the job. The additional funding announced by the Chancellor in the Budget is central to the delivery of this plan—I note that he opposes that funding, which is deeply regrettable—but we need to improve productivity as well. That is why the plan sets out steps to free up patient appointments that are unnecessary or of low clinical value, but, crucially, staff time in productivity gains is also important, so as well as making the most of the additional investment, we are making the most of delivering value for taxpayers’ money—

[Mr Speaker]

Order. Please help me a little bit. You have had a good run today—don’t spoil it.

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[Tristan Osborne (Chatham and Aylesford) (Lab)]

T5. Pharmacy First is an incredibly popular service that has allowed many residents in Chatham and Aylesford to be referred for illnesses or urgent repeat medicine supplies. Can the Minister indicate whether there warrants a further review and expansion of this offering, to include further access to medicines, including those to treat common dental conditions with bacterial infections, so that patients with these very painful emergency needs can seek immediate over-the-counter appointments?

[Mr Speaker]

Can Members please remember that these are topical questions?

[The Minister for Care (Stephen Kinnock)]

We are making a priority of resuming consultations with the sector to stabilise community pharmacy. Pharmacy First has built on existing services to increase the clinical scope. The conditions treated under Pharmacy First vary across the UK, and the NHS will keep this under review.

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[Wes Streeting]

The hon. Member is right to raise cases where there are multiple comorbidities or complex conditions requiring a range of care services. That is why we need to design services around the patient, not expect patients to contort themselves around the services. Our approach to neighbourhood health services should make a real difference in that regard, but we have to go further and faster on health and care integration, and we absolutely will.

[Mr Speaker]

Order. I call Kevin McKenna to ask the final question.

[Kevin McKenna (Sittingbourne and Sheppey) (Lab)]

I strongly welcome yesterday’s announcement about using initiatives such as community diagnostic centres to move services closer to the public. In the Isle of Sheppey, we are particularly exposed as a coastal community, but thankfully a new CDC will really help. Unfortunately, my experience in the NHS over the past few years shows that while the previous Government talked the talk about shifting care to the community, they failed to deliver. Will the Secretary of State set out what steps will be taken, so I can show my constituents that this shift will actually happen?