NHS Pensions
Luke Evans Excerpts(3 weeks, 2 days ago)
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Dr Luke Evans (Hinckley and Bosworth) (Con)
(Urgent Question): To ask the Secretary of State for Health and Social Care if he will make a statement on NHS pensions in the light of the statutory deadline for both remediable service statements and remediable pension savings statements being missed.
The Minister for Secondary Care (Karin Smyth)
I thank the hon. Member for Hinckley and Bosworth (Dr Evans) for asking this question, which gives me the opportunity to provide further information following the written parliamentary statement that I issued yesterday to update the House on the delivery of remediable service statements to affected members.
I have extended the deadlines for the NHS Business Services Authority to issue statements to ensure that members have enough time to make informed decisions. Once members have received statements, they will be able to use a tool provided by His Majesty’s Revenue and Customs to retrospectively adjust their annual allowance between 2015-16 and 2022-23.
Separately, the original deadline to issue the 137,000 remediable pension savings statements was 6 October. The NHS Business Services Authority issued statements to 57,000 members by this deadline, of which 23,000 were found to contain incorrect information; these have since been recalculated and reissued. The NHS Business Services Authority is working to issue outstanding statements as quickly as possible.
A revised delivery timetable has been developed and shared with trade unions and employer representatives. By the end of March, 106,000 statements had been issued. Statements for 11,000 members will be produced once further information has been received from their employers. The remaining 20,000 statements require additional manual input from the NHS Business Services Authority before they can be produced, and will be issued in July. There have been delays on all sides, which we have been aware of since last July. In fact, the Department had escalated issues of design with the previous Government, as I am sure the hon. Gentleman understands.
We know that this matter is really important and that there are high numbers of high earners in the NHS, which is why we have taken the decision to be open and transparent about the timeline that we can now commit to, having worked tirelessly to reduce the delays. Although these delays will cause inconvenience to some members, I have been crystal clear that no one will face any financial detriment as a consequence. Compensation arrangements are in place for direct financial losses, certain HMRC interest charges, and the costs of financial and accountancy advice.
The Government do acknowledge the impact of the delays on affected members. We are working hard to issue outstanding statements and to protect members from any financial detriment the delays may cause.
Dr Evans
What is going on with NHS pensions administration under this Government? I declare an interest as someone with an NHS pension. Today, the Government have missed the statutory deadline for issuing remediable service statements to doctors, and they are now pushing the deadlines back to December 2026. In mid-March, the Government confirmed that just 21 statements had been issued out of 380,000; as of yesterday’s written statement, there are still more than 370,000 outstanding. This creates huge tax liability uncertainties.
We and the British Medical Association have been raising concerns for months. Why has it taken the Government so long to act? Ministers have announced a revised delivery plan, but how will it work in practice? Will there be more staff to help with the backlog? What changes are being put in place to ensure that the deadline is not missed again?
What was most concerning, however, was the complete absence of any mention of the remediable pension savings statements in the written statement. This issue really matters, as doctors who are taking on overtime or who work privately rely on these statements to be able to track their contributions and avoid excessive tax bills. According to Dr Sharma from the BMA,
“There’s no doubt that without up-to-date information, doctors will be pre-emptively reducing or turning down extra work to avoid additional pension…bills that they might not even be due.”
The statutory deadline for the 137,000 statements was, as we heard, 6 October 2024. In February, Ministers confirmed that 60,000 were outstanding and that the majority would be issued by the end of February; by March, however, the backlog had actually grown to 70,000. Can the Minister explain how two legal deadlines have been missed? Will the Government be following up with the regulator to ensure that this does not happen again? Do the Government have confidence in the NHS Business Services Authority? With the Secretary of State abolishing NHS England, what does this mean for the future of this vital organisation?
We all want to see waiting lists fall, but as one newspaper put it today,
“Labour’s pledge to slash NHS waiting lists is being sabotaged by a litany of administrative errors, pension delays and punitive tax rules.”
I urge the Government to take swift action.
Karin Smyth
As I outlined in my response and in the written ministerial statement, we have taken action. We were made aware of some of these problems when we came into office in July, and we have pushed the NHS Business Services Authority to move faster than it would have done under the hon. Gentleman’s Government, so that action is happening quicker than it would have done before. We do have faith in the NHS Business Services Authority to get on with this and ensure that there is no financial detriment, in line with the timetable outlined yesterday, and as I have further made clear today.
Madam Deputy Speaker, the hon. Gentleman could have asked me more about waiting lists, which have fallen for the last five months in a row. He could have asked me about the 2 million more appointments that have been provided to deliver for patients seven months early. He could have asked me about the hundreds more GPs who are now working in the health service, or the impact of cancelling the strikes on services for people, or the record funding. In fact, last week in the Chamber he spoke on behalf of the National Pharmacy Association; this week, he could have congratulated the Minister for Care, who is sitting next to me, on the agreement to produce more pharmacy services.
We are making improvements to the NHS every day. The Darzi report reported not only the breadth but the depth of the decline that we inherited. We are resolving that, and fixing the fundamentals of the NHS.
Eating Disorder Awareness
Luke Evans Excerpts(3 weeks, 2 days ago)
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Dr Luke Evans (Hinckley and Bosworth) (Con)
It is a pleasure to serve under your chairmanship, Mr Stuart, for your maiden appearance as Westminster Hall Chair. I am grateful to the hon. Member for Bath (Wera Hobhouse) for securing the debate. She and I share many opinions on body image, algorithms, social media, steroid use and eating disorders. Although I am responding to the debate as spokesperson for His Majesty’s official Opposition, I am pleased to have the chance to build on the work that the hon. Member and I have enjoyed bringing forward together.
The hon. Member for Bath was right to point out that one in 50 people will suffer with an eating disorder or disordered eating. That means that we likely all know someone who suffers. It is true for people close to me, too, and I have seen what can happen both personally and professionally. It is therefore timely that the theme of Eating Disorders Awareness Week 2025 was “Eating disorders can affect anyone”. That is an important fact to recognise. Why? Because we know that eating disorders have some of the worst outcomes of any mental health diagnosis. Early intervention is key to break the cycle. Without doing so, it is devastating not only for the patient but for families and friends, the health service and, ultimately, society.
Disordered eating can take a variety of forms, from limiting the amount of food eaten, eating very large quantities of food at once, getting rid of that food through unhealthy means—through purging, laxative misuse, fasting or excessive exercise—or a combination of all of those. That can be one reason why it is so damaging. With other medical issues such as alcohol, drugs or gambling, the aim is abstinence, but of course that simply cannot be the case in this instance: we all need to eat.
Disordered eating is not just about the compulsive element. It is far more complex than that. Drivers of control and shame are so powerful. A sufferer told me:
“Eating disorders are not about food. At least they didn’t start that way. We, the eating disordered, started by using dysfunctional eating habits and starvation to control our feelings and gain a sense of control of the world around us. This soon spiralled into a dangerous daily obsession of reaching our ultimate unattainable goal; being thin enough. For us, to be thin enough is finally to be good enough.
Every room entered, every street walked involved detailed analysis of the physiques of others, feeling pride and superiority if I was the thinnest, and earth shattering shame and disgust if I was not. Both galvanised my resolve.”
Worse still, many people who suffer with eating disorders simply do not want to get better. The disease does not want to let them get better. The quote goes on:
“My eating disorder gradually robbed me of my happiness, my relationships, my health and my sanity. The insanity is that despite all this I could not stop. I did not want to stop. I was petrified to change. Thinness had become my identity, and starved detachment was my way to cope with my feelings and my life.”
My experience is that sufferers of depression and addiction would bite your hand off for a magic bullet. Alas, the same is not the case for eating disorders, and that is the barbarity of the disease. Yet we know that catching an eating disorder earlier can make all the difference, and debates like this one can dramatically help with awareness and prevention.
Beat’s survey from December and January gathered findings on lived experience of eating disorders from 1,900 people, which showed that four in five people thought that greater public awareness would make them feel more comfortable to talk about their eating disorder, two in three would not feel comfortable talking to their teacher about the issue, two in three would not feel comfortable talking with their line manager, and two in three would not feel comfortable talking with a colleague. More needs to be done to make it feel acceptable do so.
The covid-19 pandemic, and lockdown specifically, contributed to a surge in demand for children and young people’s eating disorder treatment. That is no surprise, given the lack of control in a lockdown. In Q1 of 2021-2022, 3,400 people were treated, compared with 1,900 people in Q1 of 2019-2020. We have seen some recent glimmers of hope from the data on waiting times for children and young people in eating disorder services. Recent data showed that between October and December 2024, 80% of urgent referrals—350 out of 433—to children’s eating disorder services were seen within one week. During the same time period, 81% of routine referrals—2,064 out of 2,251—were seen within four weeks. But more still needs to be done.
I believe that we are starting to see the fruit of the last Government’s investment, as investment in children and young people’s eating disorder services consistently rose each year from 2016, reaching £54 million in 2023-2024. This helped to expand the community eating disorder teams across the country. That was in addition to the £79 million invested through the covid-19 mental health and wellbeing recovery action plan to expand young people’s mental health services, which has enabled 2,000 more children to access eating disorder services.
Furthermore, I remember the Westminster Hall debate the hon. Member for Bath brought to mark Eating Disorders Awareness Week last year. I was pleased to hear the then Conservative Minister, the former Member for Pendle, Andrew Stephenson, announce an additional £3 million funding so that 24 hubs received a share of £8 million in 2024-25. That is more than double the original target of funding 10 hubs, with organisations across England benefiting.
Those were positive steps but the new Government should accelerate that momentum. In October last year, before I was a shadow Minister in the Department of Health and Social Care, I called on the then Minister, the hon. Member for Gorton and Denton (Andrew Gwynne), to convene an expert roundtable to discuss eating disorders, given the challenges faced by Governments in tackling the issue. Although the Minister at that time did not commit to it, he stated the following:
“When we were in opposition we gave support to the then Government, and I can assure the hon. Gentleman that we will do everything we can to support people who have eating disorders and to get the right provision and support at the right time for those people who need it.”—[Official Report, 10 October 2024; Vol. 754, c. 191WH.]
I renew the question to the Minister today. Will he convene a cross-party roundtable of experts and campaigners? Will he also commit to a national eating disorder strategy, as requested by the APPG report?
Since taking office, the Government have consistently reaffirmed their commitment to children’s and young people’s mental health. However, progress is unclear. I would like an update from the Minister on a couple of key tangible commitments made in the Labour manifesto. First, Labour promised to recruit 8,500 new mental health staff. Will the Minister tell us how many extra mental health staff have been recruited since the Government took office, and how many will be targeted for eating disorders?
Labour’s manifesto also promised
“access to specialist mental health professionals in every school, so every young person has access to early support to address problems before they escalate.”
That builds on work by the Conservative Government to have mental health support teams in 35% of schools by the end of 2023, which was achieved, and to be across all schools by 2024. Of course, the election punctuated that. Will the Minister update us on what progress has been made on that commitment? What assurances can he provide to eating disorder services, given that spending on mental health is projected to reduce as a proportion of overall spending in 2025-26, which was announced in last week’s written statement?
Finally, I want to repeat the question that my right hon. Friend the Member for Melton and Syston (Edward Argar), the shadow Secretary of State for Health and Social Care, asked the Health Secretary at oral questions in February:
“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?”—[Official Report, 11 February 2025; Vol. 762, c. 165.]
Although I was pleased to hear the Health Secretary recognise the importance of the issues, further details from the Minister would be helpful. To conclude, although there is a long road to go in preventing eating disorders and supporting those who suffer, I live in hope that
“Healing doesn’t mean the damage never existed. It means the damage no longer controls your life.”
Hughes Report: First Anniversary
Luke Evans Excerpts(4 weeks ago)
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Dr Luke Evans (Hinckley and Bosworth) (Con)
It is a pleasure to serve under your stewardship, Ms Furniss. As a GP who has seen patients with valproate and mesh injuries, standing here with a chance to raise this issue is humbling for me.
I am grateful to the hon. Member for Washington and Gateshead South (Mrs Hodgson) for proposing this debate. It is yet another important topic that she has brought to the House. She is in danger of rivalling the hon. Member for Strangford (Jim Shannon) for securing so many Westminster Hall debates on health. The fact that we have two worthy champions fighting it out to be the person in the country doing the most for health is a true testament to the dynamics we have; I congratulate the hon. Member for Washington and Gateshead South on that. I remember her powerful contributions to last month’s Westminster Hall debate on women’s health, and she has done the same today. With her personal experience of her mother’s situation, and as the chair of the APPG first do no harm, she is a true champion.
Now that we are past the first anniversary of the Hughes report, this debate is an important opportunity for the women and families affected by valproate and pelvic mesh to get clarity from the Government on what progress is being made on the recommendations of the report and a way forward more broadly. It is heartening to see how the Chamber has come together to ask unanimously for that progress. I welcome the fact that the previous Government took productive steps and asked the Patient Safety Commissioner, Dr Henrietta Hughes, to undertake work in this area. Her report was issued a year ago, and it is clear that the victims are anxious for some form of redress for the harms that have been caused. The report states:
“The first point to make clear is that the Commissioner thinks that there is a clear case for redress based on the systemic healthcare and regulatory failures revealed by the First Do No Harm review in 2020. The Commissioner supports a restorative practice-based redress scheme, co-designed with affected patients, and which is, therefore, very different from court proceedings which seek to attribute blame.”
Of course an election halts progress, but now, with new Ministers and a new Government nine months in, it is right to continue keeping the spotlight on this topic. To that end, my questions echo many of those raised by others. Could the Minister clarify the Government’s position on the recommendation for financial redress, and could she give a timeframe for when they will respond to the report? Has the Minister met with Dr Hughes and campaigners to discuss the report, and will she commit to communicating with all those affected, as that is so important to help reduce some of the anxiety? It has already been a long and painful journey for victims, so continuing to take steps forward to address the fallout is important.
Further to the Hughes report, I am glad that the last Government took several actions to begin addressing the injustices suffered by victims of valproate and pelvic mesh. The former Health Secretary, my right hon. Friend the Member for Godalming and Ash (Jeremy Hunt), established the Cumberlege review, and significant progress was rightly made before the election on implementing seven of Dr Hughes’s recommendations. Those included an unreserved apology to the women and children affected, and their families, on behalf of the healthcare system, for the time the system took to listen and respond. I am pleased to see that the hon. Member for Gorton and Denton (Andrew Gwynne), the new Minister at the time, reiterated that apology when these issues were last debated in December 2024. Progress also included the appointment of Dr Hughes as the first Patient Safety Commissioner to advocate for patients and improve the safety of medicines and medical devices, and a network of specialist centres established to provide comprehensive treatment, care and advice for those affected by implanted mesh.
Hon. Members have already referenced the Westminster Hall debate on these issues last December. Looking at the record of that debate, I was pleased to see from the hon. Member for Gorton and Denton that the Government were committed to implementing the remaining three recommendations as a priority. He said:
“It is a priority for this Government. We are working at pace, and we remain focused on making meaningful progress. This is a complex area of work, involving several Departments, but we are committed to providing an update at the earliest opportunity. I have heard the desire for urgency today, and I hope that we can make the progress that Members want to see.”—[Official Report, 5 December 2024; Vol. 758, c. 175WH.]
I know that there has been a change in personnel in the ministerial team since that debate, but can the Minister confirm that it remains a priority for the Government regardless? Given that it is now four months since the last debate, and the Minister recognises the desire for urgency, what new update can she provide on the progress that has been made in implementing these recommendations since December?
As stated, I was in the debate on women’s health last month, in which the hon. Member for Washington and Gateshead South raised the issue. The Minister’s response was:
“On sodium valproate and pelvic mesh, the Cumberlege review made nine recommendations, of which the then Government accepted seven. I can confirm that the national pause remains in place.”—[Official Report, 27 February 2025; Vol. 762, c. 518WH.]
I also note that the Minister frequently quotes the following lines in her response to written parliamentary questions from colleagues:
“The Government will be providing an update to the Patient Safety Commissioner’s Report at the earliest opportunity.”
So could she say whether today is “the earliest opportunity”? If it is not, would she be kind enough to give an estimate of when that might be?
During that December debate, the shadow Minister, my hon. Friend the Member for Sleaford and North Hykeham (Dr Johnson), also raised concerns about the experiences of some of the women within the specialist mesh centres, and urged Ministers to look into that. I would be grateful if the Minister could set out whether she shares those same concerns. If so, what steps has her Department taken to address these and look into them?
Finally on sodium valproate, we have heard from my hon. Friend the Member for Harrow East (Bob Blackman) and the hon. Member for Bexleyheath and Crayford (Daniel Francis) about the difficulty we have when it comes to valproate, given the damage it can cause but its importance as an epilepsy drug in supporting people to keep seizure free. The report itself states:
“However, the Commissioner continues to have concerns about incomplete adherence to the Pregnancy Prevention Programme requirements. As a result, in November 2023, she recommended that NHS England create a fully funded and resourced system for improving the safe use of the most potent teratogenic medications, beginning with the safe use of valproate.”
With that being said, could the Minister update this House on the workstream regarding teratogenic medications? More importantly, given the news of the abolition of NHS England, what safeguards are being put in place to ensure that this system is resourced adequately?
“One year on” is a milestone to be celebrated—for getting this far after such a torrid journey in raising concerns, having them heard and getting them responded to—but it is just that: a milestone on a journey, not a destination. For those so affected, and their families, they will be keen to know what redress they are due and the mechanisms to deliver it, so that their cases might finally be fully rectified. After all, we cannot undo the past, but we can make amends for it, and I hope that the Government will continue to act on the recommendations to do so.
Oral Answers to Questions
Luke Evans Excerpts(4 weeks, 2 days ago)
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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?
Stephen Kinnock
We will publish the economic analysis imminently. He mentioned the National Pharmacy Association, which gives me the opportunity to say that I think that the collective action that it is taking is premature, unnecessary and detrimental to community pharmacy patients. I urge the NPA to reconsider its position and wait for the outcome of our negotiations with the CPE, which will come very shortly. We will announce that very soon.
Dr Evans
The National Pharmacy Association, which has been waiting for months to get the answer, is advising all its 6,000 pharmacy members to reduce services and hours, for the first time in 104 years. That has never happened before under a Labour Government, or under the Lib Dems or the Conservatives, but it is happening under this Government. Its chair said:
“The sense of anger among pharmacy owners has been intensified exponentially by the Budget”,
citing unfunded national insurance contributions and national living wage increases. The Minister acknowledges that there is potential action. What contingency plans does the Department have to ensure that we keep patients safe if pharmacies close their doors in industrial action next week?
Stephen Kinnock
On the NPA, it has taken us a while to clean up the utter mess that we inherited in community pharmacy. That involved agreeing financial envelopes and getting into negotiations with CPE. Those negotiations have been constructive, and I am delighted to confirm again that we will soon announce the outcome of those negotiations. What we see here is the shadow Minister apparently taking the side of people taking collective action in a premature way that is detrimental to patients. They would be better off waiting for the outcome. The Government are taking industrial relations into the 21st century, as opposed to the performative nonsense that we saw for 14 years.
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.
Down’s Syndrome
Luke Evans Excerpts(1 month ago)
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Dr Luke Evans (Hinckley and Bosworth) (Con)
It is a pleasure to serve under your chairmanship, Mr Turner, and to respond in this debate. I credit the now Minister, the hon. Member for Bristol South (Karin Smyth), who said, when speaking about this issue in January 2022:
“Our constituents expect us to see guidance and perhaps be part of scrutinising it, raising objections and problems and improving it—that is the role of a Member of Parliament”.––[Official Report, Down Syndrome Public Bill Committee, 26 January 2022; c. 7.]
We have seen that exemplified here today. I give credit to my right hon. Friend the Member for Beverley and Holderness (Graham Stuart) for all he has done to raise this issue, but he was actually trumped by the hon. Member for Thurrock (Jen Craft), to whom I pay tribute for her ability to speak so openly, so personally and in such an informed way about the issues at hand.
In January 2022, the then shadow Minister closed by saying,
“this is an example of how Parliament and the proper role of Members of Parliament can be made real. That is only for the good of our constituents.”––[Official Report, Down Syndrome Public Bill Committee, 26 January 2022; c. 7.]
I agree with her entirely.
Turning to the debate itself, it is unusual to have unanimous feelings from across the House, but that is what we have heard in this debate. It is an accolade to everyone that we have got this far, but some things are still outstanding, particularly two issues—the progress of seeing the guidance and ensuring that it is accurate and effective. It is important to ensure that the guidance is robust and reflects the needs of the community. We do not want to rush publishing the guidance, which could mean that key issues are not addressed, because it would undermine the efforts of the last three years and fail the very people the Act is aimed to support.
My former colleague, Sir Liam Fox, who has been mentioned here and introduced the private Member’s Bill, has written to the Chair of the Health and Social Care Committee about these reforms; with your permission, Mr Turner, I would like to quote some extracts. He said:
“When the House of Commons unanimously passed the Down Syndrome Act, it felt like a real dawn had arrived for those with Down Syndrome and their families. We were promised new government guidelines covering health, education and social care that would phenomenally improve service provision and provide accountability to service users”.
He said later:
“Despite repeated promises we have not yet seen the formation of an effective cross Ministerial task force. There has been little Ministerial engagement with stakeholders, with many identical letters being sent out in response to demonstrably different queries. Now, three years after the legislation reached the statute book, this is completely unacceptable.”
He finished by saying:
“I believe that it is now time for both Ministers and officials to be held to account for the lack of progress in producing coherent guidelines, something that is regarded as a betrayal by many of those who were so encouraged and inspired by the passage of the Down Syndrome Act itself”.
Therefore, to echo many of the sentiments expressed in this Chamber today, I have some gentle questions about the guidance.
First, though, it was interesting to hear from the hon. Member for Mid Cheshire (Andrew Cooper) that a letter has been sent out, which I welcome. I wonder whether the Minister might take back to the Department the suggestion that a copy of the letter might be placed in the Library, for the public and all of us to see.
For my first question: can the Minister clarify whether the updated guidance will be published, and if so, when? Secondly, will she commit to holding a debate or a statement on the guidance, on having it laid before Parliament? Thirdly, how will the Government monitor compliance with the guidance?
To help with the above, the National Down Syndrome Policy Group, which drafted the original Down Syndrome Bill and worked with Sir Liam Fox and previous Ministers to support its journey through Parliament, has been trying to engage further with Ministers. It has highlighted to me multiple requests for Ministers to meet the APPG on Down syndrome, the policy group and MPs, which have yet to be successful. I echo that call: will the Minister commit today to her fellow Minister meeting with the policy group and the APPG to follow this up?
The theme of World Down Syndrome Day, which is indeed this Friday, is “improve our support systems”. We know that, with the growth in life expectancy for people with Down syndrome, access to social care will be critical. Therefore, can the Minister confirm whether the needs of people with Down syndrome will be considered in the first stage of Baroness Casey’s commission into adult social care? With the Government’s 10-year plan in production, could the Minister outline how Down syndrome will be addressed in the context of that plan?
I look forward to hearing from the Minister about how this Government will build on the foundations of the Down Syndrome Act, and about the strengthening and enabling of support. If we see it through that prism, the world shines brighter when we see people for their abilities rather than their disabilities.
Karin Smyth
We want to ensure that the guidance is published as soon as possible, and we appreciate patience while we make that happen. It is important that we continue to work with people and organisations with lived experience to develop the guidance. We hope that the update we provide will assure everyone of the priority attached to that important piece of work.
As for the scope of the guidance—with regard to other genetic conditions or learning disability—a commitment was made during the Bill’s passage through Parliament to consider the links and overlaps with other genetic conditions and/or a learning disability. Therefore, the guidance will be Down syndrome-specific, in line with the Government’s statutory duty—which we are clear about—under the Act. It will also include references to where it could have wider benefit. We want to take the opportunity of the guidance to help as many people as possible and to provide examples of good practice to support relevant authorities to implement improvements in practice.
On employment, we heard through engagement with our partners that employment is crucial to improving life outcomes. People with Down syndrome can bring many skills and strengths to the workplace. We want every person with Down syndrome who can and wants to work to have the right support and opportunity to do so. That is why a dedicated chapter on employment will be included in the guidance.
On implementing the guidance, we know that ultimately much depends on how the guidance is put into practice across our communities. To support implementation, NHS England published statutory guidance on 9 May 2023 to require that every ICB had a named lead for Down syndrome. I think that the right hon. Member for Beverley and Holderness said that there was only one, and I recognise the name, because it is my own area—well done, them. That might not have happened, but it was said in 2023.
The executive lead on Down syndrome will lead on supporting the chief executive and the board to ensure that the ICB performs its functions effectively in the interests of people with Down syndrome. We recognise the importance of ensuring that people with Down syndrome are able to make complaints, if they have concerns about the quality of and access to care. We expect the named lead to ensure that concerns are acted on at the local level.
Karin Smyth
I am sorry, but I think I have only a minute to go.
This week has been a powerful reminder of how far we have come regarding awareness of Down syndrome. It has also made us reflect that much more remains to be done. When the guidance is launched for public consultation, we will welcome Members’ support to ensure that the communities they represent are aware of it and can share their views.
I will just highlight the issue of regression, which my hon. Friend the Member for Thurrock mentioned. The guidance will deal with specific health needs, and regression will be part of that.
I thank the right hon. Member for Beverley and Holderness again for securing the debate and other hon. Members for joining the discussion. In particular, I thank the co-chairs of the APPG, the right hon. Member for East Hampshire (Damian Hinds) and my hon. Friend the Member for Mid Cheshire (Andrew Cooper), for their work, and everyone who works tirelessly to improve our support systems and services. It is incumbent on us all, working with people with Down syndrome, their families and carers, to get this done.
I appreciate that a number of requests have been made for different individuals and groups to meet my hon. Friend the Minister for Care. He is keen to do that. I will not make specific commitments, although the right hon. Member for Beverley and Holderness tempts me to do so, but I will make the commitment that my hon. Friend will be in touch via his office with colleagues who made such requests, to ensure that we make best use of the time and bring people with us on the implementation of this guidance, which is so crucial—I remember my time on that Bill well. I am thankful for the opportunity to be part of the debate this afternoon.
Women’s Health
Luke Evans Excerpts(1 month, 4 weeks ago)
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Dr Luke Evans (Hinckley and Bosworth) (Con)
May I, too, welcome the Minister? Gosh, what a debate to come into—it is such a wide-ranging field. I am so glad that she has been ably supported by the hon. Member for Hastings and Rye (Helena Dollimore) who put in a fantastic effort and managed to cover so many topics.
When I came to look at this debate, I thought about the best way I could try to touch on many of the topics. I thought a physiological view might be quite useful, starting with birth. Earlier this week, we had a debate on maternity services. The point is this: there is an explicit risk in pregnancy and birth, but we should do all we can to mitigate those risks. We know from the last 10 years that the maternal mortality gap has reduced from five times to two times, but much more can still be done. I am pleased that we heard that the Government are working through getting the Ockenden recommendations in place.
That leads me on to talk about postpartum depression, breastfeeding, and supporting recovery post-caesarean section delivery or episiotomy. We have heard about infertility and miscarriage. We have not even mentioned looking after a newborn. These are tough things to go through.
Young girls have to deal with body image, which is a personal hobby horse of mine. We heard about eating disorders. In 2023, we saw an investment of £4 million into new research, but there is still much more to do. Of course, that leads us to cosmetic surgery and when we need to regulate there. There is the issue of menarche and managing periods, not only from the contraceptive angle, but what to do when they are too heavy, too painful, irregular or do not happen at all. All these things require time, dedication and compassion to find out what works for that individual and what can be done to support, inform and empower that woman.
Returning to medical problems, Members have spoken eloquently about incontinence, as well as polycystic ovary disease and endometriosis, which are really common problems that are hard to diagnose and even harder to treat. I hope that the roll-out of 161 community diagnostic centres, which the new Government commit to carrying on with, make a giant leap forward in allowing women to get the diagnosis they need.
There is, of course, screening. We talked about breast screening, but cervical screening has not been mentioned. Screening is so important, and I urge every woman to consider it. What about the successful roll-out of the HPV vaccine, over a decade ago, to dramatically reduce cervical cancer? From 2019, it has also been offered to boys to help reduce that further. We need support for both lobular and ductal breast cancer. We have not really mentioned ovarian cancer and how difficult it is to pick up, often happening far too late.
Working through life, there is the menopause and the impact it can have on women: confusion, depression, anxiety and sexual dysfunction. It is still not well understood. The last Government, along with many from across the House, campaigned for better understanding to create a supportive environment. This is still developing, and long may it do so. Choice is hard too. Non-HRT or HRT? There are pros and cons. Of course, we had difficulties with shortages during the pandemic. Linked to the menopause, and not mentioned today, is the risk in old age of osteoporosis and fractures. That is critical. We know that women are significantly more affected by that than men, and prevention is much better than dealing with a broken hip or a broken wrist. I could go on.
Women’s health was rightly a priority under the last Government, which had almost 100,000 responses to their call for evidence to deal with the gender health gap. The last Government published the country’s first women’s health strategy in 2022, and expanded specialist women’s health hubs across England to improve access and quality of care for services such as menstrual problems, contraception, pelvic pain and menopause. They improved access to hormone replacement therapy and addressed barriers to health services faced by women who suffered from trauma from things like domestic abuse. Further still, the Government appointed Dame Lesley Regan as the first women’s health ambassador to step up efforts to improve women’s health, and Helen Tomlinson as a cross-Government menopause ambassador to find out the experiences of women employed in different sectors.
Turning to the issues here and now, I have some questions for the Minister, and some context. The Royal College of Obstetricians and Gynaecologists wrote to me on 29 January, just before the announcement by the Labour Government, with the following:
“We express our deep concern about the speculation of the Government’s decision to remove the target for all ICBs to set up and run a women’s health hub in the planning guidance”.
It went on to say:
“Removing the target may well lead to women’s health hubs being closed down, and a worrying rollback on the progress made in improving women’s health services for your constituents. It is self-defeating for the UK Government to close women’s health hubs when they are a clear success story for reducing waiting lists and moving care closer to home—they should instead be given ringfenced funding and expanded.”
I know the Minister cares deeply about improving women’s health, but it is hard not to see this is as a potential row back.
My first question is: what commitment can the Government give, in the light of dropping these targets, that women’s health remains a priority? Secondly, to help demonstrate this commitment, would the Government consider the call by the Royal College of Obstetricians and Gynaecologists for sustained investment in expanding women’s health hubs? Considering what we have heard today from the hon. Members for Walthamstow (Ms Creasy) and for Luton North (Sarah Owen), would the Department make a request in the spring statement and spending review to see that this would be the case? If not, why not?
I have spoken in the past in this Chamber about learning from previous work, so my third question is, how many times have the Government met with the women’s health ambassador since the general election? Can the Minister set out how this role would work alongside the Government’s new menopause ambassador? I hope that in asking these kinds of questions, it will kickstart the system into looking at how we can improve women’s health.
In the short time I have left, it would be remiss of me not to pick up on some of the key issues at the moment: osteoporosis, menopause, workforce and waiting lists. There has been some concern about the Labour Government’s commitment to their own promise of universal fracture liaison services by 2030. The Royal Osteoporosis Society has said:
“We all want to believe that Ministers will honour their promise, but people with osteoporosis tell us their faith is waning. It doesn’t need to be like this—we appeal to Wes Streeting to restore trust and confidence in the specific, measurable pledge that he campaigned on, and for which many people voted.”
Dr Evans
I am really sorry; I am tight on time. Question No. 4 is, could the Minister kindly clarify, confirm and commit to that promise? If not, why not?
On the menopause, when the women’s strategy was announced in 2022, the then shadow Health Secretary—now the current Health Secretary—said:
“I challenge the Secretary of State to go further than the proposal he outlined to train incoming medical students and incoming doctors. What plans do the Government have for clinicians who are already practising? We need to upskill the existing workforce, not just the incoming workforce. However, let us be clear: informing clinicians is no good if we do not also improve access to hormone replacement therapy, so where is the action in the strategy to end the postcode lottery for treatment?” —[Official Report, 20 July 2022; Vol. 718, c. 977.]
As we are now eight months into the Labour Government, question No. 5 is, when will the strategy document he talked about be produced and presented to the House? Has he made an assessment since July 2024 of HRT medication access in terms of locality?
Turning to workforce, we know that the demand for women’s services is outstripping the supply of generalist and specialist support. The Royal College of Obstetricians and Gynaecologists has highlighted ongoing problems with maternity workforce staffing and agreed that the NHS long-term workforce plan was a good first step on the way to properly staffed maternity services. Therefore, question No. 6 is this: we know that the Government will be looking at a refresh of the plan this summer, so will the Minister give an undertaking today that women’s health will be a priority in both primary and secondary care? Will she update the House on the obstetrics workforce planning tool, which the DHSC commissioned to help maternity units calculate staffing requirements, and when it will be rolled out across the country?
Given that time is tight, I will close by saying that I have heard it said that a healthy woman means a healthy family, a healthy community and a healthier world. That is hard to dispute that; it is now for the House to deliver it.
Dr Rupa Huq (in the Chair)
Finally, for what we think is her first outing as a Minister in Westminster Hall—although she is a veteran of the Chamber already— I call Ashley Dalton.
Ashley Dalton
That is something that we will take on board and consider as we move forward.
We have heard a lot about menopause and peri- menopause from many Members, including my hon. Friend the Member for Broxtowe (Juliet Campbell). We are supporting women through the whole menopause process. Menopause and perimenopause symptoms can be wide-ranging and debilitating. NHS England is developing a range of tools and interventions to help upskill more GPs in menopause care, including awareness of mental health symptoms during menopause, and developing a menopause workforce support package for employees. I can also confirm that we are using community diagnostic centres to pilot pathways for women who suffer from post-menopausal bleeding.
Ashley Dalton
I will come back to the hon. Gentleman on that, but I thank him for raising the issue.
We have also talked a lot about what underpins this topic: research and innovation, and my hon. Friend the Member for Stafford raised that point in particular. We are taking strides in vital research. By the spring, the NIHR expects to launch its sex and gender policy, which will ensure that research is designed, conducted and reported in a way that accounts for sex and gender—a point raised by the hon. Member for Canterbury. That will support our understanding of how women might be impacted differently by health conditions.
The hon. Member for Bath (Wera Hobhouse) talked about eating disorders and also about breast cancer, which a number of people raised. As I am sure the hon. Lady appreciates, that issue is important to me, as I was diagnosed with a breast cancer when I was under the age of 42. It is an important issue.
Health in the workplace continues to be an important issue for us, and we are dealing with that through our make work pay strategy and the Employment Rights Bill, which will set out some of those steps, including support for women experiencing menopause in the workplace.
On sodium valproate and pelvic mesh, the Cumberlege review made nine recommendations, of which the then Government accepted seven. I can confirm that the national pause remains in place.
Maternity Services
Luke Evans Excerpts(1 month, 4 weeks ago)
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Dr Luke Evans (Hinckley and Bosworth) (Con)
I am pleased the hon. Member for North Shropshire (Helen Morgan) pointed out that many people actually do have a good birth. I think that is really important, as there is a danger we scare potential mothers. There is good-quality care up and down the country, but it could be better.
The hon. Member for Redditch (Chris Bloore) pointed to my work. I never actually served in Redditch in the obs and gynae and the paeds there; my time was done in the early 2010s over at Worcester. One of my favourite times as a doctor was being on the elective C-section list, and seeing the mothers go in, having the music there, and seeing birth after birth. It was fantastic. I also experienced one of the worst things that I have ever had to do as a paediatrician—being handed a lifeless baby and trying to sort that out. Worse still was an emergency C-section after a baby went into the mother’s bladder. Both went off to the intensive care units, and I had to go and speak to the father, who was expecting a normal delivery, to tell him what was going on.
This is the reality of what happens, because having a baby does carry inherent risks. What we are talking about here is what we can do to mitigate them. I think that is the heart of what the hon. Member for Chichester (Jess Brown-Fuller) so eloquently set out; this is about the safety of mitigation. Her story about Bendy and Steph will stick with many people, because that is exactly what this House and the NHS should be trying to avoid. The aim should be to mitigate as much risk as we can.
We have also heard talk about breastfeeding and post-partum mental health, which is really important. Those things should form part of a strategy. Not all patients receive a safe and timely assessment when they are being triaged, with instances of phone triage going unanswered and some women discharging themselves before even being seen or picked up, due to the delays. That was backed up by the Care Quality Commission, which found that unsafe practices in triage form the basis of 81% of the enforcement actions issued to providers and were found to be a safety concern in about a third of all inspections.
The hon. Member for Epsom and Ewell (Helen Maguire) pointed to the fantastic quality of care that exists, despite the conditions—we know that 18% of the NHS estate has been described as not fit for purpose and lacking the space for facilities. In my constituency, we have a plan to bring forward an improved maternity centre for Leicestershire. That, too, has been delayed in the future hospitals programme, but at least funding is coming forward to try to deal with that.
Looking at the record of the previous Government, from 2010 to 2022, the rate of stillbirth decreased by 19.3%, the neonatal mortality rate for babies born over 24 weeks gestational age of viability decreased by 36%, and maternal mortality decreased by 17%. In 2015, the then Government launched the national maternity safety ambition, which was to halve the 2010 rates of stillbirth, neonatal and maternal deaths, and brain injuries in babies occurring during or soon after birth by 2025. The current Government have not yet set out an updated ambition for the next decade, so I would appreciate it if the Minister would bring that forward.
As of December 2023, there were 2,361 full-time equivalent midwives working in NHS trusts and other core organisations. That was an increase of 3,700, or 18.9%, since 2010. On the other hand, the birth rate is falling while the number of midwives is rising. I recognise that births are taking place and are somewhat more complex than they used to be, due to things like diabetes, weight and age. It is really important that we have a plan to deal with that; I hope the Minister will comment on that going forward.
That leads me on to community midwives and continuity of care, which we know is inextricably linked to improved care. A report by Cochrane, a non-profit organisation that produces global research to improve health outcomes, showed that women who experience continuity of care—in other words, seeing the same midwife or teams of midwives in pregnancy—have far better outcomes. During the last Parliament, funding was provided for the implementation of continuity of care models. As of April 2024, an additional £186 million had been allocated to improve the quality of care for mothers and babies and to increase the number of available midwifes in post.
I further welcome the £6.8 million in funding provided by the previous Government to help to implement continuity of care for black and ethnic minority groups living in the most deprived areas. As we have heard in the debate, that is a real concern—the hon. Member for Worthing West (Dr Cooper), with her professional experience, pointed to the disparities we see in seeking behaviours among those from BAME backgrounds when it comes to having babies. We also saw that in our work on the Health Committee—I have asked the Minister to look at the two reports on litigation and the Ockenden report in the last Parliament. There is a lot of good cross-party work there that could help to inform current thinking.
Of course, far more remains to be done in the area of saving babies. NHS England published its own delivery plan for maternal and neonatal services in March 2023. Commitments included updating the “Saving babies’ lives” care bundle by 2024 and introducing a national maternity early warning score and updated newborn early warning trigger and tracker to follow up the babies in those cases. The “Saving babies’ lives” care bundle is helping to provide the best practice for providers to reduce neonatal mortality and is rightly a major component of NHS England’s maternal and neonatal services delivery plan. Will the Minister provide an update on the implementation of version 3 of the care bundle?
There are a few closing questions that I would like to pose. The maternal mortality gap has been reduced over the years, from five times to two times, but clearly we need to do more. What further action will the Government take to address the issue of the black and Asian maternal mortality gap, and what ambition will be set out? At the general election, the Government stood on a manifesto to recruit more midwives. Will the Government confirm how that fits into the long-term workforce plan? I am pleased that they have stuck with the previous Government’s plan, and are looking to amend it.
In the new operational planning guidance, NHS England has committed to implementing the key actions in the three-year delivery plan. Will the Minister update us on progress against some of those actions, including the commitment to introduce a national maternity early warning score system and an updated newborn early warning trigger and track tool? As part of their response to the East Kent review, the previous Government established a group overseeing maternity safety services nationwide chaired by my former colleague, Maria Caulfield. Will the Minister provide an update on the national oversight group’s work? Are she or any of her ministerial colleagues part of those discussions?
My final question is about litigation, which was raised by my right hon. Friend the Member for Godalming and Ash (Jeremy Hunt). Under his chairmanship, the Health and Social Care Committee produced a report looking at different maternity models, including in the likes of Japan, and at how can we reduce the cost for taxpayers while improving clinicians’ ability to have the honest discussions we need, and to feel that they can come forward and blow the whistle.
Birth is not about making babies; it is about making mothers—strong, competent and capable ones. We do that by supporting, respecting and informing mothers every step of the way. That is an admirable aim for this House and the NHS, and I look forward to the Minister’s comments.
Cardiovascular Disease: Prevention
Luke Evans Excerpts(2 months, 1 week ago)
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Dr Luke Evans (Hinckley and Bosworth) (Con)
Before I start my speech, I think it was Gandalf who said:
“A wizard is never late…Nor is he early; he arrives precisely when he means to.”
I think it is correct protocol to be here at the start of a debate, although I for one would certainly like to see the Minister sprinkle his magic on this topic, because I hope that he will provide some enlightening answers in response to such an important debate.
Once again, I thank the hon. Member for Strangford (Jim Shannon) for his industrial strength in always securing these debates. I believe it is said that the man who moves a mountain begins by carrying away small stones; the hon. Member for Strangford is moving the metaphorical health mountains, one Westminster Hall debate at a time. I raise my hat to him, because I have had the chance to respond to a debate of his at least half a dozen times. He always conducts himself in an incredible manner and provides incredible detail, so I thank him for that.
If we can tackle the risk factors behind cardiovascular disease and identify it at an early stage, we can make a significant difference by reducing the number of people lost to premature deaths every year. The hon. Member for Ilford South (Jas Athwal) spoke movingly about his mother and his father. That was followed up by the hon. Member for Mid Sussex (Alison Bennett), who spoke about her father 13 years on; her father will be very proud to see his daughter in this debate. I am sure the parents of the hon. Member for Ilford South would be proud of his achievements as well, and the fact that he is raising such an important topic.
I come to this topic as a GP, and this is pretty much the bread and butter of life for a GP: advising on healthy lifestyles, and managing blood pressure, angina, obesity, smoking, heart failure, strokes and many more conditions. I pay tribute to the hon. Member for Dudley (Sonia Kumar), who pointed out how important that is. It is not just the doctor’s role any more; this is the MDT approach, and actually a quality MDT really helps the GP to understand where they need to look and to manage their workload, which is so important not just for clinicians but, most importantly, for the patients. It is an honour to take part in this debate and to help to shape it.
From a public health perspective, the last Government made significant progress on things such as calorie labelling, salt and sugar reformulation and smoking cessation, which are all contributors to cardiovascular disease. It was just three years ago that the NHS published its CVD prevention recovery plan, which set out four high-impact areas for every part of health services to focus on risk factors, detection and management. Examples include the rolling out of blood pressure checks in high street pharmacies and allowing people to measure blood pressure at home. The NHS long-term plan set out five ambitions to detect and treat people at risk of developing CVD. The plan has been revised twice, in 2022 and 2024.
This work was reinforced by the introduction of the NHS digital health check in spring 2024, which aimed to prevent 400 heart attacks over four years. The National Audit Office report into CVD, which was published in November 2024, said the disruption to the NHS caused by the covid pandemic has had substantial impacts on elective care, and this has undoubtedly had an impact on the prevention and treatment of cardiovascular disease. We do not have to look back too far to think about lockdown and the effect that that had on people’s physical activity, their ability to seek help and some of the preventive and advisory medicine that would have normally taken place. Following the NAO report, the Government committed to reviewing the NHS health check programme. Will the Minister confirm the timescales for the review and when the reports on the outcome will be published?
The hon. Member for Strangford rightly pointed to cholesterol and lipids. Lipids are often not given the attention needed; they are hugely important when addressing cardiovascular disease, so I thank the hon. Gentleman for mentioning them. I have done constituency casework on this topic as a Back-Bench MP. He mentioned lipoprotein(a), and I have been questioning Ministers about the development of genetic testing for familial hypercholesterolaemia and the development of a familial hypercholesterolaemia service in Leicestershire. Although this is a complicated and involving space, given the great advances in the testing and understanding of lipids, it is really important that we get to the bottom of it to understand the environmental impacts that are causing this, as well as the genetic ones at play.
To that end, work has also included looking at how bodies can track patients and the difficulties that familial hypercholesterolaemia services have in cascading to local people’s relatives, which I think is what the hon. Member for Strangford was pointing to. This is probably beyond the scope of this debate, but given the hon. Gentleman’s success with this debate, it would be great if he were to secure a Back-Bench debate on lipids. Will the Minister consider asking the Department to look at improving the clinical pathways for familial hypercholesterolaemia and the possible roll-out of screening for both patients and family members? I appreciate that this has to be done through an evidence-based approach.
More people are living with multiple long-term conditions; that is no different for many people living with CVD, who are also living with other conditions, such as diabetes. That is why the last Government were developing the major conditions strategy to try to improve outcomes across major conditions, including cardiovascular disease, as well as cancer, diabetes, respiratory disease, mental health and musculoskeletal disorders. Since the general election, Ministers have decided to go in a different direction, so will the Minister reassure me that the NHS 10-year plan will address the impact of those long-term conditions? As the hon. Member for Mid Sussex pointed out, inequality plays a role when it comes to cardiovascular disease, so I would be grateful if he would comment on that.
I think the quote goes, “Study the past if you would divine in the future,” and I am always keen to gain insight from across the House of what has previously happened. I note that almost a year ago today, there was a debate held in the main Chamber on the topic of heart and circulatory diseases by the then MP for Watford, the brilliant campaigner Dean Russell, who talked about his experience of having a heart attack. Of course, the debate was just a few months before the general election, but it gives us a good insight into what the then shadow Health team were thinking before they came into government, which they were successful in doing. The then shadow Minister, now the Minister for Secondary Care, was responding. She said:
“Labour has a mission to reduce deaths from heart attacks and strokes by a quarter within 10 years…Under our ‘Fit for the Future’ fund, we would double the number of scanners—speeding up heart and circulatory disease diagnosis”.
What is the amount in that fund? Has it been deployed, and what is the timescale? What scanners were specifically commissioned for cardiovascular disease? The then shadow Minister went on:
“We would also incentivise continuity of care in general practice, which would improve care in our communities for people living with heart and circulatory disease.”—[Official Report, 22 February 2024; Vol. 745, c. 940.]
No one has to tell me, as a GP, about the importance of continuity of care, so will the Minister explain what this would look like in the GP contract? What incentivisation is being considered for GPs?
The then shadow Minister went on:
“That is why Labour will introduce a child health action plan that will put prevention at the top of the agenda”.
Forgive me, but looking on the Government’s website and speaking to the House of Commons Library, I cannot see a report or plan on this topic; if I have missed it, will the Minister provide it? If there is not one, will the Minister set out the goals and timelines for achieving the plan, if the Department will provide them, and place it in the House of Commons Library?
On research, the then shadow Minister went on:
“That is why Labour’s regulatory innovation office would make Britain the best place in the world to innovate by speeding up decisions and providing a clear direction based on our modern industrial strategy, alongside a plan to make it easier for more patients to participate in clinical trials.”—[Official Report, 22 February 2024; Vol. 745, c. 941.]
Eight months into the new Government, I believe a chair has not been found, so will the Minister update me on when the role will be filled? Given that this was the stated aim of the Labour party in the CVD debate, what conversations is he having with the Department for Science, Innovation and Technology about speeding up cardiovascular trials?
I thought it fitting in closing to use the lines of Dean Russell, who used his closing remarks back then to point to the importance of data, education, protection and research in dealing with cardiovascular disease. I think the entire House can get behind that. The story of the hon. Member for Ilford South is a testament to the life advice that Dean gave to us then:
“if anyone at home is worried, they should get checked. If they are concerned that they have symptoms, they should get them looked at. It is better to get rid of fears before the event than to wait for them to become a reality and have to deal with the outcomes of that.”—[Official Report, 22 February 2024; Vol. 745, c. 944.]
I think we can all agree on that, too.
David Mundell (in the Chair)
I am sure that the Minister will begin with an apology to me, to Mr Shannon, as the Member in charge, and to all other participants, because it was very clear on the Order Paper that these proceedings would begin at 3 pm.
David Mundell (in the Chair)
I am sure the Minister will have heard the three points that Mr Shannon raised. On that basis, I will put the Question.
Dr Evans
On a point of order, Mr Mundell. In perfect symmetry, this debate has taken a somewhat different procedural pathway than usual; that is indeed what can happen to patients with cardiovascular disease—things surprise them, although we have systems for dealing with cardiovascular disease. My concern is that some of the questions I raised on behalf of His Majesty’s Opposition have not had the chance to be answered. I would be grateful if the Minister would take them away and write to me—perhaps I could put them in a letter. Would it be within the scope of the Chair’s powers to allow that to be the case, Mr Mundell?
David Mundell (in the Chair)
That is not technically a point of order, but I am sure the Minister has heard what you have had to say. I am sure he and, indeed, the hon. Member for Glasgow South West (Dr Ahmed)—who was here from the start—will have noted all the points that Mr Shannon raised. If the points that Mr Shannon raised at the end—and indeed earlier, in his contribution before the Minister spoke—were unaddressed, I am sure that the Minister will write to him.
Oral Answers to Questions
Luke Evans Excerpts(2 months, 1 week ago)
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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?
Wes Streeting
It is absolutely ridiculous, Mr Speaker. Conservative Members turn up, criticising and carping about this Government’s elective reform plan, but I remind the hon. Gentleman that when his party was in office, it delivered the longest waiting lists in the history of the NHS. If he wants to do a pop quiz, he can use Google.
Dr Evans
This is the Secretary of State’s own plan. There was one example in the plan, but as an article in The BMJ on 17 January helpfully pointed out, that one example—which featured Sarah, who had sinus pain and hearing issues—was quietly removed from all online and future drafts after
“a flurry of GPs pointed out that her treatment”
was “wholly inappropriate.” That article went on to say that
“Sarah can pick up her dose of unnecessary radiation along with her weekly shop.”
On this part of the Government’s plan, The BMJ concluded:
“Sarah’s story is one of over-investigation, fragmented and inappropriate care, spurious choice, and a lack of senior decision making at first presentation. Activity for activity’s sake has little to do with high quality care.”
Does the Secretary of State agree with The BMJ, and if not, why not?
Wes Streeting
I always believe in holding our hands up when mistakes are made. I am happy to say that the reason that case study was removed from the published elective reform plan is because it was a genuine mistake, for which I accept responsibility as the Secretary of State. Now, maybe the Conservative party might like to accept responsibility for the highest waiting lists and lowest patient satisfaction in history, and finally have the decency to apologise to the country for the mess it left us in.
Draft Health and Social Care Act 2008 (Regulated Activities) (Amendment) Regulations 2025
Luke Evans Excerpts(2 months, 2 weeks ago)
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Dr Luke Evans (Hinckley and Bosworth) (Con)
It is a pleasure to serve under your chairmanship, Sir Desmond.
I thank the Minister for stepping in, and we agree that this SI needs to be passed with urgency. I also agree that it is not the place for a discussion of the CQC and its failings. She highlighted a couple of issues of concern, on which I would like to probe the Government a little, such as ending the exemption for sports arenas and cultural events. Given the Manchester Arena bombing and inquiry, it is clear that protections need to be in place, but the Opposition are concerned about the burden on small businesses and charity groups, which may well have to deal with the red tape involved in being regulated by the CQC. I would therefore be grateful if the Government considered producing an impact assessment of that red tape and how it will work in practice. CQC registration makes perfect sense when there are medical interventions in arenas, but how is it likely to work for a small football club run on a voluntary basis, or for a charity? At this point, I declare an interest: my brother is a sport and exercise medicine consultant and the medical director of the Lawn Tennis Association and so could in theory come within scope of some of these changes.
As part of the consultation response, the Government stated that
“further policy and operational consideration”
was needed. Will the Minister clarify what that means in practice? I also want to ask the Minister a question about regulation 5 of the 2014 regulations, which set out the criteria for an individual to be considered a fit and proper person to take up a role as a director of a health service body or provider. The last Government started a review of the duty of candour expected of healthcare professionals. Will the Minister provide an update on when the Department will publish the outcome of that consultation, and have the Government made an assessment of how the outcome of the consultation may affect the provisions of the 2014 regulations as they relate to criteria for directors of health and care providers?
Overall, the Opposition are supportive of the direction in which the Government want to go with this legislation. We understand the urgency of the timetable in front of us, but the concerns felt by Opposition Members will need to be addressed, so that we do not inadvertently overburden some of these institutions, which are already feeling difficulties when it comes to regulation. I would be grateful for the Minister’s answers.