Department of Health and Social Care

Luke Evans Excerpts

Tuesday 30th June 2026 Commons Chamber

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

I will dispense with the formalities to jump straight in. The hon. Member for Oxford West and Abingdon (Layla Moran) asked whether the Government have a clear, funded and transparent plan. Simply put, the Government appear to have made commitments they cannot properly explain, cannot fully cost, and cannot tell Parliament how they intend to pay for.

We are of course talking about the UK-US pharmaceutical arrangement, which will see 0.3% of GDP in 2026, rising to at least 0.6% by 2036—or an overall medicine spend of 10% to 12% of the UK NHS budget by 2036. That may bring benefits and investment, it may avoid tariffs, and it may help some patients get treatment faster, but those benefits do not remove the three key basic questions: what will this cost, how will it be funded, and what will the NHS have to forgo as a consequence? Those questions remain unanswered, which is a running theme from this Government.

Since Labour took office in July 2024, the pharmaceutical sector has issued a serious set of stark warnings. In January 2025, AstraZeneca cancelled its £450 million expansion near Liverpool, citing as a factor in the decision

“the timing and reduction of the final offer compared to the previous Government's proposal”.

However, that was not isolated. In March 2025, the leaders of some of the UK’s biggest pharmaceutical companies warned that the country risked becoming “uninvestable”. That warning turned into decisions, with MSD cancelling its plans for a £1 billion research centre in London, Eli Lilly pausing its work on the Gateway Labs hub, and Sanofi saying that it would not make substantial UK R&D investment until it saw appropriate recognition of the value of innovation.

[Joe Robertson (Isle of Wight East) (Con)]

Given that there are so many unanswered questions and such little information, rather than estimates day, wouldn’t the better name for this debate be “a complete stab in the dark” day?

[Dr Evans]

Or guesstimates day, for want of a better pun. That is part of the problem. If the Government are so confident, why do they not produce the impact report so that they can justify this? At the end of the day, we have seen that those decisions are not isolated; they are different companies, making different decisions, but all with the same concern. It is a pattern: tax rises, more regulation, more red tape—a more toxic concoction.

The Government will say that the deal is part of the answer, but Ministers cannot point to potential benefits while avoiding certain costs. The House of Commons Library is clear that the Department’s main estimate for 2026-27 does not include budget cover to meet the expected increase in pharmaceutical spending associated with the UK-US arrangement. That is the central problem. The Government say that the total cost in the current spending review period is expected to be around £1 billion, but the former Minister, the hon. Member for Glasgow South West (Dr Ahmed), also said,

“Total costs over the Spending Review period are expected to be approximately £1 billion. The final costs will depend on which medicines NICE recommends and the actual uptake of these.”

That is an important admission, because the final cost depends on future NICE decisions and uptake, and other estimates are higher.

The Library briefing cites analysis suggesting that spending could be around £1.7 billion by the end of 2028, and around £14 billion by 2036, depending on the assumptions. Is the £1 billion the central estimate, and if so, what are the lower and higher ends of the estimate range? Why will the Government not publish the modelling so that we can see? My next question is even sharper: where is the money coming from? We know from leaked WhatsApp messages that Labour MPs have been asking who they can tax to pay for benefits, so where is the money coming from? Both the House and the public are right to ask.

The Government have said that additional costs will be funded from existing NHS budgets, with future funding settled at the next spending review. However, if the money is coming from existing NHS budgets, it is coming from somewhere within the NHS. It might be the workforce, services, capital or future growth, but it will not be cost free. As Jonathan Benger, the chief executive of NICE, put it,

“If they choose to spend money on defence, they’ve got to pay for that somehow, either by raising taxes or removing money from somewhere else. If they choose to spend money more on medicines, similarly, that has to be paid for.”

That is the reality.

The former Secretary of State told the House that the Government would not cut NHS budgets to fund the pharma deal, but the former Health Minister, the hon. Member for Glasgow South West, later turned around and said:

“The deal will be funded by allocations made at the Spending Review, where record funding for the NHS was secured. Future funding will be settled at the next Spending Review.”

Those statements need reconciling. If it is funded from NHS allocations, that is NHS money. Can the Minister rule out any cuts from the frontline?

Finally, I will turn to transparency. I want to point out that the UK-US pharmaceutical arrangement is not a treaty-based free trade agreement. It has not been through the Constitutional Reform and Governance Act process. We have not seen what is going on. The Government need to publish their impact assessment, and yet they cite commercial sensitivity. Of course, there is a way round that: the Minister could redact it and give that to the Committee so that we and this House can see what is going on.

I will cut my speech short there. I will simply pose—

[Madam Deputy Speaker (Ms Nusrat Ghani)]

Order. Very quickly, shadow Minister. Ten seconds.

[Dr Evans]

What is the policy’s true cost? How will it be paid for? What will be displaced in the NHS to make it happen?

[The Parliamentary Under-Secretary of State for Health and Social Care (Preet Kaur Gill)]

I will try to answer all the questions that have been put to me in the short time I have. First, I am grateful for the contributions made by hon. Members, and I thank the Chair of the Health and Social Care Committee, the hon. Member for Oxford West and Abingdon (Layla Moran), for securing this debate.

The UK-US pharmaceuticals arrangement is an important step forward for patient access to innovation and the future of our life sciences sector. This arrangement is fundamentally about patients by ensuring that they can benefit from life-changing medicines as they are developed, rather than see the UK being left behind. We have already seen the benefit from those changes, with NICE approving life-changing treatments such as vorasidenib, a brain cancer drug for patients as young as 12.

The UK’s life sciences sector is one of our greatest national strengths. It saves lives, supports jobs and underpins innovation across our economy. I am proud that thanks to this arrangement, the United Kingdom will be the only country in the world to have secured a commitment to tariff-free access for pharmaceutical exports into the United States.

The Chair of the Committee raised NICE and VPAG changes and rebates. My right hon. Friend the Member for Hayes and Harlington (John McDonnell) also raised a number of issues, as did my hon. Friend the Member for York Central (Rachael Maskell). I will address them now.

The joint Government and industry taskforce has been discussing the options for continuing to evolve our system to ensure that we maximise benefits to patients and the economy. It will make recommendations on pilot programmes as per the UK-US arrangement commitment, and I look forward to providing an update to the Committee on that in due course.

I know there has been concern that these changes undermine NICE’s independence, but that is not the case—let me just be clear about that. NICE will continue to make its recommendations based on evidence, clinical effectiveness and value for money, free from political interference. The change will allow Ministers to set the overall threshold within which NICE operates, not to determine individual decisions. This will preserve NICE’s core role as an independent evaluator, while ensuring that the framework that it uses reflects how we value innovation and patient benefit.

Concerns were also raised about the fact that the UK commitments are larger than the US commitments, but I do not agree. The UK has made policy changes to improve access for patients, while the US has committed to tariff protection for UK exports, which is significant given the scale of that market. The commitments deliver improved patient access in the UK and protection for UK exports.

[Dr Luke Evans]

Will the Minister give way?

[Preet Kaur Gill]

I am trying to get through all these questions as quickly as I can. I will give way to the hon. Gentleman shortly.

On the VPAG changes and rebates, alongside changes to NICE recommendations, the arrangement affects how pricing and repayment mechanisms operate through the voluntary scheme for branded medicines pricing, access and growth. To ensure predictability for the industry going forwards, given the unexpectedly high payment percentage for newer medicines for 2025, the Government have committed to ensuring that future VPAG rates do not exceed 15%. This will support life sciences investment and patient access to medicines while ensuring that the scheme can continue to work for both industry and the NHS, keeping the medicines budget sustainable. I look forward to engaging with the sector on the future of the voluntary scheme, with negotiations due to begin next year informed by the outcomes or interim findings from pilot programmes that were launched as early as this September.

[Dr Evans]

The Minister would save a lot of time simply by publishing the impact assessment, which would answer every one of the questions that she is trying to find the answers to in her folder, so will she—yes or no?

[Preet Kaur Gill]

With respect, I am going to answer the questions that have been put to me by many hon. Members, and I am coming to the impact assessment.

We have been clear that the estimated short-term impact is around £1 billion in England over the spending review period. Costs will increase over time as NICE approves more medicines, but precise long-term costs cannot be modelled as a single figure; they depend on future medicines, NICE approvals, uptake and wider commercial developments.

Members mentioned a number of figures. I do not recognise the £9 billion and £14 billion figures for costs. Spending on innovative medicines increases year on year as new treatments become available, so underlining growth would be expected to continue regardless of this arrangement, and often the figures cited publicly do not take that into account. We are committed to increasing spending on medicines as a proportion of NHS spend, ending the recent decline in the proportion of health spend dedicated to medicines and increasing spending on innovative medicines to 0.6% of GDP.

The Chair of the Science, Innovation and Technology Committee, my hon. Friend the Member for Newcastle upon Tyne Central and West (Dame Chi Onwurah), and my hon. Friend the Member for North West Cambridgeshire (Sam Carling) raised a really important point. Life sciences is one of our most productive sectors. It underpins research and development, clinical trials and high-value manufacturing, and it supports jobs across the country. Over £1 billion in industry investment has already been secured since the announcement of this arrangement in December last year. That includes AstraZeneca’s recent announcement of a £300 million investment into R&D sites at Cambridge and Macclesfield. That demonstrates the confidence that this key sector has in the UK. Maintaining a strong commercial environment helps ensure continued investment and the development of new treatments. This is not separate from patient benefit. It enables the pipeline of the new medicines that NHS patients ultimately rely on.

National Lung Cancer Screening Programme

Luke Evans Excerpts

Thursday 25th June 2026 Westminster Hall

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

It is a pleasure to be here in an air-conditioned room while we continue this debate. It is poignant that it is so hot today, because we know how that can impact people with respiratory illnesses; we are probably talking about this issue at a very useful time.

I too thank the hon. Member for Wokingham (Clive Jones) for securing this important debate. As has been said, lung cancer remains a leading cause of cancer death in the UK, but it is also one of the cancers where early detection can make the biggest difference. I know that at first hand from my first year as a junior doctor working on a respiratory ward. It was eye-opening and harrowing, but also sometimes successful. I urge anyone who has the chance to visit a respiratory ward to see how important it is—and I believe that would make a difference to smoking rates.

It is great that the hon. Member for Wokingham secured the debate, and great to see the hon. Member for Strangford (Jim Shannon) secured the debate, because it is a good debate—it is a good day. This is really a success story. The Liberal Democrat spokesperson, the hon. Member for Didcot and Wantage (Olly Glover), rightly told us John’s story; because of the screening that has been put in place, there will be plenty more Johns in the future, which is exactly what we want to hear. Often we talk about the problems, but this is a really good example of something positive that has come forward, and it all started under the previous Conservative Government.

The roll-out of community diagnostic centres has fundamentally changed how we diagnose disease. There are now more than 170 centres across England, expanding capacity and bringing scans closer to where people live. Nationally, they have delivered millions upon millions of additional tests and have helped to ease pressure on acute services, with the clear aim of diagnosing conditions such as cancer faster and improving patient outcomes.

Only this month I went to the first year anniversary of the opening of the CDC in Hinckley, a £24 million investment that has seen 59,000 patients through its door and is expanding. That means patients do not have to travel as far into Leicester or Nuneaton, and that they get their diagnoses more quickly and in a modern tech building. That is absolutely fantastic for my community, but I know that is replicated 170 times across the country. That matters because, when it comes to diseases like lung cancer, early diagnosis is everything. The sooner we can identify a problem, the sooner we can act, and crucially, the better the chances of survival.

There is a real success story to talk about. The NHS lung cancer screening programme has its roots in work started by the Conservative Government, building on more than a decade of UK research and pilot studies. Following successful trials and local pilots, NHS England launched the targeted lung health check programme in 2019, focusing on high-risk groups in areas with the worst outcomes. That approach, using mobile scanners and proactive interventions, proved effective in detecting cancer earlier and reaching underserved communities.

On the back of that success, and with a formal recommendation from the UK National Screening Committee in 2022, the Government announced a national roll-out in June 2023, committing to expand the screening across England and ultimately to reach full coverage by 2030. Since then, the programme has transitioned from pilots to a full national screening service and now forms a central part of efforts to improve cancer survival. I am pleased to see that the Government are continuing on that trajectory.

Why does this matter? The NHS lung cancer screening programme is now delivering at scale and showing clear results. About 2.8 million people have been invited, with 1.5 million checks completed and close to 1 million scans carried out. Some 6,000 to 7,000 cancers have been detected, roughly three quarters of which have been identified at stage 1 or 2, the earlier stages, in comparison with fewer than 30% before the programme started. About 1.4% of the scans lead to a diagnosis, demonstrating a targeted and efficient approach, and uptake stands at about 60%. In short, the programme is not only reaching those most at risk, but consistently shifting diagnosis to an earlier, more treatable stage and saving lives at a national level.

As I say, we welcome the proposed expansion of the lung cancer screening programme, but it is vital that steps be taken to improve the uptake of screening and lung health checks. The fact that uptake stands at 60% means that 40% of those invited are not coming forward, and they are often the ones at highest risk. The question is why. Can the Minister set out what specific interventions the Government will introduce to increase uptake, particularly among the most deprived and hard-to-reach groups? To that end, can he confirm how the Government plan to deliver targets set in the national cancer plan, including the allocation of resources and funding for the lung cancer screening programme, over the next few years?

As my new Scottish Conservative colleague, my hon. Friend the Member for Aberdeen South (Douglas Lumsden), may rightly point out, progress on lung cancer screening is uneven. England is now rolling out a full national programme; Wales has committed to an implementation, with the first invitations expected from 2027; Scotland remains at a pilot stage, with a national roll-out likely to be years away; and Northern Ireland is still in the early planning phases, without a programme in place. Given that variation, will the Minister set out what discussions are taking place across all four nations? Most importantly, what lessons are been learned from the English experience that can be actively shared to support a faster and more consistent delivery and roll-out across the UK?

More broadly, this issue speaks to the need for a coherent approach to respiratory disease. Under the last Conservative Government, there was a clear attempt to take a more joined-up approach to the country’s biggest killers through a major condition strategy, which was announced in 2023. It explicitly placed chronic respiratory diseases, alongside cancer and cardiovascular disease, as one of six national priorities, recognising both its scale—it affects millions—and its contribution to avoidable ill health. A detailed framework, setting out a shift towards prevention, early diagnosis and management of those conditions, was published later that year. However, although the direction of travel was established and widely consulted on, the strategy never reached full publication or implementation, because there was a general election.

This Government have taken a different route, with modern service frameworks. They have committed to developing modern service frameworks for frailty, dementia, mental health and cardiovascular disease—just a few areas—so I ask the Minister directly: will the Government develop a modern service framework for respiratory disease? If not, how do they intend to drive the same level of improvement for a condition that affects millions and underpins outcomes in lung cancer?

We are all serious about improving cancer survival. Across this House, we all have that ambition, but we must match our ambition with delivery. Just like the 10-year plan, the delivery chapter is missing. I worry that the same could be argued for respiratory conditions. I just hope that I am proved wrong.

--- Later in debate ---

[Stephen Kinnock]

The hon. Gentleman is absolutely right. There is a lot more work to be done, and it is a priority for the Government: it is right up there in the 10-year plan and the priorities. As he said in his excellent speech, we need to mobilise every one of the shifts—from analogue to digital, from hospital to community and from sickness to prevention—in the battle against cancer, because it is a formidable enemy and we need every single weapon we can deploy to defeat it.

We are determined to break the historical pattern of slow progress and finally give people with less survivable cancers the focus, urgency and outcomes that they deserve. That commitment is already being translated into action through the NHS lung cancer screening programme. The programme is designed to identify cancers at an earlier stage among those at highest risk, particularly people aged 55 to 74 with a history of smoking. Smoking remains responsible for about 72% of lung cancers, which is why a targeted approach is both clinically effective and evidence-based.

The results so far have been extremely encouraging: more than 1.8 million people have attended a lung health check through the programme, and more than 11,000 people have been diagnosed with lung cancer. Most importantly, 77% of cancers detected through the programme have been diagnosed at stage 1 or stage 2; outside the programme, the equivalent figure is about 30%. That means that thousands of people are receiving a diagnosis earlier, accessing treatment sooner and benefiting from significantly improved prospects for survival.

The programme is already demonstrating how earlier diagnosis can transform outcomes. Recent NHS England data shows a significant improvement in early-stage diagnosis in areas participating in the programme. That means more people are being diagnosed when treatment is most effective and when there is the greatest opportunity for curative intervention.

The hon. Member for Wokingham and others have spoken about the importance of a truly national programme. I agree that every eligible person should have the opportunity to benefit from lung cancer screening. That is why the Government are committing more than £650 million to complete the roll-out of lung cancer screening across England by 2030. Through the national cancer plan, we have committed to ensuring that every eligible person in England receives their first invitation for a check by 2030, helping thousands more people to benefit from earlier diagnosis and improved outcomes.

This investment reflects the Government’s confidence in the programme and the evidence supporting it. By 2035, lung cancer screening is expected to diagnose up to 50,000 cancers and identify at least 23,000 cancers at an earlier stage, helping thousands more people to receive potentially lifesaving treatment. This represents one of the most ambitious cancer screening programmes anywhere in the world.

[Dr Luke Evans]

I appreciate that this is not part of the Minister’s brief. The speed of the programme’s roll-out is fantastic, but there remains a concern that if 60% of people have taken it up, 40% have not done so, despite having had an offer that could have been given to someone else who wanted to go. Can the Department take that point away and work out what is being done to close that gap of more than a third? There is clearly a greater opportunity to get more people in and get them detected sooner.

[Stephen Kinnock]

The shadow Minister is right that promoting and maximising uptake is a crucial indicator of success for the programme. I thank him for giving me the opportunity to take that point away; I will discuss it with my hon. Friend the Member for Washington and Gateshead South, and we will get back to him in writing as soon as possible.

Hon. Members have rightly raised the issue of inequalities. We know that lung cancer does not affect all communities equally: it remains one of the cancers most strongly associated with deprivation. People living in the most deprived communities experience significantly higher rates of smoking, a higher incidence of lung cancer and poorer health outcomes, which is why the lung cancer screening programme has prioritised roll-out in areas of greatest need.

By targeting communities at highest risk first, the programme is helping to reduce long-standing inequalities in cancer outcomes and ensuring that those who are most likely to benefit from earlier diagnosis are reached as a priority. Reducing inequalities is therefore central to our approach. The national cancer plan includes a strong focus on reducing variation in cancer outcomes and ensuring that patients benefit from earlier diagnosis, regardless of where they live, their background or their circumstances.

We are also conscious of the concerns that have been raised about access to services in rural and coastal communities. Through the continued expansion of diagnostic services, including community diagnostic centres, to which the shadow Minister rightly referred in his speech, we are bringing tests and scans closer to where people live and helping to improve access across the country.

Alongside screening, we continue to invest in diagnostic capacity, treatment services, research and innovation. We are exploring pilots for self-referral chest X-rays, which could help to streamline diagnostic pathways and make it easier for people with concerning symptoms to access investigations more quickly. We are also supporting the adoption of innovative technologies that can improve diagnosis, reduce waiting times and help clinicians to identify cancers earlier.

Alongside all our efforts to catch and treat cancer earlier, through our 10-year plan for England we have also committed to shift from sickness to prevention. We know that smoking is the leading cause of preventable death in the UK. It claims around 80,000 lives a year, puts huge pressure on our NHS and costs taxpayers billions. It causes one in four of all cancer deaths in England, including from lung cancer, and kills up to two thirds of long-term smokers. It costs health and care services £3 billion a year—resources that could be freed up to deliver millions more appointments, scans and operations. The cost of smoking to our economy is even greater, with £18.6 billion lost in productivity every year and with smokers a third more likely to be off work sick.

That is why the Tobacco and Vapes Act 2026 is the biggest public health intervention in a generation, breaking the cycle of addiction and disadvantage and putting us on track towards a smoke-free generation. Over the next 50 years, that smoke-free generation will save tens of thousands of lives and avoid up to 13,000 cases of lung cancer, stroke and heart disease.

Although survival rates for lung cancer have improved significantly over recent years, we recognise that there is still much more to do. The Government are determined to ensure that England becomes a world leader in cancer survival, and that patients benefit from earlier diagnosis and better outcomes, regardless of where they live.

I again thank the hon. Member for Wokingham for securing this vital debate, and I thank all the Members who have contributed. Through the continued roll-out of lung cancer screening, investment in diagnostic and treatment capacity, support for research and innovation, and the commitment set out in the national cancer plan, we are taking decisive action to diagnose more cancers earlier, improve survival and reduce the number of lives lost to lung cancer. Once again, I am grateful for the opportunity to set out the Government’s position today.

Community Hospitals

Luke Evans Excerpts

Tuesday 16th June 2026 Westminster Hall

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

It is a pleasure to serve under your chairmanship, Sir Jeremy. I congratulate the hon. Member for South Cotswolds (Dr Savage) on securing the debate.

It is fantastic to have the chance to champion community hospitals and what they stand for and provide. I put on record my thanks to the Hinckley and Bosworth Community Hospital, which does fantastic work in my area, in Hinckley. Also, only last week, I was lucky enough to go to the one-year anniversary celebration for my community diagnostics centre—a £24 million investment, set up by the last Government, that we have now carried through. To date, it has served more than 59,000 patients, and it is expanding the delivery of services that it can provide, meaning that services that are provided within the community and people do not have to travel to the likes of Nuneaton or into Leicester. That is exactly what the leftward shift is all about: bringing those services to the community.

It may come as no surprise that I have a personal connection to community hospitals—you might expect me to talk about my job, Sir Jeremy, but it actually began much before that. My father was a GP down in Dorset; on Christmas days, before we were allowed to open our presents, we used to visit the community hospital and do the ward round with all the patients. As a child I really looked forward to that—first, because I got to meet Father Christmas, but secondly, because of the family feel of that community hospital had. That is the essence of what these places provide: that ability to be within our communities, to give the support and the family feel that we want to keep hold of and treasure because it is so important. Especially when dealing with healthcare, we often forget about wellbeing, and that is what these community hubs can provide.

Looking at the Government’s direction of travel, it very much sets out how neighbourhood health centres should look, but it is not quite so clear about how that dovetails with community hospitals. How do integrated health hubs fit in with community hospitals? It is not clear in the 10-year plan, and it is certainly not clear in the documentation coming out. Given that the Government are expecting ICBs to commission those hubs, and given some of the stories that we have heard—for example from my hon. Friend the Member for Bognor Regis and Littlehampton (Alison Griffiths), who is championing and fighting for the services in her area—the worry is that the Government are not explicit on what ICBs should be doing on community hospitals. We have this intention and general belief, but the actual direction of how this will work is clouded.

I therefore pose a question to the Government: are they considering a national strategy for community hospitals—or even a definition? That is one of the biggest problems when we look up community hospitals. What is the definition of a community hospital? Are community diagnostic centres included in that, or not? What about intermediate care? What about step-down care? What about clinics that provide endoscopy? I must admit that, when I look at community hospitals, I am never quite sure what the definition is; looking into the detail, I struggle to find any definition that the Government have come up with.

Those are key questions about the leftward shift. I think we all agree that that would be welcome, but it is about the delivery plan. Of course, the 10-year plan has no delivery chapter, which again leads us back to the questions for the Minister today. I appreciate that this is not her portfolio, but these questions will keep coming time and again: how do we actually deliver, and what does this look like in the guise of neighbourhood health centres?

On that point, when it comes to delivery, I would like to pose something to the Minister: it was reported in the news over the weekend that NHS capital spend could be under threat to fund the defence investment plan. I hope she will be able to stand at this Dispatch Box and say that that is categorically not true—but that is going to be important.

That leads me on to another question that I would like to pose to the Minister. The response to a written question about the abolition of NHS England and its impact on services stated:

“The abolition of NHS England is causing no disruption to the development of new services.”

Will the Minister state that from the Dispatch Box? Certainly, from what we are hearing on the ground, the ICB changes—losing 50% through redundancies—are having a significant impact on the way in which services are planned and delivered. I am therefore keen to understand the rationale behind that statement.

To finish where I started, community hospitals really are the healthcare that feels human. They are local, they are close to home and they are something that we across this House should aspire to. That family approach is where we all want to be; it is how we get there that is the question for the Government.

[The Parliamentary Under-Secretary of State for Health and Social Care (Mrs Sharon Hodgson)]

It is a pleasure to serve under your chairmanship this morning, Sir Jeremy. I congratulate the hon. Member for South Cotswolds (Dr Savage) on securing this important debate. I thank all hon. Members who have taken part: we have heard from 10 Back-Bench Members on the issue this morning. We have heard powerful accounts of the value of community hospitals and community health services more widely, and the difference that these services can make to patients and their families. That can be particularly true for rural communities, as we have heard.

I also want to acknowledge my hon. Friend the Member for Cumbernauld and Kirkintilloch (Katrina Murray). I think she said that she had worked for 22 years in community hospitals, and she spoke powerfully about being at work in her community hospital 10 years ago today when the news broke about our good friend Jo Cox. I join my hon. Friend in offering deepest condolences to Jo’s sister, my hon. Friend the Member for Spen Valley (Kim Leadbeater), to the wider family and to Brendan and their children. We can all recall where we were on that awful day when we heard the horrifying news.

This debate goes to the heart of a wider question: how we deliver more care closer to home, and the role of community hospitals in that future. That is why the Government’s ambition to shift more care out of hospitals and into communities matters so much. As we look to the future of the NHS, we want a stronger neighbourhood health service, better integration between health and social care and easier access to support, closer to where people live. To do this, we will deliver 250 neighbourhood health centres, with 120 of them opening by 2030. That will make it easier for people to access care closer to where they live, up and down the country. These centres will provide easier, more convenient access to a wide range of health and care services on people’s doorstep. We want to see a neighbourhood health centre in every community.

[Dr Luke Evans]

The Government have set out a great ambition, but the Minister is talking about neighbourhood health centres and we are talking about community hospitals. Where do they dovetail and how do they fit? What definition is she using to put this together?

[Mrs Hodgson]

Hopefully, I will answer those very points as I make progress in my speech.

We are already taking forward the neighbourhood health centres. The first wave of 27 neighbourhood health centres has been announced across England, backed by £50 million. Community health services are a vital part of our ambition on neighbourhood health and in moving care into communities. As we have heard, community health services deliver a wide range of services, from adult musculoskeletal services to community paediatric services and more.

Recognising the vital role that community health services play in neighbourhood health, and the wider health and care system, we have set clear ambitions through our medium-term planning framework. For the first time, we have set a target for systems to reduce long waits for community health services. By 2028-29, at least 80% of activity delivered by community health services should take place within 18 weeks, bringing those services in line with targets for elective care.

In 2025, we published “Standardising Community Health Services”, which describes the core components of NHS ICB-funded community health services for children, young people and adults. ICBs will need to adapt based on local needs and priorities. Further guidance was published in February 2026 with additional detail on the community health services that ICBs should commission. This is hugely important: we know that there is variation between the services available across the country and that there are long waits. That is why the Government are taking action to reduce unwarranted variation and cut those waits, so people can access high-quality community services wherever they live.

[Dr Evans]

I am sorry to hammer this home, but every single point that the Minister has made has been about community services. She is spot on, but the question is where community hospitals fit in. Are they the correct vehicle that the Government want to use to help deliver some of those services, or are the Government moving away from the community hospital model and into further hubs? Both would be reasonable approaches and could be defended or pulled apart. The question is what the Government are choosing, because it is not clear from the Minister’s answers which it is.

[Mrs Hodgson]

As the hon. Gentleman has acknowledged, this is not actually my brief. As much as I can try to answer his questions, I think I might have to commit that the relevant Minister will write to him on that specific point.

For patients who still require hospital care, we are delivering millions of additional appointments and reducing waiting lists across elective care. The Government’s elective reform plan sets out commitments to reduce disparities across elective care access and waiting times, including by improving practical support for patients through better transport options. Virtual care models will offer patients in remote areas better access and more convenience by providing services that are more responsive to their needs. Expanding digital access is also crucial to improving the experience and health outcomes for rural communities. Digital services can improve access for many patients, but they must complement, not replace, high-quality, local face-to-face care.

Oral Answers to Questions

Luke Evans Excerpts

Tuesday 9th June 2026 Commons Chamber

[Mr Speaker]

I call the shadow Minister.

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

Last month, the Health Service Journal reported that the elective waiting list target was met largely—largely—because a record number of patients were removed from waiting lists in March without receiving treatment. Can the Minister tell the House how many patients were removed in March and what happened to them, and whether she is satisfied that they definitely did not need treatment?

[Karin Smyth]

As I have said, I am still a bit perplexed about why the Conservatives are perpetually highlighting their inadequate management of the health service, and the idea that patients are simply referred to a waiting list and then left there for a couple of years, which is what happened on their watch. It is important that patients know why they are on a waiting list, and obviously that they get the best clinical care as quickly as possible.

I do not have to hand the exact figure for March, which will be published as part of the normal process of publishing the waiting list figures. However, I can tell the hon. Gentleman that completed pathways were 5.9% higher in the 21 months from July 2024, when we took office, to March 2025 than in the previous 21 months. Patients, as they deserve, are getting the right care in the right place under this Government.

[Dr Evans]

It is not just the Conservatives who are raising this issue; it is patients and the Health Service Journal. The answer is that 350,000 people—a city the size of Coventry—were wiped off the waiting list with no treatment, and that is 100,000 more than the month before. If there is genuinely nothing to hide, the Government should not worry about putting out the figures. Will the Minister commit to a review to find out what has happened to those 350,000 patients, or does she believe that waiting list targets should be met by removing patients from the figures rather than actually treating them?

Community Pharmacies

Luke Evans Excerpts

Tuesday 2nd June 2026 Westminster Hall

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

It is a pleasure to serve under your chairmanship, Ms Jardine, and I thank the hon. Member for Tiverton and Minehead (Rachel Gilmour) for securing this important debate. It is important that we discuss community pharmacies, given their place not only in the health landscape but in the hearts of many of my constituents and people across the nation. I, too, have visited multiple pharmacies, both in my shadow role and as an MP, and I, too, went to my local pharmacy for my flu jab, back in Newbold Verdon. I am very grateful to them because I found the system very easy to use and to get into. It is really important to see that system change that makes it more accessible and easier for people to make the choice to improve their own health and protect others.

There are positives in this debate that we must celebrate. Community pharmacies are one of the most accessible parts of our health service. For millions of patients, particularly older ones, those with long-term conditions or those living in rural communities, the local pharmacy is often the front door to the NHS. They provide expert advice, dispense vital medicines, support prevention and increasingly deliver clinical services that help to reduce pressure on GPs and hospitals—as a former GP, I am very grateful for that—and that is why this debate is so important.

Ministers want community pharmacies to do more, but I worry that, at the same time, they are actually making it harder for pharmacies to survive. This debate is timely, given that the Government agreed the community pharmacy contractual framework for 2026-27 last Friday. I expect that the Minister will reference that, but I will let Community Pharmacy England’s response speak for itself:

“Accepting this deal does not mean we think it is enough—for this year or the future.”

It went on to say:

“It means the opposite…the sector is in a critical position, and that we now need urgent work on a sustainable long-term solution, including reform of the contract, funding and reimbursement model.”

Given the Government’s enthusiasm for reviews and long-term plans, I would be grateful if the Minister updated us on what meetings he will have to work on the framework and the wider funding model, along with what changes we can expect and in what kind of time.

The reality is that pharmacies continue to face mounting financial pressures, many related to the Government’s tax rises. Over the last two years, the Government have made a conscious choice not to exempt community pharmacies from their taxes and have even voted against that. In the first year of this Labour Government, pharmacies faced higher employer national insurance contributions alongside increases in the national living wage. In the second year, they have lost the temporary business rates support that they relied on, with the replacement not matching the rise in their costs.

The sector is clear that much of the additional funding announced through the new framework will simply be absorbed by those rising costs. The headline findings from Community Pharmacy England’s latest “Pharmacy Pressures” survey, due to be published later this month, show that 100% of pharmacies report that costs are higher than at this time last year and that three quarters are losing money, while 86% say that it is taking longer to procure medicines and 76% say that patients are already being directly impacted by the pressures on their businesses.

The National Pharmacy Association put it plainly last Friday when it said it was concerned that much of the funding increase will need to be spent on increased costs, including national living wage contributions, inflation and business rates rises,

“rather than addressing chronic under-funding”.

Those figures tell a simple story. The Government are asking pharmacies to do more while making it more expensive for them to keep their doors open.

What discussions has the Minister had with the Chancellor regarding business rates for community pharmacies? Has he even raised the sector’s concerns with the Chancellor, and if so, what response did he receive? Will he press for a package of support similar to that made available to other sectors such as pubs, to help with those pressures?

The rising costs also cast a shadow over the Government’s plan to expand independent prescribing through community pharmacy. We can all see that independent prescribing has enormous potential. It could improve patient access to care, make better use of pharmacists’ clinical expertise and help to deliver the Government’s ambition of shifting care from hospitals into the community. But the sector itself is not convinced that the necessary investment is in place. Community Pharmacy England has said:

“we are not persuaded that sufficient investment is being made to enable the full and effective introduction of IP…given the workload, enhanced clinical responsibility, clinical governance and infrastructure requirements that it will entail.”

It went on to warn that

“the addition of IP to the CPCF risked being set up to fail.”

That should concern us all in this Chamber. If pharmacies are expected to become a cornerstone of neighbourhood healthcare, as set out in the NHS 10-year plan, what steps are the Government taking to ensure that the necessary workforce, governance and infrastructure are in place to support that ambition? What response does the Minister have to those concerns, and what steps will he take to ensure that independent prescribing is the success we all want it to be?

Alongside the financial pressures, pharmacies continue to face significant challenges in the medicine supply chain. Analysis by the National Pharmacy Association earlier this year highlighted rising prices for a number of cancer medicines and concerns about the impact on availability. At the same time, the number of medicine price concessions has reached record levels. There were 204 concessions agreed in April, surpassing the previous record set only a month earlier. Community Pharmacy England has now confirmed a new record of 219 concessions for May, with further requests still under negotiation.

Behind those numbers are real patients facing delays, uncertainties and difficulties accessing the medicines that they need. Community Pharmacy England has warned that those figures reflect the continuing fragility of medicine supplies in the supply chain and that the wider instability from the middle east crisis is adding pressure. Of course, I cannot hold the Government responsible for that, but it is their duty to look at that volatility and to reassure patients and the sector that resilience is being put in place and measures are being looked at. I would be grateful for an update from the Minister on what that looks like.

Before I conclude, I will raise an important point that is affecting dispensing practices. We have not talked about those today, but they are part of the real fabric of the community network. Dispensing GPs provide essential primary care medicine supplies to 10 million patients in remote, rural and coastal communities, where access to a community pharmacy is limited. For many patients, they are the primary point of access to medicines. Earlier this year, dispensing practices were informed that the central NHS England funding for the EMIS web dispensing module would cease and that the costs would instead be passed directly to the practices.

The proposal generated significant concern among dispensing practices, the British Medical Association and the Dispensing Doctors’ Association. Concerns centred on the lack of consultation, the timing of the changes and the potential impact on the sustainability of dispensing services. Following representations from the sector, implementation has now been paused and central funding has continued. I welcome that decision. However, the uncertainty created caused understandable concerns for practices, their patients and the planning of future services, particularly for those in rural communities. When I wrote to the Minister to raise that issue, he responded that an assessment will take place this year of the long-term provision of dispensing modules and that NHS England will consult relevant bodies such as the Dispensing Doctors’ Association as part of that. Will the Minister provide further details on that assessment today? What criteria will be used? Who else is being consulted? If NHS England is going, who will take that work on? When can dispensing practices expect greater certainty about future arrangements?

I would also be grateful if the Minister addressed concerns about the discount abatement—what is called the clawback system. Dispensing practices continue to argue that the current arrangement creates inequalities for them compared with community pharmacies. Equally, community pharmacies are upset about the clawback, so there is an obvious tension. Given that the Government are looking at the long-term structure, I would be grateful if the Minister took that away and considered how we can modernise that aspect to ensure that there is equity in the system as well as an understanding from both sides.

Ministers have made it clear that they want pharmacies to play a greater role in prevention and neighbourhood healthcare and in reducing pressures elsewhere in the NHS. We in the Opposition agree, yet throughout this debate we have heard concerns from across the sector about rising costs, medicine supplies, independent prescribing and dispensing services. The question is whether Government policy is keeping pace with the expectations being placed on pharmacies, or whether Ministers are making it harder for the sector to deliver the growth and innovation they say they want to see. Community pharmacies have repeatedly demonstrated their value to patients in the wider health service. I therefore look forward to hearing from the Minister how he intends to address those concerns and provide greater confidence to a sector that remains vital to communities up and down this land.

--- Later in debate ---

[Stephen Kinnock]

My hon. Friend makes a vital point. It appears that the Scottish Government are stuck in the analogue age, and we need digital solutions. I join him in encouraging the Scottish Government to get with the programme, get with the NHS app and get moving on some of these important initiatives.

We all know that we simply cannot make the shift from hospital to community without our community pharmacies. I am not the only one to see that—I am sure that all of us have made use of community pharmacies in our constituencies, and that colleagues will know the importance of the accessibility of pharmacies in towns and villages across the country. There are over 10,000 pharmacies in England. They are busy dispensing medicines, offering advice, and delivering care and services to support our communities. Patients across the country can also choose to access over 400 distance-selling pharmacies, which deliver medicines to patients’ homes free of charge, playing a vital role in reaching the most isolated members of our society. However, I acknowledge that access is not the same in all areas of the country. Rural areas often have fewer community pharmacies, so people have to travel further to access a pharmacy as well as other services.

Colleagues have also been right to raise concerns about pharmacy closures in the past. Local authority health and wellbeing boards are responsible for assessing whether local needs are adequately met by the existing providers, and what improvements are needed to ensure that people can access services. Those assessments inform integrated care boards’ commissioning decisions. In areas where there are fewer pharmacies, our pharmacy access scheme provides additional financial support to eligible pharmacies. The scheme helps pharmacies that are critical for patient access to stay open and provide local communities with continued access to medicines and excellent healthcare advice. In certain rural areas where there are no pharmacies, dispensing doctors can supply medicines to patients directly without the need for a pharmacy.

The hon. Member for Tiverton and Minehead will be aware that there are currently 14 pharmacies in her constituency. I am aware of the closure of two pharmacies in her constituency since 2017, and that the local population instead get their medicines from the neighbouring dispensing GP or from one of the over 400 distance-selling pharmacies available nationally. I also note that the latest data shows that there are 199 pharmacies in Devon, with 914 across the south-west. The Government are committed to supporting the critical role that they play in serving their communities.

[Dr Luke Evans]

The Minister points to the important partnership between community pharmacies and dispensing GPs. There are concerns about the change in the EMIS module and the future for dispensing practices. If the Minister does not have the answers here, will he write to me about what is happening with EMIS and where he is looking to take dispensing practices in the future?

[Stephen Kinnock]

I absolutely commit to writing to the hon. Gentleman with more detail. He raises some important points, and I will get back to him.

The Government have always been clear that investment must come with modernisation, and our 10-year health plan and our three shifts set out a clear pathway to getting there. In her 2024 Budget, the Chancellor took important decisions that enabled us to give the sector a record 19% uplift across 2024-25 and 2025-26. It was the largest uplift of any sector across the NHS in that spending review period. I am proud that just a few days ago, we announced another significant uplift in funding for community pharmacies. That means a further £340 million uplift for the sector this financial year, to support the supply of medicines and delivery of vital services across our country. That will include supporting the introduction of pharmacist prescribing as part of NHS services in autumn 2026, to expand access to NHS care and strengthen support in communities across England, delivering upon the commitment made in our manifesto. That 10% uplift is almost three times the growth of the overall NHS budget, and it shows that when we talk about making the left shift, we are putting our money where our mouth is.

I will start with the shift from sickness to prevention, because community pharmacies will be vital in making sure that vaccine coverage reaches every part of our country. The NHS vaccination strategy in our 10-year health plan commits us to increasing vaccine uptake through primary care. One way that we are getting that done is through the national vaccinations programme. Alongside a core offer of vaccination in GP practices, we are making sure that vaccines are offered through sexual health services, maternity services, schools, health visitors and community pharmacies. Selected community pharmacies across the country have already been commissioned to provide MMR and RSV vaccines.

The expanded vaccination programmes make use of pharmacy teams’ expertise in delivering vaccines, releasing pressure on GPs and helping to protect the most vulnerable members of our society. We have also seen a significant increase in the provision of flu jabs within community pharmacies, with approximately 4.7 million people being vaccinated by pharmacists in the 2025-26 seasonal flu vaccination programme up to February 2026. That is up by around 600,000 vaccinations the previous year, showing the progress that has been made.

When we talk about prevention, we are not just talking about vaccines, because community pharmacies are also delivering the hypertension case-finding service, which spots people at risk and helps to prevent cardiovascular disease. Nearly 3.6 million free consultations were delivered in the 12 months to February this year. That is a great example of the sickness to prevention shift in action.

Turning to our shift from analogue to digital, so many pharmacists and pharmacy technicians are not working with technology that is equal to their skill, talent or ambition. I am afraid to say that it is a similar story across other parts of the NHS, where the outdated technology is holding staff back from realising their full potential. We are supporting pharmacies through digital transformation. Last year, a new Amazon-style prescription tracker went live on the NHS app across nearly 1,500 community pharmacies in England, enabling patients to check on their prescriptions through real-time updates.

This year, we want to make digital access even easier, with stronger links between pharmacies and general practice as we build stronger neighbourhood health teams across every community. That will make them match-ready for the introduction of pharmacy prescribing as part of NHS services from this autumn. Digital also has a huge role to play in our supply chains and improving the public’s access to the medication they need. That has included our secondary legislation to enable the expansion of hub-and-spoke dispensing between different pharmacies, to make it possible for more pharmacies to use automated dispensing, realise economies of scale and increase efficiency and productivity.

Additionally, GPs cannot currently see live national shortages when prescribing, but this year we will make it possible for GPs to be aware of these shortages in real time. That will mean that patients no longer have to go from pillar to post looking for medicines that are not available, because GPs will be able to prescribe an antibiotic unaffected by supply issues.

In the NHS that is fit for the future, pharmacies will play a key role in the shift from hospital to community. We have already begun making huge progress in rebuilding primary care and fixing the front door to the NHS by ending the 8 am scramble, whether through extra funding for general practice, hiring more GPs or the introduction of online services. We will go even further to ease the pressure on GPs by making sure that pharmacists are making the most of their clinical abilities.

That is why the Government have been promoting the Pharmacy First campaign, although I take on board some of the very interesting suggestions about the rebranding. I will have a think about that; I am not going to make any rash decisions today. The most recent data shows that the number of people polled who knew that their pharmacy would treat Pharmacy First conditions rose from 71% to 79%. Trust in the advice given by the pharmacy team increased from 61% to 70%, and intention to use the pharmacy if people had conditions covered by Pharmacy First went up from 32% to 37%.

Health Bill

Luke Evans Excerpts

2nd reading
Monday 1st June 2026 Commons Chamber

[James Murray]

I am going to make some progress.

The single patient record will mean that wherever a patient is being treated, even if they are not at their local GP or are in a hospital they have never been to before, those caring for them will have access to all the accurate, relevant, up-to-date information they need. Through this new approach, we will bring together people’s health and social care records digitally, securely and conveniently, and make them available to patients on the NHS app.

A number of Members have raised questions about data privacy, so let me be very clear on that point. Patients rightly expect their highly personal and sensitive medical details to be protected, and they will be. Under our plans, strict safeguards, strong cyber-security and clear controls on who can read information will be backed by an audit trail of who has accessed what. The single patient record will also be subject to existing forms of scrutiny and oversight in the NHS, from data protection officers to legislative safeguards. Where the single patient record is being used for research or planning, it will be treated the same as all other sensitive health data, subject to the same legal protections, ethical approvals and governance.

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

The Secretary of State is making himself the data controller of all the data that will be in place. What impact does that have on the sections he has just talked about?

[James Murray]

When the data is held by a GP surgery or an NHS hospital trust, for instance, the relevant bodies will remain the information controllers. Where that information is then shared through the single patient record, the Department of Health and the Secretary of State will take on a role as data controller as well. That will all be governed in the way that data protection currently applies across the NHS, through existing forms of data security. Fundamentally, it will reorientate the NHS to be a service that revolves around patients, rather than patients having to revolve around the NHS.

Wheelchair Provision: Independent Review Body

Luke Evans Excerpts

Tuesday 21st April 2026 Westminster Hall

[Jim Shannon]

I thank my hon. Friend for her intervention; she underlines the point. I was going to give the example of a young fella from Newtownards. He lives in Dundonald, but he is more seen in Newtownards. He has severe, complex mobility needs, but he is the brightest wee boy you ever met in all your life, and he always encourages and lifts me when I meet him. He is a Chelsea supporter, so he needs some help at the minute, because they are not doing too good. I am a Leicester City supporter, and we are not doing too good either, so we have something in common.

There was just no way in the world that the NHS could give him the wheelchair that he needed for his special needs—similarly to the example that my hon. Friend mentioned in respect of those who have served in the forces. The only way that wee boy could obtain the wheelchair that he needed was through fundraising. Dessie Coffey in Newtownards has been fantastic. He raises money for all charities, but he did so especially for this wee boy. Over a period of time, we raised about £6,000 to help him with his wheelchair, and today that wee boy has some independence.

I wrote to one of the Manchester United stars—my mind just went blank and I cannot remember who it was, but he no longer plays for them—and he sent me a signed autograph, so I gave it to the wee boy and he sold it for £100. Again, if it was not for individual fundraisers, he just would not have had the money. I very much believe that we need an independent national review body to oversee wheelchair provision, and I support the hon. Member for Bexleyheath and Crayford in his call for one.

Some might ask why we need another body in an already complex system. The answer is quite simple: because the current system is failing the very people it was built to serve. Northern Ireland has the longest health waiting lists in the United Kingdom. People are waiting years for orthopaedic surgery, and while they wait, their mobility needs change, often without the system keeping pace. Just last year, we saw the collapse of NRS Healthcare, which was the main provider of repairs for our regional service. The Business Services Organisation stepped in to steady the ship, but that moment of crisis exposed the fundamental truth that out wheelchair services are fragile.

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

The NRS case is so important. I am keen to understand how the Government are ensuring the ongoing provision and servicing of wheelchairs, given that NRS has gone bust. I have been contacted by constituents who worked at high levels in NRS, and who are concerned that those contracts will not be followed up. Is the hon. Member concerned about that, too?

[Jim Shannon]

I certainly am. The shadow Minister always speaks with great knowledge on such matters, and I look forward to his speech. Hopefully, the Minister will respond positively to his point. Although waiting lists do not fall under the Minister’s responsibility, the fact is that they are of such length all over the country that mobility is declining, and support is needed more than ever.

One of the greatest merits of having an independent review body would be the death of the data desert. Currently, we do not have a full, transparent picture of the true demand for wheelchairs in the United Kingdom. An independent body would mandate high-quality, comparable data, forcing the Department of Health to confront the true scale of the backlog. The issue of data comes up during almost every debate we have on health. How can we know how to respond if we do not have the data and information? Perhaps the Minister could tell us how we can quantify the demand through data, which clearly needs to be collected.

We also need accountability that has teeth. Currently, when things go wrong, users are often left to navigate a complaints maze with their trust. An independent body would act as an impartial watchdog, ensuring that the wheelchair equality framework is not just a document on a shelf in Belfast or elsewhere, but a standard to which every service user can hold their trust. I gave the example of the wee boy—his name is Reuben Walls—and how fundraising got him what he wanted, but we need a system to help those who cannot fundraise and do not have the finances.

Every day that a child waits for a wheelchair or an adult sits in an ill-fitting seat that causes pressure sores, the cost to the health and social care system grows. Research shows that the right wheelchair can deliver a societal return worth triple its cost. Having an independent body would ensure that we treat wheelchair provision not as an optional extra, but as a vital investment in our economy and health. We need a national body that listens to the Wheelchair Collective, champions the user voice and ensures that the promise of

“the right chair, at the right time, right now”

is kept for every citizen in this United Kingdom of Great Britain and Northern Ireland. I look to the Minister and the Government to ensure and provide that, and I think all of us here today wish to see the same thing.

--- Later in debate ---

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

I thank the hon. Member for Bexleyheath and Crayford (Daniel Francis). He is becoming a regular in these Westminster Hall debates, rivalled only by the hon. Member for Strangford (Jim Shannon). It seems that there is a competition to be the one who makes the most representations.

On a serious note, last month in the debate on disability equipment provision the hon. Member for Bexleyheath and Crayford spoke passionately and movingly about his personal experiences. We should treasure so much, in this House, people bringing their experience to try to make things better for their constituents, their family and the nation. The hon. Member deserves a lot of credit and I thank him for securing this debate. I also thank the all-party parliamentary group for wheelchair users for its work to ensure that wheelchair users are heard, and I thank the Wheelchair Alliance and others who continue to hold this House, Ministers and the Opposition to account on these issues.

There is little disagreement in the debate about the nature of the problem. The Government themselves acknowledged last month, in the debate on disability equipment provision, that too many wheelchair users wait too long for the equipment they need, with knock-on consequences for their independence, health and ability to participate fully in daily life. That admission is welcome, but recognition alone is not enough. The question before us is how responsibility, accountability and improvement are to be delivered in practice. On that point, the picture is far less clear. Ministers have been explicit that they do not intend to publish a national strategy for wheelchair services. At the same time, the Government are embarking on a major restructure of the NHS in England. Understandably, that combination raises concerns about where national oversight will sit in the future, how consistency will be ensured and who will ultimately be accountable when services fall short.

During last month’s debate on disability equipment, the Minister acknowledged the uncertainty created by the changes, noting that seemingly small gaps in practice or responsibility can have disproportionate impacts on the quality of life of disabled people. That is precisely why clarity matters. As the NHS is reshaped, wheelchair users and their families need to know who is responsible for setting expectations nationally, who is responsible for commissioning locally and who steps in when the system is not working. Without that clarity, there is real risk that the responsibility becomes fragmented and that unacceptable variation goes unchecked. Ministers often rightly point to the role of integrated care boards in commissioning wheelchair services for their local populations, but ICBs are being asked to do a great deal at once—to meet 18-week standards for community services, adopt the best practices set out in the wheelchair quality framework, and now to do so while operating with up to 50% reductions in headcounts and constrained budgets. So it is fair to ask whether those competing pressures risk pushing wheelchair provision further down the list of priorities rather than elevating it to where it should be. Going forward, who will be responsible for overseeing the wheelchair quality framework itself, and how are the Government assessing whether that is genuinely improving outcomes on the ground rather than simply setting aspirations?

There are also practical questions that remain unanswered. The Under-Secretary of State for Health and Social Care, the hon. Member for Glasgow South West (Dr Ahmed), previously undertook to look at the reuse and return of disability equipment, which could have real benefits for patients and for public value. Many will be keen to hear what progress has been made on that work and whether it will form part of a more coherent approach in provision.

Finally, I raise the issue of innovation. In my constituency of Hinckley and Bosworth, local businesses have shown how responsive, user-focused solutions can make a real, tangible difference. I mentioned Mounts and More as a primary example last time. As the national structure evolves, innovation like that must be supported rather than stifled.

As the Minister responds this morning, wheelchair users and their families are listening carefully. They will want assurances that, amid the structural change, accountability will not be diluted, responsibility will not pass around the system, and there will be clear leadership to ensure faster, fairer access to the equipment that is so fundamental to independent living. I have three questions to the Minister on that basis.

First, as NHS England is abolished through an NHS service modernisation Bill, can the Minister set out clearly which body will hold national responsibility for wheelchair service standards and oversight, and how Ministers will be held accountable when or should services for wheelchair users fail across different parts of the country? Secondly, who will be responsible going forward for overseeing and enforcing the wheelchair quality framework? What assessment have the Government made to date as to whether that is making a difference, and how we can have improvements?

Thirdly—I touched on this in my intervention—many wheelchair users will have had provision from NRS Healthcare. Given the size and scale of the impact of NRS collapsing, there is real concern about servicing their contracts and making sure their wheelchairs are maintained. What have the Government done and what do they have to say on that topic?

[The Parliamentary Under-Secretary of State for Health and Social Care (Dr Zubir Ahmed)]

It is a pleasure to serve under your chairmanship, Dr Murrison. I congratulate my hon. Friend the Member for Bexleyheath and Crayford (Daniel Francis) on securing this important debate and also on challenging us, born of his lived experience, to make the lives of disabled people better and better lived across our country. We are grateful for his presence in this House and this place, every single day. I am also grateful to my hon. Friend for the work he has done to champion this interest more generally in his capacity as co-chair of the all-party parliamentary group for wheelchair users.

In recent months wheelchair services have received considerable attention, both within Parliament and more widely. As has been highlighted, last month I participated in a debate on the provision of disability equipment, brought forward by the hon. Member for Aberdeenshire North and Moray East (Seamus Logan). I have been struck by the compelling testimonies shared during those discussions and the ones today, highlighting the profound impact that timely access to appropriate disability equipment can have on people’s lives.

This is a matter clearly deserving of much more attention. Since the previous debate on this topic, I have written to the national quality board to request that disabled people and the equipment they use are considered as part of the board’s ongoing work to improve quality and reduce inequality across health and care services. I am pleased to update that the board has confirmed it will take this forward.

This Government remain steadfast in their commitment to ensuring that disabled people can access the services and support they need. Through our reforms to health and social care, we are dedicated to delivering meaningful change that will make that vision a reality. Integrated care boards, as has been highlighted, are responsible for commissioning local wheelchair services. Responsibility for providing disability equipment lies with local authorities or the NHS, depending on the person’s needs.

For adults and children with long-term complex needs, services are typically provided by NHS wheelchair services. There is a range of NHS wheelchair providers across England, as we have heard. I acknowledge the concerns that the hon. Member for Hinckley and Bosworth (Dr Evans) raises about NRS. My hon. Friend the Minister for Care and I will be having discussions about that, and it would be appropriate to write the hon. Member an urgent letter to update him, as I know that he is genuinely concerned about the topic. ICBs are expected to monitor service provision and effectively manage contracts with their commissioned providers.

Although the latest data from NHS England shows a reduction in wheelchair waiting times for adults, I recognise that far too many people of all ages, as we have heard today, experience unacceptable delays for appropriate equipment. The covid pandemic had a significant impact on wheelchair services, from which we are still suffering in terms of supply chain disruption. That has meant that waiting times for both adults and children have fluctuated unnecessarily—well, unacceptably—as services have worked to recover. Those with more complex needs can also experience delays due to the lead-in time for supply of more bespoke equipment.

I understand that there have been complaints about the quality of services commissioned by some ICBs. Some of these are being dealt with on an individual basis by the Parliamentary and Health Service Ombudsman, following escalation by individual patients. As part of its oversight of ICBs, NHS England is also gathering intelligence through regional teams to understand fully the issues being raised.

It is important that local commissioners have the discretion to decide how best to meet the needs of their local population, and we are giving systems control and flexibility over how that is done. None the less, the Government are taking action to support local systems in delivering effective wheelchair services. Although there are no plans at the moment to establish a national review body to oversee wheelchair provision, the medium-term planning framework, published in October, requires that from this year all ICBs and community health services should actively manage and reduce waits over 18 weeks and develop a plan to eliminate all 52-week waits. The framework also states that in 2026-27, ICBs are required to

“increase community health service capacity”—

including wheelchair services—

“to meet growth in demand, expected to be approximately 3% nationally per year”.

[Dr Evans]

Can the Minister just clarify who he sees as responsible for the framework?

[Dr Ahmed]

Ultimately, ICBs are responsible for delivering the framework. The Government are held accountable in the manner being seen today, and I have no doubt that in the new structures that we propose there will be further accountability, because in many ways the middleman will be removed and we will have more direct oversight as to what is going on with wheelchair services and other services up and down the country.

I take the hon. Member’s point on data as well. I am the Minister responsible for data, health innovation and innovation in general, and I think this moment of restructuring, whether in relation to wheelchair services or other parts of the system, is a moment for us to really get into the 21st century with our capabilities for monitoring data for operational and capacity planning. I am very happy to share with him some of my thoughts about that over a cup of tea later, if he is interested.

The community health services situation report will be used to monitor ICB performance against waiting time targets in 2026-27. Those targets will guide systems to reduce the longest waits. In addition, the 10-year plan makes a commitment to reviewing the complaints regulations, and NHSE and the Department of Health and Social Care are developing plans to achieve that.

NHS England has developed policy, guidance and legislation to support ICBs to reduce delays and unacceptable regional variation in the quality and provision of wheelchair services. In April 2025 NHS England published the wheelchair quality framework, in collaboration with the wheelchair advisory group, which I understand includes the Wheelchair Alliance and Whizz Kidz, both of which were recognised by hon. Members in the debate today.

That framework is designed to assist ICBs and NHS wheelchair service providers in delivering high-quality provision that offers improved access, outcomes and experiences. The framework sets out quality standards relevant to all suppliers and aligns with the Care Quality Commission assessment framework that applies to providers, local authorities and integrated care systems. Those quality standards should be used to develop local service specifications and to benchmark current commissioning and provision.

Other measures taken by NHS England include the establishment of a national dataset on wheelchair waiting times to increase transparency and to enable targeted action if improvement is required, and the introduction of the legal right to a personal wheelchair budget in 2019. Personal wheelchair budgets provide a clear framework for ICBs to commission personalised wheelchair services that are outcomes-focused and integrated with other aspects of care.

Oral Answers to Questions

Luke Evans Excerpts

Tuesday 14th April 2026 Commons Chamber

[Mr Speaker]

I call the shadow Minister.

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

Under the Labour Government’s new GP contract, Bracknell GPs and all GPs will have to refer through a single point of access. Can the Minister confirm that every referral deemed clinically necessary by a GP will be reviewed explicitly by a specialist consultant before being rejected or redirected?

[Stephen Kinnock]

I am astonished that the Conservatives seem to be teaming up with the British Medical Association in opposition to our reforms. They ought to listen to their voters and their members, who are crying out for change. We are getting the NHS to do things differently because that is the only way we are going to turn it around. Advice and Guidance is seeing more investment in GPs and getting patients cared for in the right place at the right time.

[Dr Evans]

The House will have heard that there was not an answer—that was a no. It is plain for all to see that this means patients will be blocked from seeing a specialist. They could potentially be assessed by a non-doctor, under Government pressure, with a target of one in four referrals being bounced. The Government’s own answers show that patients never appear on a waiting list. This is not about improving healthcare; it is about massaging the waiting lists, isn’t it, Minister?

[Stephen Kinnock]

I have honestly never heard so much nonsense in my entire life. We invested £80 million in Advice and Guidance. Some 1.1 million Advice and Guidance requests were diverted from the waiting list, so that care is being delivered in the right place. We have embedded A&G into the core contract, recognising it as routine practice, removing annual sign-ups and providing more predictable funding. The shadow Minister seems to be saying that patients who do not need to be treated in hospital should be treated in hospital. That runs completely counter to the entire strategy, which is about moving care from hospital into the community. The Conservative party needs to get with the programme.

Endometriosis Services

Luke Evans Excerpts

Tuesday 24th March 2026 Westminster Hall

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

It is a pleasure to serve under your chairmanship, Mr Dowd. Hon. Members have share powerful and distressing stories and experiences from their constituents. They are typified by Monica and I pay tribute to her for coming here to explain her story.

We must recognise the reality faced by many women and girls living with endometriosis. For too many, it means years of pain and possibly being dismissed, and it definitely means lives put on hold. From a GP’s perspective, the diagnosis is frequently delayed because symptoms overlap with other conditions such as fibroids, adenomyosis, irritable bowel syndrome, PCOS or pelvic inflammatory disease.

However, this debate is really about access, and there is a risk that current changes will make access worse, not better. The hon. Member for Ipswich (Jack Abbott) is a stalwart for raising that point as a central issue. The last Government drastically increased testing. They rolled out 161 community diagnostic centres across the country, which carried out ultrasounds, MRI and CT scans, and blood tests. That has helped with diagnosis by ruling in endometriosis and, equally importantly, ruling it out. That is not to mention the elective surgical hubs, 48 of which were delivering gynaecological procedures by March 2024. Those were important steps, but capacity remains constrained.

The first women’s health strategy, which committed to reducing diagnostic times for endometriosis, was also published in 2022. That strategy is now due to be renewed. In March 2026, the Women and Equalities Committee published a report from its inquiry into the menstrual health of girls and young women, which states that women’s health has not been “sufficiently prioritised” in recent proposed reforms to the healthcare system. The Government’s plan to renew the women’s health strategy is an opportunity to do so. Will the Minster confirm that those recommendations will be considered, and confirm when the renewed women’s health strategy will be published?

[Mims Davies (East Grinstead and Uckfield) (Con)]

The points my hon. Friend makes, as a clinician and an MP, are very important. Eleanor, my constituent from East Grinstead, has faced dismissal and delay. She has multiple issues, including pelvic congestion, which she says have ripped her life apart. Will my hon. Friend talk about the impact on A&E if that health strategy does not work? Far too many women see their symptoms as normal and extreme pain is dismissed too easily, which can lead to A&E trips.

[Dr Evans]

I am grateful to my hon. Friend for raising her constituent’s case; Eleanor must be suffering, and the aim is to try to get more people into primary care so they can get the support that they need. That view is shared by both sides of this House and that leftward shift into primary prevention would be helpful. Access will be crucial, which is why some of the Government’s changes to that access—which I will touch on later—are concerning.

Women’s health hubs were intended to improve access to care for menstrual problems. They were rolled out by the last Government with £25 million of investment and 39 out of 42 were in place. However, after Labour came in, it removed the national targets in January 2025, leading to an article from the Health Service Journal in April 2025 that stated:

“Most integrated care systems lack a women’s health hub offering full services—contrary to government claims—according to research seen by HSJ.”

It is not clear whether those numbers have improved and what the situation now looks like. I ask the Minister to provide any updates she has on those women’s health hubs, how they are functioning and whether they are fully operational; if she does not have that information—I know she is a new Minister—I would be happy to receive a letter on that.

That leads on to Endometriosis UK pointing out that there have been shortages in trained clinicians and diagnostic specialists. We know that as we expand community diagnostic centres, that will be really important. Under the last Government, there was a workforce plan. We have heard talk of a workforce plan, but it has been delayed multiple times by the Government. I wonder whether there is a date for when that will be finalised, because it is really important.

Finally, the heart of this debate is access to primary care. In a debate on endometriosis at the start of this month, the Minister for Secondary Care said:

“We have introduced Jess’s rule, which requires GPs to rethink diagnoses for their patients.”—[Official Report, 5 March 2026; Vol. 781, c. 1068WH.]

That rightly encourages GPs to rethink the diagnosis and refer when needed, but at the same time, every referral will now have to be routed through advice and guidance. In effect, it is moving to a single point of access, with a system explicitly aimed at diverting a significant proportion of referrals back to GPs. The new advice and guidance are aiming for about 25% of GP referrals to be diverted back to GPs for “10 high volume specialities”—of which gynaecology will be one—meaning one in four referrals will be bounced back under the neighbourhood health framework released 17 March.

On the one hand, GPs are told to refer; on the other hand, the system is designed to send those patients back, which risks patients being kept on waiting lists and away from secondary and specialist care. That really matters for endometriosis. It is a perfect test case, and the new NICE guideline is crystal clear. Recommendation 1.1.3 states:

“Gynaecology services for women with suspected or confirmed endometriosis should have access to: a gynaecologist with expertise in diagnosing and managing endometriosis, including training and skills in laparoscopic surgery; a gynaecology specialist nurse with expertise in endometriosis; a multidisciplinary pain management service; a healthcare professional with an interest in gynaecological imaging and fertility services.”

All those services are gatekept as secondary care. Someone might have a normal scan in primary care, primary care treatments might fail and a GP might know that they will need to be referred to a specialist—yet they will not be able to get access. Women’s waits could become longer, not shorter. I have tabled multiple parliamentary questions on advice and guidance and have received only holding answers, despite the changes coming in on 1 April.

I ask the Minister three questions. First, does she accept that mandating advice and guidance risks delaying referral? Secondly, how will this system avoid conflicting with Jess’s rule? Thirdly, will GPs retain the ability to refer directly into secondary care when clinically necessary?

Endometriosis is already hard enough to diagnose and treat; for patients, it is harder still. If access is to improve, the Government must set out clearly how this new system will work. If they cannot do that, they risk making access worse, rather than better—and that is something none of us wants to see.

[The Parliamentary Under-Secretary of State for Health and Social Care (Mrs Sharon Hodgson)]

It is a pleasure to serve under your chairmanship, Mr Dowd. I congratulate my hon. Friend the Member for Ipswich (Jack Abbott) on securing this very important debate. I am honoured to respond to it on behalf of my hon. Friend the Minister for Secondary Care, who unfortunately cannot be here today—this area of policy would normally fall under her portfolio.

I want to start by thanking Monica for sharing her story with us today through her MP and—as we heard—friend, and for being with us today in the Public Gallery, along with a large number of women who are suffering from this most painful and debilitating condition. Monica’s distressing experience highlights that we still have more work to do to ensure that all women with endometriosis can access the care they need.

As we have heard, for too many years women with endometriosis have felt unheard or dismissed and have been left to cope alone. We recognise the wide impact the condition has on education, work, family life and wellbeing, as well as on mental health, as the hon. Member for Eastleigh (Liz Jarvis) said, and we acknowledge that that is unacceptable.

This year’s Endometriosis Awareness Month theme is “endometriosis doesn’t wait”. That highlights the urgent need to reduce diagnosis times, improve care and address the impact of this debilitating condition. The Government are not waiting: we have already taken action to ensure that women with endometriosis have access to the services that they need. Many women spend years seeking answers, as we have heard today, being misdiagnosed, having symptoms minimised or being passed from service to service. The experience highlighted by all hon. Members who have spoken in the debate and by Endometriosis UK’s recent report underlines why earlier diagnosis and consistent, compassionate care must be central to our approach.

That is why we have introduced Jess’s rule, requiring GPs to reconsider diagnosis where symptoms persist, as the shadow Minister, the hon. Member for Hinckley and Bosworth (Dr Evans) mentioned. We are also rolling out Martha’s rule, giving in-patients in acute hospitals in England the ability to initiate a rapid review of their case by someone outside their immediate care team. Those measures will help ensure that women’s concerns are not dismissed.

[Dr Evans]

Those were the words that the Minister’s colleague read out in the previous debate, but I have no gripes about the Department saying the same thing. My question is about Jess’s rule and its interaction when there is a single point of referral. There will be a rub between GPs who say that someone needs to be seen because they might have a diagnosis of endometriosis and the system saying that those patients will be bounced back. I would be grateful if the Minister could clarify what that rule will look like in practice, because endometriosis is a good example to demonstrate it.

[Mrs Hodgson]

I was going to come on to what the hon. Gentleman said about that, as well as his request for an update on women’s health hubs. I will take the opportunity to write to him about that update and his specific question on how referrals will work. I am aware that colleagues have raised issues with referrals and, as the hon. Gentleman says, endometriosis will be a good example of whether that system is working as it should. I do not have the answer to hand, but I commit to writing to him on that.

We are also expanding access to diagnostic services. Community diagnostic centres are being rolled out countrywide for women on gynaecological pathways. Last month, 106 centres offered out-of-hours appointments so that women could get vital tests around work and caring responsibilities.

We are modernising how specialist care is delivered. In September, we announced the new online hospital NHS Online, which will be unconstrained by geographical boundaries. It will better align clinical capacity with patient demand so that patients will be seen and triaged faster. Earlier this year, we confirmed that menstrual problems, often a sign of conditions such as endometriosis, will be among the first nine conditions available for referral from 2027. Details are being worked through ahead of next year’s launch. Additionally, we are supporting integrated care boards to expand women’s health services at neighbourhood level, building on the successful pilot of women’s health hubs, so that good practice is spread and services are improved everywhere.

NHS England is currently updating the service specification for severe endometriosis, which will improve the standards of care for women with severe endometriosis by ensuring specialist endometriosis services have access to the most up-to-date evidence and advice. That will be published in due course.

Tobacco and Vapes Bill

Luke Evans Excerpts

Consideration of Lords amendments
Monday 23rd March 2026 Commons Chamber

[Madam Deputy Speaker (Ms Nusrat Ghani)]

I call the shadow Minister.

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

I welcome the new Minister to her place; she is stepping in and taking the Bill through this stage, like a technical finishing substitute. I, too, have been substituted for my hon. Friend the Member for Sleaford and North Hykeham (Dr Johnson), who spent a huge amount of time going through the Bill in Committee. I place my thanks to her on the record. Because of what she did, I have not had to do it, which has been a relief.

Eradicating smoking among young people is a public health priority. There may be differences in how we would achieve that, but the objective is shared by Members across the House, and we will not divide the House on the Bill tonight. There has been important common ground. As my colleague Lord Kamall said in the other place, smoking is harmful, vaping is less harmful than smoking, and not vaping is better than vaping. I think we can all agree that those principles should guide this legislation.

Those principles underpinned the Bill introduced by the previous Government. Since then, it has expanded, and at times it risks losing focus on its central aim of reducing smoking, particularly among young people. The Opposition have been concerned, for example, about measures that have placed additional burdens on hospitality and retail, and about restrictions on vaping that could undermine its role as a quitting tool for adult smokers. I therefore welcome the changes made in the House of Lords and the Government’s acceptance of them.

Further, the exemption of the adult mental health in-patient setting from the ban on vapes vending machines is a sensible and compassionate decision. Ministers were right to respond to concerns raised by peers, including my colleague Lord Moylan, and mental health charities, and we welcome the changes to clause 12. It is also right that local authorities will be able to retain proceeds from fixed penalty notices to support enforcement under the amendments to clause 39.

However, the Bill marks not the end of the process, but simply the end of the beginning. Key questions remain, including about the regulation of flavours and descriptors, advertising, and the designation of vape-free places. Those decisions will pretty much determine whether the Bill works in practice. It is therefore essential that the Government proceed in a way that is proportionate, enforceable and sustainable. We have already seen the importance of that balance. I welcome the decision to drop proposals to extend restrictions in pub gardens, which would have placed further strain on the hospitality sector. However, Ministers should take note. Restrictions should be targeted at areas where there is a clear and significant risk to public health. Possible considerations include restrictions outside schools and playgrounds, and I gently ask the Minister to reflect that approach as further regulations are developed.

The Lords also strengthened the Secretary of State’s powers in relation to cigarette filters, enabling more effective regulation of components that contribute to environmental harm. In addition, a series of technical amendments were agreed to, aimed at clarifying definitions, improving compliance mechanisms and ensuring that secondary legislation is subject to the appropriate level of parliamentary scrutiny. For example, Lords amendment 1, relating to age verification regulations under clause 1, requires the affirmative procedure to be used, increasing oversight of a core part of the Bill. Those are sensible improvements that reflect the spirit of constructive scrutiny.

A key and central issue raised throughout the passage of the Bill has been the risk of unintended consequences, and particularly the growth of the illicit market. Whether we are for the Bill or against it, one concern unites us all: the black market. If regulation is too restrictive or poorly enforced, it will drive consumers away from the legal market and into illegal supply, which would undermine both public health and enforcement. The Opposition proposed an annual report on illicit tobacco and vaping activity, which the Government rejected. Given the concerns raised throughout the passage of the Bill, I would be grateful if the Minister could set out clearly how the Government will monitor and respond to changes in the illicit market.

We support the broad objectives of the Bill, but we will be watching closely. Its success depends not on its intentions, but on its delivery. When it was first introduced, I spoke about my experience as a junior doctor on a respiratory ward—my first hospital job. I saw patients struggling for breath, families in distress, and moments when, despite everything, there was little more that could be done. The true test of the Bill is simple: in years ahead, fewer families should have to experience the same pain, suffering and despair. Let us hope this works.

[Mary Kelly Foy (City of Durham) (Lab)]

I declare an interest: I am proud to be the co-chair of the all-party parliamentary group on smoking and health. I am pleased that the Bill has returned from the Lords with minimal amendments. All the amendments before us are either Government amendments or have Government support, so I hope that the Bill can achieve Royal Assent as soon as possible. I understand that the amendments put forward today by the Secretary of State are simply to correct drafting errors, so I assume that they will need only brief consideration by the Lords.

I am proud that the Bill will become law under a Labour Government. I hope that this Government will be remembered as the one that began the end of smoking in this country. In a few decades’ time, I hope that people, particularly young people, will look back on smoking with disbelief, and will say, “Can you believe that selling tobacco, a lethal product, with the aim of getting us hooked, was ever allowed?”

Before coming to this place, I was a councillor in Gateshead council, where I held the public health portfolio from 2009 to 2019, and I chaired the Gateshead Tobacco Alliance. Tackling smoking was a central part of my work during that time, and it continues to be so today, because it remains the single biggest driver of health inequality in communities like mine and across the north-east.

In areas of high deprivation, smoking is not just a public health issue, but a deeply entrenched inequality. It is far more common in disadvantaged communities, where people are more likely to start smoking younger, find it harder to quit, and suffer the worst health outcomes as a result. That means higher rates of cancer, heart disease and respiratory illness, and lives cut tragically short. I have seen that reality at first hand over many years, and it is why action like that set out in the Bill is so important.

We should remember that tobacco is the single most harmful commercial product on sale in the world. It is sold for profit, while killing around two thirds of its long-term users and generating enormous returns for the companies that manufacture it. It is highly addictive, and many who start smoking wish they never had. Over 80,000 people die in this country every year because of it, and if it was introduced today, it is unthinkable that it would ever be permitted.

This Government are right to legislate for a smokefree generation, because there is a fundamental imbalance at the heart of this issue. Companies are making vast profits from a product that drives disease, kills two in three of their customers, deepens inequality and places huge costs on our NHS and wider society. We know how important it is to work towards a truly smokefree future, and to drive smoking rates down to as close to zero as possible.

In the north-east, we have a clear declaration for a smokefree future, endorsed by all directors of public health, our integrated care boards, Fresh, all 12 local councils and all 10 local hospital trusts. That kind of whole-system commitment is vital, not just for improving health but for tackling poverty, supporting a more productive region and preventing the premature loss of loved ones to smoking-related disease. That work is already delivering results. In County Durham, smoking rates have nearly halved over the last decade, reflecting a sustained effort across prevention and support to help people quit. However, rates remain higher in some communities, so we cannot afford to lose focus now.

I am equally pleased about the strong cross-party support for the Bill. We saw that clearly in debates in the other place. The APPG on smoking and health is a great cross-party effort, which I am proud to co-chair with the hon. Member for Harrow East (Bob Blackman).

There is much to welcome in the amendments. In particular, amendment 80, which requires the Government to review the Act, is an important addition that strengthens the Bill. To be clear, it is not a sunset clause, nor is it a test of whether the smokefree generation policy has succeeded in its health aims—the impact assessment makes it clear that we are playing the long game—but rather it will assess how smoothly implementation has progressed and what burdens, if any, have fallen on retailers. I am confident that it will report positively, and that it will encourage other countries to follow our lead. I note that a similar private Member’s Bill is before the French Parliament, which I hope reassures colleagues about the policy’s compatibility with EU law.

--- Later in debate ---

[Dr Evans]

I am glad the Minister has addressed many of the questions that I posed. One was about the designation of vape-free places, and I think there is consideration of what that will look like. How will the Government approach that? I would welcome it if she could at least set out the framework of what she might think about in her new role.

[Mrs Hodgson]

That is being looked at, and I can write to the shadow Minister with the details as we progress. I will commit to doing that.