Draft Human Medicines (Amendments Relating to Hub and Spoke Dispensing etc.) Regulations 2025

Luke Evans Excerpts

Monday 2nd June 2025 General Committees

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

It is a pleasure to serve under your chairmanship, Mr Stuart.

I will not go through everything the Minister set out, but we are amending the Human Medicines Regulations 2012 and the Medicines Act 1968 to enable hub and spoke dispensing.

The regulations before the Committee will improve seven key areas. They will enable cross-business outsourcing; clarify the legal definitions of wholesale dealing and retail sale; extend outsourcing to NHS GPs; establish hub and spoke frameworks, legally defining what the hub and spoke model is and enabling hubs to assemble medicines; tighten up labelling and information rules; introduce data-sharing provisions; and clarify premises-based supply.

The pros of doing that, and the reason why the previous Government were introducing legislation to do so, is that it will provide efficiency gains, improve access, modernise the legislation, and improve patient safety and data protection. There are some cons and concerns, however, particularly regarding the complexity of implementation and whether pharmacies will need to invest in new systems. There are data privacy risks, as the world is seeing an increasing number of cyber-attacks, which is a concern as we are adding more areas for data sharing. In addition, the regulatory ambiguity resulting from removing definitions from the 1968 Act may cause initial confusion during the transition.

Between 16 March and 8 June 2022, the previous Government consulted on legislative proposals to allow pharmacies and dispensing doctors to access hub and spoke dispensing models. Two different models were proposed:

“Model 1 is where the patient presents a prescription to the spoke. The spoke then sends the relevant information on to the hub so that they can carry out their agreed dispensing actions. The hub then sends these dispensed medicines back to the spoke, which may have further responsibilities to perform such as providing advice on the medicine to the patient, before supplying them to the patient.

In model 2, the same pathway is followed in that the patient presents a prescription to the spoke, which then sends the relevant information to the hub. The hub then assembles and prepares the medicine before supplying the completed order directly to the patient.”

On Monday 13 May 2024, shortly before the general election was called just over a year ago, the previous Government published a response to the consultation. The majority of respondents, being medium and larger pharmacy chains, representative sector organisations and other related businesses, supported the proposals. However, a majority of individuals, smaller pharmacies and independent pharmacies did not support the policy change.

At the time, the proposed next step was to make several amendments to the 2012 regulations, including the creation of two new models: spoke-hub-spoke and spoke-hub-patient. The previous Government intended to lay a final statutory instrument before Parliament and the Northern Ireland Assembly with a view to the legislation coming into force on 1 January 2025. However, because of the election, that statutory instrument was not laid.

The Minister reiterated this Government’s position in response to a question from the hon. Member for Warrington South (Sarah Hall):

“A wide range of community pharmacies and representative organisations fed into the public consultation on hub and spoke reform, and I am pleased to confirm that their responses were overwhelmingly positive in support of model 1 of hub and spoke, which we will be going with.”—[Official Report, 25 March 2025; Vol. 764, c. 774.]

There are two problems here—the implementation and the principle—and I will take them in turn.

The impact assessment, which was updated in April 2025, found uncertainty about the potential costs of establishing the hubs, the operating costs and the level of uptake of hub and spoke dispensing. Paragraph 78 stated:

“It has not been possible to determine the initial set up costs for hubs, due to the variety of different hub solutions and because we do not have a concrete assessment of the number and types of hubs that might open due to this policy.”

Paragraph 136 said:

“The key uncertainties in this IA are around the level of take up of hub and spoke arrangements and the net level of savings to dispensing costs that could arise”.

And paragraph 137 said:

“Ultimately hubs are private businesses who would need to conduct their own analysis and research into the level of market interest when deciding how much to invest in building hub capacity.”

In the light of that, can the Minister tell us whether there will be any further funding to implement this change? How will he record data on uptake and changes? And what incentive is there for businesses to take this up? Will it be mandated? Given the abolition of NHS England, where will the data be collated, who will collate it, and when will it be published?

I have now addressed the practical part, so I will now focus the Committee’s attention on the other part. The previous Government proposed to take forward both models: model 1, which was patient-spoke-hub-spoke-patient; and model 2, which was patient-spoke-hub-patient. I have been contacted on the latter by Pharmacy2U, which is the largest online distance-selling pharmacy.

Every month, Pharmacy2U dispenses more than 3 million items directly to the homes of 1.5 million customers, so it offers an alternative for patients. It asks why there was no formal consultation on the changes from the previous Government’s position, whether Ministers had considered whether this change excludes the perspectives of distance-selling pharmacies, and what the expected impact of excluding model 2 will be.

[Sadik Al-Hassan (North Somerset) (Lab)]

It is a pleasure to serve under your chairship, Mr Stuart. I refer hon. Members to my entry in the Register of Members’ Financial Interests as a registered pharmacist, and previously a superintendent pharmacist of a distance-selling pharmacy. Although it is great to hear the hon. Member refer to distance-selling pharmacies in this august place, I remind him that he is representing the views of only one, admittedly large, distance-selling pharmacy, and that there is perhaps a wider range of views among distance-selling pharmacies.

[Dr Evans]

Of course, and I thank the hon. Gentleman for that point, with his august history as a pharmacist. My job in the Opposition is to raise these issues with Ministers for consideration. At the heart of my point is that, by choosing only one model and not offering two, we are closing down the opportunity for not only patients but businesses. If we want to invent in the NHS, that seems a bad way of doing it. It is why the last Government suggested that having a couple of models allows people to invest in, invigorate and improve our system, because otherwise, innovation will fall behind. That is at the heart of the questions I am posing to the Minister.

That leads me nicely on to my follow-up question. Does this mean that the Minister will choose not to introduce model 2? Is that likely to be in line in the future, and if so, when?

Those questions go to the principle of this. The last Government decided that there were two options to accommodate all different fields, be it dispensing GPs, community pharmacies, large-scale chemists and pharmacies or, indeed, distance-selling pharmacies. It is really important to take into account the whole environment we have in the health service. We will not divide the Committee, but we would like answers to those questions about the practicalities and policies behind the regulations.

Mental Health Bill [Lords]

Luke Evans Excerpts

2nd reading
Monday 19th May 2025 Commons Chamber

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

A rough road is not the same as a collapsed bridge. Both slow you down, but one stops you entirely. There is a simple distinction that is often missed in the public discourse: the difference between mental wellbeing and mental health. Every one of us faces challenges that affect our mental wellbeing, such as stress, burnout and grief, but fortunately not all of us experience diagnosable mental health conditions. Recognising that nuance helps us talk more openly and responsibly about what support is needed, for whom and where.

At the heart of this Bill are the most vulnerable people in our society. Tonight we have debated not how Parliament serves the powerful, but how it protects the most vulnerable while upholding freedom, how it safeguards the public without surrendering to fear, and how it balances the need for control with the imperative of compassionate care. Mental incapacity may dim a person’s ability to choose, but the law must never let it extinguish their right to matter.

Reform of mental health law must recognise that protecting someone from themselves or others is not carte blanche to own their life, but simply involves borrowing the reins for a time to steer the person to recovery, and handing them back when agency is restored and they are fully equipped to chart their path once more.

We have heard personal testimonies in today’s debate. The hon. Member for South Derbyshire (Samantha Niblett) talked about her mother being sectioned, the hon. Member for Bermondsey and Old Southwark (Neil Coyle) talked about his mother being sectioned for schizophrenia, the hon. Member for Winchester (Dr Chambers) talked about his friend who died of suicide, and the hon. Member for Dorking and Horley (Chris Coghlan) talked about his friend who was murdered. The hon. Member for Thurrock (Jen Craft) spoke about her personal experience with OCD and bipolar, the hon. Member for Aylesbury (Laura Kyrke-Smith) talked about her post-natal depression and the suicide of a friend, the hon. Member for Southend West and Leigh (David Burton-Sampson) talked about his friend Sam who died from suicide, and the hon. Member for Stroud (Dr Opher) spoke about his close relative who was sectioned for psychosis. It shows that this discussion has got to the top of the nation and that it is at the very heart of every part of our communities.

The hon. Member for Winchester talked about the problems of suicide for the professions, particularly doctors, vets and farmers. The hon. Member for Bermondsey and Old Southwark said that he has had a ride-along three times with the police. I am pleased he is getting on so well with the police, but, more importantly, he made the very valid point that that is not a role for the police. The hon. Member for Penistone and Stocksbridge (Dr Tidball) talked about autistic people and learning difficulties, using her specialist abilities from her professional aspect as chair of the APPG. My hon. Friend the Member for Runnymede and Weybridge (Dr Spencer), whose CV is as long as the Bill itself, talked about compassionate treatment, how to use the legislation and, most importantly, the scope of the powers, in essence because of the need to be precise when using such powers.

The hon. Member for Rochester and Strood (Lauren Edwards) talked about the importance of support for learning disabilities and autism. It is really important that this is about community, given that last week was Mental Health Awareness Week, for which the theme was community. The hon. Member for Dorking and Horley spoke passionately about Fiona’s campaign for Christopher’s case, and we will look closely at that amendment in Committee. The hon. Member for Sittingbourne and Sheppey (Kevin McKenna) is a nurse who also brings his professional experience to this House. He and I both came into this House to try to change the NHS, and while we chose different sides, there is clearly passion there.

My hon. Friend the Member for Farnham and Bordon (Gregory Stafford) talked about his experience of improving the system and policies to improve mental health care. The hon. Member for Thurrock—a member of the Health Committee, as I was—talked passionately about OCD and bipolar, and how important it is to show that people can achieve whatever they put their mind to, no matter how high the barriers in front of them. The hon. Member for St Neots and Mid Cambridgeshire (Ian Sollom) told a passionate and moving tale about Declan, and the tragic story, which really helped bring to life what can, unfortunately, go on in this country. The hon. Member for Whitehaven and Workington (Josh MacAlister) spoke about the higher level of suicide in his area, and the importance of making sure that that is identified.

The hon. Member for Dewsbury and Batley (Iqbal Mohamed) talked about the racial discrepancies, which is really important. The key thing is evidence of why that is happening, and to make the legislation effective off the back of that. The hon. Member for Ashford (Sojan Joseph) talked, as a mental health care nurse and chair of the APPG, about personalised care, which is so important. That leads me to the hon. Member for Guildford (Zöe Franklin), who also talked about putting the patient at the centre. The hon. Member for Southampton Itchen (Darren Paffey) talked about local services such as Lighthouse and No Limits, again showing the community support, and the hon. Member for Leicester South (Shockat Adam) talked about the placement of children, at which we will be looking very closely in Committee. The hon. Member for Mid Cheshire (Andrew Cooper) pointed out the impact that social media can have on young people’s minds. The mental wellbeing of this House would not be the same without hearing the dulcet tones of the hon. Member for Strangford (Jim Shannon) from the back Bench.

The hon. Member for Blackpool South (Chris Webb) talked about the mental health charities that he has seen at first hand and about how people suffer. The hon. Member for Aylesbury rightly shone a spotlight on maternal health, which often gets missed in this conversation. The hon. Member for Southend West and Leigh talked about men’s mental health—a passion of mine—and he was right to point to the men’s mental health strategy that the Government are bringing forward, and in which I encourage everyone to take part. The hon. Member for Worsley and Eccles (Michael Wheeler) rightly talked about learning from others, and we have definitely done that in this debate. The hon. Member for Stockton North (Chris McDonald) talked specifically about the men’s shed, and I look forward to seeing his campaign on Labour for lawn mowers in its next manifesto.

The hon. Member for Stroud and I have both seen more than a handful of patients with mental health issues in our time, and I love his idea, which I hope will be brought forward, about having management plans already decided by the patient, so that when they are in crisis, that has already been dealt with. Last but not least, the hon. Member for Dartford (Jim Dickson) talked about the accumulative attention across this House that has led us here today, which is really important. We heard that the first mental health Act was introduced in 1959, but I am shocked—not once, but twice—to find I am the same age as the Mental Health Act 1983 and that I share the same year as the Health Secretary.

In 2007, the previous Labour Government introduced community treatment orders and independent mental health advocates, all aiming to increase the support for people at risk of being detained and allowing patients who have been detained to be discharged to communities if certain conditions allowed. However, valid concerns were raised, and Members on both sides of the House have agreed that more needs to change. I am pleased that the Bill builds on the work of the previous Government, who made significant strides in addressing the long-standing disparity between physical and mental health.

As has been mentioned, former Prime Minister Baroness May commissioned the independent Wessely review into the 1983 Act. I, too, pay tribute to their work in this journey. His report built on the principles of choice and autonomy, least restriction, therapeutic benefit, and people as individuals. The Conservative Government worked to create a draft Bill, which as we heard underwent significant scrutiny—we even have Members here who were part of it—recognising the need to get it right. Much of the Wessely report’s recommendations are here in front of us tonight, built around advance choice documents, improving advocacy, reform of community treatment orders, and changes around autism and learning disabilities, to name some of the 150 recommendations. On behalf of His Majesty’s official Opposition, I am pleased to stand here today and say that we support the principles behind the Bill. We will work constructively with the Government to scrutinise and improve it in Committee, and ensure that we pass good legislation that will do what is intended.

The Minister understands that progress in principle must become progress in practice, so I would like to jog his memory about some of the questions asked by my right hon. Friend the Member for Melton and Syston (Edward Argar). Does the Minister believe there are enough treatment facilities, particularly in the community? Are there adequate places of safety for people being detained once police and prison cells are removed? Does the mental health tribunal system have capacity to deal with more cases? And what will happen following the abolition of NHS England, which commissions specialist mental health services? Does he believe in hitting the mental health investment standard? Will he commit to doing so going forward? To that end, will he set out a timetable for this House, the services and the public to all work towards, to be held account to?

There is little greater moral burden than deciding for someone who cannot decide for themselves where care ends and control begins. Make no mistake, this is what this House is grappling with tonight and throughout the passage of the Bill. Involuntary care should never be the first instinct or answer, but a resort to prevent harm to both the individual and those around them. Compassionate care, therefore, demands precision. Without precision, we simply have sentiment. As His Majesty’s Opposition, we will endeavour to ensure that the Government’s sentiment becomes a commitment.

World Asthma Day

Luke Evans Excerpts

Thursday 15th May 2025 Westminster Hall

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

It is a pleasure to serve under your chairmanship, Dr Huq.

I would also like to place on record my thanks again to the hon. Member for Strangford (Jim Shannon). Those unkind might say he chases the spotlight of Westminster Hall, but they would be grossly mistaken: he chases purpose, which is why we find him everywhere, with boundless energy, trying to make a difference, and nowhere more so than in health. This must be the sixth debate I have had with him, if not more, so I take my hat off to him—he really is a champion in this space—and I thank him for what he does.

Asthma teaches us never to take a single breath for granted. When simply breathing becomes a conscious effort, we realise just how much strength it takes just to stay alive. I have seen that as a clinician working in A&E and as a GP; one of the scariest moments is when a child comes in having an asthma attack, or worse still, has one in the GP surgery, and having to manage the inhalers, the puffs they take and what to do when they deteriorate.

I have a personal story too—if we are declaring interests—to share with the hon. Member for Bournemouth West (Jessica Toale). I suffered from mild asthma growing up as a child and into my teens, but I ended up in an intensive care unit after having my appendix taken out. I ended up with bilateral pneumonia. That is highly unusual in the first place, but even more so when it is a doctor involved—we seem to be the most complicated to treat. It meant that afterwards I was left with significant breathing problems and symptoms that behaved like asthma—so much so that I would need steroids to solve them. I was also under the brittle asthma clinic in Oxford when I lived there.

I know at first hand what it is like to suffer when it is impossible to breathe, when someone’s ability to run is taken away or, worse still, they up in the middle of the night in a panic. This is a very timely and important debate that the hon. Member for Strangford has brought forward, and he has my sympathies and gratitude for doing so. On that line, I also thank Asthma + Lung UK for all the work it does to highlight this issue. As we have heard, with 7 million people suffering, this is the bread and butter of the NHS: from primary care to secondary care, day in, day out, people are being diagnosed with and treated for asthma.

As we await the 10-year plan for the NHS next month, this debate provides the chance for us to ask where we have got to with the Government. The last Government had come forward with the major conditions strategy but, alas, the new Government decided to take a different direction. Of course, that is their prerogative—no Government are bound by their predecessors. However, it does raise the question: what next? The Government will need to set out what they will do as an alternative to tackle asthma and other respiratory conditions.

It would be helpful to hear from the Minister today what assurances she can give about the inclusion she may have made of these conditions in the plan. Can she also set out what engagement her Department has had with patient groups such as Asthma + Lung UK, who put a lot of time into previous submissions to ensure the last Government understood what was needed? It would be sad to see that replication being needed, but at least the work would not be lost.

Part of dealing with asthma and respiratory conditions is vaccines and prevention. Work is clearly needed to increase uptake of the respiratory syncytial virus vaccine. I welcome findings that there was nearly a 30% reduction in hospital admissions among those aged 75 to 79, thanks to this vaccine, but the UK Health Security Agency has warned that many more older adults remain unprotected from RSV. To illustrate that point, up to the end of March, only half of eligible older adults had been vaccinated and more than 1 million people were yet to receive their vaccine.

I think we all share concerns about the significant increase in the number of bed spaces occupied by people with flu in the 2024-25 winter. That was partly due to vaccination rates among eligible groups being below what we would hope for. This winter, three times as many people as in the previous year were hospitalised because of the flu, which contributed significantly to waiting times in A&E departments. Without a clear increase in vaccination, the NHS will continue to face difficulties in urgent and emergency care. What steps will the Minister take over the next few months to increase the uptake of RSV, flu and pneumonia vaccines, particularly by those who suffer with asthma and COPD?

As a clinician, I remember over the years having to deal with different sets of guidelines. The hon. Member for Strangford hit the nail on the head. It was great to see the BTS, NICE and SIGN guidelines all coming together in November 2024, but there is a challenge in having guidelines, rolling them out and making sure clinicians are educated on the changes. What steps have the Government taken to ensure that ICBs and royal colleges are aware of the guidelines and that they are percolating down to everyone who might need to see them?

Access to fractional exhaled nitric oxide—FeNO—testing is an important step in diagnosis. There is also spirometry. Given the success of community diagnostic centres, have the Government given any thought to how such apparatus could be rolled out to communities so that more people might get access to it?

One thing that is really important with respiratory diseases, especially asthma, is smoking cessation. The Tobacco and Vapes Bill is going through Parliament, but is there any targeted approach for those who suffer with asthma to help them to reduce smoking?

Much of asthma care is delegated to nurses, not doctors. How does that fit into the forthcoming workforce plan? Will special consideration be given to respiratory nurses in both primary and secondary care? After all, they have become the experts in exactly what to prescribe and when.

Finally and most importantly, what steps are being taken to reduce asthma deaths, especially preventable ones? The word “preventable” is the biggest key here. I am keen to hear from the Minister how the Government intend to tackle this problem.

Breathing: it is the first and last thing we do, but we rarely notice it until it has gone—or, in the case of asthma, until it is threatened. I know the Minister understands that, and I know the people out there watching understand it. I hope that understanding transforms into policy.

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

It is a pleasure to serve under your chairship, Dr Huq. I thank the hon. Member for Strangford (Jim Shannon) for bringing this timely debate forward as we mark last week’s World Asthma Day. It shows real leadership from the chair of the APPG for respiratory health. In that spirit, I would be delighted to take him up on his offer of a meeting. We will arrange that as soon as we possibly can—I am keen to do it.

I thank hon. Members for their contributions. I am more than happy to meet the hon. Member for Birmingham Perry Barr (Ayoub Khan) to discuss the issues that he raised, including prescription charges. There are currently no plans to review the list of medical conditions that entitle someone to apply for a medical exemption certificate. However, approximately 89% of prescription items are dispensed free of charge in the community in England and a wide range of exemptions are already in place. Eligibility depends on factors such as the patient’s age and whether they are in qualifying full-time education, are pregnant, have recently given birth or are in receipt of certain benefits. People on low incomes can apply for help with their health costs through the NHS low income scheme. Children are of course entitled to free prescriptions.

NHS England’s children and young people’s transformation team have been working closely with the MHRA on dose counters being added to inhalers. The “British National Formulary for Children” has been updated with guidance and supportive resources for patients and clinicians, which have been widely shared. We are awaiting an update on progress on making dose counter inhalers dominant in the supply chain from the pharmaceutical industry. I will be more than happy to update the House when we have it.

I thank my hon. Friend the Member for Bournemouth West (Jessica Toale), who focused on air quality, which is a priority for the Government and part of our prevention strategy, and the technology to help to manage asthma. There are a range of technologies available to help people to manage their asthma, and NHS England and NICE are exploring the potential for the platforms for digital self-management of asthma to be evaluated, but that depends on the technology readiness level. Guidelines developed jointly by NICE, the Scottish Intercollegiate Guidelines Network and the British Thoracic Society to harmonise recommendations across the organisations were published in November 2024, and I hope they are useful.

Before I respond to the Front-Bench contributions—if there is anything I do not cover, please let us know and we will endeavour to write with the relevant details—I want to pay tribute to charities and campaigners: people who are doing the hard yards of helping to equip our hospitals and supporting people to manage their conditions in their day-to-day lives. I thank Asthma + Lung UK, Beat Asthma and the Asthma Relief Charity, to name just a few. The shadow Minister, the hon. Member for Hinckley and Bosworth (Dr Evans), asked about the contributions by charities to the major conditions strategy. I reassure him that engagement with such stakeholders has been central to the development of the 10-year plan. All submissions made to the major conditions strategy have been taken into account—nothing was wasted.

As the hon. Member for Strangford outlined, asthma is the most common lung condition, affecting nearly 5.5 million people in the UK. Just under one in 10 kids live with asthma, and more than 12,000 people have died from asthma attacks in the last 10 years. World Asthma Day is not just about treating a condition; it is about shining a spotlight on inequalities. I strongly agree with the hon. Gentleman that everyone, regardless of where they live or how much they have in their bank account, has the right to access the inhaled medications they need to control their condition and treat attacks.

Nevertheless, statistics published by Asthma + Lung UK just this month show that Asian people with asthma from the most deprived quintile in England are almost three times more likely to have an emergency admission to hospital than their white counterparts. Black people with asthma from that group are also more than twice as likely to be admitted to hospital. This is a burning injustice. As if that were not enough, the annual economic burden of asthma in the UK is around £3 billion a year. Lung conditions collectively cost the NHS £11 billion annually. That is why we must act.

I will update Members on NHS England’s activities in this space before moving on to wider Government efforts. NHS England is taking steps to support integrated care systems to improve outcomes for people with asthma through its national respiratory programme by providing targeted funding, clarifying what systems should be doing to ensure that people with asthma receive a high-quality and timely diagnosis, and working with key partners, industry representatives, patient groups and clinicians to support improved respiratory disease management. That will include shared decision making on inhaler choice and making better use of inhalers to reduce the overuse of reliever inhalers and encourage the use of preventer inhalers.

The hon. Member for Strangford raised the issue of access to and roll-out of treatments. Healthcare Quality Improvement Partnership, on behalf of NHS England, commissioned a national audit across respiratory care, which includes asthma, and all data from the audit is published for open access. NICE is working with BTS, SIGN, NHS England and others to review the resources available to support implementation of the guidelines, and plans to publish a respiratory toolkit. To support implementation of NICE guidance, NHS England has been engaging with health system partners across the country to co-ordinate resources and implementation efforts to make sure that patients are on the appropriate treatment regime.

NHS England is also protecting our children and young people through the national bundle of care. It is putting asthma care at the top of the agenda by giving asthma a higher priority within systems, providing funding for regional leadership, and strengthening governance and accountability to improve outcomes. It has also played a crucial role in making training easier and more readily available for staff by bringing together existing guidance and resources with a structured training scheme. Since its publication there has been a noticeable reduction in hospital admissions.

The hon. Member for Strangford and the shadow Minister both raised spirometry, a diagnostic test for asthma as well as other respiratory diseases. NHS England is working with a range of partners, including Asthma + Lung UK, the British Thoracic Society, the Association for Respiratory Technology and Physiology and clinical leads to make sure that systems have everything they need to increase the number of people receiving early and accurate diagnosis for respiratory disease. In the past year the Government have made extra funding available to make sure that staff have the proper training and accreditation to use spirometry effectively.

On inequalities, NHS England is taking steps to uplift the most deprived quintile through Core20PLUS5. That initiative focuses on five areas of improvement, of which chronic respiratory disease is a key part. There are targeted interventions to detect and treat asthma. The PLUS population groups include ethnic minority communities, people with a learning disability, autistic people, coastal communities, people with multimorbidity and protected characteristic groups. Core20PLUS5 also has a dedicated workstream for children and young people. The primary focus is to address over-reliance on reliever medications while decreasing the number of asthma attacks. That has made some progress, with clear reductions in the over-prescribing of reliever inhalers over the past few years. Between April 2022 and February 2025 the proportion of patients with asthma who received six or more reliever inhaler prescriptions fell from just under 20% to under 16%. The Government are supporting systems to take innovative approaches to expanding access to their diagnostic services, with a particular focus on addressing health inequalities.

Finally, the NHS rightly offers the flu vaccine free of charge to people with severe asthma as seasonal illnesses pose more of a threat to them than others. NHS England has been working with the severe asthma collaborative to develop the capacity of severe asthma centres to improve patient access to biologic treatments and to reduce variation in prescribing and patient management. That work has shown improved identification of patients with potential severe asthma in primary and secondary care, resulting in referral to severe asthma centres for consideration of their eligibility for biologic therapy. For four in 10 asthma patients with severe asthma those treatments can significantly improve their quality of life. However, it is vital that biologics are prescribed only following specialist assessment. Currently, the NHS is deploying six biological treatments approved to treat severe asthma.

The shadow Minister raised the issue of vaccines. I reassure him that a strategy and action are being delivered to increase vaccination uptake, including RSV and flu, because that is a priority for the Government. Returning to biologics, significant work was undertaken to drive uptake and access to them through the NHS England severe asthma collaborative, and patient outcomes are submitted to the UK severe asthma registry. That has improved the identification of patients with potential severe asthma, and has resulted in those people being referred to the relevant care pathways.

Every member of the Government is committed to raising the healthiest generation of children in our history. We are taking steps to protect our kids from obesity and smoking, which are major risk factors; each one is responsible for roughly a third of asthma deaths. We are taking action through the Tobacco and Vapes Bill, which I am pleased to say has just passed Second Reading in the other place.

In her autumn Budget, my right hon. Friend the Chancellor took steps to ensure that the soft drinks industry levy remains effective. We have not just uprated the levy to bring it in line with inflation; we also published a consultation just last month on two proposed changes—reducing the lowest sugar tax threshold from 5 grams to 4 grams of total sugar per 100 ml, and removing the exemption for milk-based and milk substitute drinks. Finally, my right hon. Friend the Secretary of State for Energy Security and Net Zero is cleaning up our air with Great British Energy and a raft of other measures.

My Department will shortly be publishing its 10-year plan for health to make our NHS fit for the future. We will shift the focus of our NHS from sickness to prevention, hospital to community, and analogue to digital. Until then, we are already taking steps on prevention by helping people to lose weight and quit smoking or vaping, and by helping to clean up our air. We are helping people to get diagnosed closer to home by requiring community diagnostic centres to provide spirometry tests. The Government remain committed to ensuring that existing CDCs, where they are not already, are rolled out at full operational capacity at their permanent site.

[Dr Luke Evans]

The Minister mentioned spirometry. Could she comment on FeNO, and if not, could she write to us? The guidelines are built around that, but access is going to be an issue.

[Ashley Dalton]

Yes, I confirm that I will write to the shadow Minister on FeNO at a later date. NHS England is also piloting a digital annual asthma check.

I am sorry, Dr Huq, this is highly irregular, but I am feeling extremely unwell; I need to go and make myself okay. [Interruption.] Thank you for your forbearance, Dr Huq. Crohn’s is not something that we have debated in this Chamber; if we did, no doubt I would be the responding Minister, and I can assure you that I would be able to speak from personal expertise.

Brain Tumours: Research and Treatment

Luke Evans Excerpts

Thursday 8th May 2025 Commons Chamber

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

I start with a personal apology to my constituents on this VE Day. While I cannot stand there in person among those marking our victory in remembrance in Hinckley and Bosworth in north-west Leicestershire, I am carrying out the very duty that people gave their lives to protect. The sacrifice of those who fought in world war two ensures that the work of this Parliament and democracy itself endures. Their courage lives in every free debate, every vote cast, and every moment we serve the public good. That should never be forgotten or taken for granted. I am therefore privileged to respond on behalf of His Majesty’s Opposition to such an important topic that resonates with so many—brain tumours.

I pay tribute to the hon. Members for Mitcham and Morden (Dame Siobhain McDonagh) and for Witney (Charlie Maynard) for bringing forward this debate. I was also pleased to hear this important issue raised only yesterday in Prime Minister’s questions by the hon. Member for Forest of Dean (Matt Bishop), talking about his constituent’s remarkable and inspirational story about overcoming glioblastoma. Although the Prime Minister did not respond with details about brain tumours specifically, these are important opportunities to raise and debate this topic while telling the human stories, and I look forward to hearing from the Minister today.

One such story is an example from my own constituency of Hinckley and Bosworth, involving Katherine and Simon Tansey and their daughter Isla. I have told this story in the House in years past, but it is so poignant that I am not shy about telling it again. We can choose to be affected by the world or we can choose to affect the world, and my constituent Isla chose the latter. In August 2017, seven-year-old Isla Tansey woke up unable to walk. After many horrible treatments, surgery and radiotherapy, she was diagnosed with DIPG—diffuse intrinsic pontine glioma—in January 2018. Isla’s mum described the terminal illness as the most traumatic and heartbreaking experience for a family to go through.

Sadly, Isla passed away in July 2018, but not before inspiring thousands around the world with her positivity and creativity through her hobby: painting stones and pebbles. Isla asked others to join her by painting their own stones with any design, but she asked them to include the hashtag #islastones and the words “photo.post.rehide”, and then to send pictures to a dedicated Facebook page for her to see. They were subsequently to leave the stones somewhere hidden so that when they were found, they could spread a little bit of the joy that Isla had given them.

Isla’s mother Katherine hoped that one day a child might find the stones, learn about Isla’s story and become a researcher in childhood cancer. Thousands of people took part, and more than 149 countries were involved. Although Isla could no longer walk, she loved to see where all the stones ended up and where they would travel next. This included the Taj Mahal, New Zealand, Disneyland and America, with one stone reaching Antarctica. Through the stones and the people who made them, hid them and posted their photos, Isla travelled the world.

The hashtag #islastones grew to a community of over 65,000 members from all across the world. In 2019, a year on from Isla’s passing, a world record was set at the Celebration of Smiles event in Hinkley for the largest display of painted stones, with 8,542—all in remembrance of Isla. Off the back of that, Simon and Katherine set up the Islastones Foundation to raise research grants, awareness and smiles to help fight childhood cancer. They were awarded the Points of Light award from the then Prime Minister in 2023.

Why does this matter? We have all heard the statistics in this debate, but these are the real stories behind the cases, and our constituents all rightly ask for real understanding, for listening and for something to change. I am reminded of the quote:

“Your life is a message to the world. Make sure it is inspiring.”

Isla’s message was truly inspiring, and I hope the Government’s message on cancer and brain tumours will be the same.

I turn to the substance of the debate. It is clear today that Members are asking for greater priority to be given to accelerating research into brain tumours and treatments. The motion partly focuses on the £40 million of funding provided by the previous Government for research into brain tumours, and I understand the frustration of MPs from across the House at the speed of allocations to projects since 2018.

At this point, I must pay tribute to the Tessa Jowell Brain Cancer Mission for its work with the NIHR. This collaboration has led to the NIHR issuing funding calls for researchers to evaluate treatments for brain tumours and to expand the network of trials for brain tumours, including the national brain tumour consortium. Looking over the debates, I noticed that the Minister said on Second Reading of the Rare Cancers Bill:

“In the five years since 2018-19, the NIHR has invested £11.3 million directly in brain cancer, with a further £31.5 million to enable brain tumour research in 227 studies involving 8,500 people. The commitment remains in place. I can confirm that there is no upper limit on that funding. We are exploring additional research policy options to encourage more clinical trials in early phase research and the development of medical devices and diagnostics.”—[Official Report, 14 March 2025; Vol. 763, c. 1434.]

That is of course encouraging, but campaigners want to see projects up and running as soon as possible. To that end, would the Minister consider the calls from Brain Tumour Research to create a set of dedicated funding streams for early-career researchers, improved access to clinical trials and better integration of brain tumours in cutting-edge cancer initiatives, especially given the proposed abolition of NHS England?

It is that deep desire to get research moving into potential new treatments that led to the Rare Cancers Bill, proposed by the hon. Member for Edinburgh South West (Dr Arthur). The shadow Secretary of State, my right hon. Friend the Member for Melton and Syston (Edward Argar), was pleased to support the legislation when it was introduced in March. I was glad to note that the Bill received Government support, and it was endorsed by the Brain Tumour Charity, Brain Tumour Research and other patient groups. I welcome the Bill’s intention to encourage industry to concentrate more research on treatments for rare and less common cancers, including brain tumours, particularly through the review of the orphan drug regulations. However, it is vital that there is alignment with the national cancer plan, which is likely to set the direction of cancer policies for the next five to 10 years. Can the Minister confirm whether the key measures in the Bill will be included in the upcoming national cancer plan?

As well as accelerating research into brain tumours, we must take steps to increase participation among those personally affected. One of the aims of the Rare Cancers Bill is to get more patients into clinical trials for rare cancers, including brain tumours. It is sobering that the Brain Tumour Charity’s survey found that only 12% of respondents have participated in a clinical trial. We also know from the Institute of Cancer Research that brain tumour clinical trials have the lowest recruitment of any cancer type. This is why the last Government asked Lord O’Shaughnessy to review the barriers to commercial clinical trials in the aftermath of the covid pandemic. I know that the Government have stated that they are committed to implementing the recommendations of the O’Shaughnessy review, but can the Minister provide further details on what progress has been made to date?

On a side note—but a related one—at a recent VE Day celebration in Donisthorpe I met a constituent who raised with me the issue of the acquired brain injury strategy. That cross-party initiative has been championed by the hon. Member for Rhondda and Ogmore (Chris Bryant), who is now a Labour Minister. Somewhat fortuitously, I was able to tell my constituent that I was taking part in a debate on brain tumours today. She and the likes of Headway and the Child Brain Injury Trust are keen to ensure that they are able to support people through the changes that the Government are pushing through on personal independence payments and disability support, so would the Minister consider reviewing or updating the acquired brain injury strategy in the light of these changes?

Finally, I want to end on a positive note. The discussions between the MHRA and Northwest Biotherapeutics are providing hope that people living with new or recurrent glioblastoma may have access to a new treatment, DCVax-L, which could make a real difference in prolonging their survival from this terrible disease. It is important that we build on these developments, and take steps to reduce barriers to research in brain tumours and access to new treatments as they develop. After all, as one brain tumour survivor said:

“Hope is the anchor that kept me steady through the storm of my diagnosis”.

I hope that this very debate will bring hope to those suffering and their families, and will demonstrate that the Government are listening and working for better outcomes.

Oral Answers to Questions

Luke Evans Excerpts

Tuesday 6th May 2025 Commons Chamber

[Mr Speaker]

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

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

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

[Wes Streeting]

As I have announced to the House, Baroness Casey’s independent commission is up and running. She is making contact with parties across the House as part of the work of her commission, and it is for her to decide the basis on which she engages with parties. I look forward to working with parties at the conclusion of the process.

[Dr Evans]

I thank the Secretary of State for that change, making the process no longer cross-party. The Government have said that the changes will not be implemented fully until 2036. Only this week, the Health and Social Care Committee released its new report on social care and the huge cost of inaction. The report called for new actions that could be taken now, such as the publishing of annual assessments of unmet care needs for adults, and annual estimates of how much delayed discharges cost the NHS. Will the Secretary of State commit to those two today?

[Wes Streeting]

I take the Select Committee seriously, and I will look carefully at its report, but the shadow Minister has some brass neck. He mentions this Government having been in office for 10 months, but the Conservatives had more than 10 years in office, and we are picking up the pieces from the mess they left behind. That is why they were kicked out of government, and why they are being kicked out of opposition. Looking at this lot, I think: this must be how the islanders felt, looking at the dodo.

Draft Health and Social Care Information Standards (Procedure) Regulations 2025

Luke Evans Excerpts

Tuesday 29th April 2025 General Committees

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

It is a pleasure to serve under your chairmanship, Ms Jardine. I am grateful to the Minister for coming to the Committee to explain why we may well need this SI, but I have some questions. I will not go through the benefits of these changes, but there are some risks, which are a concern for Opposition Members. We will not divide the Committee, but we would be grateful for some comments on those and on how we have got to where we are.

We know that we need to hold NHS bodies and private providers to the same standards on information. We also know that we can capture patient data more consistently across the NHS and private providers, which will greatly improve our understanding of patients’ experiences and the services they use. As the Minister rightly pointed out, the last Government recognised that and put in place the Health and Care Act 2022 to allow information standards to be applied to private providers in health and adult social care that are registered with the Care Quality Commission.

The last Government gathered views on proposals for how procedures should be changed, and I would be grateful if the Minister could comment on how that process has impacted on this SI and how it links to these procedures. Secondly, as I noted, the regulations relate to information standards applied to private providers registered with the CQC. As we know, the CQC has had some issues with its performance, so what is the Government’s assessment of its capacity to deal with compliance with these regulations?

That leads us into the question of the impending abolition of NHS England. The statutory instrument, and indeed the Health and Care Act, talk about NHS England. How will the legislation we are creating be impacted, given that it looks towards NHS England?

Turning to specific examples of information standards, one important example is accessible and transparent information under the accessible information standard. That was raised by the Royal National Institute for Deaf People, which told me before this Committee that making standards such as the AIS mandatory could have a powerful impact on the RNID. Will the Minister take that back to her Department and look at how long it will take to enact these standards, given that the Act was in 2022?

On the AIS, there is also a concern that, as the explanatory memorandum seems to suggest, we would put in place only a forward-thinking approach, rather than a backwards application. There is therefore a question whether things such as the AIS would need to be revised to make them mandatory, which could further delay the accessibility we are looking for.

That leads us on to interoperability, which is a Union question. Paragraphs 4.4 and 4.5 of the explanatory memorandum say that the extent of the regulations will be England and Wales and that the impacts will be felt in England alone. We have people on the border with the likes of Scotland and Wales, so what conversations is the Minister having with her counterparts in those jurisdictions to make sure that data is shared? At the end of the day, people have accidents in different places and seek health in different jurisdictions, and that will have a massive impact.

Finally, there is a question—which often comes up when we discuss NHS data—about what the wider impact looks like when it comes to trade deals and negotiations. That may be beyond the scope of this debate, and I do not expect the Minister to speak on behalf of her Trade colleagues, but it does raise the question of why this measure is being brought in specifically now? Is it just a timing issue, or is there a wider game afoot, in the sense that this issue would be part of, for example, a US trade deal or a closer alliance with the EU? I would be grateful if the Minister could comment on whether such discussions have taken place within the relevant Department.

I am grateful to all the civil servants and to everyone assembled here for taking part in the debate.

[Karin Smyth]

First, I thank the shadow spokesperson for the Conservative party’s support in bringing forward the regulations. As he rightly said, some of this work continues work done under the last Government and results, as I said in my introductory remarks, from the 2022 Act.

As I also said, standardisation has not been taken up across the system in the way that we would like, and this instrument provides a framework everybody can lean into. To go to the hon. Gentleman’s last question first, that reflects our need to make sure that, for the benefit of patients, clinical safety, patient support and efficiencies in the system, we have a framework that everyone works to and brings their standards into—I will not veer into something more technical that is beyond my ken, on the detail of computer systems. We wanted to make sure that we had that framework in place, and we were keen to bring it forward in an SI that is transparent for the House, so that we can all understand how this proposal is part of the wider Government mission.

As I said, this proposal started off under the last Government, and it has been brought forward now. There was an engagement exercise with stakeholders, and the response was published in November. We therefore need to issue the regulations now, particularly in advance of the Data (Use and Access) Bill. So that is the timing issue. I cannot comment further on trade deals, but that is why we are doing this: to make the system in England work better for all our patients.

To the hon. Gentleman’s point about cross-border issues, I am an MP in Bristol, and I understand those issues. We are looking at our responsibilities for England. We are keen to work with the devolved Administrations on all healthcare and cross-border issues. The Department will continue to talk to them, and I hope they are willing to continue to work with us. If there is anything further to add, I will make sure that it is communicated to the hon. Gentleman.

On the hon. Gentleman’s point about the CQC, he will be aware that the organisation has undergone a number of difficult issues in the recent past. We have had new leadership in place since before Christmas, and it is keen to provide support on wider issues. Safety, in particular, is in its remit, and the hon. Gentleman, as a practising clinician, will be acutely aware of the need for different systems to be able to talk to each other to highlight issues of safety and so on. We will absolutely ensure that the CQC is working as part of this wider system.

Colleagues and staff at NHS England obviously have concerns about changes, but the need to have data that works across the whole system—that has that interoperability at its core—is a priority for everybody working in it. That is clearly part of what the NHS needs to do, and although some people may move, that is absolutely a priority for the NHS moving forward.

To the hon. Gentleman’s point about the RNID, I had not heard that. Clearly, accessibility for all is important. I am happy to make sure that we get back to him and the RNID on that issue.

[Dr Evans]

If it would be of use, I am happy to give the Minister the letter the RNID provided to me before this meeting, to give her the context. I believe that the RNID would also be happy to give briefings, if that would help.

[Karin Smyth]

I thank the hon. Gentleman for that, and I am sure that officials have talked with the RNID. It is absolutely right that he brings that issue to my attention, and I will make sure we get a reply back to him and the RNID on the detail and on the time it will take to enact these standards. I visited the NHS England team up in Leeds, where we spoke about providing wider access—for example, by using the app—and about working with groups such as the RNID to make sure that what we produce is accessible for disabled people. The hon. Gentleman raises a really important point, and I will make sure that we get back to him on it.

With that, I will make sure that we check the record, and if there is anything else, we will get back to the hon. Gentleman. Otherwise, I would be grateful if the Committee could support the SI.

Question put and agreed to.

NHS Pensions

Luke Evans Excerpts

Tuesday 1st April 2025 Commons Chamber

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

(Urgent Question): To ask the Secretary of State for Health and Social Care if he will make a statement on NHS pensions in the light of the statutory deadline for both remediable service statements and remediable pension savings statements being missed.

[The Minister for Secondary Care (Karin Smyth)]

I thank the hon. Member for Hinckley and Bosworth (Dr Evans) for asking this question, which gives me the opportunity to provide further information following the written parliamentary statement that I issued yesterday to update the House on the delivery of remediable service statements to affected members.

I have extended the deadlines for the NHS Business Services Authority to issue statements to ensure that members have enough time to make informed decisions. Once members have received statements, they will be able to use a tool provided by His Majesty’s Revenue and Customs to retrospectively adjust their annual allowance between 2015-16 and 2022-23.

Separately, the original deadline to issue the 137,000 remediable pension savings statements was 6 October. The NHS Business Services Authority issued statements to 57,000 members by this deadline, of which 23,000 were found to contain incorrect information; these have since been recalculated and reissued. The NHS Business Services Authority is working to issue outstanding statements as quickly as possible.

A revised delivery timetable has been developed and shared with trade unions and employer representatives. By the end of March, 106,000 statements had been issued. Statements for 11,000 members will be produced once further information has been received from their employers. The remaining 20,000 statements require additional manual input from the NHS Business Services Authority before they can be produced, and will be issued in July. There have been delays on all sides, which we have been aware of since last July. In fact, the Department had escalated issues of design with the previous Government, as I am sure the hon. Gentleman understands.

We know that this matter is really important and that there are high numbers of high earners in the NHS, which is why we have taken the decision to be open and transparent about the timeline that we can now commit to, having worked tirelessly to reduce the delays. Although these delays will cause inconvenience to some members, I have been crystal clear that no one will face any financial detriment as a consequence. Compensation arrangements are in place for direct financial losses, certain HMRC interest charges, and the costs of financial and accountancy advice.

The Government do acknowledge the impact of the delays on affected members. We are working hard to issue outstanding statements and to protect members from any financial detriment the delays may cause.

[Dr Evans]

What is going on with NHS pensions administration under this Government? I declare an interest as someone with an NHS pension. Today, the Government have missed the statutory deadline for issuing remediable service statements to doctors, and they are now pushing the deadlines back to December 2026. In mid-March, the Government confirmed that just 21 statements had been issued out of 380,000; as of yesterday’s written statement, there are still more than 370,000 outstanding. This creates huge tax liability uncertainties.

We and the British Medical Association have been raising concerns for months. Why has it taken the Government so long to act? Ministers have announced a revised delivery plan, but how will it work in practice? Will there be more staff to help with the backlog? What changes are being put in place to ensure that the deadline is not missed again?

What was most concerning, however, was the complete absence of any mention of the remediable pension savings statements in the written statement. This issue really matters, as doctors who are taking on overtime or who work privately rely on these statements to be able to track their contributions and avoid excessive tax bills. According to Dr Sharma from the BMA,

“There’s no doubt that without up-to-date information, doctors will be pre-emptively reducing or turning down extra work to avoid additional pension…bills that they might not even be due.”

The statutory deadline for the 137,000 statements was, as we heard, 6 October 2024. In February, Ministers confirmed that 60,000 were outstanding and that the majority would be issued by the end of February; by March, however, the backlog had actually grown to 70,000. Can the Minister explain how two legal deadlines have been missed? Will the Government be following up with the regulator to ensure that this does not happen again? Do the Government have confidence in the NHS Business Services Authority? With the Secretary of State abolishing NHS England, what does this mean for the future of this vital organisation?

We all want to see waiting lists fall, but as one newspaper put it today,

“Labour’s pledge to slash NHS waiting lists is being sabotaged by a litany of administrative errors, pension delays and punitive tax rules.”

I urge the Government to take swift action.

[Karin Smyth]

As I outlined in my response and in the written ministerial statement, we have taken action. We were made aware of some of these problems when we came into office in July, and we have pushed the NHS Business Services Authority to move faster than it would have done under the hon. Gentleman’s Government, so that action is happening quicker than it would have done before. We do have faith in the NHS Business Services Authority to get on with this and ensure that there is no financial detriment, in line with the timetable outlined yesterday, and as I have further made clear today.

Madam Deputy Speaker, the hon. Gentleman could have asked me more about waiting lists, which have fallen for the last five months in a row. He could have asked me about the 2 million more appointments that have been provided to deliver for patients seven months early. He could have asked me about the hundreds more GPs who are now working in the health service, or the impact of cancelling the strikes on services for people, or the record funding. In fact, last week in the Chamber he spoke on behalf of the National Pharmacy Association; this week, he could have congratulated the Minister for Care, who is sitting next to me, on the agreement to produce more pharmacy services.

We are making improvements to the NHS every day. The Darzi report reported not only the breadth but the depth of the decline that we inherited. We are resolving that, and fixing the fundamentals of the NHS.

Eating Disorder Awareness

Luke Evans Excerpts

Tuesday 1st April 2025 Westminster Hall

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

It is a pleasure to serve under your chairmanship, Mr Stuart, for your maiden appearance as Westminster Hall Chair. I am grateful to the hon. Member for Bath (Wera Hobhouse) for securing the debate. She and I share many opinions on body image, algorithms, social media, steroid use and eating disorders. Although I am responding to the debate as spokesperson for His Majesty’s official Opposition, I am pleased to have the chance to build on the work that the hon. Member and I have enjoyed bringing forward together.

The hon. Member for Bath was right to point out that one in 50 people will suffer with an eating disorder or disordered eating. That means that we likely all know someone who suffers. It is true for people close to me, too, and I have seen what can happen both personally and professionally. It is therefore timely that the theme of Eating Disorders Awareness Week 2025 was “Eating disorders can affect anyone”. That is an important fact to recognise. Why? Because we know that eating disorders have some of the worst outcomes of any mental health diagnosis. Early intervention is key to break the cycle. Without doing so, it is devastating not only for the patient but for families and friends, the health service and, ultimately, society.

Disordered eating can take a variety of forms, from limiting the amount of food eaten, eating very large quantities of food at once, getting rid of that food through unhealthy means—through purging, laxative misuse, fasting or excessive exercise—or a combination of all of those. That can be one reason why it is so damaging. With other medical issues such as alcohol, drugs or gambling, the aim is abstinence, but of course that simply cannot be the case in this instance: we all need to eat.

Disordered eating is not just about the compulsive element. It is far more complex than that. Drivers of control and shame are so powerful. A sufferer told me:

“Eating disorders are not about food. At least they didn’t start that way. We, the eating disordered, started by using dysfunctional eating habits and starvation to control our feelings and gain a sense of control of the world around us. This soon spiralled into a dangerous daily obsession of reaching our ultimate unattainable goal; being thin enough. For us, to be thin enough is finally to be good enough.

Every room entered, every street walked involved detailed analysis of the physiques of others, feeling pride and superiority if I was the thinnest, and earth shattering shame and disgust if I was not. Both galvanised my resolve.”

Worse still, many people who suffer with eating disorders simply do not want to get better. The disease does not want to let them get better. The quote goes on:

“My eating disorder gradually robbed me of my happiness, my relationships, my health and my sanity. The insanity is that despite all this I could not stop. I did not want to stop. I was petrified to change. Thinness had become my identity, and starved detachment was my way to cope with my feelings and my life.”

My experience is that sufferers of depression and addiction would bite your hand off for a magic bullet. Alas, the same is not the case for eating disorders, and that is the barbarity of the disease. Yet we know that catching an eating disorder earlier can make all the difference, and debates like this one can dramatically help with awareness and prevention.

Beat’s survey from December and January gathered findings on lived experience of eating disorders from 1,900 people, which showed that four in five people thought that greater public awareness would make them feel more comfortable to talk about their eating disorder, two in three would not feel comfortable talking to their teacher about the issue, two in three would not feel comfortable talking with their line manager, and two in three would not feel comfortable talking with a colleague. More needs to be done to make it feel acceptable do so.

The covid-19 pandemic, and lockdown specifically, contributed to a surge in demand for children and young people’s eating disorder treatment. That is no surprise, given the lack of control in a lockdown. In Q1 of 2021-2022, 3,400 people were treated, compared with 1,900 people in Q1 of 2019-2020. We have seen some recent glimmers of hope from the data on waiting times for children and young people in eating disorder services. Recent data showed that between October and December 2024, 80% of urgent referrals—350 out of 433—to children’s eating disorder services were seen within one week. During the same time period, 81% of routine referrals—2,064 out of 2,251—were seen within four weeks. But more still needs to be done.

I believe that we are starting to see the fruit of the last Government’s investment, as investment in children and young people’s eating disorder services consistently rose each year from 2016, reaching £54 million in 2023-2024. This helped to expand the community eating disorder teams across the country. That was in addition to the £79 million invested through the covid-19 mental health and wellbeing recovery action plan to expand young people’s mental health services, which has enabled 2,000 more children to access eating disorder services.

Furthermore, I remember the Westminster Hall debate the hon. Member for Bath brought to mark Eating Disorders Awareness Week last year. I was pleased to hear the then Conservative Minister, the former Member for Pendle, Andrew Stephenson, announce an additional £3 million funding so that 24 hubs received a share of £8 million in 2024-25. That is more than double the original target of funding 10 hubs, with organisations across England benefiting.

Those were positive steps but the new Government should accelerate that momentum. In October last year, before I was a shadow Minister in the Department of Health and Social Care, I called on the then Minister, the hon. Member for Gorton and Denton (Andrew Gwynne), to convene an expert roundtable to discuss eating disorders, given the challenges faced by Governments in tackling the issue. Although the Minister at that time did not commit to it, he stated the following:

“When we were in opposition we gave support to the then Government, and I can assure the hon. Gentleman that we will do everything we can to support people who have eating disorders and to get the right provision and support at the right time for those people who need it.”—[Official Report, 10 October 2024; Vol. 754, c. 191WH.]

I renew the question to the Minister today. Will he convene a cross-party roundtable of experts and campaigners? Will he also commit to a national eating disorder strategy, as requested by the APPG report?

Since taking office, the Government have consistently reaffirmed their commitment to children’s and young people’s mental health. However, progress is unclear. I would like an update from the Minister on a couple of key tangible commitments made in the Labour manifesto. First, Labour promised to recruit 8,500 new mental health staff. Will the Minister tell us how many extra mental health staff have been recruited since the Government took office, and how many will be targeted for eating disorders?

Labour’s manifesto also promised

“access to specialist mental health professionals in every school, so every young person has access to early support to address problems before they escalate.”

That builds on work by the Conservative Government to have mental health support teams in 35% of schools by the end of 2023, which was achieved, and to be across all schools by 2024. Of course, the election punctuated that. Will the Minister update us on what progress has been made on that commitment? What assurances can he provide to eating disorder services, given that spending on mental health is projected to reduce as a proportion of overall spending in 2025-26, which was announced in last week’s written statement?

Finally, I want to repeat the question that my right hon. Friend the Member for Melton and Syston (Edward Argar), the shadow Secretary of State for Health and Social Care, asked the Health Secretary at oral questions in February:

“Will he back Beat’s call for broader access to intensive community and day treatment for those with eating disorders—there are limited places currently—and set out a timetable in which that will be delivered?”—[Official Report, 11 February 2025; Vol. 762, c. 165.]

Although I was pleased to hear the Health Secretary recognise the importance of the issues, further details from the Minister would be helpful. To conclude, although there is a long road to go in preventing eating disorders and supporting those who suffer, I live in hope that

“Healing doesn’t mean the damage never existed. It means the damage no longer controls your life.”

Hughes Report: First Anniversary

Luke Evans Excerpts

Thursday 27th March 2025 Westminster Hall

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

It is a pleasure to serve under your stewardship, Ms Furniss. As a GP who has seen patients with valproate and mesh injuries, standing here with a chance to raise this issue is humbling for me.

I am grateful to the hon. Member for Washington and Gateshead South (Mrs Hodgson) for proposing this debate. It is yet another important topic that she has brought to the House. She is in danger of rivalling the hon. Member for Strangford (Jim Shannon) for securing so many Westminster Hall debates on health. The fact that we have two worthy champions fighting it out to be the person in the country doing the most for health is a true testament to the dynamics we have; I congratulate the hon. Member for Washington and Gateshead South on that. I remember her powerful contributions to last month’s Westminster Hall debate on women’s health, and she has done the same today. With her personal experience of her mother’s situation, and as the chair of the APPG first do no harm, she is a true champion.

Now that we are past the first anniversary of the Hughes report, this debate is an important opportunity for the women and families affected by valproate and pelvic mesh to get clarity from the Government on what progress is being made on the recommendations of the report and a way forward more broadly. It is heartening to see how the Chamber has come together to ask unanimously for that progress. I welcome the fact that the previous Government took productive steps and asked the Patient Safety Commissioner, Dr Henrietta Hughes, to undertake work in this area. Her report was issued a year ago, and it is clear that the victims are anxious for some form of redress for the harms that have been caused. The report states:

“The first point to make clear is that the Commissioner thinks that there is a clear case for redress based on the systemic healthcare and regulatory failures revealed by the First Do No Harm review in 2020. The Commissioner supports a restorative practice-based redress scheme, co-designed with affected patients, and which is, therefore, very different from court proceedings which seek to attribute blame.”

Of course an election halts progress, but now, with new Ministers and a new Government nine months in, it is right to continue keeping the spotlight on this topic. To that end, my questions echo many of those raised by others. Could the Minister clarify the Government’s position on the recommendation for financial redress, and could she give a timeframe for when they will respond to the report? Has the Minister met with Dr Hughes and campaigners to discuss the report, and will she commit to communicating with all those affected, as that is so important to help reduce some of the anxiety? It has already been a long and painful journey for victims, so continuing to take steps forward to address the fallout is important.

Further to the Hughes report, I am glad that the last Government took several actions to begin addressing the injustices suffered by victims of valproate and pelvic mesh. The former Health Secretary, my right hon. Friend the Member for Godalming and Ash (Jeremy Hunt), established the Cumberlege review, and significant progress was rightly made before the election on implementing seven of Dr Hughes’s recommendations. Those included an unreserved apology to the women and children affected, and their families, on behalf of the healthcare system, for the time the system took to listen and respond. I am pleased to see that the hon. Member for Gorton and Denton (Andrew Gwynne), the new Minister at the time, reiterated that apology when these issues were last debated in December 2024. Progress also included the appointment of Dr Hughes as the first Patient Safety Commissioner to advocate for patients and improve the safety of medicines and medical devices, and a network of specialist centres established to provide comprehensive treatment, care and advice for those affected by implanted mesh.

Hon. Members have already referenced the Westminster Hall debate on these issues last December. Looking at the record of that debate, I was pleased to see from the hon. Member for Gorton and Denton that the Government were committed to implementing the remaining three recommendations as a priority. He said:

“It is a priority for this Government. We are working at pace, and we remain focused on making meaningful progress. This is a complex area of work, involving several Departments, but we are committed to providing an update at the earliest opportunity. I have heard the desire for urgency today, and I hope that we can make the progress that Members want to see.”—[Official Report, 5 December 2024; Vol. 758, c. 175WH.]

I know that there has been a change in personnel in the ministerial team since that debate, but can the Minister confirm that it remains a priority for the Government regardless? Given that it is now four months since the last debate, and the Minister recognises the desire for urgency, what new update can she provide on the progress that has been made in implementing these recommendations since December?

As stated, I was in the debate on women’s health last month, in which the hon. Member for Washington and Gateshead South raised the issue. The Minister’s response was:

“On sodium valproate and pelvic mesh, the Cumberlege review made nine recommendations, of which the then Government accepted seven. I can confirm that the national pause remains in place.”—[Official Report, 27 February 2025; Vol. 762, c. 518WH.]

I also note that the Minister frequently quotes the following lines in her response to written parliamentary questions from colleagues:

“The Government will be providing an update to the Patient Safety Commissioner’s Report at the earliest opportunity.”

So could she say whether today is “the earliest opportunity”? If it is not, would she be kind enough to give an estimate of when that might be?

During that December debate, the shadow Minister, my hon. Friend the Member for Sleaford and North Hykeham (Dr Johnson), also raised concerns about the experiences of some of the women within the specialist mesh centres, and urged Ministers to look into that. I would be grateful if the Minister could set out whether she shares those same concerns. If so, what steps has her Department taken to address these and look into them?

Finally on sodium valproate, we have heard from my hon. Friend the Member for Harrow East (Bob Blackman) and the hon. Member for Bexleyheath and Crayford (Daniel Francis) about the difficulty we have when it comes to valproate, given the damage it can cause but its importance as an epilepsy drug in supporting people to keep seizure free. The report itself states:

“However, the Commissioner continues to have concerns about incomplete adherence to the Pregnancy Prevention Programme requirements. As a result, in November 2023, she recommended that NHS England create a fully funded and resourced system for improving the safe use of the most potent teratogenic medications, beginning with the safe use of valproate.”

With that being said, could the Minister update this House on the workstream regarding teratogenic medications? More importantly, given the news of the abolition of NHS England, what safeguards are being put in place to ensure that this system is resourced adequately?

“One year on” is a milestone to be celebrated—for getting this far after such a torrid journey in raising concerns, having them heard and getting them responded to—but it is just that: a milestone on a journey, not a destination. For those so affected, and their families, they will be keen to know what redress they are due and the mechanisms to deliver it, so that their cases might finally be fully rectified. After all, we cannot undo the past, but we can make amends for it, and I hope that the Government will continue to act on the recommendations to do so.

Oral Answers to Questions

Luke Evans Excerpts

Tuesday 25th March 2025 Commons Chamber

[Mr Speaker]

I call the shadow Minister.

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

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

[Stephen Kinnock]

We will publish the economic analysis imminently. He mentioned the National Pharmacy Association, which gives me the opportunity to say that I think that the collective action that it is taking is premature, unnecessary and detrimental to community pharmacy patients. I urge the NPA to reconsider its position and wait for the outcome of our negotiations with the CPE, which will come very shortly. We will announce that very soon.

[Dr Evans]

The National Pharmacy Association, which has been waiting for months to get the answer, is advising all its 6,000 pharmacy members to reduce services and hours, for the first time in 104 years. That has never happened before under a Labour Government, or under the Lib Dems or the Conservatives, but it is happening under this Government. Its chair said:

“The sense of anger among pharmacy owners has been intensified exponentially by the Budget”,

citing unfunded national insurance contributions and national living wage increases. The Minister acknowledges that there is potential action. What contingency plans does the Department have to ensure that we keep patients safe if pharmacies close their doors in industrial action next week?

[Stephen Kinnock]

On the NPA, it has taken us a while to clean up the utter mess that we inherited in community pharmacy. That involved agreeing financial envelopes and getting into negotiations with CPE. Those negotiations have been constructive, and I am delighted to confirm again that we will soon announce the outcome of those negotiations. What we see here is the shadow Minister apparently taking the side of people taking collective action in a premature way that is detrimental to patients. They would be better off waiting for the outcome. The Government are taking industrial relations into the 21st century, as opposed to the performative nonsense that we saw for 14 years.

--- Later in debate ---

[Mr Speaker]

That concludes Question Time.

[Dr Evans]

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

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

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

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

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

[Mr Speaker]

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