Access to NHS Dentistry

Nusrat Ghani Excerpts

Thursday 22nd May 2025 Commons Chamber

[Several hon. Members rose—]

[Madam Deputy Speaker (Ms Nusrat Ghani)]

Order. Because so many Members wish to contribute and we have to conclude by 5 pm, we will have a time limit of three minutes starting from now. I call Sir Julian Lewis, who I think can manage that—I think you can do it.

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[Several hon. Members rose—]

[Madam Deputy Speaker (Ms Nusrat Ghani)]

I call Ben Maguire. [Interruption.] I call Dr Andrew Murrison.

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[Peter Prinsley]

That is certainly a suggestion that should be investigated.

We must increase the number of dentists, as we have only 24 dentists for every 100,000 people in the east of England. We also need to increase the number of training providers and training places, but even with the opening of a dental school it will take ages for there to be new dentists.

One suggestion is that we sort out the dental accreditation system. Hon. Members may not know that there are only 600 opportunities to take the accreditation exam each year, but there are 6,000 people planning to take the exam—that will take 10 years. We must get the General Dental Council to increase the number of exam opportunities.

We have begun to address this political emergency, but we must go further with a clear and fair offer focusing on what the Minister described as the triangle of patients, practitioners and the public purse, providing a service that ensures that we give excellent, affordable care for all, including prevention, especially for the most vulnerable, and in a way that means we can pay for it. NHS dentistry can be saved. Let us have a sign on the door saying, “Urgent NHS dental appointments available here.” Would that not that be great?

[Madam Deputy Speaker (Ms Nusrat Ghani)]

I call the Liberal Democrat spokesperson.

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[Dr Chambers]

I absolutely welcome that fantastic initiative.

I visited two dental practices in Winchester, and both told me exactly the same thing: they want to do more NHS work, and they want to be there for their communities, but because of the current NHS dental contract they simply cannot make it financially viable. They are effectively subsidising their NHS patients with income from private work. The British Dental Association estimates that private dentistry in England cross-subsidises NHS care to the tune of £332 million a year, which is due to rise to £425 million if NHS practices are not offered any help with the tens of thousands in additional staff costs brought in by the increase in national insurance. With the NHS work they do perform, they do not have time for the education—the proactive, holistic healthcare— that they want to do. Instead, they have to get people through in a quick turnaround. I say this clearly: dentists are not the problem. They are doing their best within a contract that is outdated and damaging.

I also want to speak to something that is often overlooked in this conversation: oral health is not just about teeth. I know that my dentist colleagues, as in veterinary practice, routinely identify serious conditions such as oral cancers and squamous cell carcinomas during routine dental checks. Those cancers are often aggressive but spotted early, they can be treated. We also know that infections in the mouth can lead to things such as endocarditis, which is not a trivial condition, and there is good evidence that periodontitis can contribute to the onset of dementia. How many cancers are we missing? How many heart problems are we not avoiding by not having routine dental checks?

I will sum up now as I know that we are pushed for time. The Liberal Democrats will continue to fight tooth and nail for an NHS that includes dentistry. I managed to avoid making any jokes about equine dentistry, and Members will be glad to hear that straight from the horse’s mouth. We do not want NHS dentistry to be an afterthought; it has to be a core part of a truly universal, holistic health service. Everyone deserves access to routine dental care. Many Members have said that they live in areas that are dental deserts, where NHS dentists are rarer than hen’s teeth. It is clear that we have cross-party consensus. Let us get the dental contract reformed and let us make this Parliament the last one during which anyone has to extract their own teeth.

[Madam Deputy Speaker (Ms Nusrat Ghani)]

I call the shadow Minister.

Mental Health Bill [Lords]

Nusrat Ghani Excerpts

2nd reading
Monday 19th May 2025 Commons Chamber

[Neil Coyle (Bermondsey and Old Southwark) (Lab)]

I add my thanks to the Secretary of State and his whole ministerial team for bringing forward this crucial legislation so early in this Government, alongside other positive measures to fix our NHS. It was Labour that built the NHS and saved it in 1997, and here he is with his team, fixing our crucial NHS.

I serve a community, in Bermondsey and Old Southwark, with a higher prevalence of mental health conditions and psychoses. We are fortunate to have South London and Maudsley NHS foundation trust on our doorstep. This legislation will be crucial for the service professionals working on the frontline, as well as all those who need support. My borough of Southwark has additional help, funded by Southwark’s Labour council and our integrated care board, including direct access to help through online systems, and a drop-in hub for young people—a means of support that allows them to avoid GP wait times and delays in accessing help. I am glad that this legislation adopts a similar principle of ensuring early access to help, but despite the additional support in Southwark, as the local MP, I see the impact that poor mental health has on people’s lives, which are blighted by ill health and discrimination. I am acutely aware that just 5% of people with schizophrenia are in employment, for example. This Bill offers a chance to tackle some of the issues, but it is overdue.

I look forward to working with local organisations and people with direct experience, including trade unions in mental health services, carers, Blackfriars Settlement, food banks, and the drop-in clubs that support people with mental health conditions throughout Southwark, which are doing fantastic work, often on a shoe-string budget. As the constituency MP, I also see the impact on whole neighbourhoods if someone’s ill health causes them to behave erratically, and sometimes antisocially—noise and drugs are often interrelated issues. There can also be police involvement, following cuckooing by criminals who take advantage of vulnerable people. I hope that the Bill will challenge that growing phenomenon. It would be good to hear from the Minister whether communities—including landlords and neighbours, where appropriate—can trigger interventions to support people in crisis.

Just two weeks ago, I joined a ride-along with the police 999 response team. Some might say that it was not the first time I had helped the police with their inquiries. On that ride-along, which was my third with the local police, I saw again the consistent and sad overlap between what they were dealing with and mental health crises. I ended my shift with those police officers at King’s College hospital, trying to seek support for one ill man. I hope that the Government will retain the extension of section 135 and 136 powers, delivered in a Lords amendment. That would ensure that there was trained and qualified support, which would reduce the time that police lose. The amendment would save thousands of hours a week of officers’ time in London alone, and police could be redirected to areas where they are more needed.

Going back further, in the run-up to the introduction of the Mental Capacity Act 2005, I was working at the Disability Rights Commission, and I recall that mental health organisations were almost envious of that legislation, given the need to reform the Mental Health Act. They wondered when access to advocacy and patient-centred treatment would be delivered for people with mental health conditions. It is sad that there have been missed decades in between, but I am glad that this Bill is before us today.

The advance choice documents are a step towards a return to the greater choice and control lost in recent years, as services declined under the last Government. The use of nominated persons, as outlined by the Secretary of State, also offers a great step forward, as does access to extended use of independent mental health advocates for those in hospital. That should be automatic, as Mind has advocated. It is great that the legislation is based on the Wessely independent review and the principles underpinning it.

On a more personal level, and going back even further, the reason I became more aware of politics was my mum’s diagnosis of schizophrenia in the early ’80s—at roughly the time when the Secretary of State was born. Then, Rethink was still called the National Schizophrenia Fellowship. Mum has been through the mill in the decades in between. I will not suggest that she has been detained more times than I have had hot dinners—hon. Members can see by my waistline that that is not true—but the fact that the Mental Health Act has not been updated since then is appalling. When I joined the Labour party in the early ’90s, I never dreamed that I could play a part in improving legislation as an MP. I want to flag a couple of concerns, based on family experiences.

Recently, Mum told us that she believed she worked at a bank. That was news to us in the family—no doubt, it was news to the bank—as she is 75 and has not had to work for some time. I can laugh about it, but it is upsetting that she is unwell; it is frustrating that the system is mad; and trying to access support for her is maddening for us as a family. Her GP denies that she is unwell and refuses to see her. The last time this happened, she was sectioned for six weeks until she was back in rude health—and believe me, she was very rude when she came out.

South London and Maudsley NHS foundation trust estimates that it costs £3,000 a week to keep someone in hospital until they recover. NHS England has put a figure of £20,000 on detaining someone with schizophrenia until they are well. Those costs are avoidable if GPs act faster. Will the Bill result in better trigger points? This is not about artificial intelligence; it is about using known data in the system, so that there is access to supportive interventions that help individuals who have a mental health condition; help their family avoid the pain and suffering that they share when an individual is unwell; save a community the misery of associated antisocial behaviour or other problems; potentially save the police a fortune, as a result of their no longer having to accompany people to hospital for treatment, where that can be avoided; and, of course, save the NHS thousands in avoidable hospitalisation and in-patient treatment.

GPs can be part of the solution, but too often, they pass the buck and avoid the issue, as the Gardenia surgery in Luton does, pretending that everything is okay, despite prescriptions being uncollected, which leads to the inevitability of mental ill health rising fast. I hope that the Bill will lead to better community care, as the Secretary of State has outlined, but I also hope that GPs and pharmacists will be supported in triggering outreach work from mental health trusts when someone does not collect their repeat prescription, for example. I hope that it will be confirmed clearly that this will be in the legislation, or that the Government will indicate a willingness to accept an amendment along those lines.

My final, linked point is that the Bill should come with Government targets for reduced readmissions and sectioning. If the Bill is successful, people will not be discharged and readmitted in quick succession, and patients known to the system will not require routine, cyclical readmission. With the right support, the dysfunctional system can be replaced. That will have huge benefits for people’s mental health, and will mean huge savings for the NHS. There were, I think, 52,000 detentions last year. I hope that the Government will set out how that figure will fall.

I really look forward to supporting the Bill’s progression. The Bill will be transformative for the people I serve in my community, and the people I love in my family. It will be transformative for millions of people across the country—people with mental health conditions, their families, carers and service professionals—and, if it is done right, it will save the NHS a fortune, too.

[Madam Deputy Speaker (Ms Nusrat Ghani)]

I call the Liberal Democrat spokesperson.

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[Chris Coghlan (Dorking and Horley) (LD)]

Eight months ago, in my maiden speech to Parliament, I said that Fiona Laskaris would succeed in changing the law that prevented her from saving her autistic son, Christopher, from murder. I am here today to honour that commitment. We are on the cusp of changing the law. We have got this far thanks to the National Autistic Society; MPs from across the Chamber working together to overcome injustice, including the right hon. Member for Godalming and Ash (Sir Jeremy Hunt), the hon. Member for Rotherham (Sarah Champion), the right hon. Member for Leeds South (Hilary Benn) and my right hon. Friend the Member for Kingston and Surbiton (Ed Davey); steadfast support from my party, the Liberal Democrats, and support from the Prime Minister and the Government, in a way that represents Parliament at its best; and Elisa Menendez and Romilly Weeks from ITV, who ran the story. Above all, we got this far because of the courage and determination of Fiona Laskaris to save others from the fate that befell her son, Christopher. Fiona and Cara, Christopher’s sister, are in the Gallery.

Christopher was not unlike many autistic children. He was a sensitive, intelligent, loving and compassionate boy, who once asked his mum to stop on the way to school to rescue a lamb that was stuck in a fence. I first met Fiona when I was eight. I stayed in my bedroom and ignored her, perhaps because I was angry that she was buying my home off my dad; my mum had died when I was a few months old, and I was a sensitive boy. Well, they moved in; Christopher grew up in my old bedroom, and he loved the house as much as I did, but as a young man living alone in Leeds, he struggled. Despite Fiona pleading for help for years, she was never able to attain for him the mental capacity assessment that he needed to determine his support requirements. Horrifically, he was exploited and murdered by a man who had just been released from jail. Christopher was 24. We are working with the Government on an amendment to the Bill to ensure that the views of family members are considered when determining an adult’s requirements for a mental capacity assessment.

Christopher’s story is not unique. King’s College London found that in 2022 alone, there were 95 preventable deaths of people with autism and learning disabilities in cases in which the Mental Capacity Act 2005 had not been correctly followed. It can be hard to grasp the scale of the special educational needs and disabilities crisis in this country, but tens of thousands of SEND children are out of school, including 1,800 in Surrey alone. We are losing autistic children, including my constituent Jennifer Chalkley, to avoidable suicide, and, at worst, we are abandoning autistic people in their 20s to murderers; we are failing a generation. How we answer their call for justice will serve as a measure of who we are, and I believe the answer is less a matter of money than of leadership. We know from Nobel laureate James Heckman that early intervention is exponentially more effective and economical in today’s brutalised system, which has cost the lives of Christopher, Jennifer and too many others.

Although this amendment is only a small part of the answer, it can save lives. If one grieving mother can change the law, perhaps we can change the other things, too. If we succeed, it will be above all because of the voices of broken but unbeaten parents, like Fiona, demanding change. Although Christopher had a difficult life, he had the most precious thing that any man can have: a loving and devoted mum. It is up to us to ensure that Fiona is a witness that in our country, it is possible for the vulnerable to be heard, for injustice to be overcome, and to find, beyond grief, hope.

[Madam Deputy Speaker (Ms Nusrat Ghani)]

That was a very moving speech.

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[Jen Craft]

I will come to that point a little later, but that confinement is detrimental to their mental health. It can sometimes be hard to pick apart a co-existing or co-occurring mental health condition from the behaviour exhibited within that environment. This is part of the reason that it is all but impossible for some detained individuals, in the circumstances they are in, to demonstrate the behaviour change they need to prove they have become sufficiently well to be released.

My attention was drawn last year to the case of a young woman called Bethany, who was detained for the best part of half a decade under the Mental Health Act. She is an autistic young woman whose parents believed that her entering a secure unit was the best choice. However, she ended up being locked up for days, weeks and then months on end in a room with only a mattress on the floor. She was unable to see her family or her support network, and her parents were absolutely devastated at being unable to get her out of that environment and seeing her continually deteriorate. It is hard to imagine the anguish of people seeing someone that they love go through this. When this happens to someone or their family, how on earth can they ever again trust the system that put them there? Learning disabled people and autistic people who have been through that have their confidence in accessing support taken away. In turn, that can create a vicious cycle.

I strongly welcome the moves that this Bill makes towards removing learning disability and autism as a reason alone for detention. However, similar to my hon. Friend the Member for Sittingbourne and Sheppey (Kevin McKenna), I note that the Government have said that these changes to detention criteria will only be switched on when systems can demonstrate a sufficient level of community support. That is a source of real concern. As the NHS Confederation has warned, the

“success of the reforms will be dependent on the wider infrastructure to support”

the Bill. As others have said, there is no clarity on what a sufficient level of support means in practice. We do not know where we are heading or when we will have got there.

The most successful support for learning disabled and autistic people to live independently in their communities is integrated care that encompasses health, housing, occupation and much more besides. I would welcome the Minister’s assurances on how that will be delivered in the timescales set out and how we get from where we are now to where good is. The continual detention of people in this way should shame us all, and an end to that cannot come fast enough.

I sound a note of caution—I think this is fairly similar to that of the hon. Member for Runnymede and Weybridge—that the legislation continues to allow for the co-occurrence of mental health conditions to be a reason to detain someone with a learning disability and autism. That in and of itself could lead to this continual cycle where people are detained for longer than is necessary for their treatment while in an environment that is entirely counterproductive to them becoming well. We also need those with a specialism in learning disability and autism to be present in assessing whether an individual also has a co-occurring mental health condition.

Finally, I put a plea in to the Minister that there is a real need for those who live with a learning disability or autism to be properly consulted. A number of disabled people’s charities that are run by people with a learning disability, such as the “Bring People Home from Hospital” campaign, which is operating under the auspices of Inclusion London, do not feel that they have had sufficient opportunity to input. A very minor point is that some relevant documents related to this legislation have not been printed in easy read. If they have, it has taken a while for them to arrive. People who have a lived experience of these conditions are unable to contribute in a meaningful way.

More broadly, I welcome the legislation’s attempt to make progress in putting patient voice at the heart of care, particularly through advance choice documents, but there is scope to go further. The Royal College of Psychiatrists is advocating for a statutory right to an advance choice document, which the pre-legislative scrutiny Committee also recommended. That would ensure that all patients who would benefit from one would get one, with the aim of reducing detentions and involuntary treatment. While I recognise the importance of this step and this legislation alongside the Government’s investment in mental health crisis centres, a pledge to recruit 8,500 mental health staff and the Secretary of State’s commitment to the mental health investment standard, there is a desperate need to transform community mental health services to put patient voice and experience at its heart and avoid the need for detention orders in the first place.

As a member of the Health and Social Care Committee, I have had the privilege of hearing from some extraordinarily courageous individuals who shared their experience of living with a serious mental illness. It is in that same spirit that I will share my own experience now. I hope that it offers an insight into the limitations of our current system.

I was diagnosed with obsessive compulsive disorder as a teenager, and with bipolar disorder in my 20s. In two and half decades with these conditions I have received good care, but sadly that is the exception and not the rule. I have never been asked what it is that I want from treatment, what it is that I want for my life, and how I can be helped to get there. I have received care that is patronising, reductive, inconsistent and non-existent. During mental health crises I have had to tread a fine line between proving that I am ill, and sometimes extremely ill, and proving that I am not so ill that I need to lose my liberty, because I know that more often than not, treatment is based not on therapeutic care but on risk management. Like thousands of others, I have had to create my own care package and my own route to treatment, because I made the decision that I deserved to live, and I deserved to live well—and also that my children deserved their mum. However, I am very aware that my ability to do this is based on a number of privileges, in no small part a very supportive family, which so many do not have.

While I welcome the Bill for its advances in reducing the amount of detention and increasing the agency of those who are detained, I must call for a significant overhaul of community mental health services to prevent crises from occurring in the first place. We know that we can and must do better. I ask all Members to note that when we discuss people’s serious mental illnesses, we often talk as though they were “others”, which they are not. Let me say this: “There is someone standing here among you, a Member of Parliament, who has a serious mental illness. It does not prevent me from doing my job or from living my life; in some ways, it makes me better at it.” While the Bill continues its passage through Parliament, can we please bear in mind that we are talking about individuals, and individuals who will be affected by it, and that what we seek to do—and what I hope we will accomplish—is give people who live with serious mental illnesses the ability and the right to live the best lives that they possibly can, with all the support that we can make available?

[Madam Deputy Speaker (Ms Nusrat Ghani)]

The hon. Lady’s family must be very proud.

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[Several hon. Members rose—]

[Madam Deputy Speaker (Ms Nusrat Ghani)]

Order. I want to retain the tone of this debate, but to get everybody in, we will have a speaking limit of seven minutes, which is still quite a long time.

Parkinson’s Awareness Month

Nusrat Ghani Excerpts

Thursday 1st May 2025 Commons Chamber

[Patricia Ferguson (Glasgow West) (Lab)]

I congratulate my hon. Friend the Member for Dunfermline and Dollar (Graeme Downie) on securing this important debate at the end of Parkinson’s Awareness Month.

I would like to begin by paying tribute to my old friend and former colleague Margo MacDonald, SNP Member of this House briefly in the 1970s and Member of the Scottish Parliament for the SNP and as an independent from 1999 until her death in 2014. Anyone who knew Margo will remember that she was a force of nature and that anything she did was done with her typical determination, wit and good humour. I credit Margo with my limited understanding of Parkinson’s and its variability, because for all the time she was in the Scottish Parliament she had Parkinson’s, but it did not stop her being one of the most effective communicators and advocates for her constituency.

In my constituency, some 222 people are believed to be living with Parkinson’s as we speak. I want to thank those who care for them—professionals, family members and volunteers alike—for their hard work and commitment. As we have heard, there is no cure for Parkinson’s, and current treatment can manage only some of the symptoms. It can be a frightening disease, and one that can lead to depression and despair.

In Scotland alone there are approximately 30 new diagnoses every week. In 2024, Parkinson’s UK in Scotland produced an excellent report called “Scotland Can’t Wait”. In the report, Parkison’s UK in Scotland highlighted the many challenges that people with Parkinson’s currently face and the problems that will arise if the challenge of the increasing number of people being diagnosed is not addressed. The report drew on experience and robust data and makes some very important points.

It highlights that investing in professional staff who can offer the kind of specialist treatment that people with Parkinson’s need would be an important step forward. Existing staff are already stretched, and if action is not taken soon they will be pushed to breaking point. Ensuring that people get the appropriate medication when it is needed, whether they are in hospital or at home, is also vital. Crucially, the mental health impacts of Parkinson’s need to be addressed, including Parkinson’s dementia, which can be frightening for patients and their families.

A recent freedom of information request revealed that since the year 2020, less than half a million pounds was spent by the Scottish Government on research into Parkinson’s disease. By my calculations, that is something like £34 per person suffering from the disease in Scotland. That seems to me to be a woeful amount of money. I recognise that the effort to find a cure for Parkinson’s will inevitably have to be a global exercise, and one that this Government, I am sure, will want to play a large part in. But everyone has to get their act together and up their game, including the Scottish Government. At the end of the day, we want to find a preventive approach to Parkinson’s, but a cure along the way would be helpful too.

Parkinson’s UK in Scotland called its report “Scotland Can’t Wait”, and rightly so. The 30 people diagnosed every week cannot wait, and the 222 people in Glasgow West certainly cannot either. It is time for Governments on both sides of the border to act and work with Parkinson’s UK and Parkinson’s UK in Scotland to ensure that we do better for people with Parkinson’s for their families and the staff who support them. Parkinson’s UK has shown us the way; it is now time that we follow it.

[Madam Deputy Speaker (Ms Nusrat Ghani)]

We now come to the Front Benchers. I call the Liberal Democrat spokesperson.

[Alison Bennett (Mid Sussex) (LD)]

I thank the hon. Member for Dunfermline and Dollar (Graeme Downie) for bringing forward this important debate, and I thank all Members who have contributed. Everyone has made excellent contributions that were thoughtful and moving.

Right now in the UK around 153,000 people are living with Parkinson’s, and that number is set to increase to 172,000 by 2030. Richard from Burgess Hill in my constituency is one of those many thousands. I count Richard as a friend; he is someone I greatly admire for his courage and tenacity. I was lucky enough to speak to him recently and get a brief insight into his life with Parkinson’s. He told me that something he has noticed since his diagnosis is increased anxiety. He says that he now gets anxious about everyday things in a way that he never used to. He also said that the part of experience he has found most depressing is knowing that it is, in his words, “a one-way street”, where his condition can only be managed by using ever-increasing levels of medication.

From even a short conversation with Richard, it is clear just how complex people’s experiences can be. It is also clear to me that we need to do better, as many hon. Members have said, and that we have solutions already but we just need to get on with it. Parkinson’s is the fastest-growing neurological condition in the world. It is progressive, it fluctuates, and it affects everything from movement, swallowing, sleep and speech through to mental health. There are over 40 symptoms, and each person’s experience is unique. Half of those living with the condition, like Richard, experience anxiety or depression, and up to 60% can develop psychosis. They are also six times more likely to develop dementia.

Parkinson’s UK has identified some of the major failings in care today. They include long waits for specialists, a lack of access to expert multidisciplinary teams, people not getting their medication on time in hospital, and limited mental health and dementia support. There is also a postcode lottery when it comes to advanced treatments such as Produodopa and deep-brain stimulation. Those failings have consequences: unplanned hospital stays, severe complications and worsening mental health. Parkinson’s costs the UK an incredible £3 billion a year. In England alone, unplanned hospital admissions cost £277 million. So this is not only a health crisis but one with significant economic impacts.

I and my Liberal Democrat colleagues believe that the system must change urgently and that the Government have to act. First, we have got to fix the basics. To do that, we need to review the medicines supply chain. People with Parkinson’s must get their meds on time. We also need to expand the MHRA’s capacity, reversing the 40% workforce cut, and reducing the time for treatments to reach patients.

Secondly, we need to put care and support front and centre. We can do that by giving people with Parkinson’s access to a named GP—someone who knows their story and their condition—and by making mental health a priority, not an afterthought. That means regular mental health check-ups, easier access to services through walk-in hubs and restoring the mental health and dementia care targets that the Government have abandoned.

Thirdly, the Government must step up and support carers. Behind every person with Parkinson’s, there is often someone else who cares for them; someone who is quietly exhausted. We must provide respite breaks and ensure that carers have access to paid leave. We need to fix the broken social care system once and for all. It is time for those cross-party talks—no more delays. As I have said in this place before, we will clear our diaries to get those talks happening. This issue is simply too important for diary clashes. I wonder whether the Minister can give us any clarity and a date on those vital talks.

Finally, we have got to help people live and work with dignity. I and my Liberal Democrat colleagues are campaigning for: a new right to flexible work; better accessibility standards for public spaces; a stronger blue badge framework; the incorporation of the UN convention on the rights of persons with disabilities into UK law; and the closing of the disability employment gap. We can do that if we implement a dedicated strategy for disabled workers, simplify the application process and introduce adjustment passports so that workplace support follows the person, even if their job changes.

This is a health issue, an economic issue and a social justice issue. As others have said, it is about human dignity. We owe it to people living with Parkinson’s that we must do better, not some day but now. Let us build a future where those with Parkinson’s like Richard get the proper help and support they deserve.

[Madam Deputy Speaker (Ms Nusrat Ghani)]

I call the shadow Minister.

Hospitals

Nusrat Ghani Excerpts

Wednesday 23rd April 2025 Commons Chamber

[Matt Turmaine (Watford) (Lab)]

I draw attention to my entry in the Register of Members’ Financial Interests. I welcome this Opposition day debate on hospitals and the state of the NHS, which is on its knees after 14 years of mismanagement by the previous Government, but I find myself blinking in the dappled light of a new reality.

Reading the motion as drafted, one could be forgiven for thinking that an unchallenged Tory Government over the last 14 years alone were responsible for the chaos that we witness but, pinching myself to wake from the dream, I recall that the Liberal Democrats were part of that Government for five long years. They may want to forget about it, but we remember it. We remember the rose garden, where the blue Tories and the yellow Tories harmoniously, hand in hand, drew up their plans to devastate our health and social care public services through the austerity programme. We remember the bedroom tax, which was voted for multiple times by the Liberal Democrats. We remember the Lansley reforms and the Liberal Democrat spokespeople squirming in television interviews as they tried to justify the chaos into which they were about to plunge the NHS.

Under the previous Labour Government, we had the highest satisfaction levels and lowest waiting times, but what we inherited in July last year was an unmitigated disaster. The Tory-Lib Dem coalition tore up the last Labour Government’s plans for a new hospital in my constituency as part of the austerity programme. The staff at that hospital do a remarkable job, and I put on record my gratitude to them, even when I was wandering around dressed as a giant bunny rabbit on Sunday.

The Tories and the Liberal Democrats—nobody else—are responsible for the 14-year delay in getting a new hospital in Watford. If they had not done what they did, we would have had a new hospital by now, but we do not. Not a brick has been laid. They should hang their heads in shame at this total betrayal of Watford’s residents. The new hospital programme was not funded beyond March, and as the Prime Minister said in response to my question to him a few weeks ago, the hospitals existed only in the imagination of Boris Johnson.

I welcome this motion recognising the devastating state of the NHS, but let us be acutely aware that responsibility for that lies with the Liberal Democrats, who table this motion, and with the Conservatives in the previous Government. It is all very well to want to magic a hospital out of thin air, but it will be this Labour Government who finance and deliver it.

[Madam Deputy Speaker (Ms Nusrat Ghani)]

Picturing the hon. Member in a rabbit outfit has woken us all up.

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[Clive Jones (Wokingham) (LD)]

I am proud to declare my interest as a governor of the Royal Berkshire hospital. The Royal Berks is an incredibly important place for me. I have been treated there many times, friends and family work there, and my constituents rely on the dedication of its hard-working staff. The way that this important community asset was treated by the previous Conservative Government is a scandal. They have left a record of broken promises and a building that in many places is literally crumbling.

Looking at the Conservative legacy, before the 2024 general election, they introduced a seven-year delay to the construction of the new hospital in 2023. That is a seven-year delay for something that was never funded in the first place. The Conservatives’ dithering and delays have resulted in £7 million being wasted at the Royal Berkshire hospital on surveys, investigations and the development of a hospital programme that was never going to go anywhere, and the Conservatives knew that all the time. Their behaviour over the last five years has been shameful, and they have deceived my constituents.

My hon. Friend the Member for Henley and Thame (Freddie van Mierlo) has highlighted many of the issues at the Royal Berkshire, so I will not repeat his points, but there is a maintenance backlog amounting to £102 million, and staff have recently told me that an additional £300 million is needed for maintenance. Will the Minister confirm that there will be a proper maintenance programme for the next 20 years? I have to thank her for her guarantee that when the Royal Berkshire NHS Foundation Trust requires funds to purchase land for the new site, her Department will provide those funds. I would be grateful if she could confirm that that position has not changed, and also that the planned cuts and savings at the trust to balance its budget will have no impact on its ability to deliver vital maintenance at the hospital site.

[Madam Deputy Speaker (Ms Nusrat Ghani)]

I call Danny Chambers to wind up the debate for the Liberal Democrats.

--- Later in debate ---

[Karin Smyth]

On a point of order, Madam Deputy Speaker, could you advise me whether it is in order that the hon. Member for Sleaford and North Hykeham (Dr Johnson), who opened the debate for the Conservatives, was not in her place for the close of the debate? I think that is discourteous to the House, and I would like your advice on how we rectify this matter.

[Madam Deputy Speaker (Ms Nusrat Ghani)]

The point of order is most definitely on the record. It is a point of courtesy to be here for the close of a debate if you are here for the opening. No doubt, Opposition Front Benchers will make that very clear to the Member.

NHS Pensions

Nusrat Ghani Excerpts

Tuesday 1st April 2025 Commons Chamber

[Karin Smyth]

It is important that people have confidence in the pension system. That is why we took action in July on coming into office to understand the depth of the problems that occurred under the previous Government. This is a complicated issue, which is why we want to be clear with people that there will be no financial detriment to them. We will continue to work with employers and trade unions to ensure that the issue is resolved as quickly as possible, in line with the timelines I have outlined.

[Madam Deputy Speaker (Ms Nusrat Ghani)]

I call the Liberal Democrat spokesperson.

[Helen Morgan (North Shropshire) (LD)]

The delays will be deeply worrying and will make financial planning very difficult for those affected, all of whom are people who have dedicated their working lives to supporting the NHS and tirelessly saving lives. NHS workers and their families are being left in the dark by Government delays and may as a result miss out on using their full allowances, which is unacceptable—they deserve better.

The revised delivery plan prioritises members based on their likelihood of facing financial detriment, so clearly some financial detriment is expected for those who are impacted. Can the Minister estimate what the likely financial detriment is of missing the statutory deadline, or how much compensation, as she just mentioned, is likely to be paid? Can she tell us why the NHS Business Services Authority has failed to meet the deadlines? In response to a written question from my hon. Friend the Member for St Albans (Daisy Cooper), the Minister said that there are 112 people working on it. Will she confirm whether that is likely to be sufficient to ensure that future deadlines are met?

Tobacco and Vapes Bill

Nusrat Ghani Excerpts

Report stage
Wednesday 26th March 2025 Commons Chamber

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

The right hon. Member might be forgiven for thinking that we are starting from a zero-sum game, but we already have restrictions, as people must be 18 to purchase cigarettes and vapes. Shop workers are already challenging customers on their age, so the regulations do not come from nowhere. Secondly, if you read the Bill, you would know that there is a date specified that would be very clear on identification—

[Madam Deputy Speaker (Ms Nusrat Ghani)]

Order. Interventions should be short and the term “you” refers to me in the Chair.

[Sammy Wilson]

It is easier to distinguish between a 16-year-old and a 24-year-old. Usually, the younger the age, the easier it is to make that determination, but it is much more difficult when people are older, yet that distinction will have to be made.

The idea may be that the cost of the licence will be so expensive that many small retailers will be squeezed out of the market, and the only outlets will be bigger stores where there are security guards. However, the sale of tobacco provides an important part of the income of many small retailers. Whether we like it or not, we are putting a burden on people who will find that they are exposed to dangers and difficulties, and will be subject to the law if they make the wrong decision.

The second issue, which has been touched on today, is what happens when people cannot get the tobacco that they want. Where do they go? They go to people who are prepared to sell it to them illegally. We cannot run away from the fact that the sale of illegal tobacco is already lucrative, especially because of the tax increases that we have introduced. It is lucrative for criminal gangs and it funds many of their activities. We have heard statistics that 7% of cigarettes and 33% of rolling tobacco are already sold by criminal gangs. In Northern Ireland, it is probably far higher because paramilitaries were involved in the trade and used it to fund their activities for so long. If anybody thinks, “Oh well, we’ll deal with that problem when it comes,” look at the history of Northern Ireland, where hundreds of millions of pounds found its way into the coffers of terror gangs and action was not taken, because it was sometimes too hard or too difficult to trace the things. Yes, action has now been taken, but do not think that we are going to have an all-out assault on the booming industry that this legislation will produce.

My last point about the Bill being impractical is that it cannot apply in Northern Ireland because, as part of the EU single market, we are under the tobacco products directive. The Irish Republic tried to introduce similar legislation and found that it could not because of that directive. That is why we have tabled new clause 3, challenging the Government to amend the Windsor framework so that the legislation will apply across the United Kingdom. This is not a counsel of despair because I believe that there is an alternative, as set out in the amendment. Indeed, the Government’s own modelling suggests that a much more practical way is to set the age limit at 21.

If the figures and the modelling are correct—although there are questions about the tobacco modelling on doing away with smoking in a generation—and if we impose the age limit of 21, which avoids some of the problems we have talked about with the sale of tobacco, we reach zero consumption by 2050, just as we do with the generational model. That avoids many of the problems and difficulties I have outlined and the consequences for retailers, rather than rushing into this. It is a headline-grabbing measure, but it has not worked elsewhere. Why did New Zealand drop it? Because of the booming market in illegal tobacco. I believe that in a number of years, we will find that we made the same mistake.

--- Later in debate ---

[Sir John Hayes]

I tell you, there are two things about this legislation—

[Madam Deputy Speaker (Ms Nusrat Ghani)]

Order. “I tell you”? Sir John Hayes, you should know better than that.

[Sir John Hayes]

I said “two”. I said that there were two things about this legislation.

[Madam Deputy Speaker]

I think it was “you”, but no matter—time is short.

[Sir John Hayes]

Well, let me rephrase it. I tell you, Madam Deputy Speaker, that there are two things about this legislation—I have got it right now—and the first is its core objective and the second is the means by which that objective is met. I am, at the moment, talking about the means by which it is met, and I will say a little more about that when I address some of the amendments in my name and those of other Members. When we pass measures in this House—when we make laws—we should concentrate on both their purpose and their effect. If we do not do that, we are not doing our job as lawmakers. My concern about the Bill is that the effect will be compromised by the means, regardless of its purpose.

I entirely endorse what was said by my hon. Friend the Member for Gosport (Dame Caroline Dinenage) about plastic filters. I think that her new clause 2 would be a helpful addition to the Bill, and I should be amazed if the Minister did not embrace and adopt it. Perhaps it could be tabled as a Government amendment, but we may vote on it later. I am sure that the Government Whips will want to whip their Members to support it, because it is environmentally right, terribly sensible and entirely deliverable. It would oblige the industry to do the right thing and create filters that are biodegradable and which, as we heard earlier, are produced in immense numbers.

I have mentioned amendment 4, in the name of the right hon. Member for East Antrim, which deals with this nonsense of the rolling age of consent. It is a straightforward amendment that proposes that the age of consent should be 21—a considerable increase on where we are now—and that retailers must observe that. The hon. Member for Falkirk (Euan Stainbank) said that the matter was already being dealt with because there was already an age of consent. Yes, there is one age of consent, but not a series of ages of consent, with the need to assess people’s age presumably by some formal means. Perhaps they will have to take their passports with them every time they go to the newsagent to buy their papers and their ounce of Golden Virginia, or whatever else.

--- Later in debate ---

[Several hon. Members rose—]

[Madam Deputy Speaker (Ms Nusrat Ghani)]

Order. I apologise to all Members, but we will now have a speaking limit of five minutes.

[Tristan Osborne]

I appreciate that you want to guillotine speeches to five minutes, Madam Deputy Speaker.

It is a pleasure to speak on the Bill and, as a member of the Public Bill Committee, to see it come before the House. I welcome the contributions of Members across the House, and the quality of the scrutiny we saw in the Public Bill Committee. I also want to reflect on the years of campaigning and service undertaken by Ministers and shadow Ministers that have brought us to this place, and on the advocacy in broadcasts and on the news of people who were smokers but who say that they never should have started. I also welcome the views of young people in my constituency who, when speaking to me at schools and colleges, have told me how vapes are becoming more pernicious and more commonplace in their lives.

I will speak to Government new clause 11 and new clause 6 on age verification and the rising escalator, and I will challenge some of the points made about enforcement. I will also talk to new clause 13 on education and a road map to a smokefree generation, and to new clause 19, which sets annualised reporting on nicotine-based products. I will also challenge some of the Opposition’s misconceptions about trading standards and the regulatory landscape.

The Bill is forward thinking and responds to an issue, but it builds on previous legislation over many years and best practice in other places and other countries to regulate and reduce smoking. We know that noble crusaders on public health have in the past taken action to clean our air, clean our water, and introduce seatbelt restrictions and food standards. We know that public health measures work. Smoking is the largest preventable cause of illness and premature death in the United Kingdom, killing about 80,000 people a year. It is estimated to cost £2.4 billion to the NHS and a further £1.2 billion in costs every year, with smokers five times more likely to need social care support at home. The annual economic productivity loss adds up to £27 billion. Not only is there an ethical and social motivation behind the Bill; there is an economic one as well.

Age verification was a topic of debate in Committee. I welcome Government new clause 11 and new clause 6 on age verification. Government new clause 11 introduces digital identification, and links in with Government legislation to introduce digital ID over the next five years. This is absolutely enforceable. In many off-licences and supermarkets today, age challenge happens at bespoke counters. Individuals under the age of 18 who try to purchase vapes or tobacco-based products are challenged on their age. All the Bill will do is introduce a fixed date, which can then be assessed using any form of digital ID. It is no more onerous than what is currently happening, but it will require training and a transition period. I challenge the comments made by some opposing the measure that it is somehow unenforceable. We already enforce age restrictions on the sales of products—it already happens.

Male Suicide in Rotherham

Nusrat Ghani Excerpts

Monday 24th March 2025 Commons Chamber

[Amanda Martin (Portsmouth North) (Lab)]

rose—

[Madam Deputy Speaker (Ms Nusrat Ghani)]

I believe the hon. Lady has permission from the hon. Member for Rother Valley (Jake Richards) to make a brief contribution.

Rare Cancers Bill

Nusrat Ghani Excerpts

2nd reading
Friday 14th March 2025 Commons Chamber

[Patricia Ferguson (Glasgow West) (Lab)]

I thank my hon. Friend the Member for Edinburgh South West (Dr Arthur) for bringing forward this Bill. If, as we always say, politics is the language of priorities, then my hon. Friend has got his absolutely correct. I thank all Members who have shared their experiences and their stories, some incredibly moving. They should be what inspires us to take forward all the action we are proposing today.

I was struck by the fact that the hon. Member for Wokingham (Clive Jones) and I have something in common, which we probably would not want to have in common, in that we were both diagnosed with breast cancer in 2008. I have to say, my breast cancer was a strange breast cancer, and it always feels slightly strange talking about it, because no one’s ever heard of it. It is not a rare cancer as such, because it is a breast cancer, although there are some who argue it is actually a soft tissue sarcoma—whatever, it was treated as a breast cancer. It is called a phyllodes tumour.

Unlike other breast tumours, phyllodes tumours do not go into the ducts, but into the connective tissue. It presents differently from other cancers of the breast, and the treatment is also different, in that the only treatment that works is excision. Excision can be anything from a lumpectomy to a mastectomy. The hope is that there are clear margins, which mean the patient will be okay, but—and it is a big “but”—when a malignant phyllodes tumour is present, it can spread, and it can be difficult or impossible to treat. That is when it becomes a very different outcome.

I mention it today not because it is a rare cancer, but because it can be difficult to diagnose. It does not show up in a mammogram, for example, and there is no definitive explanation why such tumours occur. Some research is going on just now, but it is not conclusive as yet. A lot more work needs to happen, and because incidence is so low, it is difficult to research. The things we know about it for certain seem random to me. They tend to occur more often in the left breast. Why? I have no idea. They usually occur when a patient is in their 40s. As I have said, they do not seem to respond to chemo or radiotherapy, and they are not thought to be genetic or hormonal.

The reason I mention my case is that it can be a lonely thing to have an unusual cancer. When trying to explain it to family and friends, you say, “No, it did not show up in a mammogram. No, I am not getting chemotherapy or radiotherapy. No, I do not know why it happened. No, I had not heard of it either.” You begin to doubt yourself a little, and you begin to question what is actually going on. For someone with a very rare cancer, it must be incredibly difficult when there is not a background of research, not anything that they can read, and no one can give them a pamphlet about it and tell them what is happening.

It seems to me that we should know more about cancer full stop. We have got to 2025, and we know some things about cancer. We know how to treat some cancers, but there are so many others that we do not have the answer for. We need people to be diagnosed more quickly, which means that we have to have the research. We need people to have the best possible treatment, which means we have to look at the drugs and find out what works and what does not work, and where a drug can be transferred from one thing to another successfully. Crucially, we have to know why it is that some people get cancer and others do not.

This Bill will make a huge difference to the lives of some of the people we have heard about today. For some, as we know, it will not be soon enough. It is the responsibility of every single one of us to make change happen, and we have an opportunity today to take that step forward. My hon. Friend the Member for Mitcham and Morden (Dame Siobhain McDonagh) spoke about her sister, Margaret, who I worked with for a time in the Labour party. While I was listening to the other speeches, I was reflecting on what my hon. Friend said. I think we all need to be angry. We need to say—to shout it from the rooftops—that change begins today.

[Madam Deputy Speaker (Ms Nusrat Ghani)]

That was very powerful. I call Leigh Ingham.

--- Later in debate ---

[Johanna Baxter (Paisley and Renfrewshire South) (Lab)]

I will be brief, because I understand that we are at the end of the debate, but I rise to support the Bill and pay tribute to my hon. Friend the Member for Edinburgh South West (Dr Arthur) for bringing it forward, and for the dignified, collegiate manner in which he has gone about things. Up to 95 people in Paisley and Renfrewshire South will be facing a less survivable cancer. That is 95 people who will wait longer for a diagnosis, will face a postcode lottery to access specialist treatment, and will be left asking why there are so few treatment options available.

The truth is that rare cancers do not receive the research attention or funding that they need. The Bill would take decisive action to change that. It would introduce measures to break down systemic barriers preventing research and innovation in rare cancers. These are not abstract policy changes but lifesaving reforms that would give patients with rare cancers greater access to clinical trials. Researchers would have better tools to study the diseases, and pharmaceutical companies would be given stronger incentives to invest in treatments that could transform lives.

Behind every rare cancer diagnosis is a person fighting for their future, a family searching for answers and healthcare professionals looking for better treatment options. We cannot allow those individuals to be left behind simply because their condition is considered rare. We have the opportunity to change that. By supporting the Bill, we send a clear message that no cancer is too rare to matter, and that no patient should be forgotten. I am proud to support the Bill and thank my hon. Friend for bringing it forward.

[Madam Deputy Speaker (Ms Nusrat Ghani)]

I call the shadow Secretary of State.

--- Later in debate ---

[Dr Arthur]

With the leave of the House, I would like to thank a few people. First and foremost, I thank the Minister for her speech. I met her yesterday, and she was filled with genuine passion, energy and excitement for this subject. It is great to see her come here today and use her power to support this Bill, and let us hope that it passes.

I thank the shadow Secretary of State, the right hon. Member for Melton and Syston (Edward Argar). Before this debate, people told me that he was respected across the House, and he has shown why. I must also thank my hon. Friend the Member for Crawley (Peter Lamb). People in the Gallery will not know this, but he has worked really effectively, right throughout the debate, to ensure that all the people who wanted to speak could do so. I thank him for that.

I thank the Whips and the Speaker’s Office for managing the debate sensitively, because this is quite a difficult subject, and I thank you, Madam Deputy Speaker, because it was you who pulled my ping-pong ball from the goldfish bowl. It was very skilfully done.

I wish I had time to thank everybody who spoke in the debate. Sadly, I do not, but they have my thanks and respect. They have done a great job of thanking each other as the debate has proceeded, so I thank them all. I will watch the debate again over the weekend, because it has been quite incredible and quite moving.

I thank our colleagues from the Department of Health and Social Care, who are in the officials’ box. They have been fantastic. Without them, this Bill would not have happened. Privately, there have been a few Sir Humphrey moments, but those from the Department have been absolutely fantastic, and that was very clear yesterday when I met the Minister.

I thank the charities that backed the Bill. They did not just back it; they helped get it to where it is. They were not just backing a finished product; they influenced and shaped it. I think that is why so many people are here to support it.

I thank the staff in the Public Bill Office for their patience and so much more, and I thank the staff in my office. I think Noel and Solomon are here today, but it is a team effort. Back in Edinburgh are Lucie, Salim, Xavier, Evie and Hannah. [Hon. Members: “Hear, hear.”] They deserve that.

In all the contributions today, we have heard evidence that people with a rare cancer diagnosis face great injustice, because their chances are so much slimmer and they face so much uncertainty. We have shown that we want change. We are not just being angry; we are using that anger to get even, which is really important. We talk in this Chamber, but often there is no action. Today we have talked and agreed, and hopefully there is going to be action.

[Madam Deputy Speaker (Ms Nusrat Ghani)]

That was most definitely Parliament at its best.

Question put and agreed to.

Bill accordingly read a Second time; to stand committed to a Public Bill Committee (Standing Order No. 63).

National Cancer Plan

Nusrat Ghani Excerpts

Tuesday 4th February 2025 Commons Chamber

[Several hon. Members rose—]

[Madam Deputy Speaker (Ms Nusrat Ghani)]

Order. I know that some of these contributions are quite emotional, and if people need to leave the Chamber after they have spoken, that is okay by me.

[Peter Swallow (Bracknell) (Lab)]

Ethan was just 15 and studying for his GCSEs when he was diagnosed with a brain tumour. Sadly, he passed away two years later. I had the privilege of meeting his mum, Nikki, this weekend at two events organised to raise money for brain tumour research. In Ethan’s memory, will the Minister commit himself to improving outcomes for people with brain tumours through the national cancer plan?

Women’s Health Strategy

Nusrat Ghani Excerpts

Thursday 30th January 2025 Commons Chamber

[Victoria Atkins (Louth and Horncastle) (Con)]

On a point of order, Madam Deputy Speaker. On this incredibly important issue of the women’s health strategy, and the fact that the word “woman” has been excluded from the updated planning guidance, could you help me understand this? As a common courtesy to both you and the House, when a Minister is unable to organise herself such that she can get to the Chamber on time, is it not courteous to apologise to those of us she has kept waiting before we were able to discuss this important subject?

[Madam Deputy Speaker (Ms Nusrat Ghani)]

I thank the right hon. Lady for her point of order. She is, of course, correct that it is courteous to the House for an apology to be made. Five minutes of time was wasted this morning. I think the Minister would like to make a further point of order.

[The Minister for Secondary Care (Karin Smyth)]

Further to that point of order, Madam Deputy Speaker. I absolutely, unequivocally apologise.

[Madam Deputy Speaker]

I thank the Minister.