Jhoots Pharmacy

Nusrat Ghani Excerpts

Wednesday 15th October 2025 Commons Chamber

[Stephen Kinnock]

I agree with everything the hon. Gentleman has said. It is completely and utterly unacceptable if a business such as Jhoots is not paying its staff. If there are indeed these reports that controlled drugs are not being handled properly, I would strongly recommend that any mishandling of drugs be reported to the General Pharmaceutical Council, which regulates pharmacy professionals and premises, so that appropriate action can be taken.

The hon. Gentleman asked about the payment of staff. Pharmacy staff are vital parts of the NHS part of what a pharmacy does. Pharmacy staff provide vital services to our communities and should be paid according to their contracts; any failure to do so is completely unacceptable. Of course, pharmacy staff are employed not by the NHS, but by the businesses they work for, so any dispute between staff and a pharmacy business should be raised with the Advisory, Conciliation and Arbitration Service, ACAS. I am also in touch with the Pharmacists’ Defence Association—the PDA—which is doing important work representing its members. I will be meeting them soon as well. Of course, we have responsibility for the NHS part of the work, but it is up to individual businesses to ensure that their employees are treated fairly.

The hon. Gentleman rightly mentions the review of suitability to operate, and we are now looking at that across the board. We are looking at the role of the General Pharmaceutical Council and what is taking place with ICBs taking contract action. Where there is no sign of improvement and pharmacies continue to be in breach, the next escalation is to strike them off the pharmaceutical register, which takes some time, because certain pharmacies—I am not going to name names, but I am sure the hon. Gentleman can imagine who—are trying every single thing they can to appeal, push back and stop the actions that we are seeking to take, which is elongating the process. However, I want to be clear: if there is clear breach and action is not taken to remedy that breach, pharmacies will be struck off the pharmaceutical register.

[Madam Deputy Speaker (Ms Nusrat Ghani)]

I call our very own pharmacist, Sadik Al-Hassan.

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

Thank you, Madam Deputy Speaker. As a pharmacist for nearly 20 years and the MP of North Somerset, I have the dubious pleasure of having two Jhoots pharmacies in the town of Portishead in my constituency. I cannot say two operating pharmacies, because they have shuttered their doors, with reports of them not having paid their bills, their rent or their staff. As a pharmacist, I know that this affects the perception and view of community pharmacy up and down the country. What plans do the Minister and the Department have to ensure that bad actors in the pharmacy space—as Jhoots, in my opinion, appears to be—are dealt with more quickly and effectively under new legislation?

[Madam Deputy Speaker (Ms Nusrat Ghani)]

Order. Questions should not be statements.

[Stephen Kinnock]

I pay tribute to my hon. Friend’s direct professional expertise and experience as a pharmacist. He is right to point to the fact that the regulatory framework is not as strong as it needs to be. I have spoken with officials in my Department who have worked in the pharmacy sector for many years, and they have never seen behaviour like this before. It is quite unprecedented. Nevertheless, it is shining a light on the fact that we do not have a strong enough regulatory framework. We need to look at the way that business owners are regulated. There is strong regulation of pharmacists and pharmacy staff such as technicians, but business owners are not regulated as strongly as they could and should be.

My hon. Friend is right that speed is also important, which is why we need to look at ways of fast-tracking particular cases where there is clear breach, because sometimes the appeal process can be very slow indeed. We are looking at all of this in the round, and I have commissioned urgent advice from my officials to see how we can beef up the regulatory framework.

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[Madam Deputy Speaker (Ms Nusrat Ghani)]

I call the shadow Minister.

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

Only this weekend, the National Pharmacy Association chief executive, Henry Gregg, said that he is concerned that

“reports of Jhoots Pharmacy branches across England failing patients risks damaging community pharmacy’s reputation and could imperil its ability to secure a good 2026-27 funding settlement.”

Communities across the country have been left without functioning pharmacies. Doors have been locked without notice, patients have arrived to find no pharmacist, no prescriptions and no stock, and staff have gone unpaid and been threatened with the sack. Jhoots Pharmacy faces allegations of not paying wages, having premises repossessed and serious regulatory breaches. The General Pharmaceutical Council has already intervened several times, yet for many patients it is too late—they simply cannot get their medicines. This is not an isolated business failure; it exposes a deeper fragility in the community pharmacy network on which local people depend for basics and often lifesaving care.

I have four questions for the Minister. First, when was NHS England first made aware of these closures, and has the Minister met the Jhoots leadership? If not, why not? If he did, what was the outcome? Secondly, has the Department assessed how many people have been left without local pharmacy access as a result of Jhoots’s actions, and what is the Minister doing to remedy this, considering it is happening across the country? He mentioned ICBs, but there are several involved. Thirdly, what mechanisms exist to ensure continuity of care when a contractor collapses or walks away? Again, he mentioned ICBs, but is there a national contingency plan? Finally, will the Government now review whether the current model, under which chains are expanding rapidly through acquisition and debt, is fit to safeguard community pharmacies in the long term? Linked to that, can the Minister definitively confirm that the funding settlement has not been compromised?

The 10-year NHS plan states that it wants to move more care into the community, yet it is completely missing a delivery chapter on how to achieve that. At the same time, we have issues such as Jhoots. I hope the Minister will be taking steps to investigate this issue in its entirety and to safeguard against this type of incident happening again, and will spell out the delivery aspect of the 10-year plan.

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[Stephen Kinnock]

I pay tribute to my hon. Friend’s work on the Select Committee. NHS England is assessing the situation and preparing contingency plans in case Jhoots becomes insolvent. Such plans involve working with other local pharmacies and dispensing GP practices to ensure that patients continue to have access to medicines. Continuity of care, as she rightly points out, must be at the heart of our response, and we are working at pace to ensure that is protected.

[Madam Deputy Speaker (Ms Nusrat Ghani)]

I call the Liberal Democrat spokesperson.

[Helen Morgan (North Shropshire) (LD)]

May I first thank my hon. Friend the Member for West Dorset (Edward Morello) for raising this appalling issue? Pharmacies are at the heart of our communities and are relied upon by millions. They are under increasing pressure across the country, where we are seeing irregular opening hours and unannounced closures. Families living in communities that rely on Jhoots pharmacies, such as those in the constituency of my hon. Friend and many other parts of the country, will be deeply concerned that they and their loved ones could be about to be left without medicines that they desperately need. Staff have been placed in an intolerable situation.

The National Pharmacy Association’s chief executive has said, as we have heard, that Jhoots risks damaging the reputation of community pharmacies. The Government urgently need to grip this issue and ensure that patients and the staff of these pharmacies are not being let down. Will the Minister and the Secretary of State agree to meet all the Members in this place whose communities are affected by potential closures? Will he update the House at the earliest opportunity as to what steps he is taking to stabilise the crisis in community pharmacy across the country? Is he confident that integrated care boards, which are distracted by 50% cuts to their budgets and top-down reorganisation, have the capacity to deal with this urgent situation as they head into planning for the next winter crisis?

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[Stephen Kinnock]

My hon. Friend has put her finger on an issue within all this, which is that if we are looking to bring in other pharmacies to replace Jhoots or, indeed, to take over a Jhoots store, we cannot do that in the latter case until such time as there is an insolvency and that business is no longer a going concern. There is a process, set out in legislation, for opening new pharmacies. Potential new pharmacy contractors can apply to open in an area and evidence how a new pharmacy can provide benefits for patients, but it is a challenge for them to make such a case if a Jhoots pharmacy is still listed as open and providing services. It is something of a Catch-22 situation. We first have to resolve the issue with Jhoots and take the necessary action, and then we can see where we are with potential gaps in the market.

[Madam Deputy Speaker]

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

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

The case of Jhoots is clearly hugely unfortunate given the incredible work that community pharmacies do up and down the country for our constituents. I am pleased to hear the Minister say that this case will not negatively affect the funding settlement, but it is set against the backdrop of a very precarious sector where actors who want to do good by our communities and do a high-quality job often find that they simply cannot make ends meet, and bad actors find a way to move in. When the Committee looked last at this issue, the workforce was a key plank to why the sector is not sustainable. What update can the Minister give us on the inclusion of pharmacists in the workforce plan?

Mental Health Bill [Lords]

Nusrat Ghani Excerpts

Report stage
Tuesday 14th October 2025 Commons Chamber

[Richard Baker (Glenrothes and Mid Fife) (Lab)]

The Bill addresses fundamental flaws in our current mental health legislation in relation to the rights of people with learning disabilities and autistic people. I will focus my comments on new clauses 32 and 33, which I have tabled. They are also about vital rights within our mental health legislation and relate closely to the powerful comments made by the right hon. Member for Salisbury (John Glen) and by my hon. Friend the Member for Isle of Wight West (Mr Quigley).

New clause 32 would provide for mandatory independent care, education and treatment reviews for patients detained in long-term segregation. In her report, “My heart breaks”, Baroness Hollins highlighted the harms and sufferings that are so often associated with long-term segregation, and assessed how introducing care, education and treatment reviews can reduce the incidence and use of segregation. I very much welcome the provisions on reviews of care and treatment that Ministers have already included in the Bill, but it has now been demonstrated that independently-chaired reviews are making a real difference and lead to inappropriate long-term segregation being challenged and addressed. The human impacts are substantial. New clause 32 would make such reviews a requirement when someone has been placed in segregation for 72 hours.

New clause 33 seeks to introduce a new level of scrutiny in cases where patients with autism or learning disability have been detained for more than five years. I believe there is a very strong case for an additional check and balance when people have been under detention and compulsory measures for so many years. I understand that the latest data for England shows that 350 people with a learning disability or autism who are currently in in-patient units have been detained there for more than 10 years.

In a previous role, I provided advocacy for the family of a young man, Kyle, who has a learning disability. He is a patient in the State hospital in Carstairs in Scotland, but his family live in the north-east of Scotland. His mother and grandmother have to make a round trip of nearly seven hours to see Kyle for visits which have in the past been restricted to a single hour. Kyle was convicted of no crime when he was admitted to Carstairs in 2009. He has been there for 16 years. The toll that this has taken on his family has been horrendous. The situation is devastating for them, and there is no end in sight. Although it is a case for the Scottish mental health system, it has provided me with an insight into what many people with learning disabilities and their families will be experiencing in England today, and the limitations of mental health tribunals in dealing with these issues.

People with learning disabilities have been losing their liberty for years because of their disability; this is a human rights emergency. It is clear that we have to do far more to prevent these situations from happening. The Bill will help to do that with its welcome measures on prevention, but where these cases are happening now, I believe there should be an additional level of scrutiny—an extra check and balance so that after so long, someone with the right level of authority and expertise can challenge providers to do better and to ask the question, “How can it be that someone has lost their liberty and their right to a family life, because we cannot make their care and treatment work in a community setting?” Although I very much welcome the introduction of the care, education and treatment reviews, I believe we should go further in these circumstances. That is why new clause 33 would make provision for notification to the Care Quality Commission when someone has been detained for more than five years.

This is an excellent Bill. It will do so much for the rights of people with learning disabilities and autism, but there are several areas where I hope the Minister can outline what further ambitions the Government have to ensure that our mental health system is fit for purpose and based on human rights.

[Madam Deputy Speaker (Ms Nusrat Ghani)]

To squeeze in a few more Back Benchers, the speaking limit is now three minutes.

[Layla Moran]

This is a long-overdue and very welcome Bill, but frankly it will not even touch the sides of what most of our constituents and communities need when it comes to the wider mental health landscape. I support many of the amendments to improve it, not least those laid by my hon. Friends on the Liberal Democrat Benches. I need to make a couple of quick points, because we want the Bill to succeed.

The Minister will know that since December the Health and Social Care Committee has been conducting an inquiry into community mental health services, because we recognise that unless we start tackling these matters upstream, we will not achieve the Bill’s aims. For so many, it feels like they are walking through an NHS desert: they simply cannot get the appointments they need; they do not feel supported; and no one can navigate this complex system.

Just a few weeks ago, while still on maternity leave, I decided to have a keeping-in-touch day and the Committee decided to visit an oasis in this desert—the incredible Barnsley Street neighbourhood mental health centre in Tower Hamlets. Unfortunately, the centre is one of only six pilots set up to this level across the country, but we heard some amazing stories of how people had been diverted away from in-patient mental health units by an approach that truly puts the patient at its centre. It was inspiring. However, we heard from the centre that its funding will not continue beyond April. It is only just starting to gather the data it needs; system change is desperately needed in this space, but the concern is that the system will change without robust data behind it. My question to the Minister is, will the centres be funded beyond April? If not, how can the Department make decisions about the system based on data that does not represent a full calendar year?

I also want to speak in support of amendment 9. I pay tribute to Cyril and Dianne whose son Leon suffered from schizophrenia for many years and sadly completed suicide in January 2019. He was let down by community mental health services. Leon’s mother, Dianne, saw the illness get worse and worse, and when she tried to re-refer him into the system after he had been detained, she was told, “Computer says no.” This Bill will improve the lives of families like Dianne and Leon’s, because Dianne’s pleas would have been heard under the new nominated persons provisions. Amendment 9 would be an extra step, ensuring that the plan is shared with parents and carers—with the nominated person. I pay tribute to those who have campaigned so doggedly for the inclusion of nominated persons in the Bill.

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[Madam Deputy Speaker (Ms Nusrat Ghani)]

I call Jen Craft to make the final contribution. All those who have contributed to the debate should make their way back to the Chamber.

[Jen Craft (Thurrock) (Lab)]

Thank you very much, Madam Deputy Speaker—I will be as brief as possible. I will speak to new clause 37, which stands in my name and which seeks to support the Government in ending the scandal of the inappropriate detention of people with a learning disability and/or autism. I declare an interest as the chair of the all-party parliamentary group on learning disability.

Currently, a learning disability or autism, in and of itself, can be grounds for detention under the Mental Health Act. As we all know, this is an absolute scandal—something from a previous age that should be a source of moral shame to everyone in our community. The Bill seeks to address this by removing autism or a learning disability, in and of themselves, as criteria for detention under the Mental Health Act. That offers a lifeline—a light in the tunnel of darkness that a number of people who are detained under the current Act face.

However, the impact assessment for the Bill states that the proposed changes to the detention criteria in clauses 3 and 4

“will only be switched on when systems are able to demonstrate sufficient level of community support”.

The families and carers of those have a learning disability or autism and who are detained under the Mental Health Act, and the organisations that support them and people who advocate for them, know that too often this vulnerable group of people are pushed to the bottom of a list of competing priorities, and very often slide off it.

We know that this Government and the Department of Health and Social Care have a number of competing priorities to deliver on, and the concern for people who fall into this bracket under the legislation is that their concerns just will not be addressed and that this absolute scandal will continue in perpetuity. People who have a learning disability or autism will be detained because our community services just are not up to snuff; we have so categorically failed them that the only thing we can think to do is to lock them away from society.

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[Stephen Kinnock]

I am really struggling for time. I am sorry, but I cannot take any more interventions, because it is not fair to Members who have tabled amendments.

Amendments 41 and 42 would prevent children with competence from choosing a step-parent or kinship carer as their nominated person if that is the most appropriate person for them. A nominated person can be overruled or displaced if acting against the child’s best interests. Parents will always maintain their rights under the parental responsibility.

Many amendments concern statutory care and treatment reviews designed to help to ensure that people with a learning disability and autistic people receive the right care and treatment while detained and barriers to discharge are overcome. Reviews will happen within 28 days of detention, and at least once a year during detention. This can be more frequent, depending on needs. Patients’ families and advocates can request a review meeting at any point. In respect of new clause 32, we have consulted on making some restrictive practices, including long-term segregation, notifiable to the Care Quality Commission within 72 hours.

Let me now deal with amendments 14 and 26 and new clauses 31 and 37. I acknowledge the importance of having a clear plan to resource community provision for people with a learning disability and autistic people to implement these reforms. We have committed ourselves to an annual written ministerial statement on implementation of the Bill post Royal Assent. Following conversations with my hon. Friend the Member for Thurrock (Jen Craft), we will work with stakeholders, including people with lived experience, to shape our road map for commencing changes to clause 3. The written ministerial statements will give updates on progress, as well as setting out future plans. It is not possible at this stage for us to commit ourselves to the specifics of implementation and community support, which depend on the final legislation passed, future spending reviews, and engagement with stakeholders to get implementation planning right.

As for the concerns raised by my hon. Friend the Member for Shipley (Anna Dixon) about the detention criteria in the Bill, it is vital that the work “likelihood” is included in those criteria to set clear expectations of what clinicians need to consider. However, we are clear about the fact that our intention is not to set a threshold for detention. Under the new criteria, a harm does not have to be likely to justify detention. The criteria require likelihood to be considered holistically, alongside the change, nature and degree of the harm.

I know that the shadow Minister, the hon. Member for Hinckley and Bosworth (Dr Evans) is keen for me to deal with the question of public safety. The key point is that there are detention criteria in clause 5, which makes a clear reference to harm either to the patient or to other persons. That is clearly a consideration of public safety, and we therefore believe that amendment 40 is surplus to requirements.

I trust that, on the basis of the assurances I have given, Members will be content not to press their amendments and new clauses.

[Madam Deputy Speaker (Ms Nusrat Ghani)]

Zöe Franklin, is it your pleasure that new clause 2 be withdrawn?

[Zöe Franklin]

I beg to ask leave to withdraw the motion.

Clause, by leave, withdrawn.

New Clause 26

Duty to establish carer liaison service

“(1) The Mental Health Act 1983 is amended as follows.

(2) In Part X (Miscellaneous and Supplementary), after section 133 insert—

“133A Duty to establish carer liaison service

(1) The managers of every hospital providing services under this Act must establish and maintain a dedicated carer liaison service.

(2) A service established under this section must provide—

(a) support to unpaid carers when a patient for whom they provide care is—

(i) awaiting admission to hospital for treatment under the Act;

(ii) receiving treatment in hospital under the Act;

(iii) set to be discharged from a hospital where they had been receiving treatment under this Act;

(b) timely and accessible information regarding the discharge of the patient they care for, including details of—

(i) the patient's discharge plan; and

(ii) aftercare arrangements under section 117 of this Act;

(c) support for unpaid carers to identify their own needs and connect to relevant local services for post-discharge support, including local authority adult social care services, general practitioners, and local carers' centres;

(d) facilitation of effective communication and collaboration between unpaid carers and the patient's multidisciplinary clinical team regarding the discharge process;

(e) assistance to unpaid carers in developing or updating a carer's support plan in the context of the patient's discharge, including guidance on—

(i) their rights to assessment and support as carers

(ii) their participation in education or employment;

(iii) available counselling services;

(iv) support in planning for emergencies in relation to the patient;

(v) benefits for the carer and patient; and

(vi) other forms of local support; and

(f) services to ensure that the perspective of the unpaid carer, as a key provider of support, is considered during discharge planning, where appropriate and with due regard to patient confidentiality and consent.””—(Dr Chambers.)

This new clause would require hospitals to establish a dedicated liaison service for the carers of patients detained under the Mental Health Act.

Brought up, and read the First time.

Question put, That the clause be read a Second time.

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[Madam Deputy Speaker (Ms Nusrat Ghani)]

Order. Before I ask for the next decision, I remind colleagues in the Chamber that once the doors are locked, Members should not be forcing themselves through the doors to either Lobby.

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[Stephen Kinnock]

I beg to move, That the Bill be now read the Third time.

Since the Mental Health Act 1983 was passed, and since it was updated in 2007, attitudes towards mental health have shifted dramatically, and our understanding has grown, but the law has been neglected. That is why this Government were proud to announce this Bill in our first King’s Speech, fulfilling our manifesto commitment and taking the first steps towards ensuring patients are consistently treated with dignity and respect—promise made, and promise delivered.

It is clear that adults and young people with mental health issues have been let down for years, which is why we are transforming the current mental health system through our 10-year health plan, including through recruiting more than 8,500 additional mental health workers, delivering more NHS talking therapy appointments than ever before, increasing the number of mental health crisis centres, and providing access to a specialist mental health professional for every school in England.

Today, we are another step closer to delivering the reforms to dealing with people with severe and acute mental health disorders, a step closer to strengthening and clarifying the criteria for detention, and a step closer to better supporting clinicians to make the right decisions around appropriate care and treatment, including community treatment orders. We want to make sure that patient choice and patient needs are at the heart of decision making. That is why we are introducing these reforms to enshrine in law measures such as the clinical checklist, the use of advance choice documents, the role of nominated persons and the expansion of advocacy services.

We are increasing the scrutiny and oversight of compulsory detention. We are making sure that those patients who are detained have a clear path to recovery and to discharge. We are introducing statutory care and treatment plans for all patients, so that their needs are met both during and after their hospital stay. To reduce reliance on in-patient care and ensure that people with a learning disability and autistic people get the right support, we are limiting the scope for detention. We are also introducing a package of measures to improve community support, including statutory care, education and treatment reviews and dynamic support registers. We are introducing stronger safeguards for people who lack capacity or competence to consent to treatment—a potentially highly vulnerable group. Those patients will receive a second opinion-appointed doctor at an earlier stage in their treatment.

This Bill has been the product of years of work predating this Government, and it is right that we thank hon. Members and peers for their scrutiny and support over many years. We should particularly note the work of the former Prime Minister Baroness May for launching the independent review that paved the way for this legislation, along with the review chair, Sir Simon Wessely, and his vice-chairs, Steven Gilbert, Sir Mark Hedley and Baroness Neuberger.

I thank Members who served on our Public Bill Committee, including the Chairs, and the clerks and all the parliamentary staff who have worked hard to ensure that the Bill was subject to the proper scrutiny while ensuring smooth and quick passage. I also thank the Joint Committee on Human Rights and particularly Lord Alton for its report and recommendations. I am grateful to the devolved Governments for their support during the Bill’s passage and to the Welsh Senedd and Northern Ireland Assembly for granting legislative consent. I thank the Bill team, my private office and all the officials and stakeholders over numerous years who have worked hard to get this legislation to where it is today.

Above all, thanks go to those with lived experience who have bravely shared their personal experiences with us through the independent review, through our consultation with stakeholder groups and through Members across both Houses. The Bill is the product of sustained effort over a number of years. That work will continue following the Bill’s Royal Assent, but none the less it is an important moment to acknowledge and pay tribute to those who have got the Bill to where it is now.

The work continues as we look to implement the legislation. The first priority once the Bill gets Royal Assent will be to draft and consult on the code of practice. We will engage closely with people with lived experience and their families and carers and with commissioners, providers, clinicians and others to do that. Much has been done, but there is much more to do. This Government are delivering on our commitment to modernise the Mental Health Act, and the work begins now to deliver that change on the ground. The Bill will of course now go to the other place, and I thank peers for their previous extensive consideration. I hope the noble Lords will be able to agree to the changes made in this House, so that the Bill can make swift progress to Royal Assent. I commend this Bill to the House.

[Madam Deputy Speaker (Ms Nusrat Ghani)]

I call the shadow Secretary of State.

[Stuart Andrew (Daventry) (Con)]

I want first to recognise and thank everyone for the constructive debates we have heard here and in the other place throughout the Bill’s passage. In particular, I thank the shadow Minister, my hon. Friend the Member for Hinckley and Bosworth (Dr Evans), for everything he has done on the Bill, especially in Committee. I pay tribute to my hon. Friend the Member for Runnymede and Weybridge (Dr Spencer) for his expertise, whose involvement with the Bill began before he was elected to this place. I also pay tribute to my right hon. Friend the Member for Salisbury (John Glen) and my hon. Friend the Member for Farnham and Bordon (Gregory Stafford) for their thoughtful contributions.

This is clearly an important and emotive issue, and the respect and sensitivity that have been shown by all sides is a testament to this House. Since the election, we have said that we would not oppose for the sake of opposition. While we have rightly asked tough questions of the Government, we have done so with the best interests of patients at heart, because everybody here wants to help and support vulnerable people better—those patients with the most severe and complex mental health needs. This Bill, which started under the previous Government—I pay tribute to former Prime Minister Baroness May for that—and continued under this Government, will achieve that. We welcome efforts to improve the patient’s voice and involvement in their own care, to ensure that patients receive effective and appropriate treatments, to minimise restrictions on liberty so far as is consistent with patient and public safety, and to treat patients with dignity and respect.

Although we are disappointed that opportunities to strengthen the Bill further have been missed, especially in public safety and the protection of vulnerable children, we listened closely to what the Minister said and to his assurances on action, for which we thank him. We will of course continue to push on these matters, not on party political grounds, but because doing so is the right thing for patients.

We are very disappointed that the proportion of health spending on mental health has been reduced. We welcome the Government’s continuation of our work looking again at how we treat and protect people with the most severe mental health illnesses, so that we can improve the safety, treatment and dignity of patients and the wider public, and ensure that our laws remain relevant and proportionate in the modern world. The Government must now turn their words into action and deliver on the commitments that they have made.

I thank everybody again for the constructive way in which they have dealt with the Bill. We are pleased to support its Third Reading. We hope that it will bring improvements for those we all care about: the patients.

[Madam Deputy Speaker (Ms Nusrat Ghani)]

I call the Liberal Democrat spokesperson.

Suicide Prevention

Nusrat Ghani Excerpts

Thursday 11th September 2025 Commons Chamber

[Several hon. Members rose—]

[Madam Deputy Speaker (Ms Nusrat Ghani)]

As colleagues can see, over 10 Members are hoping to speak. We need to begin winding up by 4.30 pm, to let the Front Benchers contribute, so unfortunately I will have to set a time limit of four minutes to ensure that everyone can get in. I call Liz Twist, who chairs the all-party parliamentary group on suicide and self-harm prevention.

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[Amanda Hack (North West Leicestershire) (Lab)]

I thank the Backbench Business Committee for granting this debate and my hon. Friend the Member for Doncaster East and the Isle of Axholme (Lee Pitcher) for securing it and for making his opening remarks in such an amazing way. We heard the devastating numbers and the personal experience of the impact that suicide has had on our communities and on ourselves. These people were important to us and, I hope, by discussing this difficult subject not only can we offer comfort and support, but provide the hope that we can put in place improvements to prevent someone else from taking their own life.

I want to speak about two friends: my childhood friend who lost her dad to suicide when we were just in our teens; and one who made the decision to take his own life just a couple of months ago. It was not until my friend’s funeral in July that I reflected that while those suicides were more than three decades apart, the similarities between the two men who made that decision were stark. They were both men in their early 50s, successful and running their own businesses. They were amazing family men who were well respected in their work and in their social circles. Yet they still both made that ultimate decision to take their own lives, leaving those left behind to unpack their grief and sorrow with the overriding question: “Why?”

In the face of such loss, we often search for answers—something to help us make sense of the silence and the unanswered questions. While no single explanation can ever truly account for an individual’s decision, patterns begin to emerge when we look more closely at the broader picture. We can look at age and gender, and the risk of suicide is highest among men aged between 45 and 54. It is three times more common among men than women—a gap that only continues to grow. We can look regionally too. Between 2021 and 2023, the east midlands had a suicide rate of 11.3 deaths per 100,000 people, placing us above the national average and making us the fifth highest of the English regions. We also need to look nationally, and we have to create some hope.

Local authorities develop strategies to prevent suicide, but the funding for voluntary services has, sadly, gone awry in recent years. We need the much more important national debate. We can look at the limits of existing mental health support and the reality that nearly a third of people who die by suicide are in contact with mental health services in the 12 months leading up to their death.

Those are of course important insights, but they are just insights, just statistics. We have to search for answers to this difficult question. Although we might never know why someone decides to take their own life, what matters is what we do with the information that we do know. We know that we have to build resilience for young people in schools, teaching our young people how to promote good mental health and wellbeing in themselves. We need to equip people with the language to talk about how they feel, the confidence to ask for help, and the tools to support themselves and each other through the inevitable challenges in their life. We can also look to our local organisations, such as the Leg Up Project in my constituency. Its core philosophy is about building resilience, and tackling loneliness and isolation.

The Government’s commitment to transform mental health service with 24/7 neighbourhood mental health centres is a fantastic start, but it will mean nothing if we are not giving people the tools that they need to communicate to get themselves there in the first place. Prevention of deaths by suicide will come from continued conversations, a growing understanding of the mental health landscape and hearing the voices of those whom we have lost and those of us struggling now—those voices are the ones that truly matter.

[Madam Deputy Speaker (Ms Nusrat Ghani)]

We now come to the Front Benchers, and I call the Liberal Democrat spokesperson, Dr Danny Chambers. We have three doctors on the Front Benches.

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[Dr Evans]

I thank the hon. Lady for all the work she does with the APPG. I am looking holistically at the different parts of what we are trying to do in this space. I have already outlined all the funding that the previous Government put in, and I will come on to some of the other problems, such as the national insurance rise, because she will know that they will have a devastating impact.

At the time, the Minister also stated:

“We will be evaluating the impact of the fund, and the services that have been provided by the grant-funded organisations. Learning from this evaluation will help to inform…the Government’s mission to reduce the lives lost to suicide.”

Could the Minister provide further details about that evaluation, such as when it will be completed and whether the Government would reconsider their decision to end the grant funding if the results show that it has had a positive impact in supporting suicide prevention?

Charities were not exempted from the increase in employer national insurance contributions in the Budget. That has significantly hampered their financial situation. We just have to listen to what the Samaritans said in response to the spending review last year:

“The reality is that funding for suicide prevention has dwindled down to next to nothing. To deliver our life-saving work, charities are reliant on donations—on the generosity of the public. And this is even more precarious at a time when many people across the country are facing economic hardship.”

I point that out not to score political points, but to draw attention to the fact that the Labour Government need to set a direction and plan to deal with the leading killer of men and women under the age of 30.

In closing, I want to recognise that yesterday was World Suicide Prevention Day. Every year, 720,000 people across the world take their own lives. The theme this year was, “Changing the Narrative on Suicide”. It calls on us all to challenge harmful myths, reduce stigma and foster open, compassionate conversations about suicide. That leads me to where I started: if men do not know their value, if they do not know they have someone to confide in and if they do not truly believe that we care, we will not break the cycle, we will not make a difference and, ultimately, we will not save lives. That is the challenge laid before society, this House and, ultimately, this Government.

[Madam Deputy Speaker (Ms Nusrat Ghani)]

I believe we have a new Minister, Dr Zubir Ahmed—congratulations on the promotion and welcome to the Dispatch Box. Just in case you need to know, we have been touched by young male suicide in my constituency of Sussex Weald, so I will be listening closely to your response.

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[Madam Deputy Speaker (Ms Nusrat Ghani)]

That was incredibly powerful.

NHS Pensions: Frontline Patient Care

Nusrat Ghani Excerpts

Thursday 17th July 2025 Commons Chamber

[Karin Smyth]

I thank my hon. Friend, who is a superb advocate for his constituents. I met him again yesterday as he advocated for services in his constituency—that is the focus of Labour Members. He is absolutely right; as I said in my statement, this is part of the overall mess that we inherited from the Conservatives. As I said in my previous response on this issue, the problems outlined by Lord Darzi are wide and deep. It is still shocking, after a year in government, to be faced with the level of disaster that was left to us after a complete abdication of responsibility for sorting out the problems. We will continue to focus on getting more of the appointments that people so need and on reducing waiting lists, which is what our constituents expect.

[Madam Deputy Speaker (Ms Nusrat Ghani)]

I call the Liberal Democrat spokesperson.

Rare Cancers Bill

Nusrat Ghani Excerpts

Report stage
Friday 11th July 2025 Commons Chamber

[Sir Christopher Chope (Christchurch) (Con)]

I beg to move amendment 1, page 1, line 5, leave out “and”.

[Madam Deputy Speaker (Ms Nusrat Ghani)]

With this it will be convenient to discuss the following:

Amendment 2, page 1, line 6, at end insert

“and

(c) set out a timetable for implementing any changes in the law recommended by the review.”

Amendment 3, page 1, line 7, leave out “in particular”.

Amendment 4, page 1, line 9, leave out “three” and insert “two”.

Amendment 5, page 2, line 3, leave out “in the opinion of the Secretary of State”.

Amendment 6, in clause 2, page 2, line 7, leave out from “are” to end of line 8 and insert “arrangements in place to”.

Amendment 7, page 2, line 12, after “appointed” insert

“within the period of 6 months beginning with the day on which this Act is passed”.

Amendment 8, in clause 3, page 2, line 33, leave out

“in the opinion of NHS England”.

Amendment 9, page 2, line 40, leave out subsection (4).

[Sir Christopher Chope]

This is certainly not a trivial Bill; it is a really important piece of legislation, which I congratulate the hon. Member for Edinburgh South West (Dr Arthur) on introducing and pioneering. It was not a Government handout; it was an idea that he thought needed to be the subject of legislation and he has pursued it. We had a fantastic Second Reading debate. There is tremendous interest in the Bill. May I therefore make it clear at the outset that my amendments are designed to try to strengthen the Bill rather than anything else?

I explained my position to the hon. Gentleman yesterday. He said, understandably, that to a large extent he was constrained, because he was trying to negotiate with the Government and with the Department of Health and Social Care, and unless he showed himself to be reasonably compliant, he would not have got the Bill to a state where it could be accepted by the Government.

I note the different positions on this, and I fully understand and respect the hon. Gentleman’s position. The hon. Member for Mitcham and Morden (Dame Siobhain McDonagh) basically said that if she had introduced such a Bill, she would have got so steamed up about it that she would have included a lot more strength and safeguards, and as a consequence it probably would not have got anywhere near being considered on Report. Those are two different approaches. I am, relatively speaking, neutral on the matter—I am a sympathetic supporter of the Bill—but I have a lot of background experience of how Governments always try to give themselves wriggle room, in effect to maintain control over everything, and in my view the Bill could be improved by being amended, with the will of the House, on Report.

We could talk about taking some of my amendments to the other place, but the trouble is that the Government machine may say that there will not be any more sitting Fridays in this House, so if the Bill were to be amended in the other place it might fall completely, because it would need to be brought back here. That is why it is important that the House should consider these amendments now rather than leave them to the other place.

Amendment 1, which is to be read with amendment 2, is a prime example of the point I made earlier. We have a commitment from the Government that:

“The Secretary of State must…carry out a review of the law relating to marketing authorisations for orphan medicinal products that are for the diagnosis, prevention or treatment of cancer”—

great—

“and…prepare and publish a report setting out the conclusions of the review.”

But what is the timescale for that, and what will happen after those conclusions are produced? There is no obligation on the Government to do anything else. The review and its conclusions could be just left on one side. We in the House are in a position to tighten those provisions up and say, “This is not good enough. There should be a timetable for implementing the changes in the law recommended by the review.” That is the essence of the two amendments.

To look at another gap that could be exploited by the Government, the Bill says that the report must be

“published before the end of the period of three years beginning with the day on which the Act is passed”.

I have tabled amendment 4 to say that the period should be two years.

In respect of both those points, I have had a helpful email from Diana Jupp from Pancreatic Cancer UK, who writes on behalf of more than 30 charities representing patients affected by rare and less common cancers. She comments on my amendments. On amendment 2, she says,

“We are keen to push for this change with the Department once we reach implementation stage of the Bill.”

With the greatest of respect to Diana Jupp, we can do this now. Instead of leaving it to her and her colleagues to try to pressurise the Department later, we in this House have the power to change the legislation in the way that I have suggested, so that there would be a timetable set out for implementing the changes in the law recommended by the review.

In response to amendment 4, Diana Jupp says that

“this timeline has been agreed with the Department and in our opinion would tie into the timelines of other developing cancer policy implementation, including the cancer plan.”

Obviously, the most important part of her comment is that the timeline has been agreed with the Department, because if it had not been, the Department and the Minister would not have taken the Bill forward in this way and agreed to it.

On the timeline, I draw the House’s attention to the evidence base set out in the impact assessment. It says that the whole process will take one year. The Department reckons that it will cost £130,000 and sets out how many full-time equivalent civil servants will be involved in it. If it will only take one year, why are we saying that it needs to have three years? That is an example of why we need to tighten up the Bill, because if this is a review that needs to and will be carried out, why do we not get on with it? To suggest that it will take longer than a year is to go against the Department’s own evidence set out in the impact assessment.

The impact assessment says on page 6, under the heading “Mandating a Government review of the orphan drug regulations”:

“This will place a duty on the Government to publish a review which will be a comparison of orphan drug Regulations (specifically Part 5 of the Human Medicines Regulations 2012) and international regulatory approaches to supporting the research and development of orphan medicinal products that are for the diagnosis, prevention or treatment of cancers. Since the review is concerned with orphan drug regulations it is by default covering rare cancers. The findings should be published within 3 years.” On page 7, paragraph 19 on financial costs says,

“It is difficult to estimate the resourcing costs required for the orphan drug review, since the exact scope remains to be agreed. However, we estimate the cost to the Department of Health and Social Care to produce and publish a report on orphan drug Regulations to incur costs of approximately £0.14m in relation to staff resource. This reflects the cost of 0.3 x SCS staff, 1 x FTE Grade 6 or Grade 7 staff, 0.3 x Grade 7 staff and 0.5 x SEO staff for one year.”

That is what the Government say: only one year will be necessary.

In that case, why is my generous amendment, which would restrict the period from three years to two years, unacceptable to the Government? There is a history of dragging of feet at the Department of Health and Social Care, I am afraid; we certainly heard about that on Second Reading. I give the House that specific example of why, on the Government’s own evidence, they should accept the change from three years to two.

Amendment 3 would leave out “in particular” from line 7, which reads:

“In carrying out the review the Secretary of State must, in particular, consider regulatory approaches in other countries.”

The amendment is intended to probe rather than anything else. Why do the words “in particular” need to be incorporated? Surely it would be simpler to say that the Secretary of State “must consider regulatory approaches in other countries”—full stop, period. But that is not how it is at the moment.

Amendment 5 would leave out the reference to the Secretary of State. This is to do with the definition of a rare cancer. Currently, clause 2 would add this wording to the National Health Service Act 2006:

“The research that the Secretary must facilitate or otherwise promote under subsection (1)(a) includes research into cancers that in the opinion of the Secretary of State are rare cancers.”

Why cannot it not just say “that are rare cancers”? Indeed, clause 2 would also add this wording to the 2006 Act:

“In this section ‘rare cancer’ means a cancer that affects not more than 1 in 2000 people in the United Kingdom.”

That is an issue of fact. The Secretary of State should not be able to basically have a veto over the interpretation of what is or is not a rare cancer.

This is just another example of the control freakery within the Department. I am sorry that so far the Minister does not seem to have stood up to officials who have persuaded him, no doubt, that we need the expression

“in the opinion of the Secretary of State”.

Again, the argument is quite straightforward and the people from Pancreatic Cancer UK are on my side, but they are obviously very keen for the Bill to get on to the statute book. We all have to recognise that it is within the Government’s power to prevent it from making any further progress. That is why it will be quite difficult, I suppose, to persuade the Minister to accept amendment 5.

Amendment 6 would leave out from “are” to the end of the line and insert “arrangements in place to” in this statement in clause 2:

“In discharging the duty under subsection (1)(a) in relation to those cancers, the Secretary of State must, in particular, ensure that there are such arrangements in place as the Secretary of State considers appropriate to”.

Why can we not just say “arrangements in place to enable potential participants in clinical trials”, and so on? Why do we need to give the Secretary of State discretion —a veto, essentially—over whether he considers those arrangements to be appropriate? It seems to me completely redundant, unnecessary and, indeed, oppressive. It is counter to the expressed wishes of this House on Second Reading, when there was impatience over the delay, because of the need to get on with this, and suspicion over the failure of the Department of Health and Social Care—under not just this Government but previous Governments, which I would be the first to accept—to actually deal with the crisis involving people who are subject to rare cancers. That is amendment 6. I am trying to beetle through these amendments quite quickly, Madam Deputy Speaker, so that other people can participate in this important debate.

--- Later in debate ---

[Gregory Stafford (Farnham and Bordon) (Con)]

To your delight, I am sure, Madam Deputy Speaker, and to the delight of the whole House—especially that of the Government Whips—I am not going to speak for very long on Report, although I am not promising not to speak for some time on Third Reading. I wish to briefly speak to amendments 5 and 8 tabled by my hon. Friend the Member for Christchurch (Sir Christopher Chope). Before that, though, I congratulate the hon. Member for Edinburgh South West (Dr Arthur) on the Bill. I am generally supportive of it and think it is entirely necessary.

Turning to the amendments, my hon. Friend the Member for Christchurch is right. It does concern me that the words

“the opinion of the Secretary of State”

are included proposed new subsection (2) of section 1E of the National Health Service Act 2006. As my hon. Friend has pointed out, proposed new subsection (4) of section 1E and proposed new subsection (5A) of section 261 of the Health and Social Care Act 2012 set out the definition of a rare cancer, and if the Bill passes, that definition will become law. I therefore think there is a contradiction within this piece of legislation: it contains an absolute definition of a rare cancer, but adds some ambiguity by referring to the “opinion” of the Secretary of State. I ask the Minister to explain how both those things can be true. If the Secretary of State decides that there is some other definition of a rare cancer, how can that possibly be in line with the definition that is written into the law?

As the hon. Member for Edinburgh South West has said, the definition that has been included in the Bill—that a rare cancer is

“a cancer that affects not more than 1 in 2000 people in the United Kingdom”—

aligns it with the UK rare diseases framework, which was published by Lord Bethell in the other place in 2021. It seems to me that that is an effective and suitable definition, so again, I ask the Minister whether he expects there to be some other definition. If he does not expect that, why is it necessary to include the words

“the opinion of the Secretary of State”?

The Bill is not even consistent. Proposed new subsection (2) of section 1E of the National Health Service Act 2006 refers to the opinion of the Secretary of State, but proposed new subsection (5A) of section 261 of the Health and Social Care Act 2012 talks about

“the opinion of NHS England”.

As my hon. Friend the Member for Christchurch has pointed out, NHS England is fortunately going to be abolished very soon. When that happens, will we have to pass either primary legislation or secondary legislation to delete those words from the Bill? Would it not be better if we deleted the words “the opinion of NHS England” now? Why will the Minister not consider removing them? If there is some reason why he thinks the Secretary of State might have to change the definition, why are those two clauses of the Bill not consistent?

I hope hon. Members will see that what the hon. Member for Christchurch and I are trying to achieve—certainly through amendments 5 and 8—is to establish a clear definition of a rare cancer. We are aiming to ensure that there is no ambiguity in that definition, and if there is to be ambiguity, we want to at least ensure that the body or authority that is going to make any changes is consistent in the legislation.

[Madam Deputy Speaker (Ms Nusrat Ghani)]

I call the shadow Minister.

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

I rise to speak on behalf of His Majesty’s official Opposition in support of the Rare Cancers Bill, and to welcome its thoughtful and necessary intervention on behalf of a group of patients who have been under-researched, under-represented, and under-acknowledged for too long. I commend the hon. Member for Edinburgh South West (Dr Arthur) on bringing this Bill forward, and on his ongoing dedication to the issue.

The case for the Bill is clear: rare cancers—defined, in line with the UK rare diseases framework, as conditions affecting fewer than one in 2,000 people—are individually uncommon but collectively account for more than 20% of all cancer diagnoses. However, as we know, patients with rare cancers routinely face delayed diagnosis, limited treatment options and far fewer opportunities to participate in clinical research.

The Bill does not claim to be a silver bullet, but it does mark a significant step forward in how we think about and legislate for research, regulation and data access in rare cancer care. It is focused, proportionate and strategically aligned with the existing NHS and National Institute for Health and Care Research frameworks.

Clause 1 places a duty on the Secretary of State to carry out a review of the law relating to marketing authorisations for orphan medicinal products that are for the diagnosis, prevention or treatment of cancer. It also rightly requires that the review includes comparisons with regulatory approaches in other countries. This is vital. The explanatory notes rightly observe that research into rare cancers is often commercially unattractive because of small patient populations and high developmental costs. If our regulatory environment creates further barriers to entry, patients suffer—not because the science does not exist but because the system does not support it.

The UK’s current approach to orphan designation lacks the pre-authorisation incentives found in systems such as the European Medicines Agency and the US Food and Drug Administration. The review required under the Bill is the opportunity to ask whether we are doing enough to attract the research and development that rare cancer patients deserve.

--- Later in debate ---

[The Minister for Care (Stephen Kinnock)]

I am grateful to my hon. Friend the Member for Edinburgh South West (Dr Arthur) for bringing this Bill before the House, and I congratulate him on getting it to Report. Amendment 1 allows amendment 2 to be inserted into the Bill. Amendment 2 would require the Secretary of State, having carried out the review described in clause 1, to set out a timetable for implementing changes to the law recommended by the review. However, it would not be appropriate to presume the outcome of the review of orphan drug regulations that is outlined in clause 1. Amendment 2 presupposes that the review will recommend changing the law, and that there are changes the Secretary of State would be willing to support, following a legal consultation. That is not considered appropriate at this stage.

Amendment 3 is unnecessarily restrictive, introducing wording that confines the review unnecessarily. We want to ensure that a thorough review is conducted, and my hon. Friend the Minister for Secondary Care will be working with her officials to ensure that that happens. For amendment 4, the three-year timeframe to prepare and publish the review and the necessary resourcing requirements have been discussed with officials in my Department and at the Medicines and Healthcare products Regulatory Agency. I remind Members that the text in the Bill reflects the statutory deadline, but we will endeavour to publish a report ahead of the three-year timeframe, which has been put forward to be consistent with the MHRA’s overall workplan.

On amendment 5, there are different definitions of a rare cancer, and we worked with my hon. Friend the Member for Edinburgh South West to agree the definition in the Bill as a cancer that affects not more than one in 2,000 people in the UK. However, a level of discretion for the Secretary of State is required over what falls within that definition, since the facts underlying and the data on diagnoses are constantly changing. The amendment would make it difficult to implement the clause in practical and operational terms.

Amendment 6 would remove the ability of the Secretary of State to exercise discretion as to how their duty would be discharged. This is not considered appropriate, since it makes the operation of clause 2 less workable in practice, and would lack the Government’s assessment of what in all the circumstances would be the most appropriate manner of implementation. Amendment 7 would introduce a specific timeframe—just six months—to allow the appointment of the specialty lead. Although I agree that we will need to appoint the specialty lead promptly, introducing a statutory timeframe is not considered workable for practical reasons. There could be unforeseen delays; for example, recruitment processes might delay the appointment beyond six months.

On amendment 8, as mentioned previously there are different definitions for a rare cancer. That is because the data on cancer diagnoses is constantly changing, and decisions on whether the criteria for a rare cancer are met will inevitably involve an element of judgment. The amendment would make it difficult to implement the clause in practical and operational terms.

I turn finally to amendment 9. It is essential that information relating to people’s health and care is shared appropriately, lawfully, and in line with their reasonable expectations. Amendment 9 would remove the provision confirming that any sharing of information pursuant to the powers created by the Bill, and under NHS England’s existing powers, must be in accordance with data protection legislation. That includes compliance with key principles such as lawfulness and fairness. That layer of assurance is essential for the protection of patients, and clause 3 is a standard provision that makes that explicit.

For those reasons, I ask the hon. Member for Christchurch (Sir Christopher Chope) to withdraw all nine of his amendments.

[Madam Deputy Speaker (Ms Nusrat Ghani)]

Sir Christopher, is it your pleasure that amendment 1 be withdrawn?

[Sir Christopher Chope]

Is it possible to respond, Madam Deputy Speaker?

[Madam Deputy Speaker]

Very briefly. I was asking whether amendment 1 would be pushed to a vote or withdrawn, so if you could alert me to that it would be very useful.

[Sir Christopher Chope]

I will respond briefly to the debate. In so doing, I thank my hon. Friends the Members for Hinckley and Bosworth (Dr Evans) and for Farnham and Bordon (Gregory Stafford) for their contributions.

I listened for what the Minister would say in response to my point about NHS England, but I did not hear the expression “NHS England” come from between his lips, and I wonder whether that was an oversight or whether it was left out of his brief deliberately by officials from NHS England. Amendment 8 specifically deals with NHS England, and my hon. Friend the Member for Hinckley and Bosworth referred to it. Does the Minister’s reluctance to intervene at this stage show that he is in denial about the policy in relation to NHS England? I presume that he is in such denial.

We have had a classic example from the Minister of why the civil service is ruling okay, because it can come forward with a valid objection to every possible suggested alternative and amendment. I do not think that this attitude will be very helpful to the people we are trying to help through the Bill—namely, those who are suffering from rare cancers and who want us to make progress in this area. I will not press any of these amendments to a vote, but I hope that when the Bill gets to the other place there will be more persistent probing, particularly on the issues around NHS England and the definitions.

To give credit where it is due, I was pleased with what the Minister said about the specialty lead. As discussed, we do not need legislation for this anyway. He said he wants to have that dealt with promptly but is fearful of accepting an amendment that requires it to be done within six months because of the possibility of unforeseen delays. I take it from that that he is going to get on with that aspect, and let us hope that that goes faster rather than slower. I beg to ask leave to withdraw the amendment.

Amendment, by leave, withdrawn.

Third Reading

Children’s Health

Nusrat Ghani Excerpts

Thursday 10th July 2025 Commons Chamber

[Several hon. Members rose—]

[Madam Deputy Speaker (Ms Nusrat Ghani)]

Order. To ensure everyone gets to contribute, we will have to have a three-minute speaking limit. I call Sarah Hall.

--- Later in debate ---

[Leigh Ingham]

I am already on record as criticising Staffordshire county council today, so I will hold off in this debate—although it could be better at everything.

My commitment to play is why I co-sponsored the amendment to the Planning and Infrastructure Bill, in the name of my hon. Friend the Member for Bournemouth East (Tom Hayes), that seeks to provide in law for sufficient play opportunities, especially inclusive play opportunities. I call on the Government to invest in potential, and to give every child the opportunity to grow up healthy, confident and, importantly, resilient—ready not just for school, but for life.

[Madam Deputy Speaker (Ms Nusrat Ghani)]

I call the Liberal Democrat spokesperson.

[Alison Bennett (Mid Sussex) (LD)]

I would like to begin by paying tribute to a wonderful charity based in Mid Sussex called Group B Strep Support. Ever since its founder, Jane, lost her own baby, Theo, 30 years ago, Jane and the team have been campaigning for better outcomes for pregnant women who contract group B strep, because the impact on their babies can be profound; it is the most common cause of life-threatening infection for newborn babies. I open by asking the Minister whether she will meet the team from Group B Strep Support so she can better understand the potential of better screening of pregnant mothers.

As a mother myself, I do not take for granted the health of my children. All of us who are parents know that the health of our children can turn on a sixpence. We also know that the system that surrounds children and families and keeps children healthy has been allowed to crumble. As hon. Members have said, we are in the middle of a children’s health crisis in this country. This week, the Children’s Commissioner produced a damning report on the health of children across the country. The review told us that children in England are facing “Dickensian levels” of poverty, and are going without basic needs like heating, a place to wash, somewhere to eat breakfast or safe transport to school. Hon. Members use the word “unacceptable” a lot in this place and it may be overused, but in this case it is very true. We should be ashamed that children are facing this reality in 2025.

Our young people, who should expect to grow up to be part of a prosperous, happy and successful nation in the coming years, are being let down. Under the Conservatives, things got worse and worse. On their watch, in the period from 2022 to 2024 alone, the number of children waiting for over 52 weeks for an appointment increased by 60% for elective paediatric services and by 94% for community health services. However, this situation is not inevitable. The UK has world-leading researchers, passionate healthcare workers and a proud tradition of protecting public health. Britain’s children should be among the healthiest in the world. We are a wealthy country with a welfare state and universal healthcare.

However, we lag behind our peers. One in 11 children lives with asthma, and our country has one of the highest emergency admission rates for school-age asthma in Europe; it is avoidable, yet it is still happening. The number of children living with life-limiting conditions has risen by 250% in less than two decades. Some 2.5 million children in England are living with obesity, as other hon. Members have mentioned this afternoon, and over 1 million of them already have health complications. Almost one in five children now struggle with their mental health, which is a 50% increase in just five years.

However, children are waiting longer than ever to be seen. Since 2020, paediatric waiting lists have grown by over 166,000 children, but the number of consultants has barely budged, with over 50,000 children now waiting for more than a year to be seen. The Conservatives let those problems pile up; now the Labour Government cannot afford inaction.

The Liberal Democrats believe that every child deserves the best start in life, no matter their background, postcode or parents’ income. We also think that it benefits us all to have happy and healthy children growing up across the country. We would start by fixing the NHS from top to bottom, which means ensuring that everyone can see a GP within seven days, or 24 hours if it is urgent. I welcome the announcement in the NHS 10-year plan that same-day appointments will become available where necessary. My colleagues and I will push the Government to ensure that that pledge becomes a reality.

Fixing the NHS also means ending the scandal of children turning up to hospital with a mouth full of rotting teeth because there is no dentistry nearby. It means rebuilding the primary care and community services that have been starved of funding for over a decade. I know from conversations with my constituents in Mid Sussex that those problems are very real, and with them happening in what is a relatively well-off part of the country, it is clear that they are systemic.

However, it is not just about treating illness; we have to be determined to prevent it. That is why we would reverse the Conservative cuts to public health and invest in programmes that get children moving, eating well and thriving. We would tackle the poverty that drives so many health issues by ending the cruel two-child limit and reversing the benefits cap. We would expand free school meals to all children in poverty and work towards universal free meals in primary schools. We were glad to see the Government listen to Liberal Democrat calls for an expansion of free school meals, and are campaigning for that to go even further, because no child should go hungry at school—ever.

When it comes to mental health, we would transform the system from the ground up. That means having mental health hubs for young people in every community, regular check-ups at key points in life, a dedicated mental health professional in every school and a proper cross-Government strategy to understand and tackle the root causes, from bereavement to bullying and social media pressure. Children’s mental health is not just a health issue; it is an education issue, a family issue and a justice issue. It needs more than one Department and more than one Minister.

My Liberal Democrat colleagues have led the fight for early intervention, for holistic support and for real accountability. We have championed ideas such as a register of bereaved children, because how can we help if we do not even know who needs support? I ask the Minister to therefore commit to implementing such a register.

We face a real challenge, but we have the ideas, the evidence and the plan. Now someone has to get on and deliver the change that children across the UK so desperately need, so I urge the Government to take action. Let us build a country where no child is left behind and where every child and parent has, at the very least, the opportunity to be healthy and to look to the future with confidence.

[Madam Deputy Speaker (Ms Nusrat Ghani)]

I call the shadow Minister.

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

Before I start, I should declare my interest as a consultant paediatrician and a member of the Royal College of Paediatrics and Child Health, which the hon. Member for Stroud (Dr Opher) mentioned earlier. I congratulate him on securing this important debate.

Getting the right start in life is one of the most important factors in adult health and wellbeing. We must ensure that the NHS is providing the best treatments and preventive care available for children, while prioritising safety and convenience for patients and cost-effectiveness for taxpayers. I have seen significant improvements in paediatric care in my career. We must look broadly at the social and environmental factors that affect children’s health and ask what more we can do to help protect and prevent illness in children. Prevention is better than cure, which is one of the Government’s three shifts, with which I agree and on which I wish to focus today.

Often children brought to hospital to see consultant paediatricians have conditions that have been caused, or further complicated, by social and environmental factors. These are things that medics cannot treat on their own, and, as every professional knows, we must work with parents, families and children to achieve the very best outcomes. One very clear example is the childhood obesity crisis, which many right hon. and hon. Members have mentioned already this afternoon. Research shows that 36% of children in year 6—these are 10 and 11-year-olds—are now overweight or obese. I have seen some extreme cases in my practice—for example, a nine-year-old who weighed over 80 kg—of young patients who have suffered serious illness because of their weight. These are the tip of the iceberg, but they are undoubtedly part of a much broader shift.

We know what causes obesity: lack of exercise and a diet too high in calories. But this is more complicated than that. There are complex problems with roots in broader issues such as poverty and family work patterns. The Government cannot determine what each child eats, but there are things that they can and should do to help support parents and their children. What is the Minister doing to encourage exercise, participation in sport and active travel to school? What is she doing to improve the quality and availability of food for parents and families? What is she doing to improve the quality of school food, to build nutrition education into the curriculum and to help children learn about managing their own health and how to cook healthy food?

I know the 10-year plan includes reference to the reformulation of some products, but there is a risk that manufacturers encouraged to remove sugar from products will simply replace it with sweeteners and other chemicals. What is the Minister doing to ensure that they do not solve one problem and then walk unwittingly into another?

The hon. Member for Lowestoft (Jess Asato) mentioned tooth brushing. We often hear that tooth extractions are the leading cause of hospital admissions among young children. Can the Minister provide details on the steps that she is taking to improve youth dental outcomes, such as broadening access to NHS dentists, pursuing fluoridisation schemes and encouraging the use of fluoride varnish?

Parents have a responsibility here too. According to the chief dental officer, who I spoke to the other day, children who brush their teeth twice a day with a fluoride toothpaste, reduce the amount of high-sugar drinks they consume and reduce the sugar in their diet can significantly reduce the risk of needing fillings and having dental decay.

Another area raised today is mental health. Young people face mental health pressures from home and school worries, friendship concerns and many other factors. In particular, we know that the covid lockdown had a serious impact on children’s development and socialisation. We also know that social media is causing increasing harm to children—whether by contributing to anxiety about body image or personal achievements, or by exposing children to harmful material and ideas. The previous Government’s Online Safety Act 2023 was a welcome step in addressing some of these issues, but the Government rejected a Conservative amendment to the Children’s Wellbeing and Schools Bill to help reduce the use of phones in schools. What more does the Minister plan to do to encourage children away from their screens and back towards a healthier existence with their friends and families?

I also want to discuss neglect. A total of 25,350 children are currently on a child protection plan for reasons of neglect—a marked increase from 20,970 in 2014. Organisations such as the National Society for the Prevention of Cruelty to Children have highlighted the fact that numbers are typically underestimated in neglect cases, but we should not underestimate the harm caused to health and development by neglect. What steps are the Department and the Government in general taking to get a more accurate picture of neglect and to intervene on behalf of the children who are suffering?

One area of improvement is the balance of acute and community care, and, again, the Government have talked about this in their three shifts. We know the Government are keen to move acute care into the community, but does the Minister agree that we should ensure that core community care is available more widely and more quickly in the community first before giving them extra work to do? Too often in my practice I see children with paediatric problems who have been referred to hospitals because of long waits and capacity problems in the community. What steps is the Minister taking to ensure that there is enough supply in the community sector to deal with the problems that children face?

In summary, children’s health is a large and complex policy area. We know that we can make good progress when we treat these complex conditions with new research and novel treatments. We know that most children will get better—in fact, one reason that I enjoy paediatrics is that almost all the patients get better, because they are robust, resilient and great fun. We must help parents do things that help protect children’s health today and prepare those children to manage their own health tomorrow.

[Madam Deputy Speaker (Ms Nusrat Ghani)]

I now call the Minister, who has up to 5 pm, although we do need a few minutes at the end for the lead Member to wind up.

NHS 10-Year Plan

Nusrat Ghani Excerpts

Thursday 3rd July 2025 Commons Chamber

[The Secretary of State for Health and Social Care (Wes Streeting)]

With permission, Madam Deputy Speaker, I shall make a statement to the House on “Fit for the Future”, the Government’s 10-year health plan for England.

There are moments in our national story when our choices define who we are. In 1948, the Attlee Government made a choice founded on fairness: that everyone in our country deserves to receive the care they need, not just the care they can afford. It enshrined in law, and in the service itself, our collective conviction that healthcare is not a privilege to be bought and sold, but a right to be cherished and protected.

Now it falls to our generation to make the same choice: to rebuild our national health service, and to protect in this century what Attlee’s Government built for the last. That is the driving mission of our 10-year plan.

In September, Lord Darzi provided the diagnosis: the NHS was broken by 14 years of Conservative under-investment, and by their catastrophic top-down reorganisation. In the past year, Labour has put the NHS on the road to recovery. We promised 2 million extra appointments; we have delivered more than 4 million. We promised 1,000 new GPs on the frontline; we have recruited 1,900. We have taken almost a quarter of a million people off waiting lists, cutting them to their lowest level in two years. And we have launched an independent commission, chaired by Baroness Casey, to build a national consensus around a new national care service to meet the needs of older and disabled people into the 21st century.

Today, the Prime Minister has set out our prescription to get the NHS back on its feet and make it fit for the future. Our plan will deliver three big shifts. The first is from hospital to community. We will turn our national health service into a neighbourhood health service. The principle is simple: care should happen as locally as it can—digitally by default, in a patient’s home if possible, in a neighbourhood health centre when needed, and in a hospital where necessary.

We will put neighbourhood health centres in every community, so people can see a GP, nurse, physio, care worker, and therapist, and they can get a test, scan or treatment for minor injuries, all under one roof. The NHS will be organised around patients, rather than patients having to organise their lives around the NHS. It will be easier and faster to see a GP. We will train thousands more, end the 8 am scramble, provide same-day consultations, and bring back the family doctor. If you are someone with multiple conditions and complex needs, the NHS will co-create a personal care plan, so your care is done with you, not to you.

Pharmacies will play an expanded role in the neighbourhood health service. They will manage long-term conditions, treat conditions such as obesity and high blood pressure, screen for disease and vaccinate against it. We will also reform the dental contract, to get more dentists doing NHS work, rebuilding NHS dentistry.

Over the course of this plan, the majority of the 135 million out-patient appointments done each year will be moved out of hospitals. The funding will follow, so a greater share of NHS investment is spent in primary and community care.

The second shift is from analogue to digital. No longer will NHS staff have to enter seven passwords to login to their computers, or spend hours writing notes and entering data. Our plan will liberate frontline staff from the parts of the job that they hate, so they can focus on the job that they love—caring for patients. For the first time ever, patients will be given real control over a single, secure and authoritative account of their data. The single patient record will mean that NHS staff can see medical records and know a patient’s medical history, so they can provide them with the best possible care.

Wearable technology will feed in real-time health data, so patients’ health can be monitored while they stay in the comfort of their own home, with clinicians reaching out at the first signs of deterioration. The NHS app will become the front door to the health service, delivering power to the patient. You will be able to: book and rearrange appointments for you, your children or a loved one you care for; get instant advice from an AI doctor in your pocket; leave feedback on your care and see what feedback other patients have left; choose where you are treated; book appointments in urgent care so you do not wait for hours; and refer yourself to a specialist where clinically appropriate. Of course, patients can already do all that, but only if they can afford private healthcare. With Labour’s plan, every patient will receive a first-class service—whatever their background and whatever they earn.

The third shift is from sickness to prevention. Working with the food industry, we will make the healthy choice the easy choice to cut calories. We will roll out obesity jabs on the NHS. We will get Britain moving with our new NHS points scheme, and we will update school foods standards so that kids are fed healthy, nutritious meals. We will tackle the mental health crisis with support in every school to catch problems early, 24/7 support with virtual therapists for those with moderate need, and dedicated emergency departments for patients for when they reach crisis point.

The science is on our side. The revolution in artificial intelligence, machine learning and big data offers a golden opportunity to deliver better care at better value. New innovator passports and reform of the National Institute for Health and Care Excellence and the Medicines and Healthcare products Regulatory Agency will see medicines and technology rapidly adopted. Robotic surgery will become the norm in certain procedures, so patients recover from surgery at home rather than in hospital beds. The NHS will usher in a new age of medicine, leapfrogging disease so that we are predicting and preventing, rather than just diagnosing and treating. It is therefore the ambition of the plan to provide a genomic test for every newborn baby by 2035. Thanks to my right hon. Friend the Chancellor, this plan is backed by an extra £29 billion a year by the end of the spending review period, as well as the biggest capital investment in the history of the NHS.

Alongside investment comes reform. This plan slashes unnecessary bureaucracy and devolves power and resource to the frontline. It abolishes more than 200 bodies, because listening to patients, guaranteeing safety and protecting whistleblowers is core business for the NHS and should never have been outsourced. The plan commits to publishing league tables to rank providers. We will intervene to turn around failing providers, and we will reinvent the foundation trust model in a new system of earned autonomy. Pay will be tied to performance, so that excellence is recognised and failure has consequences. Tariffs will be reduced to boost productivity. Block contracts will end, with funding tied to outcomes. The plan gives power to the patient, so hospitals are financially rewarded for better service. It closes health inequalities by investing more in working-class communities, and it establishes a national investigation into maternity and neonatal services to deliver the truth, justice and improvement that bereaved families deserve.

I am sometimes told that NHS staff are resistant to change. On the contrary, they are crying out for it. They suffer the moral injury of seeing their patients treated in unfit conditions. They are ones driving innovation on the frontline, so their fingerprints are all over this plan. The public are desperate for change too. Each of us has our own story about the NHS and the difference it made to our lives. We also know the consequences of failure. To succeed, we need to defeat the cynicism that says that nothing ever changes.

We know that the change in our plan is possible because it is already happening. We have toured the length and breadth of the country and scouted the world for the best examples of reform. If Australia can effectively serve communities living in the outback, we can surely meet the needs of rural England. If community health teams can go door to door to prevent illness in Brazil, we can certainly do the same in Bradford. We know that we can build the neighbourhood health service, because teams in Cornwall, Camden, Northumbria, and Stratford—where I was with the Prime Minister and Chancellor this morning—are already showing us how to do it. We will take the best of the NHS to the rest of the NHS. We will apply to best examples of innovation from around the world to benefit people here at home. Above all else, we will give power to the patient. This plan fulfils Nye Bevan’s commitment in 1948 to put a megaphone to the mouth of every patient. It will restore the founding promise of the NHS to be there for us when we need it.

Of course, we know that there are those on the right who are willing us to fail. They will exploit the crisis in the NHS in order to dismantle it. The hon. Member for Clacton (Nigel Farage) and his cronies argue that universal healthcare could be afforded in the 20th century but not in the 21st. Labour rejects their declinist pessimism and so do the public. But that is the choice—it is change or bust, and we choose change.

We know that the British people are counting on us. It falls to us to ensure that the NHS not only survives but thrives, and we will not let our country down. Of course, if we succeed, we will be able to say with pride that will echo down the decades of the 21st century that we were the generation who built an NHS fit for the future and a fairer Britain where everyone lives well for longer. I commend this statement to the House.

[Madam Deputy Speaker (Ms Nusrat Ghani)]

I call the shadow Secretary of State.

Infant Feeding

Nusrat Ghani Excerpts

Tuesday 1st July 2025 Commons Chamber

[David Reed (Exmouth and Exeter East) (Con)]

I thank the hon. Member for bringing this important issue to the Chamber. My wife and I are expecting our first in the coming weeks, so as hon. Members will expect, this is an important subject in which I am quickly upskilling myself. In my constituency, I have a similar group called Exmouth Bosom Buddies, which does a fantastic job that we know relieves pressure on the NHS. What more does the hon. Member think can be done to allow such groups to grow, thrive and flourish so that they can continue their vital work?

[Madam Deputy Speaker (Ms Nusrat Ghani)]

Before the hon. Member gets to her feet, I am just reminded of the midwifery-led Crowborough birthing unit, which helps the lovely mums in my constituency.

[Jess Brown-Fuller]

The hon. Gentleman highlights how important it is to have that community-based support in an area. Unfortunately, not every mother across the UK can say the same. There are areas where they have to travel up to an hour by car to attend that sort of group, and I will come on to that point.

When I had my daughter, five years after my son, the support that I had relied on had all but vanished. The Milk group was now being run out of, in effect, a broom cupboard at my local leisure centre, with no opportunity to socialise with other mums. Only six months later, the pandemic hit and my daughter’s health visitor reviews were done via Zoom, often without my daughter even on the screen. The local children and family centre in my constituency never reopened in the same way after the pandemic.

I was one of the lucky ones because I had already built my village around me five years earlier and I had a network of friends and family that I could call on. However, for those who have become new mothers in the last decade, that support has been all but vaporised, with community support groups patchy and often delivered by volunteers or those wonderful midwives in their time off.

It is essential to acknowledge and support those parents who cannot or choose not to breastfeed, to ensure that they feel empowered and confident in the decisions they make for their children’s nutrition and wellbeing. I am a proud advocate of every parent having choice, but that choice should be an informed one. Currently, it is not a level playing field, with formula companies preying on the vulnerability of parents.

The Competition and Markets Authority launched a market study into the formula industry in February 2024 and published its results earlier this year. The study provided a comprehensive, in-depth and up-to-date exploration of the infant formula market in the UK through a consultative process that has offered unique insights into the industry. A short extract from the CMA’s overview of its findings states:

“parents are often in vulnerable circumstances when they first make choices about whether and which infant formula to use, their brand choice is often based on incomplete or unclear information, and they are typically then reluctant to switch brands. Against this backdrop, manufacturers place significant emphasis on building their brands—including through their willingness to supply the NHS below cost—and differentiating their products to attract parents, rather than competing strongly on price. And price competition between retailers has typically been weak…Our analysis indicates that these features, in combination, are leading to poor outcomes for parents in terms of the choices they make and prices they pay for infant formula.”

In short, a vulnerable, extremely tired new parent is making choices on which formula to buy, but the claims on boxes of commercial infant formula are often unfounded. Parents have to choose between a £7 tin of formula and a £14 tin of formula, even though they are nutritionally equivalent. At a recent event, we heard the testimony of parents who had purchased the more expensive brand with the bold claims on its packaging, believing that they were doing the best for their child, only to then use fewer scoops when making a bottle to make the tin last longer. We have only to look at our supermarket shelves and see the formula milk locked in glass cabinets to understand that we have a crisis in families being able to feed their babies.

The cost of living challenges have spiralled into a food insecurity crisis, yet formula manufacturers increased prices by 24% in one year in 2023 and prices continue to rise well beyond inflation. Research shows that parents rarely switch brands once they have introduced a formula milk. This gives formula companies a clear incentive to offer their products to maternity wards at reduced prices, knowing that parents are likely to continue using the same brand when they go home. To address this, the CMA recommends standardised infant formula labelling in healthcare settings, which would eliminate this form of exploitative marketing.

Formula companies are also restricted from advertising newborn formula, but they get round this by advertising their follow-on, or stage 2, milk and making the packaging look exactly the same. The CMA recommendations ask for the Government to assess whether infant formula and follow-on milks are “clearly distinct”, then communicate that assessment to the manufacturers and enforcers. A Mintel report from 2016 reported that in 2015, for every baby born in the UK, companies spent a staggering £21 just on marketing follow-on formula. The CMA has made 11 recommendations to the Government, all of which aim to improve outcomes for parents. I am calling on the Government today to implement all 11 recommendations and finally to level the playing field for those parents who rely on formula to feed their babies.

This debate is timely, as last week I was delighted to host the World Breastfeeding Trends Initiative’s launch of its 2024 report here in Parliament. I would be delighted to give the Minister a copy if she does not already have one. The key takeaway from the report is that the UK has one of the lowest breastfeeding rates in the world. The report not only highlights the gaps in policy but creates a report card system for each of the four nations. I want to highlight a few things that were mentioned in the report.

Importantly, data—though its collection is uneven across the four nations—shows that the majority of mothers do set out to breastfeed. Despite this, by six to eight weeks, around 70% of babies in the UK receive some formula, and by six months only 1% of babies are exclusively breastfed.

Department of Health and Social Care

Nusrat Ghani Excerpts

Tuesday 24th June 2025 Commons Chamber

[Rebecca Smith]

I entirely agree with my right hon. Friend. Indeed, St Luke’s hospice in my constituency will be facing exactly the same issues.

At risk of closure is Tubb pharmacy in Newton Ferrers in my constituency, which I have raised in this place before. Pharmacist Esi has been helped massively by an incredibly active community. The pharmacy supported a petition I delivered here in Parliament, and it provides essential services to the two rural villages of Newton Ferrers and Noss Mayo, but it is seeking Government action in order to secure its future.

While the estimates may highlight a commitment to delivering care closer to home, according to Community Pharmacy England there is still no clear path to the sustainable funding and operational model that is required by community pharmacy. It is needed by community pharmacies such as Tubb in Newton Ferrers, and it is needed by community pharmacists such as Esi. It is needed by the whole country to be able to deliver community pharmacy, Pharmacy First and, ultimately, to relieve pressure on primary care. I urge the Minister to provide this substantial funding for community pharmacy. I know that the Minister agrees that this work is incredibly important, and I urge her to ensure that we bring it to the fore as quickly as possible so that there can be a future for community pharmacy across the country.

[Madam Deputy Speaker (Ms Nusrat Ghani)]

Order. Due to time constraints, I must now call the Front Benchers, starting with Helen Morgan.

Terminally Ill Adults (End of Life) Bill

Nusrat Ghani Excerpts

Report stage
Friday 13th June 2025 Commons Chamber

[Sir Desmond Swayne (New Forest West) (Con)]

On a point of order, Madam Deputy Speaker. I wonder if you can assist me as I am at a loss as to what amendment we are discussing.

[Madam Deputy Speaker (Ms Nusrat Ghani)]

I have no doubt that if the right hon. Member gives the hon. Member for Gosport (Dame Caroline Dinenage) a moment, she will address it quickly, because even Members who are contributing do not have long.

[Dame Caroline Dinenage]

Thank you, Madam Deputy Speaker. I am addressing new clause 13, which provides the strict regulation of life-ending substances and self-administering devices. That means there will be transparency about what substances are used and how they are stored, prescribed and delivered. We owe it to patients, clinicians and the public to ensure that every part of the process is governed by clinical standards and ethical safeguards. For those physically unable to swallow or self-ingest, the new clause ensures that devices to support self-administration can be safely used. Without that, we risk creating a system that excludes some of the very people it is meant to support.

While we must regulate the system properly, we must also reject amendments that would undermine or stall the Bill’s delivery. Amendment 19 proposes adding suicide prevention, the Mental Health Act and deprivation of liberty safeguards to the code of practice. As the Minister who put much of that legislation through, those are really important topics for me, but this is not the legislation to address them. Let us keep the code focused on the Bill’s core function of ensuring a safe, consistent and compassionate assisted dying process.

Amendment 20 would allow non-adherence to the code to be used in civil or criminal proceedings. That is not appropriate. Guidance is meant to help professionals navigate difficult decisions, not become a legal trap. If clinicians act negligently, existing law already applies. We should not be creating new liabilities for those acting in good faith in very difficult conditions.

I also oppose amendments 97 and 27, which would require the MHRA to license drugs specifically for assisted dying and the National Institute for Health and Care Excellence to recommend them. That would make the Bill unworkable.

--- Later in debate ---

[Madam Deputy Speaker (Ms Nusrat Ghani)]

As Mr Speaker has already mentioned, in order for everybody to get in—well, in order for most to get in—we need speeches to be shy of six minutes, and interventions to be short. I call Gregory Stafford.

[Gregory Stafford]

Thank you, Madam Deputy Speaker. I am conscious of those comments and will try to limit my remarks to new clause 13 and some of the amendments to it.

The Royal College of Physicians, the Royal College of Psychiatrists, the Royal College of Pathologists, the Association for Palliative Medicine and the British Geriatrics Society have all said that there are problems with this Bill, and I have heard nothing from its sponsor, the hon. Member for Spen Valley (Kim Leadbeater)—despite trying to intervene on her a number of times—about what she has done to ensure that their concerns have been addressed. This brings us directly to a fundamental concern: namely, the means by which assisted death would be carried out under new clause 13. The impact assessment for the Bill recognises that

“The safety and efficacy of those substances used for assisted dying is currently difficult to assess”.

--- Later in debate ---

[Caroline Voaden]

I take issue with some of the language being used. We have heard the words “murder”, “killing” and “suicide”. Twenty-three years ago next week, my husband died of terminal cancer. He was in extreme pain and was given morphine to relieve it. As the pain got worse, he was given more morphine so that he could die gently and not in complete agony. This is about helping people die in a civilised way, and helping their families to not go through the horrendous experience of watching a loved one die in agony. To call it murder and killing is so wrong, and we have a duty to mind our language with this Bill. It is about helping people die quickly and with dignity. It is assisted dying.

[Madam Deputy Speaker (Ms Nusrat Ghani)]

Order. Before Dr Spencer resumes, I note that this has been a well-tempered debate. Let us keep it so. We know our constituents are watching.

[Dr Spencer]

I thank the hon. Member for her intervention. Of course there are situations in which a decision to end one’s life is perfectly understandable—indeed, rational. I spent my career looking after people, many of whom presented to me and to medical services with thoughts about wanting to end their life. Many of them had mental illness. Some had terminal illness. The fundamental problem with the Bill is that it has a complete blind spot for those people who are highly vulnerable. It is scandalous that we have got to this point and are still having a debate about the core concepts. The Bill should have been dealt with properly from the start with a royal commission or a review so that we did not get to the point where we are still debating core principles on Report.

--- Later in debate ---

[Several hon. Members rose—]

[Madam Deputy Speaker (Ms Nusrat Ghani)]

Order. The hon. Lady has made it clear that she is not taking interventions at this time.

[Ellie Chowns]

The evidence shows that it is dying people themselves, facing the end of life, who wish to have the choice. Only small numbers of them will take up that choice, but it is crucial, humane and compassionate for us to offer them the choice. Assisted dying is complementary to palliative care, not contradictory, and this Bill has been through a huge amount of scrutiny—far more than any other Bill in this Session. Therefore, I deeply hope that the House will pass this compassionate, humane, clearly drafted and tightly structured Bill, to offer a dignified death to those who are facing death.

--- Later in debate ---

[Andrew Pakes (Peterborough) (Lab)]

rose—

[Madam Deputy Speaker (Ms Nusrat Ghani)]

Order. Before an intervention is taken, may I put it on the record that Members should not be wandering into the Chamber and then very quickly making an intervention? Lots of Members are waiting to speak and to make interventions. Is that the case? Have you been in the Chamber for a while?

[Andrew Pakes]

indicated assent.

[Madam Deputy Speaker]

Okay, go on.

[Andrew Pakes]

I did use the facilities, Madam Deputy Speaker; I apologise for that. I am a gentleman of an age. [Laughter.]

I thank my hon. Friend for taking an intervention. We are about to reach the 80th anniversary of the landslide 1945 Labour Government, which set the NHS in train, and the 77th anniversary of the NHS. Fundamental to that is her point about the NHS being free at the point of need and being about care, compassion and life. What assessment has she made of how the Bill, if it goes through unamended, will fundamentally challenge that great victory and legacy that Labour Members cherish?

--- Later in debate ---

[Dr Huq]

Will I get more time? [Laughter.]

[Madam Deputy Speaker (Ms Nusrat Ghani)]

indicated assent.

[Jess Asato]

I thank my hon. Friend and I recognise the time constraints. On the issue of vulnerable groups, she may know that a letter has been sent about eating disorders but the spokesperson for the Bill’s sponsor dismissed it, saying that the concerns raised were old news. Does she agree that there is a problem with the way the Bill is being run, as so often the concerns and evidence presented by groups have been dismissed out of hand?