Obesity and Fatty Liver Disease

Peter Dowd Excerpts

Tuesday 28th October 2025 Westminster Hall

[Peter Dowd (Bootle) (Lab)]

It is a pleasure to see you in the Chair, Mr Efford. I find it difficult to believe that the hon. Member for Strangford (Jim Shannon) was a big fat pudding, but I suspect that even if he was, no one would have really noticed, given his charm and personality—I say that in all sincerity, as he knows.

I thank my hon. Friend the Member for Worthing West (Dr Cooper) for being the driving force behind today’s debate. She has indicated that

“people do better in more equal societies.”

To some extent, as she made clear, that goes to the heart of what we are discussing. I will not repeat what she and other Members have said, but I will briefly discuss inequality in relation to my constituency. I also thank the British Liver Trust for its comprehensive and incredibly enlightening briefing on the issues that we face, which put into context the impact of those issues on our constituents. We are talking about individuals—mothers, fathers, sons, daughters and children—whose lives can be destroyed by this dreadful condition. My hon. Friend set the scene in relation to that. Time and again, the trust reinforced that fatty liver disease is a silent killer that is on the increase and clearly has been for a considerable time.

To put that into context—some figures have been mentioned—there are about 19,000 deaths each year across the country. If my maths is right, that is about 52 deaths every day. In my constituency, that would equate to about 29 deaths a year, but I suspect the figure would be much higher if health inequalities were factored in, given that the rate of the disease is five times as high in the most deprived areas, of which mine is one. The figure in my constituency might be five times that amount —100 or 150 deaths a year.

We should take into account that the average age of death is 61 for men and 62 for women, which, in this day and age, is really no age at all. In men, the chance of death is twice as high as in women. In that context, it is also important to emphasise that nine out of 10 cases of liver disease could be prevented.

I hope that this debate will enable the calls to action by the British Liver Trust and by hon. Members to be heard in relation to prevention, early diagnosis, treatment and tackling inequalities. Perhaps the most sobering issue, which my hon. Friend the Member for Worthing West touched on, is the level of fatty liver disease in our children. She indicated that as many as 40% of children are affected in the more deprived areas, whereas in less deprived areas it is more like 14%—and even 14% is far too high.

I am pleased that my hon. Friend has enabled us to look at this issue in more depth. I look forward to the responses from the Opposition spokespeople, the hon. Members for Sleaford and North Hykeham (Dr Johnson) and for Winchester (Dr Chambers), and of course my hon. Friend the Minister.

--- Later in debate ---

[The Minister for Secondary Care (Karin Smyth)]

It is a pleasure to serve under your chairmanship, Mr Efford. I congratulate my hon. Friend the Member for Worthing West (Dr Cooper) on securing the debate. We have veered quite a long way into the public health arena in the last while, but that demonstrates how important it is. I pay tribute to the expertise that my hon. Friend brings to this House and everything that she is doing to promote public health, including sharing the news about the winter flu vaccine—I will get that in while I am here, Mr Efford, because it is so important.

As has been said by many, including the resident GP on these Benches, my hon. Friend the Member for Stroud (Dr Opher), we have all learned from this debate. Well done to the British Liver Trust for its fantastic campaigning and briefing, which has clearly paid dividends. My hon. Friend the Member for Worthing West has given me the chance to update the House on the Government’s efforts to tackle the obesity crisis. I am here on behalf of the Under-Secretary of State for Health and Social Care, my hon. Friend the Member for West Lancashire (Ashley Dalton), who is responsible for public health, but this issue concerns us all. Many of us have been involved in this area for some time, and it is one of the defining public health challenges of our time.

We heard today some of the facts. Obesity is a major risk factor for both fatty liver disease and cardiovascular disease; there are common risk factors such as high blood pressure, high cholesterol and type 2 diabetes. Non-alcoholic fatty liver disease now affects about one in three adults in the UK. Prevalence has increased with the rise in obesity rates. Currently, almost two thirds of the adult population in England are overweight or obese, and almost 29%—almost 13 million people—are living with obesity. When children in England start school, just over one in five of them are overweight or obese, and that rises to more than one in three by the time they leave primary education. Children living with obesity are five times more likely than other children to live with obesity as adults.

We have heard that there are major inequalities in how obesity is distributed across the United Kingdom. That was highlighted brilliantly by my hon. Friend the Member for Bootle (Peter Dowd), and by my hon. Friend the Member for Blackpool North and Fleetwood (Lorraine Beavers), who talked about the loss of her constituent Stuart. My hon. Friend the Member for St Helens South and Whiston (Ms Rimmer) spoke eloquently for Sara and her stepmother Dorothy on their loss of Stephen, which brought home to all of us the real impact of this disease on people’s lives.

Kids in deprived areas are twice as likely to struggle with obesity as those in the least deprived, so this is an extremely serious matter. We are effectively hobbling the life chances of a little boy or girl before they have had a fair start. The Government cannot and will not look the other way as a generation of kids miss out on the best start in life. The points made by my hon. Friend the Member for Worthing West make sense, given that we both stood on a manifesto that committed to halve the gap in healthy life expectancy between the richest and poorest regions in England, and reverse the legacy left to us by the last Government. We share that goal. The question is: how do we get there?

On my hon. Friend’s calls for a liver strategy and a childhood obesity plan, our 10-year health plan sets out decisive action—we have heard about some of it in this debate—on prevention to tackle the obesity crisis head on and create a fairer, healthier food environment. We are looking at people as a whole: where they live, what services they need and how to prevent illnesses in their communities. That will help us to be better prepared for the changing nature of the disease and allow our services to focus more on the management of chronic long-term conditions. I will talk more about prevention later.

On my hon. Friend’s call to extend the levy model, we are taking steps to ensure that the soft drinks industry levy, which the Lib Dem spokesman, the hon. Member for Winchester (Dr Chambers), discussed eloquently and which colleagues know as a sugar tax, remains fit for purpose. On the request that my hon. Friend the Member for Worthing West made for an ICB pathway, we are working with partners including the British Liver Trust to raise awareness and address the stigma related to hazardous and harmful levels of alcohol use and viral hepatitis, which are key drivers of liver disease. We will continue to work with communities and help those most affected by liver disease through the community liver health checks programme.

[Peter Dowd]

This must be one of the safest places in the Palace, with at least three medics and a vet in the Chamber. My constituency has been designated a pride in place area. One of the aims of that programme is to create safer, healthier environments. Does my hon. Friend agree that there is a great opportunity in those areas, which include an area of her constituency, for funding to be used in a lateral way for local community initiatives such as those that have been highlighted during the debate? There is real opportunity for those initiatives to be tested out, with local people making local decisions.

[Karin Smyth]

My hon. Friend is absolutely right. The pride in place programme does just as it says on the tin, and it is important. The Government’s drive is to make sure that those communities, which know best what they need, are the drivers of how that is done. We will think laterally and bring together all that they know about why there is that level of deprivation in those communities. I know that, with his experience as chair of a primary care trust and as a local councillor, my hon. Friend is well placed to see what needs to happen for us to bring things together and think laterally. In my community, the legacy of the tobacco industry is the source of so much of the long-standing inequality.

The ICBs need to be tied into that community work and support it, and make sure that community health checks proactively identify people suitable for liver cancer surveillance. More widely, as my hon. Friend the Member for Stroud said, our shifts, and particularly the transfer to community and neighbourhood health, absolutely support that agenda. I know that hon. Members will make sure that that agenda is well delivered. This disease lends itself very much to that drive, which we are determined to make happen.

My hon. Friend the Member for Worthing West asked for us to be patient-ready for the next generation of liver disease medications. If my hon. Friend the Minister for Innovation, Lord Vallance, were here now, he would happily chew her ear off about everything that the Government are doing to ensure that the next generation of life sciences discovery is available to NHS patients. I will touch briefly on medicines later.

My hon. Friend also asked about local food partnership funding and action on food affordability. I cannot go into those points in detail here, but we absolutely recognise them, and we are working closely with my right hon. Friend the Secretary of State for Environment, Food and Rural Affairs to develop DEFRA’s cross-Government food strategy to provide healthier and more easily accessible food, particularly in deprived areas. I encourage my hon. Friend to ensure that she is completely aligned with that agenda, as I am sure she is. We want to make that work. On her call to enforce the 9 pm watershed, I will update the House on where we are in delivering our manifesto commitments.

Prevention is clearly an important part of this work, and our manifesto specifically promised to restrict advertising of junk food to children, along with banning the sale of high-caffeine energy drinks to under-16s. We are consulting until 26 November on that ban, and the restrictions on junk-food advertising will take legal effect on 5 January. I thank the advertisers and broadcasters who are doing the sensible thing in getting ahead of the regulations by applying the restrictions already.

We have also restricted volume price promotions such as “buy one, get one free” on less healthy food and drinks, and given local councils stronger powers to block new fast-food outlets near schools. We will go further. Current promotion and advertising restrictions on less healthy food and drinks use an outdated nutrient profile model. That was formulated under the previous Labour Government, almost 20 years ago, because we also took this agenda seriously when we were last in government. We will update the standards that apply to the restrictions, and we will consult on their implementation in the coming year.

In a world first, as per our 10-year plan, by the end of this Parliament all large food businesses will be required to report against standardised metrics on sales of healthier food. That means that the large food companies will have to tell us regularly how healthy the food they are selling is, and whether that is improving. That will set full transparency and accountability around the food that businesses are selling, and it will encourage healthier products. We will also set new targets to increase the healthiness of food sales in all communities. Finally, with regard to liver disease, we are exploring innovative approaches to early detection, such as intelligent liver-function testing, to reach more people at a stage when liver damage can better be reversed.

Our focus is prevention—we have the shining example of the hon. Member for Strangford (Jim Shannon)—but we do need to treat the millions of people who already live with obesity in the UK, so let me say what we are doing for them. First, we are building relationships with the biggest pharmaceutical companies to expand access to weight-loss services and treatments across the NHS.

Secondly, obesity drugs can be game changers in supporting weight loss, and we are entering what could be a golden age for obesity drugs, with many more in the pipeline. Over the summer, the NHS started its roll-out of the weight-loss injection Mounjaro through GPs. About 220,000 people, prioritised by clinical need, are expected to receive Mounjaro on the NHS over the next three years.

Thirdly, our obesity pathway innovation programme, supported by industry, is testing new ways of delivering that care, including through pharmacy-led services in the community and through digital services—again, part of our shifts. We recognise that these drugs are not a replacement for good diet and exercise, as exemplified by the hon. Member for Winchester, and they are not the first thing for patients or the NHS to try. That is why we have committed to doubling the number of people who can access the NHS digital weight-management programme.

On hospital to home, we are providing treatment options for children by shifting care from hospital to community. That comes back to the point made by my hon. Friend the Member for Worthing West about the left shift. Earlier this year, the Government announced that we would support thousands of severely obese children to lose weight and live healthier lifestyles, thanks to the roll-out of specialist NHS clinics and new digital smart technology to deliver expert care at home. That game-changing tool is helping our specialists support and keep track of children’s weight-loss programmes, without those children needing to leave home, while offering regular advice to them and their parents to help build healthier habits.

I have set out how the Government are tackling the obesity crisis head on, especially when it comes to safeguarding our children’s future, but while we are shifting the focus of our NHS to prevention, we are also doing more to help people who are already affected by obesity and fatty liver disease, especially through medicines and new technologies and by shifting care from hospital to home. We remember that we stood on a manifesto that committed to tackle the root causes of ill health and to close the gap between the richest and the most deprived areas. That is exactly what we are focusing on through our 10-year health plan. This Government will not sit by and let ill children become ill adults—not on our watch. I thank my hon. Friend the Member for Worthing West for securing this debate.

World Stroke Day

Peter Dowd Excerpts

Tuesday 28th October 2025 Westminster Hall

[Chris Bloore (Redditch) (Lab)]

It is a pleasure to serve under your chairship, Ms Vaz. I thank the hon. Member for Twickenham (Munira Wilson) for securing this important debate and for sharing her personal story and those of her constituents. That is exactly why this is such an important issue for us to speak about. Stroke can happen to anyone, at any time, in any family.

Stroke is the leading cause of complex adult disability in the UK, yet too often it remains underfunded, understaffed and under-prioritised. Recovery does not end when someone leaves hospital—for many, that is just the beginning. Relearning to walk, to speak, to eat or simply to live independently again takes extraordinary strength and proper support. Physiotherapy, occupational therapy and speech and language therapy can transform lives, but right now only 17% of community services have access to all three.

In Redditch, there are around 2,000 stroke survivors. I thank everyone who has contacted me, from Redditch to the Lenches, from Harvington to Wychbold, to share their stories and experiences. This issue cuts across every age, every background and every family. I have spoken to people in their 30s and 40s whose lives were turned upside down overnight. Stroke affects not only individuals, but their loved ones, their workplaces and their communities.

I thank the organisers of the Redditch stroke support group for everything they do to help local stroke survivors and their families.

[Peter Dowd (Bootle) (Lab)]

Does my hon. Friend agree that organisations such as the one he mentioned, the Stroke Association and others have a vital role to play in bringing these matters to the attention of this House for as long as it takes?

[Chris Bloore]

I wholeheartedly agree with my hon. Friend. The work of those organisations—the listening, guidance and encouragement—is often what helps people to take the first steps back towards confidence, independence and hope. They are a vital part of our community and I am deeply grateful for their dedication.

The Government’s 10-year health plan is an opportunity to do better: to shift our focus from hospital to community and from sickness to prevention. We know that nine in 10 strokes are linked to preventable risk factors such as high blood pressure and heart disease. Prevention saves lives, but it must be matched by proper rehabilitation and support for those already living with stroke, because one in four stroke survivors will have another stroke within five years.

As we mark this World Stroke Day, I pay tribute to the Stroke Association, to our incredible NHS staff and, above all, to all survivors and carers, who show every day what courage and recovery looks like. With the right help, life after stroke is not just possible; it can be full of purpose, love and dignity.

GP Services: Christchurch

Peter Dowd Excerpts

Tuesday 20th May 2025 Westminster Hall

[Peter Dowd (in the Chair)]

I will call Sir Christopher Chope to move the motion and I will then call the Minister to respond. I remind other Members that they may make a speech only with prior permission from the Member in charge of the debate and from the Minister. There will not be an opportunity for the Member in charge to wind up, as is the convention for 30-minute debates.

[Sir Christopher Chope (Christchurch) (Con)]

I beg to move,

That this House has considered access to GP services in Christchurch.

It is a pleasure to serve under your chairmanship, Mr Dowd. This short debate was triggered by the perverse decision, announced last week, of the Dorset integrated care board to refuse permission for Burton surgery to reopen. The surgery is a premises in Burton village in Christchurch constituency, which has had a GP surgery for more than 30 years. The surgery was converted from a guest house. It has good car parking nearby and a pharmacy adjoining it, and is a well-loved community facility.

In 2007, the GP practice in Burton was amalgamated with Christchurch medical practice and became a branch of that practice. Then, in December 2023, patients were told that the Burton premises would be closed and all patients transferred to Christchurch medical practice in Purewell. I wrote to the integrated care board to express my concern at the impact that would have on the people of Burton. Although the ICB said that it was powerless to intervene because the surgery was only a branch, local residents were confident that another GP practice would acquire the premises and continue to provide GP services, because the building is in really good order: it has 11 consulting rooms and is a very attractive proposition for another GP practice. It was expected that it would be put on the open market for sale.

Much to everybody’s frustration, that did not happen. The owners of the practice decided instead to do a closed deal with a veterinary hospital based in Christchurch, which agreed to acquire the site, thereby excluding the possibility of another GP practice taking it over. However, one thing they had not thought about was that they needed to get planning permission for a change of use. The planning application was strongly opposed by local residents, backed by me, and it became a major issue in the general election campaign. Eventually, Bournemouth, Christchurch and Poole council refused the application on a series of grounds, the principal one being that

“insufficient evidence has been submitted to demonstrate that the loss of a community facility at this site would not result in a substantial decline in the range and quality of facilities and services available for local people.”

In essence, the local planners said that it was necessary to keep the surgery in Burton because removing it would take away an important community facility. If nobody else was willing to open such a community facility, I would not have been able to put forward this argument, but another practice has now purchased the premises and is willing and ready to open a branch in them. However, in order so to do, it had to apply to the integrated care board for permission. It did just that last November. Extraordinarily, it took months before a decision was reached—so long that I raised the issue in an oral question. The Secretary of State himself took it on board and, as a result, the ICB was pushed into having to make a decision on 23 April. As I understand it, the decision was made on 23 April, but was not communicated until some time afterwards.

In the meantime, and in anticipation that the application to reopen the branch was essentially a formality, South Coast Medical completed the purchase of the building and started the refurbishment. The plan was that it would reopen this summer. The ICB’s decision to refuse permission for the branch surgery to reopen is, in my view and that of my constituents and local residents, beyond belief. I appeal to the Minister to intervene on behalf of the 4,500 patients whom the ICB accepts would choose to re-register at Burton were the surgery to reopen.

Ironically, it is said that the cost of re-registering those 4,500 patients would be a significant burden on the health service. That is because people who are in their first year with a GP are thought to be more burdensome, so the GP gets paid a slightly larger amount for each of them. To describe the exercise of patient choice in that way—as a burden on the NHS—seems to me to be pretty wide of the mark.

After I heard the outcome of the application, I tabled a series of questions, one of which sought to establish how many people have been transferring from one practice to another in Christchurch each year, because I wanted to get a feel for that. The answer, from the Minister for Care, stated that the information is not available.

Some of the arguments made in favour of not allowing the surgery to be reopened, in answer to another of my questions, were based on the number of appointments already taking place in Christchurch. That prompted me to table a named day question on that subject. At about 9.30 am this morning I received a holding response, saying that the information relating to the number of appointments at surgeries in Christchurch over the past couple of years is not available, yet the ICB says that it used that very information to help it reach its conclusion. I hope the Minister will explain why the ICB, which I think is basically the custodian of all this information, so far has not decided to share that information with Ministers. Either it has the information or it has not been wholly open in suggesting that the information helped in its decision.

Rare Cancers Bill

Peter Dowd Excerpts

2nd reading
Friday 14th March 2025 Commons Chamber

[Peter Dowd (Bootle) (Lab)]

I rise to support my hon. Friend the Member for Edinburgh South West (Dr Arthur). I know he has put a huge amount of effort into bringing the Bill before the House, in collaboration with many others, including patients, families, professionals and charities. I send my condolences to him, his wife and family on the death of his father-in-law, and to Tilly’s family. To lose a child is unbearable and against the natural order of things.

The Bill is much needed and I welcome the opportunity to make some observations about it. Before I do so, I refer to my hon. Friend the Member for Calder Valley (Josh Fenton-Glynn) and his brother. I live in the area of Lunt that he referred to, where there is going to be a remarkable legacy for his brother: the area has been rewilded and there will be a forest there in due course, which is absolutely fantastic. I invite him and his family to come down—I will show them around and they can see the legacy that his brother has left us.

I also want to refer to comments made by the chief executive officer of the Brain Tumour Charity, Dr Michele Afif, about the context of the Bill and why it is before the House. In an online article last month, she wrote:

“During my clinical career I was frequently moved by the courage and determination of my patients and their families.”

It behoves all of us to support the endeavours of my hon. Friend the Member for Edinburgh South West to help those people who “don’t have a voice”, as Dr Afif says, by giving our unambiguous backing to what she calls “a Bill of hope.”

We must ensure that that hope is turned into reality: that is the job of every Member in the Chamber. We owe it to those affected by rare cancers to champion their needs, treatment and lives. The proposed legislation would be a starting point—a first base. It will enable and facilitate the promotion of research into rare cancers and better access to clinical trials, as has been said, and initiate a review of marketing authorisations for so-called orphan products, which I will explore in more detail.

It is devastating to have a cancer diagnosis. We all know family members who have been diagnosed with one form or another. The shock and trauma that comes with such news is hard to take in, as the hon. Member for Wokingham (Clive Jones) said. But then to find out subsequently that the spectrum of intervention with medicines or other allied interventions is limited because of the rare nature of a particular cancer surely adds to that distress and worry. As the hon. Member for Esher and Walton (Monica Harding) and my hon. Friend the Member for Mitcham and Morden (Dame Siobhain McDonagh) said, with glioblastoma, questions inevitably sweep through the minds of those affected as to whether an appropriate medicinal intervention is available or even on the horizon.

Orphan products are those drugs that are used to treat not only rare cancers but other rare diseases. The pharmaceutical industry is reluctant to develop the drugs because of the cost, time and effort when they will not be commercially productive, given the number of people who will use them. The fact that these potentially lifesaving, or life-changing, drugs are not produced leaves a significant lacuna in the treatment options for those with rare cancers. Although there is a public health need—of that there is absolutely no doubt—there is no resource to enable that lacuna to be filled. That resource should be made available.

I am therefore pleased that clause 1 of the Bill will place a duty on the Secretary of State for Health and Social Care to undertake a review of the law relating to marketing authorisations for potential orphan medicines. I note that the Bill will require an assessment of regulatory approaches in other countries, which is also welcome. That is an excellent and much-needed step in the right direction, linked in with the other requirements in the Bill relating to research programmes and initiatives. It sends a clear and unambiguous message to those affected and those who will be affected—that could be anybody in this Chamber and, as we have heard, it is some people in this Chamber—that the Government have heard what they have said and are not only listening to that message and that plea, but are taking practical action to put it into effect, which is more than welcome.

Other countries have introduced similar legislation in this respect. The provision in clause 1(2) will help to form a more progressive, informed approach and its requirements will enable information, practices and protocols from other jurisdictions to be harvested. For example, Genetic Alliance UK points out that there are as many as 7,000 rare diseases—possibly more—affecting one in 17 people, with approved treatments available for only one in 20 rare diseases more generally. Although those are not significant cohorts of people per se in a particular disease category, collectively millions of people are affected in one fashion or another by a rare disease, including rare cancers—and it is no less the case for rare cancers: a disease is a disease, and those affected by it, whether it is rare or not, are entitled to equity of care and intervention.

In this case, such potential interventions cannot simply be left to market arrangements. That is why it is important to facilitate a more comprehensive approach to the development of orphan medicines, which must be set against the context of, for example, a 2022 survey of 61 orphan medicines that received EU approvals between 2018 and 2021. Of those, 36 orphan medicines were made available in England, compared with 55 in Germany, 50 in Italy, 48 in France and 31 in Spain. While those medicines do not specifically relate to cancer, that helps to contextualise the difference in numbers for orphan medicines.

A research programme between 2020 and 2025 at the University of Sheffield, funded by the Wellcome Trust, indicated:

“Furthermore, only a third of EU authorised orphan drugs are recommended by NICE… Thus, the medical needs of UK rare disease patients are potentially underserved compared to both the USA and EU.”

Indeed, the programme is called the Orphanisation project. Clearly, as the university puts it, there is a

“major international debate…currently ongoing about how we might improve patients’ access to orphan drugs, raising important questions about how to value these medicines, and the ethics of resource allocation”.

The project sets out a path for being creative in progressing the relatively new concept of orphanisation,

“as a way of understanding contemporary changes in the biopharmaceutical sector. Specifically, the project examines the extent to which orphanisation occurring in the EU, UK, and USA”,

and seeks to understand how it is informed by

“different technologies, institutions, and actors, addressing the implications for industry, health policy and patients”.

I look forward to the progress that it will make. I believe that the proposals in the Bill will help. They follow through systemically and consistently to change that scenario for the better. International explorations and comparisons are one method to inform decision makers about how they can be more proactive in facilitating access to medicines for those most in need of them, especially when the size and extent of the available medicinal range is limited. That is often the case with the rare cancers we are talking about, and rare diseases more generally.

Once again, I thank my hon. Friend the Member for Edinburgh South West for enabling the House to debate this issue and for the opportunity to tease out many of the issues affecting our constituents and, as I referred to earlier, to discuss crucial lifesaving and life-enhancing treatments for diseases more generally.

I again pay tribute to all those colleagues who have brought their stories and their experiences to us today, including my hon. Friends the Members for Calder Valley and for Mitcham and Morden, the hon. Members for Wokingham and for Witney (Charlie Maynard) and others. They deserve our admiration and thanks, but more importantly, they need our support to get the job done. That point has been made by so many. Such expositions, however painful for the Members concerned, bring home the real need for this House to act on this issue, which is literally a matter of life and death. Finally, I look forward to seeing the Bill progress through the House in the coming weeks, as no doubt do many others. I thank you, Madam Deputy Speaker, for your indulgence.

Dental Healthcare: East Anglia

Peter Dowd Excerpts

Wednesday 11th December 2024 Westminster Hall

[Peter Dowd (in the Chair)]

I will call Jerome Mayhew to move the motion and the Minister to respond. As is the convention for 30-minute debates, there will not be an opportunity for the Member in charge to wind up.

[Jerome Mayhew (Broadland and Fakenham) (Con)]

I beg to move,

That this House has considered dental healthcare provision in East Anglia.

It is lovely to see you in the Chair, Mr Dowd. I am grateful to colleagues from East Anglia for supporting this debate and, I hope, making some interventions. I am also grateful to the Minister for Care for coming yet again to Westminster Hall, because this is not the first time that we have had a debate on dentistry in the east of England, and in East Anglia in particular. The reason for those numerous debates is the significant problem of access to NHS dentists in particular, but also to private dentists.

Peter Aldous, who I am sorry to say lost his seat at the recent election, was a doughty campaigner on the issue. I pay tribute to him for the numerous debates he brought forward. Most recently, in September, the hon. Member for Norwich South (Clive Lewis), who is not here today, held a debate on the topic. Time is short, so I will not focus on the need as much as I normally would, but the Minister has been here before and knows very well how significant the need is for increased access to NHS dentistry in East Anglia.

I will give highlights, however, because the Secretary of State for Health and Social Care has described Norfolk not only as a dental desert, but as the “Sahara of dental deserts”. The Minister—the noble Baroness, Lady Merron—confirmed in the other place on 25 November that the Norfolk and Waveney area has

“the worst ratio of NHS dentists to patients in England”.—[Official Report, House of Lords, 25 November 2024; Vol. 841, c. 479.]

In my last debate in this forum, I was shocked to report that in Norfolk and Waveney the ratio of dentists per 100,000 population was 39, when the national average was 52. Now I have to update those figures, because the Secretary of State has recently confirmed that the figure of 39 has dropped to 36 per 100,000 of population, while the national average has increased to 53. It is getting worse, not better.

The data from this month is even more concerning. The British Dental Association confirms that there are 3,194 NHS dentists in the east of England, which are the statistics we previously used. BDA’s further analysis last month reveals that that equates to just 1,096 full-time equivalent dentists in NHS roles. If those figures are run through the population, there are 17 full-time equivalent NHS dentists per 100,000 population in the east of England. Those are truly shocking figures.

The issue can be sliced and diced in another way. The amount of money that the Government spend on people’s mouths in the east of England makes for sobering reading. The national average is £66 per mouth spent on dental treatment by the NHS. In the east of England, that figure is just £39. What is it? Is it that our fillings and dental work are cheaper in the east of England, or are we doing less? It is not due to less demand; we have the greatest demand. We had more than 1,000 people presenting in the past year at NHS A&E with significant dental problems. I believe I am right in saying that dental concerns are the single biggest reason why primary school children present at hospitals.

Rare Autoimmune Rheumatic Diseases

Peter Dowd Excerpts

Tuesday 10th December 2024 Westminster Hall

[Peter Dowd (Bootle) (Lab)]

It is a pleasure to see you in the Chair, Dr Huq. I thank the hon. Member for Strangford (Jim Shannon) for bringing this issue before us today, because it is one of those subjects that does not get the attention that it needs. It is really important to tease out some of the issues, because there is a danger that they could be forgotten if we do not. The hon. Gentleman pushes this matter time and again.

The whole question of rare autoimmune rheumatic disease needs to be set in the context of the wider issue of rare diseases, which are conditions that affect less than one in 2,000 people. There are 7,000 rare diseases, affecting one in 17 people, which is 3.5 million people. They can be of a genetic or non-genetic origin and they affect adults and children. Some 75% of rare diseases affect children and more than 30% of children with a rare disease die before their fifth birthday. That is a sobering statistic.

We have to put the issue into that context: it affects the lives of so many people, not just those who are directly affected by the particular disease, but their family members and friends. A disease can also have an impact on someone’s work-life balance and their job, as well as more broadly. There are challenges, but I thank the Rare Autoimmune Rheumatic Disease Alliance for bringing those groups together to push for this issue. It believes, as we all do, that getting together gives us more strength. I support that, and I have no doubt that the Minister supports that too.

We do not want rare diseases, particularly this type of disease, to be left at the back of the queue. The Government acknowledge that, so I am not pointing the finger at them, or at health professionals. Many people with this type of disease say that they do not get the support they need, but they do not blame individual clinicians, practitioners or healthcare workers; they blame the system in so far as it does not bring those professionals together in, for example, the clinical networks that the hon. Member for Strangford referred to. This is not a finger-pointing exercise, but it is important that where we can identify, and have identified, problems in the system, it is our responsibility to try to fix those problems.

The hon. Gentleman also touched on the need for defined, measurable and identified standards to reduce inequalities in healthcare provision. RAIRDA is working with others to set out key statements that it believes will form the quality standards for the future. It has set out the challenges, such as the challenge of focusing on this issue and the points that the hon. Gentleman raised that the time from symptoms to diagnosis can be from two and a half years to as much as five years, and potentially beyond.

There is also a challenge with access to specialist knowledge and expertise, and the hon. Gentleman’s valid point, which I repeat, about the need for those specialist networks. There is the challenge of getting support out to the people—the professionals—dealing with our constituents in one way fashion or another. I know the UK rare diseases framework, and the England rare diseases action plan in my case, has been trying to help patients to get a diagnosis faster but we need to do more.

There has been a push to raise awareness among professionals, but we need to do more there. We need better co-ordination of care and improved access to specialist care, treatment and drugs. We also need to focus on the needs of the various nations. Although they all face similar problems, it is important to have a focus at a national and potentially regional level.

I support the hon. Gentleman, who made important points. We will no doubt come back to this issue. I know that the Minister will respond, as he always does, constructively and positively, so I look forward to hearing what he and Members from other parties have to say. I will finish by saying to the hon. Gentleman that at no point during my contribution did I mention either Shakespeare or Sophocles.

Suicide and Mental Health of Young People: Tatton

Peter Dowd Excerpts

Tuesday 26th November 2024 Westminster Hall

[Peter Dowd (in the Chair)]

I will call Esther McVey to move the motion. I will then call the Minister to respond. There will not be an opportunity for the Member in charge to wind up, as is the convention for 30-minute debates.

[Esther McVey (Tatton) (Con)]

I beg to move,

That this House has considered the matter of suicide and mental health of young people in Tatton constituency.

It is a pleasure to speak under your chairmanship, Mr Dowd. I would like to convey my appreciation to the Minister for replying to this extremely important and sensitive debate on the management of withdrawal from antidepressant medication, specifically selective serotonin reuptake inhibitors, and the profound impact that that process can have on the mental health and suicide risk of young people.

I would like to begin by conveying my sincere thanks to my constituent, Gina Russell, who met me and bravely shared the experience of her daughter, Olivia, who tragically took her life in September 2021, following withdrawal from SSRI medication. Olivia’s mum is unable to be with us in Westminster Hall today. However, I know that she and her family are watching this debate at home, as they are determined to help prevent others having to suffer the same fate as Olivia.

I would also like to place on record my thanks to the charities Mind, Rethink Mental Illness, PAPYRUS Prevention of Young Suicide, as well as to The Children and Young People’s Mental Health Coalition and the House of Commons Library for the information provided to me before this debate. While the information was insightful, it was deeply disturbing, as it revealed that Olivia’s experience of declining mental health as medication was withdrawn was far from unique and was a known risk, which made me determined to pursue this debate on behalf of her family and thus bring Olivia’s story and her family’s suffering to a wider audience.

Let me start by painting a picture of Olivia, who was an intelligent, creative and hard-working 25-year-old who had just left Tatton to live in London. Her parents remember her as wonderful and vibrant—a loving daughter and a loving younger sister to her brother, Luke; a cherished and adored granddaughter; and a loyal, kind and supportive friend. She lit up a room and was admired by all who knew and loved her.

In November 2020, during the pandemic, Olivia became anxious. She began taking an SSRI—citalopram—to manage her anxiety. Initially, Olivia responded well to treatment. However, when the time came to discontinue the medication in June 2021, she experienced a rapid decline in her mental health, which was far worse than what she had previously faced. She then resumed SSRI treatment in August 2021, finally taking her life in September 2021. When she first came off her medication it was without consulting her GP, because she was feeling better. She should have been warned about stopping taking the antidepressant. The family was later to discover that citalopram is one of the most difficult antidepressants to come off.

Tragically, the Royal College of Psychiatrists suggests that between a third and half of people who take antidepressant medications experience withdrawal symptoms to some extent. The severity and duration of these symptoms, and whom they affect, is not certain. In Olivia’s case, the withdrawal symptoms were severe and the resulting deterioration in her mental state ultimately led to her taking her own life. Members should bear in mind that suicide remains the leading cause of death among young people under 35 in the UK, and the mental health of young people has declined alarmingly in recent years.

Mental Health Support

Peter Dowd Excerpts

Thursday 10th October 2024 Westminster Hall

[Several hon. Members rose—]

[Peter Dowd (in the Chair)]

Order. This is clearly a popular subject. Lots of people had indicated previously that they wished to speak; there are obviously people who wish to speak who had not indicated beforehand, and others will want to intervene. The Minister and Opposition spokespersons have 10 minutes each. Having done the calculations, we will regrettably introduce a formal three-minute time limit on Back Benchers. You will be able to see the time on the screen, and regrettably I will have to cut you off in your prime if you go over three minutes. Just bear that in mind, please. I am sorry for the tutorial, but it is worth having, I suppose. Please bob if you do want to speak.

[Helen Maguire (Epsom and Ewell) (LD)]

It is an absolute pleasure to serve under your chairmanship, Mr Dowd, as I speak for the first time in Westminster Hall. I thank the hon. Member for Ashford (Sojan Joseph) for securing this important and timely debate on World Mental Health Day, and for speaking so well.

Mental health can affect any of us at any time, young or old. Unfortunately, too many people simply do not get the support they need and some go on to take their own life. Speaking personally, husbands of two friends of mine, a friend’s brother and a friend have taken their life, destroying families who are left behind figuring out how to cope.

Since becoming the MP for Epsom and Ewell, I have been shocked by the lack of mental health support, but also amazed at the ingenuity of local residents to provide it in its absence. I had the pleasure of meeting Charley Moore the other day—a Surrey female firefighter and founder of an all-female support group in Epsom and Ewell called Grow and Glow. She had a mental health crisis last year and found it very difficult to access support. She found many mental health groups for men, but she could not find any specifically for women, so she set one up.

I was also proud to meet two mental health charities the other day that were recognised at the BBC Surrey and Sussex Make a Difference Awards last week in my constituency. One was We Power On, which is a men’s mental health “walk and talk” support group set up by Chris Waller after he and his friend reconnected during lockdown and discovered that they were both struggling with their mental health. He won the bravery award. He takes people out at the weekend, walking on the lovely Epsom downs and sharing their experiences.

The other charity, Joe’s Buddy Line, was set up by Ivan Lyons, who won the community award and is one of my constituents. Ivan’s son was an award-winning radio producer on Capital Radio. Sadly, in 2020, Joe took his own life. Through Joe’s Buddy Line, Joe’s family advocate for mental health to be treated equally and with the same seriousness as physical health. The charity provides mental health support, advice and resources for schools. It is encouraging schools to put a mental health policy in place in every single school, giving teachers the support that they need to support the young people of today. The charity has highlighted to me that currently it is not a statutory requirement for a school to have a mental health policy. Such a policy would foster a whole-school approach, so today I am calling for a statutory requirement for all schools to have a specific mental health policy.

Too many people are simply suffering and too many lives are being lost, yet some of that is preventable. Early intervention and prevention are absolutely key. First, to ensure that our young people get the support they need before they reach crisis point, we need to equip them with the tools they need to build resilience to cope with modern life. We must ensure that no one feels alone in their mental health journey, and we need to normalise conversations about how we are feeling mentally. I am absolutely proud that in my constituency, individuals such as Ivan, Chris and Charley are taking the initiative to champion mental health support for everyone and fill in the gaps that they have identified in the services. Let us not forget—

[Peter Dowd (in the Chair)]

Order. Please sit down. May I reiterate that this is a very sensitive subject, and I do not want to have to stop people in mid-flow when they are talking? This is a very sensitive issue and it would sound rude, so I exhort hon. Members to keep to the three-minute limit. It is regrettable, as this is a very important subject, but please keep to the limit, because— I reiterate—this is such a sensitive subject, and I do not want to cut people off at a sensitive point.

--- Later in debate ---

[Dr Opher]

Absolutely; I fully agree with that.

I want to make a couple of comments about the state of mental health services, for which there are extraordinary waits: a patient of mine had to wait six months following a suicide attempt. That is simply not good enough. In Stroud, we have to wait four years for neurodiversity assessments because we do not have enough resource. In my opinion, we need to move the resource into the community.

I also support what my hon. Friend the Member for Ashford said about health and education. We need mental health support teams in our schools, and we must spread SEND provision evenly.

The Under-Secretary of State for Public Health and Prevention is with us, so I want to talk about the prevention of mental health issues. There is quite a lot of evidence about promoting maternal and infant mental health, and also about parenting and bullying at school. Using arts and culture is an incredibly strong way of improving mental health.

I was impressed with what my hon. Friend the Member for York Central (Rachael Maskell) said about the community basis of mental health treatment. For many lower-level conditions, there is no need for consultant-led care. Support that takes place in the community costs much less and can be really effective.

The CAMHS waiting list is appalling, and we have a crisis with SEND and delays with education, health and care plans. We do not have enough educational psychologists either. I want to stress what my hon. Friend the Member for Ashford said about care co-ordinators. Young people’s social prescribers are very effective and tend to de-medicalise things that can be supported in the community.

I am really impressed that we are going to get 8,500 more mental health workers. I am also impressed by what they will be doing in schools. We need to improve the physical health of people with serious mental illness, reduce the number of SSRI antidepressant medications, and promote social prescribing, the arts and community care in our mental health services.

[Peter Dowd (in the Chair)]

Can I just remind Members about modes of expression? I will be diplomatic about it.

[Lola McEvoy (Darlington) (Lab)]

I rise to speak about this issue on World Mental Health Day. I have championed it many times across my career and I will continue to do so in my time in this place.

My constituents—and, I am sure, those of all hon. Members—want something that we used to take for granted: a happy, decent life, with a better future for their children. For too many in Darlington, that is not the reality, and I believe that the current mental health crisis is a product of our times. I will focus my brief contribution not on those with severe mental illness, who are often in crisis, but on those who are struggling with day-to-day poor mental health.

I agree with the hon. Member for Hinckley and Bosworth (Dr Evans), who advocated a cross-departmental approach. Poor mental health is pushing people out of work, and that is a huge issue for the Treasury and the Department for Work and Pensions. A lack of child mental health support and a failure to tackle the online safety crisis for children is leading to school refusals, which is an issue not only for the Department for Education but for the economy and for future generations. Loneliness is impacting the physical health of our older people, which is an issue for the NHS. The lack of opportunity, quality work, maternal mental health services, veteran support and childcare support is driving people in my constituency to despair.

I have mentioned this before, but I will mention it again on this day: within my own network, I have lost seven men to suicide. Only one of them had a severe mental illness. In my region, we have the highest rate of male suicide and the lowest wages. I ask that we, as a Government who are committed to equality of opportunity for our regions, consider my constituency and my region for a cross-departmental pilot to tackle poor mental health before we lose any more people to avoidable deaths.

[Peter Dowd (in the Chair)]

I now come to the Opposition spokespersons.

--- Later in debate ---

[Dr Spencer]

I thank the hon. Gentleman for sharing something so personal in his intervention, and for sharing his experience of the impact of suicide. Many Members have shared personal experience in this debate. That is very important.

I am mindful that there will be people in the Gallery or watching at home who may be affected by the topics we are discussing, and I take a moment to point out that there are a variety of services to help people in their recovery, if one can call it that, after a loved one has tragically died from suicide, or to help people who are in crisis, such as local crisis services, the Samaritans or Mind. There is a variety of third sector and charity helplines that can help. Men’s Sheds is one organisation I know of that is very helpful. I am really pleased that the hon. Gentleman raised this issue.

I will finish with a few questions for the Minister. The Government do not have a mental health care and treatment strategy or a psychosis strategy and, following an answer to a written parliamentary question I tabled, I understand that there are no plans for a mental ill health strategy to be brought in. Given today’s debate, I wonder whether the Minister will reconsider that position. What are the Government’s plans on taking forward our suicide prevention strategy, or a specific psychosis or mental ill health strategy—however he wants to cut the cloth?

Secondly, when does he expect the Mental Health Bill to have its First Reading in this place? All Members are going to want to extensively debate and scrutinise that Bill. When does he expect it to come forward? What is his appraisal of the challenges that the Bill needs to answer when it comes to the interaction between the Mental Health Act 1983 and the Mental Capacity Act 2005 and the deprivation of liberty safeguards? What about the MM case on deprivation of liberty in the context of a restricted patient in the community, and the interaction with the Children’s Act 1989 on when children can choose a nominated representative? I realise he may not have the answers to that immediately, but I would be grateful if he could write to me. Community mental health teams are the core of psychiatric teams in the community and our psychiatric care and treatment service. What is his plan to support them?

Finally, what is his appraisal of integrated care systems and their commissioning of mental health services? The hon. Member for Hastings and Rye (Helena Dollimore) mentioned the challenges with her ICS. What is the Minister’s appraisal of that commissioning and how integrated care systems can be held to account to make sure that is being delivered?

[Peter Dowd (in the Chair)]

I want to give the sponsor an opportunity to wind up at the end. I call the Minister.

--- Later in debate ---

[Andrew Gwynne]

I am reluctant to commit Ministers to roundtables when I am covering another portfolio, because then they will do the same when they cover me in Westminster Hall debates, but I will say that we take this agenda incredibly seriously. When we were in opposition we gave support to the then Government, and I assure the hon. Gentleman that we will do everything we can to support people who have eating disorders and to get the right provision and support at the right time to the people who need it.

As I was saying, the covid-19 pandemic has exacerbated the need for mental health support. Around 345,000 children and young people were on a mental health waiting list at the end of July this year, with more than 10% of them having waited for more than two years. Some groups of children and young people are disproportionately impacted by mental health problems largely driven by a complex interplay of social and environmental determinants of poor mental health, as we heard in the debate.

We are committed to reforming the NHS to ensure that we give mental health the same attention and focus as physical health. It is unacceptable that too many children, young people and adults do not receive the mental health- care that they need, and we know that waits for mental health services are far too long. We are determined to change that, which is why we will recruit 8,500 additional mental health workers across child and adolescent mental health services. We will also introduce a specialist mental health professional in every school and roll out Young Futures hubs. We are working with our colleagues at NHS England and in the Department for Education as we plan the delivery of those commitments.

Early intervention on mental health issues is vital if we want to prevent young people from reaching crisis point. Schools and colleges play an important role in early support, which is why we have committed to providing a mental health professional in every school. However, it is not enough to provide access to a mental health professional when young people are struggling; we want the education system to set young people up to thrive, and we know that schools and colleges can have a profound impact on the promotion of good mental health and wellbeing. Doing this will require a holistic approach, drawing in many aspects of the school or college’s provision. I know there are many schools that already do this work, and my Department is working alongside the DFE to understand how we can support best practice across the sector.

As I have said, our manifesto commits us to rolling out Young Futures hubs. This national network will bring local services together and deliver support for teenagers who are at risk of being drawn into crime or who face mental health challenges. The hubs will provide open-access mental health support for children and young people in every community.

On other aspects of our plans, the mental health Bill announced in the King’s Speech will deliver the Government’s manifesto commitment to modernise the Mental Health Act 1983. It will give patients greater choice, autonomy, enhanced rights and support, and it will ensure that everyone is treated with dignity and respect throughout their medical treatment. It is important that we get the balance right to ensure that people receive the support and treatment they need when necessary for their own protection and that of others. The Bill will make the Mental Health Act 1983 fit for the 21st century, redressing the balance of power from the system to the patient and ensuring that people with the most severe mental health conditions get better and more personalised care. It will also limit the scope to detain people with a learning disability and autistic people under the 1983 Act.

Finally, Lord Darzi’s report identified circumstances in which mental health patients are being accommodated in Victorian-era cells that are infested with vermin, with 17 men sharing two showers. We will ensure that everyone is treated with dignity and respect throughout their treatment in a mental health hospital, and we will fix the broken system to ensure that we give mental health the same attention as physical health.

If I have not answered Members’ questions, those Members will be written to by the relevant Minister. I again congratulate my hon. Friend the Member for Ashford on securing the debate.

[Peter Dowd (in the Chair)]

I call Sojan Joseph to wind up very briefly.

Preventable Baby Loss

Peter Dowd Excerpts

Wednesday 4th September 2024 Westminster Hall

[Several hon. Members rose—]

[Peter Dowd (in the Chair)]

I remind Members that if they wish to speak, they should bob—as some of you have done. Thank you for that.