Down’s Syndrome

Rachael Maskell Excerpts

Wednesday 19th March 2025 Westminster Hall

[Rachael Maskell (York Central) (Lab/Co-op)]

It is a pleasure to see you in the chair, Mr Turner. I congratulate the right hon. Member for Beverley and Holderness (Graham Stuart) on securing this debate. The Down Syndrome Act is simple, but brilliant—but it is powerless without the guidance to accompany it. That is why this debate is timely.

I also call it timely because the elements of the Act determine the very structure that can support a child through to adulthood, from birth through to work. The Act depends on three main pillars, the first of which is healthcare. At this time, we are putting in place a 10-year NHS plan, putting together the NHS of the future, and looking at how we can keep ourselves well; we are putting in early intervention measures and ensuring that we have the workforce needed in the future. If this guidance is to have effect, we need the workforce and the structures to support individuals and their families. Now is the time to look at that and to put in the additional screening and support that a person with Down syndrome needs to optimise their health and keep well throughout their life.

The second pillar is that we are having a massive review of the education system at the moment. We are looking at curriculum change, recognising that the broadening of the curriculum will be much more inclusive. As we review SEND and the whole education system, it is timely to bring in this guidance. It cannot just be guidance around Down syndrome looking in; it must be looking out at other Departments. Again, the time is now. Look at the data: the figure of 80% of children with Down syndrome attending primary school drops to between 25% and 37% in secondary school. That deficit in itself indicates that we need significant change in our education system. We need a schools system that is nurturing, therapeutic and integrated, so that no child feels on the outside of the education they are rightly entitled to.

The third pillar is the place of work. We need to ensure that there are more opportunities for people with Down syndrome to engage in the labour market. Just yesterday, the Government published their plan “Pathways to Work”, which I see as a plan in two halves. The first half will enable more people to access the labour market, to follow the career of their dreams, and to have their skills and talents recognised. We need to ensure that everybody with Down syndrome has that opportunity where it can be afforded—if not in a formal workplace, by volunteering in the community or being able to have the most life-enhancing opportunities available to them. When I talk about the second half of the plan, I have deep concern for people with Down syndrome, looking at the proposed thresholds for personal independence payment in which people will have to score at least four points to meet the threshold to access vital funding to keep them independent —the key word in personal independence payments. We need to ensure that we feed into that debate.

When we get this right, it will be for the benefit of the whole of society. In York, I think of those people who work in West Offices, where the café is run by United Response and provides real work opportunities, and of the Once Seen theatre company, where I see such talent on display. We must get this guidance—

[Karl Turner (in the Chair)]

Order. I call Bobby Dean.

NHS England Update

Rachael Maskell Excerpts

Thursday 13th March 2025 Commons Chamber

[Rachael Maskell (York Central) (Lab/Co-op)]

We must remember that NHS England came out of the Tory Government’s reforms that were intended to privatise the NHS. I want to thank NHS England staff for their work. I am sorry about the way in which they have heard this announcement, because it is their jobs that are being put at risk. We have to ensure, however, that we are not replicating NHS England across the ICBs of our country, and that ICBs are also reformed to transform the NHS through the three shifts that will be placed on them with the publication of the 10-year plan. How will my right hon. Friend ensure that we have the machinery to hold the system to account, but also to put those reforms in place?

[Wes Streeting]

My hon. Friend is absolutely right: if we just replicate NHS England as it is with all the challenges in its set-up in ICBs across the land, we will have failed. Frankly, if we replicate NHS England and the Department as they are today just in one organisation, we will have failed to meet the challenge of change. It needs to feel and act like a completely new organisation, culture and way of working to modernise the state, so that if Disraeli, Gladstone, Churchill or Attlee walked into Whitehall at the end of this Government, it would not look so much like the Government they worked in during the 19th and 20th centuries. That is the reality of Whitehall today; it is not a reflection on the people who work in it, but it shows why it needs to change, and that is also true of the NHS. I look forward to working with ICB leaders to reform their ways of working, clarify their priorities, give them clearer marching orders and ensure that they can deliver.

Finally, my hon. Friend mentions the staff of NHS England—indeed, this affects staff in my Department, too—and I thank her for the care she has shown. Change is always disruptive and it can be scary, and of course that is particularly the case when job losses are involved. I want to acknowledge that on the Floor of the House, as I have to staff across both organisations this morning. I know that the Permanent Secretary and the chief executive of NHS England have done so in recent days, and I will be holding a town hall with staff next week. This really is not a reflection on them. In fact, I think they will recognise in my description of our ways of working the many things that frustrate them. None the less, they are dedicated and talented people, and some of the best people I have ever worked with in any walk of life or career work in this system. I look forward to working with them in the coming weeks and months with the same dedication and professionalism they have always shown, so that we can all look back on this time with pride, knowing that we were part of the team that took the NHS from the worst crisis in its history to getting it back on its feet and making it fit for the future.

New Hospital Programme Review

Rachael Maskell Excerpts

Monday 20th January 2025 Commons Chamber

[Rachael Maskell (York Central) (Lab/Co-op)]

I am really glad that my right hon. Friend has a grip on the hospital building programme and has developed a pipeline for scheduling the new hospitals. York is not on the list, but given that it was one of the cheapest hospitals to build, it will certainly need to be there in 10 to 15 years. How will my right hon. Friend review hospitals that are not on the list and schedule them into future programmes?

[Wes Streeting]

We keep a regular eye on the capital needs of the NHS across the board. Subject to the usual constraints on resources, supply chain construction industry capacity and so on, we will continue to do so. We are determined not to repeat the mistakes of our predecessors, but to ensure that the promises we make are promises we can keep.

Health and Social Care: Winter Update

Rachael Maskell Excerpts

Wednesday 15th January 2025 Commons Chamber

[Madam Deputy Speaker (Judith Cummins)]

Order. Members will be aware that we have pressure on time today, so I will finish this statement at around 3.15 pm.

[Rachael Maskell (York Central) (Lab/Co-op)]

Triaging patients into virtual wards will not only protect the front door of the NHS, but be far better for patients. What is the Secretary of State doing to hold integrated care boards to account and ensure that they are putting money into primary care, as opposed to where everyone always looks, which is secondary care?

[Wes Streeting]

That is an excellent question from my hon. Friend. This Government have been walking the talk on primary care since we came into office. There was an immediate release of funding, within weeks, for 1,000 GPs, who are to be employed on the frontline by this April, and an £889 million uplift in funding for general practice that we announced prior to Christmas. I think that care in the home and care closer to home will be how we not only get the NHS back on its feet, but make sure it is fit for the future. That shift from hospital to community is one of the three big shifts that will lie at the heart of our 10-year plan for the national health service.

Oral Answers to Questions

Rachael Maskell Excerpts

Tuesday 7th January 2025 Commons Chamber

[Andrew Gwynne]

Social prescribing is one of the tools, and it is an important one in addressing public health concerns in each of our constituencies. This Government are committed to ensuring that we get those shifts from sickness to prevention. We will be ensuring that local areas have public health funding in reasonable time. We are about to announce, in due course, this year’s allocations. We need to make sure that local systems maximise the use of their money, and that certainly includes social prescribing.

[Rachael Maskell (York Central) (Lab/Co-op)]

In 2022, there were more than 10,000 deaths from alcohol use. We know that more than 600,000 people have an alcohol dependency. We need to focus not just on treatment services and their funding, but on prevention. The last Government failed to bring forward a timely alcohol strategy. Will the Minister update the House on what he is doing to ensure that we are tackling this massive situation in our communities?

[Andrew Gwynne]

My hon. Friend raises an important point. As part of the Government’s health mission, we are producing a five-point plan for prevention, and alcohol harms is one of those areas. I hope to be able to update her and the House in due course on the actions we will be taking to drive down the prevalence of alcohol harms and other addictions, because they are costing lives and causing misery in communities. That is why this Government are determined to tackle these public health problems.

Health and Adult Social Care Reform

Rachael Maskell Excerpts

Monday 6th January 2025 Commons Chamber

[Mr Speaker]

We are going to finish at about 10 to 5, so the speedier we go, the more that will help.

[Rachael Maskell (York Central) (Lab/Co-op)]

I thank NHS staff for working under severe duress over this winter. One way of ensuring better patient flows is to have better rehabilitation, so will my right hon. Friend say what he is doing to improve rehabilitation access not only in acute sectors but out in the community?

[Wes Streeting]

Further to the previous question, we will be refreshing and updating the NHS workforce plan alongside the long-term plan that we will publish in May, and my hon. Friend is right that rehab is key not just to good recovery but to prevention of future demand on the NHS. I saw a great example of that rehabilitation delivered in social care settings only last week. Whether in the NHS or in social care, we definitely need to do more on rehabilitation, because rehabilitation is often secondary prevention.

Winter Preparedness

Rachael Maskell Excerpts

Wednesday 18th December 2024 Commons Chamber

[Karin Smyth]

I will do my best to address that range of questions. First, as even a stopped clock is right once—[Interruption.] Yes, twice. On that basis, I agree with the right hon. Gentleman. On correspondence and answers to parliamentary questions, again, the situation we inherited is not satisfactory. I apologise to all Members who are waiting for correspondence—it is something we are taking a grip of. We want to respond positively to questions. The Conservatives did not; we will make sure that starts to happen.

On capacity in the system, again, I remind Members that we came into office in July, which is one quarter of the way through the planning and financial year. We very rapidly looked at the plans that were baked in by the previous Government—I appreciate that the right hon. Gentleman was in the Ministry of Justice at the time, not the Health and Social Care Department—to see whether they were fit for purpose. We wanted to make sure we brought stability to the system. There are, in fact, more beds currently available in the system than last year. If there is a need to increase capacity due to a likely cold snap, the system is absolutely ready to respond in its usual way. That is why we are meeting weekly.

On meetings with clinical and managerial colleagues at NHS England—who, frankly, I see more often than many members of my own family—I can tell the right hon. Gentleman that we started those meetings immediately. I would have to check the exact date, but it was certainly in the summer. I have had fortnightly meetings since September, which, as I said, we can move to monthly meetings, chaired by the Secretary of State. We began getting a grip from day one, knowing that winter was coming, which is why I am monitoring the situation weekly. It is also why we visited the operational centre, to understand in real time what is happening across every single system and every single trust—be that ambulance issues or problems at the front end and in A&E. The one question I do not directly have the answer to is what the daily figures are; I will try to get those figures to the right hon. Gentleman later.

We all know that waiting for discharge to assess is a massive problem. That is why, as I said in my statement, we want to take a grip of the better care fund, to ensure it works better and to stabilise the social care system. I am not particularly versed in issues on supply, so I apologise if that is wrong. We will certainly get back to the right hon. Gentleman on that matter, because we want people to be taking the vaccinations where necessary.

I can confirm that we want an announcement on hospices before Christmas. On winter fuel and its impact, as Opposition Members know, we will continue to monitor the impact of all situations on individuals to ensure they are supported in the community. We urge people to make sure they access pension credit. [Interruption.] I have just addressed that, but if I have missed anything, I will come back to it.

[Rachael Maskell (York Central) (Lab/Co-op)]

Despite York’s new emergency department, a consultant has described to me the situation in emergency medicine, where patients are waiting for days to be discharged and 50 patients are waiting to be placed on wards. We know we have inherited a broken NHS. Will the Minister say what she is doing first to enable primary care to pull more patients out of emergency medicine, in order to see people in the community, and secondly to invest in social care, which will clearly address some of the backlog and the logjam in patient flows?

[Karin Smyth]

My hon. Friend’s comments reinforce how much pressure, we understand, is front facing. A&E is demonstrative of the overall pressure in the system, not just at discharge but, as she rightly says, in primary care. We took action in the summer to improve primary care, increasing the number of GPs available in the system. It is absolutely critical that primary care community services are integral to winter planning at a local level. That is what we expect from every single system. We will continue to monitor that over the winter period and into the spring. If those services are not involved in planning for any particular systems, enabling them to monitor the surge and flow of people, we very much want to understand how that is working.

Oral Answers to Questions

Rachael Maskell Excerpts

Tuesday 19th November 2024 Commons Chamber

[Wes Streeting]

It is because the Chancellor took the decisions that she did in the Budget that my Department has received £26 billion to reform and improve health and social care. As I said before the general election, all parts of the United Kingdom suffered under the previous Conservative Government, which is why I am sure that Members from across Scotland will welcome the extra £1.5 billion this year and £3.4 billion next year—the biggest funding increase since devolution. I am sure that the SNP Government will welcome the increase, and they certainly have no excuses now for not acting.

[Rachael Maskell (York Central) (Lab/Co-op)]

Fourteen years of neglect have left hospices in a perilous condition. They are dealing with the rise in national insurance contributions, pay and other cost pressures, so I welcome the fact that the Secretary of State is putting in place measures to ensure that the funding recovers. Will he assure me that integrated care boards not only will pass on that recovery from the increased costs to hospices, but will help them catch up from the Tory years of neglect of the whole sector?

National Insurance Contributions: Healthcare

Rachael Maskell Excerpts

Thursday 14th November 2024 Commons Chamber

[Karin Smyth]

The hon. Lady makes an excellent point about the importance of GPs and primary care to the wider sector. Immediately after taking office this summer, we freed up the system to employ 1,000 extra GPs through the additional roles reimbursement scheme—which the previous Government refused to implement—because we recognised the need for that extra capacity. We will be talking to general practice as part of the contract reforms over the next few months, following the normal process, to determine allocations for next year.

[Rachael Maskell (York Central) (Lab/Co-op)]

If this Government’s ambition, stemming from Lord Darzi’s report, is to be realised, significant investment is required not only in primary care but in third sector organisations. However, these organisations are concerned about the increased cost pressures on their services. Will the Minister ensure that there is sufficient support within the trickle-down approach, which the Department will now have to apply, to maintain current service levels and facilitate the urgently needed transition across health services?

[Karin Smyth]

I respect my hon. Friend’s expertise in this area. She is right, and we understand that the pressures are real, which is why we have committed to supporting the NHS and the social care system with the additional funding that my right hon. Friend the Secretary of State for Health and Social Care secured as part of the Budget settlement.

We are also working closely with the NHS, in a new relationship, to understand its needs. That is a dynamic conversation, because we want to understand what is happening in local systems as we continue to invest in them.

Cancer Strategy for England

Rachael Maskell Excerpts

Thursday 31st October 2024 Westminster Hall

[Clive Jones]

I absolutely agree with my hon. Friend. This is why we need a national cancer strategy. So many cancers do not get the resources they need. Everything is a bit too general; a lot of cancers need the focused, targeted resources that will lead to better outcomes.

[Rachael Maskell (York Central) (Lab/Co-op)]

I am grateful to the hon. Member for hosting today’s debate. In the last Parliament, the Health and Social Care Committee carried out an inquiry into future cancer. From all the evidence we received, we came to the conclusion that a bespoke future cancer strategy was needed to support the NHS, and that it should not be combined in a major conditions strategy, which frankly went nowhere under the last Government. I congratulate the hon. Member on his advocacy; will he read the Committee’s report and our letter about all the interventions that this Government could make to drive forward cancer care?

[Clive Jones]

I am aware of that report and will refer to it later in my speech.

The challenges will only grow. Experts state that one in two of us will get cancer in our lifetime. An expanding and ageing population means that the number of cancer cases is only going to grow. Cancer Research UK projects that there will be about 2.2 million new cancer cases in the current five-year parliamentary term, a 21% increase on the previous term. Cancer services are struggling now, and they will continue to struggle to keep up with demand. We have a greater number of people being diagnosed, but we have services that are not working. The challenge is stark, but there is a diagnosis for the problem. We now need to deliver meaningful action to recover England’s cancer care to full health.

The Liberal Democrats have made cancer care one of our top priorities for health. There are many policies that we think are crucial to boosting cancer survival rates. We are calling for the introduction of a guarantee for 100% of patients to start treatment within 62 days of urgent referral. We cannot just be content with replacing old radiotherapy equipment; we need replacements, but we also need more equipment. We are calling for the recruitment of more cancer nurses so that every patient has a dedicated specialist supporting them throughout their treatment.

Those crucial policies all feed into the very first step we must take, which is to give England the dedicated cancer strategy that it needs. It beggars belief that we do not have one. A cancer strategy is the best route to delivering genuine improvements for patients, for their families and loved ones and for those who work in our health system to research, prevent, diagnose and treat cancer.

The recent announcement of a 10-year health plan for England and its aim to improve health outcomes for all is very welcome, but I fear that the plan for all could be a plan for none. For example, analysis from Bowel Cancer UK found that the existing NHS long-term plan failed to sufficiently address the barriers to early diagnosis for bowel cancer. That is the case for many cancers. The approach is just too broad. We need detail, we need political will to be focused and we need a rapid and urgent turnaround.

A dedicated cancer strategy would provide a huge opportunity to fix the entire system, not just for the present but for the future—for our children and our grandchildren. It will not be simple or easy: that is why a strategy requires political will and bold leadership to bring Whitehall together and make tackling cancer a priority.

It is clear that when there is strong, bold leadership, cancer strategies work. That is the case across the world. At present, internationally and across our four nations in the UK, England is an outlier in not having a cancer strategy. Comparable countries with a cancer strategy have seen greater improvements in survival rates. For example, having started from a similar position in the 1990s, countries such as Denmark have raced ahead of England in improving survival in recent decades. Denmark’s success is linked to a series of cancer strategies that successfully and strategically built on one another over a 20-year period to tackle critical issues facing cancer services.

Past cancer strategies in England have worked. The 2000 cancer plan for England set ambitious targets across research, prevention and care outcomes. A report by the National Audit Office found that that strategy had supported progress in most aspects of patient experience.

The last Conservative Government launched a consultation on a 10-year cancer plan for England in February 2022. They promised to wage a war on cancer, yet the then Health Secretary, the right hon. Member for North East Cambridgeshire (Steve Barclay), scrapped the dedicated cancer strategy, turning it into a broader major conditions strategy. Delays, delays and more delays meant that the strategy was never published. That is just another legacy of failure from the Conservatives.

In May 2024, the Health and Social Care Committee wrote to the Government and argued that it was a mistake for the Conservatives to abandon the 10-year cancer plan. The current Government have the opportunity to turn that around. Having a cancer strategy is very popular with the public. Almost eight in 10 people think that the Government need to develop a long-term and fully funded plan for cancer. Organisations ranging from Cancer Research UK and Breast Cancer Now to global biopharmaceutical companies and medical institutions support having a cancer strategy for England. Yes, this requires effort, cross-Government thinking and focus, and the ambition to make England and the UK a world leader in cancer outcomes and research. But that effort will mean that we have the chance to save tens of thousands of lives and that millions of people will not need to suffer the upset of losing a loved one or friend.

Last week, I tabled a private Member’s Bill—the National Cancer Strategy Bill—calling for the Government to implement a cancer strategy for England. But unlike other private Members’ Bills, mine does not need to be law for that to happen; the Government could make the decision tomorrow to kick-start the work to implement it. Indeed, if my interpretation of Hansard is correct, they may well be intending to do so. In response to a question from my hon. Friend the Member for North Shropshire (Helen Morgan), the Secretary of State for Health and Social Care recently said that the Government will

“work tirelessly through a national cancer plan to make sure that we deliver the cancer waiting time standards that the last Labour Government met”.—[Official Report, 15 October 2024; Vol. 754, c. 684.]

A national cancer plan sounds quite similar to a national cancer strategy, and I would like to use the final section of my speech to make some recommendations to the Secretary of State as to what his cancer plan could and probably should include, because if the Department is seriously considering doing this, it will need to get it right. Broadly, the plan needs to cover all aspects of cancer prevention, research and care. It requires political leadership to bring together stakeholders to develop a strategy and co-ordinate implementation. It requires dedicated governance. There must be a robust central oversight function with a mandate to bridge the gap between disconnected Government structures. It must clearly detail how it will implement the strategy, with measurable objectives and achievable timelines. It must have regular, robust and transparent reporting of implementation and, inevitably, it needs dedicated resources to enable the right change.

A cancer strategy also provides the opportunity for us to unlock innovation in the future. We are living in a golden age of cancer science. New types of cancer treatment, from immunotherapies to cell and gene therapies, are enabling clinicians to attack cancer from multiple angles. These advances are helping to improve cancer outcomes. Therefore, I implore the Government, if they do take up a cancer strategy, to look at how the National Institute for Health and Care Excellence can be reformed to unblock barriers to investment and to strengthen the current infrastructure to increase genomics and biomarker testing.

I could go on. We could discuss the historical lack of strategic direction in terms of having a national policy for blood cancer, or the fact that every day 12 children and young people hear the news that they have cancer. Sadly, 10 die every week, making cancer the biggest killer by disease of children and young people in the UK. Despite that, it remains overlooked in existing strategies and reviews. That reflects the scale of the challenge we face in English cancer services; it feels like a never-ending list of things that we need to fix.

I will use this opportunity to ask the Minister a few questions. Can he assure people living with cancer and cancer charities that the Government will address the current crisis facing cancer services and build long-term resilience through a dedicated cancer strategy? Will he give his support to my private Member’s Bill, which would put into legislation a requirement for the Government to establish a 10-year cancer strategy? Will he meet me and, more importantly, representatives of the cancer community to discuss the need for a cancer strategy? Finally, will he make the case to his colleague the Minister for Secondary Care that the Royal Berkshire hospital requires an urgent rebuild?

[Rachael Maskell]

The hon. Member is making an incredible and powerful speech. Will he add one more ask to his list: for the cancer strategy to be joined up with a life sciences strategy? The UK is fantastic at primary research around cancer, but there is work to be done in scaling that research and translating it into delivering a holistic product for the whole of cancer care, with the ensuing treatments and therapies.

[Clive Jones]

I thank the hon. Member for her very good intervention. We are lucky in this country to have many life science businesses, many of which would really like to work as part of a joined-up cancer strategy. I have several in my constituency that I know would really like to do that, so I thank her for making that very good point.

Let us utilise this crucial opportunity to fix our cancer services. Some 360 people will die of cancer in the Wokingham area in the next year, and there will be around 2,000 cancer deaths over the next five years of this Parliament. We need to do our best to ensure that that figure is not reached but comes down.