NHS Corridor Care

Simon Opher Excerpts

Wednesday 8th July 2026 Commons Chamber

[Dr Simon Opher (Stroud) (Lab)]

I thank my hon. Friend the Member for Tooting (Dr Allin-Khan) for securing this debate and for her years of work in the A&E at St George’s. Emergency care is in crisis in the NHS, and corridor care is just an overspill because we cannot cope. That is because we are doing a few things wrong that we could remedy.

I work as a GP. I did a surgery last Friday and actually tried to admit someone. I rang up A&E and they said, “Well, I wouldn’t send them up at the moment, as we’ve got a six-hour wait.” I realised that, quite often, we do not have an operable emergency care service, and this is something we need to work on.

I will briefly go through a few causes and then a few remedies, and the remedies could be clinical as well as organisational. First, we have an ageing population. Frailty is increasing. In Stroud alone, in four years, the number of over 90-year-olds went up 29% in just that short period of time. We have an enormous cohort of very elderly and frail people. Secondly, as we have heard, we have a lack of beds due to delayed discharge—I will not say any more on that. Thirdly, we have a lack of care beds in the community to enable discharge. There is also a lack of capacity in GP surgeries for on-the-day appointments. In my surgery, 45% of our appointments are on the day, but we obviously need to increase that so we can absorb the demand in primary care.

[James Naish (Rushcliffe) (Lab)]

I have sat through the debate, and I do not believe that community pharmacy or independent prescribing have been mentioned. Does my hon. Friend, with his experience as a GP, endorse the changes that the Government are making to maximise the use of pharmacists to deal with some of the pressures that he mentioned GPs face?

--- Later in debate ---

[Dr Opher]

That is absolutely true. We need to look at all the ways of reducing demand on GPs and, therefore, on A&E departments—that is what my speech is totally involved in—and pharmacies have a really good role to play.

There is another thing here, which was noticed in the doctors’ strike. When we have senior clinicians on the front door of A&E, that makes the department much quieter, because they make decisions quickly and can take a bit more clinical risk as they are more experienced. Perhaps we need to rearrange how care works in A&E departments so that we do not get a backlog.

I turn to the remedies. We are beginning to turn the NHS around—that is clear from working in it and from what my patients say. Things are beginning to change. We need to do a lot more, but we are investing a lot of money in it. We must not say that things are getting worse, because I believe they are slowly getting better.

As so many have said, we need to fix social care. We could have a system whereby the community is responsible for a patient as soon as they are ready for discharge. Perhaps the community should have to pay for the patient to remain in hospital after that to encourage it to get them out of hospital.

We must stop agency working in social care, because that is causing a huge amount of stress to carers. We need care to be based on a community model so that carers cover small areas and do not have huge travel times. We also have to improve GP access. I think we should also make it so that A&E departments see only accidents and real, genuine medical emergencies.

So we need a little bit of an increase in funding for primary care. We also need GPs to be assessing emergencies up until 10 o’clock at night to relieve the pressure on A&Es. There are a couple of other things. I have said about getting more experienced doctors involved earlier in the process, but we also need to invest in scanners—so many people in A&E are waiting for tests before they go home. Also, as my hon. Friend the Member for Tooting (Dr Allin-Khan) said, it is not appropriate to have mental health assessments in A&E; we need mental health assessment units, which I do believe the Government are bringing in.

There are a few clinical factors. Perversely, we need not to be so risk-averse. For example, admitting a patient for risk of falling is ridiculous, because they are more likely to fall in hospital than in their own home. Dementia fluctuates, so just because someone has seen a slight increase in confusion, that does not mean that they need a whole batch of tests. We need to treat dementia more holistically. Polypharmacy—that is old people on loads of drugs—causes about 10% of admissions, so let us reduce that.

We need good end-of-life care. Some 50% of people with cancer die in hospital—many of them face corridor care—and we need to reduce that, because most of them want to die at home. Every older person needs an advance care plan so that, when they become ill, we know whether they want to go to hospital. That is incredibly important in pathways of care.

Corridor care did not appear overnight, and it will not disappear overnight. But, by rebuilding the NHS from the community upwards, fixing social care and investing where it matters most, we can ensure that no patient is left waiting for care in a hospital corridor ever again.

Puberty Blockers

Simon Opher Excerpts

Tuesday 23rd June 2026 Commons Chamber

[Rebecca Paul]

I completely agree with my hon. Friend; a child of this age cannot possibly consent to the life-changing, irreversible changes that come from puberty blockers. We need to remember that almost all children who start puberty blockers go on to cross-sex hormones, and there is no going back from that.

We need to remember that we have already had a trial in the UK. When we started using puberty blockers in the UK after 2011, the preliminary results came out in 2015-16 and did not demonstrate psychological benefits, with some of the females actually suffering a worsening of symptoms, including a higher incidence of wanting to hurt or kill themselves. The results of the study, which were not formally published until 2020, demonstrated no statistically significant improvement in gender dysphoria or mental health outcomes. It is important to remember the early studies that told us that, in a majority of cases, going through puberty resolved gender distress. It follows, therefore, that stopping or delaying puberty using medication derails that natural desistance, essentially locking in.

[Dr Simon Opher (Stroud) (Lab)]

Speaking as a member of the political class and the medical class, may I ask the hon. Lady whether she would accept that it is better for politicians to accept advice from medical experts around medical issues?

[Rebecca Paul]

I thank the hon. Member for that excellent question. I obviously always respect and listen to different clinicians, but what is happening with this debate is that one set of clinicians with one view is being listened to. Let me remind everyone about lobotomies. Lots of very respected people came out for lobotomies; in fact, the person behind the idea won a Nobel prize. I think we would all agree that those clinicians got that wrong, so it is incumbent upon us in this House to always question. It is absolutely right that we listen to clinicians, but unfortunately we are seeing only one set of clinicians with one set of opinions being listened to here.

A Finnish study was published in April that looked at more than 2,000 adolescents and young adults who had been referred to gender services. It found that medical interventions did not reduce psychiatric problems and may even be associated with worsening mental health. How many times have we heard it said that puberty blockers offer a pathway towards improved mental health and reduced psychiatric distress for those struggling with gender identity? I have lost count. But there is hard evidence that not only says different; it says the opposite. I would be keen to understand from the Minister and the Secretary of State whether that study was taken into account before deciding to go ahead with the trial.

I want to point out that children and young people who grow up to be same-sex attracted are over-represented in this cohort, and that is something we need to think about. If we look at the case of Keira Bell, she was a lesbian struggling with her sexuality, and instead of people saying, “It’s okay to find other women attractive—there’s nothing wrong with that. You do not need to change your body,” they said, “Ah! You’ve got gender dysphoria.” They put her on puberty blockers, and then she went on to testosterone shots. She then had her breasts removed in a double mastectomy, and then she detransitioned. This is a deeply homophobic approach to healthcare. Those on the other side of the argument think they have the progressive position. I am sorry, but you are repeating mistakes that have been made historically—

Health Bill

Simon Opher Excerpts

2nd reading
Monday 1st June 2026 Commons Chamber

[Dr Simon Opher (Stroud) (Lab)]

It is a pleasure to speak in support of the Bill, which I believe has the power to transform patient care in the NHS. Particularly after the remarks of my hon. Friend the Member for Bury St Edmunds and Stowmarket (Peter Prinsley), the House will be aware that I also have a vested interest in this, as I have been a working GP in the NHS in Stroud for at least the last three decades. Indeed, I did a surgery last Friday, and I excitedly told the other doctors that we are going to have a single patient record. Instead of being excited, they said, “It’s about time.”

Those of us working in the NHS have been calling for a single patient record for years, so it is about time that a patient can tell their story just once, and about time a GP knows what a consultant is saying and the consultant knows what the GP is saying. It is about time that, when a patient gets admitted to A&E, the doctors know what the GP has already done, and that, when a patient gets referred to a psychiatrist, they know which antidepressants have been taken. As my hon. Friend said, patients struggle to understand how all the doctors do not know what is going on. We got rid of the fax machine in our surgery only last year, so we are fairly behind on communication, but the Bill lays the foundation for that to be remedied.

The benefits of the Bill for patients are huge—their medical knowledge at their fingertips, just as they are for clinicians and for integration. We cannot have integration without a decent single patient record. On research, our data is a national asset. I fear that a company such as Palantir owning our data is a derogation of our duty, and that we should use that data as a fantastic resource. I am also worried about Palantir’s involvement with death in Gaza and the infringement of civil liberties under the Immigration and Customs Enforcement agency in America. Also, at the Chelsea and Westminster hospital, it seems that the benefits that Palantir said it would bring to the operating theatre were not provable. The data is owned at the moment by GPs, and if there is a spillage of data, GP practices are unlimitedly liable. We must change that; otherwise, no one will become a GP partner. We must also be careful, because excessive and over-the-top safeguarding could obstruct the single patient record, and that would harm patient care.

[Peter Prinsley]

Does my hon. Friend agree that we must have a single patient record, not simply federated records from other sources?

[Dr Opher]

I do agree, although that is a much bigger job. At the moment, mental health uses a different system from the hospital, and it would be great to unite them. I agree with that, but whether it would possible in the next couple of years, I am not so sure.

Let me quickly go on to NHS England. The administrative burden on GP surgeries from NHSE has been huge, as my hon. Friend has mentioned, and it will be fantastic to get rid of that. When GPs undergo CQC inspections we have to do pointless protocols to fulfil the criteria, and they involve weeks of work. I want to make a little bid here for a much more supportive, lighter touch approach when looking at proper data around GP surgeries, which we would not have to prepare for. That would be very popular with GPs.

I warmly welcome this Bill. It is about time we reduced the ridiculous administration around patients and allowed clinicians to properly care for patients, and it is about time we had a single patient record.

Sudden Unexpected Death in Epilepsy

Simon Opher Excerpts

Wednesday 22nd April 2026 Commons Chamber

[Olly Glover]

The hon. Gentleman is absolutely correct to say that awareness raising and increasing understanding are key priorities in dealing with SUDEP and epilepsy in general.

Patients with epilepsy carry a risk of premature death that is, on average, two to three times higher than in the general population, as has been outlined by Frontiers in Epidemiology. What is most devastating is the knowledge that 60% of epilepsy-related deaths each year are believed to be preventable, according to the European Journal of Neurology, with SUDEP accounting for many of these deaths.

[Dr Simon Opher (Stroud) (Lab)]

I thank the hon. Gentleman for bringing this really essential debate to the House. My constituent Emma Taylor tragically lost her daughter at the age of 19 and she now campaigns tirelessly for SUDEP Action as a policy champion. Does the hon. Gentleman agree with her on the need for the Government to promote proper first aid seizure training?

[Olly Glover]

I very much agree with the hon. Gentleman’s constituent. I thank her for her tireless campaigning and offer my condolences for her loss.

My Oxfordshire constituency of Didcot and Wantage is the home to SUDEP Action, a charity that is local, national and international in its impact. In 1995, five bereaved women came together around a kitchen table to found the charity in tribute to Alan, aged 27; Matthew, 21; Natalie, 22; and William, 22—all of whom had died, with the condition unrecognised beforehand. Jane Hanna, Sheila Pring, Catherine Brookes, Sue Kelk and Jennifer Preston faced despair together and chose to build hope. Since 2020, SUDEP Action has worked alongside the Epilepsy Research Institute to identify tackling epilepsy deaths as a No. 1 research priority.

The key challenge that SUDEP Action faces is that research insight does not reliably or quickly reach neurology consultations, primary care or social care. National Institute for Health and Care Excellence guidelines exist, but services are inadequately supported to implement them. Jane Hanna from SUDEP Action told me that my own constituents face nine-month waits for a first seizure clinic and waits of nine to 12 months for follow-ups. She told me that waits of this magnitude, such as we are experiencing in my constituency, are unsafe. Her partner Alan waited for four months and died suddenly five months later. Waits such as these are not confined to my constituency; they are reflective of a structural problem across the country.

Free safety tools exist to tackle the lack of knowledge and the complacency around seizures and SUDEP, but systemic issues are difficult to shift because of poor access, poor medicine management, failure to communicate risk and poor recording of deaths. An independent review was named after Clive Treacey. Clive died at 47 in 2017 in a hospital setting where he had lived for 10 years. The report on his life is shocking for this country in the 21st century. The Minister might be aware of the debate secured last year by the hon. Member for Lichfield (Dave Robertson), who I am pleased to see in his place tonight, and of the response from the Under-Secretary of State for Health and Social Care, the hon. Member for Glasgow South West (Dr Ahmed), who supported the Clive Treacey checklist.

GP Contract

Simon Opher Excerpts

Monday 16th March 2026 Commons Chamber

[Stephen Kinnock]

The right hon. Gentleman makes a very important point about bureaucracy. Many of the reforms that we are pushing for in the contract are designed to reduce bureaucracy. For example, by moving to a single point of access and embedding advice and guidance in the contract, we will reduce the number of transactions. In the current system, the practice needs to put in a request for a £20 payment each time it provides advice and guidance; we are embedding that and streamlining it.

The other point to make is that at the heart of our 10-year plan is the shift from analogue to digital. I have seen some extraordinarily effective artificial intelligence technology around ambient voice services, which enable an entire consultation to be recorded and put directly into the system, thereby saving the GP hours at the end of the day in writing up notes.

[Dr Simon Opher (Stroud) (Lab)]

I declare an interest as a working GP in the NHS. I probably would not be standing here if general practice had not been decimated over the last 14 years. I welcome the £485 million of extra funding, and I also welcome the fact that the capacity and access money is being channelled back into emergency GP action, so increasing the number of appointments, and increasing continuity of care by bringing back the family doctor. May I have some reassurance that the processes of advice and guidance and the referral mechanisms will not get in the way of Jess’s rule, which is about referring patients on their third presentation without any particular diagnosis?

[Stephen Kinnock]

My hon. Friend is absolutely right. The £292 million we have made available for advice and guidance is repurposed funding from the capacity and access improvement payments, so it is part of incentivising improved access and better patient outcomes. I can absolutely assure him that Jess’s rule remains fixed as a really important part of ensuring that it is three strikes and a referral. Whatever happens, that will be a top priority throughout the embedding of this contract.

Medical Training (Prioritisation) Bill

Simon Opher Excerpts

2nd reading
Tuesday 27th January 2026 Commons Chamber

[Wes Streeting]

I am clear that this is about whether the system will be ready to implement the measures in the Bill. I must say that I view the Conservatives’ amendment on this issue with a degree of cynicism. Not so long ago, they were accusing me of being too kind to resident doctors when it came to making changes to pay or conditions without something in return. They seem to have completely changed their position. I am sure that that is not remotely cynical and is for entirely noble reasons, but I will wait for the shadow Health Secretary, the right hon. Member for Daventry (Stuart Andrew), to make his case. Let’s just say that I am not entirely convinced.

The Bill implements the commitment in our 10-year plan for health to put home-grown talent at the front of the queue for medical training posts. Starting this year, it prioritises graduates from UK medical schools and other priority groups over applicants from overseas during the current application round and in all subsequent years. For the UK foundation programme, the Bill requires that places are allocated to UK medical graduates and those in a priority group before they are allocated to other eligible applicants.

For specialty training, the Bill effectively reduces the competition for places from around four to one, where it is today, to less than two to one. That is a really important point for resident doctors to hear, not least because in the debate we had on the Government’s previous offer to the BMA, that point was lost amid some of the broader and, frankly, more contested arguments between the Government and the BMA around pay. It is not just the provision of additional training posts that reduces the competition ratio; it is also the measures in this Bill. I hope that that message is heard clearly by resident doctors as they think about their own futures immediately or in the coming years. For posts starting this year, there must be prioritisation at the offer stage, and for training posts starting from 2027, prioritisation will apply at both the shortlisting and offer stages.

In the 10-year plan, we committed to prioritising international applicants with significant NHS experience for specialty places in recognition of the contribution they have made to our nation’s health. This year, we will use immigration status as a proxy for determining those who are eligible, so that we can introduce prioritisation as soon as possible. From next year, under the terms of the Bill, we will set out in regulations how we are defining significant NHS experience.

[Dr Simon Opher (Stroud) (Lab)]

Will the Secretary of State give way?

[Wes Streeting]

I give way to my hon. Friend with significant NHS experience.

[Dr Opher]

I commend the speed with which my right hon. Friend has brought this legislation to Parliament. I have been a GP trainer for 25 years. Fifty per cent of GP trainees are international medical graduates, and there has been some disquiet from them. Will he reassure our international medical graduates that they are welcome and treasured in the health service?

[Wes Streeting]

My hon. Friend is absolutely right about the contribution that international medical graduates make, and I have no doubt that that will continue to be the case for many years to come. I hope it is clear to those going through medical school or aspiring to a career in medicine that, in terms of the future of healthcare in this country, general practice is where it’s at. We are looking to shift the centre of gravity in the NHS out of hospital and into the community, with care closer to people’s homes and, indeed, in people’s homes, with GPs as leaders of a neighbourhood health service. I hope that gives encouragement to GPs serving today about the future of their profession, about which they care enormously. I also hope that that message resonates with people who are thinking about a career in medicine, when they think about what kind of career that might be.

--- Later in debate ---

[Dr Simon Opher (Stroud) (Lab)]

I will keep this short, because many of my points have already been made. I think that there are two main problems. The first is about priority for our medical graduates. To be honest, I was a little bit surprised when, about a year ago, I found out that they are not prioritised. That clearly is not reciprocated around the world, and we need to change it. The other problem is our training numbers. If we are training medical students up to graduation, we must ensure that the number training fit into our postgraduate training, because otherwise it is crazy, which is the situation we find ourselves in.

I have been a GP trainer for about 25 years, and many of the doctors I have trained as GPS have gone off to Australia. My favourite went to New Zealand and is staying there, although I keep trying to entice her back by saying how great it is that the NHS is improving. GP training is unique. It involves 18 months in general practice in a one-on-one apprenticeship-type system, and I think the system in the UK is one of the best in the world. It teaches continuity of care for patients, and it also teaches the skills that are bringing back the family doctor. This is about the doctor being the gatekeeper to the NHS, and also protecting the patient against the NHS and from over-investigation.

In fact, I always think an MP is bit like a GP, because a GP has to know a little about absolutely everything, which is the same for an MP. I would like to give a shout-out to my Stroud GP trainers group, who visited Parliament last year, and also to the 8,000 GP trainers in this country, who do a fantastic job, often going above and beyond their responsibilities.

I would like to mention international medical graduates—I have had a number of them. At the moment, 50% of those training in the UK are international medical graduates—I understand that in Teesside the figure is 100%—and we are depending on these people to provide some of our general practice. I have had fantastic trainees from India, Spain, Germany and Algeria, who have all become fantastic NHS GPs. As I have said, we must ensure that they are welcome and treasured in the NHS, because they constitute a large body of GPs in our system. Although we need to prioritise UK graduates, we must not put off international graduates from coming and helping us to deliver a new NHS.

I would like to make another point about medical training. Postgraduate medical training goes through a process, and it is important that we recalibrate this so that the number of training spots exactly matches the number of our medical graduates. That is particularly true for anaesthetists. There are bottlenecks in anaesthetics training, and if we could relieve those bottlenecks, we would get more anaesthetists training and could start to bring down our waiting list. However, that will involve a decent workforce plan, which I understand we are developing, and proper planning for the future, so we can get our waiting lists down and deliver a better NHS for everyone.

To conclude, after years of failure and the neglect of our home-grown talent, this Government are taking action so that our doctors can train, stay and serve the communities that need them most. I urge Members to support the Bill.

Domestic Abuse-related Deaths: NHS Prevention

Simon Opher Excerpts

Tuesday 20th January 2026 Westminster Hall

[Dr Simon Opher (Stroud) (Lab)]

I beg to move,

That this House has considered the role of the NHS in preventing domestic homicides and domestic abuse-related deaths.

It is a pleasure to serve under you, Sir John. I am grateful to the Backbench Business Committee for giving me the opportunity to open a debate on the role of the NHS in preventing domestic abuse and dealing with it when it presents to the NHS. I thank my hon. Friend the Member for Lowestoft (Jess Asato), who, since we secured this debate, has been appointed as the violence against women and girls adviser to the Department of Health and Social Care. I think we shall hear from her later. I also place on the record my thanks to Standing Together Against Domestic Abuse, IRISi, Respect and, from my own constituency, Stroud Women’s Refuge, which have really helped me with this speech. I declare an interest: I am a working GP and sometimes need to deal with these issues.

On average, five people a week die as a result of domestic abuse in this country. Now, there are actually more suicides related to domestic abuse than homicides. Behind each of those statistics is a life lost and a family devastated. In far too many cases, there has been repeated contact with health services and there have been moments when the health service could have intervened. The NHS is the most consistent point of contact for people living with abuse. Each year, about half a million people seek support from the NHS in relation to domestic abuse and 85% of them ask at least five times before they receive effective support. That is not because clinicians do not care. It is really about recognition of domestic abuse and getting referral services that are easy to understand and well known in practice. If we are serious about preventing domestic abuse, we must be serious about the role of the NHS—not just in primary care, but across all mental health services, across maternity services, through emergency departments and through community care. It has to go right across the NHS and not just primary care. This is really a debate about making sure that we do not miss chances and that we provide meaningful intervention when people present with signs of domestic abuse.

The Government have committed to delivering on our promise to halve violence against women and girls by 2029, and I welcome the comprehensive strategy to tackle that. For too long, support services have been unable to support victims and survivors effectively. They have been without sufficient resources and, in too many cases, women and girls have not been able to access the support they need. Therefore I welcome the Government’s supporting victims through the largest ever investment of £550 million in victim support over the next three years and an additional £5 million each year from the Department of Health and Social Care.

I would like to say a few things about how GPs specifically are often the first port of call, and how presentation to GPs is incredibly important for recognition of this issue. I shall quote from Killed Women, an organisation for bereaved families of women who have been killed by men in the UK. It says about one woman:

“She had gone to the GP a few days before her death as she couldn’t take any more. She was only offered antidepressants. On the day of her murder when I spoke to her, she said they are not helping and she had had enough. She said the GP knew her situation but yet again she was failed there.”

That shows that simply giving out antidepressants is not the right strategy. We need to build support around women subjected to domestic abuse. Often, they present with mental health issues and will not give any details of their abuse. One thing that I teach GPs in training is that there is something called a hidden agenda. Women particularly will present to the GP but they will not say that they are being abused; they will have other symptoms. We must recognise that presentation straightaway, and there are ways we can recognise it. Sometimes the woman in question will present with a partner and not feel comfortable talking about the situation. I often ask the partner to leave the consultation and I speak to the woman individually, which can be an effective way to find out exactly what is happening. We need to be aware that women in this situation are often nervous and walking on eggshells. We also have to recognise that often there are physical injuries, often of different ages. We sometimes see women presenting in sunglasses to cover up a black eye, for example. The health profession must recognise all those symptoms.

As I have said before, there are very high rates of mental health problems. Women who are being abused often present with symptoms of depression caused by domestic abuse, so we need to ask those women whether anything is going on at home. Female survivors of domestic abuse are three times more likely to develop mental illness. There are also other high risk periods, such as when women are pregnant and they often have poor outcomes in those situations. We must also be aware, across the health service, that women might disclose domestic abuse. Health visitors are in an ideal situation to hear about that type of thing and must be aware of that potentiality.

In A&E, women often present with overdose, and underneath that there is domestic abuse. Midwives are often presented with this, as are mental health workers, and even gynaecology services as well as social services. Often women present to the health service with different symptoms, but that is a cry for help, which we must recognise.

What do we need to do to support those women? One thing I am delighted about is the concept of steps to safety. The Department of Health and Social Care will roll out a domestic abuse and sexual violence referral service across integrated care boards, giving GPs the tools and ability to identify and refer victim-survivors to support. What is important is that it is a simple service with one number. If it is not simple, it will not be used by health services, and that is incredibly important. It is also important that we make use of existing resources. I visited the sexual abuse centre at Gloucestershire Royal hospital recently. It is a fantastic resource with really well-trained staff who are available 24/7.

It is really important, particularly in practices, to have a safeguarding or domestic abuse lead who is totally up to date with what is available, because quite often services change and GPs themselves are not on top of that. So that is important as well. Can I also stress the importance of women’s refuges? In Stroud we have a fantastic refuge. It does not advertise itself, for obvious reasons, and the people working there are simply amazing, supporting women who have difficulties, and often their children as well. It is inspiring to see the work they do, and it is important that those services are available immediately if women feel in danger.

Can I also make a plea for support for the perpetrators of abuse? It is usually men that perpetrate abuse and they often abuse at least five times, so it is important to catch them the first time and institute really good treatment and management for them. There are often drugs, alcohol or mental health issues behind their problems, so we must deal with that before they continue to abuse. Although that is controversial, I think that is incredibly important as well.

What do we need for the whole of our health strategy? We need things to be co-ordinated. There is a suggestion that we have domestic abuse co-ordinators for a group of GP practices. As I said, I think we need to have leads in general practice, with one person leading who can keep up to date and keep reminding the other members of staff that that is really important. When we are training in primary care, it is important to train everyone. For example, the receptionists in primary care are often aware of the people coming in. They need training to detect domestic abuse so that they can inform the doctors. It is a whole team approach, with pharmacists, nurses and physiotherapists also needing to be trained and aware of the signs and symptoms of domestic abuse.

That training should be essential for everyone, but I want to step back from mandatory training. Many people in the health service find that irksome and a tick-box exercise. I do not want domestic abuse training to simply be a tick box where someone goes on an hour-long course every year and that is it. We need a more integrated approach and it needs to be part of an appraisal process so that every doctor, nurse and healthcare worker is aware and trained in domestic abuse—but without it being made mandatory so that it does not simply become a course that people must go on, but is instead properly integrated into the service.

Last of all—and this seems incredible in this day and age—we need to share data between all of the health services, for example, A&E, GPs and mental health. We often do not get any information from mental health. It is important that we get that data sharing up to speed because domestic abuse can present in many different situations in the NHS and it is important that everyone is aware of the risks. In terms of funding, the £5 million a year from the Department of Health and Social Care is a good first step, but we need quite a lot more than that to bring this service to the fore.

In conclusion, if we are serious about preventing domestic abuse and the deaths that so often follow it, then the NHS must be properly equipped to play its full role. There are three points that I would like to make. The first is on funding, and around training and investing in services that will really help in domestic abuse. Those steps to safety are key because it must be simple for women to access those services. It is also important that wherever a woman presents to the NHS, that the person they present to is trained to detect domestic abuse and aware of what is available for that woman. Finally, we must have a comprehensive whole-health plan for the NHS and tackling domestic abuse and violence against women and girls. That must cover primary care, mental health, maternity and accident and emergency services—and I would like it to be published by 2027 at the latest.

[Amanda Martin (Portsmouth North) (Lab)]

It is a pleasure to serve under your chairmanship, Sir John. I thank my hon. Friend for securing this debate. At the beginning of this debate my hon. Friend mentioned suicide. As we are talking about NHS services, and when we have women trying to take their own lives, I wanted to highlight the devastating impact of the deaths of two people from Portsmouth who took their own lives because of coercive control. Does my hon. Friend agree that all of the agencies across the NHS, our wider health service and our police need to be joined up to stop the loss of lives and that that is a public health issue?

[Dr Opher]

I know that my hon. Friend is invested in trying to help women subject to domestic abuse. Coercive control is very important as it often stops women presenting to healthcare workers. As I have said before, one key thing as a clinician is that we have to be brave and ask the man to step out so that it is possible to have a proper conversation. They can often resist that and can get violent as well. It is important that we take a brave view on this to protect women in general.

To conclude, if we get those three things right—funding, recognition, and a comprehensive and integrated care service—we can move forward to a service that repeatedly sees and recognises abuse and immediately steps in to stop it. That is the shift I am calling for in this debate, and it is one that could save many lives.

[Several hon. Members rose—]

--- Later in debate ---

[Dr Opher]

I thank the Minister and all those who spoke and brought their fantastic experience of this really difficult problem. Let me say two very simple things. We need to imprint on healthcare workers the idea “Think domestic abuse”, so that we do not miss it. If someone presents, we must have in the back of our minds the question, “Is this domestic abuse?” That will help to identify victims much earlier. After that, we need to enable them to be referred in a simple and effective process that brings them support immediately.

I thank everyone here, and you, Sir John, for chairing the debate.

[Sir John Hayes (in the Chair)]

Thank you for winding up. This has been a really important debate and I am so pleased that everyone was able to contribute. I hope that, had I spoken in the debate and not chaired it, I would have spoken with the same passion and insight that everyone has shown.

Question put and agreed to.

Resolved,

That this House has considered the role of the NHS in preventing domestic homicides and domestic abuse-related deaths.

Therapeutic Play and Children’s Healthcare

Simon Opher Excerpts

Tuesday 6th January 2026 Westminster Hall

[Dr Simon Opher (Stroud) (Lab)]

I will be very brief. I thank my hon. Friend the Member for Leyton and Wanstead (Mr Bailey) for securing this fascinating debate.

All play is therapeutic, and I emphasise that the Government have put £18 million into new playgrounds. My constituent Tom Williams is a proponent of adventure play, which is incredibly good for kids. It reduces anxiety, it burns more calories than sport and, crucially, it provides a digital detox and improves community cohesion.

As a GP, I always had a big box of toys in my room. To examine a child, I had to play with the child; otherwise, they would scream their head off. Therapeutic play must be part of GP training in every way. The thing about therapeutic play is that it reduces the trauma, as we have heard; it actually results in fewer cancellations and, as my hon. Friend said, reduced need for anaesthetics and shorter procedure times because the child is enjoying themselves playing. I thank my hon. Friend for bringing this subject forward for debate—I will say no more.

Resident Doctors: Industrial Action

Simon Opher Excerpts

Wednesday 10th December 2025 Commons Chamber

[Wes Streeting]

That is a very thoughtful and appropriate question. Just to reassure the House, the Minister of State for Health and I have been working with Agenda for Change unions, particularly Unison, the Royal College of Nursing and GMB, to ensure that we are dealing with the structural reform of Agenda for Change that they are seeking. We have been exploring how we can deliver fairer pay for other parts of the NHS workforce and an improvement to the conditions and status of the nursing profession specifically, while maintaining fairness for all NHS workers. That is one of the considerations I have had to bear in mind when it comes to what we can offer the BMA and resident doctors. I have been very clear with the resident doctor reps about that privately, and I am happy to restate that publicly.

Doctors have not had a bad deal from this Government, frankly, and I have a responsibility to all parts of the NHS workforce, especially those who are lowest paid and who often lie awake at night worrying about their bills.

[Dr Simon Opher (Stroud) (Lab)]

On international medical graduates, I commend the Secretary of State. It is something we have discussed in the past, and bringing forward emergency legislation is absolutely crucial here, so I thank him for that. I also want to mention trainers in the NHS. I can reassure the Conservatives that we will make this happen. I have been a GP trainer for 25 years. We will work to make this happen; that is what we do in the NHS.

I have many resident doctor friends who do not like this action. Can we urge those doctors to talk to their fellows and try to call off this strike? It is not generally well supported among resident doctors, and it is something that we can change.

[Wes Streeting]

My hon. Friend makes a really good point. Sometimes during ballots people who are opposed to industrial action choose not to cast a ballot at all because they know that the turnout threshold is material. In the coming days, it is absolutely vital that every resident doctor makes their voice heard. This is their chance to tell me and their reps how they want to proceed on this deal. I respect the fact that the resident doctors committee has chosen today to present the deal in neutral terms to its members so that they can make a choice. I really do respect that. Now I urge resident doctors to make their views known and take the opportunity in front of them so that we can move forward together to make real changes to their lives.

Obesity and Fatty Liver Disease

Simon Opher Excerpts

Tuesday 28th October 2025 Westminster Hall

[Dr Simon Opher (Stroud) (Lab)]

I thank my hon. Friend the Member for Worthing West (Dr Cooper) for securing this very important debate. I also thank the British Liver Trust and the Foundation for Liver Research for providing me with a lot of data and information. As a GP, I have learned quite a lot from preparing this speech—we will come to that a little later.

As my hon. Friend said, what we really need is the right type of reform. My Government are proposing three shifts in care. Probably the most important is from cure to prevention, and this issue fits in very well with that. It also fits into the other shifts that we want. We want to get out of hospitals and into the community, and a lot of work around fatty liver disease can be done in the community. We also need to use data properly to target people and to look at the digital ways in which we can identify high-risk people.

Fatty liver disease affects 20% of the population. I do not want to repeat all the statistics that we have heard, but 12% of those people go on to develop very severe disease, and that is 90% preventable. That is a perfect example of our being able to prevent disease rather than just allowing it to happen.

As GPs, we often do a liver function test—often if someone is on a statin or something similar—as a screening test, and we find that the alkaline phosphatase is slightly raised. We then do an ultrasound scan and, lo and behold, people who are overweight often have fatty liver disease. That is often as far as it goes in GP land, so we need to change that pathway. There is an obesity epidemic and two thirds of adults are overweight. As my hon. Friend the Member for Worthing West said, children also carry a great burden of obesity and overweightness—by year 6, 32% of children are obese.

As my hon. Friend also said, there has been a massive increase. Most diseases are going down in frequency, but there has been a 400% increase in fatty liver disease. That leads first to fibrosis, then cirrhosis and even liver cancer. As she pointed out, detection is often at the acute stage when people are admitted to hospital with cirrhosis and sometimes hepatic failure. That is a sign of a poor medical system. We are failing those people.

Where I come from in Stroud, we have the fourth-highest hospital admission rate for liver disease in the whole south-west, and Gloucestershire has the highest. We need to get on and start dealing with fatty liver disease. How do we do that? As we have heard, prevention is probably the single most important thing, so I urge the Government to grab that ethos of preventing disease and really go for it. We have a national food strategy—there is plenty in there, which I will not talk about now—and ultra-processed foods are obviously causing a lot of harm. There are also some exciting options in the 10-year plan in relation to supermarkets, such as how they need to keep their data and about starting to sell healthier foods, rather than foods that are high in fat, sugar and salt. The plan also refers to the reformulation of some products.

I will point out two other things: first, free school meals reduce obesity in children; and secondly, as a Government, we are bringing in rules about advertising unhealthy food before the 9 o’clock watershed, which I welcome. We also need to halt brand advertising before that time, because when people see a sign saying “McDonald’s”, they do not think about salads, do they? That is also important.

Screening needs to be data driven. In general practice, we know that a lot of people with a BMI of over 27, for example, should get near-patient testing for liver function, and those who have raised liver function should then have a fibroscan in their neighbourhood practice. That would be a fantastic community response to the problem: neighbourhood practices could take hold of the issue and start screening properly, reducing the burden of disease on our population.

Training is also important. I am a standard sort of GP, and I did not know as much before preparing this speech as I do now. We need to educate GPs on the importance of detection.

Lastly, although GLP-1 agonists are not authorised for treating fatty liver disease, we are certain that they are effective at reducing weight and would certainly reduce fatty liver disease. We must invest in weight-management services to wrap around that treatment. We have a great opportunity to prevent disease.

--- Later in debate ---

[Dr Danny Chambers (Winchester) (LD)]

It is a pleasure to serve under your chairmanship, Mr Efford. I thank the hon. Member for Worthing West (Dr Cooper) for securing this really important debate.

We have a lot of medical professionals in the room. It might surprise colleagues that, although I am a rudimentary vet, we treat fatty liver disease quite commonly in animals as well. It is most commonly seen in very large, fat cats that are really cuddly and people like to have on their lap. It is really common for them to get fatty liver disease if they stop eating, and it is genuinely very serious and takes intense treatment. The other time we see it commonly in animals is in cows that are in good body-weight condition, immediately after they give birth; often, they end up with hepatic lipidosis, which can be quite difficult to manage.

My first charity visit as an MP—it was the week after I was elected—was to the British Liver Trust in Winchester. I met Pam Healy, its chief executive officer, who is here today. It is a brilliant organisation. I thank everyone for all the briefings we were given; the hon. Member for Stroud (Dr Opher) mentioned how much he learned from them, despite being a trained GP. On that note, I know he is doing some social prescribing—when is the comedy show?

[Dr Opher]

It is on 20 November, with Jonathan Pie, and it is on investigating men’s health.

[Dr Chambers]

Fantastic. Hopefully it will improve people’s mental health—and if they leave halfway through, it will probably improve their physical health, too. That is a fantastic initiative.

Other Members have talked about the soaring rate of liver deaths, which has shot up in the last 20 years. The hon. Member for Worthing West talked about it costing the NHS £6.9 billion directly, and some studies show that it has cost the economy over £100 billion in other ways, such as from people being off work.