Infants, Parents and Carers Bill

Simon Opher Excerpts

Wednesday 14th October 2026 Public Bill Committees

[Jess Asato]

Indeed I have, and I will come to that in a moment.

As I was saying, the Bill does not give sufficient voice to those who cannot speak for themselves—babies and infants. My amendment seeks to ensure that the Government will assess how successful services are in improving the physical, mental and emotional wellbeing of infants, parents and carers and, crucially, will assess our progress in tackling inequalities in the early years.

Although there is other legislation, such as the Equality Act, to guide secondary legislation, we know from bitter experience that future Governments could repeal legislation that has equality as its goal. Indeed, we are in difficult and divisive times in our country at the moment. There are those who would seek to repeal the Equality Act, thereby undoing any of the protective features that that Act would bring to this important Bill.

To anticipate future Government policies, the Bill must make reporting on inequality of outcomes paramount, because significant inequalities exist in many of the most fundamental measures of babies’ health and development. Black babies, for example, are more than twice as likely as white babies to be stillborn. Babies in the 10% most-deprived areas are more than twice as likely to die as babies in the 10% least-deprived areas. Babies growing up in poverty are more likely to experience domestic abuse in their family and are less likely to be breastfed.

At the moment, these inequalities, which are reported on by Government through auspices such as the Equality Act, might be identified, but in future there may be no requirement for that to be the case as part of the Bill. Simply showing that there is provision for babies, infants and their parents and carers could ensure that the Secretary of State is able to discharge their duty under the Bill, whether it actually operates to reduce inequalities or not. Under our current legislation, we still have deep inequalities, in part because the focus on reducing inequalities between areas has been lost—and lost deliberately. I think we ought to see whether we can return to making sure that that is the focus.

As it stands, the Bill does not explicitly require the Secretary of State to look at outcomes for babies and their parents, or at what those outcomes may indicate about the quality and availability of services. Although the views and experiences of parents and carers are incredibly important in understanding need, they do not paint the full picture and we cannot rely solely on them to analyse successes and failures of services. The public deserve to know the realities of inequalities in early childhood, and Governments must welcome robust scrutiny of their policies to help support babies.

The amendment also requires the Government to look at the wellbeing of parents. That is particularly important given the Maternal Mental Health Alliance report that said that one in four mothers experiences a mental health condition during pregnancy or after birth. Suicide remains the leading cause of death for women between six weeks and a year after giving birth. The amendment keeps the Bill flexible and streamlined, and I understand that it would not increase any financial cost of the Bill. It also clarifies the role of the Government in measuring success.

The Bill needs to be future-proof—indeed, the purpose of the Bill is to ensure, on a cross-party basis, that our services genuinely lead to a change in outcomes for babies, infants and children throughout their lives. It must stand the test of time, regardless of the colour, priorities or whims of future Governments. I have absolute faith in this Government and their commitment to early years investment, including the wonderful growth of Best Start family hubs, but we all saw how quickly the consensus behind Sure Start fell apart with a change in Government and how a generation of children and their parents were disadvantaged by its collapse.

[Dr Simon Opher (Stroud) (Lab)]

I thank the right hon. Member for New Forest West for bringing forward this excellent Bill. I await the technical appraisal of whether it needs to be amended, but we cannot deny that inequalities directly influence specific types of services. In my role as a GP, I have seen that children born in deprived areas need a much higher level of support from Sure Start-type services and video interactive guidance, because often relationships are poor. Those poor relationships can lead to children starting school not being able to hold a knife and fork or still being in nappies. Inequalities influence what types of services are needed. I accept the point from the right hon. Member that there may be technical guidance, but perhaps it should be integrated within the Bill.

[Jess Asato]

I thank my hon. Friend for his intervention.

Infants, Parents and Carers Bill (First sitting)

Simon Opher Excerpts

Committee stage
Wednesday 14th October 2026 Public Bill Committees

[Jess Asato]

Indeed I have, and I will come to that in a moment.

As I was saying, the Bill does not give sufficient voice to those who cannot speak for themselves—babies and infants. My amendment seeks to ensure that the Government will assess how successful services are in improving the physical, mental and emotional wellbeing of infants, parents and carers and, crucially, will assess our progress in tackling inequalities in the early years.

Although there is other legislation, such as the Equality Act, to guide secondary legislation, we know from bitter experience that future Governments could repeal legislation that has equality as its goal. Indeed, we are in difficult and divisive times in our country at the moment. There are those who would seek to repeal the Equality Act, thereby undoing any of the protective features that that Act would bring to this important Bill.

To anticipate future Government policies, the Bill must make reporting on inequality of outcomes paramount, because significant inequalities exist in many of the most fundamental measures of babies’ health and development. Black babies, for example, are more than twice as likely as white babies to be stillborn. Babies in the 10% most-deprived areas are more than twice as likely to die as babies in the 10% least-deprived areas. Babies growing up in poverty are more likely to experience domestic abuse in their family and are less likely to be breastfed.

At the moment, these inequalities, which are reported on by Government through auspices such as the Equality Act, might be identified, but in future there may be no requirement for that to be the case as part of the Bill. Simply showing that there is provision for babies, infants and their parents and carers could ensure that the Secretary of State is able to discharge their duty under the Bill, whether it actually operates to reduce inequalities or not. Under our current legislation, we still have deep inequalities, in part because the focus on reducing inequalities between areas has been lost—and lost deliberately. I think we ought to see whether we can return to making sure that that is the focus.

As it stands, the Bill does not explicitly require the Secretary of State to look at outcomes for babies and their parents, or at what those outcomes may indicate about the quality and availability of services. Although the views and experiences of parents and carers are incredibly important in understanding need, they do not paint the full picture and we cannot rely solely on them to analyse successes and failures of services. The public deserve to know the realities of inequalities in early childhood, and Governments must welcome robust scrutiny of their policies to help support babies.

The amendment also requires the Government to look at the wellbeing of parents. That is particularly important given the Maternal Mental Health Alliance report that said that one in four mothers experiences a mental health condition during pregnancy or after birth. Suicide remains the leading cause of death for women between six weeks and a year after giving birth. The amendment keeps the Bill flexible and streamlined, and I understand that it would not increase any financial cost of the Bill. It also clarifies the role of the Government in measuring success.

The Bill needs to be future-proof—indeed, the purpose of the Bill is to ensure, on a cross-party basis, that our services genuinely lead to a change in outcomes for babies, infants and children throughout their lives. It must stand the test of time, regardless of the colour, priorities or whims of future Governments. I have absolute faith in this Government and their commitment to early years investment, including the wonderful growth of Best Start family hubs, but we all saw how quickly the consensus behind Sure Start fell apart with a change in Government and how a generation of children and their parents were disadvantaged by its collapse.

[Dr Simon Opher (Stroud) (Lab)]

I thank the right hon. Member for New Forest West for bringing forward this excellent Bill. I await the technical appraisal of whether it needs to be amended, but we cannot deny that inequalities directly influence specific types of services. In my role as a GP, I have seen that children born in deprived areas need a much higher level of support from Sure Start-type services and video interactive guidance, because often relationships are poor. Those poor relationships can lead to children starting school not being able to hold a knife and fork or still being in nappies. Inequalities influence what types of services are needed. I accept the point from the right hon. Member that there may be technical guidance, but perhaps it should be integrated within the Bill.

[Jess Asato]

I thank my hon. Friend for his intervention.

Health Bill

Simon Opher Excerpts

Report stage
Monday 7th September 2026 Commons Chamber

[Steff Aquarone]

I could not agree more. That is one of many respects in which rural and coastal communities around the country have much more in common with each other than with their inland neighbours just a few miles away. Theoretically available treatment becomes practically inaccessible if it requires a journey to be made without reliable toilet access, as in Ian’s case, and in cases where access to private transport is more limited, as in the cases that the right hon. Gentleman raises.

Kelly, Samantha, Ian and so many more are entitled to the same access to good treatment and the same chance of good health as people living in urban and inland communities. It is absolutely right for the Government to pursue this Bill, and I support their aim wholeheartedly, but I challenge them to assess the Bill based on who is left behind, not just who can be helped. Accept this amendment, or explain why rural and coastal communities do not merit explicit protection.

[Dr Simon Opher (Stroud) (Lab)]

My remarks will focus mainly on new clause 69, which is in my name. Getting rid of NHS England is one of the best things that this Government have done. As working clinicians, we can at least now get away from so much admin and management.

My amendment is a simple one about self-care and health literacy. Demand for healthcare has increased enormously. Since 2019, for example, GP consultations in Stroud have gone up 30%. When I started work as a GP, patients saw me on average three times a year; it is now about eight times a year. Indeed, A&E attendance has gone up 20% over the last decade, yet the health of the nation remains the same. This is the demand side of the NHS that we very rarely discuss, and this is what I am asking the Secretary of State to address.

Let me turn to the causes of this increase in demand. There is a concept in medicine called the symptom iceberg. Most of us get symptoms every day, but we do not go to the doctor. We only go to the doctor when we have certain symptoms, and it is a very small number of symptoms, but that has increased over the last 20 years. Then there is the role of something that we call lay referrals; people used to have mums who lived next door, but now they are often much further away. We are socially isolated in an atomised society. We also have a much higher expectation for our health. We cannot fault that, but it means that, for example, people go to the doctor with very minor things. There are also factors such as AI. In my surgery, we use AI, but I believe that creates its own demands. There is also good old Dr Google, who in this country is consulted over 50 million times every year—and those who go to Dr Google usually end up thinking that they have cancer or need an ambulance, so that is clearly driving demand.

There are also doctor factors. If we carry on treating sore throats with antibiotics, people will carry on coming back. Earaches generally get better, and people do not usually need to see a doctor for headaches. We are over-diagnosing and over-medicalising everything. NHS factors includes the algorithms for 111 and litigation. I would also like to talk about health literacy. That means knowing about our health, and understanding that we are not always in totally good health, but we do not have to consult the health service just because we are feeling a little bit low or a little bit tired.

One of my colleagues in Stroud, Dr Hugh van’t Hoff, started Facts4Life, a school-based education service that goes into schools. In the last 10 years, he has worked with over 200 primary schools. He has shown that if we teach young children about health and how it is normal sometimes to feel tired or have a sore throat—stuff like that—we can reduce consultations in the NHS. We can also teach children how to understand information on the internet, so that when they look at statistics, they know what they mean, instead of thinking, “Ooh, my risk of cancer has been doubled by doing this.” That is really important.

We are also over-medicalising patients. In this country, 9 million patients in England alone—one in five adults—are on antidepressants. That is a scandal.

[Martin Wrigley]

On interpreting statistics, does the hon. Gentleman agree that when it comes to data, GP confidentiality—in respect of the Palantir federated data platform, for example—is critical, certainly when we come to the single patient record, and that the Bill should not reduce confidentiality or data privacy to achieve the single patient record?

[Dr Opher]

I thank the hon. Member for that comment. He is right. NHS and GP data is a massive resource for our scientists in this country, and I agree with him that it should be owned by the UK. It should be a sovereign wealth issue. I would like to ensure that we realise that over time.

I will return to over-medicalisation. I would like to try to divert patients with mild to moderate mental health symptoms to social prescribing, such as access to nature, arts and culture and exercise—and indeed comedy. Let us try to reduce that figure of 9 million on antidepressants, so that people do not have to come back for review. There would be fewer harms, such as suicide, in the first couple of weeks. Let us also look again at neurodivergence, and try to look for a way of not medicalising so many children with the condition.

If we are serious about reducing waiting lists and making the NHS sustainable for the future, we cannot focus only on supply; we must address rising demand, too. Giving people the knowledge and confidence to look after their own health will empower them, free up clinicians to care for those who need them most, and ultimately build a healthier population. That is what new clause 69 seeks to achieve. I urge the Government to accept it.

[Edward Morello (West Dorset) (LD)]

Only half the children in my constituency have seen a dentist in two years. There has been a 20% decrease in NHS dental practices, and some constituents have written to me recently to say that they have been quoted in excess of £7,000 for the most basic of treatments. Amendment 47 would require the Government to establish training hubs in Dorset. It would ensure that dental hubs trained dentists for the future, and would mandate final-year trainees to provide supervised treatment to NHS patients straightaway. Trainees are already providing treatment for free, paid for by the taxpayer, as part of their training. Those appointments should be for the NHS, and not for private patients.

Amendment 48 would ensure that the dental funding underspend is redirected towards additional NHS appointments, shorter waiting times, outreach, and home and school-based services. Amendment 49 would require the dental funding formula to account for rurality, an ageing population, disability, transport costs and recruitment difficulties.

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.