Gaza Healthcare System
Simon Opher Excerpts(1 week ago)
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Dr Simon Opher (Stroud) (Lab)
I beg to move,
That this House has considered Government support for the healthcare system in Gaza.
It is a privilege to serve under your chairmanship, Sir Jeremy, and I thank the Minister for attending. I also thank the Backbench Business Committee and the co-signatories of my application for the debate. I place on the record my thanks to Médecins Sans Frontières UK and Professor Ramzi Khamis for their assistance in my preparations.
This debate could not have come at a more crucial time for healthcare in Gaza: in about a week’s time, many aid agencies that provide medical care will be barred from operating there. I believe there might be an urgent question to the Foreign Secretary about this very situation today, so it is a live debate. I thank all those who have asked to speak about this crucial issue.
In June last year, when preparing to go to the main Chamber for Foreign Office oral questions, I received a phone call from my colleague, Dr Rebecca Inglis, who works for Healthcare Workers Watch. She told me that, just hours before, a GP in Gaza was killed by an Israeli soldier, shot in the head. I do not know why—perhaps because I am also a GP—but that really hit home about the situation in Gaza. More than 1,000 healthcare workers have now been murdered in Gaza, while countless others remain detained.
As well as the healthcare system in Gaza, I would like to talk about healthocide as a concept. The deliberate targeting of healthcare workers is becoming an instrument of war, not just in Gaza but in other places in the world. Healthcare workers do not have sides and are not partisan; the only side they are on is the side of humanity. We must stop this developing situation in the world. In addition, the healthcare system in Gaza is near to total collapse after such targeting. As I said, in a week’s time many aid agencies—over 30 of them—will be barred from working in Gaza. I will, then, discuss both those issues.
The targeting of healthcare workers in Gaza has been widespread and well documented. Since October 2023, 1,700 healthcare workers have been killed, hospitals have been bombed and raided, and senior doctors have been detained. I talked to one healthcare worker in Gaza who said that they could not leave the hospital in scrubs because they would be identified as a healthcare worker and arrested. Later this evening, I will host a launch event for the investigation of the Gaza aid-worker massacre on 23 March last year, when 15 emergency workers were massacred by Israeli forces.
I could not come to this debate without mentioning the tragic case of Hind Rajab, a five-year-old Palestinian girl who was murdered by Israeli forces alongside six of her family members. Crucially, two paramedics who were coming to save her life were also killed. Her voice will continue to haunt the world. I hope to meet her mother later today, and I want to be able to look her in the eye and say that this Government are doing all they can to prevent another such situation as happened to her daughter.
Healthocide is becoming a new phenomenon in war. More than 13 years ago in Syria, for example, healthcare workers were systematically targeted by the then Syrian Government and Russian forces. The same is happening in Sudan now. There is, then, a bigger point, and we must stop this happening. This country should campaign on healthocide in the world.
The situation in Gaza is grim for healthcare: not a single hospital is fully functional in the Gaza strip, while 50% of them are partially functional; only 1.5% of primary healthcare centres, or three out of 200, are fully functional; and not a single hospital is operating in northern Gaza or Rafah. Healthcare workers conduct more than 100 consultations a day; in British general practice, I am not allowed to do more than 25, so that gives a feeling of how much work these people are doing. That is putting an enormous strain on the healthcare system.
An interim rapid damage and needs assessment conducted jointly by the United Nations, the EU and the World Bank found that more than $1.47 billion-worth of damages had been inflicted on the health sector, and that reconstruction will cost about $8 billion. There is a massive need to rebuild the healthcare facilities in Gaza.
Two weeks ago, I heard direct testimony from a British doctor who had just returned from Gaza. She witnessed the wilful destruction of medical equipment—for example, cutting off the ends of all the ultrasound machines—and the systematic destruction of medical data. She described seeing patients arriving with sniper wounds that were so precise they were clearly made to cause lifelong disabilities and therefore harm young people in Gaza.
Claire Hazelgrove (Filton and Bradley Stoke) (Lab)
Like me, many residents across the Filton and Bradley Stoke constituency have been horrified to see the scale of human suffering on the ground in Gaza. It is right that our Government have been doing what they can to bring children who are in urgent medical need to the UK for treatment. Does my hon. Friend agree that it is vital that our Government continue to do all they can to help vulnerable children in Gaza?
Dr Opher
Indeed, and many of us have campaigned on the medical evacuation of young people. The Minister has delivered on that, although there have been some problems recently, which he may address. A key issue in Gaza to which I will return is that currently the medical evacuation of anyone to East Jerusalem, which is still in the occupied territories, is not allowed. East Jerusalem has some well-functioning hospitals with capacity, and that is one of the issues we need to address.
Wendy Chamberlain (North East Fife) (LD)
The hon. Member is talking passionately about the impact of physical injuries on young people, but we also know that trauma recovery for children and young people will have to be a vital part of the long-term solution for Gaza. The International Centre for Child Trauma Prevention and Recovery has pioneered a capacity-building model of training to put as many counsellors on the ground as possible. I engaged with the ICCTPR’s co-director at a fundraising event in Ceres in my constituency. Does the hon. Member agree that when the UK Government are looking at providing funding and support, they also need to look at trauma recovery?
Dr Opher
I absolutely agree. War is traumatic on so many different levels, and mental health is a key part of holistic care and must be covered in any rebuilding of the healthcare system. We also need to start to look at training people in the Gaza strip and the occupied territories, because it is better to train them than to import them.
Paul Waugh (Rochdale) (Lab/Co-op)
My hon. Friend rightly makes a passionate case for why we should be doing more to help the healthcare system in Gaza. It is quite clear that the 50 severely ill children from Gaza who were evacuated by the Government and treated in NHS hospitals were well cared for. Indeed, the Prince of Wales visited some of them in hospital and afterwards said explicitly that they had faced
“experiences no child should ever face.”
Does my hon. Friend agree that the next step the Government should take is to treat children in the region? Plenty of British medics are willing to go out there and help; the Government should be encouraging them to use their NHS expertise to treat children in the region and to train medics in the specialisms that are desperately needed.
Dr Opher
My hon. Friend is spot on. Rather than evacuating children to the NHS, which was the right thing to do while war was raging, it is better to build up facilities in the area and start training doctors and other health professionals to look after people there. We are training some Gazan medical students—I have met some of them—but the future lies in building up medical training in the area.
Rachael Maskell (York Central) (Lab/Co-op)
I am grateful to my hon. Friend for securing the debate and for the pertinent points he is making. Does he agree that the Minister should work with the Health Secretary to ensure that clinicians of all kinds can get the release they need to spend the appropriate amount of time in the region to provide training and clinical support?
Andrew George (St Ives) (LD)
I strongly support the points the hon. Gentleman is making in advancing his case. I am slightly worried about the expression “in the region”. We need to get medical workers into Gaza to make sure they can safely deploy their skills in the area. We are long past the time when the Israeli regime could justify its actions in terms of self-defence. The best way to achieve safe passage for medical aid workers in the area is to get the IDF out and get international peacekeepers in.
Dr Opher
The hon. Gentleman is spot on. The most important thing is peace, so that we can build a healthcare system. Although there has been a ceasefire, a lot of Palestinians are still dying. We first need to make a stable environment, and we need to be pragmatic. While there are functioning hospitals in East Jerusalem, we should be able to take people out of Gaza and get them treated there. As I have outlined, the healthcare facilities in Gaza have been severely damaged. I will come later to the possibility of bringing in mobile units on a short-term basis, but in the long term we need to build up the hospital sector.
Baggy Shanker (Derby South) (Lab/Co-op)
I thank my hon. Friend for securing the debate. I have read that Gaza is now home to the largest number of child amputees but, according to Save the Children, the prosthetic centres there are not functioning. Does my hon. Friend agree that Israel needs to lift all restrictions on aid getting into Gaza, so that young people can get the vital prosthetic limbs they need for day-to-day life?
Dr Opher
I thank my hon. Friend for a point well made. It is even more basic than that: we need to allow medicines into Gaza, which are not currently being transported. Other items such as prosthetic limbs are also very important, so the border needs to open up. Humanitarian aid, not just medical aid, is needed in Gaza. We need to open the borders and allow relief in.
In a sinister development, snipers seem to be targeting specific areas of the body, such as the brachial plexus, damage to which causes long-term disability, and the sciatic nerve in the leg, damage to which causes permanent paralysis. I know that war is evil in many aspects, but we should call out that cynical approach.
Public health is incredibly important for people in the Gaza strip: 89% of water, sanitation and hygiene infrastructure has been destroyed or damaged. One of the most important things is to get clean water to people. There are about 250,000 cases of acute malnutrition in children this year, as well as 37,000 cases in pregnant and breastfeeding women.
Violence against women and the effects on reproductive health have led to a 41% fall in births in Gaza, as well as a high number of maternal deaths, miscarriages and newborn mortality. We have seen strikes on maternity wards and the destruction of Gaza’s largest in vitro fertilisation clinic, wiping out 5,000 embryos. Premature births have also sharply increased, with one in five newborns requiring intensive neonatal care. Respiratory infections, acute watery diarrhoea and skin infections are widespread. This is a particularly horrifying statistic: 11 children have reportedly died from hypothermia this winter, including a two-month-old baby and one-year-old child.
There are many serious problems, among which I would like to pinpoint Guillain-Barré syndrome, which is very rare—as a doctor, I have seen it only once—and it leads to increasing paralysis and often requires ventilation. The causes are often difficult to identify, but there seems to be a Guillain-Barré syndrome epidemic in Gaza. It may be triggered by infections or other, possibly sinister, causes. Doctors in Gaza have tried to take away soil samples but have been restricted. I do not know what is causing it but Guillain-Barré is an acute problem with serious repercussions.
On top of all that, we now face an even more alarming development: 37 international non-governmental organisations, including Médecins Sans Frontières, face deregistration on 1 March—next week. If that proceeds, they will no longer be able legally to operate in Gaza, the west bank or East Jerusalem. MSF alone supports one in five hospital beds in Gaza and assists in one in three births. In 2025, it performed 22,000 surgical operations, handled more than 100,000 trauma cases and carried out more than 800,000 out-patient consultations. If these organisations are forced out, the consequences will be catastrophic.
Will my hon. Friend the Minister urge Israeli officials to reopen the humanitarian medical corridor, allowing critically ill patients to travel to East Jerusalem and the west bank for treatment? The World Health Organisation holds a list of approximately 18,000 urgent cases, yet permission to travel that short distance for care—including urgent cancer care—has been routinely denied. Will he use any possible leverage we have to ensure that the Israeli Government immediately pause the deregistration of international humanitarian aid organisations and negotiate their continued presence in Gaza?
As my hon. Friend the Member for Derby South (Baggy Shanker) mentioned, we need to establish a medical supply chain that allows medicine and equipment into Gaza immediately, and we need to find rapid alternatives to destroyed facilities. For example, mobile operating theatres could be in Gaza within 48 hours. They are about the size of articulated lorries and could be driven in, and they are self-maintaining. We could be operating with them almost immediately. We must push to allow them into Gaza. Also, we need to start rebuilding hospitals and build up field hospitals as well. There is a lot to do, but we must start on this process.
Will the Minister work with our allies to ensure that attacks on healthcare are investigated and documented wherever they occur, and that perpetrators are prosecuted? Healthocide must become recognised and exposed and we must deter it in the world. I was refused entry into the west bank last year. I realise that it is very difficult to get any leverage over the Israeli Government to influence their decisions—I respect that—and I understand that the Foreign Office tries to do what it can, but is it time to impose proper, full sanctions on Israel if it does not resolve this itself? I would like to hear the Minister’s opinion on that.
Healthcare workers in Gaza are performing the most difficult and courageous work imaginable, often literally under fire. They deserve protection and their patients deserve care. We cannot simply look away. We need action now.
Several hon. Members rose—
Dr Opher
I thank all the speakers who have contributed to what has been a very passionate debate. I have spoken to many British doctors who have worked in Gaza, and what we are presenting here—the sabotage of the healthcare system—is real. It is going on now, and we must deal with it rather than brushing it under the carpet and blaming Hamas.
Melanie Ward
Does my hon. Friend agree with me on the need for justice and accountability for horrific acts that have taken place in hospitals, including a massacre in the grounds of al-Shifa hospital, and a situation in Nasser hospital where many babies were left to die following Israeli military action?
Dr Opher
I absolutely agree. We must get to the bottom of those things because they must not be allowed to happen again. I propose that the Minister talks to Ministers in the Department of Health and Social Care about us, as a nation, providing healthcare to people in Gaza as much as we can. That is something that I have discussed with that Minister. We must be positive here and try to relieve the suffering of Gazans, because everything I have heard has been appalling.
I thank all Members and the Minister.
Question put and agreed to.
Resolved,
That this House has considered Government support for the healthcare system in Gaza.
Parkinson’s Disease
Simon Opher Excerpts(3 months, 2 weeks ago)
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Dr Simon Opher (Stroud) (Lab)
In Stroud, 295 people have Parkinson’s disease, yet we had 960 admissions for it. Although we have a good turnout for the debate today, I believe that Parkinson’s gets less attention than other degenerative diseases. That must change, because it is much more common. As a GP, I would say that diagnosis for the disease is difficult. It can present in a huge number of ways—40 different symptoms, often with rigidity. The tremor can be due to other things such as essential tremor. It can even present with constipation or depression, and indeed with dementia, where it is called Lewy body dementia, which is associated with Parkinson’s. A GP cannot make the diagnosis; they have to wait for the outpatient specialist to make it, which is why the wait is so criminal.
We need comprehensive and co-ordinated care. I believe that neighbourhood health centres will be fantastic at delivering this care. Parkinson’s specialist nurses are absolutely crucial, as are multidisciplinary teams with physios and occupational therapists. Social prescribing—signposting and getting the right benefits—is also incredibly important. Indeed, there is good evidence that dancing is really good for Parkinson’s disease—that is something a little innovative. We need timely diagnosis of patients with Parkinson’s disease, and a co-ordinated and comprehensive care plan; and most of all, we need to give them back their dignity.
Oral Answers to Questions
Simon Opher Excerpts(8 months, 1 week ago)
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Dr Simon Opher (Stroud) (Lab)
Gill Furniss (Sheffield Brightside and Hillsborough) (Lab)
The Parliamentary Under-Secretary of State for Foreign, Commonwealth and Development Affairs (Mr Hamish Falconer)
Israel must immediately allow rapid and unhindered aid into Gaza. The Foreign Secretary raised the humanitarian situation with Israeli Foreign Minister Sa’ar on Sunday. We recently announced £4 million of further UK humanitarian support for Gazans, and we will continue to urge Israel to lift restrictions on humanitarian aid to allow the UN and other aid organisations to operate safely and independently.
Dr Opher
This morning I heard from my medical colleague, Dr Rebecca Inglis, of Healthcare Workers Watch, that a GP in Gaza was killed by Israeli soldiers—shot in the head, Mr Speaker. He is just one of 1,200 healthcare workers who have been murdered by Israeli forces. Countless others have been unlawfully detained and tortured. Israel is deliberately destroying the Palestinian healthcare system. Will the Minister please raise these issues with his Israeli counterpart?
Terminally Ill Adults (End of Life) Bill
Simon Opher Excerpts(9 months, 2 weeks ago)
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Dame Meg Hillier (Hackney South and Shoreditch) (Lab/Co-op)
I rise to speak to new clauses 1 and 2, which stand in my name, and consequential amendment 2, and I will touch on others at the end. These amendments—without being dismissive of those who helped me draft them—are imperfect. Those of us who are not the promoter of the Bill have not had the support of Government drafters in tidying up the Bill. We need to acknowledge that the Bill in front of us today is the Bill—more or less—that will or will not be passed by this House. For any amendments made, by the point of Third Reading, that is it—there will be no further opportunity to redraft them.
Sadly, one of these amendments was rejected in Committee. If those changes had been discussed before the original Bill was published, or even in evidence before Committee, we would have been in a better place to get that tighter drafting that is needed in making good legislation. We are not a debating society; we are now legislating for a law that would enable the state to assist in people taking their lives. I am sad that we are able to discuss these amendments only now. I did not get the opportunity to be on the Bill Committee, but I commend all Members who spend so many hours discussing and debating those issues.
The ramifications of the clauses I want to talk about are important for potential users of a service, for medical professionals, for families and for other health professionals. The Bill currently allows doctors to suggest assisted dying to a patient who has not raised it themselves. This, I believe—as I know many others do—presents a serious risk that terminally ill patients, already highly vulnerable, will feel pressured to end their lives.
Dr Simon Opher (Stroud) (Lab)
I realise that my hon. Friend’s new clause 1 comes from a good place, but can she not see that it is inconsistent with our ethical obligations as doctors? That is why the British Medical Association has suggested that although there should be no duty to raise the issue, neither should there be a ban on doing so. I ask her to consider that the Australian state of Victoria initially had such a measure—a so-called gagging clause—as part of its Bill, but it was removed because it caused confusion and was detrimental to patient care. Should we not learn from that?
Anneliese Dodds
Yes, I do share my hon. Friend’s concern in that regard. Sadly, we all know how perpetrators of coercion operate. They will often school the subject of their coercion in how to respond to questioning, to try to hide what they are doing from others. That is a concern.
Dr Opher
Does my right hon. Friend not see that, in Committee, we were very aware of coercion? That is one of the reasons why we have a social worker on the panel of experts. Additionally, clause 1(2)(b) says it will be necessary to establish that a person
“has made the decision that they wish to end their own life voluntarily and has not been coerced or pressured by any other person”.
It is very clear in the Bill.
Anneliese Dodds
I very much appreciate my hon. Friend’s efforts, and those of my hon. Friend the Member for Spen Valley, to ensure that these matters were covered in Committee. Sadly, because of the patterns of behaviour that we see time and again with those who have been subject to coercion, I do not believe that the safeguards go far enough. That is my assessment, and I know that other Members will come to a different view.
Madam Deputy Speaker
I reassure the hon. Lady that I have heard her point. I repeat that I will not make a pre-decision on any closure motion that has not yet been moved.
Dr Opher
I will be very quick, Madam Deputy Speaker, because I am aware of the need to fit in as many people as possible.
I will address a few issues on the assessment of capacity under new clause 9. One key point about assessing capacity as a doctor is that in most cases it is very clear cut: someone either has capacity or they do not. That is quite easy and quick to establish. With a very small number of patients, it is more difficult. By amendment to the Bill made in Committee, we must now refer such a person to a consultant psychiatrist for an assessment by a specialist. They are then in the best position to assess those very difficult points of capacity. That very much strengthens the Bill.
I will speak very briefly to new clause 1. As doctors, we must, under our ethical obligations, give options to patients. If we are absolutely forbidden to do that—new clause 1 would make it a crime, so we could be convicted for doing so—that totally wrecks the doctor-patient relationship. It is unprecedented and unworkable.
Several hon. Members rose—
Dr Opher
I am sorry, I cannot give way. I am just going to go through these points very quickly.
That is why the BMA is against new clause 1. There is no duty for doctors to raise the issue, but there should not be any ban on them doing so. As I have pointed out, the so-called gagging clause was introduced in Victoria as part of the legislation. However, after five years that has now been removed by an independent review, because it caused confusion and it harmed patient care. I urge colleagues to vote against new clause 1. Let us respect the patient’s right to information, not restrict it. Let us ensure that no patient is left suffering simply because they did not know what to ask, and that no doctor is punished for trying to help.
Sarah Russell
I thank my hon. Friend for giving way. On that point, I have particular concerns—
Madam Deputy Speaker (Caroline Nokes)
Order. May I just clarify whether the hon. Gentleman was giving way?
Sarah Russell
Thank you, Madam Deputy Speaker. On that point, does my hon. Friend agree with my concerns about new clause 2, which, although genuinely meant and intended, is in danger of being read, together with new clause 1, to indicate that it should not be discussed with children at all, even if they raised it first, because of the difference between the wording of the two clauses?
Sarah Olney (Richmond Park) (LD)
I rise to speak in support of amendment 87, which stands in my name, and in support of various amendments tabled by other Members and also signed by me.
Prior to this legislation being laid before the House, I had not held strong feelings about the issue of assisted dying. I listened carefully to the arguments on both sides, including those of the many constituents who wrote to me on the issue, before deciding to vote against the Bill on Second Reading. I made my mind up very late in the day. I continue to be appreciative and respectful of the reasons why people are in favour, but, for me, the fundamental question was whether we were putting vulnerable people at risk by passing this legislation. I resolved that, on balance, we were.
The lead Member, the hon. Member for Spen Valley (Kim Leadbeater), was keen to reflect the balance of opinion across the House, as well as within parties, in the make-up of the Bill Committee, and I was happy to volunteer as the sole Liberal Democrat “no” voter, as a service to my party and to the House. It was a privilege to serve on the Committee, and I wish to put on the record my admiration and respect to all Members, Ministers, Chairs and House staff who served alongside me, and my thanks to the many witnesses who gave oral and written evidence on which we came to rely.
I regret to say, however, that my experience in Committee has only hardened my opposition to the Bill. My opposition is not rooted in a fundamental objection to the principle of assisted dying, but in the approach taken to framing the legislation.
Amendment 87 seeks to tighten up the arrangement around the first declaration, to rule out the possibility of “doctor shopping”. In oral evidence we heard from the chief medical officer, Professor Sir Chris Whitty, that a diagnosis of terminal illness and a prognosis of life expectancy cannot always be made with a high degree of accuracy and that a degree of professional judgment is required on behalf of the co-ordinating doctor, which can result in differences of diagnosis and prognosis.
That was backed up by the Royal College of Physicians this week, whose spokesperson was quoted in The Times saying that it is “extremely hard to tell” if somebody has only six months left to live. My amendment seeks to establish whether the patient has already sought and been refused permission to seek an assisted death so that the co-ordinating doctor can consider the reasons for the first refusal and whether the patient’s circumstances have materially changed since that time.
Israel and Palestine
Simon Opher Excerpts(1 year, 2 months ago)
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Andy Slaughter (Hammersmith and Chiswick) (Lab)
I can be very brief, Mrs Harris, because this speech has been honed by repetition over the past year, since Israeli tanks, troops and planes went into Gaza against not only Hamas but, significantly, the civilian population without discrimination. It mirrors, on a larger scale, the previous attacks on Gaza over the past 15 years, which I have seen with my own eyes. The Minister replying to the debate could not be more empathetic to the situation, and he could not be more sympathetic to the complaints from all parties. However, there has been a lack of action from this Government, as there was from the previous Government, and that lack of action speaks louder than any palliative words.
Dr Simon Opher (Stroud) (Lab)
Does my hon. Friend celebrate the work of Standing Together, which is a group of Israelis and Palestinian people working side by side for peace? Would he support it in its call for the suspension of arms transfers to Israel and for the immediate recognition of the state of Palestine?
Andy Slaughter
Standing Together is a fantastic group, and it is one of many Israeli and multinational groups that are protesting; we have seen that on the streets of Tel Aviv, as we have around the world.
There is yet to be any substantive action by the UK, and war crimes are being committed in Gaza. The evidence is clear; it is clear from journalists, and many brave journalists have been killed. It is evidenced by the actions of the International Criminal Court and from the ICJ, through both its advisory opinion and the South African case, and the Irish Government should be praised for their association with that case last week. It is clear from votes, decisions and debates in the UN, from the evidence of non-governmental organisations on the ground, and from the evidence of medics.
The remedies are also clear, and there are many steps that the UK Government could take. They could look at trade, including settlement trade. Why is that allowed to continue? They could at preferential trade agreements with Israel. They could look at arms sales. They should certainly be re-examining, and asking the law officers to re-examine, on a weekly basis, the actions that UK-supplied arms are being used for—not just in Gaza, but across the occupied territories. They could look at sanctions, including those against settlers that go much further than the few that have happened so far, as well as against members of the Netanyahu Government—particularly the extremists such as Smotrich and Ben-Gvir. Why have they not been taken so far?
We could also look at the question of recognition. It is the policy of the Government to recognise the state of Palestine at some point during negotiations. We are a long way from negotiations at the moment, and there seems to be no reason whatever not to allow recognition.