Eating Disorders: Prevention of Deaths

Tom Gordon Excerpts

Tuesday 2nd September 2025 Westminster Hall

[Tom Gordon (Harrogate and Knaresborough) (LD)]

It is a pleasure to serve under your chairmanship, Sir Desmond, and I congratulate the hon. Member for Isle of Wight West (Mr Quigley) on securing this important debate.

Prior to entering this place, I worked in the charity sector for type 1 diabetes charity JDRF, as it was then. In the last Parliament, Theresa May and Sir George Howarth published an inquiry report into T1DE, or type 1 diabetes and disordered eating, which the hon. Member for Cannock Chase (Josh Newbury) outlined. Over the course of the summer recess I met with Dr Tony Winston at the Aspen Centre in Coventry. One of the key takeaways when it comes to diabetes and disordered eating and that complex condition is making sure that there are clear criteria. At the moment, as has already been outlined, as an eating disorder, T1DE falls through the net: it is referred to diabetes services, but often diabetes services try to refer it on to eating disorder services too. There is a bit of a gap in the net.

One of the key needs is integration of services between those two Departments. There must also be better collection, integration and use of data to prevent death before it occurs. People with T1DE have a three times higher chance of mortality, and we know that over 100,000 people are at risk of it. One of the key findings of the inquiry report that I helped to work on was the lack of education for healthcare professionals when it comes to identifying eating disorders, particularly in other areas and specialisms. Can the Minister comment on what his Department is doing to pick up that report and implement some of those recommendations?

--- Later in debate ---

[The Minister for Care (Stephen Kinnock)]

It is a pleasure to serve under your chairship, Sir Desmond. I begin by congratulating my hon. Friend the Member for Isle of Wight West (Mr Quigley) on securing today’s debate and speaking so bravely and movingly about his family. I pay tribute to his work in the all-party parliamentary group on eating disorders, and I know that he and many other hon. Members present have worked tirelessly to advocate for those with eating disorders.

Every death from an eating disorder is a tragedy. We have heard from hon. Members about the devastating effect of these conditions, both for patients and their loved ones. But we must be clear that eating disorders are not terminal illnesses. With the right treatment and support, recovery is possible. Many across the Chamber have made that point, and I pay tribute to everyone who has contributed so powerfully. I also congratulate Arek and Claudia, who I know made outstanding contributions to drafting the speech made by my hon. Friend the Member for Beckenham and Penge (Liam Conlon).

Through the 10-year health plan, the Government will ensure that those living with eating disorders are given the support they need. We will cut waiting times and ensure that people can access treatment and support earlier. Improving eating disorder services is a priority for the Government, and a fundamental part of our work to transform mental health services. Last financial year, we provided £106 million in funding for children’s eating disorder services, an increase of £10 million since 2023-24. That increase in funding is helping our clinicians to support more people, and to change and save lives.

[Tom Gordon]

One of the great organisations that does a lot of work on the accountability of services, including eating disorder services, is Healthwatch. We know that these organisations are going to be scrapped. They have done loads of valuable work at local and regional levels. What levels of accountability will the new systems put in place for eating disorder services?

[Stephen Kinnock]

I agree that Healthwatch did some important work, but what we are doing is changing the culture of how our NHS works. As the hon. Gentleman will have seen, we are abolishing NHS England. That is of a piece with our belief that proper leadership, proper accountability and proper management of a complex system such as our NHS, and particularly its interaction with ICBs and trusts, is about having a clear line of accountability from the Secretary of State through Ministers into the system and those operating at the coalface. We believe that if more layers are put between, and cut across, those lines of accountability, that does not actually drive better outcomes—it drives poorer performance. That is the approach we are taking to the entire system.

NHS Pensions: Frontline Patient Care

Tom Gordon Excerpts

Thursday 17th July 2025 Commons Chamber

[Karin Smyth]

I thank the hon. Lady for that really constructive suggestion. In my discussions with the NHSBSA, the reviewer and officials at the Department, I have raised similar issues. I am a member of the NHS pension scheme and the parliamentary pension scheme. I tell my young people that this is a really valuable asset, and I encourage my constituents who are looking for jobs in the NHS to consider the pension scheme, because people sometimes do not look at it immediately. We should look at ways to encourage people to take part in the pension scheme—particularly for lower earners, it is a really valuable and stable contribution—and the value of it from the public purse should be well known.

I am not across the detail of the hon. Lady’s point on the Pension Schemes Bill, but I will talk with my colleagues across Government about how we can look to do that and come back to her, because I agree that it is a really valuable thing—it rewards the contribution of public service, and we should make the most of it.

[Tom Gordon (Harrogate and Knaresborough) (LD)]

I would like to take this opportunity to put my thanks on the record to the Minister. I have spoken to her outside this place about the money we have secured for removing reinforced autoclaved aerated concrete at Harrogate district hospital, which I have been campaigning on for years.

It is great having state-of-the-art hospital facilities, but if we do not have the staff there, it is all a bit moot. I want to press the Minister on the concerns raised by colleagues that people might not come back or take on additional hours in the NHS as a result of this issue. Will she commit to updating Members throughout the recess on progress on this matter?

[Karin Smyth]

I congratulate the hon. Gentleman on, yet again, shoehorning in a reference to his local hospital, for which he does a great job.

People are determined to work in and support the national health service. We take remedying confidence in pensions seriously. I will not give further deadlines before we hear from the assessor. I have asked her to come back and make a very clear statement as soon as possible after the summer recess. I will then be happy to update the House.

Coming forward to work in the NHS is a matter of choice for individuals, and we particularly want to work with consultants to ensure that their career progression is the best it can be. We very much value their work in the service.

NHS 10-Year Plan

Tom Gordon Excerpts

Thursday 3rd July 2025 Commons Chamber

[Wes Streeting]

I am grateful to my hon. Friend for her question: I can tell that she has already read a lot of the plan, not least because she had such a heavy role in shaping it, bringing her expertise to bear as we were deliberating. I also thank her constituents in Shipley, who took part in the engagement and consultation that she did locally; I hope they feel that their fingerprints are on this plan. She talks about the “My Carer” feature of the NHS app, which will make an enormous difference. I hope that the people who tend to be heavier users of health services feel that they have more power, choice, agency and control. That has to be true not just for people with physical disabilities, but people with learning disabilities. We have to ensure that the NHS is genuinely there for everyone, and that everyone has agency, voice, personalisation, power and control—that is what this plan will deliver.

[Tom Gordon (Harrogate and Knaresborough) (LD)]

I welcome the 10-year plan; its focus on prevention is right. I notice that there are a number of references to diabetes in the plan, but none to type 1 diabetes. We already have simple blood tests for biomarkers that identify people who are likely to develop type 1 diabetes, and immunotherapy, which can delay onset, is being assessed for NHS use. All the components of a national screening system are already there, so we have the opportunity to change how people are diagnosed with type 1 diabetes and the potential to eliminate life-threatening diabetic ketoacidosis, which can be how people present in hospital and find out that they have got type 1 diabetes. Will the Secretary of State clarify if the references to diabetes screening will be pertinent in relation to type 1 diabetes in specific? Will he meet me and the all-party parliamentary group for diabetes to learn from Italian lawmakers about their national type 1 diabetes screening programme?

[Wes Streeting]

I give the hon. Gentleman the assurance that we will be delivering on type 1 diabetes, as well as type 2 diabetes. He is right about the breakthroughs in science that allow us to predict and diagnose faster. Through its emphasis on technology, the plan will deliver wearables that will enable people to track their blood sugar levels in real time and enable insulin to be deployed at precisely the right time, in precisely the right amount, to provide stability, certainty and peace of mind. That will not only be important for adults with type 1 diabetes, but for parents who worry about their children. When they send them off to school or to play with friends, they will have the peace of mind that they can monitor their condition, and be reassured that they will be alerted if something does not look right. That is the peace of mind that everyone deserves and that is what this plan will deliver. I am sure the relevant Minister will be delighted to meet the APPG.

Access to GPs

Tom Gordon Excerpts

Monday 23rd June 2025 Commons Chamber

[Stephen Kinnock]

I am sure the hon. Gentleman will welcome the fact that we secured a record £889 million increase in the GP contract. That is a first step in digging us out of the very deep hole that the previous Government left for us. When I look across my portfolio, whether it is GPs, mental health, dentistry or pharmacy—you name it—it is a car crash right across the piece. I was frankly shocked by what I saw when I first went into the Department back in July. We are, I hope, beginning to get things back on an even keel. The hon. Gentleman is right, though: we do not have a shortage of people coming through GP training, but supply and demand are not matching up. That has to change.

I am sure that the hon. Member for North Down will welcome the fact that we secured £82 million of additional funding through the additional roles reimbursement scheme, leading to the recruitment of an additional 1,700 GPs. The challenge is more about getting GPs in the places where they are most needed, which is something we need to work on—other colleagues have talked about the geographical imbalance. We need to look at the formula for the way that funding is allocated across the country, as it is an important part of the access issue that the hon. Gentleman raised.

[Tom Gordon (Harrogate and Knaresborough) (LD)]

I have been working with Lib Dem councillor Hannah Gostlow to tackle some of the issues that local health services and GP surgeries in Knaresborough are facing. I recently visited a surgery and was told that it had the staff that it wanted to get in place, but did not have the consulting rooms. The problem that surgery faces is that the money from the community infrastructure levy and other sources of funding will not come until further down the line, so it cannot take on those staff because the consulting rooms cannot be built. Does the Minister agree that we need to get funding into those GP services, so that we can provide the services that local people deserve and need?

[Stephen Kinnock]

The hon. Gentleman is right; one challenge we face is that, where we are developing new centres of housing, we are not getting the social infrastructure wrapping around them. We need to use things such as section 106 agreements and the CIL, as he mentioned. That process is not always working—the developers are not always coming forward with real, concrete commitments—so the integrated care boards do not commission because they are not sure that the infrastructure will be there, and we end up in a chicken-and-egg situation. We are working closely with colleagues in the Ministry of Housing, Communities and Local Government to break through some of that and attach stronger strings to the deals being done with developers. We also have the £102 million capital infrastructure scheme for primary care, which will go some way towards addressing the issue, but this is fundamentally about getting much clearer and stronger commitments from developers.

--- Later in debate ---

[Stephen Kinnock]

If the hon. Member could write to me on that issue, I would be more than happy to look into it. I am always keen to help hon. Members to get their ICBs to move in the right direction.

We have directly provided £61 million to assist the expansion of the multidisciplinary team approach across Northern Ireland, which will help to stabilise primary care, focus on the prevention and management of conditions away from hospital settings, and better utilise the skills of the community and voluntary sector. We will provide additional funding by 2028-29 to bring back the family doctor by supporting the training of thousands more GPs and delivering millions more appointments over the spending review period, and will build further on the 1,700 additional GPs who have already been recruited. Through these improvements, we are making a difference to patient satisfaction: the latest health insight survey shows a sustained improvement in satisfaction, with 72.5% of patients who contacted their general practices in the past 28 days reporting a good overall experience—up from 67.4% in July 2024.

This Government are delivering concrete results, because we believe that everyone deserves access to high-quality care closer to home. I am delighted that general practitioners committee England voted in favour of this year’s GP contract in March. This is the first time the contract has been accepted in four years. The agreement resets our relationship and marks a turning point—a shared commitment to work together on behalf of patients and practitioners alike. The changes in the contract will streamline targets for GPs, incentivise improved continuity of care, make progress towards our health mission and, crucially, require practices to make it possible for patients to go online to request an appointment throughout the duration of core opening hours. Those changes are backed by an extra £889 million, representing cash growth of more than 7% in overall contract investment.

The NHS belongs to the people. Those are not just my words; they are in the NHS constitution. Everything that this Government have done since the election has been geared towards saving the NHS, giving it back to the people and getting it back on its feet. We are putting power back into the hands of patients, where it rightly belongs, because this is their health service and it must work for them. Ensuring that every patient has access to the care that they need is not just a priority, but a promise.

[Tom Gordon]

I thank the Minister for indulging me again. Will he join me in congratulating the many fantastic GPs in my constituency and throughout the country? It is not an easy job; we hear of the flak that they get from patients day in, day out when they are working to tight timeframes. One such GP in my area is Dr Viv Poskitt, who has been elected as a Liberal Democrat town councillor. Will the Minister share my thanks to Viv and to all the GPs across our country?

[Stephen Kinnock]

I will certainly congratulate Dr Viv Poskitt—I think I have got the name right—on being a GP, although I will probably not congratulate her on being a Liberal Democrat town councillor. The hon. Gentleman is right: GPs are the backbone, or the beating heart, of our NHS. They represent the front door, and we must fix that front door, which is currently creaking on its hinges. This Government are absolutely committed to fixing it, and to moving on from there to fix our NHS, get it back on its feet and make it fit for the future.

Question put and agreed to.

Prostate Cancer Treatment

Tom Gordon Excerpts

Tuesday 17th June 2025 Commons Chamber

[Dr Huq]

The hon. Gentleman makes a powerful point. We are seeing a theme of uneven application. The rule of law means that the law applies to everyone, so it looks like something has gone wrong here.

[Tom Gordon (Harrogate and Knaresborough) (LD)]

I thank the hon. Lady for securing this important Adjournment debate. We have heard from a number of Members who have constituents who are affected or have frustrations with the current system. I met a gentleman called David in the run-up to the general election who has metastatic prostate cancer and is not eligible for abiraterone. He asked me if we would push and do what we could in Parliament to ensure that people such as him could get the drug. He is fortunate and can afford to pay for it privately, but not everyone is in that situation. This is about ensuring that we have equality of access for everyone, regardless of their financial circumstances. Does the hon. Lady agree that we need to have another look at this issue?

[Dr Huq]

I completely agree with the hon. Gentleman that access should be based not on how deep somebody’s pockets are, but on need.

Abiraterone halves the risk of relapse. Each relapse literally costs the NHS millions—the definition of lose-lose. As many Members have pointed out, it is already successfully available on the NHS and routinely funded for use in metastatic cases in England, but sadly there is a catch: abiraterone is not available on the NHS for men with non-metastatic prostate cancer living in England.

Oral Answers to Questions

Tom Gordon Excerpts

Tuesday 17th June 2025 Commons Chamber

[Karin Smyth]

Many hon. Members across the House rightly highlight the actual experience of people throughout the entire pathway. We have heard about the investment we are making in machines and in staff to ensure, on exactly this point, that people get not just that faster diagnosis—that is so important, particularly if cancer is ruled out—but faster care across the entire pathway. The majority of people on waiting lists are on them for diagnostics, which is exactly why we are investing more in capital and investing in staff to ensure that the process is quicker and better for patients. If the hon. Member wants to write to me about any particular issues, I will obviously respond to her.

[Tom Gordon (Harrogate and Knaresborough) (LD)]

Every 17 minutes, someone in Yorkshire is told that they have cancer. Tomorrow, I will be launching a report for Yorkshire Cancer Research, which is based in my constituency, that will set out key recommendations. Will the Minister meet us to talk about how we can feed them into the national cancer plan?

[Karin Smyth]

The work that the hon. Member is doing locally with that group is essential. I will ensure that we have a good response for him, whether it is meeting me or a colleague.

Terminally Ill Adults (End of Life) Bill

Tom Gordon Excerpts

Report stage
Friday 13th June 2025 Commons Chamber

[Adam Jogee]

I thank the right hon. Gentleman for his intervention—it teaches me not to take them. I also thank him for helping my street cred this morning. He raises an important point.

Members of this House have been told that this Bill—it is this Bill we are voting on, not the principle—was rigorously tested and refined in Committee. However, we are now seeing efforts to undermine the decisions of that same Committee. Amendments 94 and 95 serve the singular purpose of undoing amendments introduced in Committee to improve the Bill and make it a safer and more conventional piece of legislation, but their implications go beyond just that: they challenge the basic tenets of our democracy.

One of the key roles at the heart of our democratic system is the role of the or a Minister of the Crown. It is our Ministers who prepare the groundwork for legislation to be enacted successfully, and amendments 94 and 95 would completely do away with that core ministerial function. They would see the responsibility for ensuring the roll-out of assisted dying in Wales—the power that we the people entrust to our Ministers and democracy—taken away from them. [Interruption.]

Conscious of your cough, Madam Deputy Speaker, I shall quickly move towards the end of my remarks—I have taken half of them out already. In my view, Ministers should be able to lead the roll-out of assisted dying in Wales, just as they should in England. It is Ministers, not the supporters of the Bill, who will be responsible for delivering these seismic changes to our health and legal systems, so it is only right that they decide when the provisions become law. Amendment 42 would put England back on an even footing with Wales.

Getting this right is literally a matter of life and death. It makes sense to avoid any possible pressure on decision making and decision makers and, at the very least, allow Ministers to enact legislation with the usual constitutional powers. One death because of a rushed decision would be one too many and should give us all food for thought. I do not want it on my conscience that our collective sticking to an arbitrary deadline led to a death or deaths that may otherwise have not taken place. We must recognise that we can prevent any such situation, and we can prevent that with our vote today. To do so, we must remove the deadline for automatic commencement in England and uphold it in Wales. I urge Members to support my amendment 42 and to vote against amendments 94 and 95.

[Tom Gordon (Harrogate and Knaresborough) (LD)]

I rise to speak to amendment 3 in my name, which would do the exact opposite of the amendments of the hon. Member for Newcastle-under-Lyme (Adam Jogee)—in fact, it would see the commencement period reduced from four years to three years. As a member of the Bill Committee, when we had the initial conversation about increasing the commencement period from two years to four years, I was the only person to speak against it, and I pushed it to a vote.

What frustrates me about the situation we are in is that, in effect, we are acknowledging that the reason we are here and debating this Bill is that the status quo is not acceptable. People are pushed to taking decisions that they should not be and having to go to foreign countries to have opportunities overseas. Those of us who support the Bill are broadly in agreement on those principles. A number of things frustrate me about the four-year period, principally that the people in office—the Government of the day—will not necessarily be here to implement it. I am really hesitant about supporting a Bill when we do not know who would see through those details.

Amendment 3 would reduce the threshold back down to three years, which would still be more than most jurisdictions around the world. Countries have implemented assisted dying legislation after as short a time as six months, 12 months or 18 months, so three years would still be a substantial increase compared with other countries. We are not innovators or leaders in this field: there is no reason why we cannot take best practice and learn from and speak to colleagues around the world. I believe that this Bill has the strongest safeguards of any, which is why I think an implementation period of three years would more than meet the requirements.

[Tony Vaughan (Folkestone and Hythe) (Lab)]

I want to put on record my sincere thanks to my hon. Friend the Member for Spen Valley (Kim Leadbeater) for the way that she has approached this Bill. Her willingness to listen to concerns from across the House has been evident, not least in new clause 14, brought forward in the names of the hon. Members for Reigate (Rebecca Paul) and for West Worcestershire (Dame Harriett Baldwin). That is a testament to how we can work together on these deeply sensitive issues.

I rise to speak in favour of new clause 14 and against amendment (b) to new clause 14. I absolutely understand the intent behind the amendment in the name of my hon. Friend the Member for Rochdale (Paul Waugh). Nobody in this House wants to see voluntary assisted dying services being advertised in a way that is insensitive, inappropriate or exploitative. We all want to protect individuals, particularly those who may be vulnerable or more easily influenced, so I fully share that concern. Although I respect the principle behind the amendment, however, I do not believe it offers the right solution.

New clause 14 rightly prohibits advertising voluntary assisted dying services to the public, while giving Ministers tightly defined powers to create appropriate exceptions through regulations. That is important, because in a healthcare system as complex as ours, we must be able to draw the line between unethical promotion and responsible professional communication. I think the new clause gets that balance right.

--- Later in debate ---

[The Minister for Care (Stephen Kinnock)]

I associate the Government with the words of the Opposition spokesman regarding the tragic incident in India.

As Members will know, the Government remain neutral on the passage of the Bill and on the principle of assisted dying. We have always been clear that this is a decision for Parliament. However, the Government are responsible for ensuring that the Bill, if passed, is effective, legally robust and workable.

Let me start with a brief observation about the process and, in particular, the time made available to Parliament to scrutinise the Bill. The Bill has received over 90 hours of parliamentary time, which is more than most Bills receive. More than 500 amendments were tabled and considered in Committee. I thank Members on all sides of the debate for their contributions during the extensive consideration and scrutiny that the Bill has received.

Given the time, I will confine my remarks on the amendments to those about which the Government have significant legal or operational concerns, and those tabled by my hon. Friend the Member for Spen Valley (Kim Leadbeater) to address significant workability concerns. Before I get into the detail, I remind the House that a full list of amendments tabled by my hon. Friend that the Government deem essential or highly likely to contribute to the workability of the Bill can be found in the letter sent to all Members by me and the Minister of State at the Ministry of Justice, my hon. and learned Friend the Member for Finchley and Golders Green (Sarah Sackman), on 15 May.

Let me start with amendments tabled by my hon. Friend the Member for Spen Valley. New clause 13 and amendments 69, 53 and 72 would allow the Government to create or change legislation to set out the end-to-end process in relation to approved substances to be used for assisted dying. They would allow for monitoring and for a regulatory regime to be designed that will offer robust oversight of approved substances and the devices used to administer them, specifically in the context of assisted dying.

Amendment 54 and new clause 15 would replace clause 35, which is currently unworkable in the wider legal context. They would align the scrutiny and certification of assisted deaths with the existing process for deaths that are not deemed unnatural. That means that assisted deaths would be scrutinised by a medical examiner rather by a coroner unless reported to the coroner by anyone who has concerns about the death.

Amendments 92 to 94 would ensure that the Secretary of State and Welsh Ministers have powers to make necessary regulations to approve assisted dying services in Wales. Amendment 95 would bring the Welsh commencement powers in line with the devolution settlement and remove the requirement in clause 54 for Welsh Ministers to lay commencement regulations before the Senedd for approval, to align with usual procedure.

I now turn to amendments tabled by other Members that the Government assess as creating potentially significant workability challenges. Amendment 97 would require the MHRA to license the approved substances to be used in assisted dying. That may present workability challenges, as licensing is not possible if the approved substances do not meet the definition of “medicinal product” under the current relevant legislation. Furthermore, licensing is reliant on the manufacturer applying to the MHRA for a marketing authorisation for that indication and providing the necessary evidence of safety and efficacy in support. Should the Bill pass, the Government would work to put in place an appropriate regulatory regime for the approval of substances. It may be helpful to note that my hon. Friend the Member for Spen Valley has tabled new clause 13, which recognises the need for a robust regulatory framework and would provide the powers needed to introduce such a framework.

Amendments 105 to 107, amendment (a) to new clause 13 and amendment (a) to new clause 14 would restrict the scope of Henry VIII powers available to the UK and Welsh Governments to make provision about assisted dying services. They would further restrict the use of powers in relation to the regulatory framework for approved substances and the devices used to administer them, and to the prohibition on advertising. I point Members towards the delegated powers memorandum published by the Government, which sets out our consideration of the Henry VIII powers in the Bill. As with legislation more broadly, the Government recognise the need, in appropriate cases, for amendment by Henry VIII powers. Members will be aware that the Delegated Powers and Regulatory Reform Committee will issue its own consideration of the Bill, which will of course be made available to all parliamentarians.

Amendment 3 seeks to shorten the commencement period to three years. Should the Bill pass, an entirely new service with robust safeguards and protections will need to be carefully developed and tested, with input from a range of delivery partners. The Government’s view is that the Bill, as amended in Committee, with a four-year backstop for commencement would be more likely to provide for safe and effective implementation.

[Tom Gordon]

One of the key things that the Bill’s sponsor, the hon. Member for Spen Valley (Kim Leadbeater), has said throughout is that four years, in the Bill as it currently is, would be a backstop. Can that be the case if the Minister is talking about a requirement of four years and that it could not have been delivered sooner?

[Stephen Kinnock]

I can confirm that it is absolutely the policy intent of the sponsor for that to be a backstop. The Government are working on that basis to ensure that it is a backstop and not a target.

Amendment 42 seeks to remove the four-year backstop. Although that is a matter for Members to decide, we note that if both that amendment and amendment 94, tabled by my hon. Friend the Member for Spen Valley, were accepted, nobody would have the power to commence reserve provisions in Wales. That would create major workability concerns for the service in Wales.

Spending Review: Health and Social Care

Tom Gordon Excerpts

Thursday 12th June 2025 Commons Chamber

[Karin Smyth]

My hon. Friend makes an excellent point about bringing down waiting lists for his constituents, and we are so pleased to see that that is continuing, as we were able to announce this morning. He also makes an excellent point about social care providers, which do an amazing job for many of us who have close family members supported by them, and it is important that they are supported and work. I am not sure whether an answer to his question about a meeting needs to be from my Department or from my colleagues in the Ministry of Housing, Communities and Local Government, but I will ensure that he has an answer.

[Tom Gordon (Harrogate and Knaresborough) (LD)]

I welcome the funding announced to repair hospitals with RAAC, which will hopefully include Harrogate district hospital in my constituency. It has already received some money to remove RAAC in one building, which has since been demolished, but it still has a £15 million business case waiting with the Department of Health and Social Care for the next round of RAAC repairs. Will the Minister set out a timetable for repairs to hospitals such as Harrogate’s and for when we should expect to know if we will receive some of that funding?

[Karin Smyth]

We are committed to ensuring that those RAAC hospitals are sorted and fit for purpose, and I was able to visit Airedale myself recently. We are asking people on the ground to do a really difficult job, keeping hospitals going and serving patients while remedying the problem of RAAC. I do not have in front of me the exact timescale for the hon. Gentleman’s hospital, but I encourage it to work very closely with the team at the Department of Health, which I think is working really well. As long as a clear timetable has been put forward, I will ensure that the hon. Gentleman gets a response to his question.

Terminally Ill Adults (End of Life) Bill (Twenty-fifth sitting)

Tom Gordon Excerpts

Committee stage
Tuesday 18th March 2025 Public Bill Committees

Division 51

Ayes: 3

Noes: 18

[Tom Gordon (Harrogate and Knaresborough) (LD)]

I beg to move amendment 350, in clause 18, page 12, line 34, at end insert—

“(d) subject to subsection (6A), provide additional assistance to administer the substance in the presence of an independent witness.

(6A) The coordinating doctor may provide the additional assistance under subsection (6)(d) when—

(a) the coordinating doctor is satisfied that the person is permanently and irreversibly unable to self-administer the substance due to—

(i) significant risk of choking as a result of dysphagia, or

(ii) the loss of use of the limbs; and

(b) the person has authorised that the additional assistance be provided.”

This amendment would define the eligibility criteria for those who are permanently and irreversibly unable to self-administer the substance and are therefore eligible for additional assistance to administer the substance.

[The Chair]

With this it will be convenient to discuss the following:

Amendment 351, in clause 18, page 12, line 35, after “substance” insert

“or to authorise additional assistance to be provided”.

This amendment would ensure the decision to administer the approved substance remains with the person but would allow those who are unable to self-administer the substance to receive further assistance.

Amendment 352, in clause 18, page 12, line 40, at end insert

“, unless the criteria in subsection (6A) are met.”

This amendment would authorise the coordinating doctor to provide additional support with administration for those who are unable to self-administer the substance.

[Tom Gordon]

It is an honour to serve under your chairmanship, Sir Roger. I speak in support of this group of amendments, which address the issue of fairness and accessibility in the Bill. The amendments seek to ensure that those who are physically unable to self-administer the approved substance due to their condition are not excluded from the choice of an assisted death.

The principle at stake here is equity: making sure that this opportunity would be available to not only those with the physical ability to self-administer but all eligible individuals, regardless of their condition. The Motor Neurone Disease Association made it clear in its written evidence that conditions like motor neurone disease can be cruel, devastating and progressive, locking people inside their own failing bodies. More than 80% of people with MND lose the ability to speak. Many lose all limb function, leaving them unable to lift even a glass of water, let alone self-administer medication.

There is a common theme here that relates to a point I made in an earlier sitting, when we debated the period of time for eligibility. For these individuals, the Bill in its current form creates a barrier. It states that the final act of ingesting or administering an approved substance must be taken by the person themselves. For someone with advanced MND, that may simply not physically be possible. The MND Association’s evidence highlights that in other jurisdictions, such as Queensland in Australia, allowances have been made for people unable to swallow or self-administer. If we fail to include such provision here, we risk excluding some of the most vulnerable people or, even worse, creating a perverse incentive for them to seek an assisted death earlier, possibly abroad, when they may still have physical function.

These amendments are not about lowering safeguards in any way, shape or form. As we know, the Bill has robust safeguards, which these amendments would maintain. It would only be applicable in instances where doctors deem it necessary, and it would not be open to more than those with conditions restricting their ability to self-administer. If the Bill is about compassion, then we must ensure that that compassion extends to everyone; if it is about choice, then we should not deny that choice to those with severe physical limitations; and if it is about justice, then we should not allow injustice to be written into the law.

[Naz Shah (Bradford West) (Lab)]

I rise to oppose amendments 350 to 352, tabled by my hon. Friend the Member for Gedling (Michael Payne). They would allow the co-ordinating doctor to provide additional assistance to administer the substance in the presence of an independent witness, in some circumstances. Those circumstances would be when, as amendment 350 says, the doctor determines that the person is

“permanently and irreversibly unable to self-administer”

the lethal substance because of an inability to swallow or the loss of use of the limbs. The amendments do not spell out what the additional assistance would be, but I think it is reasonable to believe that it refers to the doctor injecting the lethal substance into a person’s circulatory system.

My hon. Friend’s amendments comes from genuine concern about the situation that some people may well find themselves in. Some people who might otherwise qualify for assisted dying under the Bill might be unable to swallow or inject the lethal drugs. We should all respect the feeling that lies behind the amendments, but we should reject them. If we pass them, we will have accepted that doctors can help people who have qualified for assisted dying to prepare to inject themselves with lethal drugs or swallow them. The Bill does not say that doctors can do that. I do not know whether the House would have voted for the Bill on Second Reading if it had, but that is beside the point—it was not part of the Bill. If we were ever to consider taking such a radical step, we should only do so after hearing as much evidence as possible on why and how this might be necessary. I urge the Committee to oppose the amendment.

--- Later in debate ---

[Tom Gordon]

The hon. Member mentioned that down the line the Bill could be changed through guidance. I do not think there would be any scope or ability to do that. Does he agree that that point might be a little bit beyond what we all think might be possible under the terms of guidance?

[Danny Kruger]

I hope the hon. Gentleman is right. Nevertheless, one of my concerns about the Bill is that we are leaving enormous areas of clinical practice, and regulated conduct for the professionals involved in assisted suicide, to be performed under guidance that is still to be set out and that it is the job of future Ministers to determine.

I pay tribute to the hon. Gentleman, because he has correctly identified a group of patients for whom the drafted Bill may present obstacles to the fulfilment of their wish for an assisted death. My belief is that the ability to assist will probably cover almost anybody who wants it and has found a doctor who wants to help them, but the hon. Gentleman is right that there are some groups for whom that might be more of a challenge than others. I think the answer we are going to get—it is one made by hon. Members in the debate already—is that technology will fix it, and I fear it will, because I think we are going to find ourselves in a world in which it is perfectly possible for the administration of death to be enabled through some kind of technological device, which somebody with the most limited physical mobility will nevertheless be able to activate.

I fear the insistence that we have on self-administration. Although we can all acknowledge, as referenced in the previous debate, the conceptual difference between administration and self-administration, we do have this idea that we are individuals cut off from each other and that there is an essential gap between us and other people. At the very end of life, though—in the moments that we are considering and legislating for—that distinction is void, because we are intimately connected with other people, as per the clauses that we are debating. I fear that we are going to find ourselves in a world in which a laptop will be set up and even a movement as small as the blink of an eyelid by the patient will be enough to trigger what will be called “self-administration” of the fatal dose.

I oppose this group of amendments, moved by the hon. Member for Harrogate and Knaresborough, because I do not believe in assisted suicide. I do not understand why other supporters of the Bill are not following the hon. Gentleman’s lead, and acknowledging that if we believe in autonomy and assisted suicide, of course we should enable patients to have the final act performed upon them, rather than insisting on this arbitrary distinction that it is possible to insist on self-administration in all cases.

--- Later in debate ---

[Kim Leadbeater]

I completely understand where these amendments are coming from. In many jurisdictions where assisted dying laws are in place, this would be an accepted part of the process. However, as I have said repeatedly, our Bill stands in its own right, and its safeguards are stronger than those anywhere else in the world. One of those safeguards is that the line cannot be crossed between a person shortening their own death by administering the drugs themselves and by having another person—in this case the doctor—do it for them.

While I am hugely sympathetic to the argument, that is a line that I do not believe the Bill should cross. I concur with the comments of my hon. Friend the Member for Bradford West about Second Reading and what the House voted for, and with those of the hon. Member for Reigate about medical profession levels, which we discussed this morning. I also agree with the Minister’s comments about the concept of an independent witness, and with the comments from the hon. Member for Solihull West and Shirley about the concept of additional assistance. On that basis, I will not be supporting the amendments.

[Tom Gordon]

I will keep it short and sweet. I had not intended to push the amendments to a vote and will not be doing so. A lot of important points have been raised. Irrespective of whether the amendments were going to be pushed to a vote or would have been successful, it is important that we listen to and take into account the voices of people with different diseases who might wish to access an assisted death. We must also take into account the evidence that organisations have submitted, because it is important that those voices are heard too. I beg to ask leave to withdraw the amendment.

Amendment, by leave, withdrawn.

[Danny Kruger]

I beg to move amendment 435, in clause 18, page 13, line 6, at end insert—

“(9A) Where the procedure has failed, the coordinating doctor must escalate the care of the person by making the appropriate referral to emergency medical services.”

This amendment would require the doctor to escalate the care of the person in cases in which the procedure fails.

Type 1 Diabetes and Disordered Eating Services

Tom Gordon Excerpts

Wednesday 5th March 2025 Commons Chamber

[The Parliamentary Under-Secretary of State for Health and Social Care (Ashley Dalton)]

I thank my hon. Friend the Member for Cannock Chase (Josh Newbury) for securing the debate and all hon. Members who have contributed. The hon. Member for Strangford (Jim Shannon), who appears to be quickly making an exit but remains in his place, spoke about mental health. The hon. Member for South Northamptonshire (Sarah Bool) spoke about destigmatisation for disordered eating and for type 1 diabetes. By sharing her diagnosis in this place, she is making a huge contribution towards destigmatisation, and I thank her for that. My hon. Friend the Member for Gloucester (Alex McIntyre) shared his family’s story, which is heartbreaking and shows the impact that these issues have on people. My hon. Friend the Member for Worcester (Tom Collins) talked about technological advancement and support.

As my hon. Friend the Member for Cannock Chase outlined in his remarks, type 1 diabetes and disordered eating—T1DE—is not a widely known condition, yet it potentially affects up to a third of people with type 1 diabetes. People with T1DE find themselves trapped in a battle between needing to control their diabetes with insulin and trying to control their weight in an unhealthy way. It is a vicious cycle. People with T1DE experience increased ill health and, sadly, an increased chance of early death. Studies have shown that people with T1DE who restrict insulin have a mortality rate more than three times higher than those who do not.

We should pay tribute to the diabetes charities that are doing so much for people living with diabetes across the UK and tackling this problem head on, such as Beat, which has dedicated helplines for people struggling with this condition; Breakthrough T1D, which funds international research to cure, treat and prevent type 1 diabetes and its complications; and Diabetes UK, which does a fantastic job of articulating the community’s needs to Government.

[Tom Gordon (Harrogate and Knaresborough) (LD)]

I congratulate my friend, the hon. Member for Cannock Chase (Josh Newbury), on securing this debate. As was mentioned, I used to work for the type 1 diabetes charity JDRF, as it was then—it is now Breakthrough T1D. We used to regularly have meetings with Ministers in the Department of Health and Social Care. One of the key things that I and, I am sure, Members across the House would like to see is the new Government taking up the recommendations of the report by Theresa May and Sir George Howarth. Will the Minister agree to meet the APPG for diabetes to talk about how those recommendations can be implemented?

[Ashley Dalton]

I am more than happy to meet the APPG to discuss those matters.

I was really moved to read Lynsey’s story on the Diabetes UK website. One thing that really stood out to me was her experience of turning 18 and moving to an adult clinic. She said:

“I became a number in a system, rather than a patient. Every time I went, I saw a different team, and would have to explain my entire medical history. It felt like it wasn’t worth my time, and I certainly wasn’t going to have a conversation about what was going on with people I didn’t know.”

After just a few appointments, Lynsey stopped going. T1DE cuts across diabetes and mental healthcare, and Lynsey’s interactions with the NHS show that we must never treat patients like interchangeable statistics, bouncing around a cold system that does not seem to care for them. Instead, each patient should benefit from a unique, joined-up approach.

To its credit, NHS England has recognised that there is an unmet need for better treatment of T1DE. As my hon. Friend the Member for Cannock Chase has recognised, it has begun piloting type 1 diabetes and disordered eating services, two of which came online in 2019. The aim of those pilots was to develop the evidence base around how best to manage T1DE by testing an integrated pathway, which means that patients such as Lynsey would not be obliged to recount their medical history on every visit. In the past five years, NHS England has expanded on the original pilots, with funding extended for five T1DE pilot sites until March 2026 to ensure that there are sufficient patient numbers for us to get a full picture of what is happening on the ground. I thank my hon. Friend for his contribution to those pilots.

While those pilots are gathering evidence, NHS England is looking carefully at the findings, with a view to developing a future national strategy. Each of the five new pilot areas is submitting quarterly data to the evaluation, and it intends to publish its analysis of the data by September.