GP Contract

Tom Gordon Excerpts

Monday 16th March 2026 Commons Chamber

[Stephen Kinnock]

My hon. Friend and I have had some discussions about GP practices in her constituency, and I know she is doing excellent work to ensure that performance is always being driven in the right direction. She asks what we are doing right across the country; the Carr-Hill formula will be a nationwide initiative, and the contract itself is also nationwide. It is important that the Government do not try to micromanage and that ICBs and trusts work together. We are there to set the framework and ensure that everybody is clear about the outcomes; it is then up to the people at the coalface to deliver those outcomes. We do need to know where that is not working, so perhaps we could look at my hon. Friend’s survey once she has it; it would be a good way of checking in and ensuring that there is a golden thread between the outcomes that we want to see and the delivery on the ground.

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

I recently visited the Spa surgery in Harrogate and spent half a day with practice managers, GPs, partners, receptionists and nurses, and I am grateful to them for that opportunity. The Minister said earlier that he trusts GPs to make decisions, and just a moment ago he said that the Government should not be in the business of micromanaging, but the new contract outlines specific directions for spending. How does the Minister reconcile that with the fact that local GP partners tell me that the contract will remove the flexibility to manage and meet local service need, and that the uplift in funding will not cover the cost of these additional obligations?

[Stephen Kinnock]

I thank the hon. Member for his question, but it is pretty clear to us, based on the experience of advice and guidance—I think it is advice and guidance that he is referring to specifically—that the £80 million we invested in advice and guidance under the last contract has been extraordinarily successful, with very high take-up right across the country. As a result, we have kept 1.3 million people out of electives who did not need to go to those out-patient appointments. What we are doing now is embedding that in the contract, because it has been such a success.

By embedding it in the contract, we are giving more flexibility and less bureaucracy, because there will be a single point of access in the trust. GPs will be able to access the high-level consultant expertise and specialism that they need in order to assess whether or not a particular patient needs to go to an out-patient appointment. It will mean more flexibility, high-level triage and much better outcomes for patients.

Type 1 Diabetes: Infant Testing

Tom Gordon Excerpts

Monday 9th March 2026 Westminster Hall

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

It is an honour to serve under your chairship, Sir Alec. I welcome the Minister to her place; the all-party parliamentary group for diabetes had a positive and constructive relationship with her predecessor, the hon. Member for West Lancashire (Ashley Dalton), and I hope that that will continue.

I am grateful to the petitioners and to the petition’s creator, John, who is in the Gallery. He has been tirelessly campaigning in memory of his daughter, Lyla. His courage in speaking out and pushing for change has brought national attention to the urgent need to improve the way we recognise and diagnose type 1 diabetes. Earlier today, a group of cross-party MPs and of health professionals and families handed in a petition to Downing Street on this matter.

About 400,000 people in the UK live with type 1 diabetes. That includes tens of thousands of children. It is most commonly diagnosed in childhood, but can develop at any age. Crucially, it cannot be prevented at the moment and is not linked to lifestyle. There is nothing a child or their parents could have done differently. Despite our understanding of the condition, too many people are still diagnosed only when they are already dangerously ill. Too often, the warning signs are missed.

As we have heard, the classic symptoms are known as the four Ts: thirst, tiredness, thinning, and needing to go to the toilet more frequently. They are well known and simple to check. A quick finger-prick test can measure blood glucose and confirm whether urgent action is needed, but too many families find themselves making repeated visits to healthcare professionals before a diagnosis is made. In many cases, by the time that type 1 diabetes is identified, the patient is already experiencing diabetic ketoacidosis. DKA is a serious and potentially life-threatening condition caused by dangerously high blood glucose levels and the build-up of ketones in the blood. It frequently requires emergency hospital treatment. More than one in four children in the UK diagnosed with type 1 diabetes are diagnosed when already in DKA. This is an issue of health inequalities, too. We know that among children under five, and among those from deprived backgrounds, the proportion can be even higher.

These are not just statistics. Behind every number is a child, a family and a moment of trauma that could all too easily have been avoided. Lyla Story’s case tragically illustrates that. In the days before her death, Lyla showed the classic symptoms of type 1 diabetes. Her parents sought medical help and she was seen by a GP, but the symptoms were attributed to another illness. Her condition deteriorated rapidly, and sadly she passed away after developing diabetic ketoacidosis.

Since I met John months ago, he has sent endless examples of other families across the country. The same story has rung true time and again. This is not just one example; it is emblematic of our current systemic failure. There is an urgent need to improve awareness among healthcare professionals and ensure rapid testing when symptoms appear. They must be tret as a priority. NICE guidelines already state that children suspected of having type 1 diabetes should be referred immediately to a specialist paediatric diabetes team, but we know that, in practice, signs are sometimes missed or not acted on quickly enough. Ensuring that every GP practice has access to relevant glucometers and that the staff are confident about recognising the four Ts is one of the most simple and effective ways we can reduce those missed opportunities. Education and training can make a real difference. At a roundtable held by the APPG for diabetes earlier this year, we heard how quality improvement work in Cardiff has demonstrated that targeted education for primary care teams can significantly reduce emergency diagnoses.

Alongside improving diagnosis, we are entering a new and exciting phase in our understanding of type 1 diabetes, with the possibility of identifying the condition before symptoms even begin. Research has shown that the immune attack that eventually leads to type 1 diabetes produces autoantibodies in the blood long before symptoms appear. Those markers can be detected through screening, and studies such as ELSA have demonstrated that childhood screening is feasible and can identify children at risk before they become unwell.

[Christine Jardine (Edinburgh West) (LD)]

It is a pleasure to serve under your chairship, Sir Alec, for the first time. My hon. Friend has touched on training and the need for awareness. One issue is that very often even people with type 1 diabetes, because of the lack of awareness, are not aware of the symptoms as they begin to react or their insulin is very low. Does he agree that what we also need is a general awareness of type 1 diabetes among the public?

[Tom Gordon]

My hon. Friend is a passionate advocate of diabetes awareness. I completely agree that we need to do more to raise those symptoms with the general public. Everyone knows the key signs of some health conditions—heart attacks or strokes, perhaps—but sadly, type 1 diabetes is not one of those. We can do more in the House to put the issue at the front of the public’s mind; I am optimistic that we can do that across parties, given the diversity of colleagues in this Chamber. Screening offers enormous potential. It will allow families and clinicians to monitor the condition closely, prepare for treatment and, we hope, avoid the trauma of an emergency diagnosis.

I turn to some personal experience. When I was just 13, we were on a family holiday in Turkey. My little sister, who was nine at the time, collapsed by the pool. People do not often think much of it if a growing child loses and gains weight or is thirsty, particularly when abroad in severe heat. My mum had no idea that my sister was a type 1 diabetic; only when she collapsed by the side of a pool and was rushed and blue-lighted to hospital in Turkey did we find out that she was critically unwell and experiencing DKA.

I will never forget that holiday. Fortunately for my sister, everything turned out okay. We got her back to the UK and got her the support that she needed, but it was an incredibly frightening experience for our family and a stark introduction to how suddenly type 1 diabetes can present when it goes undetected. That is one of the reasons why this issue matters deeply to me, and part of the reason why I went on to study biochemistry and a master’s in public health. What can we do? I will turn to what should happen next, but first I encourage any colleagues in the Chamber who are not already members of the APPG for diabetes to join.

I want to press the Minister about a number of areas: first, on awareness of the four Ts, which we have already heard about but needs strengthening across the health system. Training for healthcare professionals, in particular those who work in primary care, should ensure that symptoms of type 1 diabetes are recognised immediately and acted on. Secondly, finger-prick blood-glucose testing should be standard practice whenever a patient presents with symptoms suggestive of type 1 diabetes. NICE guidance should make that expectation explicit, not simply implied.

Thirdly, every GP practice should have the equipment ready to carry out such tests quickly and with confidence. Fourthly, awareness—including of the four Ts—should extend beyond the healthcare system to the personal child health record, or red book, and digital resources for parents, which would help families recognise those warning signs and seek testing earlier. Fifthly, there should be stronger oversight to ensure that learning takes place when diagnoses are missed, including a clearer role for the Care Quality Commission and national improvement initiatives, too. Finally, the NHS should continue to explore what role screening programmes could play in future. Research under way, such as that of the ELSA study, will be crucial in building the evidence needed to support any future national screening programme.

Type 1 diabetes cannot currently be cured, but deaths from undiagnosed type 1 are preventable. Through better awareness, faster testing and continued research, we can ensure that fewer families experience the trauma of delayed diagnosis. If we ended up with a Lyla’s law, we would be honouring the memory of children such as Lyla and the determination of family members such as John, who are campaigning so powerfully for this change.

--- Later in debate ---

[Mrs Hodgson]

I thank the former Secretary of State for Health for her important intervention. I was not aware that she was type 1 diabetic herself, and the case of Levi that she mentioned is so pertinent to what we are discussing. Mr Story has been working with NICE, and that guidance is currently being updated. As the right hon. Member says, it is so important to get that information out there, so that all GPs are brought up to date and know that infections and viruses can be a trigger, so I thank her for that intervention.

The RightCare toolkit that is being brought forward also contains important information for clinicians in setting out what good quality diabetes care looks like for children and includes guidance on timely and accurate diagnosis. However, we recognise that more needs to be done, and that is why NHS England is working on how we can better support NHS staff to diagnose patients as quickly as possible and raise awareness of symptoms for parents and families.

[Tom Gordon]

The Minister is talking about how the toolkit will outline for GPs what good diabetes care looks like. That independent advocacy and scrutiny function often came from Healthwatch, which will be abolished in the changes to the NHS and rolled into DHSC. Can she outline how we will ensure scrutiny of services such as diabetes care, which have the patient voice at their heart?

[Mrs Hodgson]

If I may, I will write to the hon. Member on his important point, rather than giving a possibly unsatisfactory answer off the top of my head.

The NHS is exploring how IT can be better used to support GPs in making more accurate diagnoses. That includes how existing electronic patient record—EPR— systems could be used more effectively to provide prompts for GPs to consider type 1 diabetes when particular symptoms are added. I can update the House that clinical leaders in NHS England are also working with digital diabetes education providers to develop a primary care healthcare professional education module.

While we are working on options to improve type 1 diabetes diagnosis, a requirement for a mandatory finger-prick test for those presenting with possible symptoms of type 1 diabetes is difficult to enact and could not be delivered quickly. I hear the point made by the hon. Member for South Northamptonshire (Sarah Bool) in her excellent speech—many others also made this point—about how all GP practices should have the necessary equipment and finger-prick testing kits, and several hon. Members raised the issue of NHS funding for point-of-contact testing kits. I can reassure them that there is good clinician access to those tests. What we need to do is ensure that their use is at the forefront of clinicians’ minds when the symptoms present, which is exactly what Mr and Mrs Story called for in their petition.

One Member raised the abolition of NHS England. I can reassure Members that, as part of that change process, policy functions will transfer into the Department as appropriate. Clinicians follow clinical guidelines set out by NICE, which are advisory and not mandatory. They are not mandatory because they are designed as evidence-based advice to inform rather than to replace clinical judgment, allowing for tailored care for individual patients. Guidelines cannot cover every unique patient scenario, and clinicians must therefore maintain responsibility for treatment decisions.

[Tom Gordon]

I thank the Minister for being so generous with her time. Before entering this place, I worked for Breakthrough T1D, and one thing that came up all too often was that clinicians did not feel that they had the funding to give people the treatment they needed. The Minister makes the point about giving them independence, but does she acknowledge that if they do not have the funding to do that, the guidance falls at the first hurdle?

[Mrs Hodgson]

That might be a fair point on some treatments more widely, but funding is not an issue for the finger-prick test—it is very affordable for the NHS, and I am told that funding is not the issue on the point we are debating today. I am pleased that NICE has been able to respond very quickly to Mr and Mrs Story. It has engaged with them in detail and listened to their concerns about how the guidance could be clearer.

I am very pleased that NICE has recently said it will update the guidance and guidelines on the diagnosis and management of type 1 and 2 diabetes in children, to raise the prominence of the risk of diabetic ketoacidosis in children with undiagnosed diabetes. I understand that the conversation Mr Story is having with NICE is ongoing, and that NICE is also considering an update to the adult guidance in due course. I know that Mr Story has raised further recommendations with NICE to improve that guidance. I am sure NICE will be considering it very carefully.

I would like again to put on record my admiration for the huge effort and determination of Mr Story in campaigning to raise awareness and advocating for improvements. The updating of NICE guidance is tangible proof of his efforts; his time has not been wasted.

I recognise that the immediate issue raised is point-of-care testing, but I should update the House in saying that, more broadly, we are also funding the delivery of research to develop and test novel approaches for diagnosing type 1 diabetes earlier and more accurately through the NIHR. That includes an investigation of the use of a new home test for type 1 diabetes in children and young people. Studies are also identifying ways to improve the diagnosis of type 1 and 2 diabetes based on genetics, making prediction more accessible and more effective.

We are also supporting the delivery of research into type 1 diabetes treatment, again through the NIHR. That includes supporting a new UK-wide type 1 diabetes cell therapy clinical trials network. The aim is to ensure all people with the condition gain access to the latest cutting-edge treatments as early as possible. The NIHR’s research delivery network is also supporting the delivery of a study that aims to identify infants at risk of developing type 1 diabetes, and to study new treatments with the aim of preventing the development of the condition.

In addition, following the publication of NICE’s guidance recommending the use of hybrid closed loop systems as a treatment option for type 1 diabetes in children, the NHS began a five-year roll-out of HCLs in 2024. For those who are not familiar with that technology, an HCL acts as an artificial pancreas that lets a person’s insulin pump talk to their continuous glucose monitor. I am sure that adults in particular with type 1 diabetes are very aware of HCLs, but the use of HCLs in children under 19 has now increased from 36% in 2023-24 to 70% in 2025-26. That is significant progress in making that life-changing technology available to more children and young people.

Returning to the issue of diagnosis, the NHS is exploring how IT can be better used to support GPs in making more accurate diagnoses. That includes how existing electronic patient record systems could be used more effectively to provide prompts for GPs to consider type 1 diabetes when particular symptoms are added. I can inform the House that clinical leaders in NHS England are working with digital providers of diabetes education to develop an education module for primary care healthcare professionals.

A few Members mentioned screening, so I would like to take this opportunity to set out the Government’s position. Although we know that screening for antibodies would sadly not have helped Lyla, screening tests may help to improve our ability to identify those who are most likely to develop type 1 diabetes in future. We are guided by the independent scientific advice of the UK National Screening Committee, as it is vital that screening programmes are evidence-based and evidence-led. The committee does not currently recommend screening for type 1 diabetes, due to a lack of evidence.

However, the committee received a submission, via its 2024 open-call process, to consider screening for autoimmune type 1 diabetes through blood testing. Once NICE has published its recommendation on the drug teplizumab, which is expected this year, the National Screening Committee will consider whether a fresh review of the evidence for type 1 diabetes screening should be undertaken.

In addition, NHS England is looking carefully to see what further improvements might be made to the red book and to support increased awareness for parents and families so that they can see what the symptoms of type 1 diabetes are. I know that was an important part of the petition.

In closing, I thank all those present for taking part in this very important debate, as well as our constituents—all 120,000 of them—who took the time to sign the petition and press us all on this very important matter. I hope that the work that is currently being taken forward across diagnosis and awareness shows the seriousness with which this issue is being taken.

I am pleased that John and Emma Story will be meeting the Secretary of State for Health tomorrow to discuss this further, along with their constituency MP, my right hon. Friend the Member for Kingston upon Hull North and Cottingham (Dame Diana Johnson), who is here for the debate. I am sure that will be a very emotional and powerful meeting for Mr and Mrs Story. I wish them well and, in closing, pay tribute to them again for everything they have done in Lyla’s name to try to ensure that no other family follows in their footsteps.

Suicide: Reducing the Stigma

Tom Gordon Excerpts

Wednesday 19th November 2025 Westminster Hall

[Sojan Joseph]

As someone who worked in mental health services for 22 years, I absolutely agree. We need access to mental health services, and not just for young people; everyone is important. Getting help early is key to preventing suicide among young people.

The situation is worse among men working in the farming industry. The likelihood that a male farm worker will die by suicide is three times higher than the national average for men. Earlier this year, a Farm Safety Foundation report revealed that over 90% of farmers said that poor mental health is the biggest hidden problem in the industry.

What is contributing to that poor mental health and the increased risk of suicide among those working in the agricultural sector? It is driven by a combination of isolation—many work alone in remote areas—and financial pressure from market volatility, debt and rising costs. Long working hours, often exceeding 60 hours per week, lead to exhaustion and poor mental health. There is also a strong stigma around seeking help, which means that many farmers suffer in silence.

The connection between suicide and mental illness is well documented, but reducing the stigma of suicide should not be viewed solely as a mental health issue. Many individuals who die by suicide have never engaged with mental health services or displayed obvious symptoms, and not all have a diagnosed condition. People at risk often face a complex mix of personal, relational, community and societal factors. As the suicide prevention strategy highlights, common risk factors include physical illness, financial hardship, gambling, substance misuse, social isolation, loneliness and domestic abuse. Although mental health support is important, the strategy stresses that reducing stigma extends far beyond that. Focusing only on mental health risks overlooking those in acute distress who do not meet the diagnostic criteria. It also places the burden on mental health services, when in reality reducing the stigma of suicide requires a collective effort from local authorities, employers, schools, the justice system and society at large.

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

One of my constituents, Steve, founded the Jordan Legacy after he lost his son to suicide. Its work involves outreach to schools, universities, employers and community groups. I echo the point that the hon. Gentleman is making. Does he, like me, think that there should be more support for the fantastic work of such charities and organisations?

[Sojan Joseph]

I absolutely agree. Charities do a brilliant job. Youth groups in our communities used to be very good places for young people to go, and I would love to see them coming back into our communities.

Effective prevention means prioritising early intervention in schools, universities, workplaces and community settings, which are also important. Every suicide is a tragic event that has a devastating impact on the family and loved ones, and this impact can be felt across the community. That is why we must break the silence and dismantle the stigma around suicide. Every conversation matters. When people feel safe to speak, they are far more likely to seek help, and that can make all the difference.

NHS Workforce Levels: Impact on Cancer Patients

Tom Gordon Excerpts

Thursday 23rd October 2025 Westminster Hall

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

It is a pleasure to serve under your chairmanship, Mrs Hobhouse. I congratulate my hon. Friend the Member for Wokingham (Clive Jones) on securing this important debate. It is unusual to be called so quickly; we are often oversubscribed, so it is a pleasure to be able to say something a little more substantive than what I had initially prepared.

I want to talk about the impact on the workforce in my area, Harrogate and Knaresborough, and across the Yorkshire and Humber region. We need a strong and sustainable NHS workforce, which is critical to improving cancer outcomes. There is rising demand: the number of people in Yorkshire receiving urgent checks for cancer has doubled in the past 10 years and is projected to keep rising. Cancer services in our region are consistently failing to meet national targets.

Action is desperately needed to make the NHS a more attractive and sustainable career choice. That includes investing in training, improving retention and prioritising staff wellbeing. One of the biggest frustrations I hear from local staff at our hospital is the inability to even find a place to park at work and the impact that that has on the surrounding area.

I welcome the forthcoming workforce plan. I know that a number of organisations, including Yorkshire Cancer Research, will be keen to submit evidence to ensure that the needs of cancer patients in our region are fully addressed. We need to make sure that staffing levels are delivered and that the support for growing demand is not left behind.

There are a number of gaps in the workforce across my patch. Yorkshire has the lowest rate of clinical and medical oncology consultants of any region in the country, at 5.1 per 100,000 people aged 50 and above, compared with 6.6 nationally and 11.3 in London. The regional shortfall in clinical oncology consultants is 18%, higher than the national average of 15%.

As has been mentioned, we are also experiencing shortfalls and shortages in services and support staff, such as clinical radiologists. There is considerable concern, with 79% of clinical directors across Yorkshire and the Humber—the highest proportion in England—saying there are insufficient radiologists to deliver safe and effective care. The current shortfall is 33%, and the figure is projected to rise to 41% by 2029, placing Yorkshire among the worst-affected regions.

We are also experiencing the complexity of an ageing workforce. Yorkshire and the Humber has the joint highest proportion of clinical radiologist consultants expected to retire over the next five years—22%, compared with 20% in the rest of England—and a lower than average forecast of growth in that role.

I hear from local people that some of the barriers they face to accessing cancer pathways are at the point of general practice. Difficult conversations often occur at the GP. Timely access is crucial, yet we have significant variation in GP availability across the country and even across Yorkshire. For example, in Kingston upon Hull East, each GP services 3,664 patients, which is more than double the number in Sheffield South East. With one in two cancers diagnosed late, improving access to GPs is vital for early detection and therefore better outcomes. I have received a number of emails from people completing their training in the NHS as GPs and doctors on their concerns about their ability to find work. I hope the Minister—and, going forward, the workforce plan—can address that.

Research-active hospitals deliver better survival outcomes, even for patients who are not directly involved in trials. For example, bowel cancer patients treated in NHS hospital trusts with high levels of research participation had improved survival outcomes in the first year after diagnosis. What worries me is that across Yorkshire we saw a 25% decline in clinical academic posts between 2012 and 2022, which was four times higher than the national decline.

When we talk about the NHS workforce and its impact on cancer, it is important to acknowledge that the charity sector often supplements the work our NHS does. In my constituency, we have Harrogate Hospital and Community Charity, which is celebrating its 30th anniversary this year. I was pleased to run the Paris and London marathons to raise money for it earlier this year. It is a fantastic organisation that does amazing work on the ground, going above and beyond what the NHS can provide for people with a range of health issues. Last year, I was able to attend a Macmillan coffee morning at the Sir Robert Ogden Macmillan Centre, and today I attended the Macmillan coffee morning here in Parliament.

Broadly speaking, the feedback I hear from anyone accessing cancer facilities and services in my patch is that our local provision is fantastic. One constituent, John Fox, who has recently gone through those services, described an amazing team that was supportive, caring and helpful. It is important, while we talk about the issues that we are facing, to highlight some of the positives and the good experiences that people have.

In summary, what I would like to see going forward, and what I hope the Minister might be able to comment on, is how we will better invest in training, recruitment and retention of staff in the NHS and how we will address regional inequalities and support research capacity.

--- Later in debate ---

[The Minister for Secondary Care (Karin Smyth)]

It is a pleasure to serve under your chairship, Mrs Hobhouse. I thank the hon. Member for Wokingham (Clive Jones) for securing the debate, and for getting through it—I hope he is well. I thank other hon. Members for their contributions. As others have noted, I am aware of the work that the hon. Gentleman has done, using his experience for good, on access to primary care, radiotherapy and cancer. He has campaigned on behalf of his constituents in Wokingham and people across the country, as the hon. Member for Strangford (Jim Shannon) said. He has been a keen advocate for the NHS workforce’s importance to delivering the health services we need.

I thank the wife of my hon. Friend the Member for Edinburgh South West (Dr Arthur) for her service and wish her well in her new role at the hospice. It is really good to have a voice from Scotland in these debates. My hon. Friend spoke about the shocking and deeply concerning waiting times that our friends and families in Scotland are experiencing. The Scottish people will have a chance to start reversing the situation next May. I hope they take that opportunity, and I look forward to joining my hon. Friend to try to make that happen.

I have my green jacket on, but I am sorry that I could not join today’s Macmillan coffee morning, which the hon. Member for Strangford mentioned. The Under-Secretary of State for Health and Social Care, my hon. Friend the Member for West Lancashire (Ashley Dalton), is working very closely with Macmillan and many other cancer charities as she develops the cancer plan. She is in good contact with them; they do great work, and we will ensure that we continue to talk through their many asks of the Government as she develops the workforce plan.

As many hon. Members said, half of us will have a cancer diagnosis in our lifetime. The health team has certainly taken our full part in that, as 50% of us have had a cancer diagnosis. Some of us are still undergoing treatment. Although more than three quarters of all people diagnosed with cancer in the UK are 60 and over—as hon. Members said, the population is ageing—I decided to get mine at 59. My hon. Friend the Member for West Lancashire is also younger than 60, and the Secretary of State would not forgive me for not reminding everybody that he is only in his early 40s. We make the point well: as other Members said, that although incidence will increase as a result of our ageing population, cancer can strike anybody at any age.

Diagnosing and treating cancer is a growing part of NHS elective activity, and responding to demand in a way that best suits patients is crucial. That includes the issues that the hon. Members for Wokingham and for Harrogate and Knaresborough (Tom Gordon) raised about the variability we often see even in a small geographical patch, and certainly between different cancers. The hon. Member for Wokingham talked about clinical nurse specialists. Mine were absolutely fantastic, and I did know who they were. The statistics he outlined are deeply concerning, so those points were very well made. Our mission to tackle cancer and the other biggest killers is underpinned by the 10-year health plan published earlier this year, focusing on those three shifts: from hospital to community, from analogue to digital, and from sickness to prevention.

On the workforce plan, we know that we need an effective and sustainable workforce to deliver better outcomes for everyone, including those with cancer. In the 10-year health plan, we set out that, to deliver a workforce fit for the future, we need a new, sustainable approach to workforce planning. Our 10-year workforce plan will be different. It will set out how we will create a workforce ready to deliver a transformed service for patients when and where they need it, with more empowered, flexible and fulfilled staff.

Since we launched our call for evidence on 26 September, we have been struck by the huge enthusiasm of staff, the sector, stakeholders and colleagues in sharing their thoughts and ideas with us. Many have said that they would like more time to have those conversations, to test ideas and to work together to deliver a truly reformed service. I am grateful to them for raising that, and it is why we have made the decision to give more time to that process. We will now publish the plan in the spring of 2026. A spring publication will allow us to have more detailed discussions with partners, hon. Members and other stakeholders, not just to listen but to work in a truly joined-up way to deliver for staff and patients.

The shadow Minister helpfully outlined all the decisions that were made by her Government over the last few years—decisions that essentially led to many of the workforce problems we now have. We are trying to resolve those problems, and we will. She informed the House that the resident doctors committee has now decided to go on strike again, which is, of course, deeply disappointing. It will be damaging for the work we want to do, and we urge it not to go ahead. However, we will continue to commit to ensuring that the workforce is fit for purpose, including to diagnose and treat cancer. We will progress with the work that we have already started.

In July 2025, there were over 5% more staff in the key cancer professions of clinical oncology, gastroenterology, medical oncology, histopathology, clinical radiology and diagnostic and therapeutic radiography than in July 2024. There were also more doctors working in clinical oncology and more radiology doctors, compared with last year.

My hon. Friend the Member for Edinburgh South West asked particularly about haematology. NHS England has invested in expanding specialty training posts in high-demand disciplines, including haematology, and is supporting local systems to retain and develop multidisciplinary teams. That includes increased medical training posts in haematology, and enhancing the scientific workforce supply through other initiatives.

We have also ensured that the cancer-facing workforce are put on a more stable footing to ensure they have the stability they need to continue to provide the care that patients need. In 2025, we provided grant funding to the Royal College of Radiologists to encourage foundation and internal medicine trainees to specialise in clinical oncology. That work is currently under way and involves a series of webinars as well as targeted engagement. In 2024-25, around 8,000 people received training either to enter the cancer and diagnostic workforce or to develop in their roles. As part of that, more than 1,600 people were on apprenticeship courses, with more than 270 additional medical specialty training places funded. More than 1,000 clinical nurse specialist grants were made available to new and aspiring CNS workers, and it is a really valuable service.

[Tom Gordon]

I thank the Minister for giving way. As ever, she is most generous with her time. She has outlined the positive steps that the Government are taking to address the workforce challenge. Could she elaborate on the points I made about the inequalities between the north and the south in the NHS and the cancer workforce?

[Karin Smyth]

I do not have those numbers to hand but, as we outlined in the 10-year health plan, we are particularly committed to people in rural and coastal communities with regard to workforce and access to many other services. If there is anything specific the hon. Gentleman is not aware of, I am happy to furnish him with more information. We are, however, minded to rectify the variability across the country, even within towns and cities, let alone rural and coastal communities, whether that be in the north, south, east or west.

We will ensure that ongoing investment in practice education continues to enhance clinical supervision, education and training across cancer and diagnostic workforces. That will increase placement capacity, support staff retention and contribute to high-quality patient care.

We will not only ensure that the cancer workforce have the numbers to succeed, but also the skillset. Training academies in imaging, endoscopy and genomics are all being delivered across regions to provide intensive skills development and to support new models of care. We will also ensure that staff have the skills to adopt the treatments needed by cancer patients. Adoption of innovative cancer treatments is often clinician-led and self-identified, with doctors seeking out specialist training opportunities themselves. This may include overseas fellowships or short courses, after which skills are cascaded locally through continued professional development, multidisciplinary teams and peer-to-peer learning.

The complex challenge of tackling the cancer and workforce issues we face will not be solved with a single solution, which is why the Department will be publishing a national cancer plan in the new year. The plan will have patients at its heart and will cover the entirety of the cancer pathway from referral and diagnosis to treatment and ongoing care, as well as prevention, research and innovation. The national cancer plan will build on the progress of the 10-year health plan to improve survival rates and reduce the number of lives lost to the biggest killers.

On 4 February, we launched a call for evidence on the national cancer plan, which closed on 29 April. We received over 11,000 responses from individuals, professionals and organisations who shared their views on how we can do more to achieve our ambition. We have worked with crucial industry figures in the development of the national cancer plan, including the Royal College of Radiologists. The submissions are being used to inform our plan to improve cancer care. As I said, the Under-Secretary of State for Health and Social Care, my hon. Friend the Member for West Lancashire, is working hard on that issue.

I thank the hon. Member for North Shropshire (Helen Morgan) for her recognition of the improvements being made at Shrewsbury and Telford and for her contribution, and that of other local MPs, in supporting that trust. Those are very welcome improvements.

On research, the life sciences sector is critical to this Government’s growth mission and we want to make this country the best place to do life sciences. Of course, the Department is working closely with colleagues in the Department for Science, Innovation and Technology, the Department for Business and Trade, and His Majesty’s Treasury to make that happen.

Finally, through this Government’s action on workforce and cancer capacity, we will ensure the NHS has the staff it needs to treat cancer patients safely across the country. I thank the hon. Member for Wokingham for securing this debate.

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.