Ashley Dalton MP: speeches 2025

Speeches

• 27 Mar 2025 · Hughes Report: First Anniversary · Hansard source

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  It is a pleasure to serve under your chairship, Ms Furniss. I congratulate my hon. Friend the Member for Washington and Gateshead South (Mrs Hodgson) on securing this important debate, and I thank all hon. Members for their powerful words on this emotive topic. I know that my hon. Friend met with the Minister for Patient Safety, Baroness Merron, last November to discuss the transparency of industry payments to healthcare practitioners, one of the nine recommendations that the independent medicines and medical devices safety review put to the then Government in 2018. This is something that the Government take extremely seriously. We must ensure that lessons are learned, and that is why we are putting patient safety at the heart of improving our health and social care system. I will continue to build a system that listens, hears and acts with speed, compassion and proportionality. I want to repeat the apology that the previous Government made, which was echoed by my predecessor, the hon. Member for Gorton and Denton (Andrew Gwynne), and by Baroness Merron. I say to all of those mentioned today—to Samantha and her family; to my hon. Friend the Member for Washington and Gateshead South’s mam; to the constituents of my hon. Friends the Members for Leeds South West and Morley (Mark Sewards) and Stoke-on-Trent North (David Williams), my hon. and learned Friend the Member for Folkestone and Hythe (Tony Vaughan) and the hon. Member for Chichester (Jess Brown-Fuller); to Karen from Harrow East; to Bev from Bury North; to Colleen, Andy and Byron from North West Norfolk; to Paula and Gillian from Bexleyheath and Crayford; to Paula Goss; and to all those affected in the Gallery and across the country—we are sorry. We are sorry for the time the system took to listen to you and to your families. Everyone who has suffered complications from sodium valproate and pelvic mesh implants has our deepest sympathies and our assurance that we have listened and will continue to listen to those affected. I am grateful to the Patient Safety Commissioner, Dr Henrietta Hughes, and her team for the Hughes report, which was published just over a year ago. It built on the important work started by Baroness Cumberlege in 2020. We will continue to work closely with Dr Hughes on how best to support affected patients and prevent future harm, on both this issue and a number of others. The independent medicines and medical devices safety review was among the first of its kind, shining a searing spotlight on the harmful side effects of certain medicines and medical devices, including sodium valproate and pelvic mesh. The Cumberlege review revealed grave systemic issues in our health system that needed to be addressed with urgency. They covered areas ranging from the healthcare system’s lack of engagement with patients to the lack of safety monitoring for devices once they are on the market. That is why we are working to improve how the system listens and responds to concerns raised by patients; to strengthen the evidence base on which decisions are made; and to improve the safety of medicines and medical devices. Recommendation 8b of the IMMDS review stated that there should be mandatory reporting for industry payments made to the health sector, akin to the Physician Payments Sunshine Act in the US. The previous Government accepted that in principle and held a six-week consultation. I recognise the importance of transparency and trust in the health system, and the Department is considering options regarding payment reporting, with an aim to publish a response later this year. I absolutely understand why colleagues are pushing for clarity on our response to the Hughes report. I am acutely aware that this is a difficult and sensitive topic, and I appreciate frustrations about timescales, but this should not be rushed. The Government will need to consider carefully all the options and the associated costs before responding to the report’s recommendations. I assure Members that we will continue to progress this work across Government, ensuring that lessons are learned, and I will commit to writing to Baroness Merron on the timescales, as requested by so many Members today.

• 27 Mar 2025 · Hughes Report: First Anniversary · Hansard source

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  I am encouraged that the number of women still being prescribed sodium valproate has reduced significantly following the Medicines and Healthcare products Regulatory Agency’s introduction of the valproate pregnancy prevention programme. In April 2018, 27,441 women aged under 55 were prescribed valproate in England, but in March 2024, that number had come down to just under 16,000—a reduction of 42%. Nobody should stop taking valproate without advice from their healthcare professional. Beyond lowering prescription rates, I am also grateful to see Dr Rebecca Bromley, who is in the Public Gallery, heading up the foetal exposure to medicines service pilot study. The study is running for 18 months and was commissioned by NHS England. It is a multidisciplinary clinical service that is providing expert assessment, diagnosis and advice to individuals harmed following exposure to sodium valproate. We recognise those concerns. Patients know what support they need. The Government are determined to make sure that patients feel, and are, truly heard, and to give them more choice and control over their healthcare. The Patient Safety Commissioner rightly sought views from those affected about the issues they are facing with service provision and what support they feel would be most valuable. Hearing from patients is at the heart of our consideration of the Hughes report, which is why Baroness Merron held a roundtable in December with groups representing patients impacted by sodium valproate and pelvic mesh. I know she remains extremely grateful to all attendees for sharing their stories and those of the patients that they represent. I am aware of the time, and there are many issues that I have been unable to cover in the short time available. However, I commit to writing to all hon. Members who have raised specific concerns. Words cannot express how sorry we are to the women who have suffered from severe and life-changing complications from both sodium valproate and pelvic mesh. We are actively considering this issue, and I wish there were more I could say at this time. I have heard the calls for swiftness, clarity and boldness in the commissioner’s recommendations, and I shall bring that forward at the earliest opportunity. I am sure that this is not the last time this important topic will be discussed, and I know that colleagues will continue to hold our feet to the fire until this gets done.

• 27 Mar 2025 · Hughes Report: First Anniversary · Hansard source

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  I assure the right hon. Member that we are working at pace on this. It is a complicated matter, and we are taking note of previous similar situations. I assure him and the rest of the House that we will be updating the Patient Safety Commissioner at the earliest opportunity. I appreciate that it is frustrating that I cannot give an exact date or timescale in this debate, but we are working to make sure that we get this right.

• 27 Mar 2025 · Hughes Report: First Anniversary · Hansard source

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  I do appreciate the frustrations. Since we came into government last July, patient safety has been, and I can confirm that it remains, a top priority for this Government. Although it has been a year since the publication of the Hughes report, this is a complex issue involving several Departments, and it is important that we get the response right. As I have said, I will commit to writing to Baroness Merron on timescales, as requested, to get further clarification on that, and we are committed to learning from other instances in which patient safety has been impacted. The infected blood inquiry was mentioned by the right hon. Member for Salisbury (John Glen).

• 26 Mar 2025 · Tobacco and Vapes Bill · Hansard source

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  Let me begin by thanking all hon. and right hon. Members for their contributions. I will try and touch on the many amendments discussed and the key questions raised. At the heart of the Bill is the establishment of the smokefree generation by gradually ending the sale of tobacco products across the UK. Amendments 4 to 35 tabled by the right hon. Member for East Antrim (Sammy Wilson), amendments 38 to 45 tabled by the hon. Member for Romford (Andrew Rosindell), amendments 103 to 111 tabled by the hon. Member for Clacton (Nigel Farage) and new clause 12 tabled by the right hon. Member for South Holland and The Deepings (Sir John Hayes) would remove that policy or water it down. There is no liberty or choice in addiction, however, and that is why the Government are committed to creating the world’s first smokefree generation. We have the public’s backing, with 71% of adults supporting the goal of a smokefree Britain in a YouGov poll carried out in November 2023. Raising the age of sale to 21 will not meet our ambition to make the UK smokefree.

• 26 Mar 2025 · Tobacco and Vapes Bill · Hansard source

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  I would like to start by thanking all right hon. and hon. Members for their invaluable contributions during the passage of the Bill to date, and in particular, members of the Public Bill Committee for providing insight, scrutiny and debate. I am honoured to have taken on responsibility for this Bill. It is a watershed piece of legislation and the most significant public health intervention since the ban on smoking in public places in 2007. It will establish a smokefree generation by gradually ending the sale of tobacco products across the UK so that a child turning 16 this year will never be able to be legally sold tobacco, saving countless lives in the process. It will strengthen existing powers to reduce the harms of second-hand smoke in public spaces. In keeping with our manifesto commitment to the British people, it will outlaw the manipulative promotion of vapes to children to protect the next generation from becoming hooked on nicotine. Finally, it will implement robust measures to strengthen enforcement activity. I do not need to tell anyone in this Chamber that tobacco kills—we all know that. What hon. Members may not know is just how much it kills, the rate at which it kills, and the devastation it causes for individuals, families and communities across the country. Let me remind hon. Members that tobacco kills more people than any other preventable cause of death. Around 80,000 people in the UK lose their lives to tobacco every year. It robs an average of 10 years off the life expectancy of smokers. It substantially increases the risk of many major health conditions throughout people’s lives, such as stroke, diabetes, heart disease, stillbirth, dementia and asthma. This daily tragedy continues unabated, with someone being admitted to hospital because of smoking almost every minute, day in, day out, with no end in sight. Tobacco harms are not felt equally either. Our most disadvantaged communities suffer most, with 230,000 households living in smoking-induced poverty. In Blackpool, 17.5% of pregnant women still smoke at the time of delivery compared with 2.8% in Kensington and Chelsea. Over a quarter of people with a long-term mental health condition smoke. Beyond the immeasurable cost to lives in the UK, the staggering economic impact of tobacco on our NHS cannot be ignored. The treatment of smoking-related diseases consumes approximately £3 billion a year of vital NHS and social care resources. The cost of smoking to our economy is even greater: £18 billion is lost in productivity every year, far outweighing the tax receipts it brings in of around £9 billion. The Bill is a vital step to break the devastating cycle of tobacco addiction and safeguard future generations from a lifetime of ill health. But the world moves forward, and we cannot ignore the alarming rise of youth vaping. While vaping is less harmful than smoking and can be an effective quit aid for adult smokers, children should never vape. However, in the past five years, youth vaping has more than doubled. One in four 11 to 15-year-olds tried vaping in 2023, and that is no accident. It is in part due to the deliberate branding and advertisement of vapes to our children, with brightly coloured packaging and enticing sweet-like flavours—a calculated strategy to hook young people on nicotine. We cannot afford to wait to act. I turn to the Government amendments, which seek to strengthen the Bill and ensure greater clarity. As we create the first smokefree generation and strengthen age restrictions on vapes and nicotine products, we want to support retailers in taking appropriate steps to ensure they do not sell to customers under the age of sale. New clause 11 and Government amendments 47 to 49, 51 to 53, 61, 63, 65 to 67, 69 to 71, 75, 77, 79 and 81 are a package of amendments and consequential amendments to the Bill. They seek to remove potential ambiguity for retailers regarding the use of digital identity for verifying the age of prospective customers when selling tobacco, vaping and nicotine products. In Committee, Members raised concerns that the list of identity documents to satisfy the defence for a person charged with selling products to someone under the age of sale was limited, and queried the inclusion of other forms of physical and digital identity. These amendments remove the lists of physical ID from the Bill and instead provide powers for the Secretary of State and the Department of Health in Northern Ireland to specify in regulations the steps that may be taken to verify a customer’s age to meet the requirements for the defence. This revised approach better future-proofs the defence against developments in identification processes and provides the potential to recognise digital ID, as well as physical ID, in the context of the defence, supporting the widespread use of digital ID. The amendments provide the opportunity for effective interaction with part 2 of the Data (Use and Access) Bill that is currently going through Parliament, which includes provisions relating to digital verification services. Digital verification services provide an opportunity to securely verify age for in-person and online sales. We will continue to work closely with the Department for Science, Innovation and Technology and other Departments when developing the regulations. New clause 11 provides a similar power for Scottish Ministers to prescribe in regulations the steps that should be taken to establish a customer’s age as a defence to an age of sale offence. That will enable Scottish Ministers to respond to changes in technology and consumer behaviours, which may move away from the presentation of a physical document. The last Labour Government took bold action to prohibit displays of tobacco products to protect children and young people from being enticed into addiction and to create a more supportive environment for adults seeking to quit. The Bill goes further and gives powers to limit the display of a wider range of products, including herbal smoking products, cigarette papers, vapes and nicotine products. Government amendments 56, 57, 60, 62, 74, 76, 78 and 80 will alter the powers in the Bill for England, Wales and Northern Ireland that regulate displays of products and their prices, so that they also cover tobacco-related devices. As was discussed in Committee, pipes, heated tobacco devices and bongs are currently displayed in shops and can have the effect of promoting tobacco usage. The amendments will ensure that we can make regulations to stop products that facilitate the consumption of tobacco being openly displayed by retailers. The Bill bans the sale of vapes, nicotine products and cigarette papers from vending machines in England, Wales and Northern Ireland and restates the existing ban on tobacco vending machines. We know that vending machines are used to bypass age of sale restrictions and to undertake proxy purchases on behalf of people under the age of sale. Government amendments 50, 54, 55, 64, 68, 72 and 73 are clarifying amendments that make the scope of the prohibition on vending machines absolutely clear, as was discussed in Committee. The Government’s position is that the Protection from Tobacco (Sales from Vending Machines) (England) Regulations 2010 already apply where a customer has a coupon, receipt or token purchased elsewhere that can be redeemed at a machine. We are amending the clauses so that all machines that dispense products in connection with a sale are clearly captured by the ban. The Bill strengthens the enforcement regime to support law-abiding retailers while taking action against those who break the rules. Along with introducing new fixed penalty notices and new powers to create a licensing system, the Bill re-enacts provisions on restricted premises orders and restricted sale orders. Those are existing measures that local authority trading standards in England and Wales can use when dealing with a retailer that persistently breaches restrictions. That ensures there is a range of tools in the enforcement armoury, so that trading standards officers can act quickly and effectively against rogue retailers. Government amendments 58 and 59 clarify a point raised in Committee by removing a duplicative and unnecessary provision that would prevent a business or individual from operating a vending machine for the sale of tobacco, vaping or nicotine products following the issuing of a restricted premises order or a restricted sale order. Given that the Bill already prohibits the use of vending machines for tobacco, vaping or nicotine products, there is no need for restricted premises orders and restricted sale orders to expressly prohibit the use of vending machines. Together, the Government amendments will improve the implementation and enforceability of measures in the Bill to ensure the most effective protection for the public, and I commend them to the House. Turning to the other amendments in the group, I thank hon. Members for their scrutiny of the Bill so far. When I wind up, I will try to cover the key themes that are touched on. On the amendment that seeks to undermine the smokefree generation, I am sure we will hear arguments from some hon. Members who have been listening to the tobacco industry’s arguments and myths about how people should be free to make their own choices. I would say to them that smoking kills two thirds of its users. Three quarters of people wish they had never started smoking, and the majority want to quit—that is not freedom of choice. The tobacco industry took away that choice with addiction, usually at a young age. On smokefree places, we have been clear: in England, we intend to consult on extending smokefree outdoor places to outside schools, children’s playgrounds and hospitals, but not to outdoor hospitality settings at this time. No smoker wants to harm people, but with second-hand smoke, they do. If people can smell smoke, they are inhaling it. This is particularly important for children, pregnant women and people with pre-existing health conditions such as asthma or heart disease. The only way to stop this harm is to stop people smoking around others. While I understand hon. Members’ proposals to list specific places in the Bill or to add additional limits to the use of the powers, it is right that we consult on the detail before making regulations and have the necessary powers to protect children and vulnerable people from the harms of second-hand smoking. I am grateful to the co-chairs of the all-party parliamentary group on smoking and health, my hon. Friend the Member for City of Durham (Mary Kelly Foy) and the hon. Member for Harrow East (Bob Blackman), for their long-standing support for the Bill. Through their amendments, they highlight the importance of retaining a focus on support for current smokers. That is why we are investing an extra £70 million for local stop smoking services this year and working to ensure that all NHS hospitals offer opt-out smoking cessation services into routine care. I hope they will be pleased that we have been able to confirm the extension of the swap to stop scheme for the coming year, with up to £19 million of funding to provide free vape starter kits for smokers to use as quit aids. On the group of amendments relating to vape advertising, we realise that products being deliberately marketed at children is unacceptable, which is why we have included a commitment to stop vapes being branded and advertised to children. The Government are also investing £10 million of new funding for the coming year for National Trading Standards to tackle underage illicit tobacco and vapes and to boost the trading standards workforce by recruiting 80 new apprentices, providing additional boots on the ground.

• 26 Mar 2025 · Tobacco and Vapes Bill · Hansard source

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  This Bill has been put together, as I said, with collaboration across all the Governments and bearing in mind all the Government’s legal obligations under the law. All those things have been taken into account, and the Bill is able to be brought forward in that way. Our manifesto committed to delivering the smokefree generation, and we are working across all Governments to ensure that we deliver that, as well as honouring our international obligations. As a result, the Government do not consider new clause 3 tabled by the hon. and learned Member for North Antrim (Jim Allister) to be necessary. That is because we are content that measures drafted in the Bill that apply in relation to Northern Ireland are consistent with our obligations under the Windsor framework, and the proposed new clause would put us in breach of international law. In the drafting of the Bill, as I have stated, we have considered all its domestic and international obligations, and it is for those reasons that the Government cannot support new clause 3. The Bill will bring about a real change by creating a smokefree generation. As we have discussed, there is no liberty or choice in addiction, and almost all smokers want to quit and two thirds wished they had never started. I started smoking at the age of 16 and decided I would stop when I was 18—I could not stop. I thought, “I know, I’ll stop when I am 21” and then it was 25, then it was when I graduated, and then it was when I had a child. At no point was I able to give up this pernicious addiction. It took a cancer diagnosis to scare me into being able to stop smoking, and I do not wish that on any of our young people. In conclusion, many of the amendments are unnecessary because the Bill already grants the Government the power to take forward the issue through the more appropriate route of secondary legislation. This is a landmark Bill: the most significant public health intervention in a generation. It strikes the right balance on the interests of public health by being proportionate and not overly burdensome. It allows the Government to bring forward the appropriate primary and secondary legislation to ensure that we can deliver a smokefree generation that protects all our children from the addiction of tobacco, a uniquely harmful substance.

• 26 Mar 2025 · Tobacco and Vapes Bill · Hansard source

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  I beg to move, That the Bill be now read the Third time. Let me start by thanking hon. Members on both sides of the Chamber for their positive and constructive engagement today and more generally as the Bill has progressed through the House. Let me put on record my sincerest thanks to all members of the Public Bill Committee, who scrutinised the Bill extremely thoroughly and brought it to this stage. The Bill is the next step in a long history of action on tobacco, but as the House is aware, it is not a step that this Labour Government have taken alone. I thank the right hon. Member for Richmond and Northallerton (Rishi Sunak) for his ambition to make a difference to the future of our country by championing the previous Tobacco and Vapes Bill. The Bill that we are discussing today is even stronger in its ambition to tackle smoking and youth vaping, in part thanks to the contributions and debate from MPs from all parties on these most critical of issues. I thank the Opposition Front Benchers for their engagement with the Bill, particularly the shadow Minister, the hon. Member for Sleaford and North Hykeham (Dr Johnson), who has been a determined campaigner for action on youth vaping for a number of years. I also thank my officials in the Department for Health and Social Care and the devolved Governments, the Office of the Parliamentary Counsel, the Government Legal Department and the Clerks, whose tireless work and support on the Bill have enabled the development of this extraordinary legislation. When this Government took office, we promised to create a smokefree generation. Today we are delivering on that promise. By creating a smokefree UK, we are investing in a healthier society for all. The Bill will tackle the concerning rise in youth vaping and reduce the immense burden that tobacco-related illnesses place on our society and our NHS. I consider it a great privilege to have overseen these last parts of scrutiny of the Bill, and I urge all right hon. and hon. Members to support it to proceed to the other place.

• 26 Mar 2025 · Tobacco and Vapes Bill · Hansard source

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  The entire Bill is about preventing addiction among our young people and preventing their move into crime. These things are already illegal and the Government believe that existing legislation will allow for them to be dealt with. On cigarette filters, I understand hon. Members’ concerns about tobacco litter, but new clause 2, tabled by the hon. Member for Gosport (Dame Caroline Dinenage), could lead to greenwashing, improving the reputation of tobacco manufacturers while not necessarily improving environmental outcomes.

• 26 Mar 2025 · Tobacco and Vapes Bill · Hansard source

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  As the hon. Member will know, there are already measures in the Bill that allow some of the fines to be retained—they can certainly be retained to make it cost-neutral for local authorities—but I am sure we will explore that issue later on. The Bill contains regulation-making powers on a range of aspects of product requirements that already allow us to do many things that hon. Members seek to achieve, but I look forward to listening to the contributions to today’s debate on the wider list of amendments and to responding to the points that are made.

• 26 Mar 2025 · Tobacco and Vapes Bill · Hansard source

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  I thank the hon. Member for her intervention. If I am allowed to finish, that is one of the issues and that proposal may not necessarily improve environmental outcomes. However, we consider that powers are already available to the Department for Environment, Food and Rural Affairs that enable the Government to limit the damage to the environment caused by filters, so the amendments are unnecessary. Similarly, new clause 14, tabled by my hon. Friend the Member for Dartford (Jim Dickson), would prohibit the supply of all cigarette filters or cigarettes containing filters, whether they contain plastic or not. Ultimately we believe that the best way to tackle filters is through the reduction of smoking rates. On bundles of tobacco products, the Bill gives the Government the powers to regulate retail packaging of tobacco products and devices, herbal smoking products and cigarette papers, as well as vaping and nicotine products. In addition, the Bill already gives the Government powers to regulate how products are packaged together in bundles, so amendments 86 and 87, also tabled by my hon. Friend, are not necessary. Amendments 46, 90 and 91 and new clauses 8 to 10 and 15 would all undermine our promise to the electorate to stop vapes being advertised to children. We have a clear mandate, with 74% of adults in Great Britain supportive of a ban, and we will not create any exemptions that could undermine this. On amendment 90 and new clause 15, let me reassure the shadow Secretary of State and my hon. Friend the Member for Newcastle upon Tyne East and Wallsend (Mary Glindon) that the Government are not prohibiting the promotion of vapes in general as a smoking cessation tool. Let me reassure my hon. Friends the Members for Newcastle upon Tyne East and Wallsend and for Suffolk Coastal (Jenny Riddell-Carpenter) that the Bill already provides the Government with powers to limit the amount of nicotine in a nicotine pouch, to regulate vaping products in such a way that would prohibit the sale of high puff count vaping devices, including setting tank capacity limits for devices where multiple refill tanks are attached, and to ban any other ingredient that may be harmful. The Government believe that these measures are more appropriate for secondary legislation due to the technical details that need to be captured, rather than in primary legislation as new clauses 4 and 21 would require. On amendment 37, tabled by my hon. Friend the Member for Newcastle upon Tyne East and Wallsend, we recognise that vape flavours are a really important consideration for adult smokers seeking to quit smoking, but we also know that sweet or fruity flavours are the main flavours that appeal to children and that certain flavours and ingredients can be particularly harmful to health. We have been clear that we will carefully consider our future regulations so that we get the balance right, and this is subject to a statutory duty to consult. Similarly, I reassure my hon. Friend that amendment 88 is unnecessary. We will honour the long-established principles of good consultation when consulting on regulations under part 5 of the Bill, including in relation to who is consulted. On new clauses 6 and 7, while the Government are committed to protecting children from the risk of harms through addiction, our approach across all products in the Bill is for age to be verified at the point of sale, not at the point of use. Mandating any age-gating technology for vapes would create harsher restrictions on vaping than smoking. That could make vapes less accessible and attractive to adult smokers wishing to quit and use vapes as a smoking cessation tool. I recognise the concerns of the hon. Member for Harrow East (Bob Blackman) about online sales. However, it would not be proportionate to ban all online sales because that would impact on those retailers seeking to operate within the law. As was discussed in Committee, going back to the issue of wider enforcement, new clause 18 and amendment 89 do not reflect the complex processes required to develop the licensing scheme in England and Wales. Although I am sympathetic to the shadow Secretary of State’s aims, rushing to publish draft regulations within two months of Royal Assent would risk creating flawed policy. I pay tribute to colleagues in the Scottish Government, Welsh Government and the Northern Ireland Executive. This UK-wide Bill has been developed in partnership with them, and I thank them for their support. Our manifesto committed to resetting our relationship with the devolved Governments, and this Bill is a great success in demonstrating collaboration across Governments in improving the health of the nation.

• 26 Mar 2025 · Tobacco and Vapes Bill · Hansard source

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  I beg to move, That the clause be read a Second time.

• 25 Mar 2025 · Topical Questions · Hansard source

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  I commend my hon. Friend’s constituent for her work with the Brain Tumour Charity, and I wish Lily well with her treatment. The Government have launched the brain tumour research consortium, which will support efforts to speed up the diagnosis of tumours and aid the recovery of patients, and the national cancer plan will ensure that we include brain tumour patients. We know that everyone’s cancer is as unique as they are, and this will be reflected in the plan.

• 25 Mar 2025 · Topical Questions · Hansard source

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  In England, it is the responsibility of local integrated care boards to work with clinicians, service users and patient groups to develop services and care pathways that are convenient and meet the needs of patients with POTS. NICE has published a clinical knowledge summary on the clinical management of blackouts and syncope, which provides advice for UK clinicians on best practice and the assessment and diagnosis of POTS.

• 25 Mar 2025 · Topical Questions · Hansard source

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  My hon. Friend is right: coastal communities face unique challenges when it comes to health inequalities. I will shortly attend the all-party group for coastal communities, where I will meet him and colleagues to discuss these issues.

• 25 Mar 2025 · Special Educational and Disability Needs · Hansard source

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  I commend my hon. Friend for her dedication to improving support for children in her role as the opportunity mission champion. Children with special educational needs and disabilities may access a range of NHS services, including health assessments and specialised support. All integrated care boards must have an executive lead for SEND to ensure that that work receives sufficient focus. We are working closely with the Department for Education on reforms to the SEND system.

• 25 Mar 2025 · Special Educational and Disability Needs · Hansard source

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  Work to develop the Down Syndrome Act statutory guidance is being taken forward as a priority, with a view to publishing it for consultation by the summer. It does involve people with Down syndrome, as part of a wider group.

• 25 Mar 2025 · Special Educational and Disability Needs · Hansard source

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  The system we inherited has been failing to meet the needs of children with SEND for far too long—that became clear in what happened at the Accy Vic. Through the 10-year health plan, we will consider all those policies, including those that impact on children and young people. We are working closely with the Department for Education to support the delivery of the opportunity mission. I also hosted a roundtable recently with children and young people, including those with SEND, so that they can feed directly into the 10-year plan. They will be at the heart of our thinking and planning on these issues.

• 25 Mar 2025 · Cancer Care: West of England · Hansard source

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  This is a really important issue. We have reinstated the children and young people cancer taskforce, which I visited a couple of weeks ago. We have tasked it with ensuring that children and young people are a part of its work. The Department will be marking Teenage and Young Adult Cancer Awareness Month appropriately. We encourage all children and young people to get the checks that they need and be aware of cancer symptoms.

• 25 Mar 2025 · Cancer Care: West of England · Hansard source

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  I commend the hon. Member’s campaign activity for improved cancer facilities. I commend, too, Mateusz’s two half-marathons. I wonder when the hon. Member will be doing his half-marathon, but I can guarantee that I will not be joining him. The fact that this sort of activity is taking place is fantastic. Local provision for healthcare is managed by the local health system. I would be delighted to meet him and local representatives as soon as diaries allow.

• 25 Mar 2025 · Cancer Care: West of England · Hansard source

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  I know the hon. Member is acutely aware of the impact that cancer can have on families. We are committed to catching cancer earlier and treating it faster. We have achieved our manifesto pledge of 2 million extra appointments seven months early and we have invested in more surgical hubs, longer opening times, which have benefited 23 community diagnostic centres in the south-west, and new radiotherapy machines. The national cancer plan will also seek to improve every aspect of cancer care to improve patient outcomes and experiences across the country, including in the west of England.

• 14 Mar 2025 · Rare Cancers Bill · Hansard source

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  First, let me say how sorry I was to hear that my hon. Friend the Member for Edinburgh South West (Dr Arthur) recently lost his father-in-law to glioblastoma. I congratulate him on introducing this legislation less than a year after his election. His wife and children will be immensely proud to see him in the Chamber today. He has the full support of many charities, such as Pancreatic Cancer UK, the Brain Tumour Charity and Cancer Research UK, as well as people up and down the country who have written to their MP urging them to join this debate and vote for the Bill. I also pay tribute to all those right hon. and hon. Members who have lost loved ones and remembered them so powerfully today. I thank them for the courage that they have shown in sharing their stories. Particularly, I do not think that anyone in this Chamber or watching from the Gallery or beyond could have failed to be moved by the powerful stories from my hon. Friends the Members for Calder Valley (Josh Fenton-Glynn), for Cumbernauld and Kirkintilloch (Katrina Murray) and for Mitcham and Morden (Dame Siobhain McDonagh), to whom I give particular thanks for her tireless campaigning on glioblastoma following the untimely loss of her sister Margaret. I also pay tribute to those who remembered their constituents. I am delighted that very soon I will be meeting my hon. Friend the Member for Hyndburn (Sarah Smith) and Lorraine to discuss Milly’s Smiles. Let me take the opportunity to add my memories of Joe Chilcott, the son of my friends Tim and Verity and sister to Ellie, who was diagnosed with a brain tumour at the age of 10. It was heartbreaking to lose him when he was just 18. I thank all the hon. Members who have spoken today. I will seek to address as many of the issues raised as possible. There were so many stories. I recognise the people who were remembered in those stories, those in the Gallery, and the many more watching at home. They are willing the Bill to succeed. On behalf of the Government, it is my great pleasure to pledge our support for the Bill. We are undertaking fundamental reform of the NHS. People living with rare cancers must be at the heart of that change. Rare cancer patients deserve better, and the Bill gives them something that has been spoken about across the House today: new hope. Let me begin my remarks on what the Bill will do, why we support it and our policy on rare cancers more generally. Clinical research is one of the most important ways in which we can improve healthcare, by identifying the best way to prevent, diagnose and treat cancer. The Bill will encourage the placement of clinical trials for rare cancer in England, by ensuring that the patient population can easily be contacted by researchers, streamlining the recruitment process. It will also ensure a Government review of regulations relevant to orphan drug designation, to ensure that they continue to deliver for patients. Innovations in the Bill will complement the radical actions that we are developing through the 10-year health plan and the national cancer plan to fix the NHS, on which I will expand later. Research is a key part of this effort, which is why the Department of Health and Social Care, through the National Institute for Health and Care Research, invests more than £1.6 billion a year in health research. In 2023-24, the NIHR invested £133 million in cancer research. As we have heard, rare brain cancers such as glioblastoma have a devastating impact on people and their loved ones. That is why the NIHR announced in September 2024 a new package of funding opportunities for brain cancer research, and established in December a new national brain tumour research consortium, bringing together researchers from a wide range of different disciplines. That is in parallel with a dedicated funding call for research into wraparound care and the rehabilitation and quality of life of patients with brain tumours. We remain committed to accelerating new breakthroughs in high-quality research to drive improvement in the diagnosis, management and treatment of brain and other rare cancers, for better survival rates and patient outcomes. The hon. Member for Esher and Walton (Monica Harding), my hon. Friend the Member for Mitcham and Morden and others asked how the £40 million promised for brain tumours has been spent. In the five years since 2018-19, the NIHR has invested £11.3 million directly in brain cancer, with a further £31.5 million to enable brain tumour research in 227 studies involving 8,500 people. The commitment remains in place. I can confirm that there is no upper limit on that funding. We are exploring additional research policy options to encourage more clinical trials in early phase research and the development of medical devices and diagnostics. We have also talked a lot about other rare cancers, including lobular breast cancer, for which we are supporting research through the research infrastructure, including biomedical research centres. We welcome further funding applications for research on all conditions, including lobular breast cancer. We continue to consider whether abbreviated forms of breast magnetic resonance imagining —fast MRI—can detect breast cancers that are missed by screening through mammography, such as lobular and the other types of breast cancers that have been mentioned. We are also supporting the opening of 171 studies on blood cancer, providing an online registry called “Be Part of Research”, which allows users to search for and participate in studies relevant to them. Clinical trials are a crucial part of cancer research. They provide patients with early access to groundbreaking and possibly lifesaving treatments. The measures in the Bill align strongly with our commitment to that, and aim to streamline clinical trial recruitment processes. My hon. Friend the Member for Mitcham and Morden spoke passionately about how long it takes trusts to negotiate contracts. We recognise that issue and are beginning to make progress. NHS commercial contracting has been standardised, and the national contract value review has reduced study set-up times by 36%, from 305 days to 194 days in the first 12 months’ analysis. We continue in that work. The hon. Member for Wokingham (Clive Jones) and my hon. Friend the Member for Bootle (Peter Dowd) asked how we are working across borders. We are taking forward the most significant reform of UK clinical trial regulations in over 20 years, while maintaining robust protections and safeguarding for clinical trial participants. The MHRA already authorises cross-border clinical trials, including those conducted in the EU and on UK-based trial sites. The “Be Part of Research” programme uses information from national and international sources. My hon. Friend the Member for Mitcham and Morden spoke so passionately—we have all commented on her passion and anger. I appreciate her frustration and share her desire for radical action. I think we can all agree that the Government’s announcement yesterday on scrapping NHS England demonstrates our willingness to be bold, take risks and do things differently. Members raised several other matters. I will come back to them all with more detailed information on those issues, but I do not have the time to do so today. I will address the national cancer plan, however, which was raised a number of times. It is really important to fulfil our goal of transforming cancer care, and we will not just cherry-pick the most common cancers; we need a rising tide that will lift all ships. As a person who is living with an incurable cancer myself, I cannot overstate how deeply I feel the honour and responsibility of being asked to drive forward our work in creating the national cancer plan—it is my absolute honour. But while we take strides to fix cancer services, I am under no illusion that the Government or I hold all the answers, so my plea is for hon. Members to work with us and share their expertise. I ask them please to visit “Shaping the national cancer plan” on the Department’s website and to contribute evidence. The Government are committed to making a real difference for patients with rare cancers. For those affected by this devastating disease, every discovery, every treatment and every moment matters. We will do all we can to facilitate the passage of this Bill here and in the other place.

• 6 Mar 2025 · Ambulance Response Times · Hansard source

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  The hon. Member will be delighted to know that I am coming to that point next. We are working on reducing delays and getting hospital handovers back to within 15 minutes, ensuring that no handover between hospital and ambulance services takes longer than 45 minutes. We want to improve the range and co-ordination of services to avoid unnecessary ambulance conveyances, including through improving access to urgent community response and hospital at home services, and continuing to build on ambulance services and the great work that they do to increase the hear and treat rates so that people can be advised on what they can do and what services they can access that might mean they do not need that ambulance. We will also be driving consistency and commissioning practices across England for ambulance services. I will say a little more about the rurality element in a moment. We are taking the first steps in the reform and improvements that we want to see in services, and we will shortly set out further plans in the urgent and emergency care services plan. We know that there is no solution for ambulances that does not include tackling the challenges facing adult social care. Health and care services need to be more joined up. Today, there are approximately 12,000 patients in hospital beds who have no criteria to reside. They do not need to be there but cannot be discharged for reasons of capacity. Over the last month, on average, 276 of the patients with no criteria to reside were in the Somerset integrated board area. That is why the Government are making available up to £3.7 billion of additional funding for local authorities that provide social care. We are funding more home adaptations through the disabled facilities grant this year and next, so that people’s homes can be safer, reducing the risk of their needing an ambulance. We are reforming the better care fund to ensure that the pooled NHS and local authority funding spent on social care contributes to wider efforts to reduce emergency admissions and delayed discharges.

• 6 Mar 2025 · Ambulance Response Times · Hansard source

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  It is a pleasure to serve under your chairship, Ms Jardine. I am grateful to the hon. Member for Glastonbury and Somerton (Sarah Dyke) for securing the debate. I thank all the hon. Members who have taken part, including my hon. Friends the Members for Redditch (Chris Bloore), for Ilford South (Jas Athwal) and for Wolverhampton West (Warinder Juss), and the hon. Members for West Suffolk (Nick Timothy) and for South Devon (Caroline Voaden), as well as the Liberal Democrat spokesperson, the hon. Member for North Shropshire (Helen Morgan), and the shadow Minister, the hon. Member for Sleaford and North Hykeham (Dr Johnson). I will endeavour to deal with as many issues and questions as I can. If I do miss any, will hon. Members please get in touch with me afterwards, and I will make sure they are picked up? The hon. Member for West Suffolk mentioned the commitment made by the Secretary of State to meet him and visit his constituency, and I will ensure that that issue is raised. The parliamentary private secretary, my hon. Friend the Member for Ealing Southall (Deirdre Costigan), is here, and I am sure she will be happy to pursue a response. We will also do what we can to get a response from the Treasury for the shadow Minister. The hon. Member for Glastonbury and Somerton and other hon. Members rightly raised constituents’ experiences of long waits for an ambulance response. I put on record my deepest sympathies for the hon. Lady’s constituent Jim on the loss of his wife. As the Secretary of State has made clear, this is not the level of care that staff want for their patients, and it is not the level of care that this Government will ever accept for patients. Lord Darzi investigated the issues facing the NHS, and his report was honest about the challenges facing the health service. Urgent and emergency care performance remains a long way from a resilient position and there is continued high demand for A&E and ambulance services, with ongoing seasonal winter pressures. For example, in December the London Ambulance Service recorded more than 121,000 incidents, the highest on record for the service. Improvement needs to happen across the urgent and emergency care pathway and through the expansion of neighbourhood health services. Nationally, congested emergency departments reduce the productivity of ambulance services, a matter that I think almost all hon. Members raised. A huge amount of time is lost to ambulance handover delays because there is no space for patients. Having crews tied up waiting outside hospitals exacerbates poor ambulance response times. We have also seen the continued normalisation of corridor care. We will never accept patients being treated in corridors; it is unsafe and undignified. We are investing an extra £26 billion to begin turning around the NHS, and we will do all we can, as fast as we can, to consign corridor care to the history books. Lord Darzi’s investigation into NHS performance highlighted wide variation across different parts of the country. The situation is unfair to patients and goes against the principle of a universal service. I acknowledge that there can be challenges in rural areas, where longer distances often mean that patients wait much longer for ambulances than in urban areas. I often find myself in this place with the hon. Member for Glastonbury and Somerton, and we both talk about the experience in our rural constituencies. I assure her that that is on my agenda. As she says, ambulance response times for the south-west and some other areas highlight the rurality differential. In January, the South Western Ambulance Service’s average response for category 2 emergency incidents, which include strokes and heart attacks, was 51 minutes and 45 seconds, which is 26 minutes longer than the best-performing ambulance trust in England. The NHS constitutional standard for category 2 average response times is 18 minutes, and no ambulance trust in England has met that target since the pandemic. This cannot go on. Prioritising patient safety will always be the Government’s and the NHS’s main focus. We are committed to getting A&E waiting times and ambulance response times back to NHS constitutional standards. The independent review of ambulance trust culture was published in February 2024. Its recommendations included addressing workforce pressures. NHS England is working closely with ambulance trusts to implement those recommendations. We have made some significant investments in the ambulance workforce, and the number of NHS ambulance staff has grown by 9% compared with last year, but we recognise that there is much more to do on retention and wellbeing for ambulance staff. That is something that we will continue to work on. We cannot keep plugging the gaps. There is a need for more fundamental reform. We have been clear that there are no quick fixes and that to turn things around will take investment and reform. We have provided the highest real-terms capital budget for the NHS since before 2010. We announced an extra £22.6 billion in day-to-day health spending and an additional £3.1 billion further capital investment over two years. That extra investment will be accompanied by fundamental reform, of which ambulance services. In January, the Government published “Road to recovery: the government’s 2025 mandate to NHS England”, which clearly sets out delivery instructions for the NHS through the prioritisation of the five key objectives aimed at driving reform in the NHS. Improving A&E and ambulance service performance was also one of a small number of prioritised objectives in the Government’s mandate to NHS England to specifically start to address the current challenges facing urgent and emergency care. In turn, NHS England’s planning guidance for this year includes the target to improve average category 2 ambulance response times to no more than 30 minutes across 2025-26. The guidance also sets out a range of key actions for the NHS to deliver in the same timeframe, focused on reducing avoidable ambulance dispatches and conveyances and reducing hospital handover delays.

• 6 Mar 2025 · Ambulance Response Times · Hansard source

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  The hon. Member will be aware, because we have discussed the matter many times in Westminster Hall and the main Chamber, that the funding has been made available to the statutory sector bodies for employer national insurance contributions for public sector pay, and the negotiations for the delivery of commissioned services locally and within the NHS will take place locally. I am sure that we will be able to point her to some more detail on that issue, which has been discussed at length by colleagues. We have announced the largest ever increase in the carer’s allowance earnings limit since the benefit was introduced in 1976. It is worth approximately £2,000 a year for unpaid carers. We are also introducing fair pay agreements to empower worker representatives, employers and others to negotiate pay and terms and conditions in a responsible manner. That will help to address the recruitment and retention crisis in the sector. It is not all about ENICs; it is about making sure that our social care service is resourced in order to make sure that social carers are recognised for the powerful and important work that they do. We have appointed Louise Casey to help to build a national consensus on the long-term solution for social care. The social care cross-party talks, to which the Liberal Democrat spokesperson referred, have not been called off; they have been merely delayed. As I told her in the Chamber just yesterday, it is very much about making sure that we have the right people in the room and that they can attend. It is our intention for the talks to go ahead very soon. They have not been called off; they have been merely postponed. Of course, we need further reform. We are bringing it forward through the 10-year plan this spring to accompany the additional investment in the NHS. The Government will publish that plan for radical reform in the NHS, with those three big reform shifts: from hospital to community, from analogue to digital and from sickness to prevention. The reforms will support putting the NHS on a sustainable footing so that it can tackle the problems of today and of the future. The shadow Minister asked about the configuration of ambulance services. As I am sure she is aware, decisions on service configuration must be made by those who are experts in delivering it. We have also talked about the key issues of rurality. A range of adjustments are made in the core ICB allocations formula to account for the fact that the costs of providing healthcare may vary between rural and urban areas. Some of the differences, such as the tendency for rural populations to be older, are naturally captured within the formula. We continue to review the formula for the impact of the characteristics of local areas, such as rural, urban and coastal, in the development programme. I encourage all hon. Members to raise these matters with their local ICBs, which are responsible for commissioning the right configuration of local services. The NHS has increased the availability of local data on ambulance response times performance, with category 2 ambulance performance now published at ICB level, which has increased the transparency of the important data. I encourage hon. Members to use that data to direct conversations with their ICBs. We have also talked about air ambulances. I am sure that all hon. Members recognise the contribution that they make, as the Government do. The Government support the long-standing independent air ambulance charities model for the successful operation of helicopter emergency medical services in England, which gives the sector the independence to raise funds through commercial activity and sponsorship from corporate partners. The NHS continues to support air ambulance services, including through thorough training and the provision of NHS clinicians. Communities right across the country, including the constituents of the hon. Member for Glastonbury and Somerton, are struggling with poor services and crumbling NHS estates. We are putting record capital into the NHS. We will bring down ambulance response times. We will get waiting lists back down to what they were in 2010. It will take time, but we will deliver an NHS and a national care service that provide people with the care they need, when and where they need it.