Caroline Johnson MP: speeches

Speeches

• 13 Jan 2026 · Puberty Suppressants · Hansard source

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  The Secretary of State has previously said that he accepts all the recommendations in the Cass review. One such recommendation is that the Secretary of State mandate the release of data for the data linkage study. Can the Minister tell us what specific steps have been taken to mandate the release of that data?

• 13 Jan 2026 · Maternity and Neonatal Care · Hansard source

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  The maternity and neonatal plan is due in the spring, nearly two years after the Secretary of State took office. The maternity review has been delayed. There are no signs of the 1,000 additional midwives the Secretary of State said he would train. Gynaecology waiting lists are rising, with the number waiting for admission 6% higher than it was a year ago. The Secretary of State has an opportunity to save many lives, and I know that he wants to use all the opportunities available to him. May I ask him to concentrate on making more improvements in maternity care?

• 7 Jan 2026 · Rural Communities · Hansard source

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  Does my hon. Friend agree that one of the greatest examples of damage that the Government are doing to the countryside is the destruction of our best and most versatile farmland with thousands upon thousands of acres of solar farms?

• 7 Jan 2026 · Advanced Brain Cancer: Tissue Freezing · Hansard source

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  It is a pleasure to serve under your chairmanship this morning, Mr Western. I thank the hon. Member for Caerphilly (Chris Evans) for securing this debate, and the cancer charities, including Brain Tumour Research and Brain Tumour Charity, who provide invaluable support to my constituents. I also thank Owain’s family for their important campaign. I want to recognise the contribution of the hon. Member for Mitcham and Morden (Dame Siobhain McDonagh), who has shown such incredible energy and dedication to the cause over the last few years. It is impressive to get a trial up and running that offers real hope to people, so I thank her for that work. Each year sees around 13,000 new cases of brain and central nervous system cancers and 5,500 deaths. As has been said already this morning, brain cancers are the leading cause of cancer-related death for those under the age of 40. As a doctor and a granddaughter, I have witnessed the devastation that brain cancers can exact on patients and their loved ones. Despite advances in detection, neurosurgery and radiotherapy, the mortality for brain cancers has barely changed since 2000, whereas the most common cancers have seen substantial decreases over the same period. Demographics are working against us. Epidemiological modelling indicates that a quarter of the growth in brain cancer cases can be attributed to population ageing, a pattern that is expected to continue in the coming decades. Research published last year found that in England the median survival for patients with a glioblastoma was seven months. It rose to 16 months for patients with the most aggressive treatments. The reason those patients survived longer is because they had access to personalised treatments, experimental drugs or trial pathways, and much of that begins with tissue freezing. Two people can be diagnosed with glioblastoma, but their underlying genetics can be completely different. Frozen tissue enables a pathologist to undertake gold standard genomic sequencing, which not only leads to a more precise diagnosis, but helps doctors predict how a tumour is likely to behave, identify more personalised treatment strategies based on the genetic mutations driving the tumour, and determine whether the patient would be able to benefit from clinical trials that are available. Unfortunately, as we have heard, access to genomic sequencing is characterised by stark geographic inequality. High volume specialist centres, typically in urban areas, are more likely to have established tissue freezing and integrated genomic diagnosis than centres serving more rural communities. A report by the Tessa Jowell Centre of Excellence found a nearly 300% increase in whole genome sequencing activity since 2021, and around three in 10 NHS centres within its network were still not requesting it. Among centres that do freeze tissue, the activity rates vary from zero samples to several hundred, and diagnostic times are worsening. The median time from tissue collection to final integrated molecular diagnosis in 2024 was 21 days, whereas the benchmark is 14 and only 30% met that. What does the Minister intend to do to improve that speed? Tissue freezing is a basic requirement for advanced testing, but every year thousands of patients’ tissue samples are soaked in formaldehyde and embedded in wax blocks. Although formalin-fixed paraffin-embedded tissue preservation has been used in pathology labs since the early 20th century, it is not adequate for molecular work because it causes the cross-linking and fragmentation of nucleic acids and protein, meaning that any DNA or RNA that is extracted is degraded and often unsuitable for genomic sequencing and creating those important personalised cancer therapies. The British Neuro-Oncology Society has described FFPE as “suboptimal”. It results in patients being locked out of cutting-edge treatments, regardless of clinical suitability, with knock-on effects on patient outcomes and the pace of scientific research. Will the Minister explain why FFPE, rather than tissue freezing, is still determining access to personalised brain cancer treatment for some NHS patients? The Government’s 10-year health plan anticipates that by 2035 half of all healthcare interactions will be informed by genomics. That is a bold mission, but the contributions to today’s debate show that there is a gap between where Ministers want to be and where we are at the moment. In response to a written parliamentary question, the Government acknowledged: “Information on the number of NHS trusts in England that have facilities for fresh freezing brain cancer tissue samples is not currently collected.” That is a serious problem, because without the data it is difficult for Members and cancer charities to ascertain whether progress is being made, and for the Minister to make progress on delivery. Will the Minister confirm whether her Department has plans to start collecting that information? If it does not, why not? Patients should always be fully informed before they have treatment, and it has been disturbing to hear today that some have not been given all the information, particularly about what will happen to the tissue afterwards and the potential consequences of that. What are the Government doing to improve the consent process in such cases to ensure that, before the biopsy, patients are fully informed about what is happening to their tissue and are given the choice? We have heard that sometimes only a small percentage of the tissue is frozen, limiting the treatment options available. Will the Minister tell us why that is the case, and what she is doing to improve the proportion that is frozen? Every trust taking brain cancer samples must have the capacity and facilities to freeze the tissue they obtain. We are all waiting for the delayed cancer plan, which we expect to be published on World Cancer Day. I have said before that I think delaying it for presentational purposes is wrong, but I hope it will be published soon. Will the Minister confirm that the cancer plan will deliver fully informed consent, provide the necessary capability—both human resource and equipment—for freezing, and ensure that the research landscape improves, in terms of both ease of access and financial metrics, to encourage UK research investment? Everyone in this House wants treatments to improve and a cure to be found. I know the Minister is hugely committed to this issue and is working hard on it. I am interested to hear her response and to see the cancer plan, which she has been working on, as soon as possible.

• 6 Jan 2026 · Less Survivable Cancers · Hansard source

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  It is a pleasure to serve under your chairmanship, Mr Efford. I congratulate the hon. Member for Wokingham (Clive Jones) on securing this important debate. It is sadly the case that one in two of us will get cancer in our lifetime. We all know someone who is battling cancer, someone who has beaten it and, sadly, someone whose life has been cut short by it. Cancer survival rates have consistently improved, but they are still far from where we would like them to be. When we talk about less survivable cancers, we refer particularly to six types of cancer with low survival rates: pancreatic, liver, brain, oesophageal, stomach and lung cancers. Over 90,000 people in the UK are diagnosed with one of the less survivable cancers every year—20% of cancer cases—but those cancers are responsible for 42% of cancer deaths in the UK. I pay tribute to hon. Members who have shared their personal stories in this debate, because behind each statistic is an individual. As I prepared for this debate, I thought of my granda, who died of brain cancer; my Nana Burton, who died of lung cancer; and of my husband’s good friend and confidante, Richard, who died of oesophageal cancer. A key reason for the troublingly disproportionate mortality rate for less survivable cancers is their later-than-average diagnosis. Just 28% of less survivable cancers are diagnosed at stages 1 or 2, which is well below the 54% rate for cancers as a whole. That cuts survival rates significantly. Pancreatic cancer is particularly lethal, with less than 7% of people with pancreatic cancer in the UK surviving beyond five years. I am pleased that the last Conservative Government launched the targeted lung health check programme in June 2022. It led to more than 5,500 people being diagnosed with lung cancer by January 2025, with 75% of cases found at stages 1 or 2 through screening. That is encouraging progress, but clearly there is much more work to be done to improve the diagnosis rates for all six less survivable cancers. I have personally been supportive of the current Government’s Tobacco and Vapes Bill, which will ban the sale of tobacco to young people born after 1 January 2009. That will tackle one of the key risk factors for lung cancer. Will the Minister update us on the Bill’s progress, given that it was introduced on 5 November 2024 and has still not passed through Parliament? Prevention is said to be a big focus for the Government, so what is the Minister doing to improve prevention and to get the Bill passed? The APPG on less survivable cancers launched an inquiry into earlier detection and faster diagnosis in March 2025 and found that doubling early diagnosis could save an additional 7,500 lives a year. What is the Minister doing to implement the inquiry’s recommendations, which were published last June? In particular, what is she doing to explore the benefits of technology in commissioning new detection tests? What assessment has she made of the new VAPOR breath test for pancreatic cancer, which could support GPs in diagnosing less survivable cancers from unclear symptoms? I am hopeful that many of the answers to these questions, and others posed by hon. Members, will be found in the forthcoming national cancer plan. The Government have delayed that plan, along with several others, until 2026. We are now in 2026, so can the Minister confirm when the plan will be published? Rumours were swirling that it had been delayed for presentational purposes until World Cancer Day in February, but there are now further rumours that it may be delayed until early March. Can the Minister give us a date? It is encouraging to see that NHS staff carried out over 3 million cancer checks in 2024, double the number carried out a decade prior. However, as with much of the war against cancer, this is another case of positive progress with more work needing to be done. Much of that work is dependent on the workforce. The last Government built five new medical schools, including one in Lincolnshire, which are now producing their first medical graduates. However, British graduates need British jobs, and heavy competition from a surging number of international medical graduates is leaving many British graduates without a job. What action is the Minister taking to improve the recruitment of British graduates from British medical schools? Can she confirm when the further delayed 10-year NHS workforce plan will be published? Can she also assure us that that workforce plan, in combination with the long-anticipated cancer plan, will make provision to increase the number of oncologists, radiologists and specialist cancer nurses across the NHS? As other Members have said, research is absolutely critical if we are to beat cancer, particularly the less survivable cancers, where new technologies for testing and treatment could save lives. Yet the cutting-edge, world-leading research that Britain has to offer does not feel as though it has the Government’s backing. Merck has scrapped its plans for a £1 billion research centre in King’s Cross and has announced plans to make 125 scientists redundant. AstraZeneca has halted a £200 million expansion of its research site in Cambridge and abandoned a £450 million vaccine manufacturing investment in Liverpool. Eli Lilly and Sanofi have both expressed frustration at the undervaluation of innovative medicines in the UK. When I raised life sciences in a previous debate on cancer, the Minister for Secondary Care, the hon. Member for Bristol South (Karin Smyth) said that the Government “want to make this country the best place to do life sciences.” —[ Official Report, 23 October 2025; Vol. 773, c. 464WH.] What support is the Minister providing to businesses in the life sciences and pharmaceutical industries to make that political slogan a reality? What work is she doing with her colleagues in the Departments for Science, Innovation and Technology and for Business and Trade to revive lost life sciences investment and to use British research, which has the world-class facilities needed to innovate and save lives? As my hon. Friend the Member for Berwickshire, Roxburgh and Selkirk (John Lamont) said, it is important that we work together as a United Kingdom. What work is the Minister doing with our counterparts in Scotland in particular? As my hon. Friend the Member for Keighley and Ilkley (Robbie Moore) said, there is a growing crisis in the hospice sector. Hospice care, provided for those with terminal illnesses such as some cancers, improves symptom control, comfort and support—it adds life to days. What is the Minister doing to press the Chancellor to recognise that her tax and national insurance changes are creating a crisis in the hospice sector, and what is she doing to save hospices from closure in many cases? In summary, I am concerned that, 18 months in, the absence of definitive Government action for the cancer community has left us without a cancer plan or a workforce plan, while critical research continues to be driven out of this country. I encourage the Minister to provide clarity for cancer sufferers, cancer charities and the cancer workforce, who are doing such sterling work to improve people’s lives, and to get on with innovating lifesaving treatments to improve the tragic survival rates for the less survivable cancers.

• 6 Jan 2026 · Energy Bills Reduction · Hansard source

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  Socialists do have a habit of taking money from people and then asking them to be grateful for getting some of it back, so could the Secretary of State tell us how much the £150 reduction in fees will actually cost taxpayers?

• 17 Dec 2025 · Puberty Suppressants Trial · Hansard source

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  (Urgent Question): To ask the Secretary of State for Health and Social Care if he will make a statement on the pathways puberty blockers trial.

• 17 Dec 2025 · Puberty Suppressants Trial · Hansard source

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  I must first declare my interest as a consultant paediatrician who has looked after children with gender dysphoria in the past and is likely to do so in the future. We must remember that we are talking about vulnerable children. The first and most obvious question is: why? Why have this Government chosen to fund experiments with puberty blockers on physically healthy children? Despite saying he was comfortable with this trial in a briefing to MPs, the Secretary of State told the media on Friday and the Select Committee this morning that he is in fact uncomfortable with it. Why is it even being considered before the data linkage study is complete? Some 9,000 children went through the Tavistock clinic, and many of them came out regretting being encouraged to irreversibly damage their bodies. We should look carefully at those outcomes before we make the same mistakes. What steps is the Secretary of State taking to secure the data from the Tavistock and have it analysed? What steps is he taking to hold to account those obstructing access to data linkage information? What assessment has he made of the motivations of those obstructing that data, when this is a study to safeguard children? And what of the trial itself? We know that 226 children will go through this trial. Is that a limit or a target? Those children will be randomised to get puberty blockers now or in a year’s time, and all will be analysed at two years. They will still be children. They might be only 11 years old. How can the results demonstrate a meaningful outcome? The control group is not properly randomised, but chosen from the Horizon intensive trial group. Is the Secretary of State concerned that this will introduce bias? The criteria for getting puberty blockers in this trial require just one parent to consent and the clinician to think that it will benefit the child, but on what basis will the clinician decide? The Cass review said that the vast majority of children with gender dysphoria would recover, with only a few persisting with trans identities into adulthood. It is not possible to predict which those children will be, so does the Secretary of State accept that the vast majority of children in this, his Streeting trial, who will be given drugs will be physically healthy children whose distress would get better without any puberty blockers, and that the vast majority of the children in this trial are therefore being unnecessarily experimented on with risky medications under his leadership?

• 16 Dec 2025 · Transgender People: Provision of Healthcare · Hansard source

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  It is a pleasure to serve under your chairmanship, Mr Turner. I congratulate the hon. Member for North Warwickshire and Bedworth (Rachel Taylor) on securing this important debate. I declare an interest: I am an NHS consultant paediatrician and I have cared for those with gender dysphoria in the past, and am likely to do so in the future. As we discuss a fairly heated topic, we need to remember that there are people experiencing significant challenges, and they deserve the very best healthcare based on need and the best evidence. One challenge is that name and sex records are sometimes different from how people are referred to in a ward. The previous Conservative Government launched the Sullivan review, which found that a failure of NHS bodies to record biological sex meant that some people were not invited to sex-specific screening. It recommended that we should not combine questions on sex and gender, and that putting politics before patients threatens clinical care. When will the Government formally respond to the Sullivan report? When does the Minister expect to implement its important recommendations? How will the Government ensure that intimate care is provided by someone of the same biological sex where possible? I would also like to raise the issue of phalloplasty, which is a major surgery on healthy bodies, creating a penis. According to the NHS website, it causes urinary incontinence, loss of sexual function, and in 3% of cases, necrosis and loss of the penis. Is the Minister confident that the NHS is doing the right thing with this surgery? I want to move on to talk about children with trans identity. We have been talking about the puberty blockers trial. Why is that trial occurring? Drugs are, unusually, being given to children with physically healthy bodies. Despite telling Members of this House that he was comfortable with the trial, the Secretary of State said on Friday to the media that he was “uncomfortable”. Why is it being considered before the completion of the data linkage study recommended in the Cass report? Some 9,000 children went through the Tavistock gender identity and development services. Many regretted irreversible damage to their bodies. Why have the Government chosen to experiment on a new batch of children before the data linkage study recommended by the Cass report is complete? What steps is the Minister taking to secure that data? What steps is she taking to hold to account the people who are obstructing the data linkage study? What assessment has she made of the motivation of those obstructing a study that, at its heart, is designed to protect children? What of the trial itself? Some 226 children will receive puberty blockers—is that a limit? Will there be no more by law? They will be randomised into treatment now or treatment after 12 months, and analysed after just two years. When someone receives the drug for only a year, they will still be a child. What meaningful results can be obtained over that period? The true control group of those not receiving the drugs is not randomised, but chosen or matched from a different trial—the Horizon Intensive trial. Is the Minister concerned that that may introduce a bias? The criteria for getting puberty blockers under the trial require that one parent consents, not necessarily both—one might disagree—and the clinician must think it will benefit the child, but on what specific criteria will the clinician make that decision? Is the Minister concerned to ensure that ideology does not affect judgment? The Cass review said that the majority of children with gender dysphoria will recover from their distress without any medication, and that it is not currently possible to predict which children they would be. Does the Minister accept that the vast majority of children in this, the Streeting trial, are physically healthy children whose distress would get better without puberty blockers, and that this Labour Government are choosing to give potentially dangerous drugs to children, most of whom will not need them?

• 4 Dec 2025 · Acquired Brain Injury Action Plan · Hansard source

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  It is a pleasure to serve under your chairmanship, Dame Siobhain. I congratulate my right hon. Friend the Member for South Holland and The Deepings (Sir John Hayes) on securing a debate on a subject that I know is important to him, to many of our constituents and to the whole House. The brain is so important. It is responsible for moving and thinking, homeostasis, consciousness, our senses and how we interpret the world—essentially, it makes us the people that we are. Acquired brain injuries are therefore an important issue. As other hon. Members have said, acquired brain injuries are the leading cause of death and disability in those aged between one and 40. Every 90 seconds, someone somewhere in this country—over 330,000 people per year—is admitted to hospital with acquired brain injury. They can have difficulties with walking, with talking, with moving, with thinking skills, with tiredness and fatigue, and with changes in personality. People can have one large brain injury with devastating effects, but they can also have multiple, small, almost unnoticed brain injuries, the cumulative effect of which can be quite severe, and the long-term effects of which can lead to dementia. The previous Government began work on an acquired brain injury plan and made a public call for evidence in 2022. Unfortunately, that work was interrupted somewhat by the general election. It has been picked up by the current Government, who say they will publish such a plan; it is nearly the end of the year, and I hope they are not going to break that promise, and add to the list of the many other plans that they have delayed. Will the Minister tell us when the plan is going to be published? When it is published, will it include the evidence given in response to the 2022 public call for evidence by so many stakeholders, charities and other relevant organisations? What should that plan contain? I will look at it from the perspective of this Government, who are looking for the three shifts in healthcare. First, they want to move toward prevention. It seems sensible to prevent brain injury in the first place, if we can, and we know some things that we can do. When I was a teenager, horse-riding and skiing were usually done without helmets; that would be very unusual now. We have not been so successful with cycling: people know that wearing a helmet is wise, to prevent brain injury, but if we looked outside into Parliament Square, we would see lots of cyclists, many of whom are not wearing a helmet that could protect them from brain injury. What are the Government doing to make people more aware of ways that they can protect themselves from brain injury? Concussion management guidance for those taking part in elite, amateur and school sport is important, as others have said today. Stroke is a form of acquired brain injury and I spoke to representatives of the Stroke Association earlier this term. They talked about two things that can help to prevent or limit brain injury from stroke: first, blood pressure checks and identifying previously undiagnosed hypertension, and secondly, mechanical thrombectomy, which limits the injury that occurs. The previous Government rolled out blood pressure checks to thousands of pharmacies across the country. Will the Minister update us on what further steps have been taken to identify undiagnosed hypertension since she came into office? The previous Government also began to roll out mechanical thrombectomy. I understand that this Government intend to ensure that a universal service for that technique is available by Easter next year. Essentially, mechanical thrombectomy is when an interventional neuroradiologist takes a wire into the vessels, floats it up into the brain and mechanically removes a clot. It is particularly helpful for people who have had a large stroke where the damage is not yet complete in the brain. Damage can be limited significantly by the use of that very clever procedure. Earlier this week, I was kindly invited to visit the mechanical thrombectomy service in Romford and see the work done there. I was told about the delay that can occur due to inter-hospital transfer. The Minister, in response to written parliamentary questions, has talked about what constitutes a universal service: it is being able to access a service within four hours. One limit to that ability, as I understand it, is that when someone who has had a stroke attends a hospital that does not offer a mechanical thrombectomy service, the time it takes to transfer them to a hospital that does, after acceptance for the process, affects people’s ability to have that lifesaving in some cases, and certainly disability-saving, treatment. When I was a junior doctor, I was lucky enough to care for people taking part in the total body hypothermia for neonatal encephalopathy trial—the TOBY trial. Essentially, we took babies who had suffered a brain injury around the time of birth and cooled their whole body to reduce the brain injury that they suffered. That was very effective, and became standard practice. What is the Minister doing to help people who want to do research into other ways of reducing brain injury? How is she helping with research, and what is she doing to sponsor it? What work is the Minister doing with the social care teams at the Department for Education? One of the sad things that I have seen during my time as a consultant paediatrician is children with inflicted injury—particularly babies. In many cases their injuries should have been preventable because those families were known to social care before the injury occurred. What is being done to protect those extremely vulnerable children? There are other causes of acquired brain injury too. Could the Minister talk about what she thinks the most important causes are and what she and the Government are doing to reduce their incidence? The other shift that the Government want is from hospital into the community. I was lucky to meet Headway Lincolnshire this week, which told me that there were only 12 in-patient beds available for acute brain injury rehab across Lincolnshire. That is not sufficient. When the charity provides counselling services, it has to do so online from outside the county because there is no one available in the county to provide them. What is the Minister doing to ensure that there is good neuro-rehab across the country, including in rural areas? Also, what is the Minister doing to make sure that rehab is long term? Neuro-recovery takes a long time. It is not just a case of a couple of appointments on leaving hospital; it needs to be over a more sustained period. For people suffering complex injury, there are many professionals involved. Some people will have a physio, an occupational therapist, a speech and language therapist, nurses, doctors, carers and many others. NICE’s new neuro-rehab guidelines, published in October, talk about how it is difficult for patients to negotiate that, and they recommend a single point of contact. Does the Minister plan to ensure that that NICE recommendation is delivered? If so, how and when? I would like to pay particular tribute to a young lady I met recently who is one of my constituents. She experienced a traumatic brain injury as a child, but with her determination, great family and community support and rehab, she has made a good recovery and is training as a nurse so that she can help others who suffer as she has. She is an incredibly impressive young woman. She highlighted to me the need for better rehab and school support. I urge the Minister to ensure that they are delivered. The final shift that the Minister has talked about is from analogue to digital. Digital offers us huge capacity in rehabilitation from acquired brain injury. I talked to a gentleman who had had a stroke and was admitted to a rehab unit where he got involved in Wii Fit—a Nintendo game from some time ago. He was using it along with another person who was recovering from a stroke at the same time, and they became very competitive at these balance and movement games. That really helped them to recover. What is being done to make rehab more fun or competitive? Some of the exercises that people are asked to do can be quite difficult. How can we make them more enjoyable? There are apps available to improve communication, memory and fine motor skills, and virtual reality can help with cognitive rehab. How is the Minister ensuring that those are available to all who would benefit from them? In summary, we need a detailed plan looking at prevention, acute treatment and rehabilitation. I hope it will not be delayed in the same way as all the other Government plans seem to be. I also hope that it will contain a delivery chapter that sets out not just what the Government want to do, but how they want to do it and when they want to do it by. Will the Minister confirm whether the relevant workforce will be included in the plan, or whether we will have to wait for the long-delayed workforce plan? Neuro-rehabilitation is really difficult, but many people show huge courage and determination in their work to rehabilitate. We need to support them in every way that we can.

• 27 Nov 2025 · Government Transparency and Accountability · Hansard source

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  I understand what the Minister is trying to say with his whataboutery, and his “Somebody else might have done it first,” but the point is that his Government are in government, and they are not delivering on their promises. The ministerial code already requires Ministers to be open and transparent, and to answer the questions, and they are not doing that. A tightened-up ministerial code will not be worth the paper it is written, given that the current one is not being adhered to.

• 27 Nov 2025 · Government Transparency and Accountability · Hansard source

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  Take the Department that has received the most questions this parliamentary Session, the Department of Health and Social Care. It has received 15,000 questions since 4 July 2024, which is 29 questions per day. It has five Ministers and a whole army of civil servants to answer those questions.

• 27 Nov 2025 · Government Transparency and Accountability · Hansard source

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  Does the Minister understand that £130,000 for a part-time job is a damn sight more than most of my constituents—in fact, almost all of my constituents—are getting, and that if the Prime Minister has appointed somebody or signed off on someone’s appointment, having received money from the person he is appointing, the public will want to know how much that person and their businesses may have given him?

• 27 Nov 2025 · Government Transparency and Accountability · Hansard source

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  Will the Minister give way?

• 27 Nov 2025 · Government Transparency and Accountability · Hansard source

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  Because you are not listening.

• 27 Nov 2025 · Government Transparency and Accountability · Hansard source

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  I hope I speak for everyone in the House when I say that it is a special privilege to be elected to represent our constituents. The British people put their trust in each and every one of us to be their voice in this place. Our nation prides itself on a strong democracy, and the role of His Majesty’s loyal Opposition is critical to that. I remind hon. Members on the Government Benches that the relationship between Opposition and Government is symbiotic: the Opposition are here not merely to be a critic, but to subject a Government to scrutiny, which is a vital safeguard of public trust. Amplifying the voices of the British people, asking the questions that they want to see answered and offering an alternative vision for the United Kingdom are essential roles of an Opposition in a democracy. Government opaqueness is not conducive to such accountability. The Prime Minister seems to agree. He said he would deliver “a different way of working. One of openness, of collaboration and transparency in everything we do”. However, Ministers have shown a complete disregard for Parliament, the ministerial code and the Nolan principles by refusing to submit themselves to scrutiny and by withholding information from Parliament without good reason. There are a number of levers put in our hands to help with scrutiny: written questions, oral questions, urgent questions and debates on the Floor of the House, including Adjournment debates such as this one. One further lever that Members can use to hold the Government to account and ensure transparency is writing letters directly to Ministers. Now, Madam Deputy Speaker, I know that the Chancellor has had a busy week, but when I and my right hon. Friends wrote to her over 12 months ago, after last year’s Budget, to express our concerns about the rise in national insurance and how it would affect the Lincolnshire and Nottinghamshire air ambulance, we did so out of a deep concern for what the policy would mean for those charities, which deliver crucial, lifesaving care and that support our NHS every day. Despite my office chasing that correspondence, and despite our raising it in the House repeatedly and raising it with members of the Procedure Committee, we have had no reply in over 12 months. I raised the matter as a point of order earlier this week, and it has now been acknowledged that the Chancellor has the letter and excuses for the lack of response have been made, but we have still not received a reply. But, after the Budget yesterday, I guess the answer to whether the Government will help air ambulances is no. Madam Deputy Speaker, you might be thinking that this is one isolated error, but unfortunately that is not the case. A constituent of mine who has 15 years’ experience as a church warden in a village contacted me to outline the huge difference that a scheme would have on efforts to fund urgent repairs, and how removing it would harm this vital community asset. I sent my constituent’s correspondence to the Chancellor and asked for her comments on the concerns expressed. On 21 January I was informed that my correspondence had been transferred to the Department for Culture, Media and Sport, yet despite chasing I received no response whatsoever. It is 323 days since I wrote to the Chancellor and 310 days since it was passed to the Culture Secretary—no response. On 23 September 2024 I wrote to the then Secretary of State for Science, Innovation and Technology regarding my constituent’s concerns about broadband speed in his village. On 4 December 2024—relatively quickly for this Government—I received a response, but my constituent saw potential errors in the response, so I wrote back to the Minister on 23 April 2025 to request that he look into these important matters. Again, despite chasing, I received no response until 20 November 2025, 211 days after that April letter, to confirm that the Department “aim to respond within 20 working days”. You could not make it up. It does not stop there. I wrote to the Department for Business and Trade on 6 June about the UK bioethanol industry and received no response. I sent letters to the Department for Work and Pensions in July and August about my constituent’s dissatisfactory experience with and concerns about the Child Maintenance Service and received no response. I wrote to the Minister for Water and Flooding, the hon. Member for Kingston upon Hull West and Haltemprice (Emma Hardy), on half of a parish council in my constituency that wished to invite the Minister to a meeting on 22 October. Now, I understand the pressures on a Minister’s diary, but I do not understand how we have reached 27 November and the Minister has not yet been courteous enough to respond. These instances are not anomalies; taking an inordinate amount of time to respond to Members has become the Government norm. Most disappointing, however, is the fact that the responses received, despite taking so long, are too often completely unrelated to the matters raised and questions asked. On 11 June I wrote to the Secretary of State for Health and Social Care about the statutory scheme for rebate pricing for drug manufacturers to highlight serious concerns raised with me about potential impacts on a local business. I asked for clarity on three matters in three perfectly clear questions, and 156 days later I received a response from a Parliamentary Under-Secretary of State, although none of the questions I asked were answered or addressed in any proper way. Not only did I wait 156 days to receive a response; I waited 156 days to receive a response that did not answer my questions. These examples clearly demonstrate that the service this Government and Ministers are providing to MPs, and therefore to our constituents, is simply not good enough. Correspondence is not being lost in the system; it is wilfully neglected. When responses do arrive, they should be accurate. When I asked the Secretary of State for Health and Social Care at oral questions why he had not delivered on his commitment to deliver the RSV vaccine to the over-80s this winter, he told me, “We have”, when, in fact, the Government had not, with the actual expansion not happening for winter 2025. I then raised a point of order, followed by a named day question, to which a Minister responded by redefining “delivered” to mean accepting the advice of the Joint Committee on Vaccination and Immunisation—stretching credulity—all while admitting: “The RSV programme could not be expanded ahead of this winter.” This linguistic gymnastics is Kafkaesque. What other options are available to us? I understand the pressures that Departments face, but there are many Ministers to answer these questions, not to mention an army of civil servants. I again refer to the ministerial code, which clearly states: “Ministers should, where possible, provide full and timely responses to written parliamentary questions, ministerial correspondence and select committee reports.” With that in mind, earlier this month I ended up submitting 16 written parliamentary questions to the Secretary of State for Health and Social Care just to ask when he planned to respond to 16 of my named day questions, which should have been answered in three sitting days but were all overdue—in some cases by up to two weeks. In what can only be described as a farcical situation, I submitted a written question asking when the Secretary of State for Health and Social Care planned to respond to a written question, which itself asked when the Secretary of State planned to respond to another written question, which was then finally responded to. It is with regret that I must inform hon. Members that I have 11 further written parliamentary questions that remain unanswered and overdue. The oldest was due for an answer by 14 October, which I have still not received. I lament that the Nolan principles of openness and accountability have sunk to such depths under this Government that I am required to submit so many follow-up questions, but it was not always like this. Some 92% of ordinary written questions and 88% of named day questions were replied to on time in the 2023-24 Session under the Conservatives. Another lever open to us is the urgent question, yet that is just another question to which the Government do not respond with answers. The most recent and most glaring example of the Government failing to uphold their obligations to be transparent and accountable to Parliament and the public is the appointment of David Kogan as chair of the Independent Football Regulator. As the ministerial code makes clear, Ministers are responsible for ensuring that no conflict arises between their public duties and private interests. As the Commissioner for Public Appointments has made clear, the Culture Secretary breached the appointments code by not declaring her conflict of interest before signing off on Kogan as the Government’s preferred candidate, having received undeclared donations from Kogan for her leadership campaign in 2020. Despite that, the Prime Minister still felt it was appropriate to also sign off on Kogan’s appointment and to clear the Culture Secretary of any wrongdoing. It is clear that the Prime Minister was in no position to do so, having also received donations from Kogan for his leadership campaign—the very same conflict of interest as the Culture Secretary—and supposedly having recused himself from any involvement in the appointment process. When somebody is given a part-time job for £130,000 a year, and that person is giving money to the person appointing him, it is clearly in the public interest to know how much money that person has given the person appointing him—the Prime Minister or other Ministers. Despite there being an urgent question in the House on this, the Prime Minister has still not declared how much money Mr Kogan or his businesses gave. The Prime Minister says that rule makers cannot be rule breakers, so why are Ministers refusing to confirm that no current Minister has a criminal conviction? Surely the public have a right to know. How can we get around the Government’s obfuscation? It is shameful that in order to get answers to our questions, we must resort to submitting numerous freedom of information requests to public bodies to get the details on the issues we are concerned about because written questions have not been answered. I will give an example. After the strategic defence review in 2025, I submitted a written parliamentary question to the Secretary of State for Defence to ask which industry bodies, defence industry companies, media organisations and other non-government bodies or people were given access to the review ahead of its publication, and at what times. Because they did not answer the question, I submitted an FOI request. I did not receive a timely response to that. I therefore had to go back to where I started and submitted a written question on 1 September, asking when the Department planned to respond to the FOI request. I finally received a grossly belated response on 16 September—yet it was dated 9 September—from the Secretary of State. That reply was incomplete and I have had to submit another FOI request to get the rest of the information. Is this not the kind of wasteful and inefficient use of time in Government Departments and the civil service that our constituents want rooting out? Why should Members need to submit an FOI request to get an answer to their written question and then submit a written question about that very FOI request in order to get the answer that the Department clearly had all along? I am sure that Ministers are very busy, so how is that a good use of their time, or indeed Members’ time? How does it reassure Members that the principles declared as important within the ministerial code are being taken seriously? It clearly does not. Ministers have developed a habit of announcing policy to the media instead of to this House in order to avoid scrutiny. I appreciate, Madam Deputy Speaker, your many attempts, and those of Mr Speaker and other Deputy Speakers, to stop this. I asked a named day question on 11 November about the maternity and neonatal taskforce, which the Secretary of State promised an update on in June. I asked who is on the taskforce and how many times it has met. I have still not received an answer, but fortunately I read the answer in the New Statesman on the weekend, because the relevant Minister in the Lords made an announcement at a public event with the answer, which is that the taskforce has not met but will do in January, and that the people on it have not been decided yet. Why are the Government announcing the answers to questions in public and to the media but not in the House? We all have a duty in this House to answer questions and address the issues that face our constituents. These are not isolated examples; these are my experiences as one MP among 650 in this House, and I know that this is happening to many colleagues. I can only image the scale of evasion of accountability across the House. On the steps of Downing Street, the Prime Minister promised to “restore service and respect to politics”. Yet when Ministers are not firefighting reports of tax avoidance or criminal convictions, they are tap dancing around parliamentary questions and feeding policy announcements out to favoured journalists, instead of announcing them to this House and the public first. Let me be clear: accountability is not a courtesy, and it is not optional. When Members ask questions and submit letters, we are doing so on behalf of our constituents. Ministers may regard swerving, stonewalling and spin as shrewd tactics, but they are not. It is an affront to this House and to the British people we represent. It is high time that this Government lived up to their own lofty rhetoric and started giving us answers. The public deserve a lot better.

• 27 Nov 2025 · Government Transparency and Accountability · Hansard source

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  Will he answer that point?

• 25 Nov 2025 · NHS Waiting Lists · Hansard source

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  The Secretary of State does not seem entirely sure, so perhaps he can write to us with an answer—

• 25 Nov 2025 · NHS Waiting Lists · Hansard source

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  As someone who is on the waiting list myself, I do hope that the Secretary of State is correct. Waiting lists for procedures and operations requiring day care or overnight admission are both rising and higher than they were a year ago. Orthopaedic surgery waiting lists are up, yet this Government scrapped our major conditions strategy and say that they have no plans for a musculoskeletal conditions framework. Gynaecology surgery waiting lists are up, yet the Government scrapped and are now reviewing the women’s health strategy. Waits for procedures and operations in ophthalmology, general surgery, neurology and gastroenterology are going up too. When is the Secretary of State going to get a grip of the surgical waiting lists?

• 25 Nov 2025 · NHS Waiting Lists · Hansard source

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  I would first like to say I am sorry that the Minister for Public Health and Prevention is unwell and convey to her the best wishes of the Opposition. I would like the Secretary of State to consider a patient who has waited a year for a procedure and then, after three waiting list validation calls, finally sees the consultant to check that the procedure is still necessary. If the consultant agrees that it is, do the Government figures show that patient as waiting for a year or a much shorter period?

• 24 Nov 2025 · Ministerial Code · Hansard source

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  The Minister says that the Prime Minister is committed to transparency, so how much did Mr Kogan give to the Prime Minister’s leadership campaign?

• 24 Nov 2025 · Point of Order · Hansard source

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  Over a year.

• 24 Nov 2025 · Point of Order · Hansard source

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  On a point of order, Madam Deputy Speaker. It is now over one year since myself, the Father of the House, my right hon. Friend the Member for Gainsborough (Sir Edward Leigh), as well as my right hon. Friends the Members for Newark (Robert Jenrick), for Louth and Horncastle (Victoria Atkins) and for South Holland and The Deepings (Sir John Hayes), my hon. Friends the Members for Grantham and Bourne (Gareth Davies) and for Rutland and Stamford (Alicia Kearns), and the hon. Member for Boston and Skegness (Richard Tice), wrote to the Chancellor to express our concerns about the rise in national insurance affecting the Lincolnshire and Nottinghamshire air ambulance. Shamefully, despite the matter being chased repeatedly by my office, by our raising it in the House repeatedly and by raising it with members of the Procedure Committee, we have still had no reply. The Government have shown huge disrespect for this House and for people right across Lincolnshire and Nottinghamshire. With the Budget on Wednesday, what can we do to get this sorted out?

• 17 Nov 2025 · Parkinson’s Disease · Hansard source

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  As I am a rural MP myself, the hon. Gentleman will not be surprised to hear that I agree with him. The problem is with wider specialisms, too. According to the 2022 audit by Parkinson’s UK, just 40% of people with Parkinson’s had access to a speech and language therapist, 45% had access to an occupational therapist and 62% had access to a physiotherapist. I want to particularly highlight that to the Minister because there are no treatments that slow down the progression of Parkinson’s disease, but evidence published last year suggests that exercise might do, so physiotherapy—making sure that people are doing the right exercises to help them—is important. What plans does the Minister have to recruit, train and retain the NHS Parkinson’s health workforce? For the benefit of charities, hospitals and patients, will she shed any light on how her delayed long-term workforce plan, when it is published, might assist in that mission? As was highlighted by my hon. Friend the Member for Chester South and Eddisbury (Aphra Brandreth), Parkinson’s disease patients can live for many years, often with huge positivity. I was inspired to read of Neil Russell, a 65-year-old gentleman who ran from London to Barcelona—almost 1,000 miles—to raise money for Parkinson’s disease research. One in three of those living with Parkinson’s is of working age. It is crucial that they can get support, because many work as doctors, nurses, chief executives, scientists, journalists and in other professions. I was inspired by a meeting that I was privileged to have with Dr Acheson last week. He is not only working as an A&E consultant, after being diagnosed with Parkinson’s almost 10 years ago, but is leading work on a time-critical medicines project. We have already heard that medicines for Parkinson’s are time critical. If people with Parkinson’s do not get their medication within 30 minutes of the prescribed time, it can lead to them being unable to walk, talk or swallow. Research by Parkinson’s UK has found that 58% of people with Parkinson’s—a clear majority—do not get their medication on time every time when in hospital. That will not only cost hospitals £65.8 million in excess bed days and readmissions, but cost over 150 people their lives this year. That is inexcusable. Just half of NHS trusts provide staff with training for time-critical medication, and one in four trusts in England does not have policies allowing people with Parkinson’s to take their own medication in hospital. That leaves patients capable but unable to take their medication, and they suffer detriment as a result. I was pleased that last week—following repeated questions to the Minister, both in the Chamber and outside—that the Minister for Health Innovation and Safety, the hon. Member for Glasgow South West (Dr Ahmed), met me, Dr Simin Nikou from the RCEM, and Dr Acheson to talk about self-administration of medicines. I am pleased that the Minister was able to commit that the chief pharmaceutical officer will work with those individuals to ensure that there is a protocol for self-administered medicines in A&E for those who are capable of taking them, and to ensure that the protocols for time-critical medicines are enhanced. NHS England launched a three-year national quality improvement initiative on time-critical medications that is not yet complete. I worried that the Minister’s eagerness to merge NHS England and her own Department may cause such ongoing initiatives to be simply lost. I encourage the Minister to correct me if I am wrong but, from conversations with her ministerial colleague, I understand that NHS England’s three-year initiative on time-critical medicines will be completed. Research is important because, at the moment, treatment for Parkinson’s is symptom-relief treatment, not disease-modifying treatment. In fact, some of it is not symptom-relief; it is treatment to relieve side effects of the treatments that are providing symptom relief. Ramping up research is an important step towards finding better treatment, and hopefully chasing down a cure for Parkinson’s. Between 2019 and 2024, the last Conservative Government invested almost £80 million into research for Parkinson’s disease, on top of a £375 million investment over five years for research into neurodegenerative diseases. Will the Minister confirm whether that funding commitment will be renewed as part of her Government’s spending review? What assessment has the Minister made of companies pulling out of billions of pounds of life sciences investment in the UK? How does she think that will impact critical research into conditions such as Parkinson’s? Is she working with her colleagues in the Department for Science, Innovation and Technology to resolve matters for the health sector? Within the treatments that we have so far, Produodopa was approved in February 2024, and made available on the NHS, under the last Conservative Government, to around 900 people with Parkinson’s. As people with Parkinson’s often struggle with taking numerous tablets to manage fluctuating symptoms, delivering a continuous dose of medication 24 hours a day by a canula under the skin can be ideal to manage symptoms day and night. What assessment has the Minister made of the benefits of Produodopa so far? What steps is she taking to make sure that more people with Parkinson’s have access to that potentially life-changing treatment? More broadly, what is she doing to mitigate the supply issues for some Parkinson’s medications?

• 17 Nov 2025 · Parkinson’s Disease · Hansard source

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  The debate today is about the Parky charter. I am sure the Minister will answer that question in her speech—at least I hope she will. The Government established the Neuro Forum, which was designed to address the gaps in treatment and care for people affected by neurological conditions, including Parkinson’s disease, but its achievements so far are unclear. Progress in this space demands clear action, not just empty roundtables, so will the Minister confirm how many times the Neuro Forum has met in the year since it was established, what budget and resources have been allocated to it, and what its successes have been so far? The Government want to shift towards technology. New, affordable technology is available: focused ultrasound can help with tremor; at the most invasive, there are deep brain stimulators. There is also very simple technology. I recently met the former MP Steve Double, who gave me a device that shakes to put on my wrist for a few minutes. Apparently, people find that it helps with dyskinesia, rigidity, walking problems and speech difficulties. What assessment has the Minister made of the benefits of technology as a treatment pathway for people living with Parkinson’s in the UK? What is she doing to facilitate research so that, when someone has a good idea that may benefit patients, it is brought to the fore as quickly as possible? I note the Minister’s response to a written question asked by my hon. Friend the Member for Broxbourne (Lewis Cocking). Will she clarify whether NHS England’s neurology transformation programme will indeed be concluding at the end of this financial year? Will she reassure us that the conclusion of the programme, which includes Parkinson’s disease treatments, is not related to the Department’s abolition of NHS England? What will she replace it with? The linchpin of the e-petition is that it asks the Government to consider implementing the Parky charter, which encompasses faster diagnosis, better support, welfare support, access to multidisciplinary care and investment in research—all things that I and others call on the Minister to give answers to today. Given the Government’s decision to do away with the major conditions strategy, I am concerned that Parkinson’s disease will not get the research and workforce it requires. People can live with Parkinson’s for very many years. For the quality of life of the patients and their families, greater consistency is urgently required in the administration of time-critical medicines in hospitals. Parkinson’s is a condition that is time-critical by its neurodegenerative nature; the Minister’s actions must be equally urgent and time-critical.