Caroline Johnson MP: speeches 2026

Speeches

• 27 Jan 2026 · Medical Training (Prioritisation) Bill · Hansard source

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  I will speak to the amendments tabled by the Opposition. First, amendment 9 would require that from 2027, priority is given to British citizens on UK foundation programmes, and that they are prioritised for interviews and places on specialty training programmes. Clause 4 defines a UK medical graduate as a “a person who holds a primary United Kingdom qualification within the meaning of the Medical Act 1983 (see section 4(3) of that Act)”. However, it does not include “a person who spent all or a majority of their time training for that qualification outside the British Islands.” The Secretary of State has stated his intention to prioritise UK medical graduates, but he has failed to protect all British citizens in doing so. Our amendment would ensure that British citizens who study on an eligible medical course overseas were still prioritised in the Bill. There are many scenarios in which we may need to ensure that we protect British citizens. Consider, for example, a spouse, partner or child of a serving member of the UK armed forces who completes relevant training overseas while their relative is posted in Cyprus; a student at Queen Mary University of London who has completed the bachelor of medicine and bachelor of surgery course at its Malta campus but received a UK medical degree; a young British citizen who has studied in the US or France, owing to a family relocation; or, given that the largest bottleneck is not in training places but in getting a place in medical school at all in some cases, a British student who has gone to study overseas because of their fervent desire to become a doctor. Those are all entirely possible and plausible scenarios in which British citizens have completed their relevant training, and wish to bring their skills back and to relocate in their homeland for the rest of their career, but may not be covered by the Government’s prioritisation model. The Government’s prioritisation model is based on where the degree was taken, rather than also considering who did it. The Secretary of State must ensure that we do not overlook our own citizens if we are to fairly address the competitive landscape for training posts. The Opposition therefore urge the Government to accept amendment 9. Amendment 10 is a probing amendment to explore the effects of the Bill on military personnel. As a Member of Parliament representing an area with a large armed forces community, I know that medical trainees are an integral part of our serving community. The world is becoming an increasingly dangerous place, and junior trainees may be sent abroad earlier in their career than is currently the case. It is clearly wrong to penalise people who are doing brave work caring for our armed forces. They ought to be provided with optimal opportunities, and the Secretary of State has a duty to ensure that they are not overlooked. I would be grateful if the Minister covered that in her response. New clause 3 would require the Government to make an annual report to Parliament about the Bill’s impact on the number of international students at UK medical schools, and the financial impact on UK medical schools. We talked about the bottleneck, and the balance between UK and international students training at UK medical schools; clearly, becoming a UK graduate will now come with a significant premium. What impact will that have on British children getting to make their choices and become doctors if they want to? What incentives does it provide to universities to increase the number of international students, and what effect will that have overall on UK medical schools? New clause 2, tabled by my hon. Friend the Member for Runnymede and Weybridge (Dr Spencer), is about places for UK foundation and speciality training programmes, and the importance of allocation on merit, because we all want the very best doctors. When I became a doctor—believe it or not, it was 25 years ago this year, Madam Deputy Speaker—I applied for a job as a junior house officer, as it was called then. I applied for the jobs I wanted, I was interviewed by the consultants who would have been supervising my training, and then I was offered the jobs. The experience of students today is very different. They are allowed to put in a preference and say which deanery or foundation area they would like to work in, but that is all. After that, the application goes into a computer system, which gives them a single rank that is not based not on anything they have done at university, or on whether they got good results or worked hard, or anything like that. The computer system will do a first pass, and if the first choice is available, it will give the student their first choice. If it is not available because by the time its gets to that student those places have gone, the computer system will miss the student and go on to the next one. When it has completed its full pass of the list, it will start again, and when it comes to that student next time, it will give them the highest preference that is still available. Once the student has been allocated a foundation deanery, the process starts again within the locality, and I mean “locality” in the loosest possible sense. Take those applying for the Trent rotation; they could be posted in Lincoln, Boston, Nottingham, Derby or Burton. The doctor has no control over where they will go, and very little ability to express a preference. My hon. Friend the Member for Weald of Kent (Katie Lam) spoke about a student in her locality who had not been able to get a place, despite being at the top—third, I think—of their university class. It is clearly not fair to give people no opportunity to control their future. By the way, there is no right of appeal, so having been given their place, the choice for the student is: that place or no place. The hon. Member for Sunderland Central (Lewis Atkinson) spoke about ordinary children from the north-east. Having once been an ordinary child from the north-east, I agree that it is important that people have opportunity, but it is equality of opportunity, not equality of outcome, that matters. I worry that the system creates equality of outcome. We therefore support new clause 2, tabled by my hon. Friend the Member for Runnymede and Weybridge. Amendment 1 would require the Bill to take effect on the date of Royal Assent, as opposed to a date at the discretion of the Secretary of State for Health and Social Care. The Bill is deemed necessary emergency Government legislation to prioritise medical graduates in the United Kingdom for places on medical training programmes. When he announced the Bill in an attempt to avert industrial action by resident doctors in December, the Secretary of State told the House that he had been working intensively with his team to “to see how quickly we could introduce legislation” —[ Official Report , 10 December 2025; Vol. 777, c. 430.] However, the Bill does not commit to a date when these measures will be enacted. Instead, the power lies in the hands of the Secretary of State, giving him a clear bargaining chip for future negotiations. It is clear that the Government intend to pass this legislation urgently, as they have said. However, without a commencement date, there are clear concerns that the Bill is just a negotiating tactic to prevent industrial action by resident doctors, and can be scrapped at a later date. There remains the prospect of further industrial action, despite the legislation being introduced. The Secretary of State should not be asking Parliament to pass a Bill that he has no intention of enacting if the British Medical Association plays ball and holds off on strikes. Either the Secretary of State thinks that this is emergency legislation that we need to get on with and enact, or he does not. It is vital that the legislation is enacted straight away, because students are due to be given their training programme places now, and they need to decide where they are going to live. They cannot put their life on hold, and measures to prioritise UK doctors cannot be held off, until the Secretary of State has finished dangling a carrot in front of the British Medical Association. The Opposition are clear: while we are supportive of the principles of the Bill, it must be used for offers made this year. Amendment 8 would clarify that under clause 5, a UK foundation programme is a programme where the majority of training takes place inside the United Kingdom. A foundation programme is defined as “an acceptable programme for provisionally registered doctors” in section 10A of the Medical Act 1983. It is vital to clarify that a UK foundation programme is a programme where a majority of training takes place inside the United Kingdom. That is because the General Medical Council can approve foundation programmes overseas. If it is not explicit that a foundation programme needs to be in the United Kingdom, a loophole is created whereby a foundation programme could be approved overseas, creating a back way into the system and circumventing the measures that the Government have tried to put in place. I encourage the Minister to look at that carefully as the Bill progresses. In summary, we support the Bill, but we have concerns about some of the clauses, so we have tabled amendments that we hope the Government will look at carefully.

• 27 Jan 2026 · Medical Training (Prioritisation) Bill · Hansard source

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  I am pleased to respond on behalf of the Opposition, but first I should declare my interest as a consultant paediatrician and member of the British Medical Association. Medicine is a vocation, but it is also an art and a science, and training takes a long time. After, in general, five years as a medical student, new resident doctors need to train further in a specialism such as orthopaedics, ophthalmology or, in my case, paediatrics. Postgraduate training varies in length and structure among the specialties, but in broad principle it is divided into a foundation programme and more specialist training. The foundation programme is two years long and teaches a variety of skills. Specialist training is more specific, and there are well over 60 different specialties that people can choose from. It is those two phrases—the foundation programme and specialist training—that the Bill refers to. We are in a situation where there has been a huge surge in the number of applications per training post. One reason for that is the substantial increase in the number of medical school places. That was caused by action by the previous Conservative Government to improve the number of doctors in the long term. The previous Government opened five medical schools—at Sunderland, Anglia Ruskin, Kent and Medway, Edge Hill and, very close to my constituency, Lincoln. The first students at those universities graduated in 2023, 2024 and 2025, which increased the number of students looking for posts. At the time there was also a widespread expansion of existing medical school places—and, of course, there was the pandemic. During the pandemic, students who had applied for medical school and accepted offers found themselves unable to take their exams, and teacher-assessed grades meant that there was a huge increase in the number of successful applicants who got the grades they needed. There were more compared with the number that was statistically expected. The Government lifted the cap, and there was a huge number of medical students in that period. Many of them qualified last summer. That is why there is a huge increase in the number of local graduates. In response to my hon. Friend the Member for Farnham and Bordon (Gregory Stafford), the Secretary of State talked about his pledge to double medical school places, but there does not appear to have been an increase in the number of medical school places this year, and a statement from the Department for Health and Social Care at the weekend suggests that it is not a Government commitment. When the Secretary of State was asked whether he stands by his pledge, he seemed to say no, so I would appreciate it if the Minister clarified that issue. In 2024 at a visit to the Royal Derby hospital, the Secretary of State said that that site would be part of delivering the doubling of the number of medical school places that Labour is committed to in order to ensure that the NHS has the staff it needs to treat patients on time. He then encouraged people to vote for that in the 4 July general election. Will he clarify whether he stands by his pledge, and if so, when does he expect to start delivering on it? UK factors are not the main cause for the rise in numbers. The BMA has published figures from freedom of information requests that show that the number of UK graduates applying for training programmes went up from 9,273 in 2023 to 12,305 in 2025, which is an increase of about a third. Over the same period, the number of international medical graduates applying for specialist training went from 10,402 in 2023 to 20,803 in 2025, which is a doubling of applications. The surge in numbers has left British graduates facing unemployment. Some may pursue careers overseas and not return. The valuable contributions from international medical graduates are appreciated, but many complete training and return to their home nation, which could leave us with a potential shortage in the long term of consultants and GPs. The Government are right to step in to prioritise local talent. As such, we support the principles behind the Bill. However, there are some issues that we have questions about. First, the foundation programme applications are in progress. An application window closed on 8 October, and pre-allocation outcomes were due in mid-December. Foundation school applications due on 26 February are also to be delayed. The foundation programme website states that allocations can only occur once the Bill receives Royal Assent. That delay in itself, and the uncertainty associated with it, is difficult enough for young doctors and their families. Yet the Secretary of State creates an extra layer of uncertainty by adding clause 8 and the right to withhold activation of the Bill to a day of his choosing. Why is he doing that? What are the foundation programme and the people who run it to do? Should they wait, based on, “Will he, won’t he?” and, “When will he allocate it, when will he not?” Should they allocate places anyway, on the basis, as has been said already, that people need to know where they will live and sort out their arrangements? Or will they have to reallocate if the Secretary of State activates it, after it was allocated on the basis that he had not done that yet? That is not the way to treat professional, hard-working people. As my hon. Friend the Member for Farnham and Bordon said in his speech, this is not just about doctors; it is about patient safety now and in the future. The Conservatives have submitted an amendment that would activate the Bill on Royal Assent. I urge the Secretary of State to do what is right for the country and for patient safety and support it. Secondly, Labour has forgotten the British people—those we represent and should prioritise. I will say more as we consider the specific amendment, but under Labour’s Bill, foreign nationals completing a primary medical degree in Iceland, Norway, Liechtenstein, Switzerland and the UK are in a priority group. Yet a British citizen who trained in the USA, Canada, France or even the Malta campus of a UK medical school are not. The hon. Member for Sunderland Central (Lewis Atkinson) talked about the likelihood of international medical graduates leaving the UK after training, but surely that is an argument to ensure that British trainees are prioritised wherever they have trained—if the degree is suitable. The Conservative amendment ensures that British people are always front and centre, and we urge the other Opposition parties to back it. The issue of British citizens was raised earlier too. I want to clarify for the avoidance of all doubt that when we say “British citizens” we mean those from England, Wales, Scotland and Northern Ireland. There are other clarifications, which I will be grateful if the Minister can address when winding up. On military doctors, what position is in place to ensure that military resident doctors are able to access the posts that they need? What impact will the Bill have on them, particularly if, as the world is more dangerous now, they spend more time overseas in future than at present? As Conservatives, we believe in meritocracy and, as such, I support new clause 2 tabled by my hon. Friend the Member for Runnymede and Weybridge (Dr Spencer). We all want excellent doctors and—I will say more about this in Committee—a random allocation does not encourage excellence. It produces stress and uncertainty, it does not encourage excellence, so I support the amendment. We agree with the principle of the Bill, but we encourage the Government to accept amendments that encourage excellence, to think through the detail, to put politics aside and do what is right for the country, to prioritise British citizens and to activate the Bill immediately on Royal Assent.

• 21 Jan 2026 · Draft Medical Devices (Fees Amendment) Regulations 2026 · Hansard source

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  It is a pleasure to serve under your chairmanship, Ms Jardine. I agree that post-market surveillance is important for patient safety, but predictability for businesses and reducing the burden on them is also important. On 12 May 2025, the Minister for Secondary Care, the hon. Member for Bristol South (Karin Smyth), said that the SI that we were discussing on that occasion—the Draft Medical Devices and Blood Safety and Quality (Fees Amendment) Regulations 2025—would increase the fees across the MHRA for devices from June. That included fees for various things, most of which were increased by between 9% and 16%, but some fees, such as for clinical investigation charges, were increased much more. She said at the time that this would “ensure cost recovery until 2027”. —[ Official Report, First Delegated Legislation Committee, 12 May 2025; c. 3.] It is now January 2026 and the Government are back for more money. Why is that? They increased the fees for regulation 53 of the Medical Devices Regulations 2002—a regulation that the regulations that we are debating today also affect—from £240 to £261 back in June, and they plan to increase them again. Let us consider why. In May, I raised some questions about the impact assessment produced for that legislation, for two reasons. First, it did not appear that the national insurance increase or the reduction in the national insurance threshold had been accounted for in the calculations. Secondly, the impact assessment assumed a 2.2% pay rise for civil servants for the years 2024-25 to 2026-27. Even then, that level was below inflation. Regarding staff costs, the Minister in that debate said she thought they were NHS staff, but she later wrote to me to confirm that the national insurance contribution hikes were payable by the MHRA because the staff were civil servants. In response to my written questions, the Minister declined to say whether national insurance was included, but assured the House that the MHRA had “modelled…future costs”, that the uplift would be enough until April 2027 and that the MHRA would find “efficiency savings” if required to manage any future shortfall. I asked the MHRA, by way of a freedom of information request, what increases it faced in national insurance costs as a result of reductions in the thresholds and increasing the rate. It said that it faced a yearly cost of £1.9 million. I also asked: “What estimate has the MHRA made of the additional cost arising from the difference between” the pay rise estimated in the impact assessment and the actual pay rise that was given. The answer was £1.2 million. That is a shortfall of £3.1 million, or 20% of the increase in fees from the last SI. The MHRA said at that time that “we believe that, while this extra cost” —national insurance— “was not included, our fees cost-recovery methodology and approved fees are still sufficient to cover projected costs over the next two years, without any negative impact on service delivery or financial sustainability.” That letter was dated 1 August 2025, which is after that PMS legislation came into effect. There was a significant difference between the calculations that the MHRA produced and the £3.1 million figure, which raises questions about their accuracy and the grip that the Government have on the detail and our public finances. The Government are now here again, wanting to increase the registration fee by an additional 15% to £300, but this time with no impact assessment. The regulations that we are discussing today not only increase the registration fee by 15% from April 2026, but add a maintenance fee of £300 for each device in a category listed, starting with “the fee period immediately following that in which the person paid the fee for the device registration…due on the first day of each…period”. That would seem to mean that if a device is registered between now and April, they pay £261 now and £300 on 1 April, which will presumably incentivise delaying any current registrations. I can see that the Minister has adjusted for this in future years, but he does not seem to have done so for those registering this year. I am interested in how sure the Minister is that his estimate for the increase in the post-market surveillance of £17 million is robust, given that we are back six months after the Government were sure they had enough. This year, the de minimis assessment says that £6 million will come from grant in aid from DHSC, £4.9 million from DHSC financial support and £6.1 million from the fee income. The current registration fees are predicted to produce £1.6 million, leaving a difference of £4.5 million to be covered by fee increases. The de minimis assessment’s best estimate says that the MHRA needs to make £4.3 million of that, which is £300 a year on each of the devices, in the way that the Minister described. However, it also says that “we plan to seek approval for full cost recovery fee for subsequent years”, which the Minister has confirmed is his plan today. Why is that not in today’s regulations? Is that because it would have required an impact assessment? How much will this cost businesses? This will be a further £10.9 million and, if £300 a year will get the Minister £6.1 million, then for £17 million he will need about £836. That is a massive increase on businesses coming down the track next year, which I do not think he has fully considered. Burdens on businesses are important because they stifle activity and innovation. This Government have already added significant burdens to businesses: higher taxes and national insurance rates, the reduction of the national insurance threshold, the Employment Rights Act 2025 and, for family-owned businesses, the business property relief. They are now adding further costs, and I am concerned about the effects on innovation and early access to devices for patients. What is the Minister’s assessment of international comparators? In recent times we have seen a loss of pharma investment in the UK. Will the extra fees this year, and the prospect of hikes next year, deter investment? There is no impact assessment, so how can we be sure? I am particularly concerned about small businesses and microbusinesses. The de minimis assessment says that it is not possible to exempt microbusinesses. Why is it not possible? It is a political choice not to exempt them, but it is certainly possible to produce regulations that do. As the Minister described, the consultation revealed widespread concern, with only 10% support. Changes have been made following discussion with a trusted advisory group. Who is in the trusted advisory group? Whose voices from micro and small businesses were heard in that group? There has been no further consultation and no impact assessment on the regulations the Minister has presented today. I also have some specific questions about obsolescence. Do businesses need to pay a registration maintenance fee for putting a product on the market to sell or lease? That was previously a single charge that lasted for the product’s lifespan, however long that would be. There is now an annual fee. What provision is made for the clinical use and post-market surveillance of items that cease to be registered because a company goes bust or stops selling the item? Can the item still be used? How would a clinician know that the lapse of a previous licence had stopped, particularly if it was a personal piece of medical equipment such as a stethoscope? How does that affect post-market surveillance? Could registration be discontinued for some items, where someone has several categories possible, in order to register another category and force obsolescence? For example, I have seen one case where the failure to produce spare parts lead to an entire trust having to replace every single defibrillator, at great expense. If a company went bankrupt and was no longer able to pay its post-market surveillance fee, the item would no longer be registered. How would that work? I also want to ask about categories. Originally, as described in the consultation, the GMDN category was level 5, which is extremely specific. It is now level 2, which is better, but microbusinesses still pay the same charges as larger businesses, so a business selling one product would pay the same as a business selling dozens of products in the same category. Also, there is no accounting for the size of the product or the surveillance required. For example, the charge for an MRI scanner, worth £2 million, would be the same for as a single-use scalpel worth less than £1. Is that fair? I appreciate that people may sell more scalpels than scanners, but what about an umbilical artery dilator, of which not too many are used, at £24 each? Producers of inexpensive but highly specific and useful devices may be disadvantaged. What will the effects be on costs for patients? Again, there is no impact assessment, so we do not know. How much of the cost produced by these regulations does the Minister expect to be transferred back to the Government in paying for more expensive devices? Overall, there are many more questions raised than answered by these regulations. Patient safety is paramount. There is, of course, a cost to ensure that devices are properly and proportionately regulated, but the Government also need to be responsible and careful with money. As they are, the regulations are a blunt tool adding costs to businesses and a promise of much more cost to come. There is no proper impact assessment, and there is a risk to small businesses and microbusinesses and to inexpensive, low-volume items. As such, I cannot support the regulations.

• 21 Jan 2026 · Draft Medical Devices (Fees Amendment) Regulations 2026 · Hansard source

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  If a device ceases to be registered, can a doctor still use it in the NHS—legally?

• 21 Jan 2026 · Draft Medical Devices (Fees Amendment) Regulations 2026 · Hansard source

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  Will this post-market surveillance continue if a device ceases to be registered?

• 21 Jan 2026 · Draft Medical Devices (Fees Amendment) Regulations 2026 · Hansard source

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  The Minister is making a great speech, but he is not answering lots of the questions—I appreciate that he may not have all the answers. Can he commit to answering them by letter? Will he also talk about the possibility of obsolescence? If an item ceases to be registered—he is encouraging people to deregister things that they are no longer selling—can it still be used in the NHS? How would a doctor know whether something had ever been registered in the past and was safe?

• 14 Jan 2026 · Ukraine · Hansard source

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  Four years ago, when Putin invaded Ukraine, people around this country opened their hearts and their homes to Ukrainian people, and I thank them for their generosity. I particularly thank those in my constituency who welcomed people to their homes, supported them, and continue to support them to this day. According to the latest council figures, there are just over 1,000 people from Ukraine in Lincolnshire, and I want to focus on them. Just last weekend in Sleaford, I met a group led by Kelly Breislin and Betty Berthebaud. I thank them for their work in trying to bring the Ukrainian community together, and in helping them to navigate the various different systems within the British state. I met women, predominantly, and children. I also met an accountant, a doctor and a dentist, and I met a masseuse who had set up her own business in my constituency. They were grateful first to the British state and to the former Prime Minister Boris Johnson for supporting them and their country, but they were also thankful to the people who had supported them as their hosts. The Ukrainians told me of their trips out of Ukraine and the fear that many of them felt. I met two young ladies, who were just 18 when they left, as friends together, to come across to live with a family in Ruskington. I thought of my own daughter at a similar age, and how it would be to let her go to an unknown country, to live with an unknown family, in such circumstances. They told me about the cultural and language challenges they had. One of them told me about her recent visit to Ukraine at Christmas and the five days of power outages she had there, as well as about the difficulties and fear she had going back for that short period. One lady explained about how her life was on hold. When the Ukrainians first came here, they were quite content just to be safe and to have no fear of bombs. However, as time has gone by, they think of the jobs and careers they had, the futures they want to have and the difficulties they have in progressing them. For example, one young lady talked about the training challenges. She cannot do an apprenticeship because her visa does not last long enough for that, and if she wants to do a university course or a training course, she will have a similar problem. Someone wanting to stay has to apply for a new visa, and they cannot apply until 28 days before they are due to leave, but that causes problems with employment, and they are all very keen to work. I want to ask the Minister specifically about Ukrainians in the medical profession, because it seems to me that we have a shortage of both dentists and doctors. For example, the cardiothoracic waiting list went up not just last month, but over the last year, and it is higher than it was when we left office. Yet there is a cardiothoracic surgeon in my constituency who is currently unable to practise, and is instead working in a factory. I appreciate that time is very short, so I am not able to go through all the examples I would like to give, but could he or the relevant Minister write to me with the various schemes available for people with such skills to be able to use them to the fullest while they are in this country?

• 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?