Caroline Johnson MP: speeches 2025

Speeches

• 17 Jun 2025 · Crime and Policing Bill · Hansard source

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  The hon. Lady is right to say that we have seen an increase in incidences of people taking abortion pills late. Previously it was very difficult, if not impossible, to obtain the pills—it was certainly impossible to obtain them through NHS clinics—but now it is possible, because people can use a telemedicine clinic. They say that they are seven weeks pregnant and ask for pills, and we have seen examples where people have asked for the pills much further on in their pregnancy—into the 30 weeks—obtained the medicine and made themselves very unwell in doing so. Turning to coercion, when a doctor sees a patient, they take at face value everything the patient tells them. When a lady uses telemedicine to have an abortion, it is not possible for a doctor or clinician to know whether somebody else is in the room with them, or sat the other side of the camera forcing them to say what they are saying. It is not possible for the doctor to know whether the lady is pregnant or not or whether the person asking for the medicine will be the person who takes it. That is very unsafe.

• 17 Jun 2025 · Crime and Policing Bill · Hansard source

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  Every jurisdiction has a democratic right to do as it chooses and I respect that, but it is a tragedy when we hear of cases where late-term abortions have not been supported by medical care or the law, and women and infants have suffered significant harm as a result. I want to raise the case of Stuart Worby. Some people say that this issue is about protecting vulnerable women, but in this case, which was prosecuted in December 2024, a man who did not want his partner to be pregnant, when she did want to be pregnant, decided to take matters into his own hands. He asked a woman who was not pregnant to get the pills for him. He put them in a drink and gave them to his partner, inducing a miscarriage. He has rightly been put in jail for that, but the case demonstrates that there are men out there who will obtain tablets with the help of a woman. That could not have happened if women had to have an in-person appointment, because the woman arriving at the clinic to get the abortion pills on the man’s behalf would be clearly seen not to be pregnant, so would not be able to obtain the medication. My amendment seeks to protect women—women who are wrong about their gestation or who are mistaken in thinking they have had a bleed or whatever—to make sure that they have a safe termination using the right mechanisms.

• 17 Jun 2025 · Crime and Policing Bill · Hansard source

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  I thank the hon. Lady for that intervention. I think we need to consider both. I remember a case involving a lady, Carla Foster, in June 2023. From my reading of the case, she admitted to lying about where she was in her gestation, saying that she was further back in pregnancy, at seven weeks, when she was actually much further along; she turned out to be around 33 weeks pregnant when her baby—her little girl, whom she called Lily—was born. In the papers I have read about the case, she described being traumatised by the face of that baby, which could have been prevented if she had been to a proper clinic and seen a health professional, as that health professional would have clearly seen that she was not seven weeks pregnant, and that taking abortion pills intended for early pregnancy was not a suitable or safe medical intervention. If one has a termination later in pregnancy, it is done by foeticide. Essentially, an injection of potassium chloride is administered to kill the baby, and then the baby is born in the usual way, but deceased. That is why it is important to know what the gestation is—because the termination offered under the law is done by a different route, to make sure that it is done safely. We know that the later in pregnancy a termination happens, the more a woman is at risk of medical complications.

• 17 Jun 2025 · Crime and Policing Bill · Hansard source

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  I rise to speak in support of new clause 106, which stands in my name, but first I will speak briefly to new clause 1, which we have been discussing so far. The hon. Member for Gower (Tonia Antoniazzi) spoke about some pretty harrowing cases, and said how the first lady was utterly traumatised by having had her abortion at home, which she received via telemedicine. My new clause seeks to make women safer by ensuring that they are seen and given the opportunity for proper medical consultation before they get to the stage where they are given inappropriate medication because of a misunderstanding, and then end up traumatised, delivering a relatively mature foetus unexpectedly at home. The hon. Lady did not say during her speech whether she believes that a baby should be terminated right up to term, but I want to put on the record that I do not. I work as an NHS consultant paediatrician, and I have cared for and personally held babies in my hands from 21 weeks and six days’ gestation right through to term. I am very aware that babies from, say, 30 weeks upwards have a more than 98% chance of survival, so although I am supportive of women’s right to choose early in pregnancy, I am not supportive of similar rights in relation to healthy babies right up to term. Until the pandemic, women had to attend abortion clinics, where they would see a professional and talk through their desire for an abortion and the reasons for it. At the clinic, it would be checked that the woman was pregnant and how far pregnant she was. The hon. Lady raised cases of women who believed they were so far pregnant, but who turned out to be much further pregnant, which are well known; sometimes it goes the other way. One of the key reasons for this confusion is that women often bleed in early pregnancy, and they may believe that those bleeding episodes represent a period; when a woman thinks that she is 10 weeks pregnant, therefore, she may actually be 14 weeks pregnant. That consideration is important in the context of accessing an abortion because at-home abortions via telemedicine are allowed only up until 10 weeks. The reason for that is not to be difficult or awkward, or to make it more difficult for women to access abortions; instead, it is a safety issue, because we know that complications are greater later in pregnancy. What happens in the early stages is that the procedure essentially causes the foetus to be born. If that happens to a baby much later in pregnancy, the procedure will cause it to be born when it has a chance of survival, which can lead to a traumatic experience for the mother as they deliver a much larger foetus than expected. It can lead to bleeding and, in one case I am aware of, has led to the death of a mother who was given pills to take at home when she was much further along in her pregnant than she had expected.

• 17 Jun 2025 · Crime and Policing Bill · Hansard source

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  Will the hon. Lady give way?

• 17 Jun 2025 · Crime and Policing Bill · Hansard source

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  The hon. Lady is correct that if a woman got the tablets at a clinic, she could give them to somebody else, but in order to get them in the first place she would need to be 10 weeks pregnant, and the clinician would check that she was pregnant. When the medication appears not to have worked, questions would perhaps be asked about where the tablets had gone, so I think there is an inherent safety feature there. The hon. Lady brings up the issue of bus routes. That is important, but the question is whether we should improve the bus routes or make medical services less safe. Most clinical services are accessed by individuals attending hospitals or clinics, and in some respects this instance is no different, because it is important that proper medical checks are done. I am not trying to limit people’s access to what is clinically legally available. I am trying to make sure that people are safe when they do so. I want to turn to women who have been trafficked or are being forced into sex work. We talked yesterday in the House about young girls who had been groomed and raped in the grooming gangs scandal. Would we put it past those evil, nasty men to have got drugs and given them to these young girls to hide the evidence of their crimes? I would not. What about those who want to preserve the honour of their family by preventing their daughter from being pregnant? What about those who think that the baby being carried by their partner is of the wrong gender—they would like a boy but are having a girl? What about those who are trying to cover up sexual abuse, particularly of teenagers and young girls, by causing a termination to hide the evidence of their crimes? What if a partner does not want a baby? Stuart Worby got caught, was prosecuted and is rightly in jail, but how many others have done that and not got caught? We simply will never know. No one knows who is taking these medications. If we have proper clinics, gestation can be checked, a clinician can ascertain more effectively if a woman is being coerced, and they can make the abortion medically as safe as possible. My amendment is not pro-life or pro-choice. It is pro-safety.

• 17 Jun 2025 · Points of Order · Hansard source

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  On a point of order, Mr Speaker. During proceedings of the House on 2 June 2025, it became clear that some media organisations had been given access to the strategic defence review document before Parliament. We also became aware that the timing of such early access may have been different for different organisations. I asked a parliamentary question on the matter of who and when, and although the Government did not answer the question, they made clear that trade associations and think-tanks had also been given early access. I asked again, and they refused to answer but made clear that trade unions and “our people” had been given early access. Mr Speaker, Ministers are required to answer questions using the Nolan principles, which include accountability and openness. The principles state: “Information should not be withheld from the public unless there are clear and lawful reasons for so doing.” The Government have not followed these processes in answering the question, and that is particularly relevant to the Minister for the Armed Forces, because in his declaration in the Register of Members’ Financial Interests, he declares membership of the GMB and Unite, and that a family member is working as a constituent for Babcock International, and that—

• 17 Jun 2025 · Health of the Elderly · Hansard source

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  Many of those on waiting lists are elderly and have chronic conditions; rather than seeing consultants at regular intervals, which may coincide with them being relatively well, they are often kept on open appointments so that they can call when they are ill. This is efficient and responsive care. Is the Minister aware that this provision is being stopped in some areas in order to improve figures? I will quote from a letter about an elderly patient: “I regret cannot keep him on my waiting list under the open appointment” for treatment, and, “I have explained the politics of everything and where we are at.” Being re-referred to a GP each time is expensive and a waste of time. Can the Minister explain why doctors are being asked to make decisions for political reasons, instead of clinical ones?

• 17 Jun 2025 · Health of the Elderly · Hansard source

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  Last health questions, I asked about delays to crucial medications in A&E and the Secretary of State said he was interested to hear more, but his office said he would delegate it to a Minister and we still have not been offered a date, so could I encourage him to look into that, please? The U-turn on winter fuel will help the elderly to stay warm and healthy this winter, but another way to help elderly people would be to protect them from the respiratory syncytial virus. Will the Government extend the vaccination to the over-80s?

• 13 Jun 2025 · Terminally Ill Adults (End of Life) Bill · Hansard source

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  I refer right hon. and hon. Members to my entry on the Register of Members’ Financial Interests—I am an NHS consultant paediatrician. The debate so far has focused primarily on ethical considerations, legal frameworks and who will be eligible—the who, the when and the why—but I want to focus my remarks on the how. As a doctor, I know that various drugs in different combinations can be fatal; in other words, there is more than one way to kill people. Which would be the best drug, if that is what we wished to do? Which would be the most comfortable, and how do we know? Some forms of assisted dying use neuromuscular blockades, which, in common parlance, means that they paralyse the body. Imagine a situation where someone in a lot of pain is given such a drug; from the outside they would look relaxed and peaceful as their muscles relaxed, but inside they would be in a lot of pain, and unable to express that to anybody else. Do we want people to be comfortable and to know that they are comfortable, or only to appear comfortable to us? Clearly, we want them to be comfortable inside as well. We therefore need to have drugs that are properly understood and regulated for this purpose. Assisted dying is often portrayed as safe, peaceful and controlled, but the reality in comparable countries where it has been legalised so far is more complicated. Technical difficulties frequently arise, leading to complications causing greater suffering, requiring intervention and potentially leading to a prolonged and painful death. A report in The BMJ by Dr Suzy Lishman, former president of the Royal College of Pathologists—who, I should say, works at the same trust as me—showed that there is a lack of reliable data on the effectiveness and safety of the drugs used, largely due to inconsistent reporting in jurisdictions where such dying is legal. In Belgium it is estimated that only 52% of euthanasia cases are reported to the Federal Commission for the Control and Evaluation of Euthanasia. During a Select Committee visit in the last Parliament to Oregon to discuss assisted dying, which I and two other hon. Members from the Labour Benches went on, we heard about the complications being unknown in 71% of cases. No healthcare professional was present when the drugs were given so we could not really know, and we did not even know if the drugs had been taken in some cases. Where we did, we found a history of seizures, vomiting and prolonged deaths. On having been given the drugs, patients in nine cases in Oregon in 2023 had reawakened later. How they felt in the intervening time is difficult for us to know. In Washington, a 2018 report found that 31% of patients took more than 90 minutes to die. I also remind hon. Members that an absence of evidence that things are not going well is not evidence of an absence of things going wrong.

• 13 Jun 2025 · Terminally Ill Adults (End of Life) Bill · Hansard source

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  I think one of the key problems with this form of intervention, compared with others, is that we cannot ask the patients afterwards how that felt. We cannot get their feedback, because they are dead. If we are going to give them things such as neuromuscular blockers or sedatives, we may not be able to tell what they feel. There are physiological ways in which we can monitor patients and get some idea—perhaps in their heart rate or blood pressure—but we will not be doing that. That is, therefore, one of the reasons for my tabling the amendments, to ensure that the drugs are properly regulated by the MHRA, so that we know that they have been properly tested on the purpose for which they are to be used.

• 13 Jun 2025 · Terminally Ill Adults (End of Life) Bill · Hansard source

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  I do not have much time and I do not want Madam Deputy Speaker’s cough to return. [ Laughter. ] If one examines the litany of drugs involved in other jurisdictions where assisted dying is legal, it makes for troubling reading. It is often an ad hoc cocktail of lethal substances, including sedatives, analgesics, cardiotoxic agents, neuromuscular blockers and antiemetics. There is no internationally agreed drug regime. Jurisdictions such as Oregon, Canada and the Netherlands use varying combinations of barbiturates, sedatives, opioids and antiemetics. In 2020, the official Oregon report stated that, compared with single barbiturates, “All drug combinations have shown longer median times until death”. As the Bill currently stands, doctors will have to consider prescribing untested drugs or drug combinations, which could potentially breach the General Medical Council prescribing guidance that a doctor must be satisfied that the drug serves the patient’s needs. To address some of those concerns, I have tabled several amendments. Amendments 96 and 97 ensure that no drug can be approved under the Act unless there is a scientific consensus that it is effective and does not cause undue pain or side effects, and that it has been specifically licensed for that purpose by the MHRA. I cannot really understand why anyone would disagree with that. Amendment 98 clarifies that the Secretary of State is not compelled to approve any drug if, after consultation, it is concluded that no substance is appropriate or safe enough to meet the standard. Amendment 99, alongside amendment 100, mandates that before any regulations are laid before Parliament, a comprehensive report must be provided. That report must include time to death, possible complications including pain, and any likely side effect of the proposed substances. Again, I cannot see why that would be controversial, because surely we all want everybody to be fully informed and make fully informed decisions, and that is part of making an informed decision. Amendment (b) to new clause 13 requires any medical devices for self-administration be approved by the MHRA and that the Secretary of State consult the MHRA before making any regulations. That is a basic safeguard that we would expect in any medical intervention, and it should be a non-negotiable condition here. Finally, amendment 42 removes a time limit and therefore the pressure on the Secretary of State. I understand other people’s concerns about that. There is often a narrative that it will lead to patients being able to die at a time and in a place of their choosing. However, the regulations in the Bill require the doctor to stay with the patient from the moment the drug is given until they are dead. We have heard that that could take quite a long time. Do we really have enough doctors to do this at people’s homes at a time of their choosing? At the moment, I do not think we do, and I do not see how, in a short period of time, that will be achievable either.

• 13 Jun 2025 · Terminally Ill Adults (End of Life) Bill · Hansard source

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  The advocates of the Bill talk about the point of choice and autonomy in the decision about when and where a person will die. Can the Minister confirm whether we have enough doctors to provide a service for people to die at home at the time of their choosing?

• 13 Jun 2025 · Flood Prevention: Sleaford and North Hykeham · Hansard source

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  When I went around looking at the different areas of flooding in my constituency, I got a consistent message: that the EA had not performed as well as the IDBs and that it was costing more money per activity. In her final few minutes, can the Minister touch on how the IDBs can do more of the work and engage more local people in doing it for themselves?

• 13 Jun 2025 · Flood Prevention: Sleaford and North Hykeham · Hansard source

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  Before I start my remarks, I will make a declaration of interest: my husband is a farmer, and we have a small stipend to pay to the internal drainage board in relation to flood risk. My constituents in Sleaford and North Hykeham enjoy some of the most beautiful countryside that the United Kingdom has to offer. Our hard-working farmers reap the benefits of some of the best agricultural land in the country for their crops. Unfortunately, living in this area brings some environmental risks. Many Lincolnshire MPs centuries ago held the office of commissioner of sewers in the county. The job sounds unglamorous but was very important, bringing with it responsibility for managing the county’s waterways and drainage and for protecting lives and livelihoods from the risk of flood damage. I am not suggesting that I take on that role myself, but that historical flood risk has only become more acute in recent years. Land usage has intensified, our climate has become more volatile and greater pressures have started to affect our natural resources. Our county has suffered from flooding caused by overwhelmed drainage systems and excessive river levels. The effects on people have magnified too. Some people whose homes were flooded lost not just possessions, but the ability to live in their home for a long period of time; some did not return home for more than a year. Last week, I had the pleasure of visiting Heighington Millfield primary academy as it formally reopened following significant flood damage last year. The closure had major effects on the children there, who had to be bused to different schools around the county within the trust, and significant measures had to be taken to restore the school. I put on record my thanks to everybody involved in that work. The community really pulled together for those children, and the Department for Education and the Department for Environment, Food and Rural Affairs worked very hard together to ensure not just that the school was repaired, but that flood measures were put in place to try to prevent those things happening again. The school now has flood doors in place so that it can prevent flooding coming in through the doors, and it is having work done over the summer in preparation for the autumn rain to protect the outside environment, which includes bunding around the playing fields and a special garden at the back of the school on higher ground, which will absorb some of the water if the rain overtops the back again. Unfortunately, at the same time that that great work has been going on, new councillors under the direction of Reform have chosen to abolish the county council committee dedicated to managing flood risk. I will have more to say about that later. In opening this debate, I want to make a simple point. My constituents deserve to live in safety and to go about their work and education without severe disruption from climate events. We need to ensure that we are doing everything we can to protect their lives and livelihoods, and that recommendations are being followed up and maintenance work is being done on time. We also need to make the most of local expertise and experience, and not undo the good work started under the previous Government towards fostering collaboration between agencies and local people. Many communities across my constituency have been affected by flooding in recent times, and they deserve to have their experiences shared. In North Scarle, for example, residents faced huge disruption in 2024 when heavy rainfall on to already wet ground caused flooding at Mill Dam dyke. The local authority report on the event found that poor maintenance of the local watercourses had contributed to the flooding, as did problems with the surface drainage system. As I saw when I visited North Scarle in December that year, co-operation among different agencies is key in tackling these kinds of events. Lincolnshire county council is responsible for cleaning gullies and maintaining drainage, while the Environment Agency has responsibility for ongoing maintenance at Mill Dam dyke. Meanwhile, local groups such as Flood Action North Scarle contribute valuable local knowledge and experience. The EA has upheld its end of the shared responsibilities set out in the flooding report, and has engaged the local community by providing maintenance updates. It spent around £71,000 on maintenance in 2023-24. However, since the spending review published this week revealed a 2.7% cut in the DEFRA budget over the review period, can the Minister assure my constituents that the EA will still have the money to continue maintaining these dykes going forward? And what will the Minister do to ensure transparency from councils? Updates from the EA are relatively easy to access, but Lincolnshire county council’s flooding project website simply lists its own actions following each flood report as “ongoing”. My residents need more clarity than that. In Sleaford, residents faced similar problems when Field beck was overtopped in October 2023 and drainage systems again became overwhelmed. I welcome the work that the EA has done here too, with the business case for a major capital scheme approved on 2 June. I am pleased about this investment, which is projected to avoid £188 million in economic damage, deliver £74 million in people-related benefits and protect 604 properties from repeat flood damage. In Leasingham, more work needs to be done. Residents suffered flooding twice in quick succession, including in the school, in October 2023 and January 2024, when agricultural ditches overtopped and Leasingham beck exceeded its capacity. The council’s flood report recommended that the EA and Lincolnshire county council work together to carry out channel condition assessments at Leasingham beck, with the results to be reported back to the Lincolnshire flood risk and water management partnership. However, the inspections have not yet happened. Worse still, even as reports into historical flooding are calling for closer collaboration, the Reform council is undoing the successful partnerships already established. The Lincolnshire flood and water management scrutiny committee did vital work in bringing together key agencies involved in flood management and prevention: the EA, internal drainage boards, Anglian Water, district councils and other key experts. Three weeks ago, Reform abolished the committee, folding it into the generalist environment committee, which does not have the same specialist remit to cover the most important and complex environmental issue facing the county. By rejecting the valuable contributions of IDBs, district councils and local experts, Reform councillors are saying that they know better than local people who have tended the land for generations. All the main parties have opposed the committee’s abolition and have seen it for what it is: politicking with people’s livelihoods. If the Government see these reckless actions being wrought on local communities in Sleaford and North Hykeham and elsewhere in Lincolnshire, what can they do to ensure that councils uphold their responsibilities to residents? Instead of cancelling initiatives, we should be creating new ones. I was encouraged by the excellent work done under the previous Government to advance the water maintenance pilot scheme, which was designed to foster collaboration between farmers and the National Farmers Union, local drainage boards and the EA. The scheme enabled greater co-ordination and common-sense flexibility in the management of waterways—for example, by training local landowners in how to manage watercourses, and then allowing them to carry out their own minor channel clearance and maintenance work for themselves. The scheme helped to avoid the ludicrous, heartbreaking situation in which local people can see a problem with a local watercourse, are aware it is going to flood their farm, land or their home, and have the equipment and the know-how to do something about it, but the law prevents them from doing so. It is illogical. Public sector co-operation agreements already exist to help streamline those schemes and place participants on a clear legal footing. One of the great local successes under that framework was the 2018 silt dredging of the South Forty-Foot drain, a farmland drainage channel dating from the 17th century, under a PSCA between the Black Sluice drainage board and the EA. Why have the lessons of those schemes not been applied more widely? Since the last election, the scheme in my own constituency has ground to a halt, and with it have gone the benefits that were already accruing. Will the Minister commit to supporting those schemes and encouraging their wider roll-out? As she looks to her budgets, it is worth recognising that it is much cheaper for the IDB to clear drains and ditches than for the EA to do so, since the EA’s procurement process is so cumbersome that it becomes significantly more expensive. One of the things that frustrates many local people in my constituency is that they could do the job and get it done much quicker. They are waiting, and places are flooding while it is not getting done. Another thing that the Minister could discuss with the Treasury is that the IDB has been prevented from using red diesel in its pumps. The IDB has told me that the problem is that the pumps are placed in isolated places, and believe it or not, people are stealing the diesel. It is white diesel—it is expensive, so it is worth something—and people are stealing it from the pump, which is putting everyone at risk. The IDB feels that if it were red diesel in those pumps, theft would be much less likely. Brant Broughton is an area in which a number of houses flooded. We have had a less promising update from the Environment Agency in that respect; it says that it was expecting to receive a model of the river system around the summer of 2025.

• 13 Jun 2025 · Flood Prevention: Sleaford and North Hykeham · Hansard source

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  The Minister is nodding—I do not know whether she has an update on what the Environment Agency means by “the summer”. We were expecting the health plan in the spring, and that has been and gone, so if she could help with that, that would be really great. There is some concern about the overall cost-benefit ratio, given the number of houses. I encourage the Minister to remember that although the people who live in rural areas may live in areas that are less densely populated, they have as much right to a safe environment as anybody who lives in a more densely populated part of the country. There are more examples of communities in my constituency that have suffered the impacts of flooding and are crying out for a joined-up and proactive approach that will protect them from repeat occurrences in the future. In Washingborough and Timberland, a familiar story happened in recent floods: heavy rain, overwhelmed drainage and excessive water runoff led to communities being left to suffer. While the EA has carried out some channel clearance and vegetation management, flood reports make clear that responsibility falls between central agencies, the county council, landowners, and stakeholders such as Anglian Water. Once again, it is vital that open communication is at the heart of the strategy, and that politically motivated meddling is not allowed to get in the way. I took the chair of the Environment Agency and the former Minister, my hon. Friend the Member for Keighley and Ilkley (Robbie Moore), to visit the Delph at Washingborough when it was full. It was very clear that the EA’s priority had been to protect the small creatures living in the dyke by not clearing the vegetation out, but of course, once the floods came, those small creatures were no more anyway. It would have been much better for the creatures, the environment, and the wider countryside and the people who live there if those dykes had been cleared properly in the first place. Trees were literally growing in that dyke when we went to see it. There are two final communities facing specific future threats that I would like to highlight. In Ruskington, residents endured flooding in 2023 and 2024 caused by the overflow of Ruskington beck. I understand that the Environment Agency has been conducting bimonthly maintenance and debris removal, and is investigating a capital programme for defences in Ruskington as part of the next five-year funding period. Any scheme will have to meet economic viability criteria and defined cost-benefit metrics, despite future house building plans that will see more land covered, more people in at-risk areas, and more demand on drainage systems. As of December 2024, under the Government’s new targets, the central Lincolnshire partnership—of which North Kesteven forms a part—faces a house building target of 1,552 houses per year over the course of this Parliament, an 47% increase on the previous target. Can the Minister assure me that the cost-benefit analyses deciding the fate of future flood defence schemes will take account of the Government’s rampant house building plans, and will account for all the ways in which flooding impacts a community such as Ruskington, from work hours lost to home damage, insurance claims, watercourse repairs and drainage clearance? Finally, Anwick suffered in the floods of 2023, when the River Slea and its tributaries experienced very high water levels. The EA and Anglian Water have been engaged in positive liaisons to manage risks at the River Slea, Farroway drain and Anwick catchwater, but residents in Anwick contacted me in September 2024 when a sewage processing plant flooded, causing discharge and polluting smells across the area. I met Anglian Water to discuss those constituents’ concerns, but their bigger concerns are now about a biogas digester that may be built immediately next door. In this case too, it is vital that lessons are learned and that we avoid repeating mistakes that will lead to more disruption for local people in the future. Addressing the risks requires the careful allocation of money. A glance at the most recent funding allocations under the flood and coastal erosion risk management grant in aid scheme shows that many dozens of projects appear in the bidding process but receive no funding. The allocation data for the Upper Witham internal drainage board in my constituency shows 15 intended projects listed for completion between 2023 and 2040, but none has any grant funding at all allocated this year. Lincolnshire county council, meanwhile, is due to receive £103,500 in grant funding over 2025-26 for year one of the property flood resilience project. Two smaller projects will receive a total of £52,500 from non-grant public contributions, but 19 other projects will receive no funding at all. The Government have made much of the £2.65 billion in funding for flood defences that was announced in February, but as I have said before, governing effectively is about making choices. Can the Government clarify for my constituents how the EA is expected to prioritise its funding among the many equally important projects that need support, especially in light of cuts to the DEFRA budget? How much money is spent on developing schemes that subsequently do not come to fruition? What is the estimated cost—in household damage, lost output and broader economic terms—of deciding not to act? As I mentioned earlier, the hard-working farmers in my constituency do so much for our local and national economy and for this country’s food security, and it is vital that we remember them. What will become of agricultural productivity in areas left with inadequate flood defences? What will happen to food security when some of our best-quality agricultural land is lost to frequent inundation, and how are farmers meant to prepare for this uncertainty–—in economic and practical terms—when they already face such a heady mix of threats to their livelihoods? Just as farmers have been left to face the family farm tax instituted by the Labour party and have suffered the sudden loss of the sustainable farming incentive, they will also face the threat of flooding, without the help and support they need, if this Government fail to act in the long-term interests of rural communities. We have reached the time for action on flood prevention and resilience. As I noted earlier, the way to manage the risks is with local knowledge, collaborative and long-term management strategies, and proper funding—essentially, with basic common sense. First, we must keep the valuable expertise of local people within the decision-making system. IDBs, local farmers and expert local committees know their land best, and we must give them the tools and authority to manage their own environments. Secondly, we must build on projects such as the water maintenance pilot to foster long-term planning and inter-agency working. We can do more: the creation of a Lincolnshire rivers authority, for example, would provide a structured platform for long-term flood planning that could be tailored to the needs of local people, rather than to the nationwide EA or DEFRA frameworks. Finally, we must ensure that vital projects receive the necessary funding, without being held up by central agencies’ cost-benefit frameworks. Local authorities should hold budgetary power as well as decision-making power to make sure that interventions are made where they are needed most, and in a timely and efficient way. With these measures, we can make sure that local people have control over their own local environment and give them the tools they need to prevent the devastating impacts of flooding, which have blighted some areas of Lincolnshire for too long.

• 12 Jun 2025 · Long-term Medical Conditions · Hansard source

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  There is a question that I have been wondering about. Baroness Casey is doing a report for the Government on social care, but she is also doing a report on child abuse. We were told initially that those reports would run consecutively, but they appear now to be running concurrently. I do not necessarily expect the Minister to be able to answer the question now, because she is standing in for somebody else, but it would be helpful if she could get us a written answer on what proportion of Baroness Casey’s time is currently devoted to the Home Office, and what proportion to healthcare.

• 12 Jun 2025 · Long-term Medical Conditions · Hansard source

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  It is a pleasure to serve under your chairmanship, Mr Efford. I congratulate the hon. Member for Bury St Edmunds and Stowmarket (Peter Prinsley) on securing this important debate. I declare an interest as an NHS consultant paediatrician. In my clinical work, I have seen at first hand the impact that chronic conditions can have not just on the health of individuals but on their families, their carers and their wider communities. These are conditions that can shape daily life in profound and enduring ways. In some respects, the increased prevalence of long-term conditions is a success story for the medical fraternity, because some conditions that previously would have led to a patient’s death can now be managed effectively for a longer period of time, and people can continue to live happy, healthy and fulfilling lives. There is no silver bullet for tackling such conditions, but effective interventions and systems can improve quality of life, enable independence —we have heard about the importance of that—and reduce avoidable healthcare costs. Such interventions require a co-ordinated, whole-system approach, bringing together local authorities, NHS trusts, public health, education, social care and the voluntary sector. I am glad that the Government are talking about a move away from reactive and acute-based care towards prevention, rehabilitation and supported self-management in the long term. I note that the hon. Member talked about care on Teesside some years ago. As someone who grew up on Teesside, I remember the Carter Bequest hospital—I do not know whether his father had anything to do with that—which was the local community hospital providing community care for many local residents. We increasingly see patients living with not just one long-term illness but multiple long-term illnesses, known as multi-morbidity. That provides challenges, because sometimes the medication that one would ideally provide a patient for condition A is complicated because they also have condition B, for which they are taking something else that would interact with that medication. A patient might also need an operation but not be able to have it because another condition makes the anaesthetic risk too high, so the management of the second condition might have to be suboptimal as a result of the first condition. Some people have more than two conditions. One of the challenges that people with long-term conditions will face is staffing and workforce. I notice that the Government have decided to cancel, or at least significantly reduce the availability of, level 7 apprenticeships, which train our specialist nurses in advanced clinical practice, our district nurses and our community nurses. Will the Minister talk to her colleagues in the Department for Education about how there can be a move towards community care and prevention if they are going to make it more difficult to train the people who would provide that care? The hon. Member for Eastbourne (Josh Babarinde) talked about the delay in follow-up appointments. I have seen that myself. One of the challenges is that when one is under pressure to meet the 18-week pathway and there is no similar pressure on follow-up appointment timings, the consultant’s clinic inevitably ends up with more new patients and fewer follow-ups. The follow-ups get pushed back, often for many months. How will the Minister’s team ensure that the pressure to meet the 18-week pathway does not cause chronic illness to be covered less well than it is now? I was also interested in what the hon. Member for Newport West and Islwyn (Ruth Jones) had to say about exercise and lifestyle. I see a lot of children with varying conditions in my clinics as a paediatrician, and I have been amazed by how fresh air and exercise, diet and hydration, sleep, and not spending hours on computers, particularly in the evening and through the night, can make a whole range of medical conditions better. We know that the same is true of adult care in some cases. While it is not the cure for all conditions—of course it is not—in some cases it can help people to live better with the conditions that they have. I am interested that in some cases people are allowed only a few physio appointments before they get referred back to their GP. Perhaps longer courses of physio treatment could help people a little more. Multimorbidity was recognised as a priority in the previous Government’s health and care White Paper in 2022. Community diagnostic centres opened in order to play a vital role in providing quicker access to essential tests, dealing with the backlog left by the covid pandemic. There are two centres near my constituency, in Grantham and Lincoln. I visited the one in Lincoln recently, which has had very good feedback from constituents and is providing a great service. Can the Minister confirm that community diagnostic centres will continue to be well funded following the spending review? The previous Government launched a major conditions strategy in 2023, aiming to address six key areas—cancer, heart disease, musculoskeletal disorders, mental ill health, dementia and respiratory disease—but the current Government have paused work on this strategy. They came to power saying that they had a plan. They stopped the plan that we had, because they wanted to think of their own, which is fair enough. But we are now three weeks out from the first anniversary of their election, and still this magic plan has not appeared. I say to the Minister that this is too long to wait for people who are unwell. Can she, at the very least, commit that the 10-year plan will be published before we have lost one year in which the Government could have started delivering it? Musculoskeletal conditions are particularly common long-term conditions, affecting around 20 million people in the UK—that is a third of women and about 30% of men. They are the second most common cause of economic inactivity after mental health, and take a considerable toll. I thank advocacy organisations such as Versus Arthritis for their tireless campaigning on this issue. They have highlighted how these conditions disproportionately affect women and those living in deprived communities. The recent cuts to the personal independence payments proposed by the Government have disproportionately affected people with MSK conditions. Have the Government conducted an impact assessment? My concern with the PIP changes is that they were announced to meet an economic target, rather than being properly thought through. Can the Minister confirm whether they have been properly thought through? Has an impact assessment been conducted, and if so, will she ensure that it is published so that we can all study it in some detail? Mental health should be treated as a core component of long-term care. People with long-term conditions are two to three times more likely to experience mental ill health. Research shows that people who are confident in managing their long-term conditions have not just fewer A&E visits and hospital admissions but better mental health. What concrete steps are the Government taking to improve mental health provisions specifically for those with long-term conditions? Rehabilitation can be just as important to health outcomes as medicine and surgery. As was mentioned earlier in the context of strokes, some people have very good stroke rehab care, but for others that is less of the case. Rehabilitation, particularly early rehabilitation, is very important. Providing timely rehab and self-management advice would significantly reduce the number of people diagnosed with health conditions in their 40s and 50s, for example, being pushed out of the workforce, which drives both income and health inequality. Is improved access to community rehabilitation for people with long-term conditions part of the Government’s plan to shift from hospital to community care, keeping people out of hospital and in work for longer? I know that the plan is not published yet, but perhaps the Minister knows. Long-term conditions will define the health and social care agenda of the next decade. That requires a joined-up strategy across healthcare, the Department of Work and Pensions, and social care, and for the Government to support the most vulnerable and maximise the quality of life for all our constituents who suffer from long-term conditions.

• 11 Jun 2025 · NHS Funding: South-west · Hansard source

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  I would need to look at that separately and come back to the hon. Member on it, although he should perhaps direct his question to the Minister, as she has control at the Department at the moment. The problem with cutting both the ICBs and NHS England is that it risks destabilising the very structures that are designed to deliver care simultaneously. The chief executive of NHS England has stated that legislation will be required to change the duties on ICBs. When do the Government intend to introduce the health Bill and, when they do so, can the Minister rule out the removal of the duty in the Health and Care Act 2022 requiring integrated care systems to commission dental services? In paragraph 5.12 of the spending review, the Government say that 92% of patients will start consultant-led treatment for non-urgent health conditions within 18 weeks, but The Times has reported that the figure is closer to 80%. Can the Minister please clarify where the 92% figure has come from, and if she is unable to do so today, will she write to me? Much of this debate has been about infrastructure. Since the last general election, Ministers have pledged to deliver the new hospitals programme in full, without caveats or conditions. However, in Torbay, for example, the rebuilding has been pushed back, with construction now expected to begin between 2033 and 2035. Thanks to the efforts of my hon. Friend the Member for South West Devon (Rebecca Smith), Ministers have given the greenlight to rebuilding Derriford hospital’s new accident and emergency facility. Can the Minister confirm if there are plans to bring any of the other projects forward? Let me turn to national insurance contributions. The Royal College of General Practitioners has described the national insurance increase as, “the straw that breaks the camel’s back, forcing them to make tough decisions on redundancies or even closing their practice”. The Government’s promise to recruit more GPs is welcome, but hiking national insurance puts that pledge in jeopardy, as GPs will have no choice but to cut staff numbers. This is a false economy, so will the Minister use any of the money allocated today to help those services, such as GPs, air ambulances, hospices, pharmacies and others, that are affected by the national insurance contribution rise? It will not have escaped Members’ notice that, despite the Chancellor promising that the NHS plan would arrive by spring, we are now at the start of summer—indeed, the Government promised that they had one before the election last year. Will the Minister provide some clarity on when we can expect this long-awaited plan?

• 11 Jun 2025 · NHS Funding: South-west · Hansard source

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  It is a pleasure to serve under your chairmanship, Dr Huq, and a privilege to contribute to this important debate. I congratulate the hon. Member for Torbay (Steve Darling) on securing the debate at such a timely point, following today’s spending review. The focus on NHS funding, particularly in underserved regions such as the south-west, is welcome, so that every area of the UK is properly equipped to meet the healthcare needs of all communities. I, too, represent a predominantly rural constituency, so I am keenly aware of the unique challenges in healthcare provision facing remote areas. Geography should not be a barrier to treatment, but for many in the south-west and beyond, it still is. We heard in the spending review today that the NHS will receive a substantial cash uplift. We must ensure this money is spent in the most effective way possible. We do not have the allocations yet, but can the Minister enlighten us on whether there will be an amount allocated particularly for rural healthcare. The spending review document talks about efficiencies of £9 billion to be achieved by the Department of Health and Social Care. Can the Minister elaborate on how those efficiencies will be achieved? Much has been said already about the financial pressures facing integrated care boards. The Government’s proposal to restructure NHS clusters in the south-west into larger conglomerates is presented as a move towards greater efficiency, but care must be taken that this does not come at the expense of local responsiveness or patient outcomes. NHS England is legally required to assess the performance of each ICB annually and publish its findings. However, the Government have decided at the same time to abolish NHS England—a decision they took without a proper impact assessment.

• 10 Jun 2025 · Nuclear Power: Investment · Hansard source

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  Happy birthday, Mr Speaker. Energy security is important, so I welcome this investment in nuclear. One more small modular reactor can power a million homes using just two football pitches-worth of land, while solar needs 2,000 acres of good-quality farmland to power 50,000 homes. Will the right hon. Gentleman consider the importance of food security as well as energy security, reconsider the use of good-quality farmland for solar, and concentrate instead on producing nuclear?

• 9 Jun 2025 · Planning and Infrastructure Bill · Hansard source

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  Does the hon. Lady agree that car parks and rooftops might be a good place for solar, but this country’s prime agricultural land is not?

• 9 Jun 2025 · Non-stun Slaughter of Animals · Hansard source

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  When doing research for this debate, I found that the RSPCA states that 65% of all halal meat is pre-stunned; the rest of it, presumably, is not. Can the hon. Gentleman explain the difference, and why some meat would be classified as halal when it has been stunned and some would not?

• 9 Jun 2025 · Non-stun Slaughter of Animals · Hansard source

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  The Conservative Government had a consultation on food labelling, which was completed last May. The current Government said they would respond, but they have now had more than a year to do so. Does my hon. Friend agree that they need to get on with it and ensure they respond as quickly as possible?

• 9 Jun 2025 · Non-stun Slaughter of Animals · Hansard source

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  The hon. Gentleman says that this is a long-standing practice for faith communities in the UK. I looked back, and there is UK legislation on this issue from the 1920s and 1930s that supports what he said. It looks like this Government have no intention of changing that. However, I have many constituents who would prefer not to eat animals that have not been stunned, because they are concerned about the pain that those animals may suffer. Would the hon. Gentleman support changes to legislation so that labels are placed on the food so that people know whether an animal has been stunned before slaughter and can make their own choices?