Danny Chambers MP: speeches

I thank the Foreign Secretary for his eloquent and moving statement giving his perspective as a British Jew in this awful situation. Settlers have been deliberately killing Palestinian men, women and children. They have also been killing and stealing their livestock and preventing them from grazing in pastoral areas. For pastoral communities, this is absolutely devastating, and it is simply another mechanism of forced displacement. Will the Foreign Secretary consider sanctioning the Israeli Ministers who are encouraging and endorsing such violence?

I spent the summer visiting all the villages in the rural areas outside Winchester, and the common theme that came up was speed limits, and the speed at which traffic goes through small villages; people sometimes go through at 60 mph. All these villages, including Littleton, Crawley, Hambledon and Droxford, want to be able to decide whether to have a 30 mile per hour speed limit in their village, yet Hampshire county council will not even consider that. Those villages that have self-funded traffic-curbing measures do not have permission to implement them. Will the Minister consider granting a debate on how, through the local government and devolution reforms, we can empower local communities to set the speed limit in their village?

Will the Minister give way?

It is an honour to serve under your chairship, Mrs Barker. I congratulate the hon. Member for Uxbridge and South Ruislip (Danny Beales) on securing this important debate. It seems that every time I open my social media feed or emails, I am being sold some supplement or superfood to boost my immunity. We know that the most effective way of boosting our immunity is vaccination. Vaccines can achieve something even more extraordinary: they can actually eradicate diseases from the face of the earth. During the 20th century alone, we lost hundreds of millions of people to smallpox until it was eradicated in 1977. Rinderpest, a cattle disease, was wiped off the face of the Earth by vaccination—the second disease to be removed from our planet. Polio is on the brink of eradication. I recently spoke at a Winchester rotary event about polio eradication, organised by two of my constituents, Gillian Russell and Professor Kordo Saeed, both of whom contracted polio when they were children and have lifelong disabilities as a result. It is important to remind everyone that this is about preventing not just deaths, but disability and ill health that can last a lifetime. We saw the power of vaccination during the covid-19 pandemic. A century earlier, during the 1918 influenza outbreak, which killed 50 million people, there were no flu vaccines or antiviral treatments. There were not even antibiotics to treat the secondary infections. During covid, we initially had only the same blunt tools—isolation and restriction on gatherings—to try to control the disease, but then the vaccine came out. It saved a huge number of lives and gave us a route out of lockdown. We got back to seeing our families, socialising, going back to work, running our businesses and just living our lives. But there is a danger that vaccines can become a victim of their own success. We have become so unfamiliar with some diseases that we have forgotten how serious they really are. That is why falling childhood vaccination rates should particularly concern us. When politicians like Donald Trump and parties such as Reform platform anti-vaxxers, parents rightly become worried. They all want to do the best for their children, but when dangerous, provocative and downright false information is platformed, the truth is pushed further and further away from those looking for answers. Centuries ago, hospitals were filled with iron lungs for children with polio, and graveyards were filled with children under five years old who died from entirely preventable diseases. Vaccines have saved more lives than any other medical intervention in history. They are the closest thing that we have to a safety blanket from disease, and we must not allow dangerous and divisive figures online or in politics to drive people away from science and evidence-led healthcare. Science produces solutions, answers and evidence, but politicians and politics can determine whether they are trusted.

It has been well pointed out that biodiversity is not just a nice thing to have. As sad as it is to see species go extinct and to live in a less rich natural world, biodiversity is vital to our food security. In particular, pollinators can affect crop failure, and it is well documented that the number of insects and pollinators has been declining in the UK and around the world over the last few years. In my limited time, I will highlight one reason for that, which I would like the Government to work with us on: the availability of pet flea and tick treatments over the counter in supermarkets. Some of those products, including fipronil and imidacloprid, are banned from agricultural use because they are considered to be too dangerous to the environment, yet they are available without a prescription or a check of the need for them. They are often used without any clinical need, so people regularly treat animals that do not need treatment with an inappropriate product. These products are being detected in waterways and chalk streams. They damage the entire ecosystem, especially insects and the salmon that live in chalk streams. I have pressed the Government on this matter before, and the Veterinary Medicines Directorate is looking at it. This debate is about biodiversity. Allowing people to purchase in a supermarket products that are banned from agricultural use seems completely irresponsible and needs to be stopped.

While we are in the middle of this outbreak, a lot of vets and farmers have made a couple of technical suggestions that could help us to deal with it. Obviously, we want to roll out the vaccinations as soon as possible and test as quickly as possible. First, under the specified animal pathogens order, bluetongue is classified in such a way that very few labs can continue testing at the moment. Not only is that slowing down the diagnosis of bluetongue, but we cannot test for other causes of abortion that farmers regularly need to test for. Secondly, for those practices and wholesalers that have managed to secure vaccines from abroad, a lot of their labels will be in Spanish, Polish or German. Should English-labelled product become available, can we ensure that they will not have to discard the previous perfectly good product, as that would be a huge financial loss?

There is a very passionate group of people in Winchester who have long campaigned for a lido to be built in the old leisure centre, and they are very excited that one of the proposals for the old leisure centre is a lido. Could the Minister explain what support is available for such facilities, which get people outside, exercising and being part of the community, which is good for physical and mental health?

A couple of weeks ago, I visited a business called Squeaky Clean in Winchester. What was striking about that business was the number of students, young people and sixth-formers it employs, giving them their first job, getting them a CV and teaching them what it is like to work—to turn up on time, to take responsibility—before they go on to university and do other things. The owner told me that the single biggest difficulty she faces in keeping that business going is the rise in national insurance. Does my hon. Friend agree that we should be looking at this as a matter of urgency, not just for those businesses but for young people’s opportunities?

We know that food security is part of national security, and it has been another tough year for agriculture, with a record wet winter and now a record hot summer. We also have bluetongue disease going through livestock—when I was at vet school, that was a disease of northern Africa and southern Europe—which has spread through Europe to the UK and now to Scotland because of climate change. Does the Foreign Secretary agree that it is hugely irresponsible and scientifically ignorant for the Leader of the Opposition to ban Conservative candidates who believe in taking serious action to tackle climate change from standing at the next general election?

We very much welcome the Government’s initiative to give children free bus travel throughout the summer—it is a great idea. The only problem is that in Winchester and its surrounding area, Hampshire county council keeps cutting funding for bus services. Will the Minister explain what the Department is doing to encourage councils and operators to increase rather than decrease bus services?

I thank the Minister for her comments. I beg to ask leave to withdraw the motion. Clause, by leave, withdrawn. New Clause 32 Review on deaths related to antimicrobial resistant infection “Within six months of the passage of this Act, the Secretary of State must conduct and publish a review into the number of yearly deaths in the UK which are related to antimicrobial resistant infection.”— (Dr Chambers.) This new clause would require the Secretary of State to conduct and publish a review into the number of yearly deaths in the UK which are related to antimicrobial resistant infection. Brought up, and read the First time .

I beg to move, That the clause be read a Second time. Twelve young people die every week from undiagnosed heart conditions. One of those was Clarissa Nicholls, who died just before her 21st birthday, while on a year abroad in France. Her mother and friends have campaigned tirelessly not only to provide electrocardiograms to young people, but to raise awareness about early detection of heart conditions. Finding a heart condition does not mean that exercise must stop or that life goes on hold; it just means that appropriate alterations can be made to keep a person safe, active and healthy. Such a scheme has been rolled out in Italy and has been hugely successful. The new clause would push the Government to look seriously at having ECGs for young people as an early identifier for potentially fatal conditions, so that we do not lose up to 12 young people a week due just to a lack of testing.

I thank the Minister for her comments. We understand that the Government take this matter very seriously, but we are working on estimated numbers of deaths for something that will eventually be killing more people than covid. We really need some tangible figures, so I will press the new clause to a Division. Question put, That the clause be read a Second time.

I beg to move, That the clause be read a Second time. The new clause would require the Secretary of State to conduct and publish a review into the yearly number of deaths in the UK related to antimicrobial-resistant infections. I declare an interest as the secretary of the all-party parliamentary group on antimicrobial resistance. AMR is a major threat to public health globally and domestically, and it is already contributing to an estimated 35,200 deaths every year in the UK. AMR is a bit like a silent pandemic. It gets little media attention, but given the prediction that 39 million people worldwide will have died of AMR by 2040, it will eventually be pushed right up the political agenda. This is not simply a matter of people dying from infections that could not be treated; nearly all the advances in modern medicine over the last 50, 60 or 70 years would be null and void. It would be too risky for someone to have something like a hip replacement, because of the risk of getting an infection that could kill them; they would be better off living with a painful arthritic hip than taking the risk of dying from sepsis. It is the same with things like heart disease, while giving birth will once again become one of the most dangerous things a woman can do if we lose the impact and effectiveness of antibiotics. The Government invested more than £560 million in AMR programmes between 2020 and 2024, so it is reasonable that Parliament should receive an annual assessment of AMR-related deaths to ensure that that significant public investment is delivering results, represents value for money and is targeted where it can have the greatest impact. We cannot effectively tackle what we do not measure, and an annual review of deaths linked to AMR would provide a clear, consistent picture of the scale of the problem and enable Parliament and the public to track whether policies are working. Better data leads to better targeted interventions. We know that rapid diagnostic tests and different types of decontamination will be hugely important in tackling AMR, along with potential future technologies such as phage technology. Surveillance has already identified significant variations by age, deprivation and geography. Understanding where deaths are occurring, and in who, would help direct resources to the communities and services that are most affected. AMR threatens the effectiveness of modern medicine, including surgery, cancer treatment and routine healthcare. An annual review of AMR-related deaths would ensure that this growing public health threat receives the attention and urgency it deserves. The reason I am determined to push it up the agenda is that the national cancer plan does not specifically mention AMR or infection, but it is the second biggest cause of death in cancer patients. At the moment, it is not pushed up the political agenda enough.

It is an honour to serve under your chairship, Sir Christopher. I pay tribute to the hon. Member for Gordon and Buchan (Harriet Cross) for securing this timely debate. I grew up on a sheep and beef farm, and when I was about 11 years old, I bought 13 pigs from market to take home. They became more like pets; I used to play football with them—

No, I used to play football matches with them. They were a lot of fun, and I learned that of all livestock, they are potentially the most intelligent and certainly some of the most affectionate animals. I had a particularly interesting visit to Sparsholt agricultural college in Winchester with the National Pig Association. I used to love going there when I was a vet to treat the animals; now I go there as an MP to look at its teaching and facilities. It has a fantastic indoor, high-welfare unit that delivers piglets without the use of farrowing crates, and I pay tribute to the staff there for their teaching and the welfare standards that they maintain. To touch on something that many Members have spoken about today, one of the top issues threatening the pig industry is biosecurity at the border. I have been to Dover and met the vets and border inspectors there who look at the potentially illegal meat coming in and the tonnes of it that get seized. The crazy thing is that currently, if I were caught smuggling meat into the UK, I could not be arrested and my vehicle could not be seized, but the meat would be confiscated and my vehicle would have to be cleaned, because it would be a biosecurity risk. The only deterrent to trying to smuggle illegal meat into the UK would be that I might get my van cleaned for free at the taxpayer’s expense. That is absolutely ridiculous. I totally understand that enforcing biosecurity at such a busy border is difficult and comes with huge challenges, there are not even suitable deterrents in place for people who get caught. I urge the Minister at the very least to look at implementing some. One thing that the pig industry has done phenomenally well is to reduce antibiotic use by 72% since 2015—just over 10 years. That is hugely important, not only for animal welfare, but for public health. Antimicrobial resistance is like a slow pandemic; it never gets media attention, but it will kill 39 million people by 2050 if we do not take action. It is important that we do not undercut our high animal welfare and farming standards with products from countries that have lower standards. Countries that use antibiotics as growth promoters are not only farming with lower welfare standards, but contributing to this huge public health crisis, so we must do our bit to tackle that issue. The hon. Member for Doncaster East and the Isle of Axholme (Lee Pitcher) mentioned labelling. It is hugely important that we can identify where meat has been produced. Consumers are currently being hoodwinked; they believe that they are buying products from animals reared in the UK, but it turns out that they were only processed in the UK. They want to support British farmers and high animal welfare standards, so it is completely wrong that they are being hoodwinked into buying products that potentially undermine UK standards. My hon. Friend the Member for West Dorset (Edward Morello) made a very important point about the lack of small abattoirs in the UK. Their closure is a huge animal welfare issue, as animals have to be transported further than necessary to be slaughtered, and a huge economic problem too. I urge the Minister to see how the Government can work with the pig industry to move away from the CO 2 stunning of pigs. It is a big welfare concern, and the British Veterinary Association and others are keen for the industry to make a sustainable transition away from it. It causes a lot of concern to a lot of constituents, and it really upsets me as a vet. Finally, I urge the Minister to meet the National Pig Association as soon as possible to look at supporting UK farmers, maintaining high animal welfare standards and improving our nation’s food security.

New clause 15 would require that the Secretary of State lay before Parliament any trade negotiation requiring NHS spending or funding exceeding £100 million, in the form of regulations subject to the affirmative procedure. New clause 76 would require that the arrangement between the United States and the United Kingdom on pharmaceutical pricing be laid before the House to be voted on. The Institute for Fiscal Studies has indicated that, by 2036, the UK-US pharmaceuticals deal will have cost as much as £9 billion. That money could be transformative for the NHS. It could be put towards ending corridor care, as the Committee discussed earlier, or towards hiring thousands of ward staff, buying countless radiotherapy machines and starting to deliver high-quality care and help at home for the elderly and disabled. To make matters worse, Trump’s ambassador hauled in the head of the National Institute for Health and Care Excellence—the expert independent body that considers value for money in the NHS—to rebuke him over his opposition to the deal. It is utterly outrageous that a British public servant has been dressed down by a foreign regime for putting the interests of British patients and the British taxpayer first. It is crazy that billions of pounds of NHS funding is being spent to placate Trump, at the expense of the patient wellbeing. We want to support the British life sciences sector. That should be a domestic matter for the UK Government to address holistically, through negotiations with the sector; it should not be dictated from Washington. Hiking payments for medicine is the wrong approach for patients who badly need investment in frontline staff, hospitals and equipment. The lack of transparency over the full cost has already created great uncertainty in the sector, and it is astonishing that such a major decision will be made without the say of the British people via a vote in Parliament. The Government refused even to publish an assessment of the impact of the deal, which has raised suspicion and caused some to think that something is being hidden. Through the people who elected us, this House—not the White House—decides on matters of national importance. The Liberal Democrats have tabled these new clauses to allow the House to have a proper vote on the deal.

Yes, I sat on the Tobacco and Vapes Bill Committee for six weeks, going through the legislation line by line. One of the most interesting things about that Bill is not only that it will improve public health and life expectancy, but that it is probably one of the single most impactful pieces of legislation in terms of improving inequality and especially socioeconomic health outcomes. So many of the disparities in life expectancy between wealthy people and those living in relative poverty are due to levels of smoking—it is not just smoking, but that is a significant factor. It is good of the hon. Gentleman to highlight that. During the coalition, the Tories recognised that the approach I described would send a powerful message that public health is the responsibility of all Government Departments. When it was scrapped, the then shadow Health Secretary, the right hon. Member for Makerfield (Andy Burnham), said that we could tackle Britain’s looming obesity crisis only if all Government Departments pulled together. We completely agree with that statement. New clause 79 tries to address some of the issues that occurred back then, including by placing requirements on ministerial attendance and giving the Liaison Committee oversight to drive accountability. I am sure the Minister will agree that greater cross-Government working is needed. What are the Department’s plans to support that? If we want to tackle the various public health crises facing our country, we cannot do so without proper cross-Government working. In my professional life, I was made an honorary lecturer at Bristol University veterinary school in the area of One Health, recognising that animal health, human health and environmental health are completely interlinked. It is difficult to improve one without looking at the factors that improve the others, and we need that kind of approach throughout all Government Departments.

I thank the Minister for her comments. It is good to hear cross-party recognition of how important the life sciences sector is in the UK, to universities and businesses as knowledge transfer partnerships. This is a huge opportunity not only to improve the health of the nation and the treatments available, but to boost the economy. We will withdraw new clause 15, but I thought the hon. Member for Isle of Wight East spoke extremely well about his concerns relating to the trade deal.

I thank all Members for their contributions to the discussion. The hon. Member for Lichfield made the good point that a committee of 70 people may not be that efficient. He should come to the Lib Dem parliamentary party meetings, which are incredibly efficient. We have incredibly insightful discussions, which is what makes us such an effective force, so I would not knock a committee of 70 people. I appreciate the Minister’s acknowledgment of the important of cross-party work for public health. I beg to ask leave to withdraw the motion. Clause, by leave, withdrawn. New Clause 15 Impact of trade deals on the NHS “(1) Any trade negotiation which would require NHS spending or funding to exceed £100 million must be laid before Parliament by the Secretary of State in the form of regulations subject to the affirmative procedure. (2) Before laying regulations under subsection (1) the Secretary of State must publish an impact assessment about how the trade negotiation will affect NHS frontline services and patients.”— (Dr Chambers.) This new clause would require any trade negotiation which would require NHS spending or funding to exceed £100 million to be laid before Parliament by the Secretary of State in the form of regulations subject to the affirmative procedure. Brought up, and read the First time.

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

I beg to move, That the clause be read a Second time. New clause 28, tabled in the name of the Chair of the Health and Social Care Committee, my hon. Friend the Member for Oxford West and Abingdon, extends the powers of the first-tier tribunal so that, when it determines an appeal, it may order that education, health and care plans must include health and social care needs and provision, rather than just making recommendations on those matters. I am sure all Members are probably in a similar situation in that EHCPs, in their various forms, are one of the main reasons we get contacted by constituents; they certainly fill up my inbox. Following the Education Committee’s report, “Solving the SEND Crisis”, which identified significant gaps in accountability and engagement from the DHSC and health services in the special educational needs and disabilities—or SEND—system, the Health and Social Care Committee held a one-off evidence session to build on those findings, looking at the delivery of the health aspects of EHCPs. The Health and Social Care Committee followed up a recommendation that the Education Committee had made that the powers of the SEND tribunal service should be extended to allow it to issue binding recommendations to health services, not just education providers. SEND tribunals are independent national tribunals that decide appeals against local authority decisions about the special educational needs of children and young people, including decisions made about an EHCP. Currently, they can make binding recommendations in relation to education provision, but not in relation to health and social care needs. The Education Committee argued: “This would ensure that when a failure to deliver a health provision specified in an EHC plan occurs, health bodies are legally obligated to take corrective action.” When the Health and Social Care Committee raised that with witnesses in its evidence session, several were supportive of placing this duty in legislation, although they noted that it would require other reforms to workforce and commissioning arrangements to be successful. New clause 28 would provide a level playing field between education bodies and ICBs, so that ICBs are also under a legal obligation to comply with recommendations from SEND tribunals.

I pay tribute to the Royal Army Veterinary Corps. It does good work in trying to eradicate rabies in countries with street dogs, as part of hearts-and-minds engagement. We can work public health into pretty much any Department.

Just to blow my own trumpet, my greatest academic achievement was getting correspondence published in Nature on the impact of conflict on antimicrobial resistance. It might interest Members to know that, in Ukraine, 80% of wounds have novel bacteria that are displaying multi-drug resistance, which has become a limiting factor in getting soldiers back on to the frontline. We are trying to reframe issues such as antimicrobial resistance as national security and defence issues, rather than purely public health issues.

I thank Committee members for their contributions. The hon. Member for Isle of Wight East spoke particularly well and emotively—I know that he worked for Dementia UK before entering Parliament. My mother was a carer for my father, who had dementia, and my sister and I gave her respite care, although probably not enough of it. I know that many Committee members will have been in a similar situation, as it is a common disease, and it is becoming increasingly common. I also thank the Minister for her comments and reassurance. The hon. Member for Bury St Edmunds and Stowmarket made a point about children being carers. I sat on the Mental Health Bill Committee last year, and to give an example of how impactful such Committees can be, it is now a requirement, as a result of the Committee’s consideration, to identify whether mental health patients have children who are carers. That was not the case before, and we appreciated the Government engaging with us on that issue. It is often teenagers who care for adults with severe mental health issues, but they were not even identified before, so they could not be given the support they required. That has changed now, and it is fantastic to see that, through Committee scrutiny, we can make a tangible difference to people’s lives. I will not press new clauses 16 and 17 to votes, but the Liberal Democrats do think that it would be sensible and impactful to establish a national respite care scheme, so I will press new clause 18 to a Division. On new clause 16, I beg to ask leave to withdraw the motion. Clause, by leave, withdrawn. New Clause 18 National Respite Care Scheme “(1) Within six months of the passage of this Act, the Secretary of State must establish a National Respite Care Scheme. (2) The scheme under subsection (1) must make provision for— (a) a local authority carrying out a carer’s assessment under section 10 of the Care Act 2014 to be required to consider whether a carer is able to take sufficient breaks from their caring responsibilities. (b) unpaid carers to receive support to take breaks from their caring responsibilities to— (i) maintain their physical and mental health and emotional wellbeing, (ii) participate in work, education, training or recreation, and (iii) participate in family and community life. (c) a carer to receive appropriate support if a local authority carrying out an assessment under subsection (2)(a) determines that a carer is unable to take sufficient breaks from caring. (3) Under subsection (2), ‘support’ may include— (a) replacement care for the cared-for person; (b) respite services; (c) any other steps a local authority considers appropriate as support. (4) The Secretary of State must provide sufficient support to local authorities to ensure the scheme under subsection (1) is delivered in every local authority. (5) For the purposes of this section ‘unpaid carer’ has the meaning given by section 10 of the Care Act 2014 and includes a young carer within the meaning of section 96 of the Children and Families Act 2014.”— (Dr Chambers.) This new clause would require the Secretary of State to establish a National Respite Care Scheme. Brought up, and read the First time. Question put, That the clause be read a Second time.

I thank everyone for their comments. I thank the Minister for her reassurances on the seriousness of this issue. Given that we are waiting for the response to the report, I beg to ask leave to withdraw the motion. Clause, by leave, withdrawn. Ordered, That further consideration be now adjourned. — (Emma Foody.)

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

I will speak to new clauses 16, 17 and 18 together. They relate to the duty on integrated care boards to promote the health and wellbeing of carers. Certainly, as the Liberal Democrat spokesperson for mental health, and having been a carer myself—like many people in this room—I have a particular interest in the mental health of carers. Sometimes we forget that, as well as the patient, the carer also needs a huge amount of support, as what they do can be very draining. Unpaid carers are essential to the sustainability of the NHS and social care system, but carers consistently experience poorer physical and mental health outcomes than non-carers, and frequently struggle to access support for their own health needs. There are approximately 4.7 million unpaid carers in England. They provide support valued at an estimated £152 billion annually—equivalent to the annual NHS budget. Evidence consistently shows that unpaid carers experience worse health outcomes than non-carers. The GP patient survey 2025 showed that 72% of carers report a long-term condition or disability compared with 61% of non-carers. The Office for National Statistics reports that one in four adults providing unpaid care described being in “not good health”, compared with one in five adults who are not providing unpaid care. The probability of reporting being in “not good health” was higher for people providing more hours of unpaid care. Some 49% of unpaid carers reported at least one adverse health effect from providing that care. Low mental wellbeing was more common among unpaid carers, at about 20%, than among those not providing unpaid care, at 15%. An academic study analysing GP patient survey data found that, for those caring for more than 50 hours a week, the health impact of being a carer is equivalent to losing 18 days of full health every year. A study has also found that carers cancel medical treatments and appointments because nobody is available to step into their caring role, and that, because of their caring responsibilities, carers cannot find appointments at times when they can attend. A more targeted approach to support unpaid carers could help to prevent the onset of deteriorating carer health and wellbeing as a result of their caring roles. Although ICBs have broad duties relating to population health and inequalities, there is currently no explicit statutory duty requiring ICBs to improve the health and wellbeing of unpaid carers specifically.

I appreciate that. Just to reiterate, I am talking specifically about the trade deal with the United States, not about every single trade deal. We completely accept that primary legislation is not necessarily the best way to scrutinise a trade deal, but given the lack of options at the moment, we must use every political mechanism available to create transparency.

New clause 14 is about healthy life expectancy. It would require the Secretary of State to make regulations to establish a statutory target for healthy life expectancy in Great Britain and publish a strategy every two years, setting out how the target would be achieved. New clause 79 would establish a public health committee and health creation unit to promote public health and cross-Government policymaking. New clause 80 would place a duty on all Ministers to consider health outcomes and the promotion of public health when exercising their duties. All three new clauses are closely related. Over the last 100 years, life expectancy in the UK has been increasing for a variety of reasons, including vaccination, improved hygiene and medical advances, but worryingly, between 2022 and 2024, it decreased by 1.8 years for men and 2.5 years for women. That is the first time it has decreased in a while. There is an 11.1-year gap between the highest and lowest life expectancies, which is partly due to demographics and different socioeconomic situations. Socioeconomic disparity is causing a very significant difference in life expectancy. We need wider whole-of-Government working to address the root cause of and contributing factors to ill health. DHSC, the NHS and social care deal with too much in silos, which is a problem across the whole of Government. There is too much siloed working. All Departments should be working with at least one eye on the health of the nation. That is what our new clauses seek to foster. A healthy life expectancy target would provide the basic metric for that aspiration, forcing wider thinking on prevention and ill health, rather than on waiting lists and hospital performance, as important as they are. New clause 80 would place a duty on all Ministers to consider health outcomes and the promotion of public health when exercising their duties. That should aim to focus the minds of non-DHSC Government Departments that have a central role to play in the promotion of good health and longevity, whether that be housing standards or environmental regulations. We included health protection—areas such as clean water, for instance—as well as health promotion, which includes areas such as active travel. New clause 79 would create a public health committee and a health creation unit to support its work, especially between Departments. This is an idea originally introduced under the coalition Government, designed to tackle obesity, alcohol abuse and other public health problems. Although we recognise that it was not perfect, given the Tories’ lack of engagement and spotty attendance, the desire to foster cross-Government thinking was definitely right.

I am grateful to the shadow Minister for that intervention. Unless something changes significantly by the time we get to vote on new clause 76, which I understand will not be today, we will press it to a vote for transparency’s sake, but we will withdraw new clause 15. I beg to ask leave to withdraw the clause. Clause, by leave, withdrawn. New Clause 16 Duty to promote the health and wellbeing of carers “After section 14Z44 of the NHS Act 2006 insert— ‘Duty to promote the health and wellbeing of carers (1) Each integrated care board must exercise its functions with a view to improving and maintaining the physical health, mental health, and wellbeing of carers within its area. (2) In exercising its duties under this section, an integrated care board must have regard to— (a) reduction of health inequalities experienced by carers, (b) prevention of deterioration in carers’ physical and/or mental health, (c) involvement of carers in decisions relating to the care of persons for whom they provide care, and (d) the need to ensure carers are able to access appropriate preventative and other health services and support. (3) An integrated care board must take reasonable steps to ensure that NHS bodies and providers of NHS services within its area— (a) consider the health and wellbeing needs of carers in care planning and discharge processes, (b) involve carers appropriately in decisions relating to care and treatment, and (c) provide carers with information about support available to them for their health and wellbeing. (4) In preparing a Joint Forward Plan, an integrated care board must include— (a) an assessment of the health and wellbeing needs of carers within its area, (b) steps the integrated care board proposes to take to improve outcomes for carers, and (c) measures for reducing inequalities experienced by carers. (5) In this section, “carer” has the meaning given by section 10 of the Care Act 2014 and includes a young carer within the meaning of section 96 of the Children and Families Act 2014.’”— (Dr Chambers.) This new clause would introduce a duty for integrated care boards to promote the health and wellbeing of carers. Brought up, and read the First time.

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

It is well recognised that people who inflict deliberate pain, injury or violence on animals are more likely to be involved in domestic abuse, yet if someone is prosecuted for deliberately injuring an animal, they are prosecuted under animal welfare laws, meaning that their conviction is unlikely to show up under the domestic abuse disclosure scheme. Will the Minister look at how we can change the recording of such offences, so that people who deliberately harm animals are likely to be reported as being at risk of committing domestic abuse against people?

I welcome the Secretary of State’s mentioning an update to the Veterinary Surgeons Act 1966; after 60 years, it is much needed to make the Act fit for purpose to regulate new business structures and paraprofessionals such as physios, and to protect the title of veterinary nurse. Could we have an assurance that, with the change of Administration, the update will remain a priority and will not be kicked into the long grass? It is much needed right now.

My hon. Friend has just highlighted a point that was mentioned by the hon. Member for Tooting (Dr Allin-Khan). That kind of experience causes concern not only for its lack of dignity, but for infection control, antimicrobial resistance and hospital-acquired infections. That kind of treatment not only has a lack of dignity, but can be lethal. That is a huge public health issue, which my hon. Friend’s specific example highlights.

Will the Minister join me in congratulating Lib Dem-run Winchester city council on its fantastic initiative, Solar Together, which installs solar panels on council houses? So far, it has installed solar panels on 35 properties, reducing energy bills, lifting people out of fuel poverty and reducing carbon output. What support is the Minister giving to ensure that such initiatives can continue, in Winchester and throughout the whole country?

14. What steps he is taking to help tackle climate change.

This subject is of particular interest to me. For quite a few years I was a trustee of a charity that supported evidence-based medicine and quality improvement. The hon. Lady talked about a no-blame culture. We now tend to use the term “just culture” but it is the same kind of thing: we must have a safe space for people to come forward, like in the airline industry. We want to encourage reporting not only of mistakes but of near misses so that improvements can be delivered without tragic incidents having to take place. If we are to create a culture in which people will come forward to admit even potential mistakes and near misses, they cannot in any way fear punitive punishment under regulations. Does the hon. Lady agree that folding HSSIB into the CQC will make it difficult to create a culture in which people feel confident enough to want to come forward with and overtly discuss mistakes and errors?

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

The size of the contract would be pretty much irrelevant; what matters is the implications arising from the contract being signed. Does a contract potentially compromise our data sovereignty? Alternatively, if a contract failed for any reason, whether it was because of the action of a state actor or a non-state actor, would the service continue to function?

The hon. Gentleman must have read the next line of my speech. We are concerned that a DHSC employee appearing before that Committee will not clearly and openly state whether DHSC is failing. New clause 78 “would ensure that Healthwatch England and local Healthwatch organisations are funded to the level estimated by the Department for Health and Social Care” in 2013-14. We do not just want to protect Healthwatch; we want to strengthen it. As I mentioned, it receives almost £26 million a year, which is spread over 153 organisations. In real terms, that is about 60% less than the £43.5 million that DHSC originally estimated would be needed to fund the network. The Healthwatch network does such amazing work—I will not go through it all again—despite being underfunded compared with those original estimates. Imagine the work it could do if it was adequately funded. Even more worryingly, there is still no clarity on how Healthwatch’s functions will be funded once they have been transferred to the new system. Given the ongoing constraints and cuts to ICB running costs, there is a real risk that the funding for Healthwatch will simply end up being incorporated into wider ICB budgets, and money for the patient experience infrastructure could end up being cut entirely. The new clause aims to ensure that the Healthwatch network is properly funded, but it also raises the point that, if this change is to go through, funding for patient experience infrastructure must be protected. Otherwise, the Bill risks not just weakening patient experience, but removing it altogether as the funding gets swallowed by wider NHS operational demands.

For over 50 years, there has been a statutory independent patient voice in the health and care system. The creation of Healthwatch was, in part, a direct response to the issues raised by the Francis inquiry into Mid Staffs. In a 2024 Healthwatch poll, almost a quarter of NHS patients said that they had experienced poor care in the past year, but 56% of them—more than half—took no action. Of that 56%, 20% said that that was because they were scared that giving negative feedback directly to NHS services would affect their ongoing treatment. Women, people living in areas of greater deprivation, disabled people and unpaid carers were significantly more likely to give the fear of retribution as a reason for not speaking up. The Government are stripping patients of their voice in our NHS. Rather than being able to go to an independent body and express how the NHS can work better for them, patients will now be able only to give feedback to the same organisation that might have failed them. I have had experience of that in the past few weeks. My partner Emma has endometriosis, which has been an ongoing condition. She was worried that speaking to the local hospital trust specifically about the treatment she received might affect her treatment going forward. The Government have argued that the changes will bring patient insight closer to decision making, making it much more effective at securing change. The former Health Secretary, the right hon. Member for Ilford North (Wes Streeting), stated that patients do not need “ventriloquists”. That blatantly disregards the vital role played by Healthwatch in advocating not only for vulnerable patients who, understandably, do not feel confident navigating health services with often complex or combative systems, but for whole communities with a pre-existing distrust of the system. We believe that removing Healthwatch leaves the health service to mark its own homework, which creates a conflict of interest. It will significantly undermine public trust, as independence is removed. Will vulnerable people who have suffered harm or poor experiences in the health and care system really have faith in a system headed by a director in the Department of Health and Social Care, which is the very organisation running the system that caused them harm in the first place? On a local level, will they have faith going to the same ICB that oversees the providers that have failed them? One need only look at the long list of maternity failings in Mid Staffs to see that internal functions can fail catastrophically. We know all too well that the NHS default is sometimes to cover up. The public knows that, too, so independence is everything. Healthwatch has been keen in spotting and exposing challenges in the health service, such as widespread failures in the NHS referral process, yet there will be no incentive for the new system to investigate such issues, which are invisible in the main NHS performance metrics. The system does not always know what questions it needs to ask, so an independent route for unsolicited feedback is important. We also think that the provisions disadvantage hard-to-reach communities and those who may have a distrust towards the NHS and public authorities, making it harder to gain the feedback and concerns of those communities. That risks inadvertently further baking in inequalities. More widely, clarity has not yet been provided on how those functions will be funded. The reform is coming alongside major reductions in ICB running costs. Healthwatch currently receives almost £26 million a year; that is already 60% less in real terms than the original DHSC estimate to fund the network. There is a risk that the money will be absorbed into wider budgets and never spent on the patient experience infrastructure. If people want to see the value of Healthwatch, they need look no further than the Cabinet Office briefing notes on the King’s Speech, which reference a May 2025 Healthwatch report on missing medical records to make the case for the single patient record. Fundamentally, the Government are conflating patient voice with patient involvement in decision making. While greater patient voice in commissioning and decision making is needed, it is not a replacement for the advocacy and other functions of Healthwatch, which helps vulnerable people to navigate a complex health and care system and performs signposting functions. Splitting local healthwatch functions across ICBs and local authorities once again separates health and care and reinforces existing gaps between them. As we know, many issues span both areas and need a joined-up investigative approach. How will the new model ensure a joined-up view of people’s experiences across the NHS and social care? We urge the Minister to reconsider this decision. We have seen overwhelming support for Healthwatch across the sector, and it is becoming increasingly clear that many people in the NHS and the medical profession think that this is a huge mistake. Healthwatch England has played a central role in escalating the findings of local healthwatch organisations and in advocating nationally. We have three examples. The first is the call to publish research highlighting inequalities in waiting times for disadvantaged groups, and for a demographic breakdown of waiting lists, which the NHS obliged with last summer. The second example arose after Healthwatch Sunderland supported a patient with a learning disability who had received accessible screening information but risked missing care because of inaccessible follow-up letters. Healthwatch England raised that gap with national bodies and highlighted inconsistencies in communication, and, as a result, the national easy-read templates were introduced across the cancer pathway, which improved accessibility and reduced risk. The third example is that Healthwatch feeds back patients’ horrific stories of corridor care—including that of a pensioner who was left in a corridor—to NHS leaders, and lobbies for increased transparency and oversight when it comes to corridor care. I have several questions in three forms. Is the Minister genuinely sure that a director of patient experience in DHSC will be eager to advocate for patients and flag issues at a national level given that they will essentially be flagging to their bosses where work is not up to scratch? Is she sure that the level of persistence that has so often been needed to advocate for change at a national level would be forthcoming from a director employed by DHSC? What will be the mechanism for escalating local concerns that indicate national or systemic issues? Will the Minister explain where the Government envision the new director sitting in the DHSC structure, and what the reporting lines will be? How will the Government ensure that they have the resources and sense of operational independence to investigate and raise concerns nationally? Healthwatch England has often flagged issues to MPs and to the Health and Social Care Committee as a way of applying pressure on NHS leaders and Ministers to enact change.

I would not always object to that, because the whole point of the new clause is that such a contract would come to Parliament and then might well be approved if it turned out to be the best system and in our national interest. The thrust of all three new clauses is to ensure that we do not get exposed and make ourselves vulnerable, which could affect the functioning of the NHS and compromise people’s data. A future Government could set up their own AI system in the UK. How would data be used by that system? We are looking at future-proofing people’s privacy and future-proofing the ability of our country to deliver a service properly. There is also an economic opportunity. We should always prioritise domestic suppliers where possible, and even cultivate them, and help them to innovate and develop, because spending potentially tens of millions of pounds with foreign companies will not do anything to grow our own economy. Given the world-beating talent in our country, we see no reason why the long-term effect of domestic options to foreign systems could not be developed with sufficient Government support. As such, where a contract is signed with a foreign supplier, new clause 4 would require the Secretary of State to take steps to support domestic alternatives. We recognise the complexities involved with NHS procurement, and our new clauses represent one vision built on the core principles of domestic resilience and digital sovereignty. I have a few questions for the Minister, which I would appreciate some comments on. How do the Government intend to build trust in the single patient record to make sure that it is not undermined, rather like the federated data platform has been? Does the Minister agree that the poor reputation of Palantir and distrust has been an important element in the slow roll-out of the federated data platform? Has she considered undertaking a risk assessment with a national security focus of current NHS digital and tech contracts? Does she agree that, in an ever more turbulent world, building domestic capability in this area is central to the security of our country? Does the Minister agree that the domestic life sciences and tech sector is more than capable of developing and scaling many of the systems that we rely on foreign companies for at the moment? The Government have very much positioned AI and technology as the NHS’s white knight. We agree that the potential is huge, but do the Government not think that the NHS needs a long-term digital strategy to support a joined-up development and roll-out of these systems and technology? An analogy to this is how the defence investment plan and future defence procurement can help prioritise and boost economic growth in the UK. We think this is another way that economic growth could be nurtured.

This is not about closing off markets or shutting off the potential to use foreign companies if they are most appropriate. It is about prioritising and investing in UK technology and our economy to solve some of our domestic problems while also providing security. Saying that we are closing off domestic markets is misunderstanding the thrust of the new clause.

I appreciate the Minister’s response and the comments of other Members, which were insightful as usual. When we discussed whether carers could access parts of the single patient record, Members made very good points about privacy and historical health issues that a patient might not want a carer to know about. Those are very sensible concerns, but someone watching these proceedings or looking back over the record would think that there had been a lot more agonising over whether someone caring for a patient could access relevant information than over the potential systemic misuse of health information facilitated by private companies. A lot of people are worried about that when it comes to procurement, trust and sovereignty. I thank the Minister for her comments on new clause 3. I beg to ask leave to withdraw the motion. Clause, by leave, withdrawn. New Clause 4 Duty on the Secretary of State to prioritise domestic suppliers “In the National Health Service Act 2006, after section 1CC (inserted by section 6 of this Act) insert— ‘1CD Duty to prioritise domestic suppliers (1) In exercising functions in relation to the health and care service, the Secretary of State must prioritise the awarding of any contract that will involve the handling of NHS patient data to suppliers based in the United Kingdom. (2) The Secretary of State may only seek to procure technology and information systems which will handle NHS patient data from suppliers based outside of the United Kingdom where a viable domestic alternative does not exist. (3) Before signing any contract for the procurement of technology and information systems which will handle NHS patient data with a supplier based outside of the United Kingdom, the Secretary of State must consult with— (a) patient groups, (b) national security experts, and (c) staff unions, on the proposed contract and lay a report on such a consultation before Parliament. (4) Where it is proposed to sign a contract for the procurement of technology and information systems which will handle NHS patient data with a supplier based outside of the United Kingdom, the Secretary of State must arrange for a motion agreeing to the signing of such a contract to be tabled in each House of Parliament, and no such contract may be signed where a motion for its agreement is negatived by either House of Parliament. (5) If a contract is awarded for the procurement of technology and information systems which will handle NHS patient data with a supplier based outside of the United Kingdom, the Secretary of State must place a statement before both Houses of Parliament setting out whether the Government is taking, or is planning to take, steps to develop or support long-term domestic alternatives to the systems provided by the contract.’”— (Dr Chambers.) This new clause would place a duty on the Secretary of State to prioritise domestic, UK-based, suppliers for technology systems and contracts handling NHS patient data, and places restrictions on the signing of contracts for such systems with non-UK based suppliers. Brought up, and read the First time. Question put, That the clause be read a Second time.

New clauses 3 to 5 are related to the publication of risk assessments of contracts between NHS organisations and suppliers based outside the UK. They would place a duty on the Secretary of State to prioritise domestic, UK-based suppliers in the case of technology systems and contracts involving the handling of NHS patient data, and place restrictions on the signing of such contracts with non-UK-based suppliers. New clause 5 would require the Government to publish an NHS digital sovereignty strategy setting out how they intend to address risks to relevant information systems posed by foreign interference and reliance on foreign technologies, including by supporting the use of domestic technologies. We had a Westminster Hall debate on this subject recently. The lack of transparency in how some contracts are awarded is one of the central concerns about Palantir’s involvement with the NHS. We are particularly concerned about the national security considerations of offshoring the whole of our nation’s health data to any foreign company, which makes us vulnerable to political and economic changes in other countries, but especially to companies of questionable integrity in an increasingly authoritarian jurisdiction with little respect for privacy and sovereignty. We should all be worried that our health data has been so closely linked with such an organisation, which has shown itself all too eager to work closely with Donald Trump’s Administration. We know that his Immigration and Customs Enforcement agency has been using health data to identify people’s immigration status, and there is a lot of concern that people are not coming forward for medical treatment as a result. Doctors and patients have already voted with their feet and shown that they do not trust Palantir and its system for this very reason, which is also a key reason for the limited uptake of the federated data platform so far. As such, we have tabled various new clauses to try to address those concerns, to ensure that they do not plague the single patient record, which we absolutely support and want to help the Government to deliver, along with any other vital technology or data system. New clause 3 would ensure that a risk assessment is conducted of all non-UK tech and data suppliers, with particular regard for national security. It is centrally important that doctors and patients trust the systems that hold their health data and that, as a country, we trust them to be safe and secure. We should not trust rogue actors with our nation’s health information. New clause 5 deals with how we mitigate that risk. It would require the Government to publish an NHS digital sovereignty strategy, setting out how they intend to address the risks of foreign interference and reliance on foreign technologies. Our potential answer to both those questions lies in new clause 4, which would prioritise domestic suppliers that handle sensitive or confidential NHS data. We recognise that that will not always be possible, but where domestic capability does not exist and it is therefore necessary to work with foreign suppliers, to ensure the transparency and effective oversight of a contract with a foreign supplier, it must be brought before Parliament. Should a contract be signed with a non-UK supplier, it would also be subject to consultation with patient groups, national security experts and staff unions to make sure that the system is onside. If it is not, uptake of it will be stunted, as we have seen with the federated data platform.

The hon. Gentleman makes an interesting point. I suppose this is another chance to use the developing single patient record to ensure that we close the gap. The record could be formed in such a way, and the process put in place, to ensure equity in the system, with mandatory markers. Amendment 72, also tabled by my hon. Friend the Member for Epsom and Ewell, would require prior membership of the armed forces to be visible to all relevant healthcare workers under the establishment of a single patient record. It would also require the Secretary of State to publish a report on making prior armed forces membership visible on the single patient record. There are just over 1.85 million armed forces veterans in the UK, 13.6% of them women and 86.4% men. The transition from serving in the armed forces to civilian life can mean that many of those individuals struggle with mental health issues, such as post-traumatic stress disorder. The issues are often specific to the service the individuals have given. Some stats show that more than half of England’s Army veterans have some sort of health problem. I should point out that veterans do not only have mental health problems. Specific back and knee problems are much more common among infantry soldiers because of the type of training they have done over many years. The amendment seeks to make prior armed forces membership visible to all relevant healthcare workers, and to make the Secretary of State consult on the merits of doing so, so that when a GP is treating a patient, they are aware of that person’s service history without having to ask about it specifically.

The amendment was tabled in the name of my hon. Friend the Member for Epsom and Ewell (Helen Maguire), and would require medical markers for firearms licence holders to be visible to all relevant health workers under the establishment of a single patient record. I will not read through all my speaking notes but, in a nutshell, a person rightly undergoes mental health checks before they acquire a firearms licence, but that will not be reviewed until they are due to renew their firearms licence a few years later. If their mental health status changed during that time, the amendment would enable them to be flagged to healthcare workers and GPs as a person who has a firearms licence, so that any necessary proactive measures could be taken to ensure that they are still safe to have that licence, or should have it removed, rather than waiting for them to apply for a new licence in a few years’ time. The British Medical Association supports the amendment and the Royal College of General Practitioners thinks it would be valuable. A survey carried out by the Association of Police and Crime Commissioners found that 87% of existing certificate holders believe that GPs should inform the police if they become aware of health issues that could have an impact on the certificate holder’s ability to own a gun safely. Quite often, however, the GP is not aware that the person is in possession of a firearms licence.

The hon. Gentleman makes some good points, especially given his experience as the Conservative spokesperson in the Westminster Hall debate on this subject, for which he did a lot of research. I do not think we need to worry about medical professionals seeing that someone has a firearms licence and potentially treating them differently because of assumptions they make about them. Medical professionals are trained to be dispassionate, and they try to show little bias. I would be very surprised if a doctor, seeing it flagged on a single patient record that someone was in possession of a firearms licence, changed their attitude towards or approach to the treatment of that individual. I think that particular point is probably not relevant.

Will the hon. Gentleman give way?

I will speak to clause 47 and to new clauses 7 and 8, which were tabled by my hon. Friend the Member for Newton Abbot (Martin Wrigley). The sector has been calling for a single patient record for decades, and it is the single most impactful part of the Bill. It could be transformational for patient experience, care, outcomes, consistency of treatment and reducing errors. Members have talked about the hassle of people having to tell their story repeatedly or recollect the history, which many people cannot do accurately, so the clause could be hugely impactful. Polling shows that nine out of 10 Britons want better access to medical records. Many assume that a single patient record already exists and are often quite surprised when they go to another hospital and find that it has no record of what has been done in the county next door. Although the public are rightly concerned about the use of their data, especially outside of direct care and for planning and research purposes, we wholly support the idea of a single patient record. The plan is for people to be able to see their primary, secondary and social care records all in one place, all in the NHS app. It will be transformational, but patients should be in control of their data. They should be able to see who is accessing their records and should be able to opt out of sharing data. It is essential that there is sufficient control and guarantees around the sharing of data, whether for research or other reasons. The Bill does not go far enough to provide reassurances that patients will ultimately be in charge of their own data and how it is used. Trust among medical staff, patients and the public is essential for this much-needed system to succeed, and we have only to look at the pushback on the federated data platform to see that. Sufficient guardrails are necessary to make sure that secondary uses of health data are allowed only when they deliver a clear public benefit. Rules need to be future-proofed so that they are not vulnerable to change depending on the political or economic situation. There should be meaningful checks, balances and transparency. We want to make sure this technology is focused on enabling and delivering healthcare. We know that, in the US, Palantir is providing health data to US Immigration and Customs Enforcement, which is then used to support deportations. We would be really concerned if people were too worried to come forward for medical treatment because they thought that their immigration status might be passed on to another Department. There was a Westminster Hall debate recently on the concerns about Palantir and about the single patient record being abused. From an economic point of view, it seems a lost opportunity to have such a huge infrastructure project farmed out to foreign companies based abroad. First, this is a huge opportunity for companies in the UK to boost our economy, provide employment and drive innovation. Secondly, if we are reliant on foreign companies to deliver this service, we could lose our health sovereignty and their motivations might change depending on the political and economic situation of the country in which they are based. There have been recent examples of NHS staff inappropriately accessing the private health records of the victims of the Southport and Nottingham terror attacks. The decision by the University Hospitals of Liverpool Group not to inform patients of the breaches understandably raised privacy concerns. The Government must therefore ensure that there are sufficient safeguards and guardrails, and that they are communicated clearly to the public to build trust. The single patient record needs to happen, but in the right way. The issues with the FDP’s uptake have shown that patient and staff mistrust can significantly undermine a system’s effectiveness. The most important safeguards should not be left entirely to later implementation. They should be laid out in primary legislation at the beginning of the process. The Bill should be more explicit on who is responsible for decisions about access, sharing, liability and redress. That is why we have tabled various amendments, which we will get to later, most notably on our health data charter, setting out the key principles of how health data should be handled and a duty to prioritise domestic suppliers in technology procurement. We welcome Opposition amendment 49, which we debated earlier—I believe it was echoed by the NHS Alliance—suggesting that a plan should be laid before Parliament for a minimum three-month public information campaign before the system goes live. The discussion on this needs to be constructive, not alarmist, to make sure that the SPR is rolled out in a safe fashion and so that we all get to feel the benefits. Public involvement should be ongoing, visible and tied to real implementation decisions. Past NHS data reforms show that support depends on people feeling informed, heard and able to challenge decisions. Any red lines should also be clear. For example, there should be consented use for marketing or insurance purposes. We also need to discuss the role of GP practices in this debate, given that they work within the NHS but are also private businesses. GP records are among the NHS’s richest data assets, and GP practices are to remain independent data controllers. I have spoken to three different practices in Winchester, and the practice managers are quite concerned that GPs will be required to share data much more routinely than they do now, but they will still carry the legal and professional risk and will likely act as the channel to explain to patients how their data will be used. GPs will need to be brought on side for the SPR to work, and that will depend on who decides, what safeguards apply and how burdens on practices are managed. Recent experiences show the sensitivity of the issue. The British Medical Association has stated that it may consider collective action on GP data sharing. The 2022 roll-out of automated prospective GP record access through the NHS app was paused after concerns about safeguarding and the burden on practices. Will the Minister expand a little on the detail and on how all this will be implemented? What precautions will be taken to ensure that patient data is protected? Will she consider the Lib Dem proposal for a health data charter that sets out principles and responsibilities for handling NHS data?

I thank all hon. Members for their input, and the Minister for her insights. I beg to ask leave to withdraw the amendment. Amendment, by leave, withdrawn.

I beg to move amendment 71, in clause 47, page 34, line 29, at end insert— “(3A) The regulations must make provision for medical markers for firearms licence holders to be visible to all relevant health workers under the establishment of a single patient record. (3B) The regulations must include a requirement for the Secretary of State to prepare and publish a report on the potential merits of introducing a statutory requirement for mandatory medical markers for firearms licence holders to be used by those relevant in providing patient care.” This amendment would require medical markers for firearms licence holders to be visible to all relevant health workers under the establishment of a single patient record.

I thank hon. Members for their insightful input to the discussion on mental health in general and for their thoughts on our amendments. It is reassuring to see the cross-party concern for mental health and the recognition that it seems to be an increasing problem. The hon. Member for Bury St Edmunds and Stowmarket made a good point about the causes of mental health problems. We know that people in debt are three times more likely to have mental health issues than people on an average income, and that people who have served in the armed forces are at a higher risk. A whole combination of non-clinical things, such as insecure housing, zero-hours contracts and even social media for adults and children, are potentially adding to the mental health challenges that we are facing. I appreciate the Minister talking about the new cross-Department mental health strategy. It sounds valuable and it seems to address a huge number of the multifactorial issues that have led us to this point. I will happily not press any of the amendments apart from amendment 9. The mental health investment standard is one of our absolute core priorities, and I would like to press that to a vote. I thank everybody for their contributions and insight into this. Question put , That the amendment be made.

Amendments 60 and 61 would introduce a primary care investment standard that required integrated care boards to increase spending on primary care services at least in line with the growth of their total programme healthcare funding. We have discussed the importance of primary care in previous sittings, so I will be brief now, because we have a lot to get through. The primary care investment standard would be similar to the mental health investment standard. It would set a clear benchmark to which to hold the Secretary of State. Primary care is the very frontline of a health service, and it is vital to stop the rest of the health system becoming overburdened, with issues such as corridor care and long ambulance handovers often a direct result of the system’s failure properly to shift resources and focus into primary care and community care, so that we can catch diseases early and prevent people from going into hospital. If people cannot get GP or dentist appointments, they turn up to A&E. That transfers the load to what is not only not the most efficient part of the NHS for dealing with routine issues, but the most expensive part of the NHS. That is hugely expensive, as well as not ideal for the individual. Although more than 90% of patients’ direct experience with the NHS is through primary care and GP practices, less than 10% of the NHS budget in England is spent on primary care. Despite years of all Governments promising to shift patient care out of hospitals into the community, the proportion of the NHS budget spent on general practice has fallen to its lowest point in the past 10 years. The Royal College of General Practitioners’ 2025 practice manager survey revealed that although 61% of practice managers said that they need to expand the GP workforce to meet their patients’ needs, 62% said that the lack of funding in general practice is a major barrier preventing them from hiring the number of GPs they need. It has been revealed that 22 out of 27 of the first round of neighbourhood health centres are already doing some of those functions; they are simply being rebadged and slightly expanded. We know that in the NHS, money is key, and there are constant important and competing demands for the limited amount of funding. Protecting funding streams for primary care would ensure that the Government actually provided the funds to back up their ambition of shifting care into the community. The benchmark that amendments 60 and 61 would set for the Government is modest, but it would have a huge impact if we could successfully transform the NHS by shifting care into the community. We hope that the Government will view this as a spend-to-save initiative as well. One question is always where the money comes from, but having fewer demands on A&E, the most expensive part of the NHS, would save money in the long run.

All the stakeholders have said that the single patient record is part of the Bill that could be genuinely transformative. I would also like to note the Bill’s many references to carers, including the Secretary of State’s duty to promote the involvement of carers alongside patients in decision making around care and commissioning. However, the Bill is currently quite vague as to whether carers will be able to access the single patient record, and we want that to be made explicit. We want to reiterate the lack of focus on social care, which is the biggest issue facing the NHS, and emphasise our call for carers in general. The benefits that the single patient record could bring to patients have been well-established, and it is well-supported, but we believe that the single patient record could also be of huge benefit to carers. It could allow them to care more effectively for their loved ones, and it could allow it to be flagged on their own records that they are carers, so they receive the support that they need.

I thank everyone for that very useful discussion. I was pleased to see everyone broadly in agreement that we need to work out how we can provide the necessary information to provide better care, and to balance that with privacy. Everyone made really insightful points on that. I just emphasise that, as we all know, there is a difference between treatment/prescription and compliance, and compliance is where many medical treatments fall down. It is once the medical staff are not involved on a day-to-day basis, when the patient is not under their direct care or in the facility of the medical treatment, that most of the care takes place, and that is when successful or unsuccessful treatment for the medical condition occurs. If the people providing the daily care are not empowered properly, it is—well, not a complete waste of time, but the efforts of the medical staff are in vain if the compliance day to day is not accurate. I thank everyone for the discussion. I will not press the amendment to a vote, and I beg to ask leave to withdraw it. Amendment, by leave, withdrawn . Ordered, That further consideration be now adjourned.— (Emma Foody.)

I agree that there is no need for carers to see irrelevant or extremely historical information in the single patient record. Currently, however, there are a lot of carers who, for various reasons, such as not having legal power of attorney, cannot access the information that they need. We also sometimes find that the people who are carers, who are potentially the spouse of the patient and are themselves elderly—because a lot of people receiving care are elderly—do not understand the information that they are being given. There can be a situation where the person providing care does not fully understand why the patient is getting some medication, or the best way to treat them. We hear that quite a lot. We understand that the Bill is not designed to set out all the specifics of what the single patient record will look like—that key point was made in the interventions by the hon. Members for Farnham and Bordon and for Ashford. However, although we do not know exactly what it will look like, as it is being created, drafted and thought through, we would love the Minister to confirm to us that carers will be able to see the appropriate parts of the single patient records of those they care for, so that they can oversee their medical care and flag any issues. There are some specific advantages to having a single patient record when travelling between hospital trusts. For example, being able to quickly see what historical medication the patient has had, especially when it comes to antimicrobials, and the results of tests that were performed in other hospitals and healthcare settings, is absolutely vital to ensure that we do not allow antimicrobial resistance to increase at an unnecessary pace. Often, patients do not understand the type of antibiotic they are on, or remember the name of it, and that is a specific but big issue, because it can generate antimicrobial resistance. There are a few more issues that I could speak to, but I will sit down.

I beg to move amendment 60, in clause 43, page 30, line 35, at end insert— “(2A) The Secretary of State must give integrated care boards directions to increase spending on Primary Care services. (2B) The increase in spending set out in subsection 2B must be in line with the change in level of their total programme funding.” This amendment would introduce the primary care investment standard, requiring integrated care boards to increase spending on primary care services at least in line with the growth in their total programme (healthcare) funding.

It is by design.

The hon. Gentleman makes some very good points. Obviously, the whole point of this amendment is to equip people who are providing what is often the daily care for someone else with the information they need to provide that care. My family cared for my father at home for many years when he had dementia; he was on medication for other physical health issues as well, and he was not capable of administering his own medicine, or even of understanding what he was on half the time.

I would happily speak for several hours on the multifaceted reasons why young people in particular are struggling with mental health. One of my passions is ensuring that people get intervention and support before they require clinical care, but at the moment that is not happening. For a whole variety of societal reasons, including young people applying for 300 or 400 jobs and not even getting a response, more and more people are ending up on mental health waiting lists. The mental health investment standard has been widely hailed for bringing about positive change in the health service. It protects funds and provides certainty for services that are seeing dramatically rising demand and, importantly, it provides certainty about future finances. Placing it on a statutory footing in primary legislation would make it more transparent and prevent it from becoming a political football. It would also help to stop the watering down of targets that seems to have happened over the last few years. Claire Murdoch, NHS England’s national mental health director, essentially resigned over those changes. To pick up on the point made by the hon. Member for Bury St Edmunds and Stowmarket, the Milburn report and the report by the Children’s Commissioner this week showed that the number of children referred to mental health services in England has risen by over 10% in just one year—it is now at more than a million. The pressures on NHS services and funding are clear. If funding is not protected, there is a real risk that it will be cut due to competing demands. One thing I found when speaking to staff at Winchester’s A&E department is that when mental health patients turn up, having been unable to get support and often having already been on a waiting list, sometimes for more than 18 months, the average time they spend in A&E is more than 18 hours, during which some of them require constant supervision. So, we are badly supporting people with mental health issues in the most expensive part of the NHS. We cannot afford to let the mental health crisis in this country continue slipping out of control, and funding for NHS mental health services is an essential part of stopping that. New clause 33 would require the Secretary of State to “conduct and publish an annual review into the number and length of delays for patients’ receipt of mental health treatment across rural and urban areas.” Something I found interesting growing up on a farm and working as a vet is the almost unrecognised mental health issues in rural areas. That is partly because many people who work in rural vocations have minimal contact with people outside their workplace. Sometimes the vet and the postman might be the only people that a farmer sees in one, two or three weeks. There are a lot of questions about why disparities in accessing treatment in rural versus urban areas exist. Alternative approaches are needed, and some of the ideas floated have included mental health support officers for rural GP surgeries, or training vets up as mental health first aiders, because they might be a point of contact for a farmer and recognise when they are struggling. Different communities require help in different ways, and farming communities often feel overlooked. They are vital for keeping the nation fed and fit and healthy, but they have a job that involves working from before 5 or 6 in the morning until late at night. If services are provided that do not fit with that person’s lifestyle and job restrictions, they can often struggle to access them, which, when coupled with having virtually no mobile signal and poor broadband, means that people in rural areas are sometimes cut off in more ways than one. The Mental Health Act 2025 had a fairly limited focus on providing care to those with the most acute mental health problems. We need to look at preventive measures to ensure that people are supported through difficult times in their lives. These new clauses will require a report from local authorities so that we can ensure that they are providing tailored support to those in need. The Liberal Democrats strongly believe that early intervention and preventive services are key to tackling to mental health issues. These new clauses would urge mental health service providers to look beyond putting out the fire. This is about moving from crisis management to ensuring that people are supported in their local communities so that they do not reach the point of crisis. We need to treat mental health as seriously as we treat physical health. I know the Minister agrees with that; we think these new clauses will enable the Government to deliver on that ambition.

I beg to move amendment 8, in clause 47, page 34, line 19, after “behalf” insert “, including nominated carers”. This amendment makes it explicit that nominated carers can access the single patient record on behalf of those they care for.

I beg to ask leave to withdraw the amendment. Amendment, by leave, withdrawn .

Amendment 9 would place the mental health investment standard on a statutory footing, requiring ICBs to increase mental health spending at least in line with the growth in their total programme funding. Amendment 10 would enable the Secretary of State to implement financial penalties if ICBs failed to comply. New clause 27, tabled by the Chair of the Health and Social Care Committee, my hon. Friend the Member for Oxford West and Abingdon (Layla Moran), is similar. It is quite reassuring to see that the policies of the Liberal Democrats and of the Health and Social Care Committee are fairly well aligned. The Darzi report highlighted that 20% of the NHS caseload is mental health, yet at the time it was receiving just under 10% of the NHS budget in funding, and now it is receiving 8.4%. To put that in the context of real lives, when I was first elected in 2024, there were just over half a million children and young people on mental health waiting lists; as of last week, there were 1 million. While the Government have done commendable work in reducing waiting lists for physical conditions, mental health cases are increasing—and fast.

The hon. Member for Sleaford and North Hykeham covered most of the points I was going to make, so I will be very brief. The changes that are proposed to the better care fund seem like another example of decision making being taken away from local authorities and other organisations, which are often the ones that are best placed to understand the health and care needs of their local populations. This measure centralises power rather than devolving it. Ultimately, the Bill leaves the impression that social care is being pushed more and more on to local authorities. That seems like an ill-judged move, given the ongoing stand-offs we have on the funding of social care and continuing healthcare up and down the country, and it is hardly encouraging the integrated working that everyone accepts is needed to address the joint issues in social care and the NHS. We are worried that there are multiple measures in the Bill that are separating social care and the NHS at a time when greater integration and closer working are so clearly needed. If we want to grasp the nettle on corridor care, overcrowded hospitals, ambulance delays and delayed discharge, we need to get the NHS and social care working together. All those issues seem to have their roots in social care—or the lack of it. Taking these changes alongside others, such as the removal of local authorities and GPs from ICBs, it looks as though ICBs will not be capable of living up to the ambition of acting as joint committees that co-ordinate care with local trusts, GPs and social care. In summary, this all boils down to the fact that we cannot keep treating NHS services and social care as separate entities.

The hon. Lady is making very good points. The whole thrust of the argument is that there is little detail around how the single patient record will be created and implemented. This is a perfect opportunity to work out how we can empower carers while preserving patient confidentiality where necessary. If we do not focus on that in the early stages of the SPR’s implementation, before it has even been designed, we will miss the opportunity to ensure that carers have an easy way to get the right information. We should not miss that opportunity.

I beg to move amendment 9, in clause 43, page 30, line 36, at end insert— “(2A) The Secretary of State must give integrated care boards directions to increase spending on mental health services at least in line with the change in level of their total programme funding.” This amendment would place the original mental health investment standard on a statutory footing, requiring integrated care boards to increase spending on mental health services at least in line with the growth in their total programme (healthcare) funding.

What we are desperately trying to do is ensure that we are drawing on the expertise of primary care providers. The hon. Member seems not to understand that talking about 40 new hospitals the whole time with no plan to deliver them is looking at the wrong end of the health service. We need to try to keep people healthy and in the community. The new clause is an attempt to refocus thoughts on keeping people healthy in the community, rather than talking about hospitals that never existed.

It is an honour to serve under your chairship, Sir Jeremy. I have been itching to speak on this new clause, tabled in the name of my hon. Friend the Member for Epsom and Ewell (Helen Maguire)—I am not sure how to pronounce that, but I am sure it is a very beautiful place; I have never been. It would ensure that a certain range of primary care providers were consulted by integrated care boards in the development of the healthcare plans. The recent King’s Fund report, as well as many others, showed that over 90% of NHS contact with patients is in primary care in all its forms. New clause 70 relates to new clause 60, also tabled by my hon. Friend, which is about having GP representation on integrated care boards. This is an extension of that, so that dentists, pharmacy contractors and providers of ophthalmic services can all feed into integrated care boards’ healthcare plans. That is how most people come into contact with the NHS, which means that those providers have a close and deep understanding of the healthcare issues facing the demographics in their communities.

The hon. Lady makes a good point. The purpose is to ensure that those who are deeply embedded in community care are consulted by the ICBs, so that they do not miss obvious localised issues in their demographics when developing care plans. Just to give a brief example from a surgery I held recently, Joanne Cook is an occupational therapist who is campaigning for occupational therapists who have received specific training to be able to prescribe, and crucially de-prescribe, medications, in the same way that trained paramedics can. Often, occupational therapists see patients on a daily basis. They give them intimate and regular care, and are even better placed than GPs to notice small changes and adjust medications to keep people out of hospital. If integrated care boards are not drawing on the experience, knowledge and data from primary care providers in all their forms, any healthcare plans they come up with will not be relevant to those demographics. We will not be keeping people out of hospital or treating them as effectively in the community, and the whole system will not be as efficient or as targeted as it could be. I would appreciate it if the Minister considered accepting the new clause.

New clause 26, tabled by my hon. Friend the Member for Oxford West and Abingdon (Layla Moran) and the hon. Member for Worthing West (Dr Cooper), who both sit on the Health and Social Care Committee, would require the Secretary of State to review the arrangements under section 75 of the National Health Service Act 2006 and consider whether to require NHS bodies and local authorities to enter into new arrangements with one another if that is likely to lead to an improvement in how their functions are exercised. A recurring theme of Health and Social Care Committee inquiries is the impact of financial flows and how they frustrate attempts to deliver truly integrated care—an issue we discussed in earlier sittings. We all recognise that closer arrangements are needed to properly address discharge delays, which directly lead to corridor care or even unnecessary admissions to hospital. It seems that a consensus has been reached, yet the action to back that up is not there. We feel that, through this Bill, the Government are moving away from closer integration. Melanie Williams, the then president of the Association of Directors of Adult Social Services, told the Health and Social Care Committee that the NHS and local authorities “spend a lot of time debating about who pays, rather than having a conversation about how, in the longer term, we can invest in people’s outcomes to enable better health and wellbeing.” She highlighted concerns about the funding of intermediate care and community health services through aftercare under section 117 of the Mental Health Act 1983 and NHS continuing healthcare. Section 75 of the 2006 Act provides a legal mechanism for NHS bodies and local authorities to pool budgets and jointly commission health and social care services. The Select Committee has heard evidence of positive examples of such arrangements being used to commission integrated services. It also heard that the use of section 75 arrangements is inconsistent. In October 2023, the Government launched a call for evidence to explore how section 75 could be better utilised to support integration. A summary of responses published in December 2024 identified several areas for improvement, including the need for stronger inter-organisation relationships, clearer governance and financial structures, and better data sharing. The Health and Social Care Committee recommended that the Government expand the use of section 75, including the range of services that it will be used to support. This Bill is a missed opportunity for the Government to reform or promote the use of section 75 arrangements, or to provide an alternative mechanism that they believe would be more effective in addressing the challenges that funding flows present to the integration of health and care services. That is why the Select Committee suggested this new clause to prompt a review of section 72 and the introduction of guidance to support pooled budgets and jointly commissioned health and social care services.

I totally agree. We should be clear that, as other hon. Members have pointed out, there is a very big difference between someone who causes suffering to an animal for a variety of reasons, such as mental health issues or ignorance, or through neglect, and someone who deliberately causes harm to an animal because they have a sadistic personality or want to feel powerful. In this debate, it is important to consider the motivation behind causing the suffering: if someone causes deliberate suffering, it indicates that they may well cause harm to other people around them. As a vet, it is always unsettling to treat a dog with a broken rib that could have resulted from a kick when the owner says that it fell down the stairs, for example. That is a very unusual thing for a dog to do, and it would be very unusual to break a rib as a result. My concern in those situations, beyond treating the animal in front of me, extends to the people living in closest proximity to the person who has brought in the dog. We know that people sometimes even coerce their partner to stay with them instead of leaving by threatening to harm their pet. On that note, I pay tribute to organisations such as Trinity in Winchester, which has a refuge for people fleeing domestic abuse that allows them to take their pets with them, because that is a barrier to people escaping that situation. Cats Protection and Dogs Trust have very similar schemes, and they are hugely important. As vets, we are trained to recognise the early signs of diseases so that we can treat them before they become irreversible, and I believe we should take the same approach to violence. Animal abuse is not always an isolated act of cruelty; sometimes it is the first symptom of something much more dangerous. That is why I take every opportunity to discuss the important work of the Links Group, which highlights the evidence linking animal abuse with domestic abuse and other forms of violence. I ask the Minister to consider three measures. First, when someone has been convicted of abusing an animal, that information should be disclosed under the domestic violence disclosure scheme, commonly known as Clare’s law, where it is relevant to protecting someone at risk. If animal abuse predicts domestic violence, that information must be available to all those who need it. The issue at the moment is that the abuse of an animal is often prosecuted under animal welfare laws and does not show up when people look for historical allegations of or convictions for domestic violence. Secondly, anyone convicted of sexually abusing an animal should be automatically placed on the sex offenders register. At present, such convictions under animal welfare legislation carry no referral to public protection mechanisms. That means that if someone has sexually abused an animal, they are prosecuted under animal welfare laws and there is no way of tracking them, although they have a higher likelihood of committing sexual violence against other people as well. That cannot be right; it is an anomaly that this House should fix. Thirdly, anyone convicted of deliberately abusing an animal should be prohibited from owning animals in the future. The courts should have the powers to impose long-term or, where appropriate, lifetime disqualification orders. Holly’s killer had abused animals since the age of eight. He had admitted it and the RSPCA knew about it, but the legal and justice systems that are in place did not allow anyone to join those dots. We cannot allow that to happen again. By clamping down hard on deliberate animal abuse, we can protect women, spouses, children and animals from future harm.

It is an honour to serve under your chairship, Dr Murrison. I thank the hon. Member for Burton and Uttoxeter (Jacob Collier) for introducing this hugely important debate; the petitioners and Bea Elton for getting so many signatures, which is why we are discussing this issue; and Holly’s family, who are turning an absolute tragedy into something that could have a positive legacy. That is very courageous. In my many years of working in veterinary practice, one observation always stuck with me: how people treat animals is often a reflection of how they treat the people closest to them. People who treat animals with unfailing kindness tend to be some of the kindest people you will ever meet. If people deliberately inflict suffering on a defenceless animal, it is often a warning sign that that violence will extend beyond the animal and into the home. We do not know what goes on behind closed doors.

rose—

I totally understand the need for safeguards so that disclosures are not used as an excuse for harassment or inappropriate release of data. Sexually abusing an animal does not mean that someone is on the sex offenders register, and the committing of deliberate acts of violence against an animal would not automatically be included in domestic violence disclosure; but, given the way that information is recorded and stored currently, even if the police wanted to and thought it appropriate, it is unlikely that they would be able to disclose it. Would the Minister meet me to discuss how we ensure that these offences are at least recorded in a way that means that they could be disclosed if deemed necessary and appropriate?

On the economics, it costs around £850 a night to keep someone in a hospital bed and a fraction of that for a social care package. This is an absolute false economy, even if we ignore patient experience and patient recovery.

We have a few concerns about the clause in general, especially about the removal of local authority and primary care representation on the ICB. Some ICBs are already stepping back from joint commissioning arrangements with social care and the health and wellbeing boards, and it is vital that social care has a seat at the table. We have talked about this extensively in many Committees and in the Chamber, but the Liberal Democrats have been emphatic that we cannot solve any of the problems in the NHS without solving social care. At any given point, our hospital in Winchester certainly has 160 people in it who are well enough or would be better cared for in the community with a social care package; instead, they are stuck in a hospital, obviously affecting flow through the whole hospital and even affecting A&E waiting times. Combined with the changes to the pooled budgets that will affect the better care fund, we are seriously concerned that the Bill is increasingly separating the NHS and social care just at a time when the service and experts are screaming out for greater integration and collaborative working. We discussed GPs this morning. They have long-standing concerns about getting their voice heard, given their unique place in the health system. They are the front gate to the NHS and they have the most patient contact of any NHS service. Removing the duty seems to be a step in the wrong direction in that regard. Finally, the change will leave in limbo areas such as Hampshire that do not yet have a fully functional mayoral authority—our elections will be in the next couple of years. There has not yet been sufficient clarity about what the interim arrangements will be.

Just to reiterate what my hon. Friend is saying, in Winchester we are now putting an urgent treatment centre in front of the A&E, staffed by GPs to do the triage, because so many people who turn up are only there because they cannot get a GP appointment. So we now have hospital trusts paying for GPs to provide same-day GP appointments, and that is coming out of the secondary care budget instead of the primary care budget. That is obviously the most expensive place to treat patients for routine things.

Even when the right hon. Gentleman criticises, he does so in a charming way. None of this is moving the discussion to how we keep people healthy and treat them early. He may criticise our funding models and challenge the detail for achieving this measure, but if we flip that round, the previous Government promised 40 new hospitals, which were not hospitals and did not materialise. The entire focus of healthcare has been on treating people once they are sick, while people cannot get GP appointments. I hope that the right hon. Gentleman would agree that the thrust of the argument is to try to keep people healthy and treat them early, before they end up needing hospital treatment, and that that is what we should all be focusing on. If he wants to help with the details in order to get 8,000 GPs by the end of this Parliament, he can submit his suggestions to the Liberal Democrat website.

It is an honour to serve under your chairship, Sir Jeremy. The hon. Member for Isle of Wight East highlighted extremely well the difficulties of accessing hospital services on an island, but it can be a problem anywhere, including in rural constituencies. Winchester is about 60% rural. Since I was elected, an issue that I have had a great deal of correspondence about—even protests and petitions—has been the cancellation by Hampshire county council of bus services, particularly from rural villages such as Colden Common. People need buses for a variety of reasons—obviously to get to work and school—but the No. 1 issue concerning people is that of mainly elderly people using the bus to access hospital and GP services. They are really worried. It is causing a huge amount of stress that they will not be able to access hospital and GP services and not be able to remain living independently in the village that they have lived in for years. One of the new hospitals in Hampshire is due to be built in south Basingstoke. Extraordinarily, the consultation on the location of the new hospital did not include consultation with the South Central ambulance service. When moving an A&E department and maternity service to another location, it seems blindingly obvious that the ambulance service should be heavily involved in deciding where a new hospital may be located, given that it is primarily responsible for ensuring that people can get there in a timely manner. Although there is obviously a need for local councils to ensure their constituents can get to a local hospital, it is important that we have some kind of obligation. I assume it would have been an obligation that when setting up the location of new hospital services, the ambulance services must be consulted and engaged with to get their input.

I too think the hon. Member for Lichfield gave an excellent speech on the need for clarity, but there is another factor to consider. Not only is NHS England being abolished, and ICBs are having their budgets halved, but in Hampshire and other areas we also have local government reorganisation. We are going from having district councils and county councils to unitary authorities, and a mayor will be coming in next year. This is another level of reorganisation in the delivery of healthcare and social care, so there is a huge amount of change. However, there seems to be no clarity, at any level, on how this will affect services on the ground, because there are so many moving parts coming in at once.

On wraparound care, we have a fantastic initiative in Winchester where Citizens Advice spends time with patients at Melbury Lodge, the in-patient unit, to help them deal with all their life admin, such as debt issues and money issues. It has been shown that those who receive that service have a shorter stay in hospital, are significantly less likely to be readmitted and are more likely to engage with social services once they have been discharged. Is the Minister willing to meet me and the team to discuss that initiative? For every £1 spent on it, £14.08 is saved in cost avoidance for the NHS.

18. What recent discussions she has had with international partners on the potential merits of increasing sanctions against Russia.

Two years ago, I visited Ukraine, taking medical supplies in refurbished ambulances; we had to stop only twice to fill up with diesel, which made us realise just how close to us the frontline really is. It is deeply troubling that the Government are now reneging on their full support of Ukraine by pursuing an indefinite waiver on imports of Russian oil via third countries. I ask the Foreign Secretary to reverse course on this, and to close any loopholes putting any money into Putin’s war machine.

Parents in Winchester are certainly going to welcome the Government taking action on this issue and the Minister clarifying that it will be tech companies that are responsible for enforcing it, rather than the onus being put on parents. To push the Minister on AI chatbots specifically, it is excellent that we are removing access to chatbots that allow sexual relations and content, but there is so much other misinformation and bad health information being given by chatbots. That includes people with eating disorders being advised to get weight-loss drugs and misogynistic attitudes not being challenged. Could the Minister comment more on that?

1. What steps he is taking to support high streets.

It is Independent Bookshop Week, and we are fortunate to have some fantastic independent bookshops in Winchester, including P&G Wells, which I visited recently. It is possibly the longest-running bookshop in the country—it has been running continuously for over 300 years, and Jane Austen and John Keble used it. Not only is it important for our local economy and our high street; it is an important part of our historical culture and a real community hub. What is the Secretary of State doing to ensure that independent bookshops, which provide so much to communities, can cope with energy costs and business rates?

I thank the Home Secretary for her response. We have 104 different nationalities working in Winchester hospital, throughout Hampshire over one third of the workers in the social care sector are born outside the EU, and we know statistically that we are more likely to be cared for or treated by an immigrant than we are to be waiting behind one for a GP appointment. Does the Home Secretary recognise that the current visa rules for healthcare workers are driving away many of the people who are keeping our NHS and social care services running?

1. What assessment she has made of the potential impact of planned changes to immigration rules on the economy.

I too pay tribute to the hon. Member for Birmingham Yardley for her immense campaigning and work in this area. Can the Secretary of State be more specific on what actions will be taken to prevent women and girls becoming victims of AI-generated sexual content, because it really can ruin lives?

T1. If she will make a statement on her departmental responsibilities.

Thank you, Mr Speaker, for granting my hon. Friend the Member for Twickenham (Munira Wilson) this urgent question. I am very disappointed that the Minister brought petty party politics into his response, because we have consistently proposed legislation that could have been implemented months ago. I speak on behalf of parents, teachers, carers and the children themselves in asking why the Prime Minister is pleading with tech companies about this. He is the Prime Minister; he should be leading the charge on blocking child sexual abuse material on smartphones. It is absolutely baffling that we have only reached this point now. We saw earlier this year the horrifying effects of Grok and other chatbots that are able to generate and share explicit content containing women and children at the request of online users. Children deserve far more than this dither and delay. The tech companies do not even deserve this three-month ultimatum. The Prime Minister should not be begging; he should be telling the big tech companies, “No to the proliferation of child sexual abuse imagery, and no to putting profit over the safety of children.”

5. What steps she is taking to ensure the effective prosecution of domestic abuse cases.

One form of domestic abuse is financial abuse and coercion. I have been made aware of a Child Maintenance Service case in my constituency that has been repeatedly dropped at the magistrate level because of one parent failing to attend the hearing. That means that the CMS withdraws the case, not prosecuting the parent who refuses to attend, and leaving the other one trapped and without any means of escaping the loop of financial abuse. Does the Minister agree that it is deeply troubling that a case is simply dropped, without any repercussions, if a parent does not attend the hearing?

6. What steps she is taking to help improve water quality.

The Government’s own Veterinary Medicines Directorate is really concerned that pet flea treatments sold in supermarkets are washing pesticides into Britain’s lakes, waterways and chalk streams and killing aquatic life. Those treatments include ingredients such as fipronil and imidacloprid, which is banned from agricultural use to protect bees. Millions of pets are blanket-treated every month, whether they need it or not, and we already require professional advice before selling similar products to treat parasites in farm animals. Will the Minister commit to reclassifying these products so that they can no longer be sold off a supermarket shelf without professional advice? A chemical that is too dangerous for use in agriculture probably should not be available over a counter.

Q10. The Conservatives repeatedly promised us 40 new hospitals that we knew were never going to happen, but the current Government are now promising us a new hospital in Hampshire in 20 years’ time, if it gets built at all. My constituents really rely on our A&E and maternity services, but our current hospital has a huge repair backlog and rainwater leaking into clinical areas. Will the Prime Minister please break this cycle of governing parties promising us hypothetical hospitals and simply commit to fixing our actual hospital in Winchester?

It is an absolute honour to serve under your chairship, Ms Jardine. I commend my hon. Friend the Member for Tiverton and Minehead (Rachel Gilmour) for securing this fantastic and timely debate. I also note the expertise of my friend the hon. Member for North Somerset (Sadik Al-Hassan). Not only did he provide some really good insights—I thought his point about the importance of a single patient record all the way from pharmacy to hospital was especially meaningful—but I love how enthusiastically he agrees with everyone else’s points.

I completely agree. All businesses need predictability and stability. It appears that, week to week, pharmacists are trying to work out how to source drugs with changing prices, and there is an NHS contract that is not meeting their needs. When we talk about community healthcare and provision, it is important to remember that having good, well-run pharmacies means that people are being kept out of GP practices and that they are less likely to turn up at A&E. That is even better value for money for the NHS and, ultimately, for the taxpayer. There is no downside from a Government point of view to investing and heavily supporting community pharmacy, because the savings made upstream will be hugely significant. At the moment, we are treating people with conditions that should be treated in the community with the most expensive part of the NHS, in A&E and hospital, when they could quite possibly have avoided going there in the first place.

That is another legitimate point, and it was made in my second to last words, so I thank my hon. Friend for contributing. I thank the Minister for listening to our concerns.

Yes, the good ones. There has been a general consensus that pharmacies are often overlooked as a source of care for those in the community. I have visited many pharmacies in my Winchester constituency: there is Eric, who runs Springvale pharmacy up in Kings Worthy; there is Colden Common pharmacy in Colden Common; and there is the Wellbeing pharmacy on Winchester High Street, which gives me my flu jab every year. The people there actually make having a flu jab a lot of fun; we always have a great laugh. I never thought having a vaccine would be something I would look forward to, but I love going in and seeing them. We know about the 8 am rush for GP appointments, so the fact that a high street service exists where one can drop in for advice and consultations is absolutely brilliant. Pharmacies allow us to siphon off some of the pressures on GP services, but—as pharmacists have been telling me repeatedly since well before I was elected—pharmacies are currently under immense pressure. Adding to that pressure is the increase in national insurance contributions, which has saddled pharmacies and GP surgeries with additional costs. As a consequence, many local pharmacies have had to limit opening times and staff numbers. In Alresford in my constituency, the hard-working staff at Wessex Pharmacies have had to close shop on Saturday afternoons. That service will be sorely missed, particularly by those who are in full-time education or work during the week and who relied on being able to pick up their prescriptions at the weekend. In addition, shorter opening times mean that if a patient sees their GP later in the day, the required prescription is delayed by a day if the paperwork is not registered in time. For a patient with an urgent need for medication, that extra day can be extremely frustrating and worrying. Although we really do welcome the recent 10% increase in Government funding to community pharmacies, it is worth pointing out that that is giving with one hand and taking with the other. In the wake of rising costs for energy, staff and medicines, this funding increase was the first in 10 years, so it was sorely needed, but unfortunately, it did little to alleviate the extreme pressures heaped on community pharmacies in the Budget. That point comes into focus when we consider the rise in drug costs: a 20% to 30% rise for things like paracetamol and hay fever medications, and an elevenfold rise in the cost of cancer drugs since February, while the funding provided to community pharmacies has dropped by more than 20% in real terms since 2015. That is why we are calling on the Government to invest in pharmacies in smaller towns, particularly in villages and rural areas such as mine in the Meon valley. In places such as Bishop’s Waltham and Colden Common, people need access to a community pharmacy, and not only for convenience: Conservative-run Hampshire county council has cut vital bus services to the nearest big towns, which means that people without a vehicle, especially older people, absolutely rely on local pharmacies for their medication. We are also calling for a new, long-term, sustainable model for pharmacies and an expansion of Pharmacy First to give patients more accessible routine services so that we can free up GPs’ time. We want an exemption for pharmacies from the national insurance contributions increase so that funds can be spent on patients and vital medications. I come to my final, key point. I have spoken to many pharmacists since I was elected and before that, and I have had very long, in-depth conversations with them. I have also attended events in Parliament organised by the Royal College of Pharmacy and the National Pharmacy Association and I have discussed their issues with the NHS pharmacy contract. Given my professional background, I am used to sourcing, dispensing and prescribing drugs. However, the contract is so complicated that, despite my extensive conversations with those organisations, I do not fully understand it. The key message that comes out is that it costs pharmacists to dispense NHS medication in many cases, and that NHS medication is sometimes being subsidised by other sales in shops. I even met two pharmacists who said that their personal finances are subsidising some NHS dispensation. That is clearly not tenable in the long run.

It is an honour to serve under your chairship, Sir Desmond. I thank the Minister for her speech. Liberal Democrats will also support the long-term move towards a fairer farming system that rewards sustainable food production, nature recovery and climate resilience rather than relying solely on an outdated subsidy model. However, we are deeply concerned that the Government are accelerating the withdrawal of support before replacement schemes are fully available, adequately funded and trusted by farmers. We are particularly concerned that England is now the only country in the UK and Europe that does not financially support farmers in the production of food. Farmers are being asked to absorb rising costs, including increased fuel and fertiliser costs caused by war. They face uncertainty in environmental land management schemes and in the closure of the sustainable farming incentive, while facing the prospect of losing almost all remaining delinked payments in 2026 and 2027. That risks creating yet another cliff edge for the farming sector after years of Conservative mismanagement and continuing Labour uncertainty. We are also concerned that the Government continue to characterise these payments simply as “delinked subsidies” despite the fact that farmers still had to demonstrate cross-compliance with environmental standards to get the basic payment. The Liberal Democrats believe that the Government must ensure a fair transition by properly funding ELMS, restoring confidence in environmental schemes, providing long-term certainty for farmers and recognising the vital role that farmers play in producing food, restoring nature and supporting rural economies. That is why we are calling for an additional investment of £1 billion in the farming budget to support that transition. We will therefore vote against the draft regulations.

One of the main barriers to people getting back into work is poor mental health. We have very long mental health waiting lists, with a million people on them. Many of those people would rather be in work, and it is also good for their mental health to be in work. I want to highlight a initiative in Winchester that I have brought up before. It has won awards, including NHS awards. It involves Winchester citizens advice providing a person for two days a week in the local mental health unit, which is called Melbury Lodge, to help in-patients with all their life admin. People who are suffering from mental health issues, especially in-patients, are more likely than average to have debt, housing issues and other life admin problems such that, when they get discharged, they are back in the same situation as when they were admitted in the first place, and their mental health can deteriorate. The initiative is fantastic. It has been proven, through published peer-reviewed papers, that the people involved have a shorter duration of stay, are less likely to be readmitted and are more likely to engage with social services once they are discharged. Ministers will find it particularly interesting that every £1 spent on the project saves the NHS £14.08 through cost avoidance. I have met the team several times. Rolling it out in every mental health unit in the country seems like an absolute no-brainer. Given that it saves so much money and that the saving is so quick, there is no question that it cannot be afforded. This is not an investment that takes five, six or seven years to pay off; the savings are seen within months. I urge the Government to look at the project. I would be keen to have a meeting with the relevant Minister—whoever the relevant Minister turns out to be—and the team who are running this project, Winchester citizens advice and the Melbury Lodge unit. It could be hugely impactful in helping many thousands of people to get back into work. That is good for the staff, the patients and the taxpayer. We were heartened that the previous King’s Speech specifically stated that mental health would be treated as seriously as physical health. We were disappointed there was not a specific mention of mental health in this year’s King’s Speech. We urge the Government to remember to put the issue at the forefront of their efforts to try to get people back into work.

Women trying to flee domestic abuse are sometimes coerced into staying by their partner’s threatening to harm their pet, especially their dog or cat. May I pay tribute to organisations such as the Dogs Trust, which runs a dog fostering service for women while they find a new permanent home, so that they do not have to give up their pet permanently, and Trinity Winchester, which has opened new rooms for women fleeing domestic abuse, and lets them bring their pets with them? This is really needed; it breaks down another barrier that prevents women from fleeing domestic abuse.

I was speaking to farmers in Winchester just two weeks ago, and planning is a huge issue, whether they want to put in a new slurry lagoon or repurpose a barn, with a wait of more than 18 months. The process is very opaque and there is no set timeline. It is impossible to make business decisions if no timeline is given as to when they might even be told when they will have to supply information to get the planning permission.

It is an honour to serve under your chairship, Mr Stuart. I thank the hon. Member for North Ayrshire and Arran (Irene Campbell) for securing the debate and for her tireless championing of animal welfare in Parliament. This is not the first debate to be secured on animal welfare issues, and it really is making a difference. We rarely have the Gallery full, but the fact that it is today shows how many people support animal welfare and care about Herbie’s law and ending animal testing. Like other Members, I have been contacted by many constituents about this subject. I will not repeat everyone’s arguments, because they were all expressed very eloquently and put very well, but I will reiterate that an animal’s intelligence has no relation to its capacity to suffer. A sentient animal will experience pain, emotions, suffering and mental distress in the same way that we do. All the research that has been done has shown that animals have the same range and even depth of emotions as humans. They may get excited or scared about different things, but their lived experience is as real to them as ours is to us. Many people mentioned their pets. We have a labrador called Moose. When he hears the fridge door open, he comes flying into the kitchen in excitement, and if he is caught on the sofa when he is not meant to be there, he clearly feels guilt. As a vet, having seen a variety of animal species—horses, cattle, dogs, cats, chickens—in states of distress, injury or sickness, I know that the emotion and suffering they feel is as strong as any person’s. I served for years on the British Veterinary Association’s policy committee, and it very much supported the reduce, refine and replace model. That was several years ago, but we are now in a very exciting time, because it feels as though we finally have the technology that means that we really could move away from animal testing in a meaningful way and very quickly. Members have talked about computer modelling, organs on a chip and AI—the way it can model protein folding, and test various treatments and pharmaceuticals without having to use animals, potentially with even more valuable results. It is a really exciting time. We as a country, and the Government, must ensure that we are supporting our life sciences industry to do that. Life sciences are coming forward with some of the most exciting breakthroughs in medicine to help solve a whole load of diseases that we never thought could be treated, including cancers and rare diseases. They are also vital to growing the economy. As we do all we can to support the life sciences industry, both in developing new technologies and in moving away from testing on animals, can the Minister say whether any work is being done to make sure that we do not inadvertently offshore animal testing? As upsetting as it is to have animal testing in the UK, standards are higher here than anywhere else in the world. What I would hate to see happen—I am sure that everyone is united on this—is for us to ban animal testing and move away from it here, and for it simply to be offshored to somewhere with less regulation and even more suffering to be caused as a consequence. I also want to bring up the licensing of drugs that have already been tested. Currently, drugs are tested on animals; if they pass animal testing, they go on to humans; and if they pass human testing, they get a licence. The drugs have been proven to work in animals, yet they do not have a licence for the animals and cannot be used in them. It seems to me that if something has passed safety tests and been proven to work in animals, there should be automatic licensing, or what we call dual licensing, to ensure that the animals on which there has been testing have the benefit of the drug. Currently, that is not the case. We also have situations in which drugs pass animal tests but fail human tests and then cannot be used on the animals, even though they passed those tests. Although we want to move away from animal testing, it seems wrong that animals cannot mutually benefit, from a legal perspective, from the testing that has already been done. I hosted an event last week for the Humanimal Trust, which is calling for dual licensing. Its academics are from the vet school at the University of Surrey. I would be very keen for the Minister, if he is interested, to meet that team, because they have done a lot of work on this issue as well. We are looking at updating the Veterinary Surgeons Act 1966. There is currently a cascade for the prescription of drugs for animals, and sometimes pharmaceutical companies can get a retrospective licence. For example, there might be a human drug that is used in animals and is working really well. The drug company will then do the research and get a licence for that specific drug, and then no one else can use it and it becomes very expensive. We would like to look at how the Act, and the cascade for prescribing for animals, can mean that drugs that have been proven to work in humans and animals are more easily prescribed. This is a really good example that many people will have encountered: they go to the vet, who prescribes paracetamol that costs a lot of money, but then they discover that paracetamol is 16p in a shop. As vets, we are not allowed to prescribe that paracetamol for a dog. We are not trying to fleece people; it is not legal, and a vet prescribing it would be struck off. That is how the law works at the moment. I am really keen that, along with the desperately needed update to the Veterinary Surgeons Act, we look at prescribing rules and licensing as a big, holistic piece of work. I am very proud that the Liberal Democrats, in coalition, managed to bring forward the work to stop the testing of household products on animals. I am very proud to be an honorary senior lecturer at Bristol University vet school in the area of One Health. For anyone who does not know, that is the recognition that human health, animal health and environmental health are all completely interlinked. There are many diseases and things like antimicrobial resistance that affect humans and animals. We know that 75% of new and emerging infectious diseases that could potentially cause a pandemic are of animal origin. They are often related to farming practices as well. It is impossible to improve human health, environmental health or animal health without seeing the three as completely linked and addressing them all. Moving away from animal testing but having more accurate testing, and the right licensing and regulation, to ensure that animals and humans can mutually benefit from scientific advances is not only an opportunity but the morally right thing to do.

It is an honour to serve under your chairship, Mrs Barker. I congratulate the hon. Member for Bury St Edmunds and Stowmarket (Peter Prinsley) for another insightful speech; this time I will avoid comparing the anatomy of human and dog ear canals—we have covered that already. We always rightly start these speeches by paying tribute to NHS staff, doctors, nurses and everyone involved in patient care, especially given the pressures on them as a result of sheer patient numbers and working in systems that can make the job even more stressful and pressurised than it already is. They are caring for severely injured or very ill people at the toughest moments of their lives. The emotional burden of caring for people who could be dying is difficult in itself, but resident doctors work in a system that adds extra pressures and conditions that can add stress alongside that. We cannot pay enough tribute to them for even surviving in those areas. One of the best books highlighting the plight of resident doctors that I have read is Adam Kay’s “This is Going to Hurt”. It did a lot to help the public to understand just how difficult it is for a doctor to not know where their training place is going to be. It is where they are going to be forced to live and work for several years—a place where they may not have any friends or family; they might be taken away from family and spouses. They might have dependants and children. It is really difficult to plan a career, especially such a difficult and challenging career, when working with that level of uncertainty. I lived with medical students when I was a student at Liverpool University and have followed their careers since. The challenges that the hon. Member set out have been reflected in their lives and careers. I support the Government’s ambition to increase medical school placements. That is important. We have a recognised workforce shortage in the NHS, so that is an obvious thing to do, but we must ensure that we do not carry on falling into the same trap. The previous Government, under Boris Johnson, said that they would increase medical school placements—and they did, but without providing the infrastructure for training resident doctors who want to go on to specialised training. That obvious bottleneck was going to filter through. No mechanism was put in place to ensure that the NHS would have the capacity to train those extra medical students when they finished their F1 and F2. In Winchester I speak to many resident doctors, and even to their parents. Those resident doctors have gone through university, sometimes getting themselves in a fair amount of student loan debt, and are working hard on their F1 and F2. The stress of not knowing whether they will get a training placement is overwhelming, frustrating and for us, as a society, ridiculous because we are short of doctors. How have we ended up in a situation where we are training students and resident doctors, but cannot give them the further training places to continue? I urge the Government to ensure that any training places will filter all the way through for the rest of that person’s career. We know that the last Government not only thought it sounded good for winning votes to say that they would increase medical school placements, but said that they would build 40 new hospitals, though there was absolutely no funding—putting votes before a genuine long-term plan for the NHS. We then come up against a brick wall of reality. People working in the NHS end up suffering and the people who rely on the NHS—everyone—end up not getting the service that they voted for. The Liberal Democrats welcome the Minister’s statement about increasing training numbers, especially for people from more disadvantaged backgrounds. It is important that we look at the diversity of the professions. Certainly within the veterinary profession, socioeconomic diversity is not what it should be; it does not reflect society. A profession—whether the medical profession or another—offers a better service to society if it better reflects it. I once heard someone say that talent is everywhere, but opportunity is not. It is the job of all professions to ensure that we get the people with the talent enrolled on courses so that they can have fulfilling careers and offer much back to society. The statement is a really good first step, but it is a bit vague. The Minister writes about underserved parts of the UK seeing new medical spaces; how many will there be, and how will that be delivered? Will current medical schools increase their capacity? Will new teaching hospitals open to support it? The target is to place “up to 25% of students at participating medical schools…to local foundation training places”. How many medical schools have indicated that they want to participate? That will be fundamental to how this policy gets delivered. To reiterate what the hon. Member for Bury St Edmunds and Stowmarket said, we need to treat medical students and resident doctors like people; they are not just numbers. Working conditions are as important as pay, and to improve working conditions we need to double down on improving social care to avoid delayed discharge and corridor care. The doctors delivering treatment will feel that they are doing a better job, and will not feel under pressure as a result of being unable to deliver the care that they want and that patients deserve. We also need to ensure that we have a happy, resilient, passionate and excited workforce going forward. The Minister has been asked constructive questions. I ask him not to repeat the previous Government’s mistakes of talking about increasing hospital numbers and medical students, while creating a whole generation of doctors who cannot go on to serve their communities and have a fulfilling career.

T1. If she will make a statement on her departmental responsibilities.

Last week in my Winchester office, I held a meeting for parents of children with special educational needs and disabilities, and some were in tears when discussing the fight they have had to get the care to which they are entitled. Can we assure parents that any reforms made to the SEND system—which are much needed—will not cause the absolutely crippling mental health anguish, stress and anxiety that the current system has been causing?

It is an honour to serve under your chairpersonship, Dame Siobhain. I thank my hon. Friend the Member for Newton Abbot (Martin Wrigley) for his tenacity and expertise in this subject. He has done a huge amount of research, and made an absolutely excellent speech. At a moment of rising global instability, it is extraordinary that we are prepared to trust the health of our citizens and the functioning of our NHS to a US corporation that does not share our values or interests. Outsourcing the storage, handling and analysis of NHS data to a foreign company, rather than securing the national and economic benefits of this work being done by a British or UK-led organisation, is yet another example of our unnecessary reliance on others to keep our vital infrastructure running. Doctors and the public have made it clear that they do not trust this company. Fewer than half of NHS trusts have begun using this technology, in large part because of the concern from patients and clinicians. If, as the Health Secretary says, the federated data platform is “absolutely critical to the future of the NHS”, placing it in the hands of a company that staff and patients do not trust risks undermining that future from the outset. This is the central issue: we hold doctors and nurses to the highest ethical standards, and rightly so. We expect them to protect confidentiality, to act with integrity and to put patients first. So why are we asking them to use a system they do not trust and stake their professional reputations on it? Palantir is not a neutral contractor. It is a company that is deeply embedded within the political ecosystem of Donald Trump, a convicted felon whose Administration has repeatedly undermined the international rule of law. It is a company that has worked hand in glove with US Immigration and Customs Enforcement, whose behaviour is morally and legally outrageous and whose agents have operated like masked vigilantes in the deportation of individuals. We are all aware of the tragedies that that rogue Trump organisation has left in its wake. Why are we allowing a Trump-aligned company to sit at the heart of Britain’s most precious public service? Why are we comfortable placing NHS data in the hands of a company whose values are so clearly at odds with those of the British public? This is not a technical decision—this is a political choice. The NHS is not only one of our most important public services but one of the largest areas of public spending. Therefore, it is deeply concerning that Palantir’s contract for the federated data platform is so heavily redacted that it makes scrutiny almost impossible.

That is an important point. Amnesty International, whose representatives I believe are present, and others including voices within the NHS have been raising serious concerns about the potential misuse or inappropriate sharing of sensitive data. The Government must come clean about how the contract was awarded in the first place and what steps they will be taking to bring it to an end. We should be building NHS data processing capacity here in the United Kingdom, strengthening our resilience, backing our own expertise and building sovereignty in a more dangerous world. Instead, we are exporting control of one of our most valuable national assets. I ask the Government today to use the break clause, stand with NHS staff, protect patient trust and keep Donald Trump and his allies out of our NHS.

The Liberal Democrats welcome the strategy, and its specific recognition of the socioeconomic and racial disparities in women’s healthcare, which it is important to put front and centre. We also appreciate the specific recognition of endometriosis and similar conditions. My partner, Emma, suffers from endometriosis, and on many occasions I have seen her unable to stand up or barely get off the sofa, having been told for years that her symptoms are completely normal and that there is nothing wrong with her. Given that at least one in 10 women suffer from endometriosis and there are over 500,000 people on gynaecology waiting lists, clearly her experience is not unique. The picture around maternity safety is deeply troubling. Maternal mortality has increased by over 20% in the past 15 years, and there have recently been some high-profile media discussions about women and babies being let down, sometimes with devastating consequences. That is why the Liberal Democrats have been calling for one-to-one midwifery care and specialist doctors on every unit. I welcome the Government’s specific commitment on treatments for morning sickness. My hon. Friend the Member for Lewes (James MacCleary) has campaigned on that issue for a long time, and it is right that we end the postcode lottery for these medicines. The condition can be debilitating for some people, and it is not fair that women have different experiences simply because of where they live. Given that this is not the first women’s health strategy to be brought to this place—the previous Government brought one through in 2022—and the fact that many women we speak to do not feel that there has been any meaningful change, a lot of people are saying that we cannot just keep announcing strategies while women are waiting for basic care. Given the failure of the last Government to deliver meaningful change, can we have reassurances that this will not simply be another strategy announcement and that women will feel a difference in the care that they receive?

9. What assessment she has made of the adequacy of access to community spaces.

The charity St John’s Winchester runs a brilliant community space for people with dementia; I have attended it myself and sung songs with them, including Motown. It is also one of the oldest charities in the UK and provides almshouses for vulnerable people. It has been running for 900 years and has survived the plague and the civil war, which was particularly ferocious in Winchester. It has specifically cited the increase in employment costs as a reason why it has had to deregister from the Care Quality Commission. What are the Government doing to support charities that provide social care and healthcare? We know that if these charities struggle, the costs will go on to councils and the NHS.

I will bring up one more time the state of our roads, particularly in Hampshire. I was a horse vet before I was elected, so there is probably not a single road I have not driven down. Thankfully I had a 4x4, because I genuinely needed that for the roads, not just the farm tracks. Where I live in Shawford, they are not just potholes, but craters; it is like driving on the surface of the moon. Hampshire county council, run by the Conservatives, is saying that it has no money to fix the potholes. I know that council budgets are not the remit of central Government, but potholes have become such a problem. Is there the opportunity to have a debate or a review, so that we can have some emergency funding to fix these roads? It is not fair that our constituents need to pay for financial mismanagement.

It is an honour to serve under your chairship, Ms Furniss. I thank the hon. Member for Cannock Chase (Josh Newbury) for securing this important debate. Many people have to come watch in the Public Gallery, and I do not underestimate how much effort that will have taken some of them. We really do appreciate them being here today. We have heard from everyone the frustration of having a relatively rare disease with non-specific clinical signs, meaning that so many patients have been waiting years and years, in awful situations, even to get a diagnosis. What we are equally upset about is that once they have a diagnosis, the support is not available to ensure that they live the most fulfilled life possible or even, in many cases, get the most basic care that they require. On that note, I commend the hard work of EDS UK in supporting and providing training for clinicians and healthcare professionals and campaigning for standardised guidance, improved NHS services and clinical pathways to meet the needs of EDS patients. The lack of national policy has left a postcode lottery for EDS patients across the country. This is another NHS area suffering the frustratingly long diagnostic delays and lack of joined-up, multidisciplinary care that we see for certain conditions. That means that people are battling with the unexplained symptoms and pain of EDS all through childhood, and that those patients have often been told repeatedly that their tests are normal and their symptoms must be psychosomatic. It means waiting decades for an overarching diagnosis for multiple complaints and being stuck in a system that incorrectly believes that EDS is a very rare condition rather than a realistic possibility. I was interested to hear my friend the hon. Member for Bury St Edmunds and Stowmarket (Peter Prinsley) acknowledge that he probably has treated patients with this disease, having not recognised it, which is something that we are all guilty of sometimes with rarer diseases. Diagnosis is only the first step. Care is too often fragmented or non-existent, and patients struggle to get a GP appointment in the usual 8 am scramble. As a result of fragmented care, those with EDS are left to manage their own symptoms, unable to access a holistic and collaborative point of care. For many, a huge part of the burden of living with EDS comes from the lack of awareness of the condition. Unlike the situation for more visible disabilities, employers, schools and even friends and family are too often unaware of the debilitating and changing nature of this condition. Negotiating accommodations or seeking disability benefits for a condition that is little understood and largely invisible presents a huge challenge. People with EDS and those around them need clear guidance on the nature of the condition. A constituent of mine in Winchester, Dr Emma Reinhold, worked as a GP in the local community, where she became increasingly aware of EDS, with its commonly associated conditions, and how they were overlooked. That led to her development of the EDS toolkit, written in conjunction with the Royal College of General Practitioners and funded by EDS UK. That toolkit is incredible and has been shared all over the world. I first heard about it when I was knocking on doors and she popped her head out of her upstairs window to say hello. We spoke about the toolkit for about 20 minutes—me on the street and her up in her bedroom. She had been a GP in Winchester for many years and then she became seriously unwell with EDS, which was why she was at home. That was at the age of just 42. Like so many others, she had to stop working; eventually, she had no option but to take ill health retirement, so the NHS lost another GP far too soon. One patient who Dr Reinhold told me about—I think it was through that window conversation—was a woman who was in her 70s when she finally got the diagnosis that she had been looking for over many years to explain her symptoms. This is a genetic condition that she had had since birth, but it took 70 years to ensure that she got the answers that she deserved and appropriate support for her many symptoms. Emma’s open access toolkit on EDS—for anyone who is interested, it is worth googling—ought to be promoted enthusiastically by the Government as a means of promoting greater awareness on the part of all medical professionals, as well as better understanding and sensitivity on the part of everyone, so that we can ensure that all those with EDS and other hidden disabilities remain welcomed and cared for in education, the workplace and their day-to-day lives. Dr Reinhold explains that we need a co-ordinated, holistic approach to multisystem conditions such as EDS, rather than the current disjointed care that facilitates diagnosis falling into gaps between specialists, who do not always have the collective training to spot connections between apparently unrelated symptoms. Patients need national leadership, so we urge the Government to address the policy gap by working towards joined-up, multidisciplinary care across primary and secondary services, as well as supporting and promoting the existing training for staff, to ensure that those with EDS can access the care that they deserve. EDS and HSD must be integrated into NHS service specifications and long-term condition strategies as a matter of urgency. The Liberal Democrats want everyone with a chronic illness, including EDS, to have a named GP. That would improve their quality of care and allow better join-up between the range of services that they can access. We must champion the work of the Overlapping Illness Alliance and EDS UK to raise awareness of these often hidden conditions so that those in need of support are able to access it. Before the last general election, Ministers from the former Government offered to meet EDS UK, and then the election was called so the meeting never happened. Will the Minister commit to meeting EDS UK and patients, including Dr Reinhold, to better understand what would be helpful to improve their outcomes?

Does my hon. Friend agree that one immediate action the Government could take to reverse some of the damage that the Conservatives have done to our armed forces is on the Conservative decision to shut down Winchester’s Army training regiment, which trains 20% of our troops. No replacement for that facility will open in the next few years. That decision needs to be reversed.

I can reiterate that point; my partner Emma has severe endometriosis. She is regularly crippled—barely able to get off the sofa and in absolute agony. She has been told for years that this is normal and that there is nothing wrong. She had to fight repeatedly to get the diagnostic surgery that she needed, which confirmed that she has endometriosis. It is a very common story, and it is completely outrageous that people are told that crippling pain, meaning that they cannot get off the sofa, is just a normal cycle.

I also welcome the hon. Member for Washington and Gateshead South (Mrs Hodgson) to her position as Minister for Public Health. I had the privilege to serve on the Bill Committee, as other hon. Members did—indeed, I see some familiar faces in the Chamber. One of the things that struck me most was when the chief medical officer gave his evidence: he said that the Bill was not only the most significant piece of public health legislation in 30 years, but probably the single of piece of legislation that will most help to address inequality. Inequality is multifactorial, but one of the main factors in the difference in life expectancy between certain wealthier areas and certain more deprived areas is the rate of smoking. This Bill will have a huge impact, especially on the communities for which we are really trying to improve life expectancy. I am very pleased that the Government accepted so many amendments in the Lords. Some of the amendments that the Liberal Democrats are really keen on are regarding fixed penalty notices and require all the money from those fines to go to local public health initiatives, as directed by local authorities. We know that public health is so important, yet funding for such organisations is usually extremely limited, given the pressures on local authorities. Without the Lords amendments on fixed penalty notices, the money would go straight back to the Exchequer. We fundamentally believe that if we are serious about making a meaningful difference to people’s lives, that money must be used in local smoking-cessation initiatives. As the mental health spokesperson for the Liberal Democrats, I am acutely aware of the benefits of the Lords amendments that support those with long-term mental health conditions, who have higher rates of smoking than the general public. We know that going cold turkey is simply unrealistic and can even be dangerous. The exemption on vape vending machines in secure mental health hospitals ensures that people are supported professionally in quitting in a sustainable and maintained way that will not further damage their mental health. I welcome the Lords amendments on regulating filters, which have cross-party support. Not only are filters an environmental issue, but they provide a false perception of safety to smokers. Ensuring that there is awareness of the lack of protection that these filters provide and of smoking as a whole is imperative if we are to ensure that people can make informed decisions about their health and wellbeing. I am very pleased to support this Bill as it goes through Parliament; it is momentous and significant. We really appreciate the Government’s accepting the Liberal Democrat Lords amendments, which will slightly improve how the Bill will be delivered. We are very pleased that this will be a strong and impactful Bill. We hope that it will deliver meaningful change on public health for generations to come and that we will have a smokefree generation growing up.

The hon. Gentleman raises legitimate points about the pressures facing small businesses at the moment, but does he not agree that there must be better ways of supporting small businesses than facilitating children to get cancer?

I thank my hon. Friend the Member for St Neots and Mid Cambridgeshire (Ian Sollom) for securing this debate. His introduction was eloquent and his knowledge of the subject very evident. I will be honest with the House: when I first saw the title of this debate, I was not quite sure what to focus on or where to start. Everyone here has raised different issues. Do we start with addictive algorithms, underage children being able to access pornographic content, non-consensual image editing, financial scams or medical misinformation? My hon. Friend the Member for Bath (Wera Hobhouse) pointed to the harassment of people being filmed without their consent on the street. This is an absolute wild west and we have not even mentioned electoral interference by foreign powers. Part of this wild west is AI chatbots, which I have spoken about on several occasions in this House. It surprised me to learn that a third of adults have relied on an AI chatbot for mental health advice or support, or for advice on a life choice. It is also concerning that one in four teenagers has done the same thing. That is not helped by the fact that over a million people are on NHS waiting lists waiting for mental health treatment. Those people are looking for other options. Although these chatbots could be useful if designed in the right way, the concern is that they are unregulated. The medical advice that they are giving is unsafe and can be dangerous. We know that some people with eating disorders are getting advice on low calorie diets and how to access weight-loss drugs, which are completely inappropriate for them. My hon. Friend the Member for St Neots and Mid Cambridgeshire spoke about children using chatbots to get around the safeguards of online gambling companies. That is hugely dangerous. Then we come back to the general social media that people have been talking about. When I speak to people in Winchester, I hear that parents want action on social media, teachers want action on social media, and even many young people, especially teenagers, say that they think social media is dangerous and damaging. Many of them actually want us to take action on it as well. The Liberal Democrats have been working hard for the past few months to develop a position on this. My hon. Friends the Members for Harpenden and Berkhamsted (Victoria Collins) and for Twickenham (Munira Wilson) have spent months engaging with experts, charities and other organisations to come up with robust, evidence-based positions that would help us to tackle this issue. What we propose for the platforms with addictive algorithms that allow children to make contact with strangers, or for strangers to make contact with them to show inappropriate content, is to have an age rating like we see with films and video games. If we ban specific platforms, other ones pop up and we end up in a sort of regulatory whack-a-mole where we cannot keep on top of it all. If we take a principles-based approach that is based on the harm that can be caused, it can be applied to current and future platforms. To be clear, those proposals, if applied today, would effectively result in a social media ban, because current social media platforms would not be suitable for children under 16 years old. However, there is nothing to stop technology companies creating online spaces that do not have dangerous, addictive algorithms, that do not have inappropriate contact, and that do not allow strangers to contact children. They could create useful spaces where children can connect and help each other with their homework. One reason that we do not support the Conservatives’ headline-grabbing proposal of a complete ban on social media is that it would remove the ability for children to use Wikipedia to do homework. It would also mean that children under 16 would not be allowed to use WhatsApp, so they would be kicked out of the family WhatsApp group, and we know how many families rely on the WhatsApp group to run their lives. We need intelligent, proactive regulation that is fit for purpose. It is not just a matter of announcing policies that chase headlines and taking quick political positions to get a hit in the media. This is such an entrenched problem, and we need cross-party support to tackle it in a meaningful way. I think we all agree that scrolling is the new smoking. Like smoking, we already know the dangers. With smoking, we knew for decades. We knew that it was harmful and addictive, and specifically harmful for children. We know what happens: the risks are downplayed by lobbyists and the big companies, and the debate ends up shaped by misinformation and industry lobbying—and it is happening again. These new technologies, which sit at the heart of people’s emotional lives, are still subject to remarkably little scrutiny. One day we may look back on the unregulated social media landscape and AI chatbots in the same way that we now look back at smoking. We will say that we knew the risks and we knew that action had to be taken, but we waited too long and people suffered, even died—and it was preventable. These are not abstract concerns. Poorly regulated social media and AI are some of the most pressing emerging public health threats. I really would urge the Minister to agree to meet me and my Liberal Democrat colleagues to discuss the proposals we have come up with. They are backed by organisations such as the National Society for the Prevention of Cruelty to Children. They are powerful yet nuanced enough to have a genuine impact in this area, and they could be implemented immediately.

At a time when misinformation about climate change is louder than ever, these discussions are not just important but essential if we are serious about protecting our environment and our future. I thank my constituency neighbour, the hon. Member for Basingstoke (Luke Murphy), for securing the debate, for putting this issue in context, and for showing that climate change is also about health and national security. I will focus on something that we too often overlook: the direct link between climate change and global health. In veterinary science, we use the term “one health” to reflect the idea that human, animal and environmental health are completely interlinked and inseparable. Climate change does not just warm the planet; it accelerates the spread of disease across all animals, humans and plants. Climate shocks, floods, droughts and extreme heat do not happen in isolation; they disrupt sanitation, displace populations and overwhelm what are often very fragile health systems. That is exactly the type of environment in which infectious diseases thrive, and we are already seeing this. As the climate shifts, we see vectors such as midges and mosquitoes moving into different parts of the world and carrying diseases into new regions. Diseases that were once considered tropical are now being seen in other parts of the world as a direct result. In the UK, we now have a disease of livestock called bluetongue, which is spread by midges that were not previously found in northern Europe. We know that the poorest countries are hardest hit by climate change, despite contributing to it the least. We have seen that very recently in the Caribbean, which has had record-breaking storm seasons. However, this is not just a distant humanitarian issue; it is about our safety here in the UK. Disease does not respect national borders, and a threat anywhere is a threat here as well. When health systems abroad are overwhelmed, outbreaks spread faster, surveillance systems weaken, and the risk of global transmission rises. That is how local crises become global crises. Layered on top of all that is one of the greatest threats that we face in global public health: antimicrobial resistance. Antimicrobial resistance is a slow pandemic that is already under way. It gets relatively little media attention, but it is having a huge and direct effect on day-to-day medicine in the UK. It means that antibiotics stop working, routine operations such as hip replacements become high-risk procedures, and minor infections become life threatening. We are talking about returning to a world where a simple cut could kill. It is predicted that 39 million people will have died by 2050 as a direct result of antimicrobial resistance. We can add to that picture climate change, which is driving infection, increasing antibiotic use and accelerating resistance, creating a perfect storm. With falling vaccine uptake, climate change denial and growing global instability, it is often the scientists who are doing the hard work to keep us safe, yet too often their warnings are ignored. That has real-life consequences. When we cut overseas development assistance and scale back support for global health systems—for example, through the Fleming Fund—we are not actually saving money; we are directly increasing the risk to ourselves. Such funding helps to build up resilient health systems, supports disease surveillance, and reduces the spread of infection before it reaches our shores and our NHS. Prevention is not soft policy; it is hard economics. If we wait for a crisis, we have already failed. By the time a new pandemic or an antimicrobial-resistant superbug arrives in the UK, the cost will be measured not only in budgets, but in lives. This House faces a simple question: do we act early on climate, on global health and on prevention, or do we wait and pay the economic price later? A world without effective antibiotics is not an abstract future; it is becoming a very real possibility. It is one that we should not be willing to accept.

Today I present a petition on behalf of over 500 of my constituents who call on the Government to urgently review the removal of school transport for children attending Henry Beaufort school in Winchester. Under the current changes, children as young as 11 are expected to walk up to three miles—that takes over an hour—on dangerous roads to get to school. I have walked the route with parents, and it is unacceptable. The petition states: “The petitioners therefore request that the House of Commons urges the Government to work with Hampshire County Council to ensure that the school bus service from Kings Worthy to Henry Beaufort School is continued.” Following is the full text of the petition: [The petition of residents of the constituency of Winchester, Declares that the school bus from Kings Worthy to Henry Beaufort School is due to be withdrawn in April 2026; further declares that this would force children as young as eleven to walk over an hour on dangerous roads to get to school, which would be particularly dangerous in the winter months, or cost parents who will have to start work later or pay for expensive taxis; and further declares that the plans would mean more congestion, worse air quality and higher costs for parents. The petitioners therefore request that the House of Commons urges the Government to work with Hampshire County Council to ensure that the school bus service from Kings Worthy to Henry Beaufort School is continued. And the petitioners remain, etc.] [P003170]

We appreciate the Minister’s statement and the fact that the Government have moved so quickly to provide support. I have received many messages from people in the Meon valley who use heating oil and other types of energy as their main sources of heating. They understand that we cannot control international events, but they are worried that companies are profiteering, with the average price going up from £300 to £640 a tank, or from 63p to £1.40 a litre. Are the Government working at pace to ensure that Ofgem and other regulatory authorities, which do not currently regulate heating oil, will prevent companies from taking advantage of the international situation and making money off older people in particular?

There is widespread concern about the Government sticking to the decision made in 2016 to shut Army Training Regiment Winchester, which trains 20% of our troops. Has an impact assessment been carried out, and have the Government spoken with commanders at Pirbright and Winchester to ensure that they can not only maintain training capacity but increase it if necessary?

I visited the Winchester courts recently and spoke to about a dozen barriers, who were all concerned about us taking a sledgehammer to jury trials, not only because they are a fundamental part of our justice system, but because doing so will not even help to clear the backlog, as jury trials are not the limiting factor. They reiterated that it is about defendants and prisoners getting to court on time, the number of sitting days and the crumbling infrastructure. Does my hon. Friend agree that we should listen to the professionals, who know what the problems are?

rose—

Last year, I was pleased to promote a private Member’s Bill—now the Animal Welfare (Import of Dogs, Cats and Ferrets) Act 2025—to stop puppy smuggling, specifically given the issue of ear cropping. It has been illegal to crop a dog’s ears in the UK since 2006, but it was legal to import dogs with cropped ears. We thought that it was unacceptable to do that in the UK on welfare grounds, but people were getting around the loophole by acquiring dogs from abroad. This seems to be exactly the same thing. Does the hon. Gentleman agree that we should not be offshoring our ethical animal welfare issues by banning something in the UK but allowing people to get those products from abroad? If we think something is unacceptable here, it should be unacceptable anywhere.

13. What assessment she has made of the potential impact of tax changes on high street businesses.

Many businesses in Winchester that I speak to on a regular basis talk about higher energy costs and national insurance rises, and many bring up the increased red tape that has resulted from the Conservatives’ failed Brexit project. Businesses in Winchester say that they want growth, not continued red tape. About two weeks ago, I spoke to one such business, RJM International, located just off the high street. For some reason, the Government refuse to even consider reducing trade barriers to the EU by having a bespoke customs union, but industry wants it and the public are increasingly supportive. Why will the Government not even assess the economic case for a customs union and why are they clinging to a failed ideology at the expense of growing our economy?

Sophia, whom I spoke to in my constituency office in Winchester this morning, is one of many recent graduates—often with really good degrees from really good universities—who have been applying for hundreds of jobs and not even receiving replies. Has the Department carried out an assessment of the impact of artificial intelligence, in all its forms, on graduate employment prospects over the next few years? What work has been done with universities and institutions that offer apprenticeships to ensure that young people are graduating with the right set of skills to be able to work in this era of artificial intelligence?

I promise I will be as quick as possible. There is so much I would like to say about biodiversity net gain and the importance of the natural environment to people in Winchester, but I will speak only about a specific issue with one of our chalk streams that I believe the Minister could help us with. The beautiful River Meon runs through a little village called Droxford. For various historical reasons, it is classified as a public highway, and that means that people drive 4x4s along the river for a few hundred metres. It is not a shortcut to anywhere—it is not simply a river crossing—but it is damaging the riverbed. It also disrupts the spawning of the very rare Atlantic salmon that come from southern chalk streams. For over two years now, I have been working to try to stop the traffic from damaging this very precious habitat. The South Downs national park wants it to stop. The local people want it to stop. Lib Dem-run Winchester city council wants it to stop. For various reasons, we cannot get the Conservative-run Hampshire county council either to change the designation of the river so that it is no longer a highway or even just to put in a traffic regulation order to prevent people from driving 4x4s along the stretch of river. I would really appreciate a meeting with the Minister, maybe with some of the various stakeholders, to work out how we can cut through this red tape, because it is ecological vandalism, it provides absolutely no benefit to the environment and there is overwhelming support to stop the damage.

There has, rightly, been a lot of talk on both sides of the House about restricting and capping foreign donations, and how they are regulated. Does my hon. Friend agree that we also need to look at how foreign individuals and foreign states use social media to influence and change election results?

This week is Eating Disorder Awareness Week, so I would like to pay tribute to the amazing staff at Leigh House in Winchester, an in-patient unit that cares for people with eating disorders in Winchester and the surrounding area. Eating disorders are possibly some of the most serious mental health conditions people can suffer from, and the most frustrating to treat and care for. They existed before social media, but social media is certainly making things more difficult. The body images that young people—teenagers and younger—are exposed to and the normalisation of AI-altered images that are impossible to attain, but which are presented as normal and aspirational, is hugely unhealthy. We know that AI chatbots, which are often integrated into social media, are giving people mental health support and advice. I am really concerned about reports that patients with eating disorders are managing to get advice on how better to lose weight or even gain access to weight-loss drugs, which would make their condition much worse. I bring that up because there is a specific problem with AI chatbots. Some research shows that children do not recognise that a chatbot, which is often presented within social media as a companion, friend or cartoon character, does not have feelings, is not a person and does not care for their health and wellbeing. It is very possible that, with the right regulation, AI and AI chatbots could be part of extending mental healthcare to people in the community at some point in the future. At the moment, it is dangerous and unregulated, and people accessing it are not even aware that it is giving them information that is potentially harmful to their health. I do not want this to fall through the cracks of regulation. Whatever we come forward with, whether it is about social media specifically or broadcasting licences, we should bring forward principles. Banning or regulating specific social media platforms or chatbots will be very unhelpful because of the speed at which these things are developing. It is a bit like whack-a-mole: once we regulate one, another pops up. I draw everyone’s attention to the GUARD Act—guidelines for user age-verification and responsible dialogue—which was passed in the US last year. Very unusually, it had cross-party support despite the very fractious politics in the US at the moment. It regulates AI chatbots by requiring them to remind users regularly that they are not human or qualified to give medical advice, and it ensures that chatbots are not allowed to provide sexual content or have sexual or grooming-type discussions, and that users do not believe that they are speaking with therapists. I hope that we can focus our minds—especially during Eating Disorders Awareness Week—on the potential danger of young people being given what they believe to be medical advice by chatbots, which may be presented to them as friends or cartoon characters. That advice could be hugely harmful to their health. I urge the House and the Government to move with extreme speed to address the problem. About two or three years ago, most of the general public had not really heard of ChatGPT. Now, we hear that around 50% of professionals use it regularly, over one in five people use it daily, and one in three adults have already turned to chatbots for mental health advice or emotional support. That is a huge and sudden change. It is penetrating our culture and daily use. We must ensure that we do not look back on this as we did with smoking. We knew for years the damage that smoking was doing to people, but action was not taken, evidence was obfuscated and lawmakers were lobbied. They delayed, and people died needlessly. We must get ahead of this and take action as quickly as possible.

It is really encouraging to hear that 5,000 Americans came in on skilled worker visas. We are concerned that companies, especially AI and tech companies, are setting up in the UK, but not growing here, because they then relocate, particularly to silicon valley, and become multimillion or multibillion dollar companies, employing a lot of people and paying a lot of tax. Do we know, because I actually do not know, the number of people leaving to go to the US to work in tech compared with the number coming to the UK, so we can see the direction of gravity?

The biggest challenges facing the world now are global: climate change, the risk of pandemics, and antimicrobial resistance. These are global challenges, but also science challenges. The US Administration have an anti-vaxxer running the Health Department and a President who seems not to believe in climate change. Do the UK Government recognise that as an opportunity to really fly the flag for being a pro-science country and to offer refuge to scientists who want to help solve some of these huge global problems, but also help grow our economy?

Will my hon. Friend give way?

It will be. In the rural villages in my constituency such as Colden Common, people rely on the bus service to maintain their independence. If the bus service goes, they cannot get to hospital appointments and they cannot stay in the house they may have lived in for years. Does my hon. Friend agree that there is more than just an economic impact to having good transport; it actually allows people to live a full and independent life without relying on care?

It is an honour to speak in this debate and to follow such passionate speeches, including that of the hon. Member for East Kilbride and Strathaven (Joani Reid). I congratulate the hon. Member for Bury St Edmunds and Stowmarket (Peter Prinsley) not only on such an eloquent introduction to this debate, but on such an interesting history of the persecution of Jews in Britain for the best part of 1,000 years. That was very informative and provided a much-needed context for our discussion. Many Members spoke about the individuals, charities and organisations working tirelessly to ensure that the nation and schoolchildren in particular are educated about the Holocaust and will not forget it. As the average age of Holocaust survivors is 87, it is very prescient that the Holocaust Memorial Day theme is “Bridging Generations”. The Holocaust Memorial Day Trust plays a vital role in ensuring that remembrance is not limited to those whose families were murdered in the Holocaust, but includes those who, having been mercilessly killed by the Nazis, were left with no one to speak their names. The legacy of victims with no surviving family or relatives must be safeguarded through education, remembrance and memorial. If the words “never again” are to mean anything, they must represent a shared commitment to challenge hatred wherever it appears. Sadly, this year’s Holocaust Memorial Day comes against a backdrop of rising antisemitism. Jewish people in the UK are facing unacceptable and rising levels of hatred and violence—and I know from speaking to my constituents in Winchester just how isolating and frightening that can be. No one should feel anxious or scared when going to their place of worship and no one should be denied the freedom to express their religious beliefs. It ought to be a national shame that we need security measures outside places of worship, but with the murder of two members of the Jewish community just last year outside their synagogue, those measures are, unfortunately, necessary. For so many British Jews, Holocaust Memorial Day is deeply personal. It is a day of grief, of remembrance and of resilience. Primo Levi wrote: “The story of the death camps should be understood by everyone as a sinister alarm-signal.” While hatred and division persist, that alarm signal must be in our minds today, and must remain in our minds for generations to come. On my way to the Chamber today, I walked past the very moving exhibition in Parliament of the replicas of the shoes of people who were killed in those death camps. Some of those shoes are of little children. That is a stark and haunting reminder of what the Holocaust required. The Holocaust depended on the systematic dehumanisation of its victims, casting human beings as non-human to justify the unjustifiable. To murder millions, the Nazi state had to treat even little children not as children with names, families and futures, but as something less than human. In this Chamber and in our communities, schools and neighbourhoods, let us all stand with Jewish communities, because antisemitism has no place in our country or abroad. We must do all we can to ensure that Jewish people can practise their faith freely, live openly and participate fully in our society without fear. We remain today, and will always remain, committed to creating a society that never stops learning from the lessons of history.

In rural areas, there is often a double whammy. As a vet, I know from driving around in the night trying to find calvings or horses at 2 in the morning that there is also no mobile signal in places with very poor broadband. It is a problem not just in very remote rural areas: in my constituency we have issues in Sutton Scotney, South Wonston and New Alresford—a thriving market town that is in the bottom 10% for connectivity. This is not acceptable for businesses. It is not just inconvenient; it is holding businesses back.

I am very glad to be here to speak about medical devices and life sciences, because not only are they about solving many of the problems we are facing as a country, such as antimicrobial resistance in treating diseases, but they are a fantastic way of growing our economy. We welcome the fact that the Government acknowledged that the initial plans would have disproportionately affected small and medium-sized businesses. Like all SMEs around the country, they are struggling with everything from soaring energy prices to national insurance and Brexit red tape. It is vital that we reach a balance, and the Minister spoke well on this. It is imperative that funding is sufficient for the MHRA to regulate the market effectively, and we do not want to deter medical technology companies from investing in the UK. That is why we have called continually for a bespoke customs union with the EU to slash red tape and for a major boost to research and development funding, all of which would hugely benefit the life sciences sector. Will the Minister confirm that the Government are fully confident—with some sort of impact assessment or study to show this—that the adapted fee structure will not be overly punitive to business, and SMEs in particular, and will not end up inadvertently reducing the investment in and growth of medtech in the UK?

I congratulate the hon. Member for South Derbyshire (Samantha Niblett) on securing this really important debate. I really appreciate the discussion, and wholeheartedly support much of what has been brought up. One thing that I am disappointed to see is missing from the strategy is the breeding of dogs with extreme conformation. I am specifically talking about brachycephalic dogs—dogs with flat faces, including pugs, French bulldogs and English bulldogs. They are bred with such extreme conformation that they have a narrow trachea, so they struggle to breathe. They have narrow noses and what we call inverted laryngeal saccules at the back of their throat. That all impedes air flow, which means that many of these dogs require surgery in the first few months of life simply to breathe. Many owners who buy these dogs have no idea that that is going to be the situation. They might spend several thousand pounds buying a puppy, then come into the vet and discover that, within weeks or months of owning the dog, they are going to have to fork out for surgery. Some cannot afford that, which means the dog gets rehomed or euthanised—that is heartbreaking for owners and vets. In case people think I am talking about a very niche issue, the number of brachycephalic dogs increased by 3,000% between 2010 and 2020, and around that time French bulldogs surpassed labradors as the most registered dog in the UK. This is possibly the single biggest pet animal welfare situation at the moment. Aside from the breathing issues, the dogs look very cute—that is why people breed them; they look like a teddy bear, with little flat faces and big bulgy eyes—but their eyes end up getting corneal ulcers and are damaged very easily. Some of these dogs have lifelong painful eye conditions as well. The popularity of these dogs is driven partly by social media influencers posing with them and partly by companies using them irresponsibly in advertising, completely out of context—for example, for absolutely no reason, a pug pops up on the Amazon error page. It is such a problem that it is causing vets a lot of distress as well. If you talk to a bunch of vets about it, they will almost roll their eyes and say, “You wouldn’t believe how many of these I saw today. It’s really upsetting.” It is upsetting for owners as well. It is rightly illegal to intentionally cause an animal to suffer, and people get prosecuted for that. For some reason, it does not seem to be illegal to breed an animal that you know will definitely suffer—an animal that will almost certainly require surgery just to be able to breathe. This is something that the Government need to take very seriously, and something that we should really focus on. There is the potential for legislation to apply already, if it were tweaked, because it could be argued that an animal with two parents that were bred to need that type of surgery in the first place is being intentionally caused to suffer. I urge the Government to look at this, because it is possibly the biggest pet animal welfare issue that we deal with at the moment.

I can empathise with my hon. Friend’s experiences of caring for her mother. My father also died of dementia; we cared for him at home for many years. On a more positive note, I recently visited the St John’s dementia group in Winchester. It is a fantastic group with loads of activities—I joined them in singing “Sweet Caroline”, badly—and it provides vital support for those with dementia and for their carers by giving them some respite. Does my hon. Friend agree that we need to do all we can, at the local and national levels, to support such community groups, which provide light relief for people in very stressful, chronic situations?

Allies do not threaten each other, either militarily or economically, so the whole House will be troubled by comments made by the Trump Administration in the past couple of days. What is the Foreign Secretary doing to communicate with our NATO allies and the Trump Administration how unacceptable those comments are, and what are we doing to ensure the integrity of our NATO alliance?

As a fellow veterinary surgeon, I reiterate what the hon. Member for Epping Forest (Dr Hudson) just said. Every vet will have stitched up horses or treated dogs or cats that have been affected. It is not a niche problem or unusual: every vet dreads being on call on fireworks night because they know that they will be busy.

When I was studying for my A-levels, I had to work really hard to get the grades I needed to go on and study veterinary science at the amazing Liverpool University. Had social media existed at the time, I think it is really unlikely that I would have got the grades necessary, given that there are so many addictive algorithms that are distracting and bad for mental health. Will the Minister look seriously at the Liberal Democrat proposal to effectively ban social media in its current form for children? It is hugely distracting, and we want to ensure that every child can reach their educational potential.

I commend the hon. Member for Hornsey and Friern Barnet (Catherine West) on securing this hugely important debate. The cost of living, particularly the cost of food, is one of issues I get contacted about the most by my constituents. The high cost of living is being driven by rising food prices. I was astounded just last week, when someone emailed me a photo of an £8 tube of toothpaste from the supermarket in Badger Farm in Winchester. It was not a special new one that claims to whiten teeth and cure all oral ailments; it was just bog-standard toothpaste. I think we are all finding that we leave the supermarket baffled. Often, I just pop in for some essentials and I leave with a bag of shopping that has come to £50 or £60. It is affecting absolutely everyone. We are finding that people are struggling just to meet the absolute basics—not just food, but other life essentials. Several Members have spoken about farming and food producers. As a vet who grew up on a farm and so has worked in farming in many capacities, I think that that is one of the most underestimated ways of helping to address the cost of living crisis. As my right hon. Friend the Member for Orkney and Shetland (Mr Carmichael) mentioned, farm-gate prices are so low that many farmers are earning significantly less than the living wage, yet supermarket prices are so high that many people cannot afford to buy basic, decent quality food. That shows the necessity of the revised food strategy, which has to be an imperative for this Government. I know what it is like to have to get up at 5.30 in the morning to milk cows, to calve cows in the middle of the night and to work all night lambing. Farmers work all hours in all weathers, but their income at the end of the year is often not related to the amount of work they put in, because it can be affected by factors completely out of their control, such as a disease outbreak, a trade deal or a weather event. The frustration of not getting rewarded for the amount of effort, time and energy they put in is making many see long-term futures in farming as unsustainable. They need a huge amount of support. Food security is part of our national security, but 45% of our food is imported. Given the volatile geopolitical situation, food is more than ever a key component of our national resilience. While we are desperate to have food that is more affordable, we must be mindful that signing trade deals with the USA that would undercut our farmers on welfare, environmental and basic public health standards would be hugely detrimental. We do not want chicken that has been washed in chlorine, we do not want hormone-treated beef and we do not want eggs that have been produced by battery hens. That would be bad for British farming, for animal welfare and, given the antibiotic use, for public health. I urge the Government to ensure that it is enshrined in any trade deals that those standards would be protected. I want to pay tribute to the food banks in Winchester, which I have visited on more than one occasion. We have the Winchester Basics Bank and the food pantry in Unit12. I thank the huge team of more than 80 staff and volunteers for all their work; they are extremely busy at the moment. I also thank the community, faith groups and churches that support them. Taking a step back, despite all our economic troubles, we are one of the wealthiest nations on the planet. We can be a nation where an honest day’s work pays a living wage, where no one with a full-time job has to go to food banks to feed their children, and where no child ever goes to school hungry. We have to make these choices urgently; we must address them as soon as we can.

It is an honour to serve under your chairship, Mrs Harris. I congratulate the hon. Member for Montgomeryshire and Glyndŵr (Steve Witherden) on securing the debate. His absolutely fantastic speech got everyone really enthusiastic, riled up and excited about supporting science. One reason I am here is that the Winchester Science Centre is not just the biggest indoor attraction in Hampshire, but the UK’s largest stand-alone planetarium, and it has 185,000 visitors a year. I am so pleased to have it in my constituency, because science has given me the most wonderful career. I look back on the amazing things I have done because I studied science at school and took science A-levels. I have worked in Africa studying how to improve cattle production by making them more resistant to a protozoan parasite spread by the tsetse fly called trypanosomiasis, trying to create more cattle genetically resistant to that disease. I have worked in Iraq, India, all over the UK and New Zealand, simply because I studied science at school. It is the most exciting, enabling subject to study. Growing up on a farm, loving animals and loving science at school, I naturally went down the veterinary route, but my first love in science was astronomy. On the farm in Devon where I grew up there was little light pollution and the stars were incredible. I could name every constellation from the age of eight. The reason I am so moved to speak about this subject today is that the single most exciting trip we made when I was at primary school was to a planetarium. That fired up my love of science, and then watching “Star Trek” and nature documentaries while growing up on a farm shaped my world view and career trajectory. When I was a teenager, I had a favourite magazine. [ Laughter. ] I should probably clarify that it was New Scientist . To be asked a few years ago to write a few articles from a veterinary perspective for New Scientist was an ambition fulfilled. When I look back on those visits to science centres and planetariums, I wonder how many people got into science because of stars and dinosaurs. It sounds like a cliché, but they bring science to life for everyone, especially children. They help them realise what an exciting subject science can be, opening their eyes not only to studying science for a career, but to better understanding our place in the world and the importance of conservation.

I completely agree with the hon. Member. We are not here to support science centres just for themselves, just for the tourist industry or just for the economy. Some of the biggest challenges facing civilisation at the moment—global challenges such as climate change, antimicrobial resistance, risk of pandemics, biodiversity collapse, and even how to feed and provide energy sustainably for 8 billion people—are also science challenges. We need to inspire the next generation of children to recognise those as urgent problems that need to be solved. They are not hypothetical challenges; they are current challenges. Science centres are vital to inspire children to create the next generation of scientists who will help solve all those problems. We are in an era of rampant misinformation, with geopolitical turbulence and global health challenges. Places such as the Winchester Science Centre inspire collaboration, learning and the sharing of information. In a world of falling vaccine uptake, climate change denial and precarious geopolitical frameworks, it is the scientists who will do the heavy lifting to keep us all safe, and yet they are probably the most overlooked. Museums have the Department for Culture, Media and Sport to back and champion them; science centres do not have a Government Department specifically to do that. I urge the Minister to consider getting a Department such as DSIT to really champion them.

I apologise for intervening so soon, but it is important to emphasise how significant this debate is. It is not a niche issue. During my career as a horse vet, I have stitched up and euthanised more horses that have been hit by cars than I can remember—they get broken legs and their owners are injured. This is a very regular occurrence for vets. Just this morning in Winchester, in Hambledon on the B3041, a horse was hit by a car and had to be euthanised. This is not a niche problem, nor is it an unusual occurrence, so I fully support the action that my hon. Friend has taken in securing this debate.

One of the best things about the boundary changes at the last general election is that Winchester is now 60% rural. I spent many happy years driving around the countryside of the Meon valley treating horses. It is very obvious that the communities—the towns and the villages—in rural areas are cut off in many different ways, because often where there is no mobile signal there is no broadband, or no fast broadband. An added extra pressure over the last few years is that buses have been cancelled. In 2025, I spent a lot of time working with local communities trying to save or restore bus services, because they are an absolute lifeline. I took the last bus journey on the now cancelled 61 bus to Colden Common and Bishops Waltham, and the bus driver told me that the route had been going for 100 years, but Hampshire county council has withdrawn its funding. Buses are not only important for getting people to work and school, but vital for people’s independence. I have met many elderly people who used this bus to get to Winchester for hospital appointments, to go to the doctor or to do their shopping, and they say that without this bus, they will not be able to remain living in a little village, or remain living independently. It had not occurred to me that there are the communities that buses themselves create. Some people I met said that they met their friends on the bus, and they now go for coffee together and check up on each other, but they would not even have known each other had they not been on the same bus. [ Interruption. ] I have a lot to say about this bus, but I only have 45 seconds left, and it is not the only bus. Conservative Members may find it amusing, but the Conservatives on Hampshire county council have cut the funding for these buses, after they froze council tax for years. The Conservative Government cut funding for the local council, and now local people are paying the price of very poor financial decisions. The first things being cut are the buses that affect people’s everyday lives and their individual experience. That is a good example of poor financial management, and individuals are now paying the price.

I have been contacted by so many KCs and criminal barristers in Winchester, one of whom is Rosemary Burns. The collective confusion is about why we are removing such a fundamental, entrenched constitutional principle, rather than focusing on crumbling courtrooms and courtrooms sitting empty due to the cap on the number of days the court can sit and the failure of prisoner transport to bring defendants to court in time. Why are these logistical and infrastructure issues not being given a laser focus before this measure is even considered?

I thank the Secretary of State for his statement. It is really reaffirming to see the whole House express its unwavering support for Ukraine, and we hope our Ukrainian friends take heart from it. We have discussed this evening the heartbreaking situation of over 20,000 Ukrainian children abducted by Russia. Is it the Government’s position that, for this act alone, President Putin should be hauled in front of the International Criminal Court?

2. What recent discussions he has had with Cabinet colleagues on the potential merits of supporting businesses with the cost of energy.

Small and medium-sized businesses are the absolute lifeblood of our economy. Many of them, including the amazing Bar Lento—a Spanish café in Winchester that I spend a lot of time in—are the beating hearts of our communities. The average electricity bill for a small business is now £240 a month, and 92% of such businesses say that they will increase prices to deal with energy volatility. Unlike households, businesses do not benefit from an energy price cap, so they face the consequences of energy volatility all the time. Does the Minister agree that this is failing small businesses, and will he commit to a review of how to end the wild west of energy regulation?

Happy new year, Mr Speaker. One crime that most concerns farmers in Hampshire and around the country is that of illegal meat imports. Last year, I visited the Port of Dover, where I was shown some of the illegal meat that had been seized. This is not only a public health issue; it puts the UK livestock industry at risk of a notifiable disease outbreak, such as foot and mouth disease. If I were caught driving illegal meat into the UK in a lorry, the authorities would not have the powers to arrest me and would not be allowed to seize the lorry, but they would have to clean my lorry and disinfect it at the taxpayer’s expense before sending me on my way. Does the Minister agree that this is absolutely crazy and will she look at how we can equip the hard-working teams at the ports with the powers needed to provide a proper deterrent to stop this meat coming in?

Merry Christmas, Mr Speaker. I thank the Secretary of State for her comments. Let me mention something that we would like the animal welfare strategy to focus on. The Veterinary Surgeons Act was passed in 1966, and a lot has changed since then. More than 60% of veterinary practices are now owned by corporates; they used to be owned by individual veterinary surgeons. Medical care for animals is now provided by a whole range of para-professionals, including equine dental technicians, cattle hoof trimmers and animal physiotherapists, who are all unregulated. We also have very highly trained veterinary nurses, but the title of veterinary nurse is not protected. I urge the Government to make updating the Veterinary Surgeons Act a centrepiece of their animal welfare strategy. The Royal College of Veterinary Surgeons, the British Veterinary Association and the veterinary profession are calling for that. It would be good for owners, good for animals, and good for the veterinary profession, so I urge the Government to make that a key component of the strategy. I am really excited about the fact that now that I am an MP, I will not be on call for Christmas, as I have been many times. I remind everyone not to feed their dogs mince pies and chocolate, and not to let them get hold of onion gravy, as that is what keeps us really, really busy at Christmas.

Merry Christmas to you, Madam Deputy Speaker. One of the biggest issues I am contacted about in Winchester, by parents, schoolteachers, paediatricians and campaign groups, is children’s mental health, with particular reference to smartphones and social media. An emerging problem is the increased use of chatbots for mental health advice, especially by children who think that a chatbot is their friend or a cartoon character. That is causing some very dangerous outcomes. The US has just brought forward the GUARD Act—Guidelines for User Age-verification and Responsible Dialogue Act of 2025—to regulate chatbots. Given that this is an emerging and urgent problem, will the Leader of the House consider providing Government time for a debate on the specific issue of chatbots? One third of adults have already used chatbots for mental health advice and therapy.

I completely agree. As we approach the busiest and loudest time of the year and every shop and pub has music playing, which is fun for most people, it is a good time to urge people to go for a hearing test in the new year, as I will be doing. We urge the Government to look at supporting community-based services so that everyone can get the hearing assessment they need. People need information to be able to act, and if someone does not know their hearing status, they will not know what other problems they will be dealing with in the future.

I am honoured to have educated an ENT surgeon. Spaniels do have worse ear problems, given that there is a lack of airflow, and one thing that vets can get experienced at is taking a swab so that we are not using unnecessary antibiotics or inappropriate antibiotics. With a bit of experience, it is fairly easy to smell the difference between Malassezia yeast, pseudomonas bacterial infection or streptococcus intermedius—to anyone who thinks being a vet is glamorous, I say, “Spend a day sniffing ears to determine what type of microbes are down there, and it will change your mind.” It is very interesting that many Members spoke today about the impact of hearing loss on dementia. We know that dementia is multifactorial—there is no single cause—but certainly my father had hearing loss for a long time, and he developed dementia. Hearing loss certainly affected his quality of life, dementia aside. He lost the confidence to go out to socialise and barely left the farm unless he had to. We are pretty sure that a significant factor in that was that he felt he could not hear what other people were saying. He could not perform business at the market as he used to, because markets are very noisy places. The Father of the House touched on the fact that one in three adults have either deafness, tinnitus or some other type of hearing issue. What surprised me was that only 38% of people who suspect that they have hearing loss themselves have contacted a professional about it. I read that stat and was quite surprised, but I then realised that for years my partner Emma and other family members have often said, “Why do you have the TV so loud?”. I have also often noticed in a pub everyone else is talking, and I find it really hard to hear the conversation over any external noise, yet I have never gone along and had a hearing test. Quite clearly, I do not hear as well as everyone else in my vicinity, so I should probably get one. That could be a new year’s resolution for me—to go and work out whether I actually have some kind of hearing issues as well. I also note the weight given to the importance of community audiology, especially when such a high percentage of hearing loss is age-related. Those people have no need to go to a hospital to get the initial assessment, and community audiology could free up hospital time for children and other people with more acute hearing issues that need to be investigated. Audiology is one of the worst performing diagnostic services in the NHS for speed of assessment, with 40% of patients waiting more than six weeks simply for the initial assessment. That is one reason respondents to the British and Irish Hearing Instrument Manufacturers Association are advocating for open self-referral and expanded community clinics simply to minimise those delays. Delivering audiology services in the community costs 15 to 20% less than from a hospital, so it is an economically sensible model as well. We often call for more community-based services for a whole variety of medical issues to keep costs down. It should be the default for most people with age-related hearing loss. We also urge the Government to consider trialling hearing tests as part of routine health checks for people over 70 and at-risk groups and to investigate how best to support everyone, from GP surgeries to high street pharmacists and opticians, to deliver free earwax removal. They are already being successfully run by some GP practices with positive impacts on health outcomes, and the cost can be small, especially where GPs co-ordinate to pay for a service that covers a large area.

It is a pleasure to serve under your chairship, Mr Vickers. This is an important debate, secured by the hon. Member for Uxbridge and South Ruislip (Danny Beales), but it is quite something to have to follow an eminent and experienced ENT surgeon, the hon. Member for Bury St Edmunds and Stowmarket (Peter Prinsley), when speaking about hearing and hearing loss—especially as I am just a rudimentary vet. It is quite common that people bring in a dog that they assume has hearing loss because it can no longer hear its name being called in the park, yet for some reason it can still hear a treat packet or a fridge being opened in another room. On comparative anatomy, the hon. Member for Bury St Edmunds and Stowmarket may be interested to hear that one reason why up to 20% of a caseload in a day of treating small animals can be on ear-related issues is that in humans the ear canal goes straight to the eardrum whereas in dogs it bends around 90° before it gets to the eardrum. Around that corner it is often quite warm and moist, and a lot of bacteria and yeast grow in those conditions.

It is an honour to serve under your chairmanship, Mr Efford. As Mr Bennet said in “Pride and Prejudice”: “For what do we live, but to make sport for our neighbours, and laugh at them in our turn?”; so I thank my constituency neighbour, the hon. Member for Basingstoke (Luke Murphy) for securing this debate. I thought his speech was excellent, not just on the history of Jane Austen’s life, but on how relevant her works are today when viewed in terms of structural inequality, and how pioneering they were at the time. It was a very good speech, and I congratulate him on it. The hon. Member has already talked about the links that Jane Austen has to my constituency; she is buried in Winchester cathedral. She is an immense source of pride for all of us in Hampshire—with everyone claiming their little section of her life—but particularly in Winchester. She moved there in 1817 and subsequently spent her final days there. She lived in No. 8 College Street and, to celebrate 250 years since her birth, Winchester College opened it to the public over the summer. It is a mere five minutes from the cathedral, a site that many of us here will have visited and where many people come from all over the world purely to visit Jane Austen’s headstone. No. 8 College Street is a site where brilliant volunteers are brimming with knowledge about Jane Austen’s life in and around Winchester. It is also just a couple of doors down on the same street as P&G Wells bookshop, which is one of the longest continuously operating bookshops in the UK. It is very beautiful; Austen was probably one of its most famous customers, and it still sells beautiful collector’s editions of Jane Austen in the store. The cathedral, Hampshire Cultural Trust and many other local groups and businesses have put on excellent events and exhibitions to commemorate 250 years of Jane Austen this year. I thank everyone involved for their hard work, and everyone is welcome to visit. The more we learn about Jane Austen, the greater our admiration becomes for a woman with such wit, skill and literary prowess. Through her work, we enter into the mind of a young woman in a society where that voice would not usually be heard—and it is not just any voice; it is bold, witty, ironic and very funny. Austen brings us a voice that had hitherto been sidelined; when it is given centre stage, we can hear all its incredible qualities. She has a sharp and honest sense of humour and a clear-minded understanding of people and society, and emphasises the importance of taking pleasure in a good novel, which should be an inspiration to us today, particularly at a time when the proportion of the UK population reading for pleasure has been decreasing significantly. Austen delighted in the ridiculous, and was never one to take life too seriously, writing in “Mansfield Park”: “Let other pens dwell on guilt and misery.” As we celebrate her immense cultural legacy, I hope that that joy and amusement in the society of others will continue to inspire and enlighten us today. When I was younger, my mother and my two younger sisters watched the ’90s BBC adaptation of “Pride and Prejudice” on loop for about a decade, and I can still quote nearly every line from it—I should thank them for making me appeared more cultured than I actually am. As Lizzy Bennet says: “Think only of the past as its remembrance gives you pleasure.” It is with great pleasure, fondness and admiration that we celebrate the life and works of Jane Austen.

The Army Training Regiment Winchester, which puts about 20% of new recruits through basic training, is due to be shut next July, but the replacement facility at Pirbright is not due to open until 2030 at the earliest, although apparently that might be delayed. We have corresponded on this briefly, but would the Minister be willing to meet me and perhaps facilitate a meeting with the commanding officers of Winchester and Pirbright, to ensure that they have the support they need to increase troop numbers and not lose the capacity to train 20% of them?

On that point, I was alarmed to hear that one in three adults in the UK has relied on AI chatbots to get mental health advice and sometimes treatment. That is partly due to the long waiting lists and people looking for alternatives, but it is also due to a lack of regulation. These chatbots give potentially dangerous advice, sometimes giving people with eating disorders advice on how to lose even more weight. Does the hon. Member agree that this needs to be controlled by better regulation?

I thank the Secretary of State for his statement. People will be hugely alarmed at the threat of more industrial action right before Christmas, and we cannot forget how we got here. We know that the previous Government under-resourced the NHS. It was overburdened, people felt underappreciated, and the whole system was being held together by the good will of the staff. Having said that, the timing is terrible, because we have the worst winter flu outbreak in decades, right before Christmas. We have to urge the BMA to work constructively to resolve this dispute in a way that is fair for both patients and taxpayers. Given that resident doctors received a 29% pay rise last year, I think most of the public feel that pushing for another 28.9% this year is unaffordable and unreasonable. The Secretary of State touched on resident doctors’ legitimate concerns. The previous Government increased medical school places without increasing the facilities to deliver the necessary specialist training placements, so this was a predictable bottleneck that we are now up against. Waiting lists are long, we need more doctors, and we have doctors who have been trained largely at the taxpayer’s expense struggling to find work. We very much welcome the extra 4,000 placements that were announced today, which are hugely necessary. Can we ensure that they will address the acute shortages in general practice and psychiatry? To put those 4,000 places in context, 10,000 doctors applied for 500 psychiatric training places last year, and the Secretary of State said that about 40,000 doctors have applied for 10,000 places this year. Is there work to try to increase places as quickly as possible in the next few months and years? At Winchester hospital, one in five beds is taken up by people who do not have any social care packages. That is not good for them, because they are stuck in the hospital, and we want to get them home for Christmas, but it will also affect the flow through the hospital right now, during a winter flu crisis. We welcome this action and urge the BMA to call off the strikes, but can we address the legitimate grievances that the Secretary of State has mentioned?

This is the first time I have intervened on the hon. Member—it is normally the other way round. He mentioned climate change, and I was alarmed to read that last year Hampshire and Isle of Wight Fire and Rescue Service attended 197 outdoor fires and wildfires, which was one of the highest numbers in the whole of the UK. We are seeing water scarcity and abstraction from rivers against the backdrop of having had the 20-odd hottest years on the planet—year after year after year. It has to be acknowledged that that is affecting water scarcity as well.

I thank Members across the House for the constructive way in which they have all contributed towards this long-awaited Bill. In the last 40 years, attitudes to mental health and the treatments available have changed significantly, so these reforms and updates are very much needed and very much supported by everyone here. On Lords amendment 19B, we welcome the important addition. All children and young people deserve appropriate care and support when undergoing treatment for mental health problems, including the safeguarding of a nominated person. Each and every child going through the system deserves to be properly represented by a responsible adult, so we are grateful for the amendment and we are pleased to lend it our support. While we understand that the remit of this Bill very much focuses on in-patient mental health care, we cannot ignore the wider context in which this Bill needs to operate. Even the best in-patient system will struggle if we fail to invest in the preventive and early intervention services that keep people well in the first place. The hon. Member for Hinckley and Bosworth (Dr Evans) mentioned the difference between mental wellbeing and mental health issues, and ensuring that we protect people’s mental wellbeing before they go on to develop mental health issues. If we are serious about preventing people from reaching crisis point, we need to ensure that the many community-based initiatives, which the Minister and others have spoken about, are strengthened. That is why we will continue to champion walk-in mental health hubs, having a mental health professional in every school and a sort of mental health MOT check-up at key points in individuals’ lives. It has been an honour to contribute to this Bill. I want to thank the Minister for his meaningful engagement with all Members across this House for the best part of a year. My one ask of him tonight is to again consider restoring the suicide prevention grant to voluntary, community and social enterprise organisations, because I keep meeting charities and organisations that have benefited from it. It is really important that we support community organisations that can help identify when someone is reaching crisis point, because so many people who take their own lives are not in contact with NHS services. Finally, I pay tribute to all the frontline workers in mental health in clinical and community settings. Nurses, counsellors, psychiatrists, doctors, therapists, support staff, carers and charities prop up a system that is complicated, underfunded and challenging to work in, and we want them to know that we appreciate all the efforts that they continually make. The Liberal Democrats will keep pushing until mental health is given the same urgency, care and attention as physical health.

I want to give a big shout-out to the Hampshire Chronicle , which I write a monthly column for; that is one of the most vital ways to communicate with my constituents. I was speaking to the owner of the Meon Valley Times , which is a free service that anyone can access and is not behind a paywall. He told me about the difficulty of big social media companies populating their feeds with content from local journalists, who rarely get any financial benefit from that, despite doing the work. Does the hon. Member agree that these companies should be made to support local journalists and their hard work?

It is an honour to serve under your chairmanship, Sir Jeremy. I thank the hon. Member for Altrincham and Sale West (Mr Rand) for securing this debate and for speaking so movingly and emotively. I can only imagine the mixture of emotion someone feels when they receive a terminal diagnosis. We know that around six in 10 people referred for hospice care have significant psychological support needs, but there is a lack of good, standardised mental health provision for people receiving hospice care. More than 10% of suicides in the UK are in some way linked to either chronic or terminal physical illnesses, so there is a mental health undercurrent running through the heart of end-of-life care. Like many other Members, I want to pay tribute to the extraordinary hospices in my constituency. I have visited them and taken part in local fundraising events for them. I did 12 hours of exercise for Winchester hospice —I was doing boxing around midnight, and I can still feel it now, even though it was about a week ago. The inspiration I got from seeing so many members of the community raising money for Winchester hospice, or for children’s hospices Naomi House and Jacksplace, is unbelievable; so is the dedication of the staff and the volunteers, working in some of the most emotive jobs possible. It is a lifeline for the families affected by having a relative or a child with a terminal illness. Hospices across the UK are under immense strain, and only 16% of people attending them believe that their psychological support is adequate. Too many people approaching the end of life are pushed towards the overstretched NHS mental health services. If someone ends up on the conventional mental health path, they may be put on a waiting list that is more than a year long—and, I am sorry to say, they may not have that long to live. We must also recognise the quiet heroism of unpaid carers. They give up work, rest and any sense of normality to care for someone they love, and most of them receive no formal bereavement support at all. Their contribution is vast, but their support is minimal. As an aside, since many Members here have an interest in hospice and medical care, and a couple are doctors, one of the best books I have read on the subject is Atul Gawande’s “Being Mortal”. It is about the wishes of people who receive terminal diagnoses, how they want to die, the experiences they want to have while they are on that journey, and the amount of fulfilling experiences and the sense of purpose that they can have while suffering from sometimes incredibly painful diseases. As the Government develop the new modern service framework for palliative and end-of-life care, we want to ensure that mental health is absolutely at its core. That means regular mental health assessments throughout a person’s illness, embedding psychological support in palliative care teams and creating a sustainable, long-term funding model for hospices so that they can plan with certainty. It also means real support for family carers, paid carer’s leave, guaranteed respite and proper access to bereavement services. This debate is not about dying badly; it is about helping people to live really well and to live really fulfilled until the end. If we truly believe that every life has worth, that worth does not diminish in someone’s final months or days, so mental health support must be built into palliative care, and not bolted on as an afterthought.

T3. Reports that one in three adults have been relying on chatbots and artificial intelligence tools for mental health advice and therapy are concerning, because those tools are currently unregulated and potentially dangerous. One reason why people are using them is that mental health waiting lists are so long. What is the Secretary of State doing to reduce mental health waiting lists, so that people can speak to a qualified mental health practitioner instead of relying on unregulated AI tools?

I, too, thank the Prime Minister for reaffirming his commitment to the Global Fund. I secured a Backbench Business debate about the fund last week, so we really do appreciate that. The Army Training Regiment Winchester trains about 20% of new recruits, putting them through basic training. I was there last week to see the passing-out parade. However, it is scheduled to close next summer, and the replacement facility at Pirbright is not due to open until 2030 at the earliest, although we have heard that the opening will be delayed. Will the Prime Minister review that decision? A four-year gap between one facility closing and another opening, at a time when we are rightly trying to increase troop numbers, does not really make sense to anyone.

There has been a lot of discussion about police officers and other emergency service workers injured in the line of work, and there has been some mention of issues such as PTSD and other mental health issues. Does my hon. Friend agree that we need to see those as being just as important? The experiences that some of these frontline servicepeople encounter on a regular basis have long-lasting effects.

I will—the hon. Gentleman caught me two seconds before I finished.

It is an honour to serve under your chairship, Mr Mundell. I thank my hon. Friend the Member for Richmond Park (Sarah Olney) for securing this hugely important debate. I thank all the Members who have spoken today, especially the hon. Member for Cannock Chase (Josh Newbury), who was vulnerable and honest, which can be difficult in a public forum. His example will help a lot of people to understand that no matter what job we do and how much support we have around us, people still have these kinds of thoughts. Many people know that I was involved in a mental health charity that offers support to the veterinary profession. Vets have a suicide rate about four times the national average. It is a tiny profession, so everyone knows everyone, and everyone has lost friends and colleagues to suicide. Vets have challenges similar to farmers, another demographic who we know struggle quite a lot. I pay tribute to Mr Pirie for being here today. The most difficult and emotional conversations that I have had since becoming an MP have been with parents who have lost children to suicide and wives who have lost husbands. Amid the frustration and anger that they all experience, they feel that if they had just known how much someone was struggling they could have done more to support them. Even worse are the cases where someone was actively trying to access support, but did not get the right type of support at the right time and so fell through the net. I think about my own friends, Sarah Brown and David Bartram, two vets who were also trustees of a veterinary mental health charity. When we lose people, it is important that the memory of their life is not defined by how they died. Sarah was one of the funniest people I have ever met. She never missed a night out. David was an ultramarathon runner and one of the best speakers I have ever seen giving lectures. He was a hugely engaging person. It is a real shame that people get remembered for the way they died and not the positive contribution and the fun and happiness that they brought when they were here. As a mental health spokesperson, I get really concerned when I hear people from other political parties, specifically Reform, belittling mental health issues and saying that it is the new back problem, it is over-diagnosed or people should man up. Are they seriously saying that farmers, who are some of the toughest people we could ever meet, working all hours in all weathers and earning a living in the hardest way possible, and veterans, who have experienced situations that most of us can only ever imagine, are a bunch of snowflakes who need to man up and toughen up? Mental health is a real problem that can affect even the hardest people on the planet, and no one is immune to those sorts of challenge. Other Members have talked about 2023 having the highest rate of suicide for 25 years. That rate, thankfully, is slightly declining. It is interesting that the World Health Organisation states that depression is the No. 1 global disease. It affects people in all countries; it is a very prevalent issue. We are much better than we used to be at talking about depression and mental health issues, but suicide is the one aspect of such issues that still carries a lot of stigma. People still do not want to talk about suicidal thoughts, or sometimes there is shame in having a relative who died from suicide. It is not talked about as openly as it could be. I thank the Minister for his diligent work over the last year on the Mental Health Bill. We have all worked closely on that, including the Opposition spokesperson, the hon. Member for Hinckley and Bosworth (Dr Evans). It is fantastic work and I know the Minister cares very much about this issue. I also welcome the £3.6 million over three years provided under the men’s health strategy specifically for suicide prevention, although I am concerned that it is very much less than the previous £10 million-a-year suicide prevention grant fund for voluntary, community and social enterprise organisations. How will the £3.6 million be targeted? Will there be scope to support in other ways the many organisations and charities, such as the Samaritans, that have contacted me to say that the grant is a significant part of their funding to deliver their services to help prevent suicide? There are so many amazing community groups all over the country. I meet some quite regularly. The Farming Community Network, the Bishop’s Waltham men’s breakfast, the men’s sheds that are everywhere—we have one in Alresford and one in Hambledon—and Winchester Youth Counselling do brilliant work bringing people together. We must do everything we can to keep those organisations viable, running and thriving. It is so much more economic if people are prevented from heading down the route of depression, with a good social network and a lot of community support, than if they end up needing to engage with clinical services. I also thank all those on the frontline: the clinical staff, the nurses, the counsellors and the carers caring for people who are struggling with mental health issues. The mental health of carers is another huge issue.

I thank the hon. Member for intervening just in time. I reiterate how pleased we were that the Minister looked at the amendments to identify children of mental health patients. Sometimes those children are essentially carers as well, and it is really important that we know they exist and that they get the support they need.

I beg to move, That this House has considered Government support for the Global Fund to Fight AIDS, Tuberculosis and Malaria. It is an honour to serve under your chairship, Mr Dowd. It is 2025, and we find ourselves discussing whether the United Kingdom will continue supporting an organisation that has saved millions of lives. This is an important and timely debate, and it should remind us how much progress we have made, and how much we stand to lose if we step back now. When I spoke earlier this year about the US cutting funding to the World Health Organisation, I said then, and will repeat today, that global health is not charity; it is security and self-interest. Supporting international health systems does not just save lives overseas; it keeps us safer here at home. Stronger systems abroad mean fewer outbreaks reaching our shores, more stable trading partners and a healthier global economy, which Britain depends on. Investing in the Global Fund to Fight AIDS, Tuberculosis and Malaria is not only the right thing to do morally but the smart thing to do economically and strategically.

I completely agree about the importance of demonstrating international leadership on this issue. If international support declines, from us and other countries, an additional 10 million new HIV infections, including up to 880,000 in children, could occur by 2030. Those are preventable deaths—people who could be alive this time next year if we choose differently and maintain funding. Tuberculosis, often called a Victorian superbug, is on the rise again, with cases in England up 13% last year. Globally, it remains one of the leading infectious killers. It is largely preventable, treatable, and curable in the vast majority of cases, yet is too often neglected. Malaria is a microscopic parasite, spread by something as small as a mosquito, that continues to kill half a million people a year. There is a saying, “If you think you are too small to make a difference, you have never spent the night in a tent with a mosquito.” We know what works: mosquito nets, repellents, rapid tests and education. The challenge is not the science but the access. The tools exist but too many communities cannot afford or reach them. When it comes to global public health, “Nobody wins unless everybody wins.” Those are not my words but Bruce Springsteen’s. They apply just as much to global health as they do to any other struggle. If we allow international health systems to weaken and turn our backs on collaboration, we are failing not only others but ourselves. Every time we strengthen a health system abroad, we strengthen Britain’s safety at home. We reduce the risk of the next pandemic reaching our shores, protect supply chains, stabilise economies and open new opportunities for trade and innovation. If we invest now, we can cement the UK’s reputation as a global leader in health innovation, not just through our laboratories and universities, but through partnerships such as the Global Fund that translate research into real-world impact. British expertise in vaccine development, diagnostics and data science already help to shape programmes that have saved lives across the world. Continued investment allows us to share knowledge, strengthen health systems and, in doing so, build influence and resilience that benefit the UK and our global partners. We also need to be honest about the wider picture. The UK’s official development assistance budget has already been reduced from 0.7% to 0.5% of national income. The Government are now reducing it further, to around 0.3% by 2027. The Fleming Fund, which monitors and helps to tackle antimicrobial resistance, has been scaled back, and the UK’s contribution to Gavi, the Vaccine Alliance has fallen from about £1.65 billion to £1.25 billion for the next funding cycle, which is a real-terms reduction of roughly 40%. Taken together, those decisions risk sending a message that Britain is retreating from its proud record of global health leadership. If we are serious about being a world leader in science, public health and international development, maintaining our commitment to the Global Fund is one of the clearest and most effective ways to show it. A rushed transition from global aid to self-financing, forced by rapid funding reductions, will result in direct harm through reduced healthcare, stock-outs of essential medicines and untimely deaths. When this is done in the context of infectious disease, the long-term cost will rise in exchange for short-term savings.

Yes, these are really important summits, and it is important to show international co-operation. The Global Fund has been central to the progress I have spoken about. It has helped to save millions of lives and allowed millions of babies to be born HIV-free. Yet progress is fragile and without the sustained investment mentioned by the hon. Member for Exeter (Steve Race), the gains made will unravel and history will repeat itself. The United States AIDS programme—the President’s Emergency Plan for AIDS Relief—launched more than 20 years ago, has saved around 25 million lives. It supports testing, treatment and prevention in more than 50 countries. To show the impact of cuts on these programmes, following funding cuts to that initiative earlier this year, an estimated 120,000 people have died—more than the population of a constituency.

The hon. Member is completely right about the work that voluntary and church groups do on global public health.

I thank my hon. Friend for his intervention, and I am finishing up now, Mr Dowd. Britain has always punched above its weight when it comes to science, health and compassion. We helped to eradicate smallpox. We led on vaccine distribution. We have the knowledge, compassion and credibility to lead again, if we choose to. During the covid-19 pandemic, we all waited for the science to catch up—for a vaccine and for hope. When it finally arrived, the world changed overnight. With HIV, TB and malaria, we do not have to wait. The science is already there. The treatments already exist. What is missing is the political will and the funding.

I totally agree with my hon. Friend, who sits on the Foreign Affairs Committee; that is an insightful point. Many of us will remember “It’s a Sin”, Channel 4’s extraordinary drama about the HIV/AIDS crisis in the 1980s. It was joyful and heartbreaking, and it reminded us that behind every statistic was a real person—sons, daughters, friends and partners, all with lives full of love and potential. But HIV today is not a death sentence. Science has done its job. Because of one pill a day, or even a single injection every few months, people can live long and healthy lives. The UN’s 95-95-95 target—that 95% of people living with HIV know their status, that 95% of those are on treatment, and that 95% of those are achieving viral suppression—is within reach, but it will not happen by accident. It requires commitment, funding and global co-operation.

I totally agree with those comments. I will finish by paying tribute to one of my friends from vet school, Polly Birch. She was diagnosed with a melanoma in 2016 and had it removed, but in 2017, a few months after giving birth to her baby girl, Ada, she discovered it was metastatic, and she passed away. Her final post on social media was beautiful and moving. A couple of days before she passed away, she said: “Appreciate the people around you, adventure with them, buy less stuff and go out and experience the world…and look after the bees.” Finally, and perhaps most poignantly, I will quote Mary Schmich: “If I could offer you only one tip for the future, sunscreen would be it.”

It is an honour to serve under your chairpersonship, Ms Jardine. I congratulate the hon. Members for South Norfolk (Ben Goldsborough) and for Isle of Wight West (Mr Quigley) on securing this debate. I wish the hon. Member for South Norfolk all the best in his treatment. I have to say, it was hugely brave of him and emotive to hear him talk about the journey he is going through at the moment, and to hear him paying such tributes to all the staff involved in his care. I also thank Zoe’s family for coming here today, because it cannot be easy to hear people talk about this disease after everything they have been through. Many of us will know, some from personal experience, how frightening it can be to face a possible or actual cancer diagnosis. When words such as “biopsy” or “diagnostic tests” enter the conversation, that provokes deep concern, and yet those tests, as everyone has been reiterating, are absolutely vital. Early diagnosis is the single most important factor in improving survival rates. The sooner any type of cancer is identified, the sooner treatment can begin, and the more likely the outcome will be favourable. The tests are very important for people’s mental health, because sometimes the test is clear: a person knows that, and knows there is no need to worry unnecessarily. In an ideal world, someone who notices a suspicious mole or mark would call their GP; be seen within two weeks, as set out in the National Institute for Health and Care Excellence guidelines; if necessary, a biopsy would be taken; and, if cancer was confirmed, treatment would begin within 62 days. In an ideal world, that treatment would be available to everyone, regardless of their postcode. We know that is not the reality for everyone, either in Winchester or the rest of the country. We know GP access is a growing concern. In Winchester, I regularly hear from my constituents that they are waiting weeks for appointments, which means we are falling at the first hurdle. The second hurdle—treatment within 62 days—is just as worrying. In Winchester, in July 2025, only 73.6% of cancer treatments began within 62 days, well below the operational standard of 85%. The truth is that, at almost every stage of the process—from initial concern to diagnosis and treatment—we are letting too many people down. It is one of the reasons that the Liberal Democrats have been calling for a two-month cancer treatment guarantee for a long time now: a new target so that 100% of patients will start treatment within 62 days. We must also replace ageing radiotherapy machines and expand provision so no communities are left in what have rightly been called radiotherapy deserts. We do not want anyone to have to travel hours and miles when they are feeling ill for lifesaving care. The last Government’s decision to close the National Cancer Research Institute, which had co-ordinated cancer research since 2001, was a grave mistake. One oncology professor compared this to “turning off air traffic control and hoping the planes will be fine”. We owe it to patients and their families to build confidence in the system, and that means faster access to GPs, earlier diagnosis, better treatment, proper investment in research and a comprehensive long-term plan to boost survival rates. I really welcome all the comments about regulating the private medical sector to ensure they are taking biopsies, as well as the regulation of sunbeds.

On the Mental Health Bill Committee, we spoke repeatedly about veterans experiencing mental ill health, often linked to trauma from their service. They often end up in a system that does not recognise their trauma and what they have been through. Does my hon. Friend agree that it would be a good idea to have a dedicated role of veterans’ mental health oversight officer? The Lib Dems have been calling for such an officer, so that we can ensure that veterans receive the understanding and tailored care that they deserve.

I completely agree—that is hugely important. The sugar levy has been a huge success: between 2015 and 2019, the amount of sugar in soft drinks reduced by about a third, which reduced sugar intake in our collective diet by 48,000 tonnes. If we expect the Government to pay for people’s treatment when they are sick, as we rightly do, there is also an onus on them to help people to maintain their health. That is both a moral and an economic imperative. It is often not noted that as well as the direct implications of obesity, diabetes and liver issues related to genetics and diet, there are also indirect costs that affect the NHS, such as the number of hip replacements and knee replacements, and other types of expensive and intense interventions that could probably be significantly avoided if we had healthier diets. As we know, the issue with many liver problems is late diagnosis. The liver can take a huge amount of abuse in many forms until it stops functioning to the level at which it appears compromised. When symptoms are finally seen, there has often been sustained damage for quite a long period of time. The scanning that is done by the British Liver Trust and others—I encourage everyone to get their liver scanned when they come into Parliament—can pick up diseases such as fatty liver disease before the clinical symptoms are seen, which is absolutely key. The UK ought to be one of the healthiest countries in the world, but we know we are not. Winchester is a relatively wealthy constituency, yet 54% of adults are overweight or obese, along with 27% of children. We are a country with a long history of world-leading medical research, grassroots sport and high-quality food production, yet over the last 14 years people have been becoming sicker for longer. That is multi-factorial, but it is in part due to the gradual erosion of public health funding by the previous Conservative Government. The issue of improving health is multifaceted, and obesity is certainly an example of that. Factors such as poor mental health and the broken food system contribute towards the growing numbers of people who are overweight or obese. The hon. Member for Stroud talked about the importance of free school meals in helping to reduce childhood obesity, the hon. Member for Blackpool North and Fleetwood (Lorraine Beavers) talked about inequality and poverty levels, and the hon. Member for Bootle (Peter Dowd) highlighted the issues of different demographics and incomes. I spent seven very happy years in Liverpool and have very happy memories; ironically, my liver probably does not, as I was a student there for many years. There has been a political failure. As has been said, over the past 30 years successive Governments have proposed more than 700 policies to tackle obesity, yet none has ever been successful. We have never had a coherent strategy. We cannot underestimate the scope that must be taken into account when discussing how we tackle obesity. We need to look at every intervention possible, including having a robust, well-supported food production system, ensuring that everyone can afford good-quality, locally produced food, and ensuring that we expand free school meals even further to help to keep children healthy. The Tobacco and Vapes Bill is a really good example. When Chris Whitty gave evidence to the Bill Committee, he said not only that it was the biggest piece of public health legislation in 30 years, but that it is probably going to be the most significant piece of legislation to help to address inequalities, because smoking rates are one of the most significant reasons why there is such a difference in life expectancy between some of the more deprived postcodes and the wealthier ones. That type of intervention is not only good for health but really good for addressing inequality. As other Members have said, we cannot tackle this problem without also ensuring that food is produced to high enough standards, that we have limits on junk food advertising, and that we force big food manufacturers to reduce salt and sugar in their products and have a much better labelling system, so that people can make more informed and affordable choices. I am so impressed with the hon. Member for Strangford (Jim Shannon) for being able to lose 4 stone. I have put on the best part of a stone in the last 18 months, since I was elected, partly because of my increased food intake since I have been here and also because the strange hours mean that I lack time for exercise. I used to have a fairly active job, which I do not really have any more. Yesterday I went to the Winchester Boxing Club, where a guy called Glyn Parkin gave me a really good workout—I can still feel it today. I did the Compton 10K and the Alresford 10K this year—both big fundraising 10-kilometre events. Despite trying to keep up my exercise, however, it is really hard if I am not focused on food, because about 80% of weight loss is due to diet. At best, perhaps 20% is down to exercise. I am aware that if I do not get on top of my weight, it will affect everything from knees to hips, and in some ways, exercise will become more difficult. If I end up with knee or hip pain, I will end up exercising less—and when I exercise less, I make worse dietary choices as well. We need to encourage people to stay healthy and keep exercising, but if we do not get the diet right, those two things are almost impossible to achieve. I again thank the hon. Member for Worthing West for securing this hugely important debate, and I thank the British Liver Trust for all that it does. I encourage everyone to go and get scanned by the British Liver Trust when it next comes to Parliament.

Fantastic. Hopefully it will improve people’s mental health—and if they leave halfway through, it will probably improve their physical health, too. That is a fantastic initiative. Other Members have talked about the soaring rate of liver deaths, which has shot up in the last 20 years. The hon. Member for Worthing West talked about it costing the NHS £6.9 billion directly, and some studies show that it has cost the economy over £100 billion in other ways, such as from people being off work.

It is a pleasure to serve under your chairmanship, Mr Efford. I thank the hon. Member for Worthing West (Dr Cooper) for securing this really important debate. We have a lot of medical professionals in the room. It might surprise colleagues that, although I am a rudimentary vet, we treat fatty liver disease quite commonly in animals as well. It is most commonly seen in very large, fat cats that are really cuddly and people like to have on their lap. It is really common for them to get fatty liver disease if they stop eating, and it is genuinely very serious and takes intense treatment. The other time we see it commonly in animals is in cows that are in good body-weight condition, immediately after they give birth; often, they end up with hepatic lipidosis, which can be quite difficult to manage. My first charity visit as an MP—it was the week after I was elected—was to the British Liver Trust in Winchester. I met Pam Healy, its chief executive officer, who is here today. It is a brilliant organisation. I thank everyone for all the briefings we were given; the hon. Member for Stroud (Dr Opher) mentioned how much he learned from them, despite being a trained GP. On that note, I know he is doing some social prescribing—when is the comedy show?

5. How many people are in receipt of carer’s allowance.

We all know that carers give everything to care for their loved ones—physically, emotionally and financially. The Government received the carer’s allowance report three months ago, and under Lib Dem pressure have agreed to publish it by the end of the year. Do we know how many carers will be unfairly penalised in the six months between the Government receiving the report and publishing it?

In 2024, fewer than half of education, health and care plans were issued within the 20-week limit. Five months is a huge chunk of a child’s life, and parents of Winchester tell me every single week about how hard they have to fight to get the support that their child needs and is entitled to. What steps are the Government taking to ensure that EHCPs are issued in a timely manner?

5. What steps her Department is taking to help improve the SEND system.

It is an honour to serve under your chairship, Ms Lewell. I congratulate the hon. Member for Bolton North East (Kirith Entwistle) on securing this important debate. I also congratulate her and the hon. Member for Bolton South and Walkden (Yasmin Qureshi) on being such powerful advocates for health in their region. I was interested that both Members focused on poverty levels and inequality in health outcomes—a hugely important subject. The Opposition spokesperson, the hon. Member for Hinckley and Bosworth (Dr Evans), and I both served on the Mental Health Bill Committee, where we discussed repeatedly the fact that people who live in poverty are three times more likely to have mental health issues than those on an average income. I also served on the Tobacco and Vapes Bill Committee, and I remember Professor Chris Whitty saying that it was not only the biggest piece of public health legislation in 30 years, but one of the biggest interventions to address inequality, because one of the significant factors in differences in life expectancy between more deprived communities and wealthier communities was smoking levels. Despite our economic troubles at the moment, we are still one of the wealthiest nations on Earth, and we can still be one of the healthiest nations on Earth if those resources are deployed in the right way. Everyone should have the right to see a doctor or dentist and to get mental health care as and when they need it. We have touched on public health. At the moment, two thirds of adults are overweight and 10% of the NHS budget is spent on diabetes and diabetes-related illnesses. That is one reason that the Liberal Democrats are so keen on closing the loopholes in the sugar levy and extending it to sugary milk and juice-based drinks, on restricting the marketing of products high in fat, salt and sugar, on reversing cuts to the public health grant and on legislating for a right to clean air. It is also why, like the Government, we are so keen on good-quality school meals. The hon. Member for Bolton North East talked about the levels of childhood obesity in primary school and their impact on not only the individual’s health, but the NHS in terms of cost. Having good-quality nutrition in all public organisations, whether schools, prisons or care homes, is an impactful way of not only helping people to have a healthier life, but reducing the burden on NHS services. I will finish by saying that health is the No. 1 issue that comes up on the doorstep. There is a lot of concern and worry that people may not get healthcare when they need it. Whether in Bolton or Winchester, people need to know that they will be able to access healthcare, free at the point of use, as and when they need it. I commend the hon. Members for Bolton North East and for Bolton South and Walkden on securing this debate and speaking so powerfully on behalf of their constituents.

Earlier this year, I joined a brilliant organisation called Mighty Convoy to drive some refurbished ambulances full of medical supplies to Ukraine. While we were there, we bumped into another organisation called FIRE AID that takes refurbished fire engines to Ukraine from the UK. That equipment is vital for the war effort, but in addition the Ukrainians we met said that it is a great morale boost to know that not only are the British Government behind their war efforts, but the British public are too. Will the Foreign Secretary join me in thanking all the volunteers from the UK who drive equipment to Ukraine to help with that war effort?

I begin by thanking colleagues across the House who have worked so constructively on this long-awaited Bill. There has been a shared recognition that the current mental health system is failing too many people and that reform is urgently needed. I thank the Minister for engaging with us so constructively throughout the process, including as recently as yesterday; it is much appreciated. When I speak to people in Winchester—I know that hon. Members have very similar stories—mental health is one of the issues that comes up the most. We have families waiting months or even years for treatment, we have parents watching their children deteriorate, and we have people languishing on waiting lists when they would rather be working or studying. The Bill represents the biggest reform of mental health care in over 40 years. It strengthens patient autonomy, modernises detention procedures and rightly removes police stations from the definition of places of safety. These are vital and much needed steps forward and I know that Members on all sides welcome them. I will speak briefly to several new clauses tabled in my name, each aimed at strengthening the Bill’s impact for some of the most vulnerable people it seeks to protect. New clause 26 would ensure that every hospital has a dedicated liaison service for the carers of patients detained under the Mental Health Act. This is a vital step to support carers during what can be an unimaginably difficult time and to close blind spots that too often exist when someone is caring for a loved one with serious mental illness. We know that parental mental health concerns are now the most common factor in children’s social care assessments, and that those children are at much higher risk of developing mental ill health themselves. Yet only about a third of mental health professionals in in-patient settings ask whether a patient is a parent. These children and the carers who support them are too often invisible. By identifying and supporting carers properly, new clause 26 would help close those gaps and ensure that no family has to struggle in silence.

The Liberal Democrats support the Bill, which makes mental health law much fairer and more compassionate. However, reforming detention law is only half the job, because without investment in prevention and community care, the Bill risks becoming an improved way of managing failure rather than preventing it. Without proper early intervention, people deteriorate until crisis is the only door open to them. Melbury Lodge in my Winchester constituency shows what a good partnership can look like: NHS teams working with citizens advice to help patients sort out debts, bills and benefits before discharge—recovery is impossible if patients return home to a pile of threatening letters and bills. Yet schemes like that are the exception, not the rule. Debt, insecure housing, domestic abuse and bereavement are not side issues—they are often root causes—and care plans that ignore them are not truly caring. Before I bring my remarks to a close, I pay tribute to the extraordinary people working at the frontline of mental health care—nurses, doctors, counsellors, therapists, support workers, carers and charities—who hold up a system that too often feels as if it is collapsing around them. Their compassion and professionalism are the reason so many people make it through their darkest moments. They deserve much more than just thanks; they deserve a system that supports them as much as they support others. In my years of campaigning for better mental health, including as a trustee of a mental charity and, in the past year, as the Liberal Democrat mental health spokesperson, I have become more convinced that mental health cannot be seen as the responsibility of NHS services alone. It must be embedded across society, in education, healthcare, housing, farming and even in the way we support small businesses. I thank the Minister and his team for all their work on the Bill and their cross-party engagement, as well as everyone who served on the Bill Committee and the Members who have turned up repeatedly to these debates. One thing that does unite the House is improving mental health care. Question put and agreed to. Bill accordingly read the Third time and passed , with amendments.

That is a prescient point. At the moment, there is no responsibility to ensure that children in particular, and other carers too, are identified. Even if they are put in advance choice documents, if the person making those decisions does not identify them, that will not come about. We would have to be careful that there is not unnecessary duplication; however, the initiative the hon. Gentleman puts forward is not a belt-and-braces approach to identifying young carers and other carers who are struggling. New clause 7 seeks to end the detention of children on adult wards, requiring the number to be reduced to zero within five years—other Members have discussed that today—and the Secretary of State to set out how that will be achieved. It simply cannot be right that children are still being treated on adult wards. It is unacceptable and can seriously hinder recovery and effective care. Although the Bill rightly focuses on hospital-based treatment, the process has also laid bare how fragile our wider mental health services have become, with the lack of early support in primary and community care and the shortage of initiatives that help people long before they reach crisis point. That is why new clause 14 would place a duty on integrated care boards to ensure that community services have the resources they need to meet the demand and report on that regularly. Keeping people well in their communities must be at the heart of any modern mental health strategy, because if we get the community care right, we prevent crises, reduce pressure on hospitals and help people live healthier, more independent lives. Finally, new clause 22 would establish a veterans’ mental health oversight officer. That dedicated role would ensure that those who have served our country receive the understanding and tailored care they deserve when they come into contact with mental health services. Too often, veterans experience mental ill health, sometimes linked to their service, and they find themselves in systems that do not fully recognise their unique experiences. The proposal would help change that by providing proper oversight; encouraging joined-up working across the NHS, veterans’ services and the third sector; and ensuring that compassion and accountability sit at the heart of how the Mental Health Act is applied to veterans. Taken together, the proposals are about making our mental health system even more humane, more joined up, and more focused on prevention and recovery. I hope the Government will take them in the spirit in which they are intended, which is to strengthen this important Bill, which we very much support, and deliver a system that truly supports those who need it most.

16. What steps he is taking to reduce energy bills.

I recently visited St Bartholomew’s church in Hyde, which has served the residents of Winchester for over 915 years, as part of its Give to Go Green day, which raised £2,400 to support its efforts to decarbonise the church and reduce energy bills. Will the Minister join me in congratulating the congregation and the community volunteers for the leadership they are showing in this area, and will he outline what steps the Government are taking to support faith and community groups in decarbonising historic buildings while preserving their heritage?