Helen Morgan MP: speeches

Speeches

• 19 Jun 2025 · Incontinence · Hansard source

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  It is a pleasure to see you back in the Chair, Mr Deputy Speaker. I thank the hon. Member for Dudley (Sonia Kumar) for securing this important debate and for outlining the issues so well in her opening speech, particularly the importance of breaking down the taboos surrounding incontinence and the social isolation that can result from it. I have carefully scribbled out the term “incontinence” all the way through my speech and hopefully replaced it with “bladder and bowel control issues”—forgive me if I have missed one. I recognise the importance of prevention and specialist treatment. The hon. Member for Dudley highlighted the benefit to both individuals and taxpayers from investing in women’s health up front, and I echo that call. There have been lots of excellent contributions, but I thank the hon. Member for Wolverhampton West (Warinder Juss) for raising the scandal of pelvic mesh implants. I thank him for highlighting that issue and the need for redress there. Incontinence, or bladder and bowel control issues, can have a hugely detrimental impact on a person’s wellbeing and sense of dignity, as we have heard. Despite affecting millions of people across the UK, it is the subject of stigma, and the needs of those with bladder and bowel control issues are not properly considered in many aspects of life. All too often, people suffering from these issues are left without the right support, whether that is the uncomfortable bladder pressure tests that the hon. Member for Gravesham (Dr Sullivan) referred to, or the lack of access to sanitary bins in public and workplace toilets. It has been widely assumed for many years that sanitary bins for men are not required in public toilet facilities. As we have heard, many millions of men are affected by bladder and bowel control issues. The absence of sanitary bins has a wholly unnecessary and damaging impact on their self-esteem, causing embarrassment and stress and, as we have heard, withdrawal from public places and the workplace. The cost is tiny but the benefits for those affected can be significant. There has been progress in this area, thanks to the work of campaigns such as Boys Need Bins by Prostate Cancer UK, but there is much further to go. That is why it is crucial that we support all individuals with the condition by ensuring access to services such as public toilets and sanitary bins, as unfortunately that is not the case. Under the last Government, 19% of public toilet facilities—nearly 600—lost their local authority maintenance and funding between 2015 and 2021 alone. Liberal Democrat research from 45 councils found that the number of public toilets had fallen by 14% from 2018-19 to 2023. Many local authorities are on the verge of bankruptcy and do not have the spare capacity for these vital services. Proper funding of local authorities to provide services such as public toilets and sanitary bins could make a truly meaningful difference for people with bladder and bowel control issues, and I hope the whole House will agree that these individuals deserve access to basic facilities. There is also a clear need for more research into developing better treatments and mitigations for people suffering from bladder and bowel control issues. Crucially, these should avoid unnecessary discomfort or invasive procedures. As such, I support what the hon. Member for Gravesham has said. The University of Aberdeen has found that women with ongoing urinary incontinence can avoid invasive bladder pressure tests, and that non-invasive assessments work just as well in guiding treatment. An emphasis on respecting people’s dignity and reducing discomfort should be at the heart of how we approach the testing, treatment and mitigation of these issues. We also know that these issues—particularly bowel incontinence—can place a significant strain on family carers carrying out personal care, who are often under-supported and suffer from ill health themselves. Many care requests go unmet; last year, the King’s Fund estimated that nearly a third of requests for local government funding result in no support for care at home. This means that there are many thousands of families struggling with the realities of caring for a loved one with bladder and bowel control issues, which can include not only feelings of shame and embarrassment —both for them and for their loved one—but difficulty with lifting and moving a family member to clean them, and in accessing the equipment necessary to cope. That is why dealing with the crisis in social care should be a top priority for the Government. When the Secretary of State phoned me—and, presumably, the other national party health spokespeople —over the Christmas break to let me know that he was instigating the Casey review and cross-party talks to find a long-term solution to that crisis, I was hugely encouraged. Since then, the Casey review has been delayed, and the cross-party talks have apparently been cancelled. I must stress that each party giving its view to Baroness Casey is not the same as sitting in the same room and agreeing a long-term funding plan. The review’s terms of reference will not deliver meaningful reform until the next Parliament, and there is a huge risk that, again, nothing will be done by the Government of the day—in this case, despite them having a huge majority to achieve whatever they want. Meanwhile, the number of people needing care increases every year, and the step change required to transform the sector becomes larger and less politically palatable. As such, I urge the Minister to speak to the Secretary of State and help him to recover the enthusiasm for change that he showed over Christmas, because he will have my full support. However, there are simple steps that can make a difference now, such as hospitals working with family carers ahead of discharge to ensure that they are equipped to carry out heightened personal care needs. In many places, that support is not delivered, let alone ongoing support and meaningful respite care. Wait times for a continence assessment vary across the country—it can take weeks and weeks. Improving those wait times would ensure that the right care and equipment is available much sooner. There is also a chronic shortage of speech and language therapists, who can make a real difference in helping people with limited or no speech to more easily communicate when they need the toilet or want to be changed or washed. That is particularly essential in cases in which those people suffer from bladder and bowel control issues. Incontinence is not properly reflected in how we organise paid social care. For instance, too often the pay for domiciliary carers and the time they are expected to care for any one person do not reflect the fact that someone’s need for care might vary hugely from day to day. Any embarrassment, frustration and discomfort for the person being cared for will only be made worse if their carers are rushed, stressed and overworked, and if spending longer at one house could mean that those carers are effectively having to work for free. I also want to highlight the importance of good care in hospital settings. NHS England’s 2018 “Excellence in Continence Care” guidance states that “pathways of care should be commissioned that ensure early assessment, effective management of incontinence, along with other bladder and bowel problems such as constipation and urinary tract infections and their impact on social, physical and mental well-being”. I highlight this because my constituent Trevor Collins died on 21 May 2022 as a result of aspiration pneumonia and small bowel ileus, due to a small bowel obstruction caused by constipation. The coroner concluded that neglect at Royal Shrewsbury hospital and a failure to manage Mr Collins’ constipation contributed to his avoidable death. It is essential that healthcare settings follow the NICE guidelines that are in place, not only to preserve dignity but to prevent serious harm and—in the worst cases—even death. Liberal Democrats recognise the seriousness of the issues surrounding all types of incontinence and bladder and bowel control issues, and the critical importance of ensuring that people with those conditions can live in dignity. The Minister will have heard the calls in my speech. I hope she will commit to repairing our broken social care system, reinstating cross-party talks and wrapping up the Casey review this year, so that we can make the reforms that are necessary for long-term stability in the sector and the dignity of all those receiving and providing care.

• 17 Jun 2025 · Care in the Community · Hansard source

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  As we have just heard, it is widely acknowledged that the crisis in social care is a cause of dangerously high occupancy rates in hospitals that lead to the horrors of corridor care, the dreadful ambulance waiting times that we have seen and a knock-on effect on the community. When I was contacted by the family of a terminally ill man in Wem in my constituency last month, I was reminded that not only is care often provided in the wrong place, but it is often not available at all. Will the Government bring forward the timeline for the horribly delayed Casey review to report back, get it done this year and heed Liberal Democrat calls for cross-party talks so that we can agree on a long-term solution for the crisis?

• 17 Jun 2025 · Medicine Supply Chain: Community Pharmacies · Hansard source

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  Across the country, community pharmacies struggle not only with supply chain problems but with dispensing some of the critical medicines for our constituents at a loss. I was concerned to read that higher prices for United States pharmaceuticals are on the table for the next stage of trade negotiations with Donald Trump, because an additional £1.5 billion would cost both the NHS and our community pharmacies dear. What steps is the Department taking to ensure that the NHS, and the vital medicine supply on which we rely, will not be used as a bargaining chip in a trade deal with a highly unreliable US President?

• 9 Jun 2025 · Local Authority Funding · Hansard source

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  Shropshire council’s finances have been left on the brink by 16 years of Conservative administration. It is the largest landlocked county in England, and it is struggling with about 85% of its budget being spent on social care. When the Minister does his fair funding review, will he look at the difficulty and costliness of delivering services over such a wide rural area and ensure that councils such as Shropshire, which has lost its rural services delivery grant, will be able to sustain themselves in the future?

• 5 Jun 2025 · Bank Closures and Banking Hubs · Hansard source

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  Sorry, Madam Deputy Speaker; I was so absorbed by the debate that I did not hear you call my name. I congratulate the hon. Member for Blyth and Ashington (Ian Lavery) on securing this debate, which is important. In my constituency of North Shropshire, there are five market towns, but only one will have a commercial banking branch left after the closure of the NatWest in Market Drayton this year. We find ourselves in a situation of managed decline for rural constituents, with essential services slowly removed bit by bit every year. Just two months ago, I attended the opening of the Whitchurch banking hub, which is providing a vital service to a town of around 10,000 people that had lost its final bank branch. While that is great news for Whitchurch and the best alternative to a network of commercial banks, we must consider now those market towns that do not meet the criteria set by Link. For example, the lovely, historic, but quite small town of Ellesmere in North Shropshire has a population of around 5,000 people and 90 commercial units. It is a hub for a large rural area and there is no bank and no prospect of getting one, according to Link, because it does not meet the criteria. Ellesmere still has a post office, which is relied upon by local businesses for cash services. Having been the financial controller of a business in an area served only by a post office, I can tell the House that people need to do more than simply deposit and withdraw cash. Although I was a big fan of Prees post office and village store, if I needed to change the signatory on a bank account or set up a new one, it was a logistical nightmare; if I did not want to post valuable and sensitive documents, it required a half-day trip to a town with a physical branch. For someone in Ellesmere, the nearest town is Oswestry. To visit an actual bank in person is a 45-minute round trip on public transport. Someone living in the surrounding villages is in a difficult situation. Those residents might also have used their post office at some point, but now those post offices are being systematically closed down. In my constituency, from Knockin to Hadnall and from Weston Rhyn to Shawbury, outreach post offices have been closed in one fell swoop with a couple of weeks’ notice. A Post Office representative sounded surprised recently when they told me that outreach services only available for one hour a week were not well used. It seemed not to have occurred to them that if the post office is only available for a single hour, that might not be terribly convenient. I have little time left, so I will just say that for places with poor digital access, where many people cannot access online banking, it is essential that we review the criteria that Link uses to assess the need for a banking hub. A medieval market town that has been serving the centre of its community for hundreds and hundreds of years is on its knees because there is no access to banking. It is essential that we get those services back into high streets to revitalise towns such as Ellesmere and Wem as soon as possible.

• 2 Jun 2025 · Bus Services (No. 2) Bill [Lords] · Hansard source

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  I thank the hon. Gentleman for his intervention. I was about to say that I am broadly supportive of this Bill and the empowerment of local authorities to franchise bus services for those reasons. That should enhance accessibility and safety and allow local authorities to establish new bus companies, which they have not been able to do before. It is critical that local authorities can protect and establish routes that ensure access to employment, healthcare and town centres, which is one of the main aims that my own bus services Bill—Bus Services Bill No. 1, if I may be so cheeky—seeks to address, but with these new powers rightly being given to local government, I have real concerns about the ability of rural local authorities to find the funding to drive the meaningful change we so need. In November, the Government allocated £1 billion of funding for buses, and the then Secretary of State for Transport said that the funding for rural areas would be “unprecedented”, but Shropshire council received just £1.4 million in capital funding and £2.5 million in revenue funding for this financial year. That was the 53rd lowest of 73 allocations for one of the worst-served counties in the country. That funding allocation is a tiny fraction of Shropshire council’s bus service improvement plan, which outlined the need for £73.5 million of bus funding across three years to transform the county’s bus network to an acceptable standard. The cost of franchising is also likely to be prohibitive to local authorities such as mine. The Government who promised a new formula based on need, deprivation and bus mileage to end the postcode lottery have so far made it abundantly clear that living in a rural area means less money, less public services and less opportunity. There is a clear need for better transport in Shropshire. A third of North Shropshire’s children are growing up in poverty. Our deprivation may be hidden by our beautiful leafy setting, but it certainly exists, and by limiting the opportunities of these children, it is being perpetuated. The council spends around 80% of its budget on care, a percentage that is forecast to rise, and its costs for delivering services are high. At more than 1,200 square miles, Shropshire covers an area 27 times the size of Greater Manchester. The roughly 325,000 people who live there are relatively evenly distributed across the area, adding to the cost of delivery of those services. I support the principles of the Bill, but there must be recognition of the desperate situation that local council finances are in, particularly in large rural areas such as mine. The looming rise of the bus fare cap from £2 to £3 is especially concerning, forcing people to fork out a significant amount every week for return travel to their job. In rural communities such as North Shropshire, alternatives to bus travel are few and far between. For the financially vulnerable who rely on buses to access services, the impact of the hike to £3 is going to be devastating. I support the Bill’s aims, and I can see its success in cities such as London and Greater Manchester, but it is essential that rural areas are not left behind and crippled by the cost of delivering social care over a large geographical area, as they have been by previous Administrations. Buses are the best way to reduce inequality for people in rural areas and, critically, to unlock the economic growth they can offer. I hope the Minister will listen and work with his colleagues in the Treasury to help transform the opportunities for people in rural areas.

• 21 May 2025 · Potential closure of Oswestry Crown Post Office · Hansard source

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  I rise on behalf of petitioners in North Shropshire. Oswestry post office is one of 115 larger Crown, or directly managed, branches that have been listed at risk of closure by the Post Office. Its closure would leave many residents without easy access to essential postal and banking services, which are particularly important for elderly residents, small businesses and those without access to reliable public transport. An online petition with similar wording to the petition that I present today has been signed by 2,668 people. The petition states: “The petitioners therefore request that the House of Commons urge the Government to take into account the concerns of the petitioners and take immediate action to guarantee the future of Oswestry Crown post office. And the petitioners remain, etc.” Following is the full text of the petition: [The petition of residents of the constituency of North Shropshire, Declares that Oswestry Crown Post Office has been earmarked for potential closure, removing vital mail, money, travel, identity and driving services from the town centre; further declares Oswestry Crown Post Office’s role as an essential community service at the heart of Oswestry; notes that high streets in towns are already facing huge challenges, including business rate hikes and loss of bank branches; further that North Shropshire is one of the worst served constituency in the England for public transport, and this poses a significant challenge to accessing vital services that crown post offices provide; and further notes that 2,668 people have signed an online petition on this matter. The petitioners therefore request that the House of Commons urge the Government to take into account the concerns of the petitioners and take immediate action to guarantee the future of Oswestry Crown post office. And the petitioners remain, etc.]

• 19 May 2025 · Mental Health Bill [Lords] · Hansard source

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  I welcome this piece of legislation, which I think is generally in a very good place. I have had a tragic situation in my constituency, where somebody who had been admitted to hospital in a suicidal state discharged themselves, after which, unfortunately, no follow-up care was provided, and they took their own life. It has been devastating for their family. Would the Secretary of State consider looking at how the community supports people experiencing a mental health crisis who might have discharged themselves, and how we can keep them safe in future?

• 14 May 2025 · Glass Packaging: Extended Producer Responsibility · Hansard source

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  I totally agree with my hon. Friend: the continuation of the PRN scheme alongside the EPR scheme is one consideration. We need to protect local and high street businesses. The lack of clear information about what the levy will be is really problematic. Since September 2024, the price has been estimated at between £110 and £330 per tonne—a huge variation. Businesses cannot plan their cash flow and how much they need to accrue without at least some certainty about the levy that will be introduced on a scheme that is already in place. I urge the Minister to nail down that final amount as quickly as possible, so that there is certainty for managing this difficult situation. There is an enormous amount of bureaucracy involved in calculating the amount of packaging. For example, an importer of wine bottles sells bottles to the on-trade and the off-trade. Although the importer can make good assumptions about the off-trade, where people buy bottles for personal consumption, they have no idea what happens when bottles go to the on-trade—they have lost control, so how do they realistically accrue? Some of DEFRA’s assumptions are not helpful, such as that a bottle of wine or beer bought from a pub will end up being recycled by the council just because it cannot be proven that the person who bought it did not take it home with them. That seems insane. Most pubs are paying huge amounts of money to get their waste recycled privately and they are not costing the council anything, but the producer—the importer of the product—is now having to charge them. They will be paying twice, which is not sustainable for most local pubs. Small pubs will have to pay about £350 or more a year, a medium-sized pub will have to pay around £750 and larger ones will have to pay £2,000, on top of their excessive business rates. It is important to remember that pubs cannot absorb that, because of their tiny margins, so 85% of those costs are likely to be passed on to consumers anyway. The idea that the producer pays is not going to work in this instance because pubs cannot change the packaging they use, so the consumer will end up paying, which is extremely problematic. The cost will be about 5p to 7p on every bottle of beer and around 15p on a bottle of wine; that might not seem like a great increase for a one-off purchase, but it will cost consumers an extra £154 million a year to buy bottled beer, which is quite considerable. It is crucial that businesses are supported in transitioning to this scheme, because they are already struggling with the employer’s national insurance hike, the business rate increase and, for wine merchants, the changes to the way that duty is paid. I call on the Minister to take a sensible, common-sense approach to this issue and to consider an exemption from EPR for pubs. We should also reconsider the scope and timeline of its implementation, because we are at risk of delivering a crippling blow to hospitality and the drinks industry, which are already struggling with huge headwinds. In the time that I have left, I will mention the example of a wine merchant—Members may wonder how I know this information. The wine merchant in question has a turnover of £25 million and makes profits of only £500,000 a year. That is a 5% profit margin, and this wine merchant is unusual in that it is quite profitable. EPR is estimated to cost it £272,000, more than 50% of its current profit margin, so there is no way that it will be able to avoid passing that on to the pubs and the consumers that buy from it. The increase in national insurance will cost the wine merchant £92,000, and the ABV changes a further £262,000. It is a highly profitable and successful business of enormous longevity, but there may be no alternative for it other than putting up prices and laying people off. I urge the Minister to take into account these really serious concerns about the viability of businesses and to reconsider the implementation of this tax.

• 30 Apr 2025 · Gender Incongruence: Puberty Suppressing Hormones · Hansard source

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  It is a pleasure to serve under your chairmanship, Ms Lewell. For too long, children and young people who are struggling with their gender identity have been badly let down by low standards of care, exceptionally long waiting lists and an unacceptably toxic public debate. That is why Liberal Democrats have been arguing for much better specialist healthcare services for children and young people who find themselves in this distressing situation. The old system, a single clinic, with a shockingly long waiting list and rated “inadequate” by the Care Quality Commission, was clearly failing vulnerable young people at the most difficult time in their lives. Before GIDS closed, more than 5,000 young people were stuck on the list and left waiting for an average of almost three years for a first appointment. For vulnerable teenagers and pre-teens, going through what are often incredibly difficult experiences, those three years must have felt like an eternity. Liberal Democrats have consistently campaigned for action to tackle appallingly long wait times across the NHS, whether for cancer treatment or mental health, and it is right that we do so for gender identity services as well. It is clear that change is needed. That is why we have long been pressing the Government to establish new specialist services and recruit and train more specialist clinicians, so that children and young people can access the appropriate, high-quality healthcare that they need. The move to create multiple new regional centres is, therefore, a very welcome one, but only two are open now—in London and the North West—leaving those who have already been stuck on waiting lists for years to wait even longer. There is no sign yet of when the other centres will open. Would the Minister be able to give us an indication of when they might? Unless the Government show far more urgency in getting these centres up and running properly, more and more children will be denied the care they need as they languish on those long waiting lists. While it is right that treatment is largely based on talking therapies for both the child and their parents to give all gender-questioning young people the time and space to make clear and informed decisions about their future, that has got to mean that people starting their talking therapy when they need it, not after years of delay. Following the Cass review, the Secretary of State announced that the NHS would be conducting clinical trials on the impact of puberty blockers. That is due to begin very soon. I would appreciate clarification from the Minister about the current status of the trials and the terms of reference under which they will be conducted. The announcement of the trial came alongside an indefinite ban on the prescription of puberty blockers as a treatment for young people with gender incongruence or dysphoria, unless they are part of that trial. Numerous organisations, including the Council of Europe, have raised concerns about the potential ethical implications of only offering a treatment to a small group of patients taking part in a clinical trial. I believe that the Secretary of State confirmed at the Dispatch Box that the trial would be uncapped when he gave a statement on puberty blockers to the House in December 2024. Would the Minister confirm whether that is the case? The ban has caused fear and anxiety for some young trans people and their families, who have been so badly let down for so many years. I have met with families in my own constituency who have highlighted the severe mental health impacts that uncertainty over treatment can have. It is crucial that any clinical decisions are made by expert clinicians based on the best possible evidence, not politicians with a point to make.

• 24 Apr 2025 · Local Authority Procurement: Economic Growth · Hansard source

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  My constituency is a food production powerhouse, and I welcome any steps by the Government to encourage local authorities to procure British-produced food. Local authorities are under extreme pressure to procure at very low cost. What steps is the Minister taking to ensure that, first, the Groceries Code Adjudicator ensures that farmers are paid fairly for the food they produce and, secondly, the Department for Business and Trade is not about to undermine the food they produce by entering a damaging trade deal with the US that would undermine those standards?

• 23 Apr 2025 · Hospitals · Hansard source

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  I am pleased that the hon. Gentleman’s hospital is being dealt with, but I am sure that the residents of Torbay will not feel the benefit of that. I am slightly surprised that he thinks that the decade since the Liberal Democrats were in power has had no impact whatsoever. I did address the point that when a party comes into government and has to clear up the appalling mess left by the previous Government, there are difficult choices to be made. His party knows that. Labour Members, for example, have voted to retain the two-child benefit cap and keep a quarter of a million children in poverty—something that no one in my party has ever voted for. The last time I opened a Liberal Democrat Opposition day debate was in October, and the topic was primary care. I explained how the Government’s failure to invest in primary care was a false economy that increased pressures and costs in the critical parts of the system. The management of our hospital buildings displays that same false economy. Just as spending money on critical care instead of prevention and public health is a poor approach to managing a health service, waiting for the roof to collapse is an irresponsible way to manage NHS buildings. As problems are ignored and investment is poorly targeted, it is the patients and the hard-working staff striving to help them who are forced to suffer. This is not just about the new hospital programme. Across the country, there are thousands of GP surgeries that need urgent improvement if they are to provide the care that patients deserve. More than 2,000 hospital buildings across England were built before the foundation of the NHS in 1948, while the state of GP surgeries varies wildly. Many surgeries are simply no longer fit for purpose, having been built in the 1950s. Prescott surgery in my constituency, for example, has long been recognised as somewhere that needs to drastically increase in size because the population of the village has increased drastically itself. Despite the land and the community infrastructure levy funding being available, there is no sign of a new surgery being built. As the delay continues, the costs are rising and the challenge grows for both the council and the integrated care board, which are already under immense pressure to cut their costs. Instead of pursuing fantasies like the Conservatives or false economies like the Labour party, the Liberal Democrats would invest to save by starting construction now, and ending the epidemic of cancelled operations, closed-off wards and huge sums wasted on emergency repairs. That would save the taxpayer money in the long run and benefit patients much sooner.

• 3 Apr 2025 · Topical Questions · Hansard source

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  T6. Market Drayton in my constituency has really poor grassroots sports facilities for a town that serves more than 12,500 people. Shropshire’s Conservatives will not allocate any of the community infrastructure levy money from the significant recent development there to improving those facilities, so will the Secretary of State meet me to discuss how we can get proper funding in, in order to provide Market Drayton—Shropshire’s third largest town—with the sports facilities it deserves?

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

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  I thank the Minister for her opening remarks and add my broad support for the improvements that the Government have made to the Bill. I will restrict my comments mainly to amendments 1 and 2, which have been tabled in my name and the names of my hon. Friends the Members for Winchester (Dr Chambers), for Eastleigh (Liz Jarvis), for Chichester (Jess Brown-Fuller) and for Mid Sussex (Alison Bennett). I will also comment on new clause 1, tabled by my hon. Friend the Member for Bath (Wera Hobhouse), to which I have added my name. Amendments 1 and 2 would direct the moneys raised from fixed penalty notices to public health initiatives chosen by the relevant local authority. The Liberal Democrats agree with the Secretary of State and the Government that prevention is better than sickness and cure, and that public health initiatives are crucial in making those key shifts in healthcare that we all hope to achieve. The Secretary of State hopes to create a smokefree generation for those born after 1 January 2009, but there will be existing smokers who may well wish to stop, and who may need help from a public health initiative or a smoking cessation programme to do so. The Conservatives cut public health budgets by a quarter since 2015, meaning that fewer people have had help to quit. That is not what anybody hopes to achieve through this legislation or, more broadly, the reforms to the NHS. Research by University College London showed that in parts of England, smoking rates have begun to rise again, and they have been flatlining as a whole since 2020. Between 2020 and 2024, the rates rose by 10% in southern England and fell by 9.7% in the north. Overall, an estimated 7.5 million adults in England are smokers. UCL concluded that the disparity between north and south reflected the concentration of dedicated tobacco control programmes in northern regions and their positive impact, and their relative absence in the south. As the shadow Minister, the hon. Member for Sleaford and North Hykeham (Dr Johnson), mentioned, there is also evidence of significant black market activity in the United Kingdom. Cessation activities have therefore become even more important to deprive the criminal gangs involved of funds, and to ensure that people are free of their grip. Given the impact of public health initiatives, I sincerely urge the Government to accept Liberal Democrat amendment 1, and consequential amendment 2, which are in line with the Government’s objectives, and would improve health and save taxpayers money in the long run. Amendment 84, which is also in my name, is very similar to the Opposition’s amendment 85. It would restrict the ability of the Secretary of State to unreasonably designate a place as a smokefree area. If they do not mind me saying so, the Conservatives have been a bit sloppy in drafting their amendment, because they have managed to remove protections in existing law for areas where there is a significant risk of second-hand smoke in smokefree areas. The Liberal Democrats’ amendment 84 has an added safeguard: if the chief scientific officer—that is not easy for me to say—advises that there is a significant risk of second-hand smoke, an area can be designated as smokefree. The amendment also retains mention of the areas that the Secretary of State has indicated that he will designate as smokefree, including NHS premises, schools, educational establishments and children’s playgrounds. The Secretary of State has indicated that he will not designate other areas as smokefree, particularly if it would have a detrimental impact on our already struggling hospitality industry and much-loved village pubs. We take him at his word on that commitment, but I hope that the Minister can imagine a future in which a different Secretary of State is less inclined to honour a promise made by someone else at the Dispatch Box. It is right and in good order that in that scenario, Parliament should get a vote on the change of heart. I urge the Government to consider this amendment carefully and ensure that the legislation matches the promises made at the Dispatch Box. New clause 1, which I have also added my name to, would require the Secretary of State to review and report back on the presence of contaminated vapes, and to find ways to reduce their prevalence. My hon. Friend the Member for Bath has campaigned on this issue following findings by the University of Bath that one in six vapes in English schools contained the drug Spice, which can have serious side effects in children, including cardiac arrest. It seems reasonable that the Department of Health and Social Care and the Secretary of State should try to find a way of addressing that issue. I intend to push amendments 1 and 2 to a vote to ensure that there is additional funding for public health measures. I very much hope that hon. and right hon. Members will support me in this common-sense move to improve public health.

• 12 Mar 2025 · Housing Development Planning: Water Companies · Hansard source

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  The problem of historical sewers is particularly difficult, because there is no immediate developer to put on the hook. We certainly need a mechanism for dealing with historical sewers. It is a complicated problem, because we certainly do not want sewage from inadequate systems to start going into the main system, and it is difficult to say the taxpayer should to have to pay for something that happened a long time ago. Nevertheless, we need a mechanism to deal with historical sewers; there is no doubt about that. The homeowners in The Pines in Higher Heath are in a situation where the developer has refused to rectify the issues and Severn Trent has washed its hands of the matter by returning the bond. They have nowhere else to go. One resident told me: “The whole system has failed us, from start to finish…we have layers upon layers of Water, Building, Planning, Council Regulations, Controlling Authorities and processes and procedures, all designed to protect the public and the environment. Yet, a pre-existing local drainage problem, a planning process and building supervision and approval all failed to pick up and address it, and then allowed ‘defective’ drains to be built, then a Developer and a Utility company agree among themselves to terminate the S104 and totally wash their hands of us/the people who pay the taxes that fund the system that is supposed to protect us/the people.” We see there the root of the problem. People who rely on the regulatory system to protect them in their homes are being hopelessly let down by a system that provides no protection when the worst happens and push comes to shove. Clearly, the section 104 process is not fit for purpose. The conveyancing process, when solicitors are involved, never seems to detect this type of situation either. I have sympathy for the people affected. When the section 104 agreement and bond have been put in place, and people have found that through their search, they should be able to have reasonable confidence that the sewerage network will be completed as planned. I have raised many times the situation of people living in The Brambles in Whitchurch, so I will not go into all the details again. People bought houses in that development, but the developer was a rogue developer, who collapsed the company as soon as the final house was occupied. The sewage pumping system was inadequate, and another property was illegally connected to it. Fourteen households had to spend £1 million between them to fix that situation. Those householders were the people left holding the management company when everything crashed down around them, and they were liable to fix that situation. That was totally unacceptable, as well.

• 12 Mar 2025 · Housing Development Planning: Water Companies · Hansard source

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  I beg to move, That this House has considered the role of water companies in new housing development planning. It is a pleasure to serve under your chairship, Mrs Lewell-Buck. It is something of a cliché for a Liberal Democrat to be talking about sewage, but today I am breaking the mould and talking not about sewage in seas, lakes and rivers but about sewage in people’s homes and gardens. Buying a home in the UK is not easy. People spend years and years saving penny after penny, and when they finally sign on the dotted line and complete the purchase, they are relieved and delighted. They are not expecting to be forced to become an expert in complex regulations relating to drainage and the planning process. Most of all, they are not expecting raw sewage to start backing up through the manhole covers in their garden, the drains or, in the worst-case scenario, their downstairs loo, but unfortunately, that is what some of my constituents have had to deal with when buying or living near newly built houses in North Shropshire. I think the whole House should be asking itself how any water company, developer, conveyancer or local authority could think that this situation is acceptable. During my time as MP for North Shropshire, there have been multiple incidents in which constituents have been put in this troubling position by the sewerage network failing, and I am quite angry about the lack of progress in dealing with the issue. Just two weeks ago, I attended a meeting with residents of a village in my constituency that has seen a relatively large amount of development in recent years; their village is low-lying and on a gentle slope. Severn Trent, the water company, has adopted the drainage system from the new developments, so this is not a case of a dodgy developer failing to build suitable infrastructure, but it is an old, medieval village and unfortunately the existing combined sewer infrastructure is inadequate to deal with prolonged rainfall and the additional homes connected to it.

• 12 Mar 2025 · Housing Development Planning: Water Companies · Hansard source

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  I thank my hon. Friend for his intervention. He has campaigned endlessly and consistently on that point and I entirely agree with him. I was concerned when both the Government and the Conservatives voted against his amendment in Committee. Perhaps in their winding-up speeches, they will explain the rationale to my constituents, who are faced with the reality of putting cling film over their toilet every time there is a big storm. The current requirements, all of which allow consultation, have been inadequate in the example I have given, and indeed in many others. The local plan process requires local authorities to consult the water companies on infrastructure requirements. That should be a positive step; it is how future infrastructure should be determined, with plans made by both the local authority and the water company. However, many councils fail to develop local plans. Shropshire’s Conservative council has just had to withdraw an inadequate plan, having failed to satisfy the requirements of the planning inspectors, leaving the county open to a planning free-for-all in which it is unnecessary to consult water companies. I therefore urge the Minister to ensure that in the review announced at the beginning of this week, water companies are added to the list of statutory consultees. I urge him also to tighten up the rules to prevent such a fiasco from emerging again, when after years of work and of taxpayers’ money being spent on a local plan, it is not fit for purpose and the whole process has to be started again. That is unacceptable for my residents, who are paying their council tax. Another development 10 miles to the north has had similar issues, but in that case, in addition to concerns about the capacity of the pumping station and existing surface water flooding problems, Severn Trent has refused to adopt the drainage network, citing as its reason that the sewers were not built to the standard agreed under the section 104 arrangement in place. The developer, which I should say disputed that there were defects in the system, requested that Severn Trent return its section 104 bond, and it did. All of that was done without the residents’ knowledge. They only found out nearly three years later, following repeated complaints to the water company, which is tanking sewage away from the village on a weekly basis.

• 12 Mar 2025 · Housing Development Planning: Water Companies · Hansard source

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  My hon. Friend makes a good point. That is where we are going with having them as statutory consultees in the process. It is no good the water companies saying, “You cannot build those houses.” They need to be able to say, “We have this plan to improve the infrastructure. You can build those houses when we have done it.” It is probably also quite critical that they are able to say, “We are doing it fairly quickly.” I will come back to section 104 for a second. One problem is that council planning departments are hollowed out. They have neither the human nor financial resources to get involved in expensive planning enforcement action, or to ensure that every person has been thought about and invited to consult on a planning application. They need to be required to do that, because the idea that cash-strapped councils will go above and beyond is currently unlikely; many are desperately just trying to stave off a section 104 situation. We have planning legislation coming, which is welcome. I implore the Government to address section 104 agreements and the bonds that secure them, because at the moment they are not the iron-clad guarantees they should be. We need to ensure that drainage systems are built to an appropriate standard and adopted, so that people can have confidence that, when they buy a home, they will not have to deal with a raw sewage problem for years and be unable to sell their house in many instances.

• 12 Mar 2025 · Rural Communities: Government Support · Hansard source

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  It is a pleasure to serve with you in the Chair, Dr Murrison. I congratulate my hon. Friend the Member for South Devon (Caroline Voaden) on making an excellent opening speech. Indeed, because it was so excellent and covered most of the issues I would have liked to cover, and because we have very little time, I will home in on three issues. The first is public transport, which my hon. Friend the Member for Ely and East Cambridgeshire (Charlotte Cane) also addressed. Shropshire has lost 63% of its bus miles since 2015, compared with a national average of 19%. This is the biggest issue for people who live in my constituency, particularly young people who cannot see their friends or access part-time work and, often, further education. Yet the revenue allocation for Shropshire under the bus service improvement plan is only £2.5 million. Public transport is a massive issue for us, and I urge the Minister to consider whether it is possible to reconsider that allocation. Poor local authority funding has an impact on cultural opportunities for people in rural areas, including activities such as grassroots sport. For example, Greenfields in Market Drayton is a woefully inadequate sports facility for a growing town of more than 10,000 people. Essentially, the council cannot afford to improve the facility. It has great plans, but it does not have any money to implement them because local councils are so badly underfunded. The cuts to the rural services delivery grant has cost Shropshire £9 million. Shropshire is much bigger than Greater Manchester, with people spread evenly across the county at about one person per hectare, so the cost of delivering services far exceeds the cost in an urban area. Will the Minister examine how we value the cost of services when funding local councils, because we are in danger of leaving rural councils critically underfunded compared with their urban counterparts.

• 6 Mar 2025 · Ambulance Response Times · Hansard source

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  It is a pleasure to serve with you in the Chair, Ms Jardine. I thank my hon. Friend the Member for Glastonbury and Somerton (Sarah Dyke) for securing this important debate and for opening it with, as usual, a thoughtful and well-researched contribution. It is no surprise that Members have largely been in agreement in this debate, and they have made useful contributions, so I will quickly run through them. The hon. Member for Ilford South (Jas Athwal) importantly highlighted the issue of burnout and the impact of the current situation on hard-working staff in the ambulance service, and the hon. Member for West Suffolk (Nick Timothy) highlighted the huge regional variations and the inequality of service for people who live in very rural areas. The hon. Member for Redditch (Chris Bloore) told a story—which would be familiar to people in Shropshire—of long handover delays; my hon. Friend the Member for South Devon (Caroline Voaden) mentioned the importance of dealing with stroke patients and seeing them quickly; and the hon. Member for Wolverhampton West (Warinder Juss), with whom my constituents and I share the West Midlands Ambulance Service, highlighted some of our concerns with that service as a whole. I was first elected in the North Shropshire by-election back in December 2021. All that time ago, when my colleagues and I were out canvassing, it was extremely apparent that ambulance service delays were the No. 1 issue for my constituents. Every canvassing session we did, somebody heard an absolutely heartbreaking story of an ambulance delay that had led to a much worse outcome for a loved one, or possibly even a death. In all honesty, it was a shocking campaigning issue to have to focus on. Almost a year later, after being elected, I completed a shift with West Midlands Ambulance Service in Shropshire, and I was blown away by the professionalism, dedication and hard work of the ambulance crew. But suffice it to say, the delays were still as appalling as they had been a year before. Since then, there has been huge political turmoil, and that has not helped the situation. There have been four Prime Ministers, six Secretaries of State for Health and Social Care, and two Governments, and I am afraid to say we are still not seeing the improvement that we need. This winter, handover and waiting times reached the point where in some ambulance services people suffering heart attacks were at times advised to drive themselves to hospital. That is an unacceptable situation. The most recent available data for my local ambulance service in Shropshire—the rural element of the West Midlands Ambulance Service—goes up to December 2024, and it still paints a stark picture of the distressing reality facing my constituents and people across Shropshire. The mean waiting time for category 1 callouts was 12 minutes 19 seconds, while the target is seven minutes. For category 2 callouts, the mean waiting time was 50 minutes and 36 seconds, while the target is 18 minutes. Those categories include callouts to people suffering from heart attacks and suspected strokes. For category 3 callouts, the mean waiting time was well over 200 minutes, and the target is an hour. After a long campaign, £21 million was secured to boost emergency care, and there has been improvement, but response times are still totally unacceptable. At times, as many as 16 ambulances have been queuing outside the Shrewsbury and Telford emergency departments that serve my constituents. More than one in three ambulances have to wait for more than an hour to hand over a patient, and the longest wait was an astonishing 17 hours. Even this week, as we approach the spring, a constituent told me they had stopped to help an elderly lady laying on a cold pavement with a suspected stroke and had had to wait nearly an hour and a half for an ambulance or first responder to arrive. All the while, the lady’s breath become more and more shallow. This crisis is real, and it has not significantly improved. Let us look at the national picture. The Darzi report found that each day in 2024 around 800 working days were lost to handover delays. However we cut that—14,000 paramedics a year; 112 years—it is just not acceptable. It is no surprise that people have lost faith in emergency health services as a result of the last Government’s appalling neglect of the NHS. The paramedics, nurses and doctors in our emergency departments go above and beyond, but they are stretched to breaking point and are unfortunately starting to leave the service because of burnout. We are campaigning to end excessive handover delays by increasing the number of staffed hospital beds and by tackling the impact of degrading corridor care. Let me focus for a moment on social care. Crucially, A&E delays are often caused by an inability to admit patients because thousands of people are stuck in hospital every day when they would be better cared for elsewhere. Bed occupancy is well above safe levels in hospitals, and one in seven hospital beds are occupied by somebody who would be better cared for either in a care home or in their own home. Meanwhile, local authorities such as Shropshire are spending as much as 80% of their budget on social care. They are at risk of issuing section 114 notices as they are unable to cope any longer. It is really important that we get on with the cross-party talks on social care and with the Casey review. We in the Liberal Democrat party absolutely welcome that, but we urge the Government to speed up the timetable and crack on with it as soon as possible, because 2028 is too late for a long-term solution for social care. The cross-party talks that fell through last week need to be reinstated. I urge the Minister to encourage the Secretary of State to do that as soon as possible. Let us focus for a moment on the rural problem. Imagine an ideal scenario in which the issue of handover delays has been resolved, the urgent and emergency care plan has been successfully implemented and the 10-year plan has sorted out other issues across the NHS. For those who live near Oswestry, Whitchurch or Market Drayton in my constituency, the nearest community ambulance station has closed and the nearest station or hospital is well over 20 minutes away—that is, if the traffic is clear. Otherwise, if the response time targets for category 1 or 2 calls is to be met, they are reliant on a spare ambulance roaming free in the community, waiting for that call to come in. That is unrealistic. We would expect and hope that, in between calls, paramedics would go and have a cup of tea and a sit down, to decompress from some of the awful things they have seen that day, if they do not have a patient to go to immediately. Hopefully, they go back to the ambulance station in between call-outs. The implementation of this centralised model across the country is detrimental to the people who live a long way from an ambulance station. It may well be efficient in urban areas, but it certainly is not working in rural ones. I hope the Minister will commit to reviewing the service that is received in rural places. There are thousands of people in large market towns. For example, Oswestry has nearly 18,000 residents, Market Drayton has more than 12,000 and Whitchurch has nearly 10,000. These people expect to receive an ambulance within the target time. I must urge the Minister to commit to looking at ambulance station provision in those areas. I also repeat my colleagues’ calls for the Government to publish accessible, localised reports on response times and to create an emergency fund to reverse the closures of community ambulance stations that have already taken place. The Midlands Air Ambulance Charity does fantastic work across the west midlands and is one of the busiest air ambulance charities in the country. It does not have an NHS contract; it is entirely reliant on the contributions of people living locally. I wonder whether the Minister might consider putting air ambulance services on a statutory footing, because we are so dependent on them, particularly when specialist hospitals might be a long way away and air ambulance crews supply specialist support to stabilise patients where they are found, at the roadside or in their home. The situation is unacceptable, and I look forward to seeing the urgent and emergency care plan, which I hope it will consider the needs of rural areas. I must urge the Minister to look at social care, because that is one of the key things we need to do to fix the crisis in the NHS.

• 5 Mar 2025 · Department of Health and Social Care · Hansard source

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  I fundamentally agree. There are many such instances, and I chose that one because I spoke to the providers there recently. I will come on to community pharmacy, because I am particularly concerned about pharmacies, which are a key pillar of care in the community, dispensing prescriptions and providing over-the-counter medicines and advice. Critically, they also provide Pharmacy First, but they are closing at an alarming rate. Analysis by the National Pharmacy Association predicts that another 1,000 pharmacies will close—900 of them by the end of 2027—if the current rate of closures continues. That is because of a 40% real-terms cut in their funding since 2015. In fact, community pharmacies are essentially subsidising the NHS by making a loss on many of the prescription drugs that they dispense. In a few weeks’ time, in April, they will be clobbered by not only the NICs hike, but the increase in business rates, which will affect high street retailers. Shamefully, they have not even had their funding rates for the current financial year confirmed—the one that ends in three weeks’ time. Pharmacy First, the flagship plan to move care into the community, has not had its funding confirmed beyond the first week of April this year, which is in just a few weeks’ time, according to the National Pharmacy Association. In her remarks, will the Minister confirm the future of Pharmacy First? Is there a funded plan to deliver that service? What steps are being taken to keep our community pharmacies in business? If we want to see care in the community, it is essential that we support them. I want to mention dentistry. In Shropshire, Telford and Wrekin, the number of NHS dentists fell by 12.3% from 2019-20 to 2023-24. Many of my constituents cannot access a dentist, and the Government have committed to improving the situation, so can the Minister confirm when the negotiations on the new dental contract will begin? The crisis that the social care system faces is daunting, not least because of the additional national insurance hike that will take place in a couple of weeks’ time. Last week, caring organisations launched an unprecedented day of action, with thousands of people marching on Westminster to highlight the precarious state of the organisations that provide care. The Darzi review found that people waiting to access social care account for 13% of NHS hospital beds. We all understand the urgency of tackling social care, but the cross-party talks collapsed last week—they have not started. There is no date for a new meeting, and there are no published terms of reference. We think that 2028 is far too late to resolve this problem, so can the Government urgently reinstate those talks and act now to deal with the social care crisis? Before I conclude, I will talk about mental health. As Lord Darzi has said, “There is a fundamental problem in the distribution of resources between mental health and physical health. Mental health accounts for more than 20 per cent of the disease burden but less than 10 per cent of NHS expenditure. This is not new. But the combination of chronic underspending with low productivity results in a treatment gap that affects nearly every family and all communities across the country.” He is dead right. By April 2024, about 1 million people were on a waiting list for NHS mental health services, of whom 340,000 were children. My casework is full of children who wait months and months for the diagnosis and treatment that they need. The Government have removed the targets for mental health waiting lists; I urge them to reinstate those targets, so that we have parity between mental and physical health in our health service. I am very conscious of time, so in conclusion, I will just reiterate our asks. Those are to ensure that social care talks start immediately; to deal with the problems with pharmacies; and to make sure that mental health and social care receive parity.

• 5 Mar 2025 · Department of Health and Social Care · Hansard source

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  There is clearly a point in the debate at which we need to urge the Government to go further and faster. As a constructive Opposition, that is exactly what we will do. Primary care providers are on their knees, and I am afraid to say that that has been made worse by the national insurance hike announced in the Budget. They cannot meet demand for local appointments as things stand, and in many cases the constraining factor is the estate in which they operate. Prescott surgery in Baschurch in North Shropshire wants to provide additional services to the community and keep people away from hospital, but the surgery is physically not big enough. A local developer has provided land for a new surgery, and the local council has community infrastructure levy funding for that building, but it cannot be done because the ICB will not pay the notional rent, which everybody has agreed to forfeit. It is crazy. I hope that the Minister can commit to finding some kind of easy solution to that kind of nonsensical situation that we find ourselves in.

• 5 Mar 2025 · Department of Health and Social Care · Hansard source

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  I thank the Chair of the Public Accounts Committee, the hon. Member for North Cotswolds (Sir Geoffrey Clifton-Brown), for securing this debate and for his excellent opening speech. We all know that we have reached a crisis point across the NHS and care sectors, with more patients than ever waiting for treatment. That is affecting not just those in need of care and treatment, but those who work tirelessly across the NHS and care sectors, who are feeling the full brunt of the crisis. The Conservatives have a legacy of hours-long waits for ambulances, treatment in crowded hospital corridors—captured in horrifying detail by the “Dispatches” documentary, which looked into the hospital that serves my constituents in North Shropshire—and communities grinding to a halt under the weight of all sorts of waiting lists and backlogs. We urgently need to move forward. The Secretary of State has repeatedly outlined the need to shift from treatment to prevention and from hospital to community, and the Liberal Democrats absolutely support him in that endeavour—indeed, we called for many measures that would achieve that shift in our own manifesto. Stronger primary care and community services were the strong recommendations of Lord Darzi’s report, which was commissioned by the Secretary of State and has been broadly welcomed. There has been a great deal of consensus across the House today that we need to take those measures, but I fear that these estimates paint a picture of an NHS that continues to pour money into the previous, failing model in which capital budgets are drained to pay for day-to-day services and a huge proportion of increased spending goes on NHS staffing, while community care and primary care providers wrestle with the huge increase in employer national insurance contributions. When that is combined with the decision to scrap targets on mental health and community services for the sake of prioritising targets on elective care, we must ask: when will the stated objectives of the Secretary of State really be matched by actions? The latest estimates are an indictment of the broken state of the NHS after years of Conservative neglect, but we urge the Government to go further and faster to address the failure.

• 4 Mar 2025 · Regional Growth: England · Hansard source

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  The Marches region, of which North Shropshire is a significant part, is held back by the A483 road running between Llanymynech and Oswestry, which is very dangerous. There are frequent crashes and hold-ups on it, which both hinders local growth and, obviously, is a danger to life for people living in the area. Will the Minister work with his colleagues in the Department for Transport to ensure that if we cannot get a bypass, we at least get vital improvements on that road?

• 27 Jan 2025 · Topical Questions · Hansard source

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  T7. A severe shortage of specialist provision and a council in dire financial straits is leaving children with severe levels of need in my constituency making four-hour round trips to school and back every day, which is too much for many of them to cope with. What steps is the Minister taking, working with local Government to reduce such journey times for children who simply cannot cope with them?