Helen Morgan MP: speeches

Speeches

• 24 Jun 2025 · Department of Health and Social Care · Hansard source

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  I congratulate the acting Chair of the Select Committee, the hon. Member for Birmingham Erdington (Paulette Hamilton), on securing this important debate and on her excellent opening speech on the risks inherent in the spending review settlement. The Conservatives left our NHS in a disgraceful state that is impacting every one of our constituents. On their watch, people with life-threatening emergencies were left waiting hours for ambulances, hospitals were left to crumble, and accessing a GP became a huge challenge. The collapse of NHS dentistry has left some people pulling out their own teeth at home. It is essential that the new Labour Government are bold and ambitious in turning the NHS and care sectors around. The Liberal Democrats support the principles of the Secretary of State’s three shifts and have stated on many occasions the alternative means we would use to raise the necessary funds, but today’s debate is about how the money should be spent. I was pleased that the Chief Secretary to the Treasury’s statement last week incorporated a measure that the Liberal Democrats have long called for, not least in our last Opposition day debate in April: a ringfenced fund for maintenance, to deal with the huge repair backlog that has built up across the NHS estate. However, I must reiterate the need to go faster with the new hospital programme. We know that the Conservatives’ plans were unfunded, but this capital spend must be brought forward so that crumbling hospitals in places like Torbay, Watford, St Helier and Stepping Hill can be rebuilt as soon as possible, because spending billions on maintaining buildings that face demolition in the next 20 years is not a wise use of taxpayers’ money. The Liberal Democrats believe that the crisis in the NHS—particularly in accident and emergency—cannot be solved unless we transform social care. We have long argued that investment in the NHS will be pouring good money after bad if hospitals cannot discharge patients because there are no care workers to help them recover. The fair pay agreement for care workers is a start, but it will not touch the sides of the yawning abyss of current and forecast vacancies in the care sector. At a bare minimum, we need a higher minimum wage for care staff to stop the sector haemorrhaging workers. It is more urgent than ever that the cross-party talks for which the Government had such enthusiasm at the start of the year are reinstated. The terms of the Casey review, which leaves fundamental restructuring of the care sector to 2036, are not ambitious enough. The review needs to be completed this year, so that meaningful change is not put off while our population ages. I turn to mental health. The Darzi review outlined in stark terms the fact that mental and physical health are not given parity in the health service; mental ill health takes up 20% of the caseload and only 10% of the funds. Proper investment in mental health is essential to the shift from treatment to prevention. It was disappointing to see the Government abandon mental health waiting list targets and reduce the overall proportion of money spent on mental health, while proclaiming that they were meeting the mental health investment standard because, at integrated care board level, there had been a fractional increase. I urge the Minister to ensure that mental health is given priority, and to ensure that prevention, through early intervention, can bring about improved outcomes. Yesterday, the Secretary of State announced a new national investigation of maternity services. I was disappointed that no oral statement was made. Many MPs represent constituents whose families have been left distraught by maternity service failings at Shrewsbury and Telford, East Kent, Morecambe Bay, Nottingham, and potentially other trust areas. Those voices deserve to be heard in Parliament, but that opportunity was denied. I welcome the inquiry, but remain dismayed at the slow progress since Donna Ockenden’s shocking report into the Shrewsbury and Telford hospital trust in spring 2022. She recommended 15 immediate and essential actions for national implementation; three years later, that has not happened, and the Government have removed the ringfence from funding intended to ensure safe staffing levels. Her findings were consistent with those after other maternity scandals, and the Government accepted her recommendations. It is vital that the inquiry moves the situation forward and is not used as a distraction tactic to delay real action. Before concluding, I will raise the subject of the fundamental reorganisation of the NHS, which is being undertaken without any meaningful parliamentary scrutiny. NHS England announced the decision to slash ICB running costs by 50% by the end of this year, with detailed plans to be submitted by the end of last month. No impact assessment for that drastic change was undertaken by the Department and, as far as I can see, there is no funding from the Treasury for potential redundancy costs and no confirmed redundancy scheme. ICBs will be expected to transfer some statutory duties to other trusts without that change being on any formal statutory footing. The guidance from the soon-to-be-abolished NHS England has been hastily prepared. If ICB money can be spent more efficiently, the Secretary of State has our support, but surely such radical change requires scrutiny, particularly when it was not in the Labour manifesto and there has been no White Paper, no consultation, no legislation, and not even a short ministerial statement on the subject. We would all appreciate the opportunity to better understand how the process will improve outcomes for our constituents. The new Labour Government face an enormous challenge in turning around an NHS left at breaking point by the Conservatives. The Liberal Democrats’ job as an effective Opposition party is to urge the new Government to go further, faster, in tackling the issue of access to GPs and dentists, in ending the appalling scandal of corridor care and dangerous ambulance waiting times, and in bringing urgency to the issues of spiralling mental health waiting lists and the crisis in social care.

• 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.

• 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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  The hon. Member will be aware that there were not 40 new hospitals—they were not all hospitals and there were not 40 of them. The issue here is that the start dates for work on many hospitals that need urgent rebuilding have been pushed back into the 2030s, long beyond the life of this Parliament. The people who are served by those hospitals were promised new facilities and have not had them. That is devastating for those communities. If the Conservative approach was contemptible, Labour’s approach has been to procrastinate. The cost to the NHS of papering over the cracks and keeping hospitals running past their natural lifespan is enormous. That is why the Government must reverse the delay to the new hospital programme at once and urgently deliver the new hospitals that patients have long been promised.

• 25 Mar 2025 · Construction Standards: New Build Homes · Hansard source

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  Does the hon. Member agree that not only the house must be of a very high quality, but the surrounding estate that the house is built on? That is essential because the guarantees and building certificates that come with a home do not relate to that surrounding estate, and if there are problems with, for example, the drains or the roads, it can be very difficult to get them fixed, which is a nightmare for a new homeowner.

• 18 Mar 2025 · Stations: Step-free Access · Hansard source

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  Will the Minister commit to those stations that have had their design and feasibility studies done? Some had commitments from the Minister in the previous Government, before the election was called. Can she commit to getting on with those stations? It is extremely frustrating for residents in places such as Whitchurch, who thought they were getting Access for All but have had the rug pulled from under their feet.

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

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  The hon. Gentleman makes a good point. Shropshire is quite wet, so we do not often find ourselves talking about a lack of water; it would have to be an extreme summer before we found ourselves in that situation. He makes a good point that the country increasingly sees very dry periods and then extreme rainfall in winter. We need a water system fit for the future to deal with that and with localised capacity issues in the freshwater network. Finally, I call on the Government to implement the recommendations of the report published by the Department for Environment, Food and Rural Affairs in 2023 on schedule 3 to the Flood and Water Management Act 2010. The schedule would provide a framework for the approval and adoption of drainage systems; a sustainable urban drainage systems approving body, or a SAB; and national standards on the design, construction, operation and maintenance of sustainable urban drainage systems, which also have a lovely acronym—SUDS. Critically, it makes the right to connect surface water run-off to public sewers conditional on the drainage system being approved before any construction work can start. Currently, that is not a statutory requirement, but those things are often built as part of the planning process. That means that when a development happens in an area that has previously been, say, fields, the water must drain off at the same rate as it would have done had the area still been a field. That is a clever way of managing surface water, and it seems odd that the previous Government, and indeed the current Government, have not yet adopted schedule 3. That would be an important start in protecting new and existing residents from the nightmare of both surface water and foul water flooding. In conclusion, the current planning-led approach is clearly not fit for purpose. Numerous colleagues have turned up today to tell similar stories of residents dealing with raw sewage in their homes, which is just not acceptable. The planning process is failing to protect residents of both new and existing homes, opening the risk of surface water and foul water flooding. Most of us cannot imagine how awful untreated sewage in the home must be, but a failed planning system is making it a reality for far too many people. I urge the Minister to make water companies a statutory consultee in planning, to implement schedule 3 to the Flood and Water Management Act and to tighten the rules around section 104 so that rogue developers cannot get away with building illegal connections to the sewers.

• 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.

• 7 Jan 2025 · Access to Primary Care · Hansard source

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  Dentistry is a key part of primary care, yet an estimated 5 million people in England have been left without an NHS dentist. That is why today a petition is being handed in at Downing Street signed by more than a quarter of a million people. We have moved on from the election, but we do not yet have a timetable for when the negotiations for a new NHS dental contract will begin and when another 700,000 extra urgent appointments will be rolled out. Can the Secretary of State confirm the timetable for those improvements? What specifically are the Government’s plans for the new patient premium, and will he offer assurances to dentists that any changes to the current model will be outlined in detail to them as soon as possible?

• 11 Dec 2024 · Puberty-suppressing Hormones · Hansard source

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  I thank the Secretary of State not only for the content of his statement, but for its tone and his recognition of the importance of such a tone in this place. 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 increasingly toxic public debate. Before GIDS closed, more than 5,000 young people were stuck on the list for an appointment and waited, on average, almost three years for their first appointment. For teenagers going through what is often an incredibly difficult experience, three years must feel like an eternity, so change is desperately needed. The Liberal Democrats have long pushed to ensure that children and young people can access the high-quality healthcare that they deserve. We welcome the NHS move to create multiple new regional centres, but those centres must get up and running as quickly as possible. Will the Secretary of State outline what steps the Government are taking to ensure that happens in every region, and will he give a timetable for that work? Tackling waiting lists and improving access to care must be priorities. I understand why today’s news is causing fear and anxiety for some young trans people and their families, who have been badly let down for so many years—not least those I have met in my constituency, who have highlighted the catastrophic mental health impacts of the situation. It is crucial that these sorts of decisions are made by expert clinicians based on the best possible evidence. Will the Secretary of State publish all the evidence behind his decision, including the results of the consultation, to give those families confidence that this is the right move for them? We welcome the announcement of a clinical trial. We need the NHS to build up the evidence base as quickly as possible, and the Government to provide certainty that they will follow evidence and expert advice on behalf of those children.

• 16 Oct 2024 · Access to Primary Healthcare · Hansard source

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  I beg to move, That this House regrets that the NHS has been plunged into crisis by years of neglect by the previous Government, leaving far too many people waiting weeks to see a GP or unable to find an NHS dentist, and children and adults waiting months or even years to receive the mental health care they need; believes that everyone should be able to access high-quality primary care services when they need them and where they need them; condemns the previous Government for presiding over a fall in the number of full-time equivalent fully qualified GPs and NHS dentists in the last Parliament; further regrets that the Government has not yet set out a plan to invest in primary care at the level needed to meet demand; calls on the Government to boost access to GPs, NHS dentists and community pharmacists; and further calls on the Government to give everyone the right to see a GP within seven days or within 24 hours if they urgently need to and to guarantee access to an NHS dentist for everyone needing urgent and emergency care. It is a real honour to open this debate on the Liberal Democrats’ first Opposition day for 15 years. Primary care is the front door to the health service, but for too many people at the moment, that door is closed. Whether they are waking up and dealing with the 8 am calling frenzy to get a GP appointment, frantically ringing every dental practice in their area for an NHS dentist, or turning up at their local pharmacy to pick up a prescription for their loved one or themselves and finding it unexpectedly closed or the medicine out of stock, primary care is in terrible trouble and it needs fixing urgently. That is not only to make lives better for the people who are suffering because they cannot access the primary care they need, but to allow the NHS to function more efficiently. Accident and emergency is not a decent substitute door to the NHS. I am an asthmatic and as a young person I had quite serious asthma. I can remember when primary care was absolutely there for me in the middle of the night. On lots of occasions when I needed help, my dad did not have to take me to the hospital in an ambulance. Somebody came to me with a nebuliser and got me sorted out within a couple of hours, and then we all went back to bed. Now, that is not an option for a lot of people. The NHS is in a crisis, and that is causing pain and suffering unnecessarily. The crisis is also costing far more than we can afford. It is costly because early intervention and dealing with people in their community or at their home is so much more efficient than taking somebody to hospital, even if that is in a private car. And it is costly because it causes people genuine pain: the BBC reported that in Oswestry in my constituency this year, a man removed his molar with a pair of pliers because he could not find an NHS dentist. But it is also costly because people are unable to access work, and that is costing the economy. Polling commissioned by the Liberal Democrats showed that one in four people had been unable to go to work while waiting for a primary care appointment. That is not good for an economy that urgently needs to grow. We need urgent investment in primary care—in doctors, dentists and community pharmacists—to save people from having to go to hospital.

• 16 Oct 2024 · Access to Primary Healthcare · Hansard source

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  Other opticians are available, but I did! The Liberal Democrat manifesto suggested solutions to these problems, and they have been well received, as I mentioned before. We have a record number of MPs, and that is because we put this issue front and centre of our election pledge. I urge the Government to reverse the catastrophic state that the NHS has been left in by the Conservatives, to take our ideas on board and to invest in primary care as soon as possible.

• 9 Oct 2024 · Maternity Services: Gloucestershire · Hansard source

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  It is a pleasure to serve with you in the Chair, Sir Christopher. I congratulate my hon. Friend the Member for Cheltenham (Max Wilkinson) on securing this important debate. Maternity services affect every single one of us at least once in our lives, so it is important that we protect them to ensure that, for all of us, that moment—obviously, many of us experience it more than once—is a safe one. I will not mention all the hon. Members who have spoken, but I am pleased to see so many of my Liberal Democrat colleagues, who have all made excellent speeches and powerful points. I particularly thank my hon. Friend the Member for Thornbury and Yate (Claire Young) for sharing her experience, and the hon. Members for Gloucester (Alex McIntyre) and for Stroud (Dr Opher) and my hon. Friend the Member for Tewkesbury (Cameron Thomas) for sharing theirs. Obviously, the hon. Member for Stroud has his own medical expertise, which is very important. Finally, my hon. Friend the Member for Winchester (Dr Chambers) described his constituent’s shocking experience, which I think we were all upset to hear about. This is not the first debate we have had on maternity services—not even the first in this Parliament—and the reason for that is the shocking under-investment in those services. On 19 September, during recess, the Care Quality Commission issued a report, and its contents are hugely disappointing if not surprising. As has been mentioned, it spoke of the risk of normalising avoidable harm, which is an unacceptable situation to be in. Hon. Members might be aware that my interest in maternity care came about because I am from Shropshire—I represent North Shropshire—and my constituents Kayleigh and Colin Griffiths lost their daughter Pippa at Shrewsbury and Telford hospital NHS trust. They fought tooth and nail alongside Rhiannon Davies and her husband Richard Stanton to bring about the Ockenden review into the scandal that unfolded at the trust. Since then we have had a report on East Kent, and there is a review going on in Nottingham. None of that is news to us, which is shocking. I sat on the all-party parliamentary group on birth trauma, which was brilliantly led by the former Member for Stafford, Theo Clarke, and on the baby loss APPG, and I am currently trying to reconstitute the maternity APPG. All those groups have found the same failings over and over again. The CQC report tells us what we already know: 40% of maternity services are rated as requiring improvement and 18% are rated inadequate. That means that less than half are rated as acceptable, which is not excusable, particularly given that we have had so many high-profile scandals and so many commitments—I believe they were made in good faith—from the Dispatch Box that these things will not happen again, but they are happening every single day. We know from all those reports that unsafe staffing is at the root of most of the problems and that it is pushing hard-working midwives, in particular, to the brink. They work their socks off to share in what should be the most joyful moment of each individual’s life. When I had my baby nearly 16 years ago in an emergency situation, the midwife, who had been with me all afternoon, stayed on at the end of her shift to make sure that I and my baby were okay. We received excellent care and were both fine in the end, thank goodness. However, we have all relied so much on the good will of those individuals that they are experiencing burnout at an alarming rate. I was canvassing in my constituency during the general election when a midwife came running across the road in her dressing gown and slippers to tell me that she was emigrating because she had had enough and that two other midwives she knew in the county were taking the same step because they had experienced burnout on such a shocking level. Any workforce plan needs to deal urgently with that problem. Staffing is one problem, but unsuitable buildings are another. In the shocking inquiry into the Lucy Letby case at the Countess of Chester hospital, which is slightly unrelated, I read that sewage was coming up into the hospital’s sinks. How can we control infection when there is literally raw sewage in the building? It is unacceptable. We need to ensure that this Budget invests not just in the GPs, healthcare workers and midwives we so urgently need, but in the fabric of our hospitals. We have repeatedly heard that there is a failure to learn when things go wrong and that hospitals focus too much on protecting their reputation rather than on learning from terrible mistakes that might have happened—and that will inevitably happen on occasion, even with the best staff in the world, because sometimes things go wrong. Hospitals must learn from those mistakes. Finally, there is a failure among hospitals to have an open culture, so staff who have concerns are unable to raise them. The duty of candour law, to which the Government have committed, is so important, and I urge the Minister to ensure that the people to whom workers in hospitals can speak up are independent of the hospital manager and the clinical director. If workers are reporting to the person responsible for giving them their jobs, that is not a safe process. We must have independent whistleblowing procedures for people raising clinical concerns. I am sure my constituents share my anger that we have to return to this topic again and again, when we should be looking at how far we have come since the Ockenden review over two years ago. I want to touch on the point made by my hon. Friend the Member for Carshalton and Wallington (Bobby Dean) about outcomes. Black and Asian women and their babies have a far worse probability of surviving birth than white women. If that was happening in a single trust, we would have another big, important review, but because it is spread out across the country, it is being lost, so we must return to it. It is not acceptable in this country in the 21st century that ethnic or socioeconomic background is a determinant of whether having a baby is safe. We are not on track to meet our 2025 targets for reducing stillbirth and neonatal death, and those targets have not been renewed. I urge the Minister to renew them and to ensure that there is a plan in place to meet them. Finally, my hon. Friend the Member for Winchester made the critical point that spending more on medical negligence than maternity services is totally unacceptable. This country cannot afford for that to continue. We must make maternity services safe, because it is better for the mothers, better for the babies and better for the taxpayer. I look forward to hearing the Minister’s response.

• 10 Sept 2024 · Exempt Supported Accommodation · Hansard source

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  It is a pleasure to serve with you in the Chair, Sir Mark. I congratulate the hon. Member for Birmingham Edgbaston (Preet Kaur Gill) on securing this debate and on her excellent speech, in which she highlighted all the difficulties that we knew existed in this sector. She also provided some real colour about what those difficulties mean for residents of exempt supported accommodation units, for local residents who are impacted by some of the bad-faith actors, and for local communities. I do not want to go back over some of the ground that has already been covered, because she covered it so well, but I am afraid that I will have to. Before I go any further, however, I should declare that I am a vice-president of the Local Government Association. In 2022, I served on the Public Bill Committee for the Supported Housing (Regulatory Oversight) Act 2023, which was introduced by the hon. Member for Harrow East (Bob Blackman) as a private Member’s Bill. It was an important step forward that had cross-party support from the then Conservative Government, the Labour Benches and the Liberal Democrat Benches, because the issue had become so severe. The system of exempt accommodation was well described in the October 2022 report by the Levelling Up, Housing and Communities Committee as: “a complete mess. There are many good providers, but in the worst instances the system involves the exploitation of vulnerable people who should be receiving support, while unscrupulous providers make excessive profits by capitalising on loopholes. This gold-rush is all paid for by taxpayers through housing benefit.” That is a sorry state of affairs. The then Government supported the Bill introduced by the hon. Member for Harrow East, because it was seen as a good way to deal with the situation that was described by the Select Committee and by the hon. Member for Birmingham Edgbaston today. In response to the Select Committee’s report, in early 2023 the Conservative Government said that the Supported Housing (Regulatory Oversight) Act 2023 would address most of the concerns that had been raised in the report, because it would introduce national standards for support and give local authorities the powers they need to set up licensing schemes to tackle poor-quality supported housing in their area. The Act provided for local authority supported housing strategies to review the situation in their area and the availability of and need for supported housing, and those strategies were to be renewed every five years. It also required the Secretary of State to set up a supported housing advisory panel to provide information and advice about supported housing; it allowed for the Secretary of State to set standards for the support provided in supported housing; and it allowed for regulations to be made to establish licensing schemes, which would include consideration of the condition of the property, the adequacy of the care and support provided, interactions with other licensing schemes, the costs, the financial penalties and all the things that needed to go with a properly functioning licensing scheme The Act also required the Ministry of Housing, Communities and Local Government, as it is now called again, to formally consult on elements contained within it, including the licensing regime, standards and any additional measures for securing compliance with the standards. As we have heard, however, much of that has not yet happened, despite the Act going through Parliament in 2023. The Act provided for better planning regulations; it said that somebody would not be treated as intentionally homeless if they left supported accommodation; and it provided for information management and sharing powers for those involved in the provision of supported housing. All in all, it seems to have been a pretty good piece of legislation, and the problem that we are experiencing now, as the hon. Member for Birmingham Edgbaston described in great detail, is that those provisions have not been enacted quickly enough. Today’s debate is about urging the Minister to bring forward the actions that are needed now to make sure that we improve the sector. The LGA is supportive of that legislation and has been a main stakeholder working with the Ministry to ensure that the Act works for councils, providers, and most importantly, residents in supported accommodation. But the LGA has raised significant concerns about the time taken to implement the Act and about the fact that councils have limited means to challenge poor providers, other than through housing benefit claims, which is problematic. We heard from the hon. Member that Birmingham city council has actually been able to challenge providers, so it would be interesting to find out from the Minister whether that is likely to be a model in future or whether better mechanisms will be put in place. As the hon. Member said, the delayed implementation of the Act is a problem for councils that have used the SHIP payments to improve supported housing in their area. The gap in funding between the SHIP payments and the new burden spending that comes with implementation of the Act means that councils will potentially have to let go of their skilled workforce and people with good experience of dealing with the problems and social implications of poor housing. It seems that in every debate at the moment, we must talk about the funding crisis for all councils. They need long-term funding arrangements with ringfenced support for housing, because the increased pressure on council budgets from that sector means that not only are we letting people down who have an acute housing need, but we are letting down everyone else whose services are impacted by the exorbitant cost of providing housing across the whole of England, particularly in communities where the sector is out of control, as the hon. Member alluded to. The calls of the LGA are, as always, very sensible. We need to review the current funding regime for supported housing. We also need to recognise the savings to the public purse that will come from not giving those unscrupulous providers limitless amounts of public money for a very poor service that will not realise any of the benefits that supported housing should realise for its inhabitants and wider society by providing the support they need. We need to ensure that the SHIP funding is there in the interregnum between now and the new burden spending, so that councils can continue the work that they are already doing, and crucially, can retain the skilled officers who are experienced in dealing with this situation. We also need to acknowledge that a licensing scheme and its enforcement, with improved standards for supported housing, will require proper funding. Otherwise, councils will be unable to deliver on the statutory requirement that we are about to place on them. The funding is so important. I know that the Government are dealing with a financial crisis, that they have extremely difficult choices to make, and that almost all Members will standing up in every debate to ask for more money—it is a difficult position to be in—but I urge the Minister to consider that, as taxpayers’ money is wasted so flagrantly on these unscrupulous providers, it would be a good use of public money to establish a proper licensing scheme. That would mean that we were not wasting taxpayers’ money and were instead putting it into support for the individuals who have had a crisis, hopefully turning their lives around, and costing the taxpayer less in future. That would be a wise investment of taxpayers’ money. On the important issue of resource, many councils are having to let staff go because of funding pressures. We cannot enforce and practise a licensing scheme without the right people in officer roles in councils, so the recruitment and retention of those critical staff is also extremely important. I honestly do not think that I have added much to the hon. Member’s excellent speech, but I hope that I have added my voice to her cause on regulating the sector properly.

• 4 Sept 2024 · Preventable Baby Loss · Hansard source

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  The hon. Gentleman is making a powerful speech. It is good to hear the story of Agnes, and I hope that he will agree with me that sympathising with our constituents who have suffered such awful circumstances and telling their stories in Parliament is a good way to ensure that they are heard in the future.

• 19 Jul 2024 · Planning, the Green Belt and Rural Affairs · Hansard source

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  I congratulate the Deputy Prime Minister and welcome her to her place, and I welcome the shadow Secretary of State as well. Because we are talking about local government today, I declare my interest as a vice-president of the Local Government Association. The topic of today’s debate is planning, the greenbelt and rural affairs. We need to talk about planning and housing, and I will certainly do so, but we also need to talk about rural affairs, and I am slightly confused about why none of the speeches by Front Benchers has done that. I welcome the Government’s focus on house building and the reintroduction of housing targets. In England, the number of people left languishing on the social housing waiting list has reached 1.2 million, and there are 8.5 million people in this country with some form of unmet housing need. Last year, under the Conservative Government, 29,000 social homes were sold or demolished, and fewer than 7,000 were built, so we all know that we have an unprecedented need for new housing, particularly social housing. The Liberal Democrats’ ambitious commitment on social housing would be to build 150,000 social homes a year by the end of this Parliament—