Karin Smyth MP: speeches 2025

Speeches

• 10 Feb 2025 · Draft Health and Social Care Act 2008 (Regulated Activities) (Amendment) Regulations 2025 · Hansard source

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  The right hon. Gentleman makes an important point about maternity care, which is very sadly an issue of concern in many places across the country. Of course, those patients and families are absolutely right to call out poor care where they have seen it. It is absolutely right that that is fully investigated, and that is what we would expect at Leeds and in other places around the country. The CQC’s leadership in ensuring that we have safety and confidence is critical for the role. On that basis, we would like to move forward with this SI to remove the expiry date in the 2014 regulations, to amend the five-year period and to ensure that health and care providers continue to be required to register with the CQC and comply with the fundamental standards set out in the 2014 regulations after 31 March this year. We also want to make sure that services continue to be required to provide a safe and high quality standard of care. Question put and agreed to.

• 30 Jan 2025 · Medicinal Cannabis · Hansard source

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  I will come on to the research. As we have heard, and as I recognise, fewer than five patients have accessed these medicines on the NHS, so access is truly exceptional. The testimony of the children and families accessing these treatments privately—often at great personal cost, as we have heard this afternoon—is truly heartbreaking. I am sure we can all agree that all Government spending on health must be evidence-based, and colleagues are seeking to ensure that that is the case. If we are to see more cannabis-based medicines routinely available on the NHS, we need more research. The National Institute for Health and Care Research, also known as the NIHR, and the MHRA are there to support manufacturers and researchers to develop new medicines and design quality studies. I strongly encourage the manufacturers of those products to invest in research to prove that they are safe and effective and meet the rigorous standards that we rightly expect for all medicines. They should engage with the NIHR and the MHRA on clinical research and medicines licensing processes. That is key in providing doctors with the confidence to prescribe cannabis-based products in the same way that they use any other licensed medicines recommended for use on the NHS, but we are not waiting for industry to respond to patient voices. The NIHR and NHS England have recently confirmed more than £8.5 million in funding for clinical trials to investigate whether cannabis-based medicines are effective in the treatment of drug-related epilepsies. As I said when we were in opposition, and as has been highlighted today, action in this space is vital. Epilepsy is a terrible disease, and it can be life-limiting in the most serious cases. We also know that although epilepsy is a fairly common neurological condition, affecting 1% to 2% of the population, about 30% of cases will sadly have seizures that are resistant to current treatments, so it is absolutely right that the NIHR and NHS England are pioneering truly world-first trials that will investigate the safety and effectiveness of CBD and THC in adults and children with treatment-resistant epilepsy. The trials will be co-led by experts from University College London and Great Ormond Street hospital and will look to recruit around 480 patients from across the UK. The study details are published on the NIHR website, and I understand that it will publish further details soon. Further funding has also been awarded to the University of Edinburgh to investigate the efficacy of CBD in patients with neuropathic pain due to chemotherapy. Those are two examples of the type of research that we desperately need in this area of medicine, and a further 28 studies looking at cannabis-based medicines have been approved by the MHRA since 2018. It is an emotive and complex debate, but the clinical trials give me encouragement that there is a way forward. If the evidence supports it, we will see more cannabis-based medicines approved by the regulators and recommended by NICE. That is the only way we will see the evidence base improved and give clinicians the confidence to prescribe. To conclude, the hon. Member for Strangford has brought this debate forward with his customary good faith and compassion.

• 30 Jan 2025 · Medicinal Cannabis · Hansard source

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  I will take another intervention.

• 30 Jan 2025 · Medicinal Cannabis · Hansard source

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  I cannot answer the question about trials and research directly because, obviously, trials are run by the specialists at NIHR, in the usual way, and I am sure that the request for meeting has been heard. It would probably not be with me, but I am sure the officials have heard it and that the hon. Gentleman will have a response. I thank the Opposition spokesperson for reading out my contribution and highlighting how proactive we are being, only seven months since forming the new Government. I am proud that the trials that we are looking to do are world firsts. No other country in the world is taking the same action to prove that the medicines are safe and effective. I know it will not come as much consolation to those families who are at the end of their tether with talk of processes, debates and regulations. I also know it may not feel like it, based on some of the things I have said today, but I think there is a way forward. There may be some light at the end of the tunnel, and this Government will do what we can to support NHS England and the NIHR to get the trials done.

• 30 Jan 2025 · Medicinal Cannabis · Hansard source

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  It is a pleasure to serve under your chairship, Ms McVey. I congratulate the hon. Member for Strangford (Jim Shannon) on securing this debate. As he said, there are many hon. Members from both sides of the House representing constituents affected by the issue across the United Kingdom who would have liked to be here today. Obviously, health is a devolved matter. The hon. Gentleman spoke movingly about his constituents, and other colleagues talked about theirs. I agree with him. My words have been repeated back to me, so I do not need to say them again. This is an important issue for everyone in the Chamber and those who are listening in, as we all want to support people who are in very difficult circumstances. The hon. Gentleman raised some key issues, which I will address. He said that landlords and the police are unaware of the legality surrounding prescribed medicinal cannabis. I encourage him to take that up with the Deputy Prime Minister and the Home Secretary. I understand that the Home Office has notified all police forces about the change to the law, and guidance has been issued to summarise what that means. The hon. Gentleman mentioned electronic prescribing, which has been in operation for schedule 2 and 3 controlled drugs in NHS primary care settings since 2019. I am afraid there are no current plans to extend that to private clinics at this time. The hon. Gentleman also spoke about an observational study with a small patient cohort. I am afraid that it would not produce results as robust as a randomised control trial, which is the gold standard for clinical trials, nor would it add to the current evidence base. It would not provide results suitable to inform routine clinical or NHS commissioning decisions, because there would be no way to compare the findings with what would have happened in the absence of the intervention. I will come on to clinical trials in more detail, but let us be clear about the problem we face, the challenge faced by all of us involved in this debate and the challenge faced by children, many of whom have been mentioned today. Of course, we listen to Members of this House, and to patients, parents and families, who say that these medicines are safe and should be available. We must ensure the safety and effectiveness of all medicines. The benefits should outweigh any potential harm and, as the hon. Gentleman outlined, clinicians must have that assurance and clarity, too. There are currently only two cannabis-based medicines in the world with marketing authorisations or licence. They are—I hope I do not stumble over them too—Sativex, for the treatment of muscle spasms in multiple sclerosis, and Epidyolex, for treatment related to two rare forms of epilepsy and tuberous sclerosis complex. Those medicines show that it is possible to develop cannabis-based treatments that have been assessed for safety, quality and efficacy. The evidence generated on their clinical effectiveness and cost-effectiveness can enable the National Institute for Care and Health Excellence to recommend them for use in the NHS. The medicines we are talking about today are unlicensed, which means that they have not been assessed by the Medicines and Healthcare products Regulatory Agency. Indeed, they have not been assessed or granted market authorisations by any medicines regulator anywhere in the world. However, as has been noted, in 2018 the then Home Secretary, Sajid Javid, enabled the prescription of unlicensed cannabis-based products for medicinal use. That provided a lawful route to these medicines for prescriptions for individual patients who were not benefiting from standard treatments and were not part of clinical trials, while limiting the ability to prescribe to specialist doctors. That came on the heels of the review by Professor Dame Sally Davies, then the chief medical officer, which found enough evidence of benefit to recommend that cannabis-based medicine should be moved out of schedule 1 to the Misuse of Drugs Regulations 2001. For epilepsy, that evidence was mainly in relation to cannabidiol, also known as CBD, rather than products containing the psychoactive compound tetrahydrocannabinol, or THC. The review did not provide evidence to support routine prescribing or funding of those medicines on the NHS, which the previous Government should have made clear at the time. Before we see routine prescribing of these unlicensed medicines, the NHS must have greater assurance on their clinical effectiveness and cost-effectiveness at a population level. I am not a clinician—we are all here as politicians—and it is right that prescribing any medicine or treatment is a clinical decision, whether it is done on the NHS or privately. It is not for us to influence those decisions, so I cannot comment on individual cases. We want to see more medicines approved by the MHRA and available on the NHS. We inherited a broken system, and it will take time to fix that failure, but the Chancellor has made an in-year investment in the NHS to fill the black hole that we inherited and prevent our having to cut back on services. That means that, more than ever, the NHS must account for every penny that it spends and make difficult decisions on what treatments are made available. The NHS must get the best possible value for its investment in medicines and consider the cost-effectiveness of treatments to ensure that resources are used efficiently. For that to be fair, medicines or treatments initiated privately would not routinely be prescribed by the NHS unless the requested treatment was already approved under existing policies, which unlicensed medicinal cannabis is not, or when there are individual, exceptional circumstances. That remains the case even if privately funded treatment has been shown to have clinical benefit for an individual patient. This is the current NHS policy for all treatment initiated and prescribed privately, and it is not specific to medicinal cannabis.

• 30 Jan 2025 · Women’s Health Strategy · Hansard source

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  The chief executive is right that the previous Government did not have women’s health at the heart of their strategy, and that is why we do.

• 30 Jan 2025 · Women’s Health Strategy · Hansard source

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  I will try to be brief, but this is hard to explain— [ Interruption. ] No, this is to answer the right hon. Gentleman. Targets in the NHS have not been met since 2015, which was under his Government’s watch but, actually, this target has been met—there are only three places in the country that do not have a hub—so there is no target for them because that has already been met. The issue now is to look at the outcomes from those hubs to see how they are performing. We think, and the system thinks, that they do a good job. That is why they are staying, why we are committed to them, and why we want to learn from them.

• 30 Jan 2025 · Women’s Health Strategy · Hansard source

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  The hon. Gentleman is right to highlight those long waits. That is why we particularly highlighted gynaecology for attention in the elective reform plan. It is shocking that the last Government left 600,000 women on these lists, and moving back to making sure people wait no longer than 18 weeks will predominantly be helping those women. The hon. Gentleman is also right to highlight the appalling maternity situation. The Secretary of State and my noble Friend Baroness Merron, who leads in this area, have met many families to discuss their experiences, and we know those experiences are unacceptable. We know there are big issues around staffing, and it is a priority to work with NHS England to make sure that we grow workforce capacity as quickly as possible so that we can be sure that those situations are safe. There are many debates in this place about the issue and we will continue to update the House.

• 30 Jan 2025 · Women’s Health Strategy · Hansard source

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  My hon. Friend makes an excellent point about both the work of the Chair of the Select Committee, my hon. Friend the Member for Luton North (Sarah Owen), and the importance of primary and community care recognising, listening to and supporting women through women’s health, as well as making sure that our knowledge and good practice is spread across the team. This is an area where different systems have women’s health hubs using different teams and different technology, and they have different links to secondary care colleagues and specialist colleagues. By listening to each other and working together, they are so good at spreading some of that good practice.

• 30 Jan 2025 · Women’s Health Strategy · Hansard source

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  My hon. Friend makes an excellent point about maternity services, which are inconsistent and not good enough around the country. It is a source of great alarm for many people. Maternity absolutely remains a high priority within the overall women’s health strategy.

• 30 Jan 2025 · Women’s Health Strategy · Hansard source

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  I completely agree with the right hon. Member. Donna Ockenden’s work is hugely valuable, and a lot of faith and trust has been placed in it, particularly by families. I do not know specific dates, but the Secretary of State and my noble Friend Baroness Merron, who leads on this work, have been discussing the matter with Donna Ockenden. I am happy to get back to the right hon. Member with the details. On the specific point about the remit, I do not know the answer to that question. It is entirely sensible to look at progress and learn from mistakes. I know it is a challenge system, and we have to learn from those areas. If there are specific things to report back to the right hon. Member, I will get back to him, but this issue is absolutely a priority. The Secretary of State is meeting families directly. We know and understand that we have to do much better on this for everybody.

• 30 Jan 2025 · Women’s Health Strategy · Hansard source

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  I addressed most of those points in my outline statement. I think the shadow Minister wrote her comments when the Opposition thought that we were cancelling things, only to find out that we are not cancelling things. I have made clear our commitment to the women’s health strategy and how we seek to instruct the system at a local level to serve the needs of women and particularly prioritise those waiting lists. As I have outlined, the targets have already been achieved. Unusually, I will give a bit of credit to the other side, because a lot of this was rolled out and it was good practice, and the system still thinks that it is good practice, so sometimes Opposition Members should take a win. We are committed to that, it is embedded in the system, and we look forward to outcomes being improved for women.

• 30 Jan 2025 · Women’s Health Strategy · Hansard source

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  I absolutely will give my hon. Friend that assurance. The situation will change partly because there are more people like her and more women in this place. We have more women across all parties raising this issue and more women in senior positions in the National Institute for Health and Care Research. Crucially, we have women leading in science and research. Dealing with the misogyny around the system and in medical systems is also important for making sure that women lead this work. We want to make sure that the NIHR, which has a strategy to address this issue, rectifies the situation that she outlines.

• 30 Jan 2025 · Women’s Health Strategy · Hansard source

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  I thank the Committee Chair for her question. I think she was congratulating the previous Committee and Chair rather than those who are now in opposition. I was very pleased to witness some of that work when we were in opposition, and she is absolutely right about it. The work of many women Members when in opposition, and, to be fair, of many women in the previous Government, have made sure that issues around endometriosis have risen up the agenda; indeed, we had a good debate in the Chamber recently. We are committed to taking forward the strategy. We think the health hubs, for example, are doing a good job, but there is a lot of learning to be done on them, and we will continue to do that.

• 30 Jan 2025 · Women’s Health Strategy · Hansard source

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  I thank the hon. Lady for giving me the opportunity to set out our commitment to the women’s health strategy and everything that this Government are doing to fix our broken NHS, clean up the mess that the Conservatives left after 14 years and get women treated on time again. When we came into office we inherited record waiting lists. The gynaecology waiting list stood at just under 600,000 women. Let that sink in—600,000 women in pain, waiting to be cared for. Almost half the women on gynaecology waiting lists are waiting more than 18 weeks. That is why the Prime Minister kicked off 2025 with our elective reform plan, setting out how we will cut the longest waiting lists from 18 months to 18 weeks. Our new agreement with the independent sector will mean that, where there is spare capacity in the private sector, women will be treated faster for gynaecology care, paid for by the state. The Government are also committed to rooting out the appalling inequalities in maternity care. We are supporting failing trusts to make rapid improvements, training thousands more midwives for the first time, and we will set an explicit target to close the black and Asian maternal mortality gap. We are piloting a training programme to help avoid brain injury for babies in childbirth and, if successful, we will crack on with rolling it out nationally this year. In October, we extended the baby loss certificate service to help mums and dads who have suffered the heartbreak of pregnancy loss. Let me also address the issue of women’s health hubs. There was a target in last year’s planning guidance to roll out pilot women’s health hubs across the country by last December. Today, there are at least 80 hubs, and at least nine out of every10 integrated care systems have an open women’s health hub. Let me correct some fake news. We are not closing these hubs; we are not cutting them. The target to roll them out was in last year’s planning guidance. It was achieved in 93% of integrated care systems, which is why the target is not repeated in this year’s guidance—it has been met in 39 out of 42 areas. Today, we have slimmed down the number of targets for the NHS so that we can focus on fixing the fundamentals —the system that the previous Government broke. We are instructing the NHS to prioritise: cutting waiting times for operations, A&E and ambulances; making it easier for people to see a GP or a dentist; and improving the mental health of the nation. That will mean around 60,000 women with suspected cancer are diagnosed earlier and treated faster; more than 200,000 extra women will be treated within 18 weeks, as we drive down long waits; and fewer women will be forced to wait 12 hours in A&E. That is the difference that a Labour Government are making to women’s health.

• 30 Jan 2025 · Women’s Health Strategy · Hansard source

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  I have made that commitment several times from this Dispatch Box. We think the women’s health hubs are working across the country—I do not know exactly how the hon. Gentleman’s hub is working at the moment. Only three areas do not have a women’s health hub, and we expect them to get on with that and have one. We will ensure we have the learning from them across the country.

• 30 Jan 2025 · Women’s Health Strategy · Hansard source

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  Further to that point of order, Madam Deputy Speaker. I absolutely, unequivocally apologise.

• 30 Jan 2025 · Women’s Health Strategy · Hansard source

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  I am not entirely clear what the hon. Member is referring to. I have been clear that we are committed to the women’s health strategy, and we will take it forward as part of the 10-year plan. Most of the— [ Interruption. ] If it was about the women’s health hubs, they are mainly there but in different forms and with different levels of services. We want to ensure that the systems reflect their local population needs. That is an entirely proper way to go about things. As I said, unusually, we think that many of the hubs, which were rolled out as pilots under the previous Administration, are doing a good job in most areas—although not everywhere, so we want to learn from the pilots. Our commitment is absolutely to women. That is why gynaecology waiting lists are particularly targeted: we had 600,000 women on them. Women should feel really assured about the support that the Government are giving them and their health, to prioritise their health. We are keen to learn more about women’s health hubs. They will be different in different places because they have different populations, and that is entirely in keeping with the direction of travel of the Government.

• 30 Jan 2025 · Women’s Health Strategy · Hansard source

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  I thank the right hon. Gentleman for the work he does in this area. He does an excellent job and makes an excellent point. I do not know the detailed answer to that question—it is not directly my area—but I am very happy to make sure that we write to him.

• 30 Jan 2025 · Women’s Health Strategy · Hansard source

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  My hon. Friend makes a very powerful case and talks of an experience that he and his wife went through forty years ago, which highlights that it can sometimes take an unacceptably long time to get what is known as good practice through the system and to have that consistency for women and their families across the overall system. We absolutely need to ensure that maternity services understand best practice and that it is rolled out properly across the country.

• 30 Jan 2025 · Women’s Health Strategy · Hansard source

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  As I hope the hon. Gentleman knows, I think the health needs of women in Northern Ireland and the waiting lists there are particularly problematic, so finding out anything our Department can to do support or share learning across the United Kingdom is a personal commitment of mine. I will absolutely make sure that we do that. I am happy to meet, talk or even visit, which I always like doing.

• 30 Jan 2025 · Women’s Health Strategy · Hansard source

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  The hon. Gentleman can tell his women constituents what I hope everyone across the House will be able to tell their constituents: this Government inherited 600,000 women on those waiting lists, and we are committed—as said in our elective reform plan, which highlighted gynaecology in particular—to getting those waiting lists down from 18 months to 18 weeks in the lifetime of this Parliament.

• 30 Jan 2025 · Women’s Health Strategy · Hansard source

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  The hon. Lady makes the point about using targets. This is something that is a high priority, but it is not happening. That is absolutely why I mentioned it in my opening comments—to ensure that that happens.

• 30 Jan 2025 · Women’s Health Strategy · Hansard source

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  My hon. Friend is right to highlight some tragic incidents, and I know she will be working hard on behalf of her constituents. We are absolutely committed to the women’s health strategy. Clearly, that will be taken forward as part of the 10-year plan, and it is an important part of that. I met my noble Friend Baroness Merron yesterday and the team supporting that plan to make sure that we understand how those key issues are taken forward. This is an opportunity, if I may, Madam Deputy Speaker, to say that the consultation on that plan is still open for ideas. We are keen to hear in particular from young people to make sure that we get a true representation. These sorts of things are not often consulted on, so we encourage young people and people who are suffering from depression and mental health issues to contribute their thoughts about the system they face as part of our 10-year plan consultation.

• 30 Jan 2025 · Doncaster Royal Infirmary · Hansard source

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  I congratulate my hon. Friend the Member for Doncaster Central (Sally Jameson) on securing a debate on this really important issue for her constituents. Since her election, she has been a committed champion for Doncaster Royal Infirmary, and I thank her for her tireless efforts. She is absolutely right that the promises made by the previous Government were hollow and built on sand. Even for the hospitals that made it into the new hospital programme, the money simply was not there. They let down the people of Doncaster. On Monday, I had the privilege of visiting Doncaster Royal Infirmary, along with my hon. Friend and our hon. Friend the Member for Doncaster East and the Isle of Axholme (Lee Pitcher), and witnessed the outstanding care that staff are providing despite significant infrastructure challenges. I entirely agree with my hon. Friend’s comments about the situation, and about the pressure that the staff find themselves under. Staff and patients deserve better than a hospital prone to floods, fires and equipment failures, some of which I saw for myself on Monday. Doncaster Royal Infirmary now has a backlog-of-maintenance bill of approximately £114 million, and the constant need for critical repairs leaves scarce resources for developing and enhancing facilities. That is the reality facing Doncaster Royal Infirmary and hospitals nationwide after years of under-investment by the previous Government. Reversing the trend and repairing and rebuilding our hospital estate is a vital part of our ambition to create an NHS fit for the future. That is why the Chancellor announced that health capital spending is set to increase to £13.6 billion in 2025-26, representing record levels of capital investment in healthcare. I am pleased that works to address some of the most pressing issues at Doncaster Royal Infirmary are under way, with £19.8 million confirmed for the refurbishment and relocation of the critical care unit. That will deliver a safer and more accessible environment for the most vulnerable patients. Supporting projects are already in progress, including the relocation of the surgical same-day emergency care department. While I accept that this by no means addresses all the issues raised today, it is nevertheless a project that will deliver much-needed safety improvements. NHS planning guidance published today sets out the NHS’s operational capital envelopes, national capital programmes and allocation processes for 2025-26. I recognise that the guidance will be of interest to Members who wish to understand the impacts on their constituencies, but as we are here to discuss Doncaster Royal Infirmary, I will focus on the funding opportunities available for that hospital. The Government are backing the NHS with over £4 billion in operational capital in 2025-26 to empower local systems and ensure that funds are allocated according to local priorities. NHS England confirmed today that South Yorkshire integrated care board, which is responsible for Doncaster Royal Infirmary, has been allocated £107 million in operational capital to spend on its capital priorities next year. In addition to the annual operational capital allocations, the Government have allocated £750 million to an estates safety fund for 2025-26, which will focus on the worst safety risks across the NHS estate. South Yorkshire ICB has been allocated £19 million of that funding on the basis of need, critical infrastructure risk, estates incidents, and the recent maternity estates survey. Systems have been asked to prioritise their estate safety allocations to deliver maximum safety benefits locally. Their plans will be reviewed by NHS England and the Department of Health and Social Care to ensure that national and regional priorities are addressed effectively and schemes represent value for money. In some cases, estates safety funding may also be used to initiate multi-year schemes when that represents the most effective approach. I strongly encourage the trust to discuss options with the ICB for allocating some of its operational capital and estates safety funding to repairs at Doncaster Royal Infirmary. Let me also draw attention to the £1.35 billion of capital funding allocated for constitutional standards recovery in 2025-2026. Although it is not targeted directly at repairs, Doncaster Royal Infirmary may be able to benefit from some of the £24 million that has been allocated to South Yorkshire ICB to support its progress towards achieving constitutional standards for my hon. Friend’s constituents. I encourage the trust to explore possible options with the ICB that could address constitutional standards recovery as well as critical repairs, maximising value for money and, crucially, benefiting patients who deserve much better. The Government recognise that, like Doncaster Royal Infirmary, many hospitals across the country need funding to overhaul their digital infrastructure. That is why we are investing more than £2 billion in NHS technology and digital in 2025-26 to run essential services, increase productivity, improve cyber-security, enhance patient access, and ensure that all trusts have electronic patient records. I thank Doncaster and Bassetlaw trust for its co-operation on the implementation of a system-wide electronic patient record, and I want to reassure the trust that this investment in digital and technology will be available for projects beyond electronic patient records. The Government understand that long-term certainty about capital funding will be essential to addressing the critical infrastructure issues at hospitals such as Doncaster Royal Infirmary, and across the NHS estate. Capital budgets beyond 2025-26 will be determined through the current spending review, which concludes in June 2025. In conclusion, I thank my hon. Friend the Member for Doncaster Central for raising this important issue, and for her continued support, and that of her colleagues, for Doncaster Royal Infirmary. I extend my thanks to the staff of Doncaster Royal Infirmary for hosting my insightful visit, and for their candour in explaining to me how they have got into this situation in recent years. I hope to return when the new critical care unit is open. The Government are committed to repairing and rebuilding our hospital estate. It will take time—we have inherited a shocking situation—and I look forward to working with colleagues on this vital issue across the country in the coming years. Question put and agreed to.