Karin Smyth MP: speeches 2024

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Speeches

18 Dec 2024 · Winter Preparedness · Hansard source
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I join the hon. Gentleman in thanking everyone who works in the system. As I said, the NHS is getting £12 billion more this year from this Government than it had from the previous Government in the spring Budget. We are now focused on ensuring that money is used properly.
18 Dec 2024 · Winter Preparedness · Hansard source
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The hon. Gentleman tempts me to make commitments from the Dispatch Box, which I am not going to do. He makes a very serious point. The sea is an issue for many hon. Members—beautiful though it is, it has an impact on the ability of the system to manage different areas. Looking at different solutions for populations such as those he represents—be that 111, hear and treat systems, more use of technology, and pharmacies and community out-of-hospital care—is exactly what we think is the right way to go in the next few years, as part of the long-term plan. That may or may not be a building with services. We need to look at that in the round and learn from what works well in different sorts of systems.
18 Dec 2024 · Winter Preparedness · Hansard source
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I thank the right hon. Lady for her question. We have discussed this issue a number of times in this place. We absolutely understand the impact of cold and heat on the system and on people. It is something we need to address more generally. She will be aware that discussions on this issue are continuing with the DWP. If there are specific examples she wants to raise with me or the Department, I am very happy to look at them.
18 Dec 2024 · Winter Preparedness · Hansard source
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As I said in my statement, we have begun plans to stabilise the workforce and the employment Bill is going through the House, so I do not agree with the hon. Lady on that point. We know that it will take a long time, and we will of course be working with colleagues to ensure that we do develop that national care service.
18 Dec 2024 · Winter Preparedness · Hansard source
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As I think the hon. Gentleman knows, I cannot talk about individual cases from the Dispatch Box, but we will be making announcements on that subject very shortly.
18 Dec 2024 · Winter Preparedness · Hansard source
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We recognise all the costs to GPs, as contractors, and to many other parts of the system, as we have said many times in the House. We also recognise the improvements that we have made to the system by improving the number of GPs and funding the NHS by more than the last Government did. We will continue to look at that in the round to ensure that we have a sustainable system.
18 Dec 2024 · Winter Preparedness · Hansard source
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I am very pleased to reiterate that safety is the watchword for winter, as it is all year round, and to stress that that is why NHS England wrote about it today. I commend my hon. Friend for meeting her constituents locally, and I urge all Members to do the same. We are getting some fantastic ideas from staff and from patients about how to reform and change the system for the long term.
10 Dec 2024 · Lobular Breast Cancer · Hansard source
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It is a real pleasure to serve under your chairship, Ms Vaz. I add my thanks to all hon. Members for their contributions and to my hon. Friend the Member for Dulwich and West Norwood (Helen Hayes). First let me say how sorry I am to hear about her friend. Those are very precious friendships and I think my hon. Friend articulated that well today. My deepest sympathies to Heather’s loved ones who are with us today and to her wider family group. It is a really difficult time and this is a very recent bereavement to be talking about. My hon. Friend has used her voice as a parliamentarian to good effect, as she always does, and I congratulate her on doing that. I hope I can go some way to answering the questions she raised at the end of her speech. If I do not and she is not satisfied, I will make sure officials get back to her on the specifics. I also echo the words of the hon. Member for Hinckley and Bosworth (Dr Evans) about hon. Members raising their personal experiences and the importance of support from partners and wider family members for people who are going through diagnosis, treatment and sadly, often, death. We know that too many cancer patients are being failed. They are waiting too long for life-saving treatments and receiving a diagnosis too late. As my right hon. and learned Friend the Prime Minister reiterated last week, we have inherited a broken NHS but it is not beyond repair. We know it needs to be fixed and there is not a single solution. To ensure that more people survive cancer, including lobular breast cancer, we have to take a multi-pronged approach—catching it earlier so more treatments are available, raising awareness of its specific symptoms, and investing in equipment and research, as many hon. Members have raised today. All those actions are part of our plan to put the NHS on the road to recovery. As we have heard today, according to Cancer Research UK lobular breast cancer is the second most common type of breast cancer. Also known as lobular carcinoma, it impacts the lives of many—around 15 in every 100 breast cancers are invasive lobular. Treatments for lobular breast cancer are broadly similar to those for other breast cancers. Surgery and radiotherapy are effective for most patients with primary invasive types, meaning those which have not spread to other parts of the body. Systemic therapy such as chemotherapy, hormonal treatment, targeted therapy or immunotherapy are usually offered based on the stage at which the NHS catches that cancer. Another factor which can determine clinicians’ decisions on the best treatment option is how the cancer has spread or developed in each patient’s case and we understand that is different for different patients. Sadly my understanding is that when cancer is growing in more than one location, as is more common in lobular breast cancer, treatment is more challenging. The same is true when a cancer has spread to other parts of the body. To improve outcomes in such challenging cases, NHS England funded an audit into both primary and metastatic breast cancer that has spread. The scoping for this audit began in October 2022 and the results were published in September this year. NHS England are hopeful that the results will help to improve the consistency of treatments offered, as well as stimulate improvements. We know that for far too many women, lobular breast cancer is diagnosed at a later stage, which means that treatment options are more limited. The key to improving survival must lie in raising awareness, and early detection and diagnosis. I am not sure I can do it as well as the shadow Minister, but I want to use this opportunity to raise awareness of the fact that not all breast cancers form a firm lump. I think he articulated really well what women should be looking for. Lobular breast cancer patients are more likely to have thickened areas of breast tissue. Possible symptoms include an area of swelling, a change in the nipple or a change in the skin, such as dimpling. I encourage everyone to check their breasts regularly and to consult their GP straightaway if they have any concerns. While more people are surviving breast cancer than ever before, we know that lobular breast cancers can be particularly hard to detect. Another measure to support earlier diagnosis of breast cancer is screening before people notice symptoms. Our screening programme sends women their first invitation at the age of 50. To support detection, the NHS carries out approximately 2.1 million breast cancer screens each year in hospitals and mobile screening vans, usually in convenient community locations, but—this is a really shocking figure that I learned recently in another debate in Westminster Hall, which shows how important it is that Members raise these issues—take-up of breast cancer screening is currently below 70%. That is worryingly low, and we are determined to improve it. Every effort that hon. Members here and people listening to this debate can make to improve that take-up rate will help save lives. If someone is eligible for screening, they should come forward and take up that important offer. Unfortunately, even for those women who come forward for a mammogram, we know that lobular breast cancer can be more difficult to catch than other types of breast cancer. We have heard some shocking stories and examples today. To ensure that women survive, we need to be relentless in researching every possible avenue of treatment and diagnosis. Examples of innovation supported by my Department include £1.3 million invested in a Bristol-based FAST MRI project, which will determine whether different types of scans can help detect cancer in a cost-effective manner. The FAST MRI project focuses on an abbreviated MRI, which is a shortened version of a breast MRI. This type of imaging can help to detect the most aggressive forms of breast cancer sometimes missed by screening through mammography, including lobular breast cancer. My Department is also working closely with UK Research and Innovation and the Medical Research Council. These bodies are responsible for studies that look to understand the basic mechanisms of disease. Combined, they spend £125 million on cancer research each year. My officials also meet regularly with partners to discuss a wide range of our research investments and ways to stimulate new proposals. These include those for lobular breast cancers. Through the National Institute for Health and Care Research, my Department will continue to encourage and welcome applications for new research in this area. I hope this addresses the shadow Minister’s point, but funds for research are still available through the NIHR. Funds are awarded through open competition informed by expert peer review, with active involvement of patients and the public. The Department and NIHR also advise the campaign on the Lobular Moon Shot Project. It has already contracted £29 million, which I think is the figure the shadow Minister referred to, to the Institute of Cancer Research and its partner at the Royal Marsden. This proposal included work on lobular breast cancer. I hope I have addressed that point, but if I have not, then please let me know. We know that we must do more to rise to the growing challenge that cancers including lobular breast cancer represent, but for our efforts in detecting and understanding this complicated disease to be effective, we need to back fundamental reform in the health service. That is why we have launched the biggest national conversation about the future of the NHS since its birth to shape the 10-year plan. We need suggestions from hon. Members on how to go further in preventing cancer where we can. I urge everyone to visit the website change.nhs.uk to do so.
10 Dec 2024 · Lobular Breast Cancer · Hansard source
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I was going to come to that. I am not fully au fait with the change in guidelines that the hon. Gentleman referred to, so I will happily take that point away. He made a wider point about aligning across the devolved regions. Obviously, some of these issues are devolved and we have to respect the devolution arrangements. On the wider research, we should learn from each other, understanding that we have similar patient cohorts. There is lots of good medical work going on, and the Government are determined to work respectfully across the devolved nations. I will ensure that the hon. Gentleman gets a written answer on the specifics of his question. Heartbreaking stories such as Heather’s remind us that diseases such as lobular breast cancer are complex. They are hard to catch, and therefore treat. Such tragic losses are a wake-up call for us all, and I commend all hon. Members for raising those stories. For people listening in, as well as those who have attended the debate, they are an important way to raise awareness. We are grateful to those who have shared their personal stories, which help us get the NHS back on its feet so that we can better serve the people who need it. Improving cancer survival requires a multi-pronged approach to ensure that patients have timely access to effective treatments, built on the foundations of world-class research. We have already taken immediate steps to allow cancer patients to benefit from the most up-to-date technology. Through the recent Budget, we committed to surgical hubs and scanners to allow for 30,000 more procedures each year, and we are increasing capacity for tests. We have also committed another £70 million for radiotherapy machines. Lots of hon. Members have raised those points. I have outlined several measures today, and I assure Members that improving outcomes for cancer patients, including those with lobular breast cancer, remains a top priority for this Government.
10 Dec 2024 · Lobular Breast Cancer · Hansard source
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I thank the hon. Lady for that really important point. She highlights another important issue affecting the health of women and children, and I agree with her. My hon. Friend the Member for Dulwich and West Norwood spoke about women’s health overall, which is an important priority for this Government, as are these forms of cancer and the wider preventive agenda. That is another point that can be made on the change.nhs.uk website, which I will keep plugging. The issues that have been raised on it by the public and staff are really interesting and informative. My right hon. Friend the Secretary of State has been clear that there should be a national cancer plan. The hon. Member for Wokingham (Clive Jones) made helpful points about that opportunity. I will not take up his invitation for a meeting; his point would be better made by being inputted into the process with the organisations he is in touch with. That would help to shape the national cancer plan, which we can all buy into as a country. The plan will include more details about how to improve outcomes for all tumour types, including lobular breast cancer, and ensure that patients have access to the latest treatments and technology. We are now in discussions about what form that plan should take and what its relationship with the 10-year health plan and the Government’s wider health missions should be. We will provide updates on that in due course. I thank my hon. Friend the Member for Dulwich and West Norwood for bringing this important matter to the House.
27 Nov 2024 · Draft Human Medicines (Amendment) (Modular Manufacture and Point of Care) Regulations 2024 · Hansard source
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I beg to move, That the Committee has considered the draft Human Medicines (Amendment) (Modular Manufacture and Point of Care) Regulations 2024. It is a pleasure to serve under your chairmanship this morning, Mr Betts. I am grateful to be debating this important amendment to establish a tailored regulatory framework to support decentralised methods of medicine manufacture, moving innovative medicines closer to the patient. The draft regulations will amend the Human Medicines Regulations 2012 and the Medicines for Human Use (Clinical Trials) Regulations 2004. The regulations create an enabling pathway for innovative manufacturing from early-stage development in clinical trials through to the administration of medicines to patients. The UK is leading the way as the first country to introduce a framework for these groundbreaking, decentralised methods of medicine manufacturing. We are taking action to support medical advancements that are on the cutting edge of technology to benefit patients across the country. The new framework is being brought forward pre-emptively to encourage increased manufacture and supply of innovative medicines that can only be manufactured at or close to the point of care or by modular manufacturing, where products are manufactured in relocatable units. The framework will help to develop a new sector of medicines manufacturing, enabling safe innovation and development of highly specialised treatments. It will provide the flexibility to deliver medicines directly where patients most need them, whether that is a hospital ward, an operating theatre, a community health centre or even a patient’s home. These products are currently in early development. An example of a point-of-care product is a diabetic foot ulcer treatment using products derived from blood obtained from the patient and manufactured at their bedside. Modular manufacture offers significant advantages to support the faster roll-out of vaccines, for example, by allowing vaccines to be filled and finished on a local or district basis to supply mass vaccination centres. I will highlight why the change is needed. Advancing health technology increasingly means that new medicines are being developed that need to be manufactured close to the healthcare setting. Our traditional regulatory models need to change to support the new technologies. The current regulations are suited to centralised, factory-based manufacture at a small number of fixed manufacturing sites that are named on manufacturing licences and marketing authorisations. Point-of-care and modular manufacture products may be manufactured at hundreds of different sites for specific patients, when those patients need them. It would be extremely challenging for these innovative products to be regulated within the currently legislation, and it would cause significant regulatory and financial burden. The products are often developed to meet the unique needs of individual patients, using the patient’s own cells or blood, and they may need to be administered within an hour or even minutes of being manufactured. The urgency and specificity of the products cannot easily be accommodated by traditional manufacturing or by the current regulations. We need to adapt our regulatory approach to be suitable for manufacturing medicines at many different sites across the country, while maintaining regulatory oversight to ensure that manufacture is safe and consistent. The new framework will provide regulatory clarity to encourage new products and innovative approaches to support the future supply of treatments that are emerging in early-development stages and that may be life-changing for patients. Patient safety is central to the new legislation. We need to provide a regulatory framework that is flexible for new innovations but does not compromise the safety of patients who receive innovative medicines. I will set out how the UK medicines regulator, the Medicines and Healthcare products Regulatory Agency, will ensure that point-of-care and modular manufacturing products meet the necessary standards of safety, efficacy and quality. The new framework is centred on a hub-and-spoke model, with a single control site as the hub for each product, overseeing all aspects of the point-of-care and modular manufacturing system, including the spokes—individual manufacturing locations—and their activities. The control site will be the only named manufacturing site on manufacturing licence, clinical trial and marketing authorisation applications. The holder of the control site will, as the name signifies, be responsible for notifying the MHRA of reportable issues and ensuring product quality across all the manufacturing sites, the spokes. The diligence of the control site in overseeing the manufacturing locations will be scrutinised at routine MHRA inspections of the site; arrangements for that oversight will be scrutinised as part of the licensing process. A number of manufacturing spoke locations will be sampled and will be subject to inspections to ensure that the oversight claimed by the control site is independently supported by inspection findings. The new framework is a modified form of the current system for evaluation of regulatory compliance at manufacturing sites and safety monitoring. There will be no change in the expected standards that must be met for the safety, quality and efficacy of the product. As the MHRA is retaining regulatory oversight, there will be no increased risk to patient safety. I turn to the benefits. First, patients and carers will benefit from access to new and more personalised treatments in a timely and more convenient manner. There is even the potential for some patients to be treated with medicines manufactured at home, which aligns with our wider ambition to move care from hospitals to communities and reduce the need for patients to stay in hospital. Secondly, healthcare professionals will see a greater range of more effective treatment options for their patients, which will help to improve patients’ response to treatment. Lastly, innovators and industry will have clear regulatory expectations suited to innovation. The new framework will remove regulatory barriers, enabling speedier product development. Companies of all sizes—large, small and medium-sized enterprises—will benefit from that. The new framework will allow us to use effective regulation to support the development of medicines at the forefront of technology. I am pleased to bring forward the draft regulations, using powers under the Medicines and Medical Devices Act 2021, to move innovative treatments closer to the patient and support patients’ access to pioneering medicines. That work that has been ongoing for some time within the agency. I hope that hon. Members will join me in supporting these important regulatory changes. I commend the draft regulations to the Committee.
27 Nov 2024 · Draft Human Medicines (Amendment) (Modular Manufacture and Point of Care) Regulations 2024 · Hansard source
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I thank the hon. Member for Sleaford and North Hykeham for her comments. As I say, this is work that was long in progress under the previous Administration; I am pleased that colleagues from the MHRA are here today to see that work come to fruition. We are leading the world in this work. We are highly committed to encouraging our life sciences sector to take innovations directly to patients. I am pleased to have cross-party support for the draft regulations. I look forward to working with the hon. Lady and others to ensure that we make this a reality for patients. Question put and agreed to.
19 Nov 2024 · NHS Hospital Equipment · Hansard source
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The hon. Lady highlights the important matter of the lifetime of some of the machines, which we are finally addressing after the last 14 years of not addressing issues that include providing support to ensure that the machines work properly. Officials regularly meet Radiotherapy UK and the Department values its input. If there are specific incidents that the hon. Lady wishes to highlight, I am happy to respond to her.
19 Nov 2024 · NHS Hospital Equipment · Hansard source
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My hon. Friend lays bare an important issue. We all know, and critically, staff know, that we are asking them to do the most incredible job with outdated technology. It is bad for staff and it is bad for patients. That is why moving from an analogue to a digital system is crucial. I was fortunate to visit colleagues at NHS England offices up in Leeds last week to see some of the fantastic work they are doing on the app. We will ensure that the NHS comes into the 21st century.
19 Nov 2024 · NHS Hospital Equipment · Hansard source
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The Darzi review made it absolutely clear that the NHS has been starved of capital. It is 15 years behind the private sector in its use of technology and we have fewer scanners per person than in comparable countries. That is why at the Budget the Chancellor announced an investment of £1.5 billion for capital funding, which will include investment for new artificial intelligence-enabled scanners, which will help tackle that backlog.
19 Nov 2024 · Topical Questions · Hansard source
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My hon. Friend makes an excellent point on behalf of Rachel and many other women suffering from this disease. We are looking urgently at gynaecological waiting lists. They are far too high, including for endometriosis. I welcome the new National Institute for Health and Care Excellence guidelines. We will be looking at women’s health hubs and how they work, and future guidelines will help women to get a diagnosis more quickly and help with situations like Rachel’s.
19 Nov 2024 · Topical Questions · Hansard source
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My hon. Friend highlights a shocking example of inaccessibility in these important services. I will make sure that the Department responds to him and that either me or a ministerial colleague meets him.
19 Nov 2024 · Topical Questions · Hansard source
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The Department has been working with suppliers of medicines used to treat ADHD to seek commitments from them to address the issues, expedite deliveries and boost supplies. We are working with NHS England to approve the modelling for industry and communications regarding ADHD medicine supply issues. We will continue to engage with industry to address the remaining issues as quickly as possible.
14 Nov 2024 · Respiratory Health · Hansard source
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It is a pleasure to serve under your chairmanship, Mr Rosindell, for the first time in my new role. I thank the hon. Member for Strangford (Jim Shannon) for securing this debate on an important issue, and I thank other Members for their contributions. As the hon. Member for Hinckley and Bosworth (Dr Evans) said, I am covering for my hon. Friend the Member for Gorton and Denton (Andrew Gwynne). I am pleased to do so. We had an outing this morning, and I was able to talk to the hon. Member for Hinckley and Bosworth earlier, whose first ward area was in this area as a medic. I must say that he is getting his money’s worth out of the NHS at the moment—I hope he does not have to do that again. One of my jobs as a manager some 15 years ago was with the British Thoracic Society and primary care leading physicians on COPD. It was a project about living and dying with COPD and helping people to understand the disease and navigate it. I learned an awful lot about respiratory disease at that time and how people live and die with it. I commend that work. I am shocked at some of what we have heard this afternoon and what I found in preparing for this debate about quite how poor things are, and that some basic preventive measures we were talking about 15, 16 or 17 years ago are still not in place. I am really happy to be responding this afternoon. I am not sure I will be able to satisfy everyone’s requests, but I can say on behalf of the Minister for Public Health and Prevention, my hon. Friend the Member for Gorton and Denton, that he will be happy to accept the invitation to the roundtable that the hon. Member for Strangford talks about, and his expertise will be better there than mine. We are keen to pursue that conversation with the hon. Gentleman and the all-party parliamentary group. As we have heard, one in five of us will be affected by a chronic respiratory disease at some point in our life. These conditions are, sadly, the third biggest contributor to years of life lost in England. Many people out and about using public transport will know the symptoms of poor respiratory health. They might associate a wheezing or raking cough with being indicative of a smoker, but not all ill health is about personal choice. In fact, this common symptom belies a huge range of conditions, only some of them related to smoking and each requiring different interventions. On all those conditions, we are taking forward a combination of immediate bold actions and long-term reforms. The Government are taking radical action to create the first smoke-free generation. We are clamping down on kids getting hooked on vapes and protecting children and vulnerable people from second-hand smoke. Tobacco is a uniquely harmful product and smoking is the No. 1 preventable cause of death, disability and ill health. The statistics are stark: smoking claims the lives of about 80,000 people a year in the UK and kills up to two thirds of its long-term users. Second-hand or passive smoke is extremely harmful to health. There is no safe level of exposure to smoke: if we can smell cigarette smoke, we are inhaling it. Smoke is harmful, particularly to children, pregnant women or people with pre-existing health conditions such as asthma or heart disease, which may not be visible to the smoker. Our Tobacco and Vapes Bill, which we introduced last week, will be the single biggest public health intervention since the last Labour Government banned smoking in indoor public spaces. The Bill’s primary aim is to create a smoke-free generation by gradually ending the sale of tobacco products throughout the country and breaking the cycle of addiction and disadvantage, so that someone born after 2009 will never be able to legally buy tobacco. This landmark legislation will also enable the Government to strengthen the existing ban on smoking in public places and to reduce the harms of passive smoking in certain outdoor settings. It will ban vapes and nicotine products from being promoted and advertised, to prevent the next generation from being hooked on nicotine. We will hear all sorts of arguments against these sorts of policies, with people saying it is the nanny state or that they are anti-growth. However, most smokers—myself included—always wish they had never started. They have had their choice taken away by addiction induced at a young age by the tobacco industry. I remind Members present that smoking costs the economy and wider society some £21.8 billion a year through lost productivity, smoking-related lost earnings, unemployment and early death, as well as the cost to the NHS and social care of over £3 billion. Our action will save thousands of lives and protect the NHS. I pay tribute to charities such as Action on Smoking and Health and Asthma and Lung UK, which have supported our work. Through our changes we will create a healthier society and, in doing so, boost the economy. As we have heard this afternoon, smoking is only one example of how our respiratory health is influenced by our environment. Even though it has been almost 70 years since the first Clean Air Act was passed, what we breathe remains one of the greatest risks to public health in the UK. As the chief medical officer’s 2022 annual report on air pollution sets out, there is clear evidence that outdoor air pollution contributes to the initiation and development of respiratory diseases such as lung cancer. That is why the Government are committed to a preventive approach in this policy area. I assure people that we are taking a mission-led approach, working across Departments to improve air quality. We want to address the inequalities in the quality of the air that people breathe simply because of where they live. The Department of Health and Social Care will support the Department for Environment, Food and Rural Affairs to deliver a comprehensive and ambitious clean air strategy. This will include a series of interventions to reduce emissions so that everyone’s exposure to air pollution is reduced. The UK Health Security Agency, which has been talked about this afternoon, is working closely with DEFRA to review how we communicate air-quality information to ensure that members of the public, and vulnerable groups in particular, have what they need to protect themselves. I commend my hon. Friend the Member for Newcastle-under-Lyme (Adam Jogee) for his work in support of his constituents with regard to Walleys Quarry. The Minister for Public Health and Prevention visited Newcastle-under-Lyme recently and will pursue those discussions with the Environment Agency. The Government are also taking steps to reduce risks to respiratory health in people’s homes—a point addressed well by the Liberal Democrat spokesperson, the hon. Member for Winchester (Dr Chambers). Living in a home with damp and mould increases the risk of respiratory illness and conditions such as asthma and COPD. It also affects symptom severity and the risk of death for individuals with existing respiratory conditions. We are therefore putting forward an initial £3.4 billion towards heat decarbonisation and household energy efficiency over the next three years, and £1.8 billion to support fuel poverty schemes. That means that over 225,000 households will receive help to reduce their energy bills by more than £200. The hon. Members for Winchester, for Strangford and for Hinckley and Bosworth made excellent points about vaccinations. We want to encourage everyone, including ourselves—I look around the room, even at myself; I am slightly behind on my flu vaccine—to do all we can ourselves and to encourage others to take up vaccines and prevent some of the related problems. We recognise, however, that not all ill health can be prevented, so we need to act to help those who need treatment. I assure the hon. Member for Strangford and other contributors that respiratory disease remains a clinical priority. The NHS long-term plan under the last Government set a series of objectives for improving outcomes for people with respiratory disease through early diagnosis and increased access to treatments. As we have heard, and as I have said, it is quite shocking that that basic objective is not being achieved everywhere. Access to checks and basic preventive care needs to be much better spread across the country. That is why we say that we want to take the best of the NHS to the rest of the NHS. NHS England has 13 respiratory clinical networks across the country, which are vital in providing clinical leadership across primary and secondary care for respiratory services and supporting services in primary care, where of course most patient contact is. I commend my hon. Friend the Member for Sherwood Forest (Michelle Welsh) for highlighting pulmonary fibrosis. I wish her father and her family well. She is absolutely right that early and accurate diagnosis is a priority for NHS England. Work to make improvements is under way, and that should have an impact on reducing delayed diagnoses of pulmonary fibrosis. As I understand it, access to these treatments has recently been expanded to patients with non-idiopathic pulmonary fibrosis, following the publication of the NICE technology appraisal for treating progressive fibrosing lung diseases. I hope that that goes some way towards reassuring my hon. Friend, who spoke so eloquently today. As the hon. Member for Strangford and my hon. Friends the Members for Newcastle-under-Lyme, for Blaydon and Consett (Liz Twist) and for Sherwood Forest highlighted, COPD is a major contributor to inequalities in life expectancy and in healthy life expectancy. People living in the most deprived parts of the country are five times more likely to die from COPD than those in the least deprived. I have seen that both in my previous work with those working in the NHS and since becoming the Member of Parliament for Bristol South in 2015. My constituency was home to the Wills tobacco company, a huge employer in the area over many decades. Its legacy can be seen in many different ways, but particularly in the very high rates of smoking in my constituency—up to 32% in some parts. The reduced lives lived in good health, and those shocking early deaths, are things that I see every day. The impact is still very apparent in the shocking statistics on health inequality across my home city of Bristol. Let me assure hon. Members that this issue remains a priority for all of us in this Government. Reducing health inequalities is a key part of our mission. That requires us to work across Government, and it runs across all parts of Government. In NHS England, Core20PLUS5 is a national approach to inform action to reduce healthcare inequalities at both national and local system level. The approach provides a vehicle for targeted interventions to detect and treat the diseases that are major contributors to life expectancy as well as pressures on the NHS. We know that there is a particular risk of condition exacerbation around the winter, leading to emergency treatment in hospital and in-patient care. That is why the focus of the Core20PLUS5 action on respiratory health this year has been to increase vaccination uptake, including covid-19, flu and pneumovax, which can protect against serious illnesses such as pneumonia and meningitis. NHS England is leading on the development of an approach for COPD management. This will support proactive identification and management of risk in patients in winter, to reduce demand on primary and secondary care. My hon. Friend the Member for Blaydon and Consett was absolutely right to highlight the low levels of diagnosis, the number of people living with COPD and other respiratory diseases, and the impact on children that we might not even know about. The plan is to test and evaluate this approach in four sites this winter to help inform decisions on winter planning in the future. On severe asthma and access to biologic treatment, significant work has been undertaken through the NHS England severe asthma collaborative to develop the capacity of the severe asthma centres. That important work includes streamlining patient pathways to biologic therapy and reducing variation in prescribing and patient management. Patient outcomes are now submitted to the UK severe asthma registry. That has led to improved identification of patients with potential severe asthma in primary and secondary care, resulting in referral to severe asthma centres for consideration of eligibility for biologic therapy. Action to address avoidable deaths from asthma has not gone far enough. That is why we are working to ensure that asthma care has a higher prioritisation within systems, for example through the national bundle of care for children and young people with asthma workstream, which is intended to improve outcomes for children and young people with asthma. Looking further forward, a central mission of the Government is to build healthcare that is fit for the future. As hon. Members have noted, our 10-year health plan will focus on the three shifts needed to deliver a modern NHS: from hospital to community, from analogue to digital and from sickness to prevention. That is a long-term challenge and those shifts will take time to deliver, so the plan will consider what immediate actions are needed to get the NHS back on its feet and bring waiting lists down, as well as the longer-term changes needed to make the health service fit for the future. I thank the hon. Member for Strangford for his commitment to respond to our engagement exercise. I encourage all organisations and individuals to contribute to the 10-year plan at change.nhs.uk. We are keen to work with the public, patients and our partners in all the organisations that support this work. We will listen and co-design the plan with them. Disease-specific and more general long-term conditions that affect people’s health are a very live issue. Given the level of comorbidities with which people currently live, it is important to look at the person as well as the diseases. We will continue to look at that as part of the development of the 10-year plan; I know that all hon. Members will take an active part in that process. The hon. Gentleman will tell me if there is anything to which I have not responded. The hon. Member for Hinckley and Bosworth asked for an update on the RSV vaccine. As part of my portfolio working on urgent and emergency care, we are looking closely at a vaccine update, as well as at the presentation of very young children with respiratory disease in the emergency care system; I am sure that he is aware of that issue. If there is anything else that he would like to know, I will ensure that he is written to. On spirometry and fractional exhaled nitric oxide tests, a look at the NICE guidelines is long overdue, so I hope that we see some more progress on that. If I have missed something, Members may write to the Minister for Public Health and Prevention and he will respond very promptly. I thank the hon. Member for Strangford and the APPG for raising the issue. I am genuinely very pleased to see it being raised. As a contributor to admissions and inequalities, it is a very serious disease and we need to highlight it. I thank him for the invitation to take part in a discussion with healthcare professionals on the way ahead for respiratory health. My ministerial colleagues look forward to discussing that further.
14 Nov 2024 · National Insurance Contributions: Healthcare · Hansard source
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My hon. Friend has led fantastic work in previous Parliaments on the health and social care system, which he understands very well. He makes an excellent point about ensuring that additional funding goes where we want it to, which is towards supporting our constituents, particularly with social care. We have all seen the situation over the last decade over so. Improving that is critical to the urgent and emergency care system, and to the dignity of those people who need the service. We will continue to talk to them, and to local systems, about the impact of any changes.
14 Nov 2024 · National Insurance Contributions: Healthcare · Hansard source
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My hon. Friend makes an excellent point. As I said in my response to the hon. Member for Hinckley and Bosworth (Dr Evans), we faced a situation where we were told that we would have to reduce appointments by 20,000 a week. We have taken serious steps, and my right hon. Friend the Secretary of State fought hard for our Budget allocation so that we can have 40,000 extra appointments as promised in our manifesto, which was overwhelmingly endorsed by the British public. We are determined that we will bring change to the system and tackle the waiting lists.
14 Nov 2024 · National Insurance Contributions: Healthcare · Hansard source
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The right hon. Gentleman says that it is an ill-thought-through Budget. I do not know whether he agrees or disagrees with the extra funding that the Government have committed to the NHS after the disaster of the last 14 years.
14 Nov 2024 · National Insurance Contributions: Healthcare · Hansard source
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Those Conservative Members who have held on to their seats—I have been in that situation as well—know that the public, staff and patients understand exactly what state they left the NHS in. That is why they had such a disastrous election result. We are determined to change the NHS and to make it fit for the 21st century. Part of what we have done in this Budget through that extra allocation, our conversations with those in the health and social care system and our 10-year plan will do just that.
14 Nov 2024 · National Insurance Contributions: Healthcare · Hansard source
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I respect my hon. Friend’s expertise and service to the national health service. He will understand the need to make the shift into neighbourhood health services. We have been clear that we will ensure the NHS spends all its allocations in the most effective way to enable that shift, as part of our 10-year plan.
14 Nov 2024 · National Insurance Contributions: Healthcare · Hansard source
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Well, really. I am quite dumbfounded by the hon. Gentleman’s response. I respect him for his professional practice, and he knows the state of the NHS that we inherited from the previous Government, as reported in Lord Darzi’s report. He talks about joy, but there was no joy when we inherited the mess they left back in July. He talks about people being tipped to the brink, and they absolutely were, as Lord Darzi made clear. As I said, we will go through the allocation of additional funding in the normal process, which will be faster than under the previous Government because we are committed to giving the sector much more certainty. The normal process, as the hon. Gentleman should know from his time in government, is to go through the mandate and the planning guidance and to talk to the sector about the allocations due next April, as I said in my opening statement.

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