Karin Smyth MP: speeches 2025

Speeches

• 12 Jun 2025 · Spending Review: Health and Social Care · Hansard source

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  I thank my hon. Friend for her question and for the work she does to support NHS dentistry as part of the all-party group. As I have said, this issue is of huge importance to our constituents, and the shocking state in which the Conservatives left dentistry is there for all to see—particularly the shocking state of children’s oral health. That is why we acted rapidly to introduce the toothbrushing campaign—which, if I remember rightly, was ridiculed by Conservative Members when we discussed it in opposition—and the arrangement with Colgate to ensure that we improve children’s oral health. We are absolutely committed to reform of the contract; the Minister for Care is working hard on that and he will continue to update the House regularly. It is our confirmed commitment, as I have reiterated today, to increase access to dental services.

• 12 Jun 2025 · Spending Review: Health and Social Care · Hansard source

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  I thank the hon. Gentleman for welcoming, on behalf of his party, the commitment that the Chancellor has made and the extra funding that she has identified, but I think his party still opposes the way in which we have raised the funding to do just that. It is good to have your cake and eat it, but we are clear that the funding does come with reform. As I said in my statement, we are committed to improving the front door—primary care—as well as social care and discharge. That is why the NHS contribution, as part of the settlement to the better care fund, increases. He will be aware that we previously revised the better care fund to make it better and more targeted on discharge, which is important. The urgent and emergency care plan that we published a couple of weeks ago also confirms our recognition that flow through the hospital system is important for patients and staff; we must ensure that we do not face that continued crisis of corridor care over many years. We are committed to the fair pay agreement, and our colleagues in the Ministry of Housing, Communities and Local Government will make more statements in the coming weeks about how that will work.

• 12 Jun 2025 · Spending Review: Health and Social Care · Hansard source

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  I always shudder a little when I am invited to do any running, jogging, boxing or whatever else people get up to—we all have our own things we like doing. Although my hon. Friend’s fabulous city is a great place to be, I will not be able to join in this weekend, but I wish good luck to everybody taking part. We all live in hope that the SNP might learn some lessons from what we are doing to fix our NHS. We remain willing to work with the SNP, and with anybody who wants to serve patients and get a better service for their taxes. If the SNP wants to get in touch, it can do so, but the best thing to do is to elect a Labour Government in Scotland, which will hopefully happen soon. My hon. Friend makes an important point about mental health. We are committed, as we said in our manifesto, to 8,500 more people working in mental health, and to ensure that our schools and young people have the support they deserve.

• 12 Jun 2025 · Spending Review: Health and Social Care · Hansard source

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  I like how my hon. Friend says “gently”, because honestly no day goes past without him talking about this issue or, indeed, his new hospital. He is right, and he is a fantastic campaigner for the people of Harlow. He has made his point again, and I cannot make any further comment today, but he will be hearing from the Secretary of State soon on that issue.

• 12 Jun 2025 · Spending Review: Health and Social Care · Hansard source

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  As my hon. Friend said, this is a health area that I know well, and he has been the most amazing campaigner for Gloucester and the health service there since he became the Member of Parliament. He is absolutely right: dentistry is a key worry. It is one of the key areas that the Conservative party neglected for 14 years. That is why it was a manifesto commitment, and why I was able to outline today that meeting the target of 700,000 is front and centre, and part of the plan as we go forward. I know that the Minister for Care, who is responsible for dentistry, is keen to meet many hon. Members, and I will make sure he has heard that request.

• 12 Jun 2025 · Spending Review: Health and Social Care · Hansard source

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  My hon. Friend is right to highlight end of life care. We know it has been neglected. I worked on it during my time in the health service, over 15 years ago, and I feel very passionately about it. It is important that we support people. We must have a system that allows people to have those conversations, and that ensures there are options for people throughout the pathway of their life. The Minister for Care is working hard to ensure that happens as part of our overall development of the health service over the next 10 years.

• 12 Jun 2025 · Spending Review: Health and Social Care · Hansard source

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  I thank my hon. Friend for the excellent role she plays as a clinician. Her expertise is really welcome; we want to hear from a wide variety of experts in this House—that is very valuable. She understands from her professional background, as well as from her constituency, how important it is to look at the entire pathway of care for patients, and to ensure that they have the best possible care as close to home as possible. We think that is better not just for patients, but for clinical outcomes, and it is more efficient and better use of taxpayers’ money. The move from hospitals to communities is front and centre of our 10-year plan, as is delivering neighbourhood health services.

• 12 Jun 2025 · Spending Review: Health and Social Care · Hansard source

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  I am very happy to thank Dr Cameron and the whole team. As ever, with his vast experience of the health service, my hon. Friend makes an excellent point. We are reliant on clinical and managerial staff to make the system better. I know, and he knows, how low morale has been; Lord Darzi made that point very clear, and we cannot over-estimate how difficult that is for staff. That is why we have reached two record inflation-beating pay settlements for staff, and importantly, we have supported the independent process, because we want to work with staff to make things better at all levels. My hon. Friend gives an excellent example of how, by working with excellent clinical leadership and excellent managers, we can bring the best of the NHS to the rest of the NHS.

• 12 Jun 2025 · Spending Review: Health and Social Care · Hansard source

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  Yes.

• 12 Jun 2025 · Spending Review: Health and Social Care · Hansard source

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  We are committed to ensuring that those RAAC hospitals are sorted and fit for purpose, and I was able to visit Airedale myself recently. We are asking people on the ground to do a really difficult job, keeping hospitals going and serving patients while remedying the problem of RAAC. I do not have in front of me the exact timescale for the hon. Gentleman’s hospital, but I encourage it to work very closely with the team at the Department of Health, which I think is working really well. As long as a clear timetable has been put forward, I will ensure that the hon. Gentleman gets a response to his question.

• 12 Jun 2025 · Spending Review: Health and Social Care · Hansard source

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  I thank my hon. Friend for welcoming the Government’s investment in the health service. She has been such a strong campaigner for Shotley Bridge, and it has been a pleasure to work with her; I know she has continued to advocate strongly on behalf of her local population. The hospital is needed, but as she knows, in her community—and all our communities—patients should not always be expected to travel to hospital for care that can be delivered closer to home. We see massive improvements in virtual care and technology, which is why we have announced a £10 billion increase for technology over the spending review period. We are improving the NHS app and ensuring that people are enabled to do more digitally, but I recognise that does not suit everybody, so we will ensure that parallel processes are available for everybody. Our constituents deserve and need care closer to home, and want more of it.

• 12 Jun 2025 · Spending Review: Health and Social Care · Hansard source

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  My hon. Friend is absolutely right that his constituents and constituents across this country will not forgive the Conservatives for the state in which they left the NHS. That is clear from Lord Darzi’s diagnosis. We have still had no comment from the Conservatives on whether they acknowledge that. We are determined to be about the future, and that is what this settlement and the Chancellor’s announcement yesterday are about. It is about putting that extra funding that we raised last year into services and into a reformed system that reaches all parts of this country. We will tackle health inequalities, making sure that people who have not had that access and people who suffer worse health than others are raised up. We must take the best of the NHS to the rest of the NHS.

• 12 Jun 2025 · Covid: Fifth Anniversary · Hansard source

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  I am short of time, but the Under-Secretary of State for Culture, Media and Sport, my hon. Friend the Member for Barnsley South (Stephanie Peacock), who leads on this issue, has hotfooted it from Committee and will take up any issues that I do not address. I thank my hon. Friend the Member for West Ham and Beckton (James Asser) for securing what has been a moving and popular debate. As he says, we have to remember the people and communities behind the numbers. My thoughts, and those of everyone, are with the families and communities who lost loved ones because of the pandemic. We have heard the magnitude of that grief expressed today, as well as the pain of families who were unable to be with their loved ones in the normal rituals of grief and bereavement. My hon. Friend the Member for Middlesbrough South and East Cleveland (Luke Myer) spoke about the loss of his grandfather. The hon. Member for Honiton and Sidmouth (Richard Foord) talked about the loss of Adam, and we understand the battle to get compensation payments. My hon. Friend the Member for Ribble Valley (Maya Ellis) talked about women’s experiences of pregnancy and birth. I pay tribute to my hon. Friend the Member for Paisley and Renfrewshire South (Johanna Baxter) for the work that she is doing on the APPG, and I will make sure that she gets a response to her letter. It has been heartening to hear of the many ways that communities have commemorated the losses and sacrifices experienced during the pandemic. The Government will bring forward a programme of covid-19 commemorative activity, and we will set out full details in response to the recommendations of the UK Commission on Covid Commemoration. I thank Baroness Morgan of Cotes and all the commission members for their consideration in recommending how to mark this period, and for their ongoing engagement with the Department for Culture, Media and Sport, which will lead on the commemorative activity. DCMS is working with a range of partners, including my Department, and regularly engages with the covid-19 bereaved family groups. I thank those groups for their ongoing support and commend them for their strength and resilience, and for the support that they provide to other grieving families. As part of the commemoration of the pandemic, the Government supported the Covid-19 Day of Reflection in March, when more than 200 events took place. I can confirm that the Covid-19 Day of Reflection 2026 will take place on Sunday 8 March, and I hope that Members will support activities in their constituencies. As we have heard, across the river from this House stands the covid-19 memorial wall. I certainly remember the first time we stopped at that memorial after we lost my father-in-law, Brian Davies. It is a really moving and powerful tribute to the lives lost, with almost 250,000 hearts lovingly painted on the wall. For families, it is a really important space where they can remember. I agree with the hon. Member for North East Fife (Wendy Chamberlain) that it is a poignant reminder when we pass it every day, and I know that my colleagues in DCMS are working with the Friends of the Wall on that long-standing commemoration and will update the House in due course. Together we remember the courageous sacrifices made by frontline workers across the country, and we have heard about many of them today. There are too many people to mention, but they include NHS staff, train and bus drivers, refuse collectors, and supermarket and delivery staff. I agree with my hon. Friend the Member for Loughborough (Dr Sandher) that many on the frontline were the poorest and lowest paid, and they were disproportionately affected. We must continue to make sure that that does not happen again. The pandemic demonstrated the remarkable work of civil society. An estimated 12.4 million people volunteered in some way, including as vaccine volunteers, befrienders and carers, as was mentioned by my hon. Friend the Member for Coatbridge and Bellshill (Frank McNally). I will briefly turn to the steps that we are taking to ensure that the United Kingdom is better prepared for a future pandemic, which remains a top priority for this Government. My hon. Friend the Member for Glasgow North (Martin Rhodes) made a crucial point about learning lessons on PPE, as did my hon. Friend the Member for Bolton West (Phil Brickell). Later this year, we will conduct a national exercise to test our ability to respond to a pandemic, and this will involve all regions and nations of the United Kingdom, with thousands of participants. The outcome of the exercise will inform how we approach a pandemic in future. We have heard about long covid, and I would talk more about it if I had more time. The right hon. Member for Hayes and Harlington (John McDonnell) spoke about that, as did many others. Since 2020, NHS England has invested significantly in supporting people with long covid, including through specialist post-covid services for adults, children and young people, and it has invested over £57 million in long covid research, which will remain hugely important. I am grateful to my hon. Friend the Member for West Ham and Beckton for securing this important debate. As we mark the fifth anniversary of the pandemic, together we will ensure that lessons are learned, that our losses are honoured, and that as a nation we do not forget.

• 12 Jun 2025 · Duchenne Muscular Dystrophy · Hansard source

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  I thank my hon. Friend for that constructive suggestion. We need to wait to see how the NICE recommendation goes in July. With this disease and so many others, it is important to share learning and information, and trusts should be encouraged and supported in doing so. We will work with him on that constructive recommendation. I understand my hon. Friend’s concerns about the fact that non-ambulant patients are not yet able to access givinostat, but it is important to note that the eligibility criteria for participation in the early access programmes have been determined by the pharmaceutical company. NHS trusts that decide to participate in the EAP must only provide treatment in line with the criteria, which state that patients must be ambulant. A clinical trial is being carried out by the pharmaceutical company to evaluate the safety and tolerability of the drug in non-ambulant patients, and to further explore the efficacy of the drug in this population. I know that for the patients and families affected, it will be disappointing to hear that there is no access to the drug for ambulant patients before a NICE decision, or for non-ambulant patients prior to clinical trials being concluded. I want to assure my hon. Friend that we have arrangements in place to support rapid access to new medicines.

• 12 Jun 2025 · Duchenne Muscular Dystrophy · Hansard source

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  It is a real pleasure to respond to this moving debate. I know that many people with Duchenne muscular dystrophy and their families will have wanted to tune in to hear what was said this afternoon. I thank Members who have contributed in different ways to the debate. In particular, I thank my hon. Friend the Member for Stockton North (Chris McDonald), who secured this debate and advocated so powerfully for these families. He really brought to life the experiences of Benjamin, Jack and Eli, and I commend him for doing so. I first acknowledge the profound impact that this debilitating disease has on those living with it, and their families, and the urgent need for new and effective treatments. As has been said, my right hon. Friend the Secretary of State for Health and Social Care heard at first hand from people affected by this condition earlier this year, when he attended an event hosted by Duchenne UK. He met many young patients and listened to what they said about the challenges that they face. As we all know, meeting families and individuals from our constituencies leaves a long-lasting effect on us, and it is important that we continue to meet them. Timely and equitable access to innovative medicines for the treatment of DMD and other rare diseases mentioned today is of the utmost importance. The National Institute for Health and Care Excellence is the independent body responsible for assessing whether new licensed medicines can be recommended for routine use in the NHS, based on a thorough assessment of their clinical effectiveness and cost-effectiveness. Through this process, many thousands of patients, including those with rare diseases, have been able to benefit from effective new treatments at prices that represent value to the NHS. NICE has been able to recommend two medicines for the treatment of DMD: ataluren, recommended in 2023, and vamorolone, which was recommended in January this year and is now available on the NHS to around 1,700 eligible patients, in line with NICE’s recommendations. As my hon. Friend has said, NICE is appraising givinostat, and the first NICE committee meeting is scheduled for July this year. If the medicine is recommended, the NHS in England will be legally required to fund it. I am aware that a small number of patients in the UK have been receiving treatment with this drug through a company-led early access programme, established by the pharmaceutical company Italfarmaco, as we have heard. It is important to note that participation in these programmes is decided at NHS trust level, and although the drug is free to patients taking part in it and to the NHS, NHS trusts must still cover administration costs and provide clinical resources to deliver the EAP. NHS England has published guidance on free-of-charge medicine schemes, such as the givinostat EAP, providing advice on financial, administrative and clinical risks. NHS England cannot, however, centrally direct NHS trusts to participate in company sponsored EAPs like this one, or in any other private activity. To issue any form of national direction around participation in EAPs would both pre-empt and undermine the role of NICE, whose purpose is to advise the NHS on whether particular treatments should be made routinely available on the NHS. Even when there is an agreement that a company will continue to provide a drug free of charge in the event of a negative decision by NICE, participating trusts remain liable to cover the significant costs of delivering that service, including the cost of the clinical resources and staff time needed. That would be outside their funding allocation and in addition to paying for any subsequent NICE-recommended treatments that they would be mandated to fund.

• 12 Jun 2025 · Duchenne Muscular Dystrophy · Hansard source

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  I will not; I want to finish in the time available, and I think Members want to hear the full response. Outside of company-led EAPs, there are established routes for patients to get access to new, innovative medicines prior to them being licensed. The early access to medicines scheme, or EAMS, helps give people in the UK with life-threatening or seriously debilitating conditions early access to new medicines that are not yet licensed where there is a clear unmet medical need. EAMS is supported by key partners, including the MHRA, NICE and NHS England, and is a key part of this Government’s commitment to accelerating patient access to innovative, life-changing treatments, in support of the UK’s position as a global leader in life sciences. In fact, since the scheme launched in 2014, over 50 medicines, including for this disease, have benefited from being accessed early through EAMS. The innovative medicines fund has also made available £340 million of ringfenced funding for the NHS to fund early access to medicines that NICE has recommended with managed access. Through this process, licensed treatments that demonstrate substantial clinical promise but still have significant uncertainty around their clinical and cost-effectiveness can be funded. Further evidence is then collected on the drug for a defined period of time. That is considered by NICE in determining whether the drug can be recommended for routine NHS funding. The Secretary of State has been clear that if givinostat is recommended by NICE in draft guidance, NHS England should aim to work with the pharmaceutical company to provide early funding through the innovative medicines fund. This could potentially speed up access by up to five months, and the treatment could be funded as soon as this summer, if recommended. This scope of this debate is wider than just access to new medicines. It is important to note that while rare diseases are individually rare, they are collectively common. One in 17 people will be affected by a rare condition over their lifetime. The UK rare diseases framework outlines four priorities, based on engagement with the rare disease community. They are: helping patients to get a final diagnosis faster, increasing awareness of rare diseases among healthcare professionals, better co-ordination of care, and improving access to specialist care, treatments and drugs. In England, we publish a rare diseases action plan annually. These detail the specific steps we are taking to meet the shared priorities of the framework. I am pleased to highlight the 2025 England action plan, which was published in February this year on Rare Disease Day. One such action is reviewing the effectiveness of early access schemes, such as the early access to medicines scheme, the innovative licensing and access pathway, and the innovative medicines fund. They are all designed to help make innovative treatments available earlier to patients who need them. We are specifically considering how well they support access to treatment for people living with rare diseases like Duchenne. NHS England, NICE and MHRA will meet annually to continue to discuss progress on these schemes. These meetings will include representatives from patient advocacy groups and from industry, and clinical researchers, and the next one will happen in the summer. Managing a complex rare condition can be challenging, and it often means interacting with many different specialists and providers of health and social care. It can mean travelling across the country to access highly specialist care from experts. All of that can add up to a significant emotional and physical burden, and it can deepen inequalities. Co-ordination of care can minimise this burden on patients and their carers, and it can ensure that healthcare professionals work together to provide the best possible care, as we have discussed this evening. In the 2025 action plan, we have introduced a new action to incentivise providers to run clinics for multi-system disorders, in order to reduce the number of appointments and improve co-ordination of care for families. The NHS is also working to include the definition of “co-ordination of care” that is set out in the CONCORD—co-ordinated care of rare diseases—study in all new and revised NHS service specifications for patients with rare diseases. I recognise how hard it is when patients want access to these new treatments. I also recognise the distress and worry it causes, not only to patients, but their families and friends. Hon. Members have articulated that well on behalf of their constituents this evening. The Government are committed to providing access to the most innovative medicines, but it has to be at a price that provides value for the NHS, and it has to be clinically safe and effective. That is why we are working hard with industry, NICE and MHRA to make that happen. I know that my hon. Friend the Member for Stockton North will continue to work with the Government and providers to make that happen. I am grateful for the opportunity to respond to this debate on such an important issue. Question put and agreed to.

• 11 Jun 2025 · NHS Funding: South-west · Hansard source

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  I am going to just complete these points, so that I can try to address as many points as possible. In the constituency of the hon. Member for Torbay, the local ICB, NHS Devon, receives £2.5 billion of the £11.5 billion for the south-west. The allocation per capita for Devon is higher still, and above the south-west regional average. Likewise, NHS Cornwall and the Isles of Scilly ICB received just over £1.2 billion of that £11.5 billion total. The allocation per capita for Cornwall and the Isles of Scilly is above the south-west regional average and national average. To respond to the hon. Member for St Ives (Andrew George), I understand from NHS England that the ICB has had the debt written off, so that might be something he wants to follow up. My hon. Friend the Member for Truro and Falmouth (Jayne Kirkham) and others talked about funding allocations—we could talk about this for a very long time. They are difficult things to get right, and are controversial, but the funding formulation does account for older people and for rural populations. The latest financial performance position publicly available is for quarter three of last year. It showed an overall deficit position of £51.7 million against the year-to-date plans, of which Dorset ICS had the largest variance of £27.7 million. Final end-of-year positions are still being finalised and will be made publicly available in due course. For ’25-26, NHS systems overall have received £2.2 billion of deficit support funding in their allocations. All systems in the south-west have now agreed a balanced plan for ’25-26. The position on deficit support for ’26-27 will follow the spending review settlement for individual organisations agreed as part of the planning guidance process. NHS England will continue to support all organisations to deliver financially sustainable healthcare through a range of improvement measures, some of which we have heard about today. Devon integrated care board, and three trusts within the ICB, are currently part of the recovery support programme, which provides intensive support to challenged organisations. Where organisations are struggling significantly, the Department of Health and Social Care provides cash support to support the continuity of patient services—obviously, that is critically important. So that colleagues are aware, I am personally meeting with finance colleagues from NHS England and the Department of Health every week to support that work. We are clear as a Government that we need to be certain that every pound of taxpayers’ money is used to best effect, and that best practice is followed in this region and across the entire NHS. The hon. Member for Torbay asked about coronary services, and that is a local decision. NHS Devon and Torbay Foundation Trust have proposed undertaking a test-and-learn process for out-of-hours primary percutaneous coronary intervention. That service will be provided in Torbay and Exeter, which would involve a temporary change to provide out-of-hours services at Exeter only. Members will be aware that the ICB was due to make a decision on the pilot at its board meeting in May. However, following significant local feedback, the ICB has decided to reflect on those issues raised, and I am sure the hon. Member for Torbay will be following up on that. The ICB will be providing an update at its board meeting in July. In conclusion, the Government are taking the necessary steps to fix the NHS, and the Chancellor’s spending review settlement puts the NHS further on the road to recovery. I assure Members that we will write back to them on any other individual points raised.

• 11 Jun 2025 · NHS Funding: South-west · Hansard source

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  It is a pleasure to serve under your chairmanship, Dr Huq. I thank the hon. Member for Torbay (Steve Darling) for securing the debate. We could have had more time, as this is an important issue for us all across the whole south-west. I thank colleagues for taking part. The hon. Gentleman is right that the system has real challenges receiving deficit funding in our part of the NHS recovery support programme. He will rightly be following that closely. In the autumn Budget, which I think virtually everyone in this room disagreed with, the Chancellor took the necessary decisions to put our NHS on the road to recovery, with a more than £22.5 billion increase in day-to-day health spending and over £3 billion more in the capital budget over this year and the last. Today, the Chancellor has announced the conclusion of the spending review, with £29 billion more day-to-day funding in real terms than in 2023-24. There is a £2.3 billion real-terms increase in capital spending over the spending review period—something I hope everyone welcomes. The SR puts the NHS on a sustainable footing by cutting waiting lists so that by the end of this Parliament 92% of patients will start consultant-led treatment for non-urgent health conditions at 18 weeks, delivering on the Prime Minister’s plan for change commitment and prioritising people’s health. To respond to the hon. Member for Bath (Wera Hobhouse), we do encourage use of the independent sector for capacity, and that is a decision for ICBs to make sure they achieve those standards. The settlement also supports the shift from analogue to digital, with a total investment of up to £10 billion in NHS technology and transformation between ’26-27 and ’28-29, and an almost 50% increase from ’25-26. I agree with the right hon. Member for Salisbury (John Glen) that technology offers huge opportunities in geographies like ours. Thanks to the Chancellor, we are taking the necessary steps towards fixing the foundations of our NHS and making it fit for the future. Since coming into office, the Government have published our urgent and emergency care plan, which will support the NHS across England to improve the timeliness and delivery of care to patients requiring urgent and emergency care over the next year, including for next winter. We are delivering on our plan for change through the accelerated roll-out of the NHS app. We will create an NHS fit for the future and continue to invest in the latest technology, shifting healthcare from analogue to digital. Our investment and reform in general practice, to fix the front door to the NHS and bring back the family doctor, includes an additional investment of £889 million. We have published our elective reform plan, which will cut waiting times from 18 months to 18 weeks. We have exceeded our pledge to deliver an additional 2 million appointments, tests and operations—we have delivered over 3 million more. Waiting lists have fallen for the sixth month in a row and have now been cut by over 219,000 since we came to office. The Government have committed to a10-year health plan that will lead the NHS to meet the challenges set out in the plan for change to build the NHS for the future, and it will be coming very soon. I know that hon. Members across the House share the concerns of the hon. Member for Torbay about the crumbling NHS estate after years of neglect. I wish to assure Members that my right hon. Friend the Chancellor has given us the funding to begin reversing the trend of decline in the south-west and nationwide, with health capital spending rising to £13.6 billion this year. In the south-west region, allocations have been made totalling £448 million in operational capital, empowering systems to allocate funding to local priorities; over £238 million from our constitutional standards recovery fund to support NHS performance across secondary and emergency care; and £83 million from the £750 million estates safety fund to deliver vital safety improvements, enhance patient and staff environments and support NHS productivity. This includes £7.3 million for Torbay hospital in the constituency of the hon. Member for Torbay; £10 million from our primary care utilisation fund for improvements in the primary care estate; and almost £5 million to help to reduce inappropriate out-of-area placements for mental health patients in the south-west. ICB allocations have been talked about a lot today. For the south-west, they have been confirmed as totalling £11.5 billion out of a total of £116.7 billion allocated for England. The regional allocation per capita for the south-west is above the national average. We heard from my hon. Friends the Members for South Dorset (Lloyd Hatton) and for Bournemouth East (Tom Hayes) that the signs are being seen in their constituencies.

• 10 Jun 2025 · Attention Deficit Hyperactivity Disorder · Hansard source

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  It is a pleasure to serve under your chairmanship, Ms Jardine. I thank the hon. Member for Henley and Thame (Freddie van Mierlo) for securing this important debate on support for people with ADHD, and for sharing the experiences of his constituents in Oxfordshire. I know that the hon. Gentleman and others wrote to the Minister for Care, my hon. Friend the Member for Aberafan Maesteg (Stephen Kinnock) about many of the issues he raised today; I hope he found the Department’s response to that letter useful. I thank other colleagues for their interventions. These issues also affect my own constituents, and I see them in my inbox, so I understand their impact on families and communities. First, we must be honest about the challenges. The Government inherited a broken NHS with too many patients facing long waits to access services, including ADHD assessments and support. Lord Darzi’s report laid bare that the growth in demand for ADHD assessments nationally has been so significant in recent years that it risks completely overwhelming the scarce resources available. The report also shows that, at current rates, it would take on average eight years to clear the backlog of adult ADHD assessments and that for many trusts the backlog would not be cleared for decades. We absolutely recognise the need to better understand the factors behind the rise in demand for services to ensure that we offer the right support. The hon. Member for Henley and Thame asked why his trust has closed its waiting list. In preparing for the debate, I asked officials to give me a clearer understanding of what is happening in the Buckinghamshire, Oxfordshire and Berkshire West ICB, which saw a near 50% increase in referrals year on year between 2019 and 2024. I am pleased that the hon. Gentleman has had contact with the chief executive. The trust felt that it could not cope with that level of demand because it viewed it as an unmanageable risk to patient safety and staff wellbeing. That is why it made the difficult decision to close the waiting list for new adult ADHD assessments in February last year. That was the trust’s decision. As someone who worked in the system over the peak years of austerity—some people may remember them—I completely understand how trusts are often confronted with such decisions. The recent growth in demand seems quite exceptional. Integrated care boards are responsible for commissioning services in line with the health and care needs of the people they serve. It is up to local decision makers to make tough choices, because they know the situation on the ground better than Ministers in Whitehall. I understand that the ICB has established an ADHD programme steering group to stabilise its services, and it is working with local partners, including people with lived experience, to develop a new service model aimed at addressing health inequalities, providing a single-service model across the ICB, with a single provider, and providing support for people who do not benefit from medication. I understand that the trust is working to open a service for 18 to 25-year-olds as an interim measure to help those who transition from children and young people’s services to adult services, which we know is a difficult time in their lives. I am sure that the hon. Gentleman will maintain a close watch on those commitments.

• 10 Jun 2025 · Attention Deficit Hyperactivity Disorder · Hansard source

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  I will come on to shared care agreements. As the hon. Member says, this is a devolved matter, and I am focusing on support for issues facing ADHD services in England and what we are doing to support trusts to get back on top of waiting lists and improve access to services. First, NHS England has commissioned an independent ADHD taskforce, which is working to bring together those with lived experience and experts from the NHS, education, charity and justice sectors. The taskforce is developing a better understanding of the challenges affecting those with ADHD, including timely and equal access to services and support. I can confirm today—I know that this will be of interest to many hon. Members—that the taskforce will publish its interim findings shortly, with a final report expected after the summer recess. The interim report will helpfully focus on recommendations that support a needs-based approach, beyond just the health system, in which people can access support based on their needs, not their diagnosis. The report will also set out recommendations for support to be provided beyond medication, and by healthcare professionals other than specialists. Secondly, NHS England recently published an ADHD data improvement plan to inform future service planning, and on 29 May it published management data on ADHD waiting lists. Thirdly, it has been capturing examples from ICBs that are trialling innovative ways of delivering ADHD services and using that information to support systems to tackle waiting lists and provide support. Fourthly, as part of the Government’s five long-term missions, we have launched the 10-year plan to deliver the three big shifts that our NHS needs to be fit for the future: from hospital to community, from analogue to digital, and from sickness to prevention. All those shifts are relevant to supporting people in all parts of the country with a range of conditions such as ADHD. Fifthly, we are supporting innovation. Earlier this year, at a parliamentary event, many of us will have met innovators who are supported by NHS partners. I heard about the QbTest technology that complements the knowledge and skills of clinicians as part of the ADHD assessment process. I understand that 70% of NHS children’s ADHD services already use that technology, and the evidence suggests that it has a positive impact in making the assessment process swifter and simpler.

• 10 Jun 2025 · Attention Deficit Hyperactivity Disorder · Hansard source

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  I am not aware of the detail of the pathway in the hon. Member’s ICB. I suggest that that is a matter for him to discuss with the ICB, which will have heard his question about how it is delivering those services on the ground. Members raised issues around shared care agreements and the difficulties that people with ADHD are experiencing in accessing medication through such agreements, particularly when they have received a diagnosis through a private provider. It is the responsibility of secondary care specialists such as consultants, rather than GPs, to initiate treatment of ADHD. However, sometimes a shared care agreement, in which the GP takes over monthly prescriptions and routine monitoring once the patient is happy with their medication and dosage, can be put in place. The General Medical Council, which regulates and sets standards for doctors in the UK, has issued guidance to help GPs decide whether to accept shared care responsibilities for any condition. NHS clinicians need to be content that any prescriptions or referrals for treatment for any condition are clinically appropriate. All shared care arrangements are voluntary, so even where arrangements are in place, practices can decline shared care requests on clinical or capacity grounds. If I may, Ms Jardine, I will take the opportunity to update the House on the supply of medicines, which has also been raised by colleagues; I understand that it was raised at business questions recently, too. The Government recognise the difficulties that some people have experienced with accessing ADHD medication due to medicine supplies. We know how worrying and frustrating those shortages are for patients and families. I am pleased to say that we have resolved many of the outstanding issues affecting the supply of lisdexamfetamine, atomoxetine capsules, atomoxetine oral solution and guanfacine prolonged release tablets. However, some specific manufacturers continue to have issues with methylphenidate. We continue to work with manufacturers to resolve remaining issues. In fact, I met the medicine supply team this morning, as I do very regularly, to make sure we are on top of these issues as much as we can be. The team is working hard to make sure that the situation improves. Where issues remain, we are directing suppliers to secure additional stocks, expedite deliveries where possible, and review plans to support continued growth in demand for the short and long term. We have worked with specialist clinicians during this time to provide comprehensive guidance to healthcare professionals where there is a disruption to supply. We keep the Specialist Pharmacy Service website up to date with the latest availability of ADHD medicines. I commend it to people listening to the debate and to hon. Members. It also provides comprehensive guidance on switching to alternative treatments, supporting clinicians to make informed choices with their patients. I can assure colleagues that, as the Minister responsible for medicine supply, I will instruct officials to keep a close eye on this issue, so we do not see any of the progress we have made undone. I plan to hold an event, hopefully in Parliament and possibly in the autumn, to keep updating hon. Members on this issue, because I know it is one that concerns us all. In closing, I want to address the young people who may be watching or tuning into the debate at home. I know it is tough for many neurodivergent kids today. You might be stuck on a waiting list, suffering at school or struggling to find your medicine. We really do care about this. We are trying to get to grips with some of the problems we found when we came into office, and I hope you will start to feel that progress within the next few years.

• 10 Jun 2025 · Attention Deficit Hyperactivity Disorder · Hansard source

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  I will ensure that the hon. Lady gets a reply on that issue. I thank the hon. Member for Henley and Thame for securing this important debate and for giving me the chance to put on the record some of the issues the Government are addressing. The Government know there is much more to be done to get better access to timely diagnosis and support for all our constituents, but I hope the actions I have set out today provide some reassure to the hon. Gentleman and other colleagues. Question put and agreed to.

• 9 Jun 2025 · Breast Cancer Screening: Bassetlaw · Hansard source

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  I thank my hon. Friend the Member for Bassetlaw (Jo White) for bringing forward this debate on a really important topic that is close to my heart and, I know, the hearts of so many other hon. Members. It is really important to ensure that as many women as possible take up the offer of screening. They should not feel embarrassed to seek help if they feel something untoward when checking their breasts. My hon. Friend has spoken really eloquently, and has been supported by other colleagues. As she has done on other occasions, she has highlighted her family’s experience of losing a loved one due to the fear of seeking medical advice, and she is right to raise the issue of the downturn in women choosing to be screened in her constituency and, sadly, across the country. Survival rates for breast cancer can be good. If breast cancer is found early, at stage one, the five-year survival rate can be as high as 98.2%, but the five-year survival rate plummets to 26.6% when breast cancer is not found until stage four. The earlier breast cancer is caught, the earlier it can be treated, and the more likely it is that the patient will recover. Everyone is encouraged to check their breasts for lumps. There have been some excellent public health campaigns over the years from various charities explaining what to look for, be it a lump, a discharge or a dimpling of the skin on the breast. If a change is found, it is essential that no time is wasted before contacting a GP. That is why screening is an essential tool in our arsenal when trying to prevent this disease. A mammogram can identify breast cancer before it is large enough to be felt. The NHS national breast cancer screening programme invites all women aged 50 to 71 to attend a screening appointment once every three years. Mammograms can be uncomfortable, as those of us who have had them know, and many women have anxiety about having to get undressed in front of strangers, but that short discomfort could save a life. It is important that we encourage all women not to put off their scans. The NHS breast screening programme was badly affected by the pandemic, as we have heard this evening. Screening for breast cancer was paused, and when it restarted, the number of women taking up the offer did not recover to pre-pandemic levels. Even after the backlog of missed appointments had been cleared, the take-up of invitations was low, and data indicates that lots of women are still not coming forward to start their screening journey. The NHS is doing more to help to drive up engagement, and we can all do more to help, as my hon. Friend is doing. The most recent NHS data shows that breast cancer screening uptake in the area including my hon. Friend’s constituency is reported at 74.1%, with an achievable standard of 80%. That is higher than the national average of 70%, but it is short of that achievable high standard. Also, the percentage of women screened within 36 months of their previous screen is reported at 97.5%, versus the acceptable standard of 90% and the achievable standard of 99%. While more can clearly be done to increase uptake, I hope that those figures for the entire patch that includes my hon. Friend’s constituency provide some reassurance that women are coming forward to be screened. However, I absolutely take the point made by her and her colleagues that the data needs to be understood at a more granular, local level—particularly data on the women coming forward in areas of high deprivation. I will ensure that my hon. Friend has access to that information following this debate. I am pleased that the Doncaster and Bassetlaw teaching hospitals breast screening service has made significant improvements over the past year to improve attendance at appointments. I really commend my hon. Friend’s “Love your boobs” campaign, and the work that she has highlighted with local women like as Liz, Maria, Barbara, Claire and Lynn, and with men such as Danny, which makes the point that is important that men also check. The service has recently expanded availability by offering more appointments outside traditional hours. It has extended its clinic hours, and has regular Saturday appointments. The invitation method has also been changed from open appointments to timed and dated appointments, which has been shown to help increase engagement, and the service has met with the Cancer Alliance and commissioners to review ways of increasing uptake. I understand that Doncaster and Bassetlaw teaching hospitals’ breast screening service is planning to invite my hon. Friend to visit a clinic in her constituency. I hope that visit will furnish her with further information about local efforts to increase uptake, and I know she will make sure that visit happens. In February this year, the NHS launched a national breast screening awareness campaign to encourage more women to take up the offer of screening, and debates such as the one we are having tonight help raise awareness of its importance. We are not complacent: as well as increasing the uptake of routine screening, we need to make sure that the women who are most at risk are screened more frequently. The breast screening after radiotherapy dataset, or BARD, programme is working to identify and invite women who received radiotherapy involving breast tissue when aged between 10 and 35. As we have heard this evening, genetic tracing programmes are also looking at identifying carriers of genes, including BRCA, that predispose individuals to a higher risk of breast cancer. Those women are entitled to more frequent screening, and we need to ensure that they are identified and informed. The UK national screening committee is considering other changes to the breast screening programme. It is looking at whether women with denser breasts need to be screened differently, and an ongoing trial called BRAID—breast radiography to aid identification of cancers in dense breasts—is looking at breast density. The UK NSC is discussing the first findings of that trial, which I am sure hon. Members will maintain a close interest in. It will continue to review BRAID and other findings as they become available to ensure that early decisions can be made to keep the screening programme updated and dynamic. We are also investigating the age thresholds for screening. Currently, only higher-risk women are invited for screening below the age of 50. The programme stops at the 71st birthday, although women aged over 70 can choose to opt back into regular screens. A trial called AgeX is reviewing whether an additional screen three years before and three years after the existing age thresholds would increase the effectiveness of this programme and ultimately save more lives, and the EDITH research study is looking at whether artificial intelligence can be used to support the reading of mammograms. If it can, that could relieve pressure on the workforce and allow more screens to take place, as there would be increased capacity to translate the results. The Government have already invested £11 million in that trial, and we keenly await the results. More widely, the Government are committed to tackling breast cancer and ensuring that women get diagnosed and treated faster and more efficiently. That is why we will publish a national cancer plan later this year. That plan will have patients at its heart and will cover the entirety of the pathway, from referral and diagnosis to treatment and ongoing care, as well as prevention, screening, research and innovation. It will seek to improve every aspect of cancer care to improve the experience of, and outcomes for, people with cancer. Our goal is to reduce the number of lives lost to cancer over the next 10 years. I again thank my hon. Friend the Member for Bassetlaw and other hon. Members for being in the Chamber this evening, giving this House an important opportunity to shine a light on the lifesaving importance of breast screening. My hon. Friend is doing a great service in publicising her work with the NHS, and I wish her good luck with Race for Life. We all have the same goal, and together, we can improve outcomes and increase the number of women surviving breast cancer. Question put and agreed to.

• 3 Jun 2025 · Yeovil Hospital: Maternity Unit · Hansard source

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  I thank the hon. Member for Yeovil (Adam Dance) for securing this important debate about the temporary closure of maternity services at Yeovil district hospital. I know, having given birth to three myself, that choosing where to give birth and the planning of that journey, as has been outlined, is incredibly important for women. We are determined that all women are given choice over their care and are listened to and supported with compassion. The hon. Member is an advocate for the Yeovil community, and I welcome his representations, ensuring that his constituents’ voices are heard. That is an important role for Members of Parliament. I will start by acknowledging the concerns that hon. Members have raised on their constituents’ behalf, both in their letter and in this debate, and I hope I can update them on the relevant issues as they stand. In preparing for this debate, I have met the trust and Somerset ICB, and I am grateful for their time and briefing on these issues. As hon. Members know, the trust cannot safely staff the paediatric service as well as the special care baby unit. This means that it has taken the difficult decision to close the special care baby unit, which also means that it cannot safely provide maternity services—I think that point was acknowledged by the hon. Member for Yeovil. The hon. Member is concerned about the process followed by Somerset NHS foundation trust in coming to this decision, particularly about it not having consulted the local council, MPs or other stakeholders. He also identified concerns about the information going to staff. In some situations, such as this one, NHS providers may need to make a temporary service change due to a risk to the safety or welfare of patients or staff. Legislation allows them to do so without consulting the scrutiny committee beforehand, provided that that service change is needed for safety or welfare reasons. I understand that the trust briefed Somerset county council’s health overview and scrutiny committee on 15 May, and has committed to further updating the committee in October. The trust has had one-to-one conversations with affected women and families to help them with alternative plans, which have been supported by Somerset Maternity and Neonatal Voices Partnership.

• 3 Jun 2025 · Yeovil Hospital: Maternity Unit · Hansard source

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  I am not aware of the operational details of how the decision was communicated, but I am happy to come back to that. As I have said, when decisions are made for reasons of safety—which is of primary importance—sometimes staff will not be able to be consulted in the usual way. Of course, some staff will not be working at a given time, or may be on holiday, and organisations have to take particular measures to inform staff. I appreciate that that is very disruptive and personally distressing for staff who have been working in a unit and need to know where to go, but emergency situations sometimes necessitate things not being done as robustly as might be desired. Local leaders have assured me that this closure is not intended to be permanent—that is very important for hon. Members and their constituents to understand. The trust is committed to reviewing the position in three and six months, and following the three-month review, Somerset ICB will provide an update in September. Finally, once a decision is made, any permanent change would need to be based on clear evidence of better outcomes for patients. On the wider issue that has been raised this evening, as hon. Members will be aware, the Government’s position is that changes to NHS services should always be locally led and clinically evidenced. Any decision about the next steps for the neonatal and maternity services at Yeovil hospital should be taken by the local NHS, with support from the Care Quality Commission. I understand that work is currently under way to mitigate the impact of the closure and move towards safe operation of services. The NHS England South West regional team is working with the trust and the ICB to mitigate the risk of the closure and ensure that the wider systems work together to provide safe services. The trust is working closely with neighbouring hospitals in Bath, Salisbury, Poole, Dorchester and Exeter to ensure sufficient capacity, which should provide assurance to local people. Regional team clinical leaders have attended a rapid quality review meeting with ICB and trust clinical leaders, and work continues on mitigating the risks that have been identified. I have been assured that Somerset ICB will monitor progress against improvement plans, formally noting any new or emerging risks and actions required. It will also be monitoring the impact on Musgrove Park maternity unit. I understand that Somerset NHS foundation trust and Somerset ICB have also written to the hon. Member for Yeovil since the closure and that there is due to be a call with local MPs tomorrow. I think that is good progress; as I said to representatives of the trust when I met them, I commend that way of operating with local Members of Parliament. I hope it is helpful in having detailed conversations locally to reassure hon. Members and—more importantly, if I may say so —their constituents at what I appreciate is a really difficult time for women who are either due to give birth, or are thinking about starting a family. We are committed to tackling staffing challenges that the NHS faces, such as this one. For the maternity workforce, NHS England is undertaking a programme of targeted retention work for midwives. This includes a midwife retention self-assessment tool, a mentoring scheme, strengthened advice and support on pensions, and flexible retirement options. NHS England has also invested in unit-based retention leaders, who focus on retention and give pastoral support to midwives. This initiative, alongside investment in workforce capacity, has seen a reduction in the number of vacancies and in leaver and turnover rates. Maternity care remains a top priority for providers, as is demonstrated in the planning guidance, in which the NHS was instructed to improve safety in maternity and neonatal services as a priority. I know that there is concern in Somerset more widely about how this change will affect services in the local area. Let me reassure Members that NHS Somerset is committed to investing in local services for both hospitals there. That includes a commitment to a fully functioning district general hospital in Yeovil. The Yeovil diagnostic centre, which is due to open later this year, will be a modern, three-storey, state-of-the-art centre based at Yeovil district hospital. It will have the capacity to deliver an additional 70,000 diagnostic tests and out-patient appointments each year and to be open seven days a week, providing radiology, endoscopy and cardiology services, audiology tests and out-patient appointments. I thank the hon. Member for Yeovil again for raising this important issue. I know that he and his colleagues will keep a close eye on progress. I hope that I have responded to his immediate concerns tonight, and I will of course write to him and other Members shortly in response to their letter of 19 May.