Karin Smyth MP: speeches
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Speeches
- 13 Feb 2025 · HIV Testing Week · Hansard source
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It is a pleasure to serve for the first time under your chairship, Dr Allin-Khan. This is such a marvellous debate to be part of. The Secretary of State asked me to respond to it on behalf of my hon. Friend the Member for West Lancashire (Ashley Dalton), who has been attending events this week and unfortunately could not be here today. I have known her a long time and I know that she will be a fantastic champion in this area, coming to the Department every day to do battle on people’s behalf. I am grateful to the right hon. Member for Dumfriesshire, Clydesdale and Tweeddale (David Mundell) for securing this important debate and for his continued work in this area. I join my hon. Friend the Member for Colne Valley (Paul Davies) in commending the work of the APPG. I know that many hon. Members are caught in the dilemma of the two debates today, and many other people would be here, but I know that they will be listening to the debate with great interest on the fourth day of National HIV Testing Week. This debate gives me the opportunity to thank all the amazing charities and organisations that are playing such a huge part in making this week a success—the Terrence Higgins Trust, National AIDS Trust, and the Elton John AIDS Foundation, which we have heard about today, to name just a few. I also want to add my voice to the enthusiasm I have seen in my time—nine years now—across all parties on this issue. There has been a long period of cross-party collaboration. I hope that that continues and that we continue to base our work on evidence and care. It is what has got us here today. My hon. Friend the Member for West Ham and Beckton (James Asser) made that point very well and asked for more resources, so well done him. I will perhaps come on to some of that. In national testing week, we are making great strides towards the goal of no new transmissions in England by 2030. We are, as many members have said, at a crucial point in that journey. HIV testing has been revolutionised. It is now fast, free and available in the privacy of our own homes—even when our home is No. 10 Downing Street, as the Prime Minister showed us on Friday. I know that that is a powerful message not just in this country but globally, as my hon. Friend the Member for Exeter (Steve Race) highlighted. When we normalise testing, we normalise prevention, treatment and care—and we normalise saving lives. I thank every colleague who attended Tuesday’s drop-in. It is so important for all of us in this place and elsewhere to help smash the stigma however we can, transform perceptions, and drive us closer to no new transmissions.
- 11 Feb 2025 · Hinchingbrooke Hospital · Hansard source
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The hon. Gentleman has outlined the shocking state of some hospitals. I confirm again that we want a site-by-site report of those hospitals for exactly that purpose: to ensure that they are safe and to understand any critical issues before the schemes go forward. We expect that report in the summer.
- 11 Feb 2025 · Hinchingbrooke Hospital · Hansard source
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I commend my hon. Friend on his research into the previous Government, and for the hard work that he is doing on behalf of his constituents. We are committed to the rebuild of Hinchingbrooke and have put the new hospital programme on a sustainable footing, which is something that his constituents can look forward to.
- 11 Feb 2025 · Hinchingbrooke Hospital · Hansard source
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As I am sure the hon. Member knows, Hinchingbrooke hospital is in wave 1 of the new hospital programme, and his constituents can now look forward to a new hospital under this Labour Government. The hospital has received over £44 million to deliver RAAC mitigation safety works, and my right hon. Friend the Secretary of State has commissioned a site-by-site survey of RAAC hospitals, which will ensure that individual development plans address the highest-risk elements as soon as possible.
- 11 Feb 2025 · Nursing: Career Progression Inequalities · Hansard source
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My hon. Friend is absolutely right that the issue is key, and that the results are worrying. I know how proud my friends and family members were to become nurses, and what a great career nursing offered them. We have to deliver on the promise of a good career, and build on that pride in being a nurse. We absolutely recognise that we cannot rebuild the NHS without their skills and their high-quality critical and compassionate care.
- 11 Feb 2025 · Nursing: Career Progression Inequalities · Hansard source
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I know that this issue is close to my hon. Friend’s heart, after his years of service as a nurse in the health service. We have to ensure that the NHS is an attractive place for nurses to work, and that they can progress. We hear directly from staff through our 10-year plan, and work closely with the Royal College of Nursing, Unison and other trade unions through our social partnership forum.
- 11 Feb 2025 · Nursing: Career Progression Inequalities · Hansard source
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No.
- 11 Feb 2025 · Stepping Hill Hospital · Hansard source
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The hon. Lady outlines for her constituents what many across the House will recognise: the state that the last Government left the capital estate in. The autumn Budget committed over £13 billion into next year, with £4 billion for ICBs to start prioritising some of this work. We have allocated £1 billion for critical backlogs, maintenance and upgrades. A longer-term capital plan will follow the 10-year plan that we are currently developing to offer the hope for her constituents that she asks for.
- 11 Feb 2025 · Stepping Hill Hospital · Hansard source
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I thank the hon. Lady, along with my hon. Friend the Member for Stockport (Navendu Mishra), for her continued support for Stepping Hill hospital. I know that she is working hard on this issue. We are backing the NHS with over £4 billion of funding for integrated care boards for capital priorities, with a dedicated £750 million estate safety fund next year to address the poorest quality hospitals. I am pleased that the replacement of Stepping Hill’s outpatient facility is already under way, backed by £11.5 million this year. I look forward to visiting as soon as my diary allows.
- 11 Feb 2025 · Topical Questions · Hansard source
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We are absolutely committed to urgent treatment centres, which play a vital role in supporting patients, especially during periods of high demand. I understand that this is temporary, and that the centre is running a pilot. I know that my hon. Friend will work closely with his local integrated care board to ensure that it serves his constituency adequately.
- 11 Feb 2025 · Topical Questions · Hansard source
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I entirely appreciate the frustration and distress caused by medical supply shortages. We are working intensively with industry to resolve the HRT supply issues, and the problems with the supply of Estradot are expected to be resolved by the end of the month. Meanwhile, we have issued a serious shortage protocol to allow community pharmacists to supply alternative brands of the same medicine, and those remain available.
- 11 Feb 2025 · Topical Questions · Hansard source
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I holidayed in my hon. Friend’s constituency this summer—it is a very beautiful part of the world—so I understand some of the rural challenges. It is a matter for local integrated care boards how they organise ambulance services. There are many problems that we want to resolve, and I would of course be very happy to meet him.
- 11 Feb 2025 · Topical Questions · Hansard source
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My hon. Friend has been a strong campaigner on this issue on behalf of her constituents, and I congratulate her on that work. We are confident that the randomised trial will go forward, and we have invested over £8.5 million in it. I am very happy to meet her, and I urge people to come forward and support the trial. That is the way forward on this issue.
- 11 Feb 2025 · Antenatal Care: Vasa Praevia Screening · Hansard source
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I thank the hon. Member for that point. As he knows, I am always keen to ensure we share good practice across the United Kingdom so that his constituents, like mine, can benefit. We will work through the usual processes to ensure that happens.
- 11 Feb 2025 · Antenatal Care: Vasa Praevia Screening · Hansard source
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I thank my hon. Friend for his ongoing work in raising awareness in maternity services. We are committed to improving maternity care for women and babies. Evidence does not currently support screening for vasa praevia in the UK, but we have asked the Royal College of Obstetricians and Gynaecologists to review the guidance around this issue.
- 11 Feb 2025 · Antenatal Care: Vasa Praevia Screening · Hansard source
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I am incredibly sorry to hear about Cate’s experience. We want to ensure that women receive safe, personalised and compassionate maternity care and that women with the condition are supported. That is why we have asked the college to look at the guidance. I will of course be happy to meet my hon. Friend and his constituent.
- 10 Feb 2025 · Draft Health and Social Care Act 2008 (Regulated Activities) (Amendment) Regulations 2025 · Hansard source
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I beg to move, That the Committee has considered the draft Health and Social Care Act 2008 (Regulated Activities) (Amendment) Regulations 2025. This statutory instrument will amend the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014, which are due to expire after 31 March this year. It will remove the expiry date and amend the five-year period from which the regulations are required to be reviewed. Prior to the laying of this SI, the principal regulations required review every five years from 1 April 2015. The first post-implementation review was delayed until 2022 due to the pandemic. We therefore wish to conduct the next review in 2028. These regulations do not change any existing policy. The 2014 regulations set out the activities that are regulated by the Care Quality Commission and the fundamental standards with which all health and social care providers registered with it need to comply. These regulations are before the House now because if we do not amend the 2014 regulations, they will automatically expire and the CQC will have no powers to fulfil the requirements in the 2008 Act. Nor will there be an obligation on providers that are currently required to register with the CQC to comply with the fundamental standards set out in the 2014 regulations. I know that some Members may have been expecting to see further changes following the report by Dr Penny Dash on the CQC’s operational effectiveness, which uncovered significant failings in its internal workings. Its operational failings, however, do not require changes to legislation. The new chief executive Sir Julian Hartley has put in place measures to address them urgently. The regulations are silent on provisions relating to the use of restraint and on the regulation of medical care at temporary cultural and sporting events, on which the Department consulted last year. We have not overlooked those sensitive areas, and we continue to progress the work on finalising policies on them. The consultation responses on the proposal to make the use of restrictive practices notifiable to the CQC within 72 hours showed support for the measure, but highlighted a number of practical concerns, primarily that the proposed timeframe could place an additional burden on staff and risk an impact on patient care. As the Government said in their response to the consultation, further work is needed to ensure that we have the right definitions, systems and processes in place before we proceed with legislative changes. The Government will lay a statutory instrument in due course to remove the exemption relating to the regulation of medical care at temporary cultural and sporting events. With this change, providers of such care will be required to register with the CQC for the first time. I commend the regulations to the Committee and hope that hon. Members will join me in supporting the amendments that they make.
- 10 Feb 2025 · Draft Health and Social Care Act 2008 (Regulated Activities) (Amendment) Regulations 2025 · Hansard source
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In appointing Sir Julian Hartley, proper processes were conducted. He was seen to be fit and proper to lead the CQC, and we have confidence in his ability to do so.
- 10 Feb 2025 · Draft Health and Social Care Act 2008 (Regulated Activities) (Amendment) Regulations 2025 · Hansard source
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I thank the hon. Gentleman and other Opposition Members for their support for the regulations. The hon. Gentleman makes an important point regarding care at sporting and temporary cultural events. We all remember the awful events at Manchester Arena and the lessons to be learnt from there. Although there is some good practice in healthcare provided at some of these events, there remain examples of poor, unregulated healthcare that does not sufficiently protect members of the public, so it is right that the CQC has oversight of the sector. I recognise the hon. Gentleman’s points about proportionality—that is essentially the word I would ascribe to these measures. People need to be assured that there is safety and some proportionality, and I think those points should be taken on board for the next phase of this work. If we need to come back to him specifically on that or write to him about how it proceeds, we will absolutely do that. We all want to support events in our communities and support the volunteers and people who come forward for such things. They are a really important part of the fabric of our lives, so I think it is very important that people have assurances around that. I will have to come back to the hon. Gentleman on the further questions that the he asked about the CQC and the fit and proper persons test. As he rightly says, they are not a matter for this SI, but as the work goes on and as we listen to our colleagues in the other House, and their debate about the Mental Health Act in particular, there will be a number of issues that we want to make sure are dealt with properly and that will come into the next phase. We will endeavour to make sure we update him on progress with that work as well. Patient safety is a top priority for us, and the CQC plays an important role in ensuring that providers meet the standards of care that we expect for the public—patients, carers, and families and loved ones. Its purpose is to monitor, inspect and regulate health and care services and make sure that providers meet the fundamental standards of quality and safety.
- 10 Feb 2025 · Draft Health and Social Care Act 2008 (Regulated Activities) (Amendment) Regulations 2025 · Hansard source
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The right hon. Gentleman makes an important point about maternity care, which is very sadly an issue of concern in many places across the country. Of course, those patients and families are absolutely right to call out poor care where they have seen it. It is absolutely right that that is fully investigated, and that is what we would expect at Leeds and in other places around the country. The CQC’s leadership in ensuring that we have safety and confidence is critical for the role. On that basis, we would like to move forward with this SI to remove the expiry date in the 2014 regulations, to amend the five-year period and to ensure that health and care providers continue to be required to register with the CQC and comply with the fundamental standards set out in the 2014 regulations after 31 March this year. We also want to make sure that services continue to be required to provide a safe and high quality standard of care. Question put and agreed to.
- 30 Jan 2025 · Medicinal Cannabis · Hansard source
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I will come on to the research. As we have heard, and as I recognise, fewer than five patients have accessed these medicines on the NHS, so access is truly exceptional. The testimony of the children and families accessing these treatments privately—often at great personal cost, as we have heard this afternoon—is truly heartbreaking. I am sure we can all agree that all Government spending on health must be evidence-based, and colleagues are seeking to ensure that that is the case. If we are to see more cannabis-based medicines routinely available on the NHS, we need more research. The National Institute for Health and Care Research, also known as the NIHR, and the MHRA are there to support manufacturers and researchers to develop new medicines and design quality studies. I strongly encourage the manufacturers of those products to invest in research to prove that they are safe and effective and meet the rigorous standards that we rightly expect for all medicines. They should engage with the NIHR and the MHRA on clinical research and medicines licensing processes. That is key in providing doctors with the confidence to prescribe cannabis-based products in the same way that they use any other licensed medicines recommended for use on the NHS, but we are not waiting for industry to respond to patient voices. The NIHR and NHS England have recently confirmed more than £8.5 million in funding for clinical trials to investigate whether cannabis-based medicines are effective in the treatment of drug-related epilepsies. As I said when we were in opposition, and as has been highlighted today, action in this space is vital. Epilepsy is a terrible disease, and it can be life-limiting in the most serious cases. We also know that although epilepsy is a fairly common neurological condition, affecting 1% to 2% of the population, about 30% of cases will sadly have seizures that are resistant to current treatments, so it is absolutely right that the NIHR and NHS England are pioneering truly world-first trials that will investigate the safety and effectiveness of CBD and THC in adults and children with treatment-resistant epilepsy. The trials will be co-led by experts from University College London and Great Ormond Street hospital and will look to recruit around 480 patients from across the UK. The study details are published on the NIHR website, and I understand that it will publish further details soon. Further funding has also been awarded to the University of Edinburgh to investigate the efficacy of CBD in patients with neuropathic pain due to chemotherapy. Those are two examples of the type of research that we desperately need in this area of medicine, and a further 28 studies looking at cannabis-based medicines have been approved by the MHRA since 2018. It is an emotive and complex debate, but the clinical trials give me encouragement that there is a way forward. If the evidence supports it, we will see more cannabis-based medicines approved by the regulators and recommended by NICE. That is the only way we will see the evidence base improved and give clinicians the confidence to prescribe. To conclude, the hon. Member for Strangford has brought this debate forward with his customary good faith and compassion.
- 30 Jan 2025 · Medicinal Cannabis · Hansard source
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I will take another intervention.
- 30 Jan 2025 · Medicinal Cannabis · Hansard source
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I cannot answer the question about trials and research directly because, obviously, trials are run by the specialists at NIHR, in the usual way, and I am sure that the request for meeting has been heard. It would probably not be with me, but I am sure the officials have heard it and that the hon. Gentleman will have a response. I thank the Opposition spokesperson for reading out my contribution and highlighting how proactive we are being, only seven months since forming the new Government. I am proud that the trials that we are looking to do are world firsts. No other country in the world is taking the same action to prove that the medicines are safe and effective. I know it will not come as much consolation to those families who are at the end of their tether with talk of processes, debates and regulations. I also know it may not feel like it, based on some of the things I have said today, but I think there is a way forward. There may be some light at the end of the tunnel, and this Government will do what we can to support NHS England and the NIHR to get the trials done.
- 30 Jan 2025 · Medicinal Cannabis · Hansard source
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It is a pleasure to serve under your chairship, Ms McVey. I congratulate the hon. Member for Strangford (Jim Shannon) on securing this debate. As he said, there are many hon. Members from both sides of the House representing constituents affected by the issue across the United Kingdom who would have liked to be here today. Obviously, health is a devolved matter. The hon. Gentleman spoke movingly about his constituents, and other colleagues talked about theirs. I agree with him. My words have been repeated back to me, so I do not need to say them again. This is an important issue for everyone in the Chamber and those who are listening in, as we all want to support people who are in very difficult circumstances. The hon. Gentleman raised some key issues, which I will address. He said that landlords and the police are unaware of the legality surrounding prescribed medicinal cannabis. I encourage him to take that up with the Deputy Prime Minister and the Home Secretary. I understand that the Home Office has notified all police forces about the change to the law, and guidance has been issued to summarise what that means. The hon. Gentleman mentioned electronic prescribing, which has been in operation for schedule 2 and 3 controlled drugs in NHS primary care settings since 2019. I am afraid there are no current plans to extend that to private clinics at this time. The hon. Gentleman also spoke about an observational study with a small patient cohort. I am afraid that it would not produce results as robust as a randomised control trial, which is the gold standard for clinical trials, nor would it add to the current evidence base. It would not provide results suitable to inform routine clinical or NHS commissioning decisions, because there would be no way to compare the findings with what would have happened in the absence of the intervention. I will come on to clinical trials in more detail, but let us be clear about the problem we face, the challenge faced by all of us involved in this debate and the challenge faced by children, many of whom have been mentioned today. Of course, we listen to Members of this House, and to patients, parents and families, who say that these medicines are safe and should be available. We must ensure the safety and effectiveness of all medicines. The benefits should outweigh any potential harm and, as the hon. Gentleman outlined, clinicians must have that assurance and clarity, too. There are currently only two cannabis-based medicines in the world with marketing authorisations or licence. They are—I hope I do not stumble over them too—Sativex, for the treatment of muscle spasms in multiple sclerosis, and Epidyolex, for treatment related to two rare forms of epilepsy and tuberous sclerosis complex. Those medicines show that it is possible to develop cannabis-based treatments that have been assessed for safety, quality and efficacy. The evidence generated on their clinical effectiveness and cost-effectiveness can enable the National Institute for Care and Health Excellence to recommend them for use in the NHS. The medicines we are talking about today are unlicensed, which means that they have not been assessed by the Medicines and Healthcare products Regulatory Agency. Indeed, they have not been assessed or granted market authorisations by any medicines regulator anywhere in the world. However, as has been noted, in 2018 the then Home Secretary, Sajid Javid, enabled the prescription of unlicensed cannabis-based products for medicinal use. That provided a lawful route to these medicines for prescriptions for individual patients who were not benefiting from standard treatments and were not part of clinical trials, while limiting the ability to prescribe to specialist doctors. That came on the heels of the review by Professor Dame Sally Davies, then the chief medical officer, which found enough evidence of benefit to recommend that cannabis-based medicine should be moved out of schedule 1 to the Misuse of Drugs Regulations 2001. For epilepsy, that evidence was mainly in relation to cannabidiol, also known as CBD, rather than products containing the psychoactive compound tetrahydrocannabinol, or THC. The review did not provide evidence to support routine prescribing or funding of those medicines on the NHS, which the previous Government should have made clear at the time. Before we see routine prescribing of these unlicensed medicines, the NHS must have greater assurance on their clinical effectiveness and cost-effectiveness at a population level. I am not a clinician—we are all here as politicians—and it is right that prescribing any medicine or treatment is a clinical decision, whether it is done on the NHS or privately. It is not for us to influence those decisions, so I cannot comment on individual cases. We want to see more medicines approved by the MHRA and available on the NHS. We inherited a broken system, and it will take time to fix that failure, but the Chancellor has made an in-year investment in the NHS to fill the black hole that we inherited and prevent our having to cut back on services. That means that, more than ever, the NHS must account for every penny that it spends and make difficult decisions on what treatments are made available. The NHS must get the best possible value for its investment in medicines and consider the cost-effectiveness of treatments to ensure that resources are used efficiently. For that to be fair, medicines or treatments initiated privately would not routinely be prescribed by the NHS unless the requested treatment was already approved under existing policies, which unlicensed medicinal cannabis is not, or when there are individual, exceptional circumstances. That remains the case even if privately funded treatment has been shown to have clinical benefit for an individual patient. This is the current NHS policy for all treatment initiated and prescribed privately, and it is not specific to medicinal cannabis.
- 30 Jan 2025 · Women’s Health Strategy · Hansard source
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The chief executive is right that the previous Government did not have women’s health at the heart of their strategy, and that is why we do.
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