Karin Smyth MP: speeches

Speeches

• 23 Mar 2026 · Puberty Blockers Clinical Trial · Hansard source

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  It is a pleasure to serve under your chairship, Mr Mundell. I thank the hon. Member for Caithness, Sutherland and Easter Ross (Jamie Stone) of the Petitions Committee for the way in which he introduced the debate. In his usual style, he made sure that he had talked to a range of people and experts to inform this debate. I want to start by recognising that the thousands of signatures on the petition show the real strength of feeling on this issue. I thank everyone for taking part. I am acutely conscious of the young people, their families and people in the Public Gallery today and outside who are paying close attention to this debate and what is being said. I hope to address all the issues that have been raised—I have kept notes and listened carefully—as I know people want to get this on the record. I will say now that I will not take any interventions; I will just set out where I think we are. If I do not answer particular questions, I will get back to people. I want to assure colleagues and the signatories to the petition, particularly young people and their families, and those who are waiting for, have had or have been concerned about gender services, that this Government will always be led by science and not ideology. We are proceeding carefully in line with clinical advice and we will always put the interests of vulnerable children first, because their health and wellbeing are not negotiable. That is our position. Let me start, briefly, with some of the context. In 2020, NHS England commissioned Dr Hilary Cass to undertake a review of NHS children and young people’s gender services. Like others, I am sure, I have taken time over the weekend to re-read her interim report and her full report; I commend both to people with an interest in the subject. Dr Cass is one of the most pre-eminent clinicians in her field, and her review is the most definitive assessment of its kind. It laid bare the inadequacy of the now decommissioned Tavistock Gender Identity Development Service. The interim review and final report made it clear that we needed better data and a stronger evidence base to design the right services for children and young people presenting with questions around gender dysphoria or gender incongruence, given the poor evidence base for services and treatment against rapidly increasing and, as we have heard, changing demand. Dr Cass recommended a new model of care based on holistic assessment and psychosocial support, with further research into puberty blockers, specifically where they are not provided in isolation. The Labour party in opposition welcomed her report and accepted her findings, and we continue to do so in government. Many of the recommendations in her report are being implemented, including opening new NHS children and young people’s gender services while building the evidence base in parallel through a national research programme. As the hon. Member for Caithness, Sutherland and Easter Ross outlined, the rationale for the clinical trial is part of the recommendations to gather robust, contemporary and comparative evidence on the relative benefits and harms of puberty-suppressing treatments in children. That is how we can decide whether puberty suppression can be an option in NHS gender care in future. The PATHWAYS trial has undergone thorough scientific, clinical, ethical and regulatory safeguards. Following academic peer review, it was supported by the independent National Institute for Health and Care Research funding committee. It was endorsed by a multidisciplinary and multi-agency national research oversight board, and was then subject to formal regulatory approvals via the Medicines and Healthcare products Regulatory Agency; the Health Research Authority, including a review by an independent research ethics committee; and finally, the Commission on Human Medicines, which made considered recommendations to the study team that were adopted in full. As with all complex clinical trials, the top priority of each of those organisations is the safety of the trial participants. The MHRA in particular is maintaining a high level of scrutiny and taking a cautious and measured approach. Where appropriate, after initial approvals have been granted, there can be ongoing dialogue between the sponsors of clinical trials and the MHRA. That is part of the process—I want to stress that point. The MHRA has raised concerns relating to some elements of the trial design, and those questions obviously need answering. Rigorous and constructive discussions are accordingly under way between the MHRA and the trial sponsor.

• 5 Mar 2026 · Women’s Health Strategy: Endometriosis and Fibroids · Hansard source

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  I congratulate my hon. Friend the Member for Erith and Thamesmead (Ms Oppong-Asare) on securing this important debate. Baroness Merron, who leads on this work for the Department, and I are grateful to my hon. Friend for the conversations that she has been leading; for putting the spotlight on endometriosis, as well as on the renewed women’s health strategy; and for giving me the opportunity to set out what the Government are doing this Endometriosis Action Month. As my hon. Friend has said, for far too long, women with gynaecological conditions including endometriosis and fibroids have been failed. We acknowledge the impact that that has on all aspects of their lives. This Government’s message to women is clear: you do not have to put up with that any more. I am pleased to hear that my hon. Friend will be hosting a screening of the short film “This Is Endometriosis”, which is about the harrowing experience of a woman seeking care for her endometriosis symptoms. I hope to be able to get along to that screening when it happens, and I encourage others to do so, too. This Government inherited a broken NHS system that still does not understand the needs of many women and was not designed with women in mind. We are committed to changing that, and to ensuring that women are listened to and get the healthcare that they need, when they need it. Improving awareness of endometriosis, fibroids and other women’s health conditions is a vital first step in meeting our commitment to end this neglect of women’s health and reduce the stigma attached to it. My hon. Friend is doing her part through this debate. The General Medical Council has begun work to improve women’s health representation in the curricula used to train healthcare professionals. Since last year, students graduating from UK medical schools have been required to pass the medical licensing assessment, which encourages a better understanding of common women’s health problems among all doctors as they start their career in the UK. This assessment includes topics to do with women’s health, including endometriosis and fibroids. Women’s health is included in the Royal College of General Practitioners’ curriculum for trainee GPs and its women’s health library, which brings together educational resources and guidelines on women’s health. In November 2024, the National Institute for Health and Care Excellence updated its guidelines on endometriosis to make recommendations for healthcare professionals on referral and investigations for women for whom that is suspected to be the diagnosis. Taken together, these actions will improve the standard of care that women receive. It is encouraging to see not just the NHS but all our partners and arm’s length bodies taking action to raise awareness and improve training. This work has to be ongoing across Government. It is shocking, perhaps, that this started only fairly recently, but like my hon. Friend, I pay tribute to many hon. Members across the House who have led an awful lot of work to raise awareness of this issue in the last few Parliaments, and I think that work is starting to bear fruit. Last July, the Department for Education published revised statutory guidance that sets out in black and white that secondary schools should cover menstrual and gynaecological health, covering things like heavy bleeding and when to seek help from professionals. Women often spend years being dismissed, misdiagnosed or simply not listened to. This was reflected in Endometriosis UK’s recent report, which my hon. Friend has made reference to. We are clear that this is unacceptable, and that women should not have to put up with it any more. We have introduced Jess’s rule, which requires GPs to rethink diagnoses for their patients. We are also rolling out Martha’s rule, which will give in-patients in acute hospitals in England the ability to initiate a rapid review of their case by someone outside their immediate care team. These rules will help to ensure that women are listened to by their doctors, and that their concerns are not dismissed. Early diagnosis is key, and that is why we continue to roll out community diagnostic centres across the country for women on gynaecological pathways. As of last month, 106 community diagnostic centres across the country offer an out-of-hours service 12 hours a day, seven days a week, meaning that patients can access vital diagnostic tests around busy working lives. In September, we announced NHS Online, a new online hospital, to give women on certain pathways the choice of getting the specialist care that they need from their home. This will mean that wherever women live in this country, they can access the very best gynaecological care. Earlier this year, we announced that menstrual problems, which may be a sign of endometriosis and fibroids, will be among the first nine conditions available for referral from 2027. The detail is being worked through ahead of the launch next year. Our revolutionary online hospital will help reduce patient waiting times, and deliver the equivalent of up to 8.5 million appointments and assessments in its first three years. That is four times more than an average trust, and it will give women choice and control over their care. Finally, this Government are committed to encouraging integrated care boards to further expand women’s healthcare at neighbourhood level, and to support ICBs in learning from women’s health hub pilots, so that they can improve services for women, as well as for the rest of the population. Women can be impacted by a range of health conditions at the same time, including those that only affect women; those that affect women differently from, or more severely than, men; and those that affect different groups differently, such as fibroids. As my hon. Friend said, black women are disproportionately affected, and often face barriers to timely and compassionate care. This is also the case for ethnically diverse women with endometriosis, as highlighted in the Endometriosis UK report. We are not complacent about these inequalities. We are committed to building a fairer Britain to ensure that people can live well for longer and spend less time in ill health. Our 10-year health plan will focus on shifting care from hospital to communities, and on how neighbourhood delivery will help address gaps in provision and long waiting times, specifically for those from deprived areas in constituencies like mine, and women from ethnic minority backgrounds. Let me turn to the point about research made by the hon. Member for Didcot and Wantage (Olly Glover). The Department, through the National Institute for Health and Care Research, has commissioned several studies focused on endometriosis diagnosis, treatment and patient experience. The NIHR is funding seven active research awards, with investment totalling £7.8 million. That includes a new £2.3 million award for research starting in March 2026 on the effectiveness of pain management for endometriosis. As my hon. Friend the Member for Erith and Thamesmead has said, we know that services are not serving women as they need to right now, but there are some helpful signs that that is starting to change. Training and awareness are a key part of that. We need to keep highlighting the differences as women present for care. We will listen to women, and I look forward to working with my hon. Friend and others on developing and implementing a renewed women’s health strategy over the coming months. Question put and agreed to.

• 5 Mar 2026 · Palliative Care · Hansard source

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  I thank my hon. Friend the Member for York Central (Rachael Maskell) for securing this important debate. We entered Parliament at the same time; we were immediately on opposite sides of the assisted dying debate, and we remain so. Although the Government are neutral, we have always articulated our concern around palliative and end-of-life care in many debates in this House. My hon. Friend has done a marvellous job of that today by bringing forward this debate. I also thank all my hon. Friend’s colleagues on the commission on palliative and end-of-life care for the vital work they do as they continue to develop their third report. We are really grateful to all those who work or volunteer in the palliative care and end-of-life sector for the care and support that they provide to patients, families and loved ones at a time when they need it the most. As my hon. Friend the Member for Cannock Chase (Josh Newbury) said, everyone deserves a good death. I commend the shadow Secretary of State for his contribution regarding his excellent experience in the sector; he made some really valuable comments. I have talked about this before, but I too come to this debate with experience. In 2008, I worked with clinicians around end of life and how to live and die with chronic obstructive pulmonary disease—a really unpleasant disease, if there is such a thing as a pleasant disease. I was made aware that people were talking about how to live with it, but no one was really responsible for working with patients and families on how to die with COPD. I learned a lot about how we talk about death and dying in the health service and the care service, as well as the great work that our trainers and people do to support our clinicians about how best to die. That was really valuable for me when my own father died at home in 2010, supported by Macmillan and a fantastic community care team, which happened partly due to the training that I had and how I was able to articulate on behalf of my family. Things should not have to be like they are. That was 16 years ago, and it is really concerning that across the country people are still experiencing such poor care. I see lots of that good care in my own local hospital, St Peter’s, which is doing some of the innovation that the shadow Secretary of State mentioned. I want to reassure colleagues that the Government and my hon. Friend the Minister for Care, who leads on this work, are absolutely committed to creating a society in which everyone receives high-quality, compassionate care from diagnosis through to the end of life. We have heard a lot about the role of hospices today, from my hon. Friends the Members for York Central, for St Helens South and Whiston (Ms Rimmer), for Birmingham Erdington (Paulette Hamilton), for Beckenham and Penge (Liam Conlon), for Cannock Chase, for West Dunbartonshire (Douglas McAllister) and for Bury St Edmunds and Stowmarket (Peter Prinsley), and from shadow Health Secretary, the right hon. Member for Daventry (Stuart Andrew). Although we recognise that the majority of palliative and end-of-life care is provided by NHS staff and services, we absolutely recognise that many hospitals do fantastic work in this area, and they face a challenging financial situation due to a range of pressures. That is why last year we announced that we would support the sector with a record £125 million capital funding boost for those hospitals in England, to help them to provide the best physical environment for the people they care for. That money can be spent on fixing a roof, paying for double glazing or buying a new boiler. Although I take the shadow Secretary of State’s point that sometimes people are more willing to contribute to those sorts of things, I know too that finding the money to fund such repairs is what keeps those running the system awake at night, and this work also saves money in the long run, particularly on energy bills. The full £125 million has now been allocated to 158 eligible hospices by Hospice UK. My hon. Friend the Minister for Care has been touring the country to visit many of those hospices to see at first hand some of the good that the money is doing. On top of that, we are providing around £80 million in revenue funding for children and young people’s hospitals over the next three years, as been said, giving them the stability they need to plan ahead—that was welcomed by the right hon. Member for New Forest East (Sir Julian Lewis). To reassure him, we absolutely recognise the different needs of children and their families in this work. A long-term commitment was a key demand from the sector, which faces a cliff edge in funding cycles every year. Children and young people’s hospices and integrated care boards have been informed of their allocations for the next financial year, and we intend to let hospices know about funding for future years once the process is complete. We absolutely recognise that this money will not be a silver bullet, and many hospices still face pressing challenges. The need for palliative care and end-of-life care is also projected to rise in coming years with our ageing population, as we have heard. However, although around 75% to 90% of those at end of life would benefit from palliative care and end-of-life care support, only about 55% are identified as such in primary care. That is why NHS England recently wrote to all ICBs requesting an immediate update on the financial stability of hospices in their footprint and the steps needed to mitigate those risks. That will give us a clear national picture of any hospitals at risk of closure or significant service reductions and the potential impact on patients’ families and the wider urgent care system. With regard to the wider system, neighbourhood health services and their development sit at the heart of our 10-year plan. We are building a service that will deliver more personalised care closer to where people live, empower people to lead healthier, independent lives where they can, and give them a genuine choice about how to access support. I want to reassure hon. Members that the NHS medium-term planning guidance identifies those at the end of life as a high-priority cohort in the implementation of neighbourhood health. I also say to my hon. Friend the Member for Newcastle upon Tyne East and Wallsend (Mary Glindon) that the workforce plan, when it comes forward, will reflect the move into neighbourhood services. We have to move away from disjointed pathways, as my hon. Friend the Member for Worcester (Tom Collins) articulated so well in speaking about his terrible experience with his mother, and ensure a paradigm shift that looks at people holistically throughout the pathway, as my hon. Friend the Member for Bury St Edmunds and Stowmarket said. I am the Minister responsible for reforms to the system architecture, and we are asking ICBs to do more. NHS England’s strategic commissioning framework makes it clear that we expect them to commission services in line with the current and future needs of the people they serve. We are moving away from ringfenced incentive budgets, and streamlining the incentives to focus more on the outcomes that we should all expect from our systems. Via the model ICB blueprint, we have made it clear that it is the mission of ICBs to reduce inequalities through a careful assessment of the quality, performance and productivity of existing provision. As we heard in today’s debate, we have to ensure that there are high standards and focused objectives. Next month, ICBs and NHS providers will create a new plan to more effectively manage the needs of high-priority people. NHS England is supporting commissioners to understand those needs, with a dashboard that brings together all relevant local data in one place. There is currently a contracting mix in the sector, as we have heard today. When we support ICBs to commission more strategically, we have to start moving away from the grant and block contract models. That is why the Government are developing a landmark palliative care and end-of-life modern service framework, or MSF, for England. Palliative and end-of-life care has been variable across the country for far too long, but the modern service framework will put a floor under the kind of care that patients can expect, as we heard from my hon. Friend the Member for City of Durham (Mary Kelly Foy). Although it would not be right to pre-empt exactly what will be in the final MSF at this time, we are working closely with all stakeholders to ensure that everyone has access to the care they need in the right place and at the right time. As part of the MSF, we have invited colleagues from a number of organisations to engage with us.

• 5 Mar 2026 · Palliative Care · Hansard source

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  I thank my hon. Friend for her contribution. This issue warrants a longer debate, so that we can understand how to move the resources that exist. As we have heard this afternoon, when people are unnecessarily admitted to hospital, which is terribly distressing for them and their families, the resources follow them. It is about moving those resources towards neighbourhood health services, in which this cohort of people will be absolutely central, as I have said. That is what we need to be doing, and we will continue to discuss this with people as we move the service towards being community-based. Colleagues are right to champion their cause in the House today, and we will continue to work on this issue to make sure that people have good-quality care across the country. Given the measures I have outlined this afternoon, I hope Members will agree that we are listening. We look forward to working with colleagues to make sure that we develop these services for the future.

• 5 Mar 2026 · Palliative Care · Hansard source

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  My hon. Friend pre-empts my next paragraph; I thank him for his contribution. As part of the development of the MSF, we will be looking at some of the important aspects of care that my hon. Friend the Member for York Central mentioned, such as early identification of need, care delivered closer to home by integrated generalist and specialist teams, and strengthened out-of-hours community health support, including a dedicated phone line. I assure the right hon. Member for New Forest East that children, parents and carers will be included in that endeavour. As my hon. Friend the Member for Chelsea and Fulham (Ben Coleman) said, the experiences of people like Amy inform such work. Let me say to my hon. Friend the Member for Alloa and Grangemouth (Brian Leishman) that the experience of Calum and the Turner family must not be repeated. Hospices do an amazing job for people at the end of life, those with life-limiting conditions, and the whole community of family and friends who support their loved ones on that journey, including through bereavement support, as we have talked about today. The quality of care, the compassion and the love that hospices provide are second to none. We absolutely recognise that the sector faces challenges, and we are determined to work with all our partners to understand those challenges. We are not talking about spending more; we are talking about focusing on the money we have at the moment and spending it better. We are developing a values-based, outcome-focused financial model to reflect people’s experience of care throughout their lifetime. While there are no easy answers, we are supporting them with record funding and reform.

• 4 Mar 2026 · NHS Capital Spending · Hansard source

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  No, I will not, because I want to get through my final comments. We put the new hospital programme on a sustainable footing. I understand that local people across the country were led up the garden path and told something was going to happen. I think we all recognise that the money was not there and that the programme was not on a sustainable footing. We have backed it with the appropriate investment, which is rising to £15 billion over each consecutive five-year wave from 2030, averaging £3 billion a year. The exact profiles of funding will be confirmed at future spending reviews, and that is weighted to ensure that the schemes profiled most are caught in that. We are progressing wave 1, and I will continue to liaise with hon. Members on progress. My message every week to any NHS trust, to any Member of Parliament, to NHS England and to the team running the new hospital programme is that we need to deliver these hospitals. There is a large queue behind them, and we have heard about some of them today. I also understand that a number of colleagues do not have a hospital being progressed in the scheme. The Government are keen to get on with building these hospitals. As hon. Members have said, a lot of this is about trust and commitment. I want hon. Members and anyone paying attention to know that I am clear about the importance of getting on with this programme, delivering on the ground and ensuring that the programme is robust. Finally, alongside increased capital funding, we are improving how that funding is managed. As we have heard, the old processes did not work: a local scheme went to the ICB, to the region, to NHS England, to the Department, to the Treasury and back again, with huge amounts of sign-off but no control or accountability, and with no one locally understanding what was happening. We are transforming that, bringing together a team and streamlining the process, ensuring it is well governed. That will ensure that things happen more quickly, and we are already seeing that. With underspends this year, we have got the money out and into schemes already in the system. We are getting more DEXA scanners. That is how we ensure this happens on the ground. It is up to ICBs to prioritise proposals, and we are working more closely with them to support them to bring things forward. I urge all hon. Members who have spoken today, including my hon. Friend the Member for Harrow West (Gareth Thomas), the hon. Member for Torbay (Steve Darling), my hon. Friend the Member for Rushcliffe (James Naish), the hon. Members for Taunton and Wellington (Gideon Amos), for Sutton and Cheam (Luke Taylor), for Eastbourne (Josh Babarinde) and for North Devon (Ian Roome), to keep working with their local systems on particular schemes. I am happy to keep talking to people. To the hon. Member for Taunton and Wellington, let me say that I have met NHS England about looking at maternity in the area, which I know is a huge concern, and I am happy to meet him. I will get back to the hon. Member for North Devon about some of the numbers he outlined, which are not familiar to me. On another point that was made, we are ensuring that we are building in contingency for the future, because we live in volatile times. Motion lapsed (Standing Order No . 10(6)).

• 4 Mar 2026 · NHS Capital Spending · Hansard source

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  It is a pleasure to serve under your chairmanship, Mr Western. I thank colleagues for their kind remarks about my hon. Friend the Member for West Lancashire (Ashley Dalton). We will miss her. She has set a great example, not only by continuing while undergoing cancer treatment but, as hon. Members have said, by recognising that sometimes we need to look after ourselves and prioritise our constituents. No doubt she will be doing that very well, and I look forward to her contributions from the Back Benches. I congratulate the hon. Member for Carshalton and Wallington (Bobby Dean) on securing this important and timely debate. I hope that my name came up occasionally when he was perusing previous debates on this issue, because I am one of the few Members of Parliament over the past 10 years who has banged on quite a lot about capital. I am delighted to be the Minister, because the sound management of that capital is absolutely crucial to the provision of healthcare for all our constituents. I agree that it does not get enough airtime, and the hon. Gentleman made an excellent speech outlining most of the issues. We have heard a lot of contributions today, and I will try to do justice to this very wide-ranging debate. Let me remind hon. Members of the problem. I have with me Lord Darzi’s report, which said: “The NHS has been starved of capital and the capital budget was repeatedly raided to plug holes in day-to-day spending…Some £4.3 billion was raided from capital budgets between 2014-2015 and 2018-2019”. It said: “The result has been crumbling buildings” and “services were disrupted at 13 hospitals a day in 2022-2023. The backlog maintenance bill now stands at more than £11.6 billion”. The report also said that the NHS was “in the foothills” of the digital transformation that the rest of the country—indeed, the rest of the world—was undergoing. There was also a shortfall in capital investment. I kind of admire the hon. Member for Hinckley and Bosworth (Dr Evans) for defending that situation—it is a tough gig—but we all see what happened in our constituencies. I am very proud of the capital investment under the last Labour Government, and I will come back to PFI in a moment. Reversing that trend and repairing and rebuilding our healthcare estate is a vital part of our ambition to create an NHS fit for the future. That is why we are prioritising the estate to support that task. First, we are prioritising core and safety technology equipment and—this is an important measure introduced by the Chancellor—changing the rules on capital to stop capital-revenue transfer. We are also incentivising the system and streamlining the processes; the hon. Member for Hinckley and Bosworth tells us how terrible the processes were, but his party was in government. We have taken control and used Government to good effect to start streamlining those processes. Part of that is about moving towards making one team of NHS England and the Department of Health—I hope hon. Members will support us in that. We are also building the capacity and capability of the staff in order to develop and do the work we need them to do. That capacity has been completely depleted over the last 14 years. We have put a lot of information into the system to move things quickly, and I think we are all seeing the benefits of that in our constituencies. We will bring forward a capital plan in the spring to make all of that clearer for the system and for hon. Members.

• 4 Mar 2026 · NHS Capital Spending · Hansard source

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  I will finish these points and answer some of the issues that have been raised. The first 120 neighbourhood health centres will be operational by 2030 and will, as we have heard, be delivered through a mixture of public and private partnerships. I thank the hon. Member for Carshalton and Wallington for being one of the few to acknowledge that that is difficult—there is some controversy around it—but I am a strong supporter of the previous local improvement finance trust schemes and of the scheme at Southmead hospital in my local area, which was one of the better PFI schemes, and delivered unprecedented levels of care to the people of Bristol, including myself. It is important that we learn the lessons of the past, and we absolutely have, including those in the NAO report. Working with NISTA, as has been outlined, we will continue to pursue this issue and bring forward cases. I do not want to rehearse the lack of funding for the new hospital programme.

• 4 Mar 2026 · NHS Capital Spending · Hansard source

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  The Chancellor has made her key decision to put us back on track, announcing in the Budget that capital health spending would increase by £15.2 billion by the end of the spending review period in 2029-30. [ Official Report, 16 March 2026; Vol. 782, c. 6WC.] (Correction) That funding will be used as intended; in previous years, as we heard, capital funding was diverted to cover day-to-day costs. We have tightened the Treasury rules; we have changed them, because that is what Government can do—who knew! As a result, capital funding will now be fully focused on repairing, upgrading and expanding NHS buildings and facilities to support long-term productivity. This settlement represents record levels of capital investment into healthcare, and it will support the three shifts set out in the 10-year health plan: moving care out of hospitals into the community, replacing outdated systems with modern digital services and focusing on preventing illness rather than just treating it. Of course, rebuilding NHS infrastructure cannot happen overnight. I assure hon. Members that the Government do understand that long-term certainty over capital funding is needed for the NHS to move from these short-term fixes to more strategic investment. That is another key decision made by the Chancellor. That is why, through the 2025 spending review, we have delivered a four-year capital health settlement, extending to 2029-30. That is backed by a further five years of certainty for estates maintenance funding. I am genuinely grateful to hon. Members for recognising that that is a massive change that we have engineered into the system, and I think we are all seeing the benefit. That change means there is a £30 billion commitment in capital funding over five years to support the day-to-day maintenance and repair of the estate, with a further five years of funding certainty, as set out in the 10-year plan. For the first time, NHS trusts have also been given multi-year operational capital allocations, with clear funding set out until 2029-30, and indicative funding for a further five years. This is an unprecedented opportunity for local health systems to plan with confidence over a nine-year period, and I continue to encourage all Members to engage with their integrated care boards, which will be prioritising schemes over that period. Within the £30 billion, the estates safety fund will continue, providing £6.75 billion of investment over the next nine years to target the most critical building repairs, alongside £2 billion to continue supporting NHS England’s RAAC programme across the spending review. Additionally, £21 billion in operational capital over the five-year spending review will empower NHS organisations to invest in local priorities, including hospital infrastructure. It will take time to build up capacity and capability, but this marks the beginning of our rebuilding of an NHS that is fit for the future. I also assure Members that this Government recognise the pressures faced across the system and are committed to bringing performance standards back to what patients expect. That is why we are investing to expand hospital and emergency care capacity, helping to reduce waiting times and improve care for patients. Over the next four years, there is £1.9 billion for urgent emergency care to support A&E departments, as well as to support ambulance services in reducing handover times. There is also £1.5 billion for diagnostics, including funding to expand the hours of community diagnostic centres, shifting care from hospital to the community. The hon. Member for Hinckley and Bosworth noted that those centres were started under the previous Government, but we have ensured they have expanded hours and that there are more of them. Crucially, they are not built as add-ons, but are fundamental to the pathways experienced by patients in the system and ensure we have good value for taxpayers’ money. There is £473 million for mental health services, including for people with learning disabilities and autism. I think we would all agree that the mental health estate needs recognition. There is more than £280 million for community care, supporting services closer to home, and more than £139 million for electives across the next two years. To move away from paper-based systems towards modern digital services, the autumn Budget confirmed £300 million in capital investment in technology, building on the combined revenue and capital investment announced at the spending review of up to £10 billion by 2028-29. We are transforming healthcare by shifting care out of hospitals and into the community. Over the next four years, we are investing more than £400 million to upgrade primary care buildings and deliver neighbourhood health centres, as part of our commitment to those 250 neighbourhood health centres through the rebuild programme.

• 3 Mar 2026 · North Middlesex Hospital Accident and Emergency Services: Cancer Patients · Hansard source

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  It is a pleasure to serve under your chairmanship, Dr Murrison. I thank my hon. Friend the Member for Edmonton and Winchmore Hill (Kate Osamor) for securing the debate. I echo her comments about Mrs Thorn in the light of her husband Jack’s experience. My hon. Friend has worked diligently on behalf of her constituent. We know that constituents should not have to take on such advocacy when they are suffering such trauma, but their experience is always valuable. Constituency MPs are always grateful to people who share their experiences, and my hon. Friend has done an excellent job on behalf of her constituent this morning. We are clear that every patient should be treated with dignity and respect. For far too long, NHS performance and practices have not met the high standards that patients should expect, which is why we are taking action to improve cancer pathways and urgent emergency care, to build an NHS that is fit for the future. On the treatment of cancer patients in A&E in particular, far too many cancer patients and their families have been failed by the NHS, with care lacking empathy and dignity. It is not right that patients, and particularly those with a cancer diagnosis, face distressing situations waiting for care in A&E. Through our recently published national cancer plan, which my hon. Friend alluded to, we commit to addressing poor experiences, driving earlier diagnosis and supporting general practitioners to spot cancer earlier through, for example, Jess’s rule and reducing inappropriate diagnosis in A&E. Jess’s rule is a patient-safety principle that requires GPs to reflect, review and rethink a patient’s diagnosis after three unresolved presentations, to reduce missed and delayed cancer diagnosis. My hon. Friend and I entered Parliament at the same time; she had experience in primary care and I had experience as a commissioner. She will be as shocked as I am, because in 2026 cancer patients should not be going through A&E when they are known to have a condition. We have been working on that for a very long time. Our plan will reduce the need for people who are undergoing cancer treatment to attend A&E—for example, through rapid access to a booked appointment in same-day emergency care. As my hon. Friend alluded to, we already see that in other trusts, such as the Whittington in her area. That should be standard, and is in many places. We recognise that some cancer patients will have more extensive needs. For those patients, we need to deliver an enhanced level of care during and after treatment, known as supportive oncology. This will include support for severe and sometimes sudden symptoms, when people need rapid access to the right care in their home or community. That will be key to getting those patients the support they need, and thereby reducing the need for them ever to attend A&E. It is vital to deliver compassionate care in the best setting for each patient. Our national cancer plan will redesign cancer services around people’s lives, not just around hospitals, recognising that more people are living longer with and beyond cancer and need ongoing co-ordinated support. That support will increasingly be delivered through neighbourhood services and be accessible digitally through the NHS app. We will ensure that patients have a named neighbourhood lead to help to co-ordinate their care locally, working alongside hospital specialists to provide continuity, reduce fragmentation and make it easier for people to navigate services, in my hon. Friend’s constituency and across the country. We will deliver greater use of virtual monitoring and growing opportunities for treatment and follow-up in community settings, where that is safe and appropriate. This will help to ensure that patients get high-quality support early, thereby reducing the crisis situations that my hon. Friend alluded to that currently drive unacceptable and unnecessary A&E visits. Where patients do need to attend A&E, we are committed to improving standards and returning to the waiting times set out in the NHS constitution. We have expert improvement teams providing tailored support to challenge trusts like the North Middlesex, and they have shown progress, as my hon. Friend has highlighted. I pay tribute to the work of leaders locally in improving the situation—they have made progress since last year. In addition, the NHS team in London recently agreed to a pilot for the oncology assessment unit, to proactively support cancer patients away from the emergency department, as my hon. Friend discussed. If she needs more detail on the final confirmation of that pilot, I will make sure she gets it in writing after the debate, because we do think that is an appropriate way to proceed. Nationally, we recently published guidance on the model emergency department, setting out the core principles and pathways for high-performing emergency departments. Our urgent and emergency care plan for 2025-26 sets out a clear path to strengthen urgent care outside hospital. We are using data from shared patient care records and digital tools to support better triage, join up services and anticipate pressures before they arise. That is backed by £2 billion of investment in NHS digital infrastructure. We are also investing £250 million to strengthen same-day emergency care and urgent treatment centre provision, helping systems to avoid unnecessary admissions for patients and supporting the same-day diagnosis, treatment and discharge of patients. The plan is working: A&E performance is improving and people are receiving their cancer diagnosis within a month. We do not underestimate how much more there is to do and how difficult it is for many patients at the North Middlesex hospital, as my hon. Friend has spoken about, and other places. We want to take the best to the rest. We know there is more to do, but the investment and modernisation along clear pathways are starting to make a difference, and the NHS is showing clear signs of recovery. The NHS is under pressure. The Government are taking decisive action through our urgent care emergency plan, the national cancer plan and our longer-term reforms. We are putting the service back on its feet and ensuring that patients receive the high-quality, timely care they deserve. I welcome my hon. Friend raising this issue on behalf of her constituents, and many other Members discussing the issues with me. I am happy to continue working with my hon. Friend and local NHS leaders on how we can further strengthen urgent emergency care services and the delivery of the cancer plan, to reduce the disparities and support patients to receive the right care in the right place. Question put and agreed to.

• 24 Feb 2026 · Menopause Diagnosis: London · Hansard source

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  My hon. Friend makes an excellent point that many of us will, unfortunately, recognise. We need to address variability in training, through the NHS health checks and training that is being rolled out by both the General Medical Council and the royal colleges. We need to go further. There are some great examples, both in London and across the country, of multidisciplinary teams helping with training for specialist services, and of initiatives like menopause cafés to support women. We need to take those best examples to the rest of the NHS.

• 24 Feb 2026 · Menopause Diagnosis: London · Hansard source

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  The hon. Gentleman makes an important point about supply and availability across the country, which is something we monitor regularly to ensure that if there is a shortage of a medicine in an area, there are alternatives available. We will continue to keep that under review, to ensure that women have the services and the medication that they need.

• 24 Feb 2026 · Menopause Diagnosis: London · Hansard source

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  It should not be so difficult for women to get a diagnosis for a condition that every single one of us goes through. That is why this Government took a landmark step forward by including menopause in the NHS health checks for the first time ever. It is assessed that this will benefit around 5 million women. We are going further next year, when menopause will be one of the first conditions treated through our revolutionary new digital hospital, NHS Online.

• 24 Feb 2026 · NHS: Private Finance Initiatives · Hansard source

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  The health PFI programme between 1992 and 2015 delivered 126 new acute facilities for the NHS, and over £12 billion of investment in the estate. NHS PFI contracts are held by individual trusts, and the National Infrastructure and Service Transformation Authority publishes annual data on them, including the costs of all those PFI projects. The last PFI contract was signed in 2015. We are not bringing back PFI; we are bringing forward a new public-private partnership model that will draw on lessons learned from the past, to ensure that we deliver the commitments of our 10-year plan.

• 24 Feb 2026 · NHS: Private Finance Initiatives · Hansard source

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  My hon. Friend highlights an important example, where something is clearly not going well. The Department is working with the team at Alder Hey to help rectify some of those problems. That is why we will not be using that PFI model in future. We have learned those lessons and we will take forward a new PPP model for our neighbourhood health service that will transform care for people in his constituency and across the country.

• 24 Feb 2026 · Topical Questions · Hansard source

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  I am happy to discuss that issue with my hon. Friend. We are determined to have co-located UTCs; I know that that is a matter for the local commissioner, but I am happy to talk about it further.

• 24 Feb 2026 · Topical Questions · Hansard source

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  My hon. Friend makes a really important point about how important DEXA scans are for osteoporosis, particularly for women. We have already expanded DEXA scans across the country this year; we have also allocated more capital funding for such capital investment, and we will announce the allocations in due course.

• 24 Feb 2026 · Topical Questions · Hansard source

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  My hon. Friend highlights an important point about the need to have further roll-outs of CDCs, particularly for communities such as hers. We are expanding those and expanding the time available for them. We are also expanding access through the front door through the NHS app and digital. Our new online hospital service will improve the sorts of issues that she mentions so that we bring services closer to her patients and do not expect them to have to travel.

• 24 Feb 2026 · Topical Questions · Hansard source

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  I understand the issues that the hon. Gentleman and many other Members, such as my hon. Friend the Member for Great Grimsby and Cleethorpes (Melanie Onn), have raised in Grimsby and the Lincolnshire area. It is important that the clinical mapping for their new services is supported by clinicians and local people, and I am happy to continue to talk to the hon. Member for Brigg and Immingham (Martin Vickers) and others about progress with that. I am in touch with the NHS England team, and it assures me that it is continuing to do that. I also understand the additional difficulties—

• 24 Feb 2026 · Ambulance Response Times · Hansard source

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  I commend the hon. Member for going out with her crews. One of the reasons we have been so successful this year in improving the services is by looking at things such as where ambulances are located and how they operationalise their services. We will continue to work with NHS England on the best model for local constituencies.

• 24 Feb 2026 · Ambulance Response Times · Hansard source

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  We now have ambulances arriving faster, but we know there is much more to do. We have taken action to reduce handover delays by introducing release-to-rescue 45-minute handovers, supporting ambulances back on to the road to respond to patients faster. We have invested in an extra 500 ambulances. I am pleased to announce that as a result of this Government’s investment and modernisation, West Midlands ambulances are reaching patients with conditions such as suspected heart attacks and strokes almost seven minutes faster this winter than last winter.

• 24 Feb 2026 · Ambulance Response Times · Hansard source

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  I commend my hon. Friend for visiting her ambulance service, as many hon. Members do, to understand the pressures they are working under. It is a useful visit to understand those wider issues, as she says. She raised an important point about handover delays impacting staff as well as patients. Reducing these delays will ensure that staff are no longer stuck outside emergency departments. On the wider issue about the front door, NHS England’s model emergency department will set out core principles and pathways for high-performing emergency departments, which will improve patient experience and flow with lower waiting times and less overcrowding. We are committed to improving rest facilities to support staff wellbeing.

• 11 Feb 2026 · Hughes Report: Second Anniversary · Hansard source

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  I am going to close by emphasising again that we are profoundly sorry, of course, for the enduring harm experienced by women affected by sodium valproate and pelvic mesh. Their pain, which we keep in our minds at all times, and the life-altering consequences they have suffered are truly heartbreaking. We recognise the immense toll, much of which we have heard about again today, that this has taken on them and their families. We have listened closely to calls for clarity, speed and decisive action on the report’s recommendations. To be very clear, we are committed to setting out our response at the earliest credible opportunity while ensuring that it is both robust and deliverable. I think that, as we have heard again today, Members here and people listening recognise the complexity of that. I assure those listening that my hon. Friend the Under-Secretary of State is determined to progress this matter, and he is willing to meet campaigners and discuss that in more detail, as Members have asked us to do today.

• 11 Feb 2026 · Hughes Report: Second Anniversary · Hansard source

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  I thank both Members for their comments. Experienced parliamentarians will know what I will be able to say. As my hon. Friend the Under-Secretary of State, the hon. Member for Glasgow South West, outlined in his letter, costs—I think that is what the hon. Member for Aberdeenshire North and Moray East was alluding to—are part of the overall consideration, along with the complexity, in the work that he is leading on behalf of the Department across all Government Departments.

• 11 Feb 2026 · Hughes Report: Second Anniversary · Hansard source

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  I want to address the main concerns and, as I said, the Under-Secretary of State is very keen to talk with Members and campaigners. We remain committed to working alongside Dr Hughes and her team to better support patients and ensure that steps are taken to prevent similar harm in the future, both in this area and across the wider patient safety landscape. That is obviously crucial. Many Members mentioned the importance of women’s voices being heard in this area, and many of us were involved in the campaign in the previous Parliament. We must make sure that women’s voices are better heard in the health system. As my hon. Friend the Member for Morecambe and Lunesdale (Lizzi Collinge) said, the campaigners are doing that, and I pay tribute, as she did, to In-FACT, as well as Sling the Mesh and the very many other patient groups that have raised this on behalf of women. They should not have to, but I commend their work. I assure Members and people listening to the debate that we remain committed to advancing this work across Government and to looking at lessons from any cases in which patient safety has been affected. I fully understand why colleagues are asking for an official response to the Hughes report here and now. It is important that we get it right, and we need to carefully consider all options and the associated costs before coming to a decision on the report’s specific recommendations. I am sure that many Members have seen the letter that my hon. Friend the Under-Secretary of State wrote to the Patient Safety Commissioner in November, and I reconfirm, as he wrote, that that work includes looking at the costs. We must take forward the lessons learned from this work—including, as the right hon. Member for New Forest East (Sir Julian Lewis) and my hon. Friend the Member for Ellesmere Port and Bromborough (Justin Madders) highlighted, work on similar areas—and the Government are doing that. We must ensure that our approach provides meaningful, often ongoing support to those who have been so profoundly affected. The Government have to consider options for financial redress collectively, with input from a number of Departments, and we started that work immediately. As was mentioned, the previous Government did not respond to the report when it was published, but we have picked up that work. Initially, Baroness Merron was the lead Minister, and it is now the Under-Secretary of State, my hon. Friend the Member for Glasgow South West. I assure the hon. Members for Strangford (Jim Shannon) and for Aberdeenshire North and Moray East (Seamus Logan) that my hon. Friend recently met the devolved Government Health Ministers to discuss their respective positions further. He will continue to do so across all devolved Government areas; as Members have said, patients there are affected too. We have to proceed with care to ensure the correct approach. We are committed to providing updates at the earliest opportunity, once all relevant advice and implications are considered.