Neil Shastri-Hurst MP: speeches

Speeches

• 10 Sept 2026 · Vascular Sector Reform · Hansard source

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  It is a pleasure to serve under your chairmanship this afternoon, Dr Huq. As the hon. Member for Glasgow South West (Dr Ahmed)—I call him my hon. Friend—pointed out, I have a particular interest in this subject. It is a number of years since I held a licence to practise, but the debate has taken me back to clinical days. Even worse, it took me back to vivas for Royal College examinations—I am still a member and am proud to support that community. I start by thanking the hon. Member for Strangford (Jim Shannon) for securing this debate. I congratulate him and the APPG on vascular and venous disease on their work. As has been noted, vascular disease perhaps does not attract quite the same attention as cancer or heart disease. However, that does not make it any less serious. The consequences for patients can be extreme. We have heard about pain, loss of mobility, prolonged hospital stays and, in the worst cases, amputation. What makes this particularly frustrating is that a great deal of this harm is avoidable. The problems identified by the APPG are not especially complicated. There are delayed diagnosis and treatment, inconsistent referral pathways, variable access to specialist care and fragmented services. The result is that patients who might have retained their limb and their independence do not always do so. The APPG’s report therefore makes five fairly practical recommendations: the national foot attack pathway, with same-day or next-day triage; community-based foot protection services in every integrated care system; maximum waiting times for vascular assessment and revascularisation, with national reporting; commissioning that rewards outcomes rather than simply activity; and faster adoption of proven innovation. None of those propositions strikes me as particularly revolutionary. Indeed, much of the thinking behind them is not new. The “Getting it right first time” programme established under the previous Conservative Government produced a vascular surgery report in 2018, which recommended a hub-and-spoke model to improve early diagnosis, specialist decision making and timely intervention. The NHS long-term plan subsequently committed to universal access to multidisciplinary foot care teams. In 2022, NHS England introduced a two-year commissioning for quality and innovation scheme intended to encourage timely revascularisation for patients with chronic limb-threatening ischaemia. The Government have said that they welcome the APPG’s report. They have said that the Department of Health and Social Care and NHS England have engaged with stakeholders, and that recommendations will be considered as part of the cardiovascular disease modern service framework. That sounds encouraging, but there is a rather obvious difficulty: although it is welcome that the modern service framework, which was published in July, contains considerable material on cardiovascular disease, it contains no specific reference to vascular or venous disease. If the Government accept that vascular disease is an important part of the cardiovascular picture, why does their new modern service framework not specifically address it? If the answer is that the framework is intended to cover vascular disease through its wider approach to cardiovascular risk, that poses a second question: where precisely are the specific standards against which vascular services are to be judged? The APPG has given the Government some specific proposals, and it would be helpful if the Minister could tell us which of the five recommendations the Government accept and, perhaps more importantly, which they reject. The question then is who will deliver the services? The Government have embarked on a major reorganisation of the NHS, including the abolition of NHS England, and a substantial reduction in the size and cost of integrated care boards, with the Government saying that ICB budgets are to be reduced by 50%. How does the Minister expect ICBs to deliver these additional responsibilities at precisely the point when their budgets and staffing levels are being substantially reduced? Has his Department assessed the effect of those reductions on the commissioning of vascular care and foot protection services? I am far from opposed to reducing bureaucracy in the health service, but the test of any NHS reform has to come down to patient outcomes. I hope the Minister will also address the question of clinical leadership in this area. Currently, although there are clinicians with huge experience and expertise in the field, including vascular clinical leads for GIRFT, there is no national clinical director specifically responsible for vascular and venous disease. The Government have previously said that national clinical directors play an important role in policy development and implementation, which is right, but we know that the future role and responsibilities of national clinical directors are being reconsidered as part of NHS reorganisation. Could the Minister set out the Government’s position on future clinical leadership for vascular and venous disease after NHS England has been abolished? Will a clearly identified senior clinical voice continue to be responsible for that important area, and if not, who will have responsibility for ensuring that the specific recommendations on vascular care are implemented? It is helpful that the national vascular registry already collects data on major vascular procedures, including bypass surgery and major lower-limb amputations, and there has been some improvement in the proportion of vascular providers meeting the relevant CQUIN framework, but we need to be careful not to confuse the mere collection of data with improvements in care. Will the Government therefore introduce national maximum waiting times for vascular assessment and revascularisation? If they do not propose to do so, why not, and if they do, when will it take place? Returning to the national foot attack pathway proposal, the principle behind it seems difficult to argue with. Where a patient presents with a potentially serious foot problem, particularly in the context of diabetes or vascular disease, as we have heard, they should have a clear route to an appropriate specialist assessment. Will the Government commit to establishing such a pathway nationally? Will the Minister ensure that data on performance against that is published? The same principle applies to innovation. The NHS has no shortage of good ideas, but it has traditionally lacked a reliable mechanism for taking an idea that works in one hospital and making it available elsewhere. Therefore, the APPG’s recommendation to make greater use of mechanisms such as the NHS innovator passport is sensible. However, what happens at the other end? If a technology is demonstrated to be clinically effective and cost-effective, does an NHS organisation have an obligation to consider adopting it? How will the Government prevent another postcode lottery, where an effective treatment is available to patients in one part of the country but not in another? In this debate, there is not much disagreement on the broad objectives: we all want to see earlier diagnosis, faster treatment and fewer amputations, as well as better use of NHS resources. Any disagreement is about whether the Government have set out a sufficiently specific plan for achieving those objectives. It is easy to welcome a report or publish a framework; it is much harder to deliver it. The Government have a genuine opportunity to take the practical recommendations of the APPG and turn them into measurable outcomes. That is the test: will they do that, or will they just allow vascular services and vascular disease to remain a subsidiary issue within the much broader context of cardiovascular disease and hope that local services are simply able to deal with it?

• 7 Sept 2026 · Surrogacy Law and Legal Parenthood · Hansard source

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  It is a pleasure to serve under your chairmanship this afternoon, Mr Pritchard. I start by declaring an interest in this debate as a former member of the appeals panel of the Human Fertilisation and Embryology Authority. I pay tribute to the hon. Member for Lichfield (Dave Robertson) for the tone in which he opened the debate, and I recognise the more than 113,000 people who have signed this petition. Behind many of their signatures will be personal experience of infertility and loss, and a long-held wish to start a family. For intended parents, surrogacy is not simply a legal process; it is about getting a family they never thought they could have, and in many cases, it comes at the end of a long and difficult journey. Nobody doubts the love that such parents have for their children. Families formed through surrogacy deserve dignity, certainty and respect. However, our job in this House is to consider more than the wishes of the adults involved. We must speak for the child who cannot speak for themselves. We must also protect the woman who carries and gives birth to that child. The issue for us to consider is whether legal parenthood should pass automatically at birth, before the state has considered the child’s welfare, the surrogate mother’s consent and the circumstances in which the arrangement was made. As a starting-point, any reform to the legislation must do three things: first, and most importantly, it must protect the child; secondly, it must preserve the free and continuing consent of the woman who gives birth; and thirdly, it must address the safeguarding concerns arising from the increase in international commercial surrogacy. First, on protecting the child, the petition describes the upset and strain of months of court proceedings and visits from social services workers before the intended parents are legally recognised. I understand why that process might feel intrusive and unsettling. Intended parents have planned for the child and cared for them from birth, and already see themselves as a family. However, a parental order is not merely words on a piece of paper; it is the legal means by which parenthood is transferred from one person to another. That is a serious act, with lifelong consequences for the child. The process, as it currently stands, allows a court to consider the child’s welfare, establish that the surrogate mother has freely consented, examine any payments that have been made either through expenses or cash, and consider the circumstances in which the child will be raised. CAFCASS provides an independent assessment, so that the decision is not based only on what the adults expected or agreed before the child was born. It is argued by some people that those checks are unnecessary because the overwhelming majority of applications are approved. I simply do not accept that. The fact that a system usually finds that everything is in order does not mean that the checks serve no purpose at all. Their existence helps to ensure that proper standards are followed. If the process is too cumbersome, it should be made more intuitive; if families receive inconsistent advice, that advice should be made clearer; and if the courts or CAFCASS lack the resources to deal with applications promptly, the Government should address that. Delays should be reduced, but that does not warrant the underlying protections’ being diminished. I ask the Minister whether the Government remain committed to the parental order process, and what they will do to reduce unnecessary delays while retaining independent welfare assessments. My second point concerns the woman who gives birth. Under the present law, the woman who carries and gives birth to a child is the child’s legal mother. Legal parenthood is transferred only after she has given valid consent following the birth. It would be ill-judged to dismiss that as an outdated legal technicality, as it recognises the physical, medical and emotional consequences of pregnancy and childbirth. The law normally prevents consent from being given until six weeks after the child is born. That period of time is necessary: a decision made before childbirth cannot fully account for the experience of giving birth, the mother’s health afterwards or how she may feel when the child is born. If intended parents became legal parents automatically, that protection would be reversed. The woman who carried and delivered the child would instead have to take legal action if she wished to withdraw her consent or assert her own rights. That should concern us all, particularly where there is a financial or social imbalance between the surrogate mother and the intended parents. A system that depends on someone’s having the knowledge, confidence and money to begin legal proceedings may offer very little protection in practice. Compassion for intended parents cannot require Parliament to treat the woman who gives birth as a temporary party to somebody else’s story, nor should this be presented as a contest between traditional and modern families. Recognising different kinds of family does not require us to reduce the rights of the woman who carries the child. If the Government are considering recognising intended parents from birth, I ask the Minister to set out what protection would remain for a surrogate mother who changed her mind after giving birth. The third issue is of growing concern: the increase in international commercial surrogacy. The majority of parental order applications now concern children born overseas. Applications relating to children born internationally reportedly rose from 215 in 2021 to 509 in 2025; in that same year, there were 150 applications relating to children born in the United Kingdom. That marks a significant change in surrogacy in this country. International arrangements may involve large differences in wealth and power, commercial contracts that would not be enforceable here, complicated payment arrangements made through intermediaries and serious doubts about whether consent was properly informed and freely given.

• 14 Jul 2026 · Business of the House · Hansard source

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  I am normally a temperate man, but this is a farcical situation. I have huge respect for the Leader of the House, but I suspect that he has come here with gritted teeth, because the reality is that our constituents want to hear from the new Prime Minister. In fact, the Leader of the House has given a compelling reason for Parliament to sit for a further day next week. If the situation in the middle east is as precarious as he suggests, and if there are challenges facing our country, for us to have a Prime Minister who was elected not by the majority of this country but by one constituency, on a mandate that he has not set out, and through a leadership contest that has had no scrutiny whatsoever, is an affront to democracy.

• 9 Jul 2026 · Lobular Breast Cancer: Moon Shot Project · Hansard source

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  It is a pleasure to serve under your chairmanship today, Mrs Hobhouse. I am grateful to the hon. Member for Horsham (John Milne) for securing today’s debate, and to the Members from across the House who have given their voice to this campaign over a number of years. It is entirely right that Parliament should pause today to consider not just the science, the policy and the funding, but the human reality that sits behind all three of those things. Behind the words “lobular breast cancer” are people who knew something was wrong, but the system could not prove it. That is the point at the heart of today’s debate. This is not a call for special treatment or a demand that we place one cancer above another; it is a recognition that different cancers behave differently, present differently and may require different approaches if we are serious about improving outcomes. Today, we are also remembering Dr Susan Michaelis. Many people in public life are described as courageous, but in Susan’s case that word feels insufficient. She was, as we have heard, a commercial pilot, a researcher, a campaigner, a wife and a woman whose instinct, when faced with injustice or uncertainty, was not to turn away from it but to investigate it. She had already devoted much of her professional life to public safety, particularly in the aviation sector. We have heard about how she challenged assumptions, gathered evidence and pursued truth in an area where the consequences mattered for passengers, crews and the wider public. In 2013, she received her devastating diagnosis of invasive lobular breast cancer. As we have heard today, her symptoms were not dramatic; they presented as just a tiny mark on her breast. Two mammograms and two ultrasounds failed to identify the disease, and it was ultimately identified by an MRI scan. We have heard how that revealed what appeared to be a relatively small lesion of about inch that was later confirmed to be over 7 cm. That single account tells us why this debate continues to matter and shows the particular challenge of a cancer that can be harder to detect through standard imaging. Remarkably, Susan did not live her final years in retreat from the world; she continued with her work and her research, and continued campaigning. As we have heard, nine days before her death, she travelled to Manchester to help launch the scientific programme for the lobular breast cancer Moon Shot Project, knowing full well that any breakthrough would come too late for her. That is an extraordinary act of generosity and a challenge to all of us in this place. If someone is living with advanced cancer and can spend her final days and the last of her strength ask for progress for others, surely it is our responsibility and Government to find the clarity and urgency to respond. As we have heard, lobular breast cancer is not rare. It is the second most common type of breast cancer, accounting for around 15% of cases, but despite that it too often remains hidden in plain sight.

• 8 Jul 2026 · Rearmament and Warfighting Readiness · Hansard source

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  I refer Members to my entries in the Register of Members’ Financial Interests, in particular my participation in a parliamentary delegation to Ukraine in February with the UK friends of the armed forces. [ Official Report , 14 July 2026; Vol. 789, c. 12WC.] (Correction) I want to build on some of the arguments made by the hon. Member for Dunfermline and Dollar (Graeme Downie). As I sat here listening to this thoughtful and valuable debate, the issue that really struck me above anything else was that, in many ways, we are preaching to the converted in this Chamber. Those of us who are here recognise the seriousness of the moment—we understand that defence is not an optional extra and that it cannot wait for a more convenient fiscal moment—but our responsibility goes much further than this Chamber, of course. Our responsibility is to the British public, and that means telling them the truth. As we have heard repeatedly during the course of today, the truth is that the world has changed and the threats are very real. For far too long, we have risked treating defence as something done by someone else—something done by sailors under the waves, soldiers on distant deployments and pilots in the skies. However, modern deterrence asks us to do much more individually. It also requires government to be honest, and the public to understand what is really at stake. As we have heard, the Government have clearly set out that Russia could be in a position to attack a NATO ally by as early as the end of this decade. The Chief of the Defence Staff has warned that we are not as ready as we need to be, and the noble Lord Robertson, a distinguished former Secretary-General of NATO, has gone even further; he has been really blunt in his assessment that we are simply not ready. Those are the judgments of people who have spent their entire lives defending our country. We must not treat the British public like children. They do not need comforting slogans; they need searing honesty from people in public office. We cannot set out a case in which we say to them that Russia is probing our waters and hostile states are targeting our energy networks, satellites and cyber-systems, and then suggest that the answer to those dangers is promises that begin in the next decade. Quite simply, we cannot describe a 2030 threat and offer a 2035 solution. I believe that is the weakness at the heart of the Government’s approach to date. Readiness is not simply about owning equipment. It is about having the people trained to use it, having the stockpiles behind it, and having reservists who are able to mobilise. It is about factories that can surge, ports that can receive and energy systems that can endure. A nation is not ready simply because a Minister declares that it is ready. A nation is ready when the whole system is ready to row in behind it, and the reality is that national security requires choices, discipline and—we have to be blunt—sacrifices. For the past 30 years or so, we enjoyed a peace dividend, and too often we behaved as though that would never end, but we forgot the simple truth that freedom is never free; there is always a cost to be paid. It is a different cost depending on the generation, and each has to deal with it in different ways. Our duty is to ensure that this generation pays in preparedness so that the next generation does not pay in blood. The British people will understand that if we level with them, which is why the arguments for spending 3% of GDP on defence in this Parliament are not an extravagant ambition, but the bare minimum response to what is a deteriorating world. Britain is not a weak nation. We possess one of the most extraordinary armed forces in the world; we have outstanding intelligence services, world-class scientists and engineers, and above all, a people who have never failed this country when they have been told the truth. Therefore, if we want to defend the peace that we so cherish, we cannot have a resilience that starts after the crisis has begun. It is perhaps worth ending by remembering that the cost of preparedness will always be far less than the cost of war itself.