Neil Shastri-Hurst MP: speeches

Speeches

• 25 Jun 2026 · Neuropsychiatric Conditions: PANS and PANDAS · Hansard source

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  It is a privilege to respond to the debate on behalf of His Majesty’s loyal Opposition. I pay tribute to the hon. Member for North East Fife (Wendy Chamberlain) for securing the debate and for setting out the landscape facing those with PANS/PANDAS in the UK, as well as recognising the lack of knowledge about the conditions and the challenge that presents. I thank her for her sustained work through the APPG on the issue. Many right hon. and hon. Members have contributed to the debate. The hon. Member for Carlisle (Ms Minns) spoke movingly about Joanne and Jake, who have been living with PANS/PANDAS for the past six years, and the challenges of not getting the treatment or the funding that they need. The hon. Member for Henley and Thame (Freddie van Mierlo) made a good point about how those affected do not want sympathy but action. He talked about the excellent campaigning by Albie, who is in the Gallery today, following his brother’s diagnosis—I suspect Albie’s handwriting is somewhat better than my doctor’s scrawl and I commend him on his campaigning. The hon. Member for Harlow (Chris Vince), who is always keen to speak up and champion issues on behalf of his constituents, spoke about the importance of guidance. My right hon. Friend the Member for New Forest East (Sir Julian Lewis) talked about the importance of the early use of antibiotics. Above all, I want to speak directly to the families and children who are following the debate and who live with PANS/PANDAS every day, some of whom are with us in the Gallery today. For them, this is not an abstract discussion about guidance, systems or clinical pathways; it is about the child they love, the moment something changed and the exhaustion of trying to explain that change to people who may never have heard of the condition before. It is about parents who overnight become advocates, researchers, case managers and campaigners, while simultaneously trying to hold their families together, and about the children and young people whose lives can be altered suddenly and terrifyingly. As we have heard, PANS/PANDAS sit at the intersection of neurology, psychiatry, immunology and infectious diseases. That matters because they do not fit neatly into one service, specialty, clinic or budget line. For the children affected, symptoms can be sudden and severe. They include obsessive-compulsive behaviours, restricted eating, tics, anxiety, behavioural change, sleep disturbance, regression, movement difficulties, school refusal and distress that can overwhelm the entire family. For some families, the story is stark. A child who was settled and sociable becomes frightened, withdrawn and unable to eat. A child who was thriving at school begins to struggle. Families find themselves moving from GPs to child and adolescent mental health services, from paediatrics to emergency departments, and from school meetings to safeguarding conversations, often without a clear pathway or a clinician who is able to say, “Do you know what? I recognise this, and this is what we need to do next.” The first task before us is to diagnose the problem honestly. The problem is not that every scientific question has been answered, because clearly it has not. There is uncertainty and professional disagreement, and there is a need for stronger evidence, better data and more research into diagnosis, treatment and long-term outcomes. However, uncertainty has too often translated into inconsistency. It has meant too many families left without a clear answer, too many clinicians left without guidance, too many schools unsure of how to respond and too many children caught between services. Each see part of the picture, but they do not see the child as a whole. At present, there is no official NHS clinical guidance for the diagnosis and treatment of PANS/PANDAS. NICE has previously concluded that the evidence was insufficient to provide useful guidance. The Government have said that data on the number of children affected is not currently collected, because internationally the criteria cannot be agreed. Local integrated care systems are expected to plan services, but they are asked to do so without consistent national direction, which risks variation. As we have heard, in reality variation leads to a postcode lottery. It means that one family may find an informed GP, paediatrician or neurologist, while another family is left scrambling for help. It means that one school may understand the sudden onset and fluctuating need, while another school sees only challenging behaviour. It means that one parent may feel believed, while another parent feels blamed. That is the difficulty at the heart of this debate. PANS/PANDAS cut across the way our systems are organised. The NHS is still too often structured around separate silos, whether it is mental health, neurology, infectious disease, immunology or paediatrics, but children living with these conditions do not arrive in neat administrative categories; their needs are complex, sudden and overlapping. That makes it hard for families to know where to turn, as well as for clinicians who want to help but may not have had the training to do so, and for schools that see a child’s behaviour change dramatically without understanding what is driving it. We must also be candid about the emotional difficulty. Parents can feel dismissed. They can feel treated as difficult or seen as overanxious when they are simply trying to explain what has happened to their child. No child should be left waiting for help because the system is unsure about where they fit. The previous Government did not solve this issue, but foundations were laid through the UK rare diseases framework, annual action plans and engagement with research, including with the APPG and the working group. The current Government have welcomed clinical guidance being developed by PANS PANDAS UK and have said that NICE will consider national guidance as evidence improves. They have also pointed to NIHR research and extended the rare diseases framework into 2027. Where the Government do the right thing, we should welcome it, but the question is whether those actions are sufficient. Do they need to go faster? Are they reaching the families on the ground? Families do not experience this as a framework, action plan or written answer; they experience it as the moment when a child refuses food, compulsions appear, school attendance collapses or a parent is told that a professional has never heard of the condition. If the problem is complexity, inconsistency and a lack of recognition, the solution must be equal in its seriousness. The foundations have been set, and now we must all go further. We need action on guidance. The clinical guidance being developed by PANS PANDAS UK and the PANS guideline development group brings together expertise from general practice, paediatrics, neurology, immunology, infectious diseases, psychiatry, psychology and nursing. I would be grateful if the Minister could set out how the Government will engage with that guidance once it is published. Will she commit to a clear process for assessing emerging evidence? We also need to take action on professional awareness. I recall reading about these conditions in Kumar & Clark when I was a medical student, but I do not recall receiving any formal training on them. It is not enough to ask our clinicians to be responsible for keeping their knowledge up to date; atypical, complex and contested conditions require practical support. As such, I ask the Minister to consider an awareness package for frontline professionals, developed in conjunction with clinicians, families and experts. We also need action on data and research—we need better data, diagnostic clarity, and research into treatment and long-term outcomes. With that in mind, I would appreciate the Minister setting out how the Government intend to support that work and encourage greater patient involvement. There is also a need for greater consistency across local systems. If support is left entirely to local discretion, care will depend on where a family lives or how hard they are able to fight for it. Clearer information on how suspected cases can be supported across specialties should be available to ICBs, and schools also have to be part of the answer. For many families, school is where the change is first noticed; better awareness of sudden onset and fluctuating symptoms could help ensure sensible attendance policies and flexible, rapid and responsive classroom adjustments. This debate should not be one that divides the House, but one that unites it. There will be different views on the evidence, on treatment and on guidance, but there should be no difference between us on the need for children to be seen, for families to be heard, for clinicians to be supported, and for care to be based on evidence, rather than the accident of geography. For families living with PANS/PANDAS, progress will be measured by whether the next family gets an earlier answer, whether the next child is believed sooner, whether the next GP has somewhere to turn, and whether the next school understands. That is a fair and compassionate standard, and it is the one that the Government should now meet.

• 15 Jun 2026 · Brain Cancer · Hansard source

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  I am very grateful to my hon. Friend for sharing Holly’s story, which sadly, is far too frequent. I remember from my time in clinical practice that those subtle signs were sadly sometimes missed. We need to do much more to ensure that our clinicians are aware of them so that they can make an early diagnosis. Of course, when those diagnoses arrive, it is inevitably devastating. It turns lives upside down in an instant. Parents are told that their child has a condition with few treatment options, husbands and wives are forced to confront an uncertain future and children become carers. Families who should be planning birthdays, holidays and life milestones instead find themselves navigating endless hospital corridors, scans and treatments. Behind every statistic is a person and behind every policy discussion is a family desperately hoping for more time. Today, I want to particularly recognise the courage of those families whose stories have been shared, often while living through the most unimaginable grief, so that others might one day have a better chance. I also want to pay tribute to the remarkable charities, researchers, clinicians and campaigners who have worked tirelessly to keep this issue on the national agenda: organisations such as the Brain Tumour Charity, Tessa Jowell Brain Cancer Mission, Brain Tumour Research, Cancer Research UK and countless others that have not only supported patients and families, but have driven forward research, awareness and innovation.

• 15 Jun 2026 · Brain Cancer · Hansard source

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  The hon. Gentleman is absolutely right. There are countless charities that have done a huge amount of work, and what they are doing is making a tangible difference to people’s lives. Sadly, brain tumours remain one of the most challenging forms of cancer. In many instances, outcomes are no better than when I worked as a doctor in neurosurgery almost a decade and a half ago. The less survivable cancers taskforce has highlighted that one-year survival rates for less survivable cancers, which include brain cancers, remain significantly lower than the average across all cancers. Despite advances in medicine, outcomes for many patients have not improved at the pace that we would all wish to see. That is why the concerns raised by the petitioners are so important. Quite rightly, the petition calls for greater investment in research, wider access to whole-genome sequencing and stronger support for innovative treatments. Those are priorities that cannot be ignored any longer. However, before I turn to those challenges, I want to take a moment to acknowledge the progress that has been made. The National Institute for Health and Care Research has established the brain tumour research consortium, which has brought together dozens of organisations to co-ordinate research and is backed by up to £25.5 million of investment. The recently enacted Rare Cancers Act 2026 represents another significant step forward, and I want to commend the hon. Member for Edinburgh South West (Dr Arthur) for his work in bringing that legislation on to the statute book. The establishment of the national speciality lead and a dedicated cancer registry service have the potential to improve co-ordination and data collection and strengthen research. The national cancer plan has recognised rare cancers as a priority area and committed to expanding successful models such as the Tessa Jowell Brain Cancer Mission. Those developments are of course all welcome. As His Majesty’s loyal Opposition, we supported the Rare Cancers Act throughout its passage through Parliament because we recognise that patients with rare cancers deserve the same urgency, focus and ambition as those with more common conditions. However, the reality is that legislation alone does not save lives; the real test is the effectiveness of its implementation. I would therefore be grateful if the Minister could update us on what progress has been made in establishing the new structures required under the Rare Cancers Act. In particular, has the national specialty lead been appointed? When will the rare cancer registry become fully operational? How will success be measured? Patients and families deserve to know when they will begin to see tangible benefits from the legislation that Parliament has passed. The petition also raised important questions about research participation and access to innovation. The Tessa Jowell Brain Cancer Mission highlighted that fewer than 5% of eligible adult brain tumour patients were able to access whole-genome sequencing because of limitations in tissue sampling and biobanking capacity, which is deeply concerning. Genome sequencing has enormous potential to improve the understanding of tumour biology, identify personalised treatment pathways and increase participation in clinical trials. However, opportunities remain unevenly distributed across the country. The Brain Tumour Charity has also highlighted significant variations in infrastructure and staffing across neuro-oncology centres.

• 15 Jun 2026 · Brain Cancer · Hansard source

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  The hon. Lady is absolutely right that when someone is facing a devastating crisis, but has to travel excessive distances to get the treatment they deserve, there is something wrong with the system. If we are serious about accelerating research, we must ensure that every patient has a fair opportunity to participate in it. That requires investment not only in laboratories and technology, but in a workforce that supports research and clinical innovation. What specific action are the Government taking to address those disparities and ensure that advances in research can benefit patients regardless of where they live? The petition also reflects a wider frustration felt by many families facing brain cancer. When conventional options are exhausted, patients understandably look to emerging treatments and clinical trials with hope. Such hope is entirely understandable, but at the same time we must maintain rigorous standards of safety and evidence. The challenge for us as policymakers is not choosing between innovation and safety; it is ensuring that innovation can be assessed, trialled and adopted as quickly as possible, when the evidence supports it. That is why clinical research capacity and trial recruitment matter so much, and it is why access to cutting-edge treatments must remain a key priority. On that point, the Government have committed to increase spending on branded medicines, and they have set out ambitious objectives for expanding participation in commercial clinical trials. Of course those ambitions are welcome, but they must be matched by delivery. The Office for Budget Responsibility has estimated that increasing spending on branded medicines will carry significant costs over the coming years, so can the Minister explain how the Government intend to fund those commitments? Patients need confidence that the announcements we hear today will be translated into treatments tomorrow. Similarly, while we welcome the publication of the national cancer plan earlier this year, questions remain about its implementation. The shadow Health and Social Care Secretary, my right hon. Friend the Member for Daventry (Stuart Andrew), supported the ambitions set out within the plan. However, he quite rightly called for clear, funded milestones, and those questions remain unanswered. When will the Government publish measurable targets for rare cancers, and how will progress be reported? For all the challenges that we have discussed today, it is important that we recognise the reasons for hope. Medical research continues to achieve what once seems impossible. Just a few years ago, diffuse intrinsic pontine glioma was regarded as one of the most devastating childhood brain cancers, with very few children surviving beyond two years. However, through participation in innovative clinical trials, a young boy from Belgium named Lucas Jemeljanova experienced something quite extraordinary. Having been diagnosed at six, he entered the trial and, over time, scans showed a shrinking tumour, which eventually disappeared altogether. Lucas is now 13, and he is considered cured. With every breakthrough that provides a scientific curiosity, the challenge before us as a Government, as an Opposition and as clinicians and researchers is to ensure that those breakthroughs happen more quickly and often, so that they can reach patients quicker. That is what the families behind this petition are seeking, and they deserve no less.

• 16 Apr 2026 · NHS Federated Data Platform · Hansard source

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  I was expecting a promotion there, Dame Siobhain. It is a pleasure to serve under your chairmanship. I congratulate the hon. Member for Newton Abbot (Martin Wrigley) on securing the debate. He has brought forward an issue that sits right at the centre of how we shape the future of our national health service: how we use data, who we trust with it and how we ensure that technology supports care rather than complicates it. The debate has been a thoughtful one, and in many respects it has been revealing. It has shown both the promise of the NHS federated data platform and the unease that still surrounds it. That tension really matters. I am grateful for the significant contributions we have heard from right hon. and hon. Members, with 13 coming from the Back Benches by my count. Let me start by setting out where I think there is common ground across the House. The NHS is under enormous pressure as demand is rising, complexity is increasing and waiting lists remain too high. Too often, clinicians are working without the full picture in front of them. Anyone who has spent time in the health service knows that this is not a system that lacks dedication. It is, however, a system that too often lacks coherence. Data is part of that problem as it is scattered, fragmented and difficult to use in a joined-up way. Records do not always reliably follow the patient, and information is duplicated, delayed or simply not available when it is needed most. The consequence of that is not just theoretical; it is time lost, inefficiencies and, at times, patients not getting the care they should when they should. The case for doing things better is a strong one; in fact, it is unavoidable. The FDP is one attempt to respond to that challenge. It seeks to bring together information in a way that allows the NHS to work more effectively, helping clinicians and supporting managers with the ultimate aim of improving care for patients. There are some early signs that this is beginning to deliver; waiting lists have been cleaned up, and some hospitals have reported better flow through theatres and wards. Those are practical improvements. As is so often the case in government, the easier question is whether something can work; the much harder question is whether it will be accepted. There are clearly concerns here. We have heard about reluctance in part of the workforce. I am not suggesting there is uniform opposition, but there is certainly hesitation and, in some cases, disengagement. We should be careful, however, not to exaggerate that. Big reforms in the NHS have always faced resistance, often at the start. This is not necessarily something new, and on its own it is not necessarily decisive. At the same time, however, it is not irrelevant; if the people expected to use this system do not have confidence in it, its impact will always be limited. Will the Minister say what is the assessment of staff engagement with the FDP and how the Government are ensuring that this is something done with the NHS, rather than done to it? In the end, that will make the real difference. The same issue arises with public trust. People are right to care about their medical data—it is sensitive, personal and deeply private. Once confidence is lost in this area, it is very difficult to rebuild it. There are important safeguards in place: the data remains under NHS control, the access is tightly regulated, and the provider does not own or use the data for its own purposes. The legal framework underpinning those safeguards is strong. Those are not minor points—they really matter. However, we also have to recognise something else. People are not just asking whether the system is safe today, but what it enables tomorrow. Could the data be combined in ways that reveal more than people expect? Could systems evolve in ways not originally intended? Could future Governments choose to use the capability in different ways? Those are not unreasonable questions; they are the natural questions people ask when large new systems are created. Again, I ask the Minister what more will be done to reassure the public about the limits of how NHS data can be used and whether he can set out clearly where parliamentary oversight comes in if the use of data is expanded in the future. Trust is not built by reassurance alone; it is built by clarity and restraint. A significant part of this debate has understandably focused on Palantir, and it is right that it has. Palantir is now a major supplier within the NHS data infrastructure as well as elsewhere across Government, and that raises legitimate questions about not just capability but dependence. For some the concern is political, while for others it is about principle. For many, though, it is something much more practical: what happens if we become too reliant on a single provider for something as critical as health data infrastructure? I think that is a fair question. However, we should also separate those questions from the broader argument about the company’s international work. In a global economy, companies will inevitably work with different Governments, and that alone is not a sufficient reason to exclude them from public contracts in the UK. The question of procurement design, competition and resilience, however, is a different matter.

• 16 Apr 2026 · NHS Federated Data Platform · Hansard source

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  If the hon. Gentleman will forgive me, I will not. I want the Minister to have sufficient time to respond to the multiple contributions there have been today. I ask the Minister the following questions. How are the Government ensuring that the NHS is not locked into a single supplier over the long term? What is the plan for maintaining genuine competition in this space? How easy would it be in practical terms to move to an alternative system if that was ever required? There is then the issue of resilience. Some have argued that the FDP creates a single point of failure, while others have argued that the current fragmented system is itself a weakness and that greater coherence improves security and oversight. Both arguments deserve to be taken seriously. But practical questions remain: how resilient is this system to cyber-attacks or technical failure? What safeguards are in place? What happens if something goes wrong at scale? The last matter I wish to address is that of governance. With the abolition of NHS England, there is now a question about where the responsibilities for the FDP properly sit. That matters because accountability cannot be diffuse. I take this opportunity to ask the Minister: who is responsible for the programme now, where does that accountability lie, and how will Parliament be able to scrutinise its performance going forward? Better use of data has a real role to play in NHS reform, and the FDP may well prove to be part of that answer. Success will depend on more than just delivery; it will depend on confidence within the system: confidence from clinicians that the system helps rather than hinders them, confidence from patients that their data is properly protected and confidence from the public that our decisions are transparent, proportionate and properly accountable. If those conditions are met, this reform can succeed. If they are not, even the best designed system will struggle. We, as His Majesty’s loyal Opposition, will support what improves care and welcome what works, but will continue to ask questions that ensure reform is done properly in a way that sustains public trust. I look forward to the Minister’s response.

• 24 Mar 2026 · Armed Forces Bill (First sitting) · Hansard source

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  It continues to be a pleasure to serve under your chairmanship, Mr Efford. I will confine my remarks to amendment 10, concerning the continuity of NHS secondary care services for the dependants of members of the armed forces. The amendment addresses an issue that has very real consequences for the health and wellbeing of service families, and therefore for the broader integrity of the commitment we make to those who have served and do serve. At the heart of this amendment lies a simple maxim: those who serve their country, and the families who support them, should not be placed at a disadvantage when accessing essential public services as a result of the demands placed upon them by service life. That principle is, of course, recognised in the armed forces covenant; the question is whether we are giving full and consistent effect to it in practice. The difficulty arises from a defining feature of military service: members of the armed forces are required to move. They are often asked to move frequently, often at short notice, sometimes across significant distances within the United Kingdom, and sometimes further afield. Those moves are not discretionary; they are intrinsic to the operational readiness and effective functioning of our armed forces. And when service personnel move, invariably their families move with them. That reality carries with it a number of challenges, but one of the most pressing, and one that is too often overlooked, is the disruption to ongoing medical treatment for their dependants. While primary care is generally able to accommodate patient movement with relative ease, the same cannot be said for secondary care. Hospital treatment, specialist pathways and waiting lists are typically organised on a regional or trust basis. When a family crosses those organisational boundaries, continuity is not guaranteed. The consequence, in too many cases, is that dependants find themselves required to re-enter the system. A child undergoing specialist treatment, a spouse awaiting elective surgery or a family member under the care of a consultant may be told that because they have moved into a new area, they must obtain a new referral, join a new waiting list and effectively begin the process again from the start. It is important to be clear about what that represents—not a clinical judgment or a decision taken in the interests of patient care, but an administrative consequence of the way services are structured and commissioned across different parts of the NHS. It is in effect a failure of co-ordination. For the individuals concerned, however, it has a much more significant impact. It can mean delayed diagnoses, prolonged pain, deterioration in conditions that require timely intervention, and significant anxiety for families already managing the pressures of service life. It can also undermine confidence in the system and create a perception, justified or otherwise, that service families are being treated less favourably. The amendment seeks to address that problem in a proportionate manner. It does not attempt to redesign the structure of the NHS—that would be a fool’s errand—nor does it impose a rigid requirement on how services should be delivered.

• 24 Mar 2026 · Armed Forces Bill (First sitting) · Hansard source

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  My right hon. Friend is absolutely right: this is about not only streamlining the process, but giving more heft to those who wield the power to ensure that we get improved patient outcomes at the end of it. That is what we should all be seeking. Ultimately, the question before us is very straightforward: are we content to allow a situation to persist in which service families can lose their place in the healthcare system simply because they are required to move in the course of service, or do we consider it reasonable to take targeted steps to prevent that outcome? In my view, the answer is clear. Where treatment has begun, it should continue. Where a place on a waiting list has been earned, it should be respected. Administrative boundaries should not dictate clinical outcomes. They certainly should not impose additional burdens on those who have little choice but to cross them. The amendment provides a measured and practical mechanism to achieve that objective. It respects the structure of the NHS, acknowledges the reality of devolution and focuses squarely on the removal of a specific and identifiable disadvantage. In doing so, it gives tangible effect to the principles of the covenant. It recognises that our obligations to service families are not merely symbolic; they require a practical expression in the design and operation of public services.

• 24 Mar 2026 · Armed Forces Bill (First sitting) · Hansard source

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  I beg to move amendment 10, in clause 2, page 6, line 37, at end insert— “343AZC Continuity of NHS secondary care services (1) Within six months of the passage of the Armed Forces Act 2026, the Secretary of State must by regulations make provision for the continuity of secondary care treatment for a person who— (a) is a dependent of a member of the regular or reserve forces who is receiving secondary care services from a health body in one part of the United Kingdom, and (b) becomes ordinarily resident in another part of the United Kingdom when the member of the armed forces to whom that person is dependent is posted. (2) The regulations must specify that the relevant health body must take reasonable steps to ensure that any course of secondary care treatment being provided to the dependent is appropriately transferred to an appropriate health body in the area to which the dependent relocates. (3) For the purposes of subsection (2), “appropriately transferred” means— (a) the dependent’s treatment or place on a treatment waiting list is maintained upon transfer of responsibility of care between health bodies, and (b) the dependent will not require a new referral form from a general practitioner or other primary care professional as a condition for continuation of treatment upon transfer of responsibility of care between health bodies. (4) Regulations under this section must include a requirement for a national authority to issue guidance on— (a) ‎the transfer of patient records, (b) the continuation of treatment pathways upon transfer of responsibility of care between health bodies, and (c) the preservation of waiting list placement upon transfer of responsibility of care between health bodies.” This amendment would require the Secretary of State to make provision for NHS secondary care services to be appropriately transferred where a person who is dependent on a member of the armed forces must become ordinarily resident in an area for which a different NHS body is responsible for care as a consequence of the member of the armed forces on whom they are dependent’s military posting.

• 17 Mar 2026 · Meningitis Outbreak · Hansard source

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  I know from my time in medicine that all those involved in combating this outbreak will be working at pace, and they have our utmost respect. However, there will be concern about the report in The Independent in the last hour or so that certain pharmacies in the region are running out of or running low on the menB vaccine. Will the Secretary of State commit to looking into that personally and ensure that we get a robust supply chain?

• 13 Jan 2026 · Emergency and Life-Saving Skills (Schools) · Hansard source

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  I beg to move, That leave be given to bring in a Bill to require the teaching in schools of skills relating to emergency situations, including life-saving skills; and for connected purposes. This Bill seeks to ensure that every child leaving school possesses the knowledge and skills to respond effectively in emergencies, including life-threatening situations. It is about equipping young people with capabilities that matter beyond the classroom—skills that can preserve life and, in certain circumstances, protect communities. Every year, thousands of people in England find themselves at the centre of sudden, chaotic emergencies, such as a child at the roadside following a road traffic collision, a victim of knife crime bleeding out, or a medical emergency unfolding while onlookers wait for an ambulance, watching as precious minutes slip away. All they want to do is help, but too many do not know how. Not infrequently, the question asked afterwards is not what went wrong, but why no one present knew what to do. Most emergencies do not happen in hospitals; they happen in our homes, on our streets and on our roadsides. It is in those first critical moments, before professional help arrives, that outcomes are often determined—not by advanced medicine, but by whether those present can recognise what is happening, act decisively, and summon help effectively. Evidence consistently shows that early recognition and rapid intervention save lives. Delay, confusion or failure to communicate accurately with the emergency services can be fatal, but despite this, our education system still leaves too much to chance. At present, whether a young person is taught how to recognise an emergency, to remain calm under pressure, to summon help accurately, or to apply basic lifesaving interventions depends largely on postcode, school discretion or family circumstance. Some pupils receive that knowledge, but many do not—there is simply no guarantee. That is not a criticism of our schools or our teachers, who already shoulder enormous responsibility; it is simply a recognition that we have not set a clear, national expectation that these skills matter. This Bill seeks to close that gap. The Bill is built around three core aims. The first is to ensure that pupils can recognise emergency situations quickly and accurately. The difference between an accident and an emergency is not always obvious, particularly under pressure, so training pupils to assess severity, identify immediate danger and understand when urgent action is required is foundational. Secondly, the Bill seeks to prioritise effective summoning of emergency assistance. Knowing how to contact the emergency services, what information to provide, how to remain calm, and how to follow instructions given by call handlers is not always instinctive; it must be taught. Clear communication saves time, and time saves lives. Thirdly, the Bill seeks to ensure pupils receive practical, hands-on instruction in the most critical lifesaving interventions, with particular emphasis on the management of catastrophic bleeding. Uncontrolled haemorrhage is one of the leading causes of preventable death in trauma. Pupils should learn how to identify severe bleeding, apply direct pressure, use tourniquets where appropriate, and act decisively to stabilise a casualty while prioritising their own safety. This should include formal “stop the bleed” training. These lifesaving skills are not, of course, confined to domestic accidents. In mass-casualty scenarios, such as terrorist-style attacks, the rapid recognition of danger, safe decision making and early bleeding control can save multiple lives before the emergency services arrive. What is equally important is that pupils should be trained to assess risk to themselves, to avoid secondary harm and to act only when it is safe to do so. It is not about encouraging recklessness, but fostering informed, disciplined action. The importance of that cannot be overstated. In emergencies, well-intentioned but untrained bystanders can inadvertently worsen outcomes or place themselves in danger. The training envisaged under this Bill should instil practical resilience: knowing when to act, how to act and when not to act. Evidence shows that repeated practice and realistic simulations significantly improve retention and the likelihood of effective intervention under pressure. The Bill’s objectives are reinforced by the work of such organisations as citizenAID, which has led the way in educating young people on safe responses to major incidents. CitizenAID was founded by two of my former bosses: Professor Sir Keith Porter and Major General Tim Hodgetts. I had the pleasure of hosting them for a drop-in event in Parliament last year. Its programmes demonstrate that pupils can learn to recognise threats, manage catastrophic bleeding, communicate effectively and act without panic. Its work shows that structured training builds competence and confidence, particularly in high-stress scenarios. This Bill is not about turning children into paramedics; it is not about overloading the curriculum; and it is not about replacing professional emergency services. It is about ensuring that every young person leaves school equipped with a core set of practical, age-appropriate skills: how to recognise an emergency, how to respond safely, how to communicate clearly with emergency services and, critically, how to provide basic lifesaving assistance until help arrives. Preparedness is not a niche concern, but a matter of resilience. One day, any one of us may depend not on a professional, but on a passer-by. That passer-by may be a young person standing there, willing and wanting to help, but uncertain what to do in the circumstances. That uncertainty is not inevitable. Importantly, this Bill does not propose radical change. Many countries already include emergency response skills within their education systems. Here, we teach elements of first aid and health and safety in different ways, but we lack consistency and the assurance that every child will receive that education. Concerns about pressure on the school curriculum are understandable, but the Bill does not require wholesale reform, nor does it impose excessive burdens. Training can be delivered through a combination of classroom teaching, practical workshops and simulations, all supported by qualified instructors, the emergency services and voluntary organisations. The focus must be on gaining those essential, high-impact skills. The intent behind the Bill reflects a broader societal responsibility. It is not about ideology; it simply recognises that preserving life is a fundamental public good. Pupils trained in these skills will carry them into their homes, their workplaces and their communities, thereby having a multiplier effect. In doing so, schools will contribute directly to national resilience and public safety. This Bill proposes clarity and coherence: a national expectation that lifesaving knowledge is a fundamental part of the curriculum, as much as literacy or numeracy, when it comes to preparing young people for the real world. International experience reinforces that argument. Countries that embed emergency response training in schools see higher levels of bystander intervention, improved survival rates and greater public confidence. It also reflects a broader truth that resilience begins long before a crisis occurs and is built through education, confidence and preparation. By equipping young people with these skills, we not only improve outcomes in emergencies, but foster responsibility, calm decision making and a willingness to act for others. This Bill is deliberately rooted in prevention rather than reaction, and in empowerment rather than fear. No legislation can prevent every tragedy, but we can ensure that when emergencies happen, as they inevitably will, the people closest are not left powerless. This Bill does not ask the House to make a dramatic leap in policy; it asks us to take a sensible, proportionate step to ensure that our education system reflects the realities of the world our young people will face. The hardest burden for any of us to carry is not that we tried and failed, but that a life was lost while we stood by, not through indifference, but through the absence of knowledge this House could have chosen to provide. Question put and agreed to. Ordered, That Dr Neil Shastri-Hurst, John Cooper, Lincoln Jopp, Charlie Dewhirst, Blake Stephenson, Bradley Thomas and Jim Shannon present the Bill. Dr Neil Shastri-Hurst accordingly presented the Bill. Bill read the First time; to be read a Second time on Friday 29 May, and to be printed (Bill 362).

• 17 Dec 2025 · National Insurance Contributions (Employer Pensions Contributions) Bill · Hansard source

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  It strikes me that it should not be particularly controversial that a Government should be encouraging people to save for their retirement, to take responsibility for their future and to feel secure in later life. Therefore, although we are dealing with a short Bill that appears to be purely procedural in nature, its practical consequences are profound, because it takes us in precisely the wrong direction. Beneath the layer of technical language lies a troubling choice. It is a choice to tax aspiration, penalise prudence and chip away at the very habits that ensure financial security in our later years. The Government have sought to assure us that this only affects high earners and that most will not be affected, but that is not how it will feel to the majority of people in the real world. One in five people—approximately 20%—rely on salary sacrifice. Those are people who are doing the right thing; they are choosing long-term security over short-term consumption. Yet under the Bill, to save means to pay more. That is not positive pension reform; it is a stealth national insurance rise, dressed up in the cloak of technicality. At a time when businesses are struggling under huge wage bills, regulatory uncertainty and sluggish growth, the Bill quietly imposes on them yet another burden. I remind Government Members that fairness cuts both ways. It is not fair to tell people to save for their future and then tax them more for doing so, it is not fair to talk of fiscal responsibility when penalising prudence, and it is not fair to build long-term public finances on short-term revenue grabs. There is a moral component to this, because women will be disproportionately affected. Many women, on returning from maternity leave, increase their contributions to cover for that career break. The proposals as drafted will result in those who plan responsibly being encumbered with higher additional national insurance charges.

• 15 Sept 2025 · Employment Rights Bill · Hansard source

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  I am grateful to have the opportunity to speak to two specific Lords amendments proposed in turn by Lord Burns and Lord Sharpe in the other place. While addressing different clauses, both amendments essentially come down to the same principle: defending fairness, transparency and democratic legitimacy against narrow sectional interests. On Lords amendment 61, in 2016, after long and at times fraught debate, Parliament reached a carefully constructed settlement on the question of trade union political funds. That settlement was not only fair and balanced but, crucially, was broadly accepted by all sides. The compromise was a simple one: it resulted in new members contributing to a union’s political fund only if that member gave their active, informed consent. In contrast, existing members were left untouched and, importantly, unions were required to remind all members annually of their right to change their decision. This is both a fair and a balanced settlement. It is not a carve-up; it is a genuine compromise. It respected both the collective strength of unions and the personal liberty of individuals. Yet what do we see now? We see a Government seeking to dismantle that settlement, and the result is a return to an era where consent was assumed and where individuals found themselves supporting causes they did not share simply because the rules made it cumbersome to say otherwise. That is not a positive reform; it is regression. In every walk of life—whether a subscription service, an insurance policy, or a mobile phone contract—the public quite properly expect clarity in respect of the terms they are committing to. Why should those standards of fairness be cast aside when it comes to political funds of unions closely bound to the governing party? Lords amendment 62 deals with the threshold for industrial action. Strikes have consequences. We have seen that only in the last week, with transport links across London brought to a standstill, commutes drastically prolonged, and the consequential significant disruption to people’s day-to-day lives. As a former doctor who, I should point out, did not go on strike in years gone by, I have seen at first hand the consequences of medics taking industrial action: operations cancelled; out-patient appointments postponed; and the provision of healthcare delayed. When the livelihoods and wellbeing of citizens up and down this country are so significantly impacted, it is neither unreasonable nor undesirable that such action rests upon a clear majority. The 50% threshold is precisely that safeguard. It serves as a clear assurance that industrial action has broad legitimacy and is not just the preserve of a militant minority. Yet this Government seek to sweep away that protection by voting down this very sensible and considered improvement to the legislation. Both these amendments remind us that democracy depends upon consent, transparency and legitimacy. Those values have been the bedrock of Britain for generations. It would be a poor bargain indeed if they were set aside to placate the financial and political interests of a narrow few.

• 2 Sept 2025 · Defibrillators · Hansard source

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  The hon. Member makes a really important point. The consequences of vandalism or damage to this equipment can be life-changing—it can end a life. The ramifications have to be clearly pointed out and reflected in the law of the land. Secondly, my hon. Friend the Member for Dumfries and Galloway (John Cooper) and I recently wrote to the Secretary of State for Transport about expanding education on lifesaving skills as part of driving tests, and we should also incorporate it more into the national curriculum. Will the Minister speak to her colleagues in the Department of Health and Social Care and the Department for Transport about ensuring that everybody in this country knows not only where a defib is but how to operate one, to enable lifesaving interventions as quickly as possible?

• 2 Sept 2025 · Defibrillators · Hansard source

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  It is a pleasure to serve under your chairmanship, Mr Stringer. I also congratulate the hon. Member for Bishop Auckland (Sam Rushworth) on securing this important debate, and I start by sending my condolences to George Smith’s family at this very difficult time. Many Members may know that, before coming to this place, I was both a doctor and a barrister. As a doctor, I worked predominantly in acute care, so I have seen the brutal speed with which cardiac arrest can lead to death. But as a barrister, I specialised in inquests and clinical negligence, and I also saw what happened when people did not get timely interventions, and the devastating consequences that arose. As many Members have set out, the stark reality is that every minute counts. Every minute reduces life expectancy by 10%. If someone gets prompt intervention, their survival rate can be as high as 70% if their defib is within 200 metres of their location. That is a three-to-five-minute brisk walk there and back. But the stark reality is that out-of-hospital arrests have a survival rate of less than one in 12. Compared with in-hospital arrests, the survival rate to discharge is in the region of 25%. That is why this was an important focus for me when I was elected to Parliament for Solihull West and Shirley. Despite the fact that my constituency has a mix of urban and semi-rural places, only 40.32% of our defibs are within the recommended distance and there are only seven public defibs per 10,000 people, which is well below the national recommendation. Across the United Kingdom, the per-population count for defibs is approximately five to 10 times lower than it is in a country such as Japan. That cannot be right in this day and age, which is why, for one of my office fundraisers this year, we all went and did the Solihull way. We walked 20-odd miles in the day, and raised money for two defibs and some bleed kits on behalf of a brilliant charity called the Daniel Baird Foundation. It was particularly moving to be able to donate one of those defibs to the Wave café in my constituency, where a valued member of the community had sadly died some months earlier because they did not have access to a defib. I am going to reiterate a couple of calls that have already been made to the Minister, who I know has been listening carefully. First, we should exempt defibs from VAT—it is ridiculous. For every five defibs that are currently bought, we could afford another if we got rid of VAT.