Stephen Kinnock MP: speeches 2025

Speeches

• 3 Jun 2025 · Dementia Care · Hansard source

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  I thank the hon. Member for South Devon (Caroline Voaden) for securing this debate, and I commend her for her work as a member of the all-party parliamentary group on dementia. It has been a thoughtful and constructive debate, with a number of truly powerful and moving personal contributions from Members across the Chamber. This is a cause that is close to my heart. I thank all Members for their kind words about my own family, but our history is far from unique. We know that one in two of us will be affected by dementia in our lifetime—by caring for someone with the condition, developing it ourselves, or both. It is predicted that just under 1.5 million people in England will be living with dementia by 2040. Each person, along with their loved ones and carers, has a unique journey and their own heartbreaking stories. On behalf of the Government, I thank everyone working to support people with dementia, as well as their friends, families and carers. This Government will back them every step of the way. We are also backing our scientists to deliver new treatments and ways to care for people living with dementia, and I recently had the pleasure of visiting the UK Dementia Research Institute’s centre for care and technology, where I saw some of its innovative smart-home tools. A timely diagnosis is vital to ensure that everyone can access the advice, information and support that can help them to live well with dementia and remain independent for as long as possible. This Government remain committed to the national ambition for two thirds of people living with dementia to receive a formal diagnosis. We are funding evidence-based improvement projects to pilot the diagnosing advanced dementia mandate in 14 trusts. I am delighted that best practice is currently being shared and promoted with regional and local partners, following an impact assessment of the pilots. Dementia can impact anyone, but there is varying and unequal access to health services. That is why the Office for Health Improvement and Disparities is working to make our country fairer by developing a tool that provides a clear assessment of population characteristics, such as rurality and socioeconomic deprivation.

• 3 Jun 2025 · Dementia Care · Hansard source

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  We are absolutely on the record with the 66.7% target. I want to take this opportunity to set out what appears to be a philosophical difference between this Government’s approach to our health and care system and that of many Opposition Members. We believe in devolution, we believe in decentralisation, and we believe in empowering those who are closest to the citizen to make the decisions that need to be made. If others have a more centralising and deeply anachronistic approach to managing our health and care system, which I heard from Liberal Democrat and Conservative Members, that is up to them, but we believe in modernising our system, not micromanaging or having shopping lists of targets. It is about providing support and agreeing on outcomes, but leaving those who are best placed at the coalface to decide how best to meet the unmet needs of their communities. That is a very clear dividing line between us. On research, it is worth pointing out that we have done studies with UK Research and Innovation, the Alzheimer’s Society and the People’s Postcode Lottery. We have found that through our investment, ADAPT and READ-OUT are working to produce clinical and economic data that could bring blood tests to the NHS within five years to support the diagnosis of dementia. All of this means that the rate of diagnosis is improving. The latest data from April shows that the diagnosis rate has inched up to 65.5%, up 0.3% since July 2024, and it is worth noting that the 66.7% ambition has not been met since 2020. The quality and availability of care services is variable, as Members have pointed out. We are empowering local leaders with the autonomy they need. We are supporting integrated care boards. I am pleased to say that we recently published the Dementia 100 pathway assessment tool, which brings together multiple resources into a single, consolidated training tool. That launched last month, and there has been huge interest and support from the sector, with 1,000 people registering to attend the launch webinar. We have the dementia care pathway full implementation guidance, and we are supporting the implementation of that guidance through a dashboard, to enable targeted support where it is needed. All those who have dementia deserve to receive high-quality care. We must have a workforce that is equipped with the skills that are needed. We are incredibly proud of everyone who works in the care sector, and they deserve the training that many Members have mentioned. The care workforce pathway provides guidance for progression and development for professionals across adult social care with the knowledge, skills, values and behaviours that our carers need. It links learning outcomes to existing frameworks, including the dementia training standards framework. Some of those learning outcomes can be achieved through the training and qualifications eligible for funding under the learning and development support scheme. That scheme, launched in September last year, supports adult social care employers to invest in their workforce through funded training opportunities, including a range of dementia-related qualifications. I am pleased to confirm that we have backed the scheme with a £12 million investment. Pay and conditions are also vital elements of our workforce strategy, so I am sure Members across the House will welcome our groundbreaking fair pay agreement legislation in the Employment Rights Bill for adult social care workers, which is hugely significant in this context. On the question of our care workforce, a number of Members have highlighted the vital role that unpaid carers play. To support them, on 7 April the Government increased the carer’s allowance weekly earnings limit from £151 a week to £196 a week, which is the equivalent of 16 hours at the national living wage—the largest increase in the earnings limit since the carer’s allowance was introduced in 1976. We are very proud of that change. I understand that every person with dementia, alongside their friends, families and carers, has their own unique and important story of living with dementia. I know that I am not alone in this fight. I want to pay tribute to the Alzheimer’s Society, Dementia UK and Alzheimer’s Research UK for all their vital work. Together, we will build a society where every person with dementia receives high-quality care from diagnosis through to the end of life. I once again thank the hon. Member for South Devon for raising this vital topic.

• 2 Jun 2025 · Draft Human Medicines (Amendments Relating to Hub and Spoke Dispensing etc.) Regulations 2025 · Hansard source

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  I beg to move, That this Committee has considered the draft Human Medicines (Amendments Relating to Hub and Spoke Dispensing etc.) Regulations 2025. It is a pleasure to serve under your chairship, Mr Stuart. These regulations amend the Medicines Act 1968 and the Human Medicines Regulations 2012 to enable hub and spoke dispensing for pharmacies and dispensing doctors that are not within the same legal entity. Pharmacies play a vital role in our healthcare system, ensuring that patients have access to medicines and acting as an easily accessible front door to our NHS. This Government recognise the importance of community pharmacies and are committed to supporting the sector. That is why we have increased the core contract for community pharmacy funding to £3.073 billion, with the deal representing the largest uplift in funding for any part of the NHS in 2025-26—over 19% across 2024-25 and 2025-26. Community pharmacies work hard for the NHS and the patients they serve. In England alone they dispense around 1.1 billion NHS medicines every year, and that number grows year on year. Dispensing of a medicine is not just handing out a package, but covers a number of processes: the receipt of a prescription; clinical and accuracy checks to ensure the prescribed medicine regime is suitable and safe for the patient; sourcing and buying the medicines on behalf of the NHS; the preparation, assembly and supply of medicines; and advising patients to ensure they know how and when to take the medicine. It is complex and important work. As the number of prescriptions rises, we need to support our pharmacists to focus on the provision of advice and support to patients in order to optimise their use of the medicines on which the NHS spends nearly £10 billion in primary care each and every year. That is why the Government have introduced these regulations to allow all pharmacies, should they choose, to make use of hub and spoke dispensing. In hub and spoke dispensing, the routine elements of dispensing—such as sourcing products, the preparation and assembly of medicines, and labelling—take place on a large scale in a hub pharmacy, separate from the pharmacy at which the prescription was handed in, which is the spoke. There are typically many spokes to one hub. Existing hubs often make use of automated processes to realise economies of scale and increased efficiencies. Not all pharmacy businesses are able to invest in their own hub, and businesses are currently not able to engage a hub that they do not own. The Government propose changes that would level the playing field in community pharmacy by enabling all pharmacies and dispensing doctors to use hub and spoke dispensing, if they choose. Hub and spoke arrangements already exist in the UK, but the 1968 Act restricts their use to community pharmacies that are part of the same legal entity. That has limited the use of hub and spoke arrangements to the larger pharmacy chains. The proposed changes to the 1968 Act and the 2012 regulations will remove that legal restriction and allow all pharmacies, including small independents and dispensing doctors, to utilise the arrangement as and when best suits them, levelling the playing field and cutting red tape. We propose to amend the 2012 regulations and the 1968 Act using the powers in the Medicines and Medical Devices Act 2021. The amendments go beyond simply removing the barrier that currently limits hub and spoke dispensing to pharmacies within the same legal entity, and they include additional elements to ensure the policy’s safe and effective implementation by putting in place provisions to ensure accountability, governance and transparency for patients. We propose to amend the 1968 Act to remove the restriction that prevents a medicine from being sold or supplied from a different pharmacy from the one at which it was dispensed, unless those pharmacies belong to the same legal entity, and to remove section 131 of the Act, which covers the definitions of wholesale dealing, retail sale and related expressions. The definitions of those terms will now be those found in the 2012 regulations to ensure clarity across the legislation. The proposed changes to the 2012 regulations create a new model of hub and spoke dispensing. They establish a framework for the sharing of patient information between the hub and the spokes and set the following criteria for the newly permitted arrangements. Both a hub and a spoke must be pharmacies registered with the pharmacy regulator. There must be written arrangements between any hub and spoke that must include a comprehensive statement about their responsibilities to ensure that each party is clear about the process and activities for which they are responsible. The medicine label must include the name and address only of the spoke so that patients know where to address any questions about their medicines. The spoke must conspicuously display a notice on its premises and its online presence about hub and spoke dispensing arrangements, where they are in use. The changes also establish an information gateway that includes conditions for lawful sharing of relevant patient data between the different legal entities that operate hub and spoke arrangements. There is potential for this model to increase patient safety. Evidence shows that, where businesses have implemented hub and spoke systems with tracking technology, automated systems in the hub have had a dispensing error rate six times lower than manual processes. During the consultation on the proposals in 2022, respondents shared evidence suggesting that the working environment in both the hub and the spoke can be calmer and more focused, reducing some of the stresses on our valued pharmacy workforce. Providing space and time at the spoke gives staff more time to deal with complex issues and carry out patient-facing work, including explaining to patients how to get the best outcomes from their prescribed medicines. All the amendments will come into force in October 2025. They will apply across the UK, and the timescale allows time for secondary legislation to be amended, as appropriate, across the four nations. It also gives the pharmacy sector time to explore the relevance of the new hub and spoke arrangement. I hope I have explained the rationale behind amending the 2012 regulations and the 1968 Act to enable hub and spoke dispensing arrangements across different legal entities. I commend the regulations to the Committee, and I hope hon. Members will join me in supporting them.

• 2 Jun 2025 · Draft Human Medicines (Amendments Relating to Hub and Spoke Dispensing etc.) Regulations 2025 · Hansard source

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  I will endeavour to answer all the questions that have been asked, but there may well be some that I am not able to. I will be more than happy to write to hon. Members accordingly. Let me say a word on the rationale for choosing model 1. The main driver was the view that the most important aspect is the interface between the pharmacist and the patient. We felt that the spoke-to-hub-to-spoke-to-patient model best ensured the connection, at high street level, between the pharmacist and the patient, whereas the spoke-to-hub-to-hub-to-patient model would somewhat cut the high street pharmacist out of the loop. That was a balanced judgment—it was not a slam dunk. That leads on to one of the questions asked by the hon. Member for Hinckley and Bosworth, which was about whether the Government are still open to looking at model 2. We certainly keep things under review, and we want to see how model 1 goes. If there is a feeling that it needs to be reviewed, we would be happy to do so. However, as things stand, we do not have any plans to do anything other than go with model 1, for the reason that I set out. The hon. Member also asked about further funding. We have set out a pretty substantial uplift— £3.073 billion—for the pharmacy sector. We are hopeful that that will go some way to easing the tremendous pressures that the sector is facing. We also feel that the hub and spoke model will drive productivity, which we hope will enable pharmacies to do more with less. That will be a good way to address some of the funding challenges. On recording data and where the data will be held, I will write to the hon. Member. I do not have that technical information to hand. On the incentives, we are clear that this is a flexible business arrangement. All we have said is that we need to see set out in writing how the relationship between the hub and the spoke will work. That is in the draft regulations. Letting that business relationship work with the greatest possible flexibility—rather than trying to micromanage it too much with incentives set from the centre—is the best way for it to work. As I say, however, every time we will want the assurance of a clear written relationship between the two. I thank my hon. Friend the Member for North Somerset for his kind words. I have absolutely welcomed his relentless lobbying during various Divisions over the past few months—I promise him that is the truth and nothing but the truth. On VAT status, however, I will dodge the question, because of course decisions on VAT are the responsibility of His Majesty’s Treasury. I strongly encourage him to ask his question of my ministerial colleagues in the Treasury. Finally, I thank the hon. Member for South Antrim for his engagement. We have had excellent engagement with his colleagues in the Northern Irish Government. He has my absolute, 100% assurance that we will continue that engagement and, given the time available, which I set out in my speech, we will ensure that all nations are able to take this legislation on board and make the necessary changes in a way that works for devolution and for the entire system across the UK. Question put and agreed to.

• 21 May 2025 · Parkinson’s Disease · Hansard source

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  My hon. Friend is absolutely right; our system could not survive without the amazing and heroic work of our unpaid carers. One of our Government’s actions that I am most proud of is the change to the carer’s allowance. We increased the number of hours for which a carer can work and still keep their carer’s allowance by raising the threshold from £151 to £196. I hope that is giving carers the flexibility that they need. Many carers want to work but it is immensely stressful for them to balance their working and caring responsibilities. I was very pleased that we could announce that change back in January, but my hon. Friend is absolutely right that there is a lot more that we can do. I am working with colleagues in DWP and the Department for Business and Trade to look at how we can do more as a Government for unpaid carers. My hon. Friend is absolutely right to pay tribute to them; they are the lifeblood of our care system. The consultation on our 10-year plan received over 190,000 responses, giving people with Parkinson’s and other conditions a voice in the future of healthcare. I want to conclude this debate by quoting just one of those voices—that of Winston, a former St John Ambulance worker from Lewisham. He said: “People don’t always see what’s happening to me, or what Parkinson’s looks like on me. They don’t see me early in the morning. They see me looking nice and managing the condition as best I can. But I have to deal with my own bubble sometimes, and it gets burst, and things go all over the place.” I am pleased that Winston is doing fantastically well and now sharing tips with people on how to improve their public speaking abilities. His words will resonate with anyone who has a long-term condition. Stories like his should remind us why we need a health service that sees the whole person, not just the condition, to give patients the dignity, care and respect that they deserve. I thank my hon. Friend the Member for Colne Valley again for securing this important debate, and I pay tribute to all Members for making it constructive and powerful. I look forward to working with Members on this matter.

• 21 May 2025 · Parkinson’s Disease · Hansard source

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  It is a great pleasure to serve under your chairship, Mr Stuart. I pay tribute to my hon. Friend the Member for Colne Valley (Paul Davies) for securing this important debate. He spoke with real passion and conviction, as did hon. Members from across the Chamber. I do not know whether we have a full house from Dorset, but we have the hon. Member for West Dorset (Edward Morello), my hon. Friend the Member for South Dorset (Lloyd Hatton) and the hon. Member for Mid Dorset and North Poole (Vikki Slade); it was great to hear their thoughts. We also heard from the hon. Member for Strangford (Jim Shannon), who spoke, as always, with great passion and conviction. This debate follows closely on the heels of the Backbench Business debate on Parkinson’s Awareness Month, which was led by my hon. Friend the Member for Dunfermline and Dollar (Graeme Downie). I thank the Members who have spoken in both debates. I pay tribute to the invaluable work of NHS clinicians, charities and care workers who spend every single day improving the lives of people with Parkinson’s disease. I am particularly encouraged by the Parky charter, which is raising public and professional awareness about the needs of the Parkinson’s community and the importance of timely diagnosis, comprehensive care and dignity for all people with Parkinson’s. Organisations that fight for patients, such as Parkinson’s UK, are at the heart of our policies for the NHS, which is broken but not beaten. We look forward to working with them to fix the foundations of the NHS and to make it work for people with Parkinson’s in Colne Valley, throughout Yorkshire and across the country. Parkinson’s disease can severely impact every aspect of a person’s daily life, as well as the lives of their family and unpaid carers. It can put people under immense strain, and they deserve additional support to help them live with the condition. Around 153,000 people live with Parkinson’s in the UK, and it is the fastest growing neurological condition in the world. About 16.5 million people in the UK, or one in six of the population, have a neurological condition, and 600,000 people are diagnosed with one each year. Together, neurological conditions cause around 140,000 deaths every year in the UK—one fifth of all deaths—and they are the leading cause of disability. In 2019, the NHS spent just under £4.5 billion on neurological conditions and they cost the UK economy £96 billion, so tackling them presents a real opportunity not just for the Government’s health mission but for our growth mission. We must face the fact that patients are facing significant challenges, including not enough people in the places we need them, and delays to treatment and care, with long waiting times. We also listen to patients who tell us that they have experienced a lack of information and support. We are acting to address those challenges, starting with our workforce. Parkinson’s nurses and neurologists are worth their weight in gold, and they are key to meeting patient demand. This summer, we will publish a refreshed long-term workforce plan, as a first step towards rebuilding our workforce over the next decade and treating patients on time again. We will ensure that the NHS has the right people, in the right places, with the right skills, to deliver the care that patients need when they need it. We will set out in black and white the numbers of doctors, nurses and other professionals who will be needed in five, 10 and 15 years’ time. Turning to waiting lists, the NHS constitution sets out that patients should start consultant-led treatment within a maximum of 18 weeks from referral for non-urgent conditions. At the start of the year, my right hon. and learned Friend the Prime Minister announced our elective reform plan, which sets out our approach to hitting that target by the end of this Parliament. We have already surpassed our manifesto pledge to deliver an extra 2 million elective appointments, seven months ahead of the deadline; we are now on 3 million appointments and counting. Many of those were appointments for treating Parkinson’s. I know that there may be some people with Parkinson’s watching the debate at home and shouting at their telly, “Well, I am still waiting for treatment.” Although waiting lists are coming down, and recently fell for six months in a row, they are still high. I completely understand why people who are still waiting feel frustrated. I say to them: we are throwing the proverbial kitchen sink at waiting lists, and we will not stop until you see and feel the results. The NHS has begun some important initiatives to improve its neurology services, including the neuroscience transformation programme, the Getting it Right First Time initiative, a strengthened clinical reference group and the appointment of a national clinical director for neurology. The NHS is focusing on improving patient experiences, addressing the disparities in care and ensuring that patients are given their medicines on time. The neuroscience transformation programme is focusing on faster diagnoses, better co-ordinated care and improved access to specialist services. At the at the recent Backbench Business debate—and, of course, in this debate—a number of hon. Members spoke about personal independence payment as an important way of helping people to cope with the extra living costs of a disability or health condition. I am sure all Members would agree that those who can work should work. However, I am happy to reassure colleagues that our “Pathways to Work” Green Paper will make sure that people with the most severe lifelong health conditions who cannot work will see their incomes protected. We are consulting on the Green Paper to hear how best we can support those impacted by our reforms. We continue to encourage research, which is advancing our understanding of Parkinson’s at breakneck speed, through targeted funding, infrastructure support and collaboration. For example, the UK Dementia Research Institute, sponsored by this Government, is partnering with Parkinson’s UK to establish a new £10 million research centre. The NIHR is supporting research that has discovered that eye scans can detect Parkinson’s disease up to seven years before symptoms appear, which helps people to receive treatment earlier and prepare themselves as best they can. Research also underpins the entire drug discovery and development process. Produodopa is a groundbreaking new treatment for Parkinson’s disease, particularly for patients with advanced disease and severe motor fluctuations. It is revolutionary because it provides a continuous 24-hour infusion of medication via a small pump, allowing more consistent symptom control. The NHS rolled it out in February last year. It has been shown to improve motor function and has proved its worth by significantly improving the quality of life for people with advanced Parkinson’s. At the debate on 1 May, many Members emphasised the importance of staying active. Indeed, there is strong scientific evidence that being physically active can help people to lead a healthier and happier life. For example, exercise can reduce the risk of major illnesses and lowers the risk of early death by up to a third. Our social prescribing programme is a key component of the NHS’s universal personalised care and a way for GPs or local agencies to refer people to a social prescribing link worker. Those workers give people time, focusing on what matters to them and taking a holistic approach to people’s health and wellbeing. They connect people to community groups and statutory services for practical and emotional support. Looking forward, we have committed to publishing a 10-year plan for health to shift the focus of our NHS from hospital to community, from analogue to digital and from treatment to prevention. In the meantime, we have taken steps towards those shifts through the home-based care pathway, which is providing comprehensive support and care for people with Parkinson’s in their own home, and through the NIHR project to test a non-invasive vibrational cueing system, helping people with Parkinson’s to maintain their walking as they go about their everyday lives.

• 19 May 2025 · Mental Health Bill [Lords] · Hansard source

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  It was truly a privilege to be in the Chamber this evening to hear so many moving, powerful and thoughtful contributions. It really was Parliament at its best, and it is an honour for me to close the debate. The Bill has been a long time coming. Patients, practitioners, campaigners and charities have all long awaited the introduction of this legislation and have played a hugely important role in getting the Bill to this point. I would like to put on record my thanks on behalf of the Government and pay testament to their commitment to change. I thank Members in both this House and the other place, including our brilliant and esteemed colleague Baroness Merron, for all their work. As the Bill started in the other place, it has already been through extensive detailed scrutiny under the eyes of peers, many of whom were there when the Act was last revisited in 2007—I am sure they will enjoy me reminding them of that. It is testament to the cross-party consensus that has so far underpinned the Bill that the debates were constructive and largely led to the betterment of the Bill. I trust that this collegiate spirit will now continue in this House, and I thank the Opposition and the Liberal Democrats for the constructive spirit in their approach to this debate. Every speech we heard sought to improve processes and outcomes for patients and their loved ones, and there is broad cross-party support for the overall ambitions of the Bill. However, some specific issues and queries were raised in the course of the debate that need addressing. Many hon. Members asked about our implementation plans, rightly stating that legislation is only as good as its application. Indeed, we know that community service provision is very far from where it needs to be—an issue that we intend to address alongside the implementation of the Bill. Our first priority after Royal Assent will therefore be to draft and consult on the code of practice. It is essential that we listen both to practitioners and to those with experience of the Act when we draw up the statutory guidance.

• 19 May 2025 · Mental Health Bill [Lords] · Hansard source

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  Of course, we have the Online Safety Act, and there are measures within that legislation that address this issue. However, my hon. Friend is absolutely right that it is time to crack on and deal with this deeply troubling issue. I pay tribute to her excellent work, and I hope she will continue to press Ofcom to do the right thing, and to do it rapidly. We know that implementation will take time, as the pre-legislative scrutiny Committee recognised. We estimate that it will take around 10 years to fully implement all Bill’s measures, due largely to the time needed to train specialised workforce groups, including second opinion appointed doctors and tribunal judges, and the need to ensure that the right community support is available for people with a learning disability and autistic people. This timeframe necessarily spans multiple spending reviews and multiple Parliaments, so I am limited in the detail I can give today about future spend and timelines. However, we have set out in the impact assessment what we think is required in both time and funding. We expect the process of drafting and consulting on the code of practice to take at least a year. Alongside the code, we will develop secondary legislation, which will be laid before Parliament. We have already published policy papers, which contain more information on some of the delegated powers in the Bill and provide an early indication of what will be set out in regulations. We will then need time to train the existing workforce on the new Act, regulations and code, which will likely be in 2026 and 2027. Although we will commence some clauses, such as on supervised discharge, two months after Royal Assent, the first major reforms, including clauses concerning grounds for detention—excluding the changes to part 2 for people with learning disability and autistic people—and nominated persons, are expected to follow the training in mid-2027. The timelines for later phases are inevitably less defined, but we will expand the workforce and improve community support with the aim of implementing the reforms increasing the frequency of mental health tribunals from 2030-31. These timelines are indicative, and we will iterate the plans as we get more certainty on future funding and wider workforce plans. The other issue that came up a lot is the treatment of people with autism and learning disabilities. Again, implementation should be well planned to ensure that the proposed legislative changes have the intended effect. The proposed changes to the detention criteria will be commenced only when strong community services are in place so that the alternatives to hospital care are robust. Members will understand that robust implementation plans are dependent on the final legislation that is passed and on future funding, which is subject to future spending reviews. However, local systems do not need to wait for legislative changes to come into force to begin putting in place the necessary community services for people with a learning disability and autistic people. There is renewed funding in 2025-26 within ICB baselines to continue improving community support provision for people with a learning disability and autistic people. We should recognise that the Bill is the result of the independent review commissioned by the now Baroness May of Maidenhead during her premiership. Many important contributions have also come from those with lived experience of the Act and their loved ones. It takes real courage to speak openly about those experiences and to channel pain into change. As my right hon. Friend the Health Secretary said in his opening speech, the Government have demonstrated their commitment to funding mental health properly, and that commitment has been translated into real, tangible delivery: the £150 million multi-year capital investment to improve mental health urgent and emergency care pathways; 600 new or expanded crisis alternative services nationally, including crisis cafés, safe havens and crisis houses, providing an alternative to A&E or psychiatric admission; £26 million in capital investment to open new mental health crisis assessment centres, which aim to provide accessible and responsive care for individuals in mental health crisis; and 8,500 more mental health workers. We are also committed to improving early intervention and shifting care to the community to support people to live well and thrive. We have committed to improve support for young people, with Young Futures hubs, making support workers more accessible to children. We are piloting in England the 24/7 neighbourhood mental health centre model, which builds on learning from international exemplars. It is a privilege to be leading this transformational legislation through the House. I know that, because it matters so much, many people will have views on what is needed to get it right, and I look forward to further debates in that constructive and improving spirit. I commend the Bill to the House. Question put and agreed to. Bill accordingly read a Second time. Mental Health Bill [ Lords ] (Programme) Motion made, and Question put forthwith (Standing Order No. 83A(7)), That the following provisions shall apply to the Mental Health Bill [ Lords ]: Committal (1) The Bill shall be committed to a Public Bill Committee. Proceedings in Public Bill Committee (2) Proceedings in the Public Bill Committee shall (so far as not previously concluded) be brought to a conclusion on Thursday 26 June 2025. (3)The Public Bill Committee shall have leave to sit twice on the first day on which it meets. Consideration and Third Reading (4) Proceedings on Consideration shall (so far as not previously concluded) be brought to a conclusion one hour before the moment of interruption on the day on which those proceedings are commenced. (5) Proceedings on Third Reading shall (so far as not previously concluded) be brought to a conclusion at the moment of interruption on that day. (6) Standing Order No. 83B (Programming committees) shall not apply to proceedings on Consideration and Third Reading. Other proceedings (7) Any other proceedings on the Bill may be programmed.— (Anna Turley.) Question agreed to. Mental Health Bill [ Lords ] (Money) King’s recommendation signified. Motion made, and Question put forthwith (Standing Order No. 52(1)(a)), That, for the purposes of any Act resulting from the Mental Health Bill [ Lords ], it is expedient to authorise the payment out of money provided by Parliament of any increase attributable to the Act in the sums payable under or by virtue of any other Act out of money so provided.— (Anna Turley.) Question agreed to.

• 19 May 2025 · Mental Health Bill [Lords] · Hansard source

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  We are already working to reduce inequalities under the Mental Health Act. The patient and carer race equality framework is now a contractual requirement for all providers of NHS-commissioned care. It will support trusts to improve their interaction with racialised and culturally diverse communities and improve governance, accountability and leadership on improving experience of care for those communities and drive concrete actions to reduce racial inequalities within mental health services. Given that our first priority after Royal Assent will be to draft and consult on the code of practice, it is essential that we listen both to practitioners and to those with experience of the Act when drawing up the statutory guidance that supports the Act’s application. We will therefore engage with people with lived experience, their families and carers, staff and professional groups, commissioners, providers and others to do this. The code will be laid before Parliament before final publication. Alongside the code, we will develop secondary legislation that will be laid before Parliament, subject to the parliamentary process as set out in the legislation. We have already published policy papers that set out more information on some of the delegated powers in the Bill and provide an early indication of what we intend to set out in regulations. We recognise the appetite to deliver after years of delay and the importance of parliamentary scrutiny and accountability in this crucial work. We have therefore committed to laying an annual written ministerial statement on progress, so that hon. Members will have ample opportunity to hold us to account for progress made and milestones achieved. We have covered a wide range of topics and questions this evening, and I will not be able to cover all of them in the time allocated to me. I will therefore limit my comments to two areas that have come up repeatedly, namely the implementation plan and the treatment of people with autism and learning disabilities.

• 16 May 2025 · Terminally Ill Adults (End of Life) Bill · Hansard source

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  The Government’s position on the relevant clause is that the panel has to be satisfied that the correct steps have been taken, and there is not evidence of the points that the right hon. and learned Gentleman has made. Our view is that the intended effect is already catered for in clause 15. Amendment 38 would exclude from being provided with assistance a person who is not already terminally ill, as defined under the Bill. The reference to “standard medical treatment” is unclear. This could cause further uncertainty around eligibility, given that treatment could be individually tailored to each patient and their needs. Amendment 81 would remove the requirement that any references to capacity in the Bill are to be read in accordance with the Mental Capacity Act 2005. That would effectively remove the definition of capacity in the Bill. In the absence of a new definition, the Mental Capacity Act may continue to apply by default. That would, of course, diverge from the familiar concepts in the Mental Capacity Act, which could create confusion for practitioners. The stated intention of amendment 14 is to exclude a person who would not otherwise meet the definition of “terminally ill” if the person meets that definition solely as a result of voluntarily stopping eating or drinking. Our assessment is that the amendment risks introducing uncertainty over a person’s eligibility for assistance under the Bill. However, the substantive question is a policy choice for Parliament. Recognising the intent of the amendment, we do not believe that it would render the Bill unworkable. Once again, I thank all hon. Members for their contributions. I hope that these observations have helped them in their consideration of the amendments that have been tabled.

• 16 May 2025 · Terminally Ill Adults (End of Life) Bill · Hansard source

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  I thank the right hon. Gentleman for that intervention. As I say, the Government do not take a position on the policy intent that my hon. Friend the Member for Spen Valley has set out. I would simply observe that if somebody has been in a home for a considerable period of time, that home is then considered to be their home. As such, any action to take them out of that home could engage article 8 of the ECHR, on the right to family life. I now turn to the procedure for receiving assistance under the Bill, including safeguards and protections. First, I will speak to the amendments that have been tabled by my hon. Friend the Member for Spen Valley with technical workability and drafting advice from the Government. Amendment 58 clarifies the duty on the Secretary of State to make through regulations provisions for training about reasonable adjustments and safeguards for autistic people and those with a learning disability. That remedies previously unclear wording in the Bill. Amendment 60 is required to make provision for circumstances where the independent doctor dies or, through illness, is unable or unwilling to act as the independent doctor. Amendments 67 and 68, tabled by my hon. Friend the Member for Spen Valley, clarify that an approved substance can be self-administered using a device should the individual be unable to self-administer without one. Amendment 91 gives effect to amendment 273, which was accepted in Committee, by ensuring that data will be recorded in the final statement to ensure coherence within the Bill. I turn now to the amendments tabled by other Members on the subject of procedure, safeguards and protections that the Government have assessed may create workability issues if voted into the Bill. New clause 7 would limit the number of times two doctors can be jointly involved in the assessment of a person seeking assisted dying to three times within a 12-month period. In situations where there is a limited pool of doctors in any geographical location or area of medicine, that could limit access to assisted dying and create inequalities in access. New clause 9 would require the co-ordinating doctor, independent doctor and assisted dying review panels to apply the criminal standard of proof that requires them to be satisfied beyond reasonable doubt. Cases considered by the panel are civil matters, and as such it would not be usual practice for the criminal standard of proof to be applied to their decision making—and it is a very high bar. The provision would also impose additional standards on the assessing doctor that fall outside the usual framework for medical decision making.

• 16 May 2025 · Terminally Ill Adults (End of Life) Bill · Hansard source

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  Clause 15 sets out the process that the panel must go through. It includes a right for the panel to request information and input from a range of potentially interested people. Clause 15(4)(d) appears already to cater for the intended effect of the amendment in the name of the right hon. and learned Member for Kenilworth and Southam (Sir Jeremy Wright).

• 16 May 2025 · Terminally Ill Adults (End of Life) Bill · Hansard source

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  Thank you, Mr Speaker, and I thank Members across the House for their excellent contributions to the debate. As Members will know, the Government remain neutral on the passage of the Bill, promoted by my hon. Friend the Member for Spen Valley (Kim Leadbeater), and on the principle of assisted dying, which we have always been clear is a decision for Parliament. I therefore begin by clarifying that I am speaking in today’s debate as the Minister responsible, jointly with my hon. and learned Friend the Member for Finchley and Golders Green (Sarah Sackman), for ensuring that the Bill, if passed, is effective, legally robust and workable. She and I were pleased to be members of the Bill Committee, again to provide advice on the workability and technical effectiveness of the Bill as it went through detailed line-by-line scrutiny. I will not, therefore, give a Government view on the merits of any individual amendments in terms of their policy intent, as defined by the Member who tabled them, as that is rightly a matter for the House to decide. I will instead focus my remarks on amendments that the Government deem to give rise to significant workability concerns, and those amendments that have been tabled by my hon. Friend the Member for Spen Valley with technical drafting support from the Government, which have been developed to ensure that the Bill is technically and legally workable. While I will not give an assessment of all the amendments tabled by other Members, I ask the House to note that they have not been drafted on the basis of advice or with technical drafting support from officials. Therefore, the Government are unable to confirm that those amendments are fully workable, effective or enforceable, though I acknowledge the point made by the hon. Member for Bexhill and Battle (Dr Mullan). I will begin with obligations, duties and protections for medical practitioners. New clause 10 and amendment 52, tabled by my hon. Friend the Member for Spen Valley, replace clause 28 and expand the safeguards to ensure that no person is under any duty to participate. The new clause also clarifies several functions where certain professions or persons are under no duty to participate, including social care workers, pharmacists or persons acting as a proxy or witness. Finally, it provides that certain functions cannot be opted out of—for example, the recording of matters in a personal medical record. New clause 11 and consequential amendments 64 and 65, also tabled by my hon. Friend, provide for the replacement of the co-ordinating or independent doctor where that doctor is unable or unwilling to continue to carry out their functions under the Bill, other than through illness or death. A number of amendments have been tabled in this area by other Members, and I shall briefly set out the Government’s analysis of them.

• 16 May 2025 · Terminally Ill Adults (End of Life) Bill · Hansard source

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  I thank the hon. Lady for her intervention. She may have noted the comment from the hon. Member for Bexhill and Battle: approximately 500 amendments were tabled in Committee, and approximately one third of them were accepted. There was a pretty robust process for looking at whether amendments were acceptable, and the Government were involved in commenting and advising on all of them.

• 16 May 2025 · Terminally Ill Adults (End of Life) Bill · Hansard source

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  I will make some progress, if I may. Amendment 87 would require the co-ordinating doctor to “take all reasonable steps” to establish whether a first declaration had previously been made, so it may slow down the process for accessing assisting dying. Amendment 45 would significantly impact the operability of the Bill. It would duplicate the role of the assisted dying review panel, and place an additional burden on the co-ordinating doctor to convene the clinical panel. It would also require additional NHS and social care resources, particularly palliative care consultants. That could slow down a person’s access to an assisted death, because there is no requirement on when the panel must be convened, and it could take some time to set up, given the demands on health and social care professionals. The amendment does not specify who is to be on the clinical panel in situations where the co-ordinating doctor is neither a GP nor a consultant. Similarly, there is no provision for whether the clinical panel is to make its decisions unanimously or by majority. Amendment 48 would require significant changes to the functions and focus of the bodies that are proposed to present arguments to the panel as to why a certificate of eligibility could not be granted. Where an official solicitor acts as an advocate to the court, their purpose is to assist the court on a difficult or novel point of law, not to perform an adversarial function. Similarly, there is no precedent for the Attorney General, His Majesty’s Procurator General or the Treasury Solicitor to intervene in a case in the way that is envisaged, as their roles are to act on behalf of, or provide advice to, the Government, and not to represent a specific argument. In the Government’s view, there are no existing public bodies that are well suited to undertaking this adversarial role.

• 16 May 2025 · Terminally Ill Adults (End of Life) Bill · Hansard source

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  As a Minister at the Dispatch Box, with the Government being neutral, I am not commenting on the policy intent of the Bill. What I am saying is that the new clause could create significant uncertainty. For example, it is not clear how the standard it introduces would interact with the definition of “terminal illness” set out in clause 2, which requires that a person’s death “can reasonably be expected within six months”, as it is not clear whether “reasonably be expected” fits within the balance of probabilities threshold or is beyond reasonable doubt. Amendment 101 would exclude any person with a learning disability, including people with Down syndrome, from a preliminary discussion about assisted dying unless they raise the subject themselves, irrespective of whether they would otherwise be eligible. That may be subject to challenge under various international agreements, including the United Nations convention on the rights of persons with disabilities and article 14 of the European convention on human rights, which prohibits disability discrimination. Amendment 102 would introduce a requirement that “the registered medical practitioner must ensure that the person has no remediable suicide risk factors which pose a significant risk to their life” before holding a preliminary discussion under clause 5. The terms “remediable suicide risk factors” and “a significant risk to their life” have not been defined, so the amendment may be difficult to operationalise.

• 16 May 2025 · Terminally Ill Adults (End of Life) Bill · Hansard source

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  I will give way one final time.

• 16 May 2025 · Terminally Ill Adults (End of Life) Bill · Hansard source

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  I will just make a little progress. Amendment 60 may similarly prevent access to an assisted death for those residing within a care home or hospice, if that care home or hospice decided it would not allow such assistance on its premises.

• 6 May 2025 · Topical Questions · Hansard source

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  After years of neglect, this Government have agreed with the sector a record uplift to £3.1 billion for 2025-26 for this vitally important front door to our NHS. We are also supporting pharmacies to operate more efficiently, including enabling hub and spoke dispensing between all pharmacies later this year. I am pleased to say that the legislation for that has been laid. What a contrast that is with the previous 14 years. I am also pleased to see that the National Pharmacy Association has withdrawn its view on taking collective action. We are moving in the right direction, but there is still a lot more to do.

• 6 May 2025 · Topical Questions · Hansard source

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  I pay tribute to my hon. Friend, who is a qualified physiotherapist, and who is right to refer to the value of community care. I would be happy to meet her to discuss the important issue that she has raised.

• 6 May 2025 · Topical Questions · Hansard source

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  As the hon. Lady knows, we now have a commitment to providing 700,000 more urgent dental appointments. Those who do not have an NHS dentist can call 111 and will be prioritised. We are very clear that every integrated care board has a target within those 700,000 appointments, and if they are not hitting that target, we will want to know why.

• 6 May 2025 · Topical Questions · Hansard source

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  I pay tribute to my hon. Friend for improving support for ADHD and recognise the valuable perspective that she brings through her lived experience. This Government inherited a broken NHS, with too many people facing long waits for an assessment. NHS England’s ADHD taskforce is looking at how support for people with ADHD can be improved. I look forward to reading its report, and I recently had a very productive meeting with the director of that taskforce.

• 6 May 2025 · Topical Questions · Hansard source

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  I give the hon. Member that assurance. We have been clear that every ICB has a target, and that was transparently published, and we will be monitoring it. I am holding regular meetings with officials to check that every single ICB is on track to hit those targets. If ICBs are not on track to hit those targets, we will want to know why.

• 6 May 2025 · Topical Questions · Hansard source

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  The Government have launched a scheme to provide 700,000 urgent dental appointments. There are 57,500 allocated to my hon. Friend’s integrated care board. He will know that ICBs are responsible for commissioning primary care services based on the needs of the population, but I know that he is a strong campaigner for his constituents. I understand that his dialogue with his ICB on this matter has been positive and constructive, and I am sure that he will continue to fly the flag.

• 6 May 2025 · Topical Questions · Hansard source

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  We have, in fact, relaxed the rules on ARRS so that a mental health worker can be employed by the PCN. My hon. Friend is absolutely right that that is an important part of stepping from hospital to community, but there is more we can do on that. We continue to do whatever we can to ensure that mental health and GP surgeries are actively integrating.