Westminster Hall
Westminster Hall is an alternative Chamber for MPs to hold debates, named after the adjoining Westminster Hall.
Each debate is chaired by an MP from the Panel of Chairs, rather than the Speaker or Deputy Speaker. A Government Minister will give the final speech, and no votes may be called on the debate topic.
This information is provided by Parallel Parliament and does not comprise part of the offical record
Backbench Business
Westminster Hall is an alternative Chamber for MPs to hold debates, named after the adjoining Westminster Hall.
Each debate is chaired by an MP from the Panel of Chairs, rather than the Speaker or Deputy Speaker. A Government Minister will give the final speech, and no votes may be called on the debate topic.
This information is provided by Parallel Parliament and does not comprise part of the offical record
Humanist Marriage
(3 days ago)
Westminster HallRead Hansard Text Read Debate Ministerial Extracts
Westminster Hall is an alternative Chamber for MPs to hold debates, named after the adjoining Westminster Hall.
Each debate is chaired by an MP from the Panel of Chairs, rather than the Speaker or Deputy Speaker. A Government Minister will give the final speech, and no votes may be called on the debate topic.
This information is provided by Parallel Parliament and does not comprise part of the offical record
Sarah Edwards (Tamworth) (Lab)
I beg to move,
That this House has considered the recognition of humanist marriages.
It is an honour to serve under your chairship, Dame Siobhain. I start by declaring an interest as a member of the all-party parliamentary humanist group, to which Humanists UK provides the secretariat. Many Members present are also members of the APPG.
Dearly beloved, we are gathered here today to witness the joining of the hon. Member for Tamworth, my hon. Friend the Member for Morecambe and Lunesdale (Lizzi Collinge) and the hon. Member for Henley and Thame (Freddie van Mierlo), who jointly requested this debate to discuss our wish to see humanist marriages made legal throughout the UK. We are grateful to the Backbench Business Committee for granting this important debate.
Humanists UK trains and accredits celebrants who, just this morning, will probably have conducted at least four weddings and a funeral. I pay tribute to such celebrants, one of whom conducted my grandmother’s funeral, but this debate is about humanist marriage. Why? Because despite conducting tens of thousands of ceremonies every year, including weddings, they are legally recognised in only some of the UK jurisdictions in which they operate, and are not legally recognised in England, Wales or the Isle of Man.
Humanist weddings are non-religious wedding ceremonies conducted by accredited humanist celebrants. Humanists UK defines humanists as non-religious people who rely on the scientific method to understand the universe. Humanists make ethical decisions based on reason, empathy and concern for others, and believe that meaning in life is something that we all discover for ourselves through seeking happiness and contributing to the wellbeing of others.
Humanist ceremonies are a manifestation of that philosophy—an expression of self-created meaning and shared happiness. Those ceremonies should be a profound reflection of the participants’ values and beliefs, their relationship, their families and friends, and their place in the world. Central to the ceremony is a focus entirely on the couple, ensuring that it is deeply personal, while remaining inclusive of all of those attending, irrespective of their diverse religious beliefs. Humanist weddings are a manifestation of the couple’s non-religious beliefs and identity, and they are built collaboratively with their loved ones to reflect all of their contributions.
It is rare for most non-religious people to express their beliefs publicly, and unlike religious people, there is no compulsion to attend a place of worship on a weekly basis. For those who choose to have a humanist wedding, it is an opportunity for a rare public expression of their beliefs, which makes their wedding feel all the more significant and makes it all the more tragic that such weddings are not legally recognised in England and Wales.
In creating such a ceremony, humanist celebrants can dedicate up to 40 hours—sometimes more—to working closely with the couple. That substantial time investment is focused on getting to know the couple so that the celebrant marrying them is not someone who they have just met on the day, but someone who they have a solid, personal relationship with. It is focused on a deep understanding of the couple, their shared values and their feelings for one another, enabling the creation of a ceremony with enduring impact. It is more than the one-time commitment that can be associated with other forms of marriage solemnisation.
The location of the ceremony often holds particular significance as well. The focus is on finding the place that will be most meaningful, which could be where the couple met, where they fell in love or where they got engaged; it could be a garden, their local beach or where they go on holiday. For example, my hon. and learned Friend the Member for Folkestone and Hythe (Tony Vaughan) had a humanist wedding. His partner is Scottish, and he told me that they picked Scotland over England for their marriage partly for that reason, but also because they wanted the marriage to be legal. They got married in the highlands in a place of huge personal significance for them.
Humanist marriages have legal recognition in Scotland, Northern Ireland, Jersey, Ireland and Guernsey, but we have inequity within the UK because Wales and England remain the exception. The Welsh Government have long championed the change, but progress ultimately hinges on the UK Government’s willingness to act.
Humanist marriages have proved incredibly popular where they are legally recognised, with more humanist than religious marriages currently taking place in Scotland. The number of such weddings in Ireland and Northern Ireland has also grown enormously, but in England, the lack of legal recognition suppresses the huge demand.
Anneliese Dodds (Oxford East) (Lab/Co-op)
My hon. Friend is making a powerful case. When it comes to equity, I am sure she is aware that the High Court ruled five years ago that there was an issue of discrimination. The approach since then has been that we need to wait for wholesale marriage reform, but this is a very simple change. Does she agree that the Government should just take it forward, given the overwhelming case for it, and not wait for wholesale marriage reform?
Sarah Edwards
I totally agree with my right hon. Friend. I will go on to give more detail about the challenges that we are facing, and about the easy option that we have for the Government. I hope that, after today, they will take that forward and I look forward to hearing more about that.
Thousands of people still have humanist weddings each year, but to do so, they must also undergo a separate civil marriage ceremony to gain legal status. That frequently imposes a significant financial burden, with weekend civil marriage fees often exceeding £600—a cost that religious couples do not face. The alternative statutory low-cost ceremonies can cost just £57, but they are increasingly difficult to access, with many authorities restricting their availability and location, and even limiting attendee numbers.
I can attest to those challenges, because my mother, Rosi, got married this year to her partner, Henry, in England. The limitations placed on the choices available for the civil ceremony were stark, and the restrictions meant that only my brother Joe and I were able to attend. There were just a handful of slots available in a six-month period, so the choice of a humanist wedding would have been welcome.
Beyond the financial and administrative burdens, the current dual-ceremony requirement creates distressing ambiguity for couples regarding the true date of their marriage. It is inadequate that the ceremony that holds the most personal and emotional significance for a couple is not recognised as the legal date of their union.
Why has legal recognition not yet been granted? Parliament gave the Government the power to introduce legal recognition for humanist marriages through a simple order under the Marriage (Same Sex Couples) Act 2013, but the Act required a public consultation before any action could be taken. That consultation took place in 2014 and revealed overwhelming support—over 95% of people were in favour of legal recognition—but rather than acting on that clear mandate and drafting the necessary statutory instrument, the then Government referred the issue to the Law Commission for a broader review of marriage law, delaying the process indefinitely.
The main reason given at the time was concern about where those marriages could take place. The then Government argued that allowing humanist or other belief-based weddings in unrestricted locations might be unfair. They pointed out that most religious groups are limited to registered places of worship, and they worried it could seem unfair to non-religious, non-humanist couples who might want the same freedom of choice.
Although it is clear that flexibility of location holds particular importance in the humanist tradition, using that as a reason to block legal recognition has always felt disproportionate. In fact, Humanists UK recently obtained a briefing from Melanie Field, who has deep expertise in this area. She was the lead civil servant on the 2013 Act, and before that, the Equality Act 2010. More recently, she served as chief strategy and policy officer at the Equality and Human Rights Commission. Her view is clear that
“The case for removing the discrimination against humanists by making an Order under the existing power in the Marriage (Same Sex Couples) Act 2013, even if done as an interim measure pending wider reform, is overwhelming.”
She goes on to say that allowing humanist marriages to take place anywhere would not create new inconsistencies and, in fact, would align closely with the existing rules for Quaker and Jewish weddings. She sees no legal barrier, no disadvantage to other groups, and no reason that the Government cannot act.
The decision not to proceed in 2014, and the failure to act since, has meant that tens of thousands of couples have missed out on the kind of ceremony that truly reflects who they are. That injustice continues today. The 2014 decision led to a review in 2015, which led to another, broader review from 2018 to 2022. Each time, the scope expanded. What began as a simple consultation about humanist marriages—something that could have been resolved with a single statutory instrument—has now become a full-scale review of the entire marriage system. Even if that wider reform were worthwhile, it cannot be right that humanists have been left waiting all this time when a straightforward solution has been available from the start.
No end is in sight. In the 2020 High Court ruling, following a judicial review brought by six couples, the judge was clear that
“the present law gives rise to…discrimination”.
The court further stated that the Secretary of State could not
“simply sit on his hands”.
At the time, it accepted that Government inaction was only because the Law Commission review was under way—but that was five years ago. Is that justification still valid?
I hope that the Minister will be able to provide some positive news on the position that this new, progressive Labour Government are taking on the issue, because Labour Governments are at the forefront of moving the dial to reduce inequality across society and have always challenged discriminatory practices. I am proud of that legacy and I encourage the extension of our values to humanist marriages.
Let us not wait any more. The previous Conservative Government had ample time to resolve the issue, even after the Law Commission published its findings, yet despite the evidence, the public support and the legal clarity, they failed to act. Now, the responsibility and the opportunity rest with this Labour Government. This is not a complex or controversial reform; it is an easy win.
The legal recognition of humanist marriages led to a rise in the number of weddings in Scotland, and it would have excellent benefits for the wedding industry, boosting local economies and supporting small businesses. It will be hugely popular, and who does not love a good wedding? Polls consistently show that the majority of the public and, indeed, the majority of MPs support the legal recognition of humanist marriages. That support is growing as more and more couples are able to choose humanist ceremonies each year. Recognition would give the Government a legacy to be proud of—a legacy on a par with the legislation of same-sex marriage, as a moment of progress, of fairness and of aligning the law with the values of the peoples that they serve.
Let us not forget that that is what Labour promised: from 2014 to the last election, the Labour party made a clear and repeated commitment to lay the order once in power. We are keen to do that, as is my hon. Friend the Member for Hammersmith and Chiswick (Andy Slaughter), who is unable to attend today’s ceremony but said he would join us post nuptials at the reception, as he wishes to add his support. We request haste to end this discrimination and deliver a change that would give thousands of couples the right to have their deeply meaningful and humanist wedding legally recognised in every part of the UK. I ask the Minister: can we lay this legislation? We have had a very long engagement. Minister, will you marry our ambitions with your Government’s agenda? Can we finally set the date?
Several hon. Members rose—
Dame Siobhain McDonagh (in the Chair)
I do not think that I need to remind Members that they should bob if they wish to be called in the debate. As everyone can see, a large number of people would like to speak, so rather than impose a rigid timescale, I will be grateful if you could all be kind to one another and speak for approximately four minutes.
Freddie van Mierlo (Henley and Thame) (LD)
It is a pleasure to serve under your chairship, Dame Siobhain. I am delighted to co-lead this debate. Many problems that face this country and indeed the world are difficult to solve, but marriage equality for humanist weddings—as the right hon. Member for Oxford East (Anneliese Dodds), my constituency neighbour, pointed out—is something we can fix simply with the stroke of a pen. I therefore urge the Government to do so.
I will reflect on my own marriage, which was a humanist marriage. I am not religious, but I was raised going to church on Sundays and I went to a Catholic school, so I am familiar with the Catholic faith and have great respect for it. When it came down to it, however, a religious marriage did not feel right for me or my wife. The words someone needs to say at a church wedding just did not ring true for me, and the last thing I wanted to do on my wedding day was to lie.
The words we say on such a day are special and should be meaningful. The alternative to a religious marriage, in a place that is wanted, is therefore to have a registry office marriage with a celebration after, but I wanted the celebration to be the marriage—to combine, as religious ceremonies do, the legal act of marriage as defined by law and the deep and meaningful declarations of love made on the day.
That is why we decided to get married in Scotland. As my name suggests, I do not have ancestral connections to Scotland, but I often wear a tartan tie in this place because I am now so fond of the country in which I got married. I am today wearing the same tie that I got married in four years ago. Our humanist celebrant, Lesley, was absolutely wonderful. She guided us through the whole thing perfectly and even offered us a bit of advice on the snow gates in Braemar in December.
Everyone in England and Wales should have the same opportunity that has existed in Scotland for 20 years. Twenty years ago, Humanist Society Scotland wrote to the Registrar General and asked them to read the law as relates to religious marriages as also providing for humanist marriages. They were persuaded that, from a human rights perspective, given freedom of religion or belief, that had to happen, so they reinterpreted the law in exactly that way. No legislation was required, and so, on 18 June 2005, Karen Watts and Martin Reijns were married by a humanist celebrant at Edinburgh zoo.
When Scotland passed the Marriage and Civil Partnership (Scotland) Act 2014, the decision was made to update marriage law to put humanist marriages on a proper statutory footing. The first two same-sex marriages in Scotland were both humanist, and humanist marriages have only continued to grow in popularity since.
It is not just Scotland that has left England behind. In 2017, Laura Lacole and Eunan O’Kane applied to the Registrar General in Northern Ireland to ask for their marriage to be a humanist one. They asked for the law to be read similarly to the way it was read in Scotland. This was declined, but a court later found in their favour. As in Scotland, humanist marriages have since exploded in popularity in Northern Ireland.
To finish my tour of the home nations, the Welsh Government have repeatedly written to the UK Government over the years asking for a humanist marriage order to be laid or, failing that, for marriage law to be devolved to Wales. I am proud that my party has been committed to that for many years, and that it was a commitment in the last Liberal Democrat manifesto. I am also proud that the Liberal Democrats were in government in Scotland when humanist marriages were introduced there. The Liberal Democrats of course have a very good record on marriage reform. We can debate the merits of the coalition—as I am sure we will again and again—but one of the standout achievements was same-sex marriage. It is worth noting that the couple who had the first same-sex marriage in England and Wales, Peter McGraith and David Cabreza, are humanists and said they would have liked a humanist wedding.
Legal recognition of humanist marriage would especially benefit and support same-sex couples. LGBTQ people are significantly more likely to identify as non-religious, and many religious groups still do not allow same-sex marriages. Humanists UK tracks whether the ceremonies its celebrants do are for opposite sex or same-sex couples; as a result, we know that every year since 2013 more same-sex couples have chosen to have a humanist wedding without legal recognition than have had a religious same- sex marriage with legal recognition. That which there is clear demand.
Labour committed to action when in opposition; now they are in power, I urge the Government to listen to this debate. I would not change my wedding for the world, and Scotland now has a very special place in my heart, but would it not be lovely if a legacy of this Government was that such special memories can be made in England and Wales too?
Lizzi Collinge (Morecambe and Lunesdale) (Lab)
It is a pleasure to serve under your chairship, Dame Siobhain. Marriage is one of the most profound commitments we can make. It offers us a lifelong partner to grow with, a loving relationship to strengthen us and mutual support throughout our lives. When two people choose to marry, it matters that they can do so in a ceremony that reflects their beliefs.
I declare an interest: I am the chair of the all-party parliamentary humanist group, to which Humanists UK provide the secretariat. However, I speak today not on behalf of any organisation or formal grouping, but on behalf of people like me who share strongly held beliefs and convictions about the world and their place in it.
I am sure that most people in this Chamber are familiar with what humanism is, but it is worth briefly setting it out. Humanism is the belief that this life is the only life we have, and that the world is a natural phenomenon that we can understand, with no supernatural side. It is a worldview grounded in reason, evidence and compassion—a commitment to living ethically and meaningfully, not because of fear or doctrine but because of a shared humanity and a belief in people.
For those of us who hold these beliefs, they shape the biggest moments of our life, including marriage. Humanist weddings are personal, thoughtful and deeply meaningful. They are conducted by celebrants who share the couple’s values and are co-created to reflect the couple’s commitment and outlook on life. They are no less significant than religious ceremonies, yet right now humanist couples in England and Wales face a fundamental unfairness, because their weddings are not legally recognised.
As my hon. Friend the Member for Tamworth (Sarah Edwards) set out, the Government already have the power to right this injustice. The reform does not require primary legislation and it does not need a review. The Secretary of State already has the power, under the Marriage (Same Sex Couples) Act 2013, to lay an order, and a draft order already exists. It would require just 90 minutes of debate in each House. We could be done tomorrow—well, maybe not tomorrow; we are all a bit busy tomorrow.
Instead of the Government using that existing power, there have been delays and the issue has been referred for more and more reviews. The latest was the Law Commission’s full review of marriage law, which produced proposals that, in my opinion, would be difficult and slow to implement. The High Court made it clear that once the review was finished, the Government should act, but rather than taking that straightforward step, we have new proposals that complicate the process unnecessarily.
I fundamentally disagree with some of the proposals, and I will highlight my concerns in the hope that I might influence the Minister’s thinking about any new legislation. I am particularly worried by the Law Commission’s proposal to permit commercial celebrants—anyone, regardless of training—to become authorised wedding officiants with the same powers as registrars. I understand the impetus to expand choice, but this risks turning weddings into Las Vegas-style free-for-alls, which would be unprecedented in Europe.
Marriage is a binding contract between two people and the state. It is a choice that takes huge commitment and should not be entered into lightly. It is of such significance that we cannot reduce it to a mere transaction or moment or entertainment. We have to safeguard the integrity of the marriage ritual. Call me old-fashioned, but I think that how we get married matters. It signifies the seriousness of the contract we enter into. That obviously does not mean that it needs to be dour or cheerless—my wedding very much was not—but we need to safeguard the integrity and meaning of the ceremony itself.
Humanist celebrants are carefully trained. They are insured, accredited and supported through continuing professional development. That commitment is what gives their ceremonies the weight and respect they deserve. It is not just humanists who have concerns; the Church of England and local registrars share them. I rarely use the word “sacred”, but here it is entirely fitting. Allowing a free market for celebrants risks undermining the solemn and profound nature of the marriage contract. I should also highlight the aspects of the commission’s proposals that I support. For instance, the move away from the building-based system is a positive step.
As society is changed, so too is marriage. As a woman, I am very aware of the changes in both marriage and society. However, the values that marriage represents—love, commitment and stability—are fundamental to the fabric of our society, and I do not think that anyone in this room would challenge their importance. If we want to truly uphold and embed those principles in our society, they must be accessible to everyone, regardless of belief or background.
Marriage rights should reflect the profundity of the commitment made. Put simply, every citizen of this country, whatever their belief system, should have the same right to equal recognition of their solemn commitment, made in accordance with their beliefs. I hope we can act on this opportunity and finally introduce this long-overdue change.
Caroline Voaden (South Devon) (LD)
I thank the hon. Members for Tamworth (Sarah Edwards) and for Morecambe and Lunesdale (Lizzi Collinge) and my hon. Friend the Member for Henley and Thame (Freddie van Mierlo) for securing the debate.
I declare an interest: in September 2011, I had a humanist wedding. We chose a beautiful setting in the countryside and got married in a carpentry workshop, where my husband had worked for many years before all his workmates beautifully transformed it into a unique setting for a wedding. Many guests said it was one of the most special weddings they had been to, partly because it was so different from a traditional wedding. The kids loved the ice-cream van that gave out free ice creams all afternoon. The vows were written by us, the ceremony was designed by us, and we were both able to include our children in the ceremony, which was very meaningful. Having lost my first husband to cancer eight years before, the ceremony was a really special and joyous occasion marking the beginning of a new chapter for all of us after some very bleak times.
But we did have to get married two days before in a registry office, because our ceremony was not legal, so I now have two wedding anniversaries, which is complicated enough—three if we count the first one as well. The occasion that I remember as my wedding was not actually my wedding, and that feels wrong and outdated in a modern society.
I would like to compare the situation here with Scotland, where humanist marriages have been legally recognised and have exploded in number. There are more humanist marriages there than all the other faith and belief-based marriages combined. It is hard to unpick cause and effect, but in Scotland the legal recognition of humanist marriages coincided with the end of a long-term decline in the number of marriages there. My hon. Friend the Member for Henley and Thame talked about how he travelled to Scotland so that he could have a legally recognised humanist marriage. No doubt thousands of others have done the same thing—the modern-day equivalent of eloping to Gretna Green—but that really should not be necessary. It is time for England and Wales to catch up with Scotland and Northern Ireland, where humanist marriages are recognised.
It is well past time to allow people to have a humanist ceremony recognised in law. The 1,200 couples a year who have humanist weddings here should have the same opportunity to marry in line with their beliefs as their religious counterparts. It is needed under the Human Rights Act 1998. The High Court ruled in 2020 that the lack of legal recognition is discrimination, and said the Government have to act.
As we have heard, 95% of respondents to one consultation supported it. A 2025 YouGov poll found 70% in favour and only 15% opposed, and there was also a majority of every religious group in favour. This is not a controversial decision.
It is also good for marriage: freedom of information data from Scotland shows that couples married in a humanist ceremony—I am very pleased to read this—are almost four times less likely to divorce compared with all other types of marriage.
Lastly—the Government will like this bit—it is free. Laying an order under the Marriage (Same Sex Couples) Act would cost nothing. All it needs is a positive affirmation.
Ruth Cadbury (Brentford and Isleworth) (Lab)
Many thanks to my hon. Friend the Member for Tamworth (Sarah Edwards) and others who secured the debate.
The speakers we have heard already have spoken so powerfully about why this simple change in the law needs to happen. The hon. Member for Henley and Thame (Freddie van Mierlo) talked about what must have been a cost to friends and relatives to have to go to Scotland to have both parts of the event in one place. As the hon. Member for South Devon (Caroline Voaden) just said, the logistics of having to organise two functions are not great. She said she would have liked to have both parts—the formal legal part and the celebratory part—as one.
I must declare that I am a member of the all-party parliamentary humanist group, although I am actually a Quaker. As far as I can see—I think I am right in this—marriage in this country is, at its minimum, when completely stripped down, the public signing of a legal document between two people, with witnesses. It is just a legal document. But most of us end up adding to it the faith element, the friends and family element and the celebration.
There is an inequality in England and Wales. For many, traditionally, the faith component is important. Most weddings in this country can happen in the place of faith in one and the same event. In England and Wales, civil and religious marriages are permitted, but it is not possible to have a humanist marriage, or one conducted according to any non-religious system or belief. They have to be in two parts.
Quakers, for historical reasons, have had the right to hold formally agreed marriages anywhere, including outdoors—as can Jews—according to our rites and ceremonies, with a registered member of the congregation officiating. Actually, thanks to the wording of a Quaker wedding, the couple can in effect marry each other, because we do not officially have any people who are closer to God than anyone else; we are all equal in the sight of God. The wording is: “Friends, I take this, my friend Laura, to be my spouse, promising, through divine assistance, to be unto her a loving and faithful spouse, so long as we both on earth shall live.” [Hon. Members: “Hear, hear!”] My hon. Friend the Member for Aylesbury (Laura Kyrke-Smith) and I are both married to other people—
Bambos Charalambous (Southgate and Wood Green) (Lab)
There are lots of witnesses.
Ruth Cadbury
Anyway, I fully support the Humanist Society’s position to allow a couple to be married by a celebrant who shares the couple’s values and beliefs, one that works in Scotland, Northern Ireland and many other jurisdictions across the world.
I would have some concerns if the law was opened up to any non-religious belief organisations. There needs to be solemnity and dignity in the process. I would also have some concern about the potential for celebrants to sell their services as a commercial transaction, so there are some aspects of the Law Commission proposals that concern me. However, one part of the Law Commission’s recommendations that I support is for marriage to be based on the officiant rather than the building. As I have said, for Quakers, there is no such thing as a consecrated building or space in our faith, so as long as the local Quaker who is trained and formally registered is present, the marriage is legal. It can be done out of doors. I know that many humanists value nature and choose to celebrate their weddings out of doors but do not want to have a two-pronged celebration and the official bit as is currently the case. I therefore support a change in the law.
Cat Eccles (Stourbridge) (Lab)
It is a pleasure to serve under your chairship, Dame Siobhain. I also declare an interest as a member of the all-party parliamentary humanist group. I rise to speak about the arguments advanced in the past against legal recognition of humanist marriages and why I do not think they hold much weight. However, I will start with my personal situation.
I got married last year. My husband and I would have loved to have had a legally recognised humanist marriage, but because of the previous Government’s endless delays, we were denied that chance. A couple of years ago, I wrote to my MP—not me, but the former Conservative Member for Stourbridge—asking that the matter be resolved following the High Court ruling. The response I got was positive, saying that there was an ambition to remedy the situation, but clearly they were not ambitious enough.
My husband and I chose to marry at the Thomas Robinson building in Stourbridge, which is a beautiful old chapel converted to a register office. We asked about having a humanist celebrant lead the proceedings but were told that would not be possible. We would have needed a separate ceremony, which would have meant not only an additional cost to our budget and organising another event, but that our legally recognised marriage would not have been meaningful to our beliefs.
The registrar offered us a choice of wording for the ceremony from extremely religious to completely neutral. The neutral wording suited us best, but it stripped away all meaning and sentiment along with the religious references. As humanists, we believe in compassion, reason and ethical approaches to human life, giving people the right and responsibility to give meaning to shape their own lives, which makes the denial of humanist marriage even more ironic.
In opening the debate, my hon. Friend the Member for Tamworth (Sarah Edwards) referred to a new briefing from Melanie Field about why the Government should legally recognise humanist marriages. If anyone is an expert on this matter, it is Melanie. She literally led for the civil service on the Marriage Act and our Equality Act 2010. Her time at the EHRC further demonstrates her human rights expertise and no one else has been as intimately involved in both bits of legislation, so when she says that the case for making a humanist marriage order is overwhelming, that should surely carry some authority.
In Melanie’s briefing, she considers the 2020 High Court judgment. As we have heard, the judge ruled that
“there is a continuing discriminatory impact upon those who seek to manifest their humanist beliefs through marriage”,
but that it could be justified, “at this time”, by the then ongoing Law Commission review. Melanie says that this may now be different. Five years have passed since that judgment and three since the review concluded, and no action has since occurred. Obviously, that is first and foremost the fault of the previous Government, but the upshot, Melanie thinks, is that it is possible that the Court would now reach a different conclusion should a further case be brought, and that the case for removing the discrimination against humanists by making an order under the power in the marriage Act, even if done as an interim measure pending wider reform, therefore seems overwhelming.
Melanie considers various concerns raised against that course of action, mainly in a 2014 consultation run by the Conservatives. I will run through them briefly. First, a concern was expressed that the change would lead to inconsistencies with outdoor marriages. Those inconsistencies already exist, as we have heard, with some religious groups already able to hold outdoor marriages. Civil marriages also started happening outdoors in 2021. Secondly, she considers the concern that it would be unfair to allow humanist marriages on approved premises when religious groups cannot have them. She thinks it would be lawful because humanists may have intrinsic belief-based reasons to want their marriages on approved premises.
Thirdly, Melanie considers concerns that there may be other belief groups who could try to gain legal recognition, but no such other groups exist or have been identified. Fourthly, she refers to the supposed risk of commercialisation. Again, no evidence is offered that that would happen, and, as we have heard, in Scotland and Northern Ireland there are laws prohibiting profit and gain by religious or humanist celebrants. Finally, she considers the desirability—or otherwise—of piecemeal reform, and any added complexity that might arise in the law, but she thinks that this concern is insignificant when set against the context of people being denied their human rights.
Melanie also notes that the supposed solution to this issue, the Law Commission reforms, have been criticised by religious groups and others, including for devaluing marriage in a way that means they do not in fact appear to be a simple solution. She also notes that the previous Government pursued many piecemeal marriage reforms while saying that they were against such measures.
In conclusion, the humanist marriage order is not complex. It is a simple, cost-neutral change. It just recreates for humanists the legal provisions that already exist for Quakers. They are tried and tested, and they should be extended so that other couples are not refused their rights as I was.
Dame Siobhain McDonagh (in the Chair)
I am afraid that I will now impose a four-minute limit on speeches. I apologise to people for coughing, and will endeavour not to. Please do not be too distracted by me.
Rachel Hopkins (Luton South and South Bedfordshire) (Lab)
I am sorry about your sore throat, Dame Siobhain; I hope it does not trouble you too much. It is a pleasure to serve under your chairship.
I thank my hon. Friends the Members for Tamworth (Sarah Edwards) and for Morecambe and Lunesdale (Lizzi Collinge), and the hon. Member for Henley and Thame (Freddie van Mierlo), for securing the debate. I have put on the record previously that I am a humanist and a member of Humanists UK. I congratulate my hon. Friend the Member for Morecambe and Lunesdale for taking on the baton from me to become chair of the all-party parliamentary humanist group. She will be a great champion for its work. Might I add that it is very nice to be surrounded by more “out” humanists?
As a humanist, I believe that we have one life, and we shape that in the here and now. My values are based on reason, empathy and concern for other human beings. In line with that, I believe that everyone should have the right to live the life they choose. I believe that every person, whether religious or non-religious, has the right to get married in accordance with their own personal beliefs. A humanist wedding is a non-religious ceremony. It differs from a civil wedding in that it is reflective of the humanist beliefs and values of the couple, and conducted by a humanist celebrant. Unfortunately, in England and Wales a glaring inconsistency remains. The law, as it stands, means that couples who choose a humanist wedding ceremony must still have a separate civil ceremony to make their union legally binding.
Humanist marriages are legally recognised elsewhere in the UK. Since 2005, they have been recognised in Scotland; indeed, we have heard that they now account for more weddings in Scotland than those conducted by any single religious denomination. Northern Ireland followed suit in 2018 after a landmark legal case and there was further legal recognition after that in Jersey in 2019 and in Guernsey in 2021. So, why is there not recognition in England and Wales?
The current system effectively discriminates against non-religious people by denying them the legal recognition given to religious ceremonies. It is not merely a matter of paperwork; it is about equality. Legalising humanist marriages could be done with ease, as has been argued so well by many others. The Government could act on the High Court ruling of 2020, which said that the current law is discriminatory, and lay an order so that humanist couples and celebrants can have legal recognition of their ceremonies.
That would also be a popular choice. A 2025 YouGov poll found that 70% of the public support the change. It is also supported by many of us, from all parties in the House, as well as by legal experts and human rights advocates. In fact, in this debate, in this Parliament, double if not triple the number of people support a change in the law than oppose it.
The last time that I participated in a debate on humanist marriages in this place was in January 2022, at which time the Minister answering for the then Conservative Government stated:
“The Government will carefully consider the Law Commission’s recommendations when the final report is published, and it is right for us to await the outcome of that.”—[Official Report, 27 January 2022; Vol. 707, c. 440WH.]
As we have heard today, that review was subsequently published in July 2022 and recommended reform of marriage law to allow for more inclusive ceremonies. Almost three years later, it is very disappointing that we have still not seen that change come to fruition. The Minister has stated that
“The Government will set out our position on weddings reform in due course.”—[Official Report, 3 June 2025; Vol. 768, c. 153.]
For humanists in England and Wales, continued dither and delay is extremely frustrating; indeed, it is not just frustrating, but discriminatory. I hope that our Government will now act and not delay justice any longer. Let us stand up for equality and for freedom of belief in all its meaningful forms.
Peter Dowd (Bootle) (Lab)
First of all, it is a pleasure to see you in the Chair this afternoon, Dame Siobhain. Secondly, it is also a pleasure to hear my hon. Friend the Member for Tamworth (Sarah Edwards) set out in this debate the reasons for humanist marriages and why they should be recognised.
On the question of humanist marriages being recognised, I ask myself why they are not. What is the problem? My hon. Friend made what I think amounts to an unimpeachable case as to why marriages of this nature should be facilitated, as other types and classifications of marriage are, and I thank Humanists UK for the briefing that it sent. I thought, “Shall I throw in some facts and figures?” No, I think other people are much better at that than I would be. It still comes back to the question of why we are debating this issue so many years on. I am not quite sure why we should have to reiterate this request time after time after time. But we are where we are, so I decided to participate in the debate with my tuppence-worth.
I wondered what my approach should be. As you know, Dame Siobhain, we think very carefully about these matters. As I said—facts, figures, statistics? I decided not to do that. Rhetoric has its place in debate. Who has not used rhetoric in their day? What about a little bit of polemic? Should I throw a little bit of polemic in? I decided not to. What about an historical examination of the nature of marriage going back thousands of years, because marriage predates, for example, any current religious timeline in relation to the concept? I decided not to do that, either.
Perhaps taking a different perspective might add a different angle to the debate—on the nature of marriage, so to speak. Indeed, who is impartial to a quote here or there from literature in one form or another? I began to think laterally, which I have to admit is a big challenge for me in most circumstances. I looked to my constituency for inspiration—it is a fantastic place to do so. A number of streets that date back to the 19th century that are named after characters in Shakespearean plays. On the surface, they are just street names. But lo and behold, they are named after characters who were married and who faced terrible challenges in getting married.
What has that got to do with what we are talking about today? That is a fair question. It elucidates that the debate must, in part, be about the nature of marriage, the commitment of marriage, and marriage in good faith. It must also be about the wishes of the people concerned to marry as they see fit, without duress and with, of course, appropriate safeguarding mechanisms. It is also about giving those who choose to do so the capacity to marry as they see fit, and for the process to be recognised as other marriages and ceremonies are.
Shakespeare uses marriage as one of the most prominent themes, if not the most prominent, in his repertoire. Does he talk about the service? No. Does he talk about the legalistic nature of it? No. He focuses on the personal nature of marriage: the relationships, the tensions, the feelings, as Beatrice and Benedick realise when they acknowledge, reluctantly, that they are to become partners in marriage. So, let us leave the last words to Shakespeare:
“Marriage is a matter of more worth
Than to be dealt in by attorneyship.”
This debate should not be much ado about nothing.
Dame Siobhain McDonagh (in the Chair)
Just to warn the Front Benchers, I am going to reduce your time to nine minutes in order to keep the time limit for Back Benchers at four minutes.
Lewis Atkinson (Sunderland Central) (Lab)
It is a pleasure to serve under you, Dame Siobhain. Like others, I commend the hon. Member for Henley and Thame (Freddie van Mierlo) and my hon. Friends the Members for Tamworth (Sarah Edwards) and for Morecambe and Lunesdale (Lizzi Collinge) on securing this debate.
In 2009, I got married in the National Glass Centre in my constituency, in a humanist ceremony. Because, as other hon. Members have mentioned, that ceremony was not legally binding, we had to get legally married two days earlier in Sunderland Civic Centre. Choosing a humanist married reflected the shared values of my wife and me. With our humanist celebrant, we thoughtfully worked through what we wanted to say, and the commitments that we wanted to make to each other.
I would love to say that every marriage ends in a “happily ever after”. The hon. Member for South Devon (Caroline Voaden) was right to draw attention to the lower divorce rates statistic. Unfortunately, my marriage has resulted in a separation. That is a cause of sadness for me, but the shared humanist values that we committed to when we embarked on our marriage still provide an enduring basis for a positive relationship between my wife and I to co-parent our children. Even if, unfortunately, “happily ever after” is not possible in every marriage, humanist values and celebrations have significant value in bringing children up, as other hon. Members have stated in this debate. I intend to do further work in this Parliament on positive parenting in separated families.
For the meat of my contribution, I will highlight how society has changed over the last 12 years, since the Government first gained the power to enact legal recognition of humanist marriages. Others have mentioned the steps made in nations of the UK other than England and Wales. I highlight the ongoing growth in the number of census respondents who are humanist or non-religious. The share of people ticking “no religion” in the census rose from 25% in 2011 to 37% in 2021—a significant rise. Around two thirds of people who get married are between the ages of 25 and 39, and among that group 48% of people ticked that they had “no religion” in the census.
The current law essentially means that around half of people of normal marriageable age are being denied the choice of having a legally binding marriage that conforms with their beliefs. More widely, we have seen other advances for humanism in the last 12 years. Humanism is increasingly becoming a recognised part of the school religious education syllabus. Humanists are now officially included in national moments, such as the service of remembrance and Holocaust Memorial Day. They provide input into the moral and ethical issues of our time. I worked in the NHS during the covid pandemic, and humanists were officially consulted on, and contributed to, some of the advice that we received from the Department of Health and Social Care’s moral and ethical advisory group.
A lot has happened in 12 years, yet humanist marriages are still not legally recognised. As others have said, it is overdue that we change that. The order is drafted and ready to go. We have had to wait far too long for this already. I look forward to hearing how we can get this done as quickly as possible.
Laura Kyrke-Smith (Aylesbury) (Lab)
It is a pleasure to serve under your chairship, Dame Siobhain. I thank my hon. Friends the Members for Tamworth (Sarah Edwards) and for Morecambe and Lunesdale (Lizzi Collinge), as well as the hon. Member for Henley and Thame (Freddie van Mierlo), for securing the debate.
It is a timely debate for me, as it was exactly this week 11 years ago that I had my humanist wedding. It was one of the most wonderful days of my life—my husband and I, surrounded by family and friends, on a beautiful, windswept and, fortunately, sunny beach in Devon, marking and celebrating our decision to spend our lives together. I had not really heard of a humanist wedding before I started planning one, but once we realised the constraints of a civil ceremony—the limits on readings, songs, numbers of guests and locations—we quickly decided that we wanted something else: a celebration of not just our formal commitment, but our beliefs and values.
Personally, although I have every respect for people of all faiths and none, it is through humanist values that I try to make sense of the world. For me, this is the one life that I have, and I try to live in the here and now, making decisions on what I feel and see that are based on logic, reason and evidence, and rooted in compassion, dignity and respect for other people. Because my husband sees the world in the same way, a humanist wedding was the right choice for us.
I pay tribute to our incredible humanist celebrant, David Pack, who sadly passed away a few years ago, but will forever remain a central part of our special day. He helped us to create a ceremony that spoke to our values, and I want to borrow his words about why humanist weddings are so important. He said:
“A lot of couples say they find it hypocritical to make promises before a god they don’t believe in…As humanists we believe that we can find a way of living and behaving decently without needing reference to any divine authority, drawing on our own human qualities: reason, emotion, experience and empathy”.
That is what a humanist wedding enables a couple to express at that key moment in their lives. We had wonderful feedback from our guests, many of whom had never been to a humanist wedding before but found it to be a very open, inclusive and moving ceremony, from the songs to the vows and the readings, many of which we had written together.
Although I could happily be sucked into reminiscing about my wedding, I will turn to the point of today’s debate. For me, that starts with the fact that, although this week is the time we celebrate our wedding anniversary each year, it is not in fact my official wedding anniversary, which comes at the end of May, marking the date that we went to an unremarkable registry office in London to do the official bit. We felt somewhat resentful at the time, and still do to this day, because it came with extra costs, extra admin and that niggling sense that the wedding we had invited everyone to a few weeks later was somehow not the real deal. That is why I am so pleased that this debate is happening, and I am so pleased to speak in support of the legal recognition of humanist marriages.
I want humanist couples to be able to marry with a British Humanist Association celebrant of their choosing, and for this to have the same status in law as any other wedding. We have heard from others about how possible this is; I understand that the law can be changed quite quickly and easily by laying down the order under the Marriage (Same Sex Couples) Act 2013. No further legislative work is needed. I am so proud that Labour has long supported this. It would strip away legal risks, as we heard from my right hon. Friend the Member for Oxford East (Anneliese Dodds), and it would be free. It would also be popular, as we have heard. I hope that after today’s debate we can just get on with it.
Legalising humanist marriage would have a transformative impact for humanist couples across the country, stripping away the awkwardness, inconvenience, cost and injustice of needing both an official ceremony and a moment of celebration. It would enable humanists to make their wedding day what it should be: the celebration of their commitment to each other, in line with their beliefs and values, and the legal recognition of that union once and for all.
Andrew Cooper (Mid Cheshire) (Lab)
It is a pleasure to serve under your chairship, Dame Siobhain. I congratulate my hon. Friends the Members for Tamworth (Sarah Edwards) and for Morecambe and Lunesdale (Lizzi Collinge), as well as the hon. Member for Henley and Thame (Freddie van Mierlo), on securing the debate. Before I begin in earnest, I am proud to declare my interest as a member of Humanists UK and of the all-party parliamentary humanist group.
I would like to make a proposal to the Minister—one that does not need a ring, flowers or a dramatic moment on bended knee. My simple proposal is that we finally say yes to legalising humanist marriage in England and Wales. I understand the Government’s arguments, and I will focus my remarks on them, but before I get into the detail, I want to say that the fact that this was resolved in Scotland two decades ago, and could be, but has not been, resolved in England and Wales by way of a simple order, is indefensible. It demands urgent action.
I have heard the Government’s argument that they want to consider marriage law in the round, and they should certainly do that, but, thanks to the previous Government, humanist couples have already been waiting for 12 years and that has not happened. Why should they have to continue to wait, and why can they not have legal recognition of their marriages in the meantime?
While humanist couples have been waiting, many other piecemeal reforms have taken place. In 2021, the law was changed to allow civil marriages outdoors. The system of registering marriages became electronic. Mothers’ names have been added to marriage certificates. Opposite-sex civil partnerships have been introduced, along with new possibilities for conversions between marriage and civil partnership. No-fault divorce was introduced in 2022. The marriage age was raised to 18 in 2023. Weddings for whole-life prisoners were banned by this Government just last year.
While all that was taking place, more and more religious groups have been happily registering themselves to do marriages for the first time. Scientologists got the power to conduct marriage in 2014 following a Supreme Court case. The Order of St Leonard, a religious group founded in just 2009, has registered. The Goddess People of Avalon and the He Lives Bible Church, formed in 2000 and 1998, respectively, both registered. In other words, whole religions have come into existence and got the power to conduct marriage in almost the same time that humanist marriages have been under review.
Similarly, more religious groups have decided to perform same-sex marriages, most notably the Methodists in 2021. All the while, humanist celebrants have wanted to be able to perform legal same-sex marriages, but have been denied the right to do so. The previous Government argued that other religious and non-religious belief groups are arguing for legal marriage recognition, so it would be unfair to recognise humanists. However, that argument seems to be that two wrongs make a right. It is not clear who those groups even are. Muslims, for example, can already marry in mosques, and hundreds do so every year. Independent celebrants are an entirely different proposition, as we have heard, being profit-making alternatives to state registrars. It is also not clear how other religious or non-religious belief groups would be disadvantaged by humanists gaining recognition.
In the interest of time, I will wrap up. Scotland has already said, “I do.” Thousands of couples have legally married in beautiful, meaningful humanist ceremonies. England and Wales are still standing at the altar, checking their watch and waiting for the doors to open. I am not asking for sweeping reform. I am not asking the Minister to rethink everything. I am just asking for a simple answer to a simple question: will the Minister, at long last, do me the honour of making that order and recognising humanist marriages? There is no lawful impediment, just the chance to say, finally and unequivocally, “I do.”
Sam Carling (North West Cambridgeshire) (Lab)
It is a pleasure to serve under your chairship, Dame Siobhain. I thank my hon. Friends the Members for Tamworth (Sarah Edwards) and for Morecambe and Lunesdale (Lizzi Collinge) and the hon. Member for Henley and Thame (Freddie van Mierlo), who secured this debate. It has been worth it for all the puns, if nothing else.
I will use my time to speak about what a positive impact making this change would have, particularly for LGBT couples. In the 2021 census, 37% of people in England and Wales identified as having no religion. Among lesbian, gay and bisexual people, that jumps up to 63%. The numbers for trans people, while a bit less clear due to some issues with the census, are similar. With that in mind, it stands to reason that those LGBT couples would generally prefer to have a non-religious ceremony when they get married.
Indeed, that is what is happening. Humanists UK, whose stats I will be quoting throughout—I also declare an interest as a member of the all-party parliamentary humanist group—has found that, following the legislation of same-sex marriage in 2013, humanist celebrants do more same-sex marriages without legal recognition every year than there are legally recognised religious same-sex marriages. That means that many people are opting for these meaningful, inclusive ceremonies even though they do not carry legal weight. That says something very powerful about the demand. Part of that is out of necessity. Humanists UK’s statistics have also shown that less than 1% of places of worship in England and Wales have registered to perform same-sex marriages, so, in practice, a lot of the time, LGBT couples who want to get married and have their union properly recognised are left with very few real options.
That is not to downplay the Marriage (Same Sex Couples) Act 2013, which was a big step forward in LGBT rights. To give credit where it is due, that Act was one of very few positives under the previous Conservative Governments, albeit something that got through only because Members from other parties, particularly my own, supported it. That Act, as others have said, included a provision for an order to be laid in future to recognise humanist marriages without the need for further primary legislation, so we could make this change very quickly.
In Labour’s 2024 election manifesto, we committed to strengthening the rights and protections of cohabiting couples. The Minister cited that in response to a recent written question on humanist marriages, which I was pleased to see. I know the Government are currently considering the recommendations from the Law Commission report on weddings and will hopefully confirm the position on that soon. I look forward to that development, as I know humanists have been waiting a long time for legal recognition. I hope we hear more about that today.
There is huge support among various religious groups for this change, as my hon. Friend the Member for Tamworth said. More recent polling has shown there are majorities in favour across all religious groups, as well as across voters of all major political parties. Last year, Sandi Toksvig and Stephen Fry were joined by Stonewall, the Terrence Higgins Trust, the LGBT+ Consortium and the LGBT+ groups affiliated to all three major political parties in writing to the Prime Minister about what recognition would do for LGBT couples. This seems to be one of those issues on which pretty much everyone agrees.
Given the overwhelming public support, the ease with which this could be introduced and the impact it would have on LGBT couples in particular, I hope we see recognition of humanist marriages in England and Wales, joining Scotland and Northern Ireland, so that everyone in the UK has the option to have a legally recognised humanist ceremony.
Luke Taylor (Sutton and Cheam) (LD)
As always, it is a pleasure to serve under your chairship, Dame Siobhain. The Liberal Democrats are proud of our clear and consistent commitment to legal recognition for humanist marriages, which has been official party policy since 2010. It is a position anchored by a strong tenet of our liberalism—the belief that couples should be able to celebrate their marriage in the way they wish. We believe that all types of marriage ceremonies, whether religious, civil or humanist, should be treated equally under the law. It is the right thing to do and the fair thing to do. Frankly, it is deeply sad that it has not yet been done in England and Wales.
As has been mentioned, humanist marriages have been legally recognised in Scotland for 20 years, having been introduced in 2005 by the coalition Government that included the Liberal Democrats. Humanist marriages have been legally recognised in Northern Ireland since 2018, in Jersey since 2019, and in Guernsey since 2021. Today, we are reckoning with an alarming discrepancy across the British Isles in a crucial aspect of our legal system.
Do not get me wrong—I am a localist. I believe firmly in devolution of policy, and I recognise that one thing that makes our country so great is the co-existence of strong and diverse legal traditions and systems. But on the question of what really should be a fundamental right for people to marry whoever they love in the manner of their choosing, it is right that we should look to extend and entrench that right as far and as wide as possible.
All of that is to say nothing of the growing recognition of humanist marriages in other countries with similar legal traditions, a shared Commonwealth history and, in countries like Australia, New Zealand and Canada, a shared Head of State. Indeed, I have intimate knowledge of the latter. When I lived in Toronto, Ontario in 2013, I married my wife in a beautiful ceremony with our choice of officiant, in the snow, in the bandstand of a park near Niagara Falls. A word of warning, though: the temperature plunged to minus 15° during the ceremony and my eyelashes froze shut.
It was not explicitly a humanist wedding, but nor was it a religious or strictly civic wedding either. We had the freedom to choose where and by whom we were married, without the need for a second, separate official ceremony or registration, which humanists are forced to do here in England. We simply had to procure a marriage licence from the city hall and then wait for the marriage certificate to arrive in the post following the ceremony.
This ceremony is recognised as a marriage here in the UK—at least I hope it is—so my personal experience might speak to a further discrepancy in the law by which I, a British national, have what I believe is a legally recognised non-religious and non-civic marriage, while other British nationals in this Chamber are not afforded that same right and freedom of choice were they to be wed in England and Wales.
As several Members have outlined in today’s debate, humanism is a proud tradition with roots stretching back across the centuries. Today, it is alive and well in Britain, with around 5% of the population identifying as humanists, which is more than 3 million people. For the record, I am one of them. The humanist tradition is clearly well established, and the demand for recognising this kind of marriage is clearly significant.
It is not just humanists who want this kind of marriage to be recognised in law: polling published this week by YouGov and Humanists UK shows that 70% of UK adults are in favour, and that this support is widespread and cross-cutting across a wide range of religious groups and political preferences.
Recognising humanist marriage in law is clearly the right thing to do, and it is time for the law to catch up with public sentiment. The public clearly respect and are permissive of a meaningful, non-religious alternative that aligns with the values of many couples, and that recognises that the current situation—in which couples who have a humanist marriage effectively have to duplicate their enjoyment at a later date, usually in a civil ceremony—is unfair. Recognising that unfairness and treating these marriages equally under the law would be a great step forward for millions of people, and it would provide legal clarity for couples.
The moment is ripe for this kind of change. The past decade and a half have seen meaningful revision of our marriage laws, on which the Liberal Democrats are proud to have led the way. The tireless efforts of Liberal Democrat Ministers such as Baroness Featherstone were instrumental in getting the Marriage (Same Sex Couples) Act passed. I am so grateful for the hard work of people like Lynne and the countless heroes from the LGBT+ community who made this a reality.
It was the Liberal Democrats in government who led the charge to get the ball rolling on recognising humanist marriages, too. Pressure from the Liberal Democrats resulted in the coalition Government proposing what is now section 14 of the Act: the order-making power that could give legal recognition to humanist marriages at any time. Since then we have had more than a decade of missed opportunity, as Government after Government have dragged their feet on responding to a series of Law Commission reviews. In that time, support for humanist marriages has only grown stronger, and the urgent need for change ever clearer.
This Government, who talked a good game in opposition on finally delivering this change using the section 14 power, have dithered in their first year. I ask the Minister to outline the timetable for moving forward on recognising humanist marriages, to explain the Government’s consider-ations in relation to the Law Commission’s review into the matter, and to tell us why they need more time to consider the change when the issue has been under review for 12 years.
I take advantage of this opportunity to personally call for the right to recognise any marriage conducted by a registered officiant for all other groups, as I enjoyed in my marriage, because there is no reason why a humanist should have rights that any other group is denied. Far from leading to “Las Vegas-style free-for-alls”, as the hon. Member for Morecambe and Lunesdale (Lizzi Collinge) described—somewhat tongue in cheek—I see it as a basic choice in a liberal society. If a couple choose to be married by a man in an Elvis Presley costume, they should have that right.
If the Government wanted, they could start making this change tomorrow. They have inherited a state apparatus that has had that power for more than a decade, as has been clearly expressed today. I hope the Minister agrees about the need to change the law, and I invite her to say to all of us, “I do.”
Dr Kieran Mullan (Bexhill and Battle) (Con)
It is a pleasure to serve under your chairmanship, Dame Siobhain, in what has been a heart-warming debate. I thank the hon. Members for Tamworth (Sarah Edwards), for Morecambe and Lunesdale (Lizzi Collinge) and for Henley and Thame (Freddie van Mierlo) for securing this debate, and the Backbench Business Committee for granting it.
Marriage and civil partnerships play a vital role in fostering stable families and, as a result, more stable communities. Marriage and civil partnerships are more than personal milestones; they are cornerstones of strong, cohesive and enduring relationships—values that my party holds dear. When talking positively about marriage, I always like to point out that my parents were divorced; I do not approach this issue with some idealised view of what marriage represents and can mean, but understanding that an institution is not perfect does not mean that one cannot champion all of its benefits.
I must also declare an interest in that I consider myself to be a humanist, and I am a member of the all-party parliamentary humanist group—this seems to be a gathering of humanists in Parliament today.
The exact meaning of what it is to be a humanist will be different for different people, just as the interpretation and meaning of religious faith varies among individuals. To me, it has its greatest value at a community and societal level. We can all individually decide to try to lead what we consider to be moral, values-based lives, but humanism provides us with the opportunity to do so from a shared perspective.
Many humanists celebrate significant milestones—births, marriages and deaths—in ways that reflect their values and worldview. As others have said, a humanist marriage ceremony is often deeply personalised, focusing on the couple’s individuality and commitment, rather than adhering just to religious traditions. Humanist ceremonies are gaining in popularity because they offer an alternative that resonates with those who prefer secular yet still meaningful celebrations.
Approximately 1,200 couples a year choose to have a humanist marriage ceremony, and currently they all have to have a separate legal ceremony. The public, outward-facing nature of a marriage ceremony puts into action the idea that values can be even more powerful when shared and celebrated together as a community.
Previous Conservative Governments understood and recognised the importance of marriage. We delivered the groundbreaking Marriage (Same Sex Couples) Act, which allowed gay and lesbian couples to lawfully marry for the first time. Indeed, that legislation provided for a review and subsequent public consultation on humanist marriages too.
I understand that the majority of respondents to the 2014 consultation were in favour of changing the law. However, the coalition Government, which included the Liberal Democrats, decided that the legal and technical requirements of marriage ceremonies and registration in England and Wales should be considered more generally, alongside making a decision on this issue.
The Law Commission was asked to review the law governing how and where people can marry in England and Wales, and the Law Commission concluded its work in 2022. The final 500-page report on reforming weddings law set out 57 recommendations. One feature of the proposed new scheme is that regulation would be based on the officiant rather than on the building in which a wedding takes place. The report also set out a scheme by which anybody could be authorised to conduct civil marriages.
I have some concerns about the Law Commission’s proposals. I understand that the recommendations go beyond giving humanist wedding ceremonies legal status, and they would create a free-market, celebrant-based approach to the wedding industry. I disagree with the Liberal Democrat spokesperson, the hon. Member for Sutton and Cheam (Luke Taylor), that marriage is an entirely individual choice. We have talked about how its value sits within society; and if society does not regulate and choose how that operates, marriage loses its wider shared meaning. Alongside humanists, others have expressed that such a move could undermine the solemn nature of marriage.
I understand that the current Government have also taken the view that wholesale reform is preferable. But every year that passes rightly creates further pressure, as the balance tips closer to those arguing that having specific measures to support humanist marriage ceremonies is the fairer approach. Let us not forget that Scotland and Northern Ireland already legally recognise humanist marriages.
During the pandemic, the previous Conservative Government took steps to adapt our marriage laws to accommodate the social distancing regulations in place at the time. In June 2021, they recognised the need for flexibility during a challenging time for individuals wishing to marry and for wedding venues, by extending legal recognition to outdoor civil marriages on an interim basis. The measure allowed ceremonies to take place outdoors on approved premises, addressing the unique challenges posed by the pandemic.
Following a consultation, that temporary reform was made permanent in April 2022, ensuring that couples could continue to celebrate their union in a safe and meaningful manner. The reform demonstrates the ongoing Conservative commitment to marriage and proves that specific adaptations to our legal framework to meet the needs of the moment are eminently possible.
On a personal level, and as a member of the APPG, I share the frustration with the continued delay to marriage reform and, as a result, the recognition of humanist marriages. I also note the YouGov poll, conveniently published earlier this week, showing strong public support for recognising humanist marriages, with 70% in favour and only 15% opposed. The support is consistent across religious and belief groups of different kinds.
Notwithstanding the concerns I have outlined, the Opposition are positively predisposed to the introduction of humanist marriage ceremonies. While we would need to consider any proposals in detail, we hope to be able to welcome any reform package brought forward. We are increasingly sympathetic to the need for specific measures to allow humanist marriages to take place, given the ongoing delays. A number of Conservative Members who support these measures wished to attend this debate, but as is often the case, timetables can be challenging.
I hope the Minister can outline a timetable, and if she cannot, can instead explain what consideration the Government are giving to targeted reform. What do they see as the obstacles to this approach? As other Members have mentioned, the manner in which the marriage ceremonies of Quakers and Jewish groups are legally recognised provides a template for the Government.
At the heart of this discussion lies a fundamental truth: marriage and civil partnerships are institutions that promote stability, responsibility and community cohesion. These are values that I, as a Conservative, champion unequivocally. I look forward to hearing the Minister’s plans for bringing them to the fore for the humanists in our society.
The Parliamentary Under-Secretary of State for Justice (Alex Davies-Jones)
It is a pleasure to serve under your chairship, Dame Siobhain. I start by thanking my hon. Friends the Members for Tamworth (Sarah Edwards) and for Morecambe and Lunesdale (Lizzi Collinge), and the hon. Member for Henley and Thame (Freddie van Mierlo), for securing this important—and, may I say, really lovely —debate.
I should stress that the strength of feeling and frustration around legally recognising humanist weddings is very clear to me from this debate. It is important for me to acknowledge at the outset that the Government fully understand and recognise the significance of the issue to hon. Members and to humanists more widely. I am aware that a number of hon. Member from both Houses are campaigning on the issue, including those Members who secured the debate. I thank all hon. Members for taking part and expressing their deeply personal experiences and views. It has really contributed to this positive debate.
Andrew Copson, chief executive of Humanists UK, has been at the forefront of this campaign. He has met officials from my Department on a number of occasions, and it has been very helpful to understand his views on the issue as we take forward any potential reform. It is also only right that I acknowledge the frustrations that humanists have felt while campaigning for a change to the law. I appreciate that this change has been ongoing on for a long time. For many humanists, the inclusion of the order-making power within the Marriage (Same Sex Couples) Act 2013 was hard fought for, and I know that it has been disappointing to them that this power has not been used to date.
I also do not think it would be right to have this debate without recognising the important contribution that humanists make to society. Humanists have often been at the forefront of the fight for social justice, campaigning for fairness, respect and equality for all. I join in celebrating the celebrants mentioned today for all the work they do to conduct weddings, funerals and important life events. The Government hugely acknowledge the tireless work of humanists, whether that is campaigning to abolish blasphemy laws, or Humanists UK raising the profile of illegal independent schools within Government.
I know that my noble Friend Lord Khan was very pleased to attend the World Humanists Day reception last year as the Minister for Faith, Communities and Resettlement. When the Prime Minister was Leader of the Opposition, he spoke in 2021 to mark Humanists UK’s 125th anniversary, saying:
“Ever since its foundation as an ethical movement, humanists have contributed enormously to our party’s and our nation’s achievements…Humanists and Humanists UK have been at the forefront of the fight for social change: to decriminalise homosexuality, to end corporal punishment in schools, and to introduce free school meals.”
I could not have put it better myself. That quote captures the profound and lasting impact of Humanists UK.
We are having this debate because marriage is one of our most important institutions. At its best, it is a celebration of love, a symbol of enduring partnership and a deeply personal commitment. Marriage can provide many benefits, including emotional support, financial stability and legal protections. For those who choose to marry, it is a significant and meaningful decision—one that this Government are proud to promote and protect. Although the state rightly has a responsibility to ensure that marriage laws provide clarity and certainty around the legal status of marriage, we believe the conversation can and should go further. Our weddings law should always reflect the importance and meaning of marriage as an institution.
It is important to acknowledge the shape of our current law around weddings and explain how we have got to where we are, so let me begin by reflecting on the history of marriage law in England and Wales—unlike some wedding speeches, I promise to keep it brief and free of groan-inducing jokes.
Our weddings law has evolved gradually over centuries, with its core structure rooted in the 18th and 19th centuries. The foundations of weddings law were laid by the Clandestine Marriages Act 1753. The Act was designed to prevent secret or hasty marriages by requiring weddings to be undertaken by Anglican clergy in a parish church or public chapel. While the Act permitted Anglican weddings only, it explicitly exempted Jewish and Quaker marriage ceremonies. The Marriage Act 1836 marked a significant turning point, introducing civil marriage for the first time and allowing weddings to take place in registry offices and non-Anglican places of worship. It also brought in civil preliminaries, acknowledging the state’s interest in there being legal certainty about who is married.
The fundamental structure established in 1836 remains largely in place today, consolidated within the Marriage Act 1949. The model on which our law is based is broadly a buildings-based model, which means that most marriages are regulated according to the building in which they take place. There are exceptions to the system, because Jews and Quakers are not bound by this restriction and may marry in any location.
There is discrepancy in the law, because couples must choose between a civil or a religious wedding. If they opt for a religious wedding, the rules that apply will vary depending which religion the ceremony is conducted according to. Civil weddings, by contrast, must be held at a register office or at premises that have been officially approved for that purpose. Therefore, it is for historical reasons that humanists are currently unable to conduct legally binding weddings. There is no provision in our legislative framework for non-religious belief ceremonies to be legally binding, as a wedding must either be religious or civil.
As others have said, the Law Commission published a report in 2022 reviewing weddings law and concluded that it is
“inconsistent and complicated, inefficient, unfair, and needlessly restrictive”.
It found that the law does not work for couples of many different religions and beliefs, including humanists. The report was the result of extensive research and stakeholder engagement; the Law Commission received more than 1,500 responses to its consultation and engaging with more than 50 key stakeholders. It provided a number of instances where the law does not work for many couples, and one prominent example is that humanist couples are unable to have legally recognised humanist weddings in England and Wales.
The Law Commission also highlighted discrepancies affecting different religious groups. For instance, Muslims, Sikhs, Buddhists and Hindus are required to marry in a registered place of worship, regardless of whether that place of worship is meaningful in a marriage context, and must use a prescribed form of words. In contrast, Jew and Quaker couples are permitted to marry in any location and without any prescribed wording. Another example identified was the challenges faced by mixed-faith couples, who are currently unable to have ceremonies that might reflect two different faiths.
To address the wide range of problems identified with the current law, the Law Commission made 57 recommendations for reform, underpinned by the proposal that current weddings law should be overhauled and a new legislative framework should be put in place. The Law Commission proposed a new framework to ensure that all groups are treated with fairness and consistency on how they get married.
I am keenly aware that humanists have expressed the view that the Law Commission’s recommendations do not provide the solution they are seeking. One of the main reasons for that is their preference for the Government to act quickly and use the order-making power, as several hon. Members have mentioned, which would allow for humanist weddings to take place within the current legislative framework.
Andrew Cooper
I understand the Minister’s point, but that does not accurately characterise my position. I am very happy for the Government to do a broader set of reforms, but I and others are arguing that we do not necessarily need to wait for that before acting on humanist marriage. The two things could happen in parallel. Would the Minister agree with that?
Alex Davies-Jones
It is important to ensure we do this properly. I am against any piecemeal reform here. If we are to do this, we need to do it properly and together, so that it is succinct. There are ways that that can be done, as I am about to come on to.
I acknowledge the calls made during this debate for the Government to take that step, and to take it quickly, and I will address them directly. Although it is true that using the order-making power would allow non-religious belief organisations to marry within the current framework of weddings law, it is important for us to take into account what the Law Commission has said about doing that. The Law Commission highlighted the complexities of the law in this area and concluded that exercising the order-making power is not, in its view, a viable option. As a responsible Government, we must take that view into account when considering the issue of weddings reform.
Cat Eccles
Does the Minister agree that those measures already exist for Quakers? Humanists are not asking for a huge change in the law.
Alex Davies-Jones
I totally agree, and I recognise that point, which I have addressed in terms of Jews and Quakers; this is about equality before the law, but we need to recognise the concerns raised by the Law Commission about what making that change on its own could entail. We need to look at this in the round, which is exactly what the Government are doing.
I know that the hon. Members who secured this debate will be disappointed when I say that it would not be responsible for the Government to ignore the Law Commission’s report, but we cannot ignore the fact that the report identified a number of complex and significant recommendations. It is absolutely essential that those are considered carefully and in full, and that is exactly what we are doing. I stress that that does not mean the issue of humanist marriage is being overlooked. On the contrary, the Government are actively considering the matter of humanist weddings as part of their broader review of the Law Commission’s report.
As I have said, we are considering the issues very carefully. Although I know hon. Members will be disappointed that the Government have not yet made commitments in relation to the issue, I hope the debate today has at least provided some assurance that the Government understands and hear the strength of feeling on the issues, including the key importance not just of weddings, but of marriage itself, and that we are looking into them with the utmost care and attention. I hope that assures hon. Members that I very much sympathise with humanists’ wish for legally binding weddings. I am happy to confirm—and say “I do”—that my officials are working on this at pace, and that an update on the Government’s position on weddings law reform will come soon. In answer to my hon. Friend the Member for Tamworth, we may not yet be able to set the date, but we can certainly start planning.
Sarah Edwards
I thank all hon. Members for their insightful contributions to this ceremonious debate, the personal stories shared and the tone of the debate. We have witnessed a marriage today between my hon. Friends the Members for Brentford and Isleworth (Ruth Cadbury) and for Aylesbury (Laura Kyrke-Smith), which was a treat for all of us. We have had an incredibly important debate, but we have been waiting. I acknowledge the Minister’s comments, but more than a decade has passed since Parliament gave the Government power to make this change—a change backed by public support, clear legal authority and a strong moral case. The Labour Government have the chance to act and bring an end to this unnecessary injustice.
It is slightly disappointing not to hear more clarity on the timeframe. We are asking for equal treatment, fairness and recognition, and it is a straightforward and uncontroversial step to give legal status to humanist marriages. I say to the Minister: let us not wait any longer. The engagement has been long enough. The guests are ready, the vows have been written and the case is clear for finally delivering the legal recognition that humanist couples have waited so long to see. Will she pronounce our humanist marriages lawfully wedded?
Question put and agreed to.
Resolved,
That this House has considered the recognition of humanist marriages.
Long-term Medical Conditions
Westminster Hall is an alternative Chamber for MPs to hold debates, named after the adjoining Westminster Hall.
Each debate is chaired by an MP from the Panel of Chairs, rather than the Speaker or Deputy Speaker. A Government Minister will give the final speech, and no votes may be called on the debate topic.
This information is provided by Parallel Parliament and does not comprise part of the offical record
Peter Prinsley (Bury St Edmunds and Stowmarket) (Lab)
It is a pleasure to serve under your chairmanship, Mr Efford. Long-term conditions need a long-term plan. We were promised one of those, and it cannot come soon enough. The Chancellor’s statement yesterday, which committed to a 3% real-terms rise in NHS funding each year, gives me enormous hope for the future of our health service. Some 70% of that funding will likely go to the treatment of long-term conditions, so it is incredibly important that we consider how we should treat them.
Most of us at some point will collect a few long-term conditions. Some of us are born with them; sometimes, they are serious disabilities. I am sure that we will hear some stories of those challenges. I reached out to the people of Bury St Edmunds and Stowmarket and heard many stories about their experiences of using our NHS. All too often, it is the same story: it is those with long-term conditions, not deadly diseases, who feel most let down now. The reality for many is that by the time they reach my age, they are fortunate if they have never had to visit a clinic or see a nurse about something that is no longer working quite as well as it should. The wheels begin to fall off all of us eventually.
Living with a long-term condition has a profound impact on people. It can mean lost work days, missed opportunities and, for many, being pushed out of the workforce altogether. When people are unable to work because of poor health, they are cut off from society and their quality of life obviously declines. That also has a terrible effect on the economy. It is estimated that successfully addressing the crisis in long-term sickness would increase GDP by between £109 billion and £177 billion over the next five years, generating billions of pounds of additional tax revenue. This is a growing trend and as the population gets older it will simply become more pressing. I worry that we have not truly adapted our medical system to deal with this reality.
When I was a medical student, a heart attack was managed with morphine and bed rest. Things have certainly changed, and yet the NHS has not changed enough. In 1948, it was created to deal with infectious diseases and acute hospital care, but the health needs of the population have changed completely. People now live long lives with conditions such as heart disease, diabetes and arthritis. We need to focus on keeping those people in the community rather than waiting until they become so unwell that they have to be brought to hospitals.
The NHS should not just be a sickness service; it should help people to manage their conditions and live much better lives. During our debate on dementia a few days ago, I heard many moving stories about families challenged by that devastating illness. Dementia fills so many hospital beds, and the cost to society is quite staggering, but the real message of the debate was about the need for better community care and greater investment in technology and research. That is true for dementia, but it is also true for many long-term conditions. We have the time and the ideas; now, we must use them.
There is much talk about moving care from hospitals to the community, which is not a slogan but an absolute necessity. I have seen it work in practice: before I came here, I was involved in a project that moved care for people with hearing loss out of hospitals and into the community. Patients benefited from easier and quicker access to specialist NHS audiology and nursing services. We now need to see such an approach rolled out across the country.
The neighbourhood practice model advocated by my Suffolk GP colleagues must be part of the answer, with community health hubs open into the evening, resourced with nurses and mental health services and incorporating a pharmacy, with a GP who is known to the patient and to the family. Those hubs would be the place to call when sick—a better option than calling 111 or having a long wait in A&E. They would offer access to multi-disciplinary teams all in one place, a bit like the geriatric day hospitals that my dad, Professor Derek Prinsley, a pioneer of geriatric medicine, introduced into his practice in Teesside in the 1960s.
The NHS must be a neighbourhood health service, not just a national health service. That is how we join up care so that patients no longer feel like they are being pushed from pillar to post. Instead of being rushed between different appointments in hospital corridors, people should be cared for in one place, bringing lifesaving continuity of care. It is time to end the fragmented system of the past, where people ended up in A&E simply because there was nowhere else to go, and where we had older people lying in trolleys in the early hours for long-term conditions that could have been managed in primary care. A&E should be for real accidents and emergencies. That is how we must start thinking about the long-term care of long-term conditions.
At the centre of our thoughts must be the patient. Health services are all too often designed to deal with patients with a single disease, but for a growing number, that is no longer a suitable model. If I have high blood pressure and asthma, I have to visit the practice three times: once for the blood pressure check and once for the asthma check, and then another appointment to see the GP. I think we can do better than that.
How can we truly put the patient at the centre of healthcare? As I have said before, one answer is to embrace the digital transition and change the medical record paradigm. Let the patient have the record. Give them agency over their healthcare. If people knew a bit more about their health, they might care for it a bit better. More than one in five patients with a long-term condition has said they do not have enough information to manage their condition. That is 5.5 million people across the country who are not confident that they can manage their condition, so let us have the doctor ask the patient for the record, not the other way round. That would be a revolutionary change.
I would like to talk about medical research. Of course, our country has an incredible record of medical research: Jenner, who devised vaccination; Lister, who invented antisepsis; and Fleming, who discovered penicillin—British doctors who saved unimaginable numbers of lives. Then there is Dr John Snow, who removed the handle from the water pump in Broad Street, near to where we are sitting today, ending the cholera epidemic and founding the field of public health. It is on scientific advances like those that we mostly depend as we fight many long-term conditions. We will hear of artificial pancreas pumps to treat diabetes and genetic treatments to cure sickle cell disease and arthritis, but let us not take that progress for granted. We should support medical innovation and put the best technology into the hands of our doctors.
I am proud that the Government are boosting investment in diagnostic machines in hospitals across the country, because I have been told by constituents about the struggle of misdiagnosis—months and years spent unsure what is wrong with them, with doctors unable to shed any light. We are rolling out artificial intelligence and improving diagnostics across the country, and the Government have promised to support that further.
Improving researchers’ access to medical data will be part of the approach. Let us imagine the scientific advances we could make if researchers could conduct studies on sample sizes of 67 million people. Scientific and medical advances depend on our brilliant young people, who must be funded and supported as they embark on research careers. The number of clinical academics is in decline, which is a particular worry of mine. We should challenge that and reverse it. The NHS is easily the biggest employer in our country—perhaps one of the biggest employers in the whole world—but what are we doing to ensure that its people can best support us?
A failure to tackle long-term conditions is significantly impacting the NHS’s own workforce. Musculoskeletal conditions, rheumatoid arthritis and osteoarthritis are leading causes of absenteeism among NHS staff, with ambulance and clinical support staff particularly affected, but we also hear many examples of terrible workforce planning. We learn of nurses and midwives graduating from colleges carrying large debts, after working for thousands of hours on placements for free, only to find a recruitment freeze in the very hospitals that desperately need their skills. Instead, hospitals are spending huge sums on agency staff. This is not a long-term plan; this is short-term thinking of the very worst kind.
I am glad that agency spending fell last year. We must make sure that we spend wisely on newly qualified nurses and midwives, which will end up saving the NHS enormous sums. We also ought to do something about their student debt. Why not write it off if they commit to working for five years in our NHS, giving them security? Our health service needs their expertise.
What about the young doctors, of whom I have spoken before? We need enough GPs, nurses and clinicians to help people to get well, but every year, thousands of UK doctors qualify with debts of up to £100,000. Many are then sent far from home, family and friends just as they begin their careers, and after two years they face intense competition for higher training against thousands of international doctors who fill up our hospital rotas and keep our services running. Some young doctors find themselves repeating their foundation years or going overseas, and others leave medicine altogether. This is certainly not a long-term plan.
We must do better. I have seen for myself that our hospitals can run better with the resources they already have. At my West Suffolk hospital I saw the results: corridor care has been abolished and long-term waits in A&E are now a thing of the past. That has been done by taking a whole-hospital approach to improve the patient experience and ensure that the appropriate health professional is dealing with the patient at the earliest opportunity. That does not cost more, the staff are happier and the service is massively better. That is what happens when we put people first, work together across the disciplines and take real responsibility for change.
Mr Blair once spoke of dealing with crime and the causes of crime; today I speak of dealing with diseases and the causes of diseases. Poverty, poor nutrition and poor housing are at the heart of so much of our country’s ill health. Those are not just background factors; they are the root cause of suffering and long-term conditions. If we are truly committed to a healthier society, those are the challenges we must address.
The mission of our party and our Government is to lift millions out of poverty, tackle deep inequality and shape people’s health from cradle to grave. We will not accept the shocking housing conditions endured by so many of our fellow citizens. These are not simply political and economic problems; they are the underlying causes of much disease and misery, and many avoidable deaths.
There is much for us to do, but I am convinced there is much that we can do to create easier access to NHS services, improve primary care and support those who want to conduct groundbreaking medical research. I hope the Government will look to tackle our long-term conditions crisis.
Several hon. Members rose—
Clive Efford (in the Chair)
I remind Members that they must bob if they want to take part in the debate.
Shockat Adam (Leicester South) (Ind)
It is a real pleasure to serve under your chairship, Mr Efford. I thank the hon. Member for Bury St Edmunds and Stowmarket (Peter Prinsley) for his learned and absolutely excellent speech. I will focus on my profession as an NHS optometrist and discuss the impact of sight loss from long-term conditions.
Let us imagine a young mother-to-be sitting in my consulting room glowing with excitement, whose joy turns to fear as I gently explain to her that her sight is deteriorating—all of a sudden it becomes a race against time; she may never be able to see her baby clearly. Or let us imagine the teenage boy with dreams of a rugby career who leaves my room with the life-changing knowledge that he is losing his vision. Unfortunately, those are not extraordinary cases; they are everyday tragedies in my workplace.
These long-term conditions are often framed in terms of physical health, but as someone working with patients losing their sight, I see—as the hon. Member already eloquently articulated—the more profound, layered consequences everyday: the emotional trauma, isolation and loss of independence, and the inevitability of declining mental health, which I want to concentrate on.
For example, macular degeneration is the leading cause of blindness in the UK. It does not just take away people’s central vision; it also affects their ability to read, recognise faces and drive. That means grandparents may never be able to see the faces of their grandchildren; tears are a natural result of such a devastating awareness. There is also a condition called glaucoma—generally diagnosed later in life—known as a thief of sight, because it creeps up on someone silently, often unnoticed, until irreversible damage has been done. It steals more than vision; it robs people of confidence, safety and the ability to live independently. For many, the diagnosis comes too late, and with it comes a slow loss of identity.
Sight loss is not just a health issue but a social one, and its impact is profound. More than 4 million people in England with a long-term physical health condition also live with mental health problems. Those individuals experience significantly poorer outcomes and shorter life expectancies, and economically the toll is massive: between £8 billion and £13 billion a year, or at least £1 in every £8 spent on long-term conditions, is linked directly to poor mental health and wellbeing.
One extremely overlooked condition—I suspect many people have not heard of it—is a consequence of vision loss called Charles Bonnet syndrome, which causes people to see vivid hallucinations as the brain attempts to fill in the gaps left by the reduced sight. The images can be repetitive patterns, but more often and distressingly they can be realistic visions of people, sometimes long deceased, or landscapes.
Let us imagine that a person who is elderly, fragile and possibly alone is diagnosed with sight loss, and all they can see is their long-lost childhood pet—it is beyond frightening. It is not a mental disorder, yet many patients suffer in silence, afraid to talk about the hallucinations for fear of being misunderstood and misdiagnosed. Research suggests that at least one in five adults with sight loss will experience Charles Bonnet syndrome—more than 1 million people in the UK—but the figure is probably even higher. Children are affected too, but we are only beginning to understand their experiences.
People living with long-term conditions such as macular degeneration, glaucoma and diabetic retinopathy face a constant battle not just with their illness, but with a system that is not designed to meet the complex, long-term nature of their needs. We need a change in the Government’s upcoming 10-year healthcare plan, and I have some suggestions for that. We should recognise sight loss and associated conditions such as Charles Bonnet syndrome as part of the national long-term conditions framework.
We need routine mental health screening and support for people with chronic vision impairment—in fact, for all long-term conditions. We need training for all healthcare professionals, as the hon. Member for Bury St Edmunds and Stowmarket said, in integrated work, so that optometrists, GPs and nurses identify patients and support them with the psychological impact of the illness. NHS funding models and care pathways should be redesigned to reward integrated care and cross-speciality collaboration, especially where physical and mental health intersect. We need investment in early detection and care pathways.
Long-term conditions shorten lives not only through the body but through the burden they place on the mind. If we do not act, we will be complicit in that erosion. But if we do act—if we integrate care, listen to patients, fund innovations and remove stigma—we can change what it means to live with long-term conditions in this country. Let us ensure that people living with long-term health conditions, whether heart failure, arthritis, diabetes or sight loss, are not left to fall through the cracks. Sight is not a luxury, independence is not optional and suffering in silence must never be acceptable.
Alison Hume (Scarborough and Whitby) (Lab)
It is a pleasure to serve under your chairmanship, Mr Efford. I thank my hon. Friend the Member for Bury St Edmunds and Stowmarket (Peter Prinsley) for securing this extremely important debate. He speaks from a position of great experience. He rightly points to a holistic approach, putting the patient at the centre of their treatment.
By 2035, two thirds of the UK population aged over 65 are expected to be living with two or more long-term conditions, whether chronic obstructive pulmonary disease, Parkinson’s, diabetes or epilepsy. Living with an LTC can significantly reduce a person’s quality of life.
I rise to speak on behalf of those living with a condition that affects approximately 1.5 million women in the UK: endometriosis. This chronic condition, whereby tissue similar to the lining of the womb grows outside the uterus, causes debilitating pain, fatigue and often infertility, yet despite its prevalence it remains under-recognised and undertreated, like so many conditions that affect women. The average time to diagnose in the UK is more than eight years. Many women visit their GPs multiple times before receiving a referral, and some are forced to turn to private healthcare due to the lengthy NHS waiting times. That delay not only exacerbates the condition’s physical symptoms but impacts mental health and quality of life.
Endometriosis is not merely a health issue for women; it is a public health issue that costs the UK economy. Over half of those affected have taken time off work due to endometriosis, and many fear job loss or reduced income.
My constituent, Angela Tiernan, has thoracic endo-metriosis, a rare form of the condition where tissue similar to the uterine lining grows in the chest cavity, commonly affecting the diaphragm and lungs. Angela recently found out that planned surgery to confirm her diagnosis and reformulate a treatment plan would no longer be going ahead as the specialist Oxford University Hospitals has stopped commissioning the surgery, as have other specialist centres in London and Bristol. Angela has told me that patients are being advised to go private to access required treatments and surgeries that were previously available through the NHS, but have since been cancelled by the hospital. My constituent Angela and other women are now left in a position with no diagnosis and no access to investigation, care or treatment unless they can afford to go private.
Endometriosis is a long-term condition that requires a long-term solution. I ask the Minister for reassurance that endometriosis is addressed in our 10-year-plan.
Josh Babarinde (Eastbourne) (LD)
It is a delight to speak under your chairship, Mr Efford. I thank the hon. Member for Bury St Edmunds and Stowmarket (Peter Prinsley) for securing this important debate.
Many of those living with long-term conditions are people who live happy and enriched lives. They are supported not only by wonders in medical advancements, but by the communities of people—friends, family or incredible NHS and care staff—who support them week in, week out, day in, day out. But for some, the consequences when those support networks fail can be catastrophic. I would like to use this opportunity to raise awareness of the plight of my constituent, Andy.
Andy has been living with a benign brain tumour and functional neurological disorder for nearly a decade. In that time he has been treated in various medical settings. By 2022, he had been transferred from the care of London hospitals to medical facilities closer to home in my constituency of Eastbourne. Following an initial appointment there in April 2022, he was told that there would be a follow-up six months later. Outrageously, due to human error, the follow-up was not held until November 2024, a staggering two and a half years after his initial appointment. I hear of cases like that again and again, disproportionately from patients experiencing long-term health conditions. It seems there is no parity of esteem between people suffering from these kinds of conditions and people suffering from shorter-term, more emergency-based conditions.
If that was not bad enough, Andy was subsequently informed that the services and expertise needed to treat his condition, which he had been referred to Eastbourne for, were not available locally, so one has to ask why that transfer happened in the first place. But the wider question, which goes to the point made by the hon. Member for Bury St Edmunds and Stowmarket, is why towns like Eastbourne are denied such important services locally. It cannot be right that people living with long-term conditions sometimes have to travel dozens or in some cases hundreds of miles to access the care that they deserve and rightly expect.
We have seen in the likes of my town and across the country, following years of underfunding by the last Government, centres like the Eastbourne district general hospital losing core services to other towns and cities nearby, forcing residents to trek even further to get the treatment they need. The life of my constituent, Andy, has been hugely impacted by this woeful state of affairs—a broken system and broken administration within it. Both his personal and professional lives have been significantly compromised. He can, of course, take his case to the ombudsman, which he plans to do, but that process can take months if not years to conclude, and he needs answers now.
I ask the Government: what steps are being taken to address and rectify the issues, not only with the funding but with the administration of our NHS, caused by some of these things that create such grief and hardship for residents like Andy? What steps are the Government taking to ensure that local hospitals like mine are equipped to treat a broad range of long-term conditions? Most importantly, for Andy, can I get a categoric reassurance from the Government that his case will be looked into and resolved as a matter of urgency, so that neither he nor anyone else in his position has to experience this gross injustice on top of the hardship of living with a long-term condition?
Terry Jermy (South West Norfolk) (Lab)
It is an honour to serve under your chairmanship, Mr Efford. I thank my hon. Friend the Member for Bury St Edmunds and Stowmarket (Peter Prinsley) for securing this debate. This is also an appropriate time to acknowledge his more than four decades of service as a surgeon in the NHS.
I want to use my time to talk about strokes, because I, like millions of people across the country, have a personal account of dealing with this life-altering medical condition. At 11 am on 13 August 2013, I received a message from a relative saying, “I think your dad has been in a crash. The car is all smashed up and the doors are wide open outside the house.” I was at work in Cambridge that morning, and my parents’ house was back in Norfolk. Not being able to reach my dad, I managed to get a message to my sister to go round. She found my dad in bed.
Unbeknown to any of us, including my dad, he had been having a stroke all morning. Getting ready for work, he struggled to put on his coat. He forgot to pick up his car keys and initially left the house without locking the door. My mother did not think too much of it. He then somehow managed to drive her to work and drove himself to his engineering factory just a bit further down the road. When he got to work, they sent him home. They thought he was drunk.
On the way home, my dad crashed into a parked lorry. Dazed and confused, and in the midst of his stroke, he drove home and took himself to bed, thinking he had a cold. If he had not left the car abandoned outside the house, and if that relative had not raised the alarm, he would have been in bed for the rest of the day alone and he likely would not have survived. As it turned out, we were able to get him to hospital and we managed to have a further 10 years with him. My dad was 55 when he had his stroke. He was fit and healthy. He worked full time. He showed no warning signs, and then—wham. He had a full-on, major stroke from nowhere.
As a family, we did not know much about strokes at all. I had no idea that they came in all shapes and sizes, with varying levels of severity. The recovery, too, is variable. Strokes directly affect 100,000 people each and every year. Approximately one in four men and one in five women aged 45 can expect to have a stroke if they live to 85. Stroke is the fourth leading cause of death in the UK, and a leading cause of disability. Tragically, nine out of 10 strokes are preventable through early detection and management of conditions such as high blood pressure.
Last month was Stroke Awareness Month, which is an important opportunity to highlight how to spot a stroke. I urge Members to look at F-A-S-T—face, arms, speech, time—the method to recognise symptoms. Is the face drooping? Does one side of the face feel numb? Is the arm weak? Can the person raise both arms? Is speech difficult? Ask the person to repeat a simple phrase. Check to see whether speech is slurred or strange. If these symptoms are observed, it is time to call 999—F-A-S-T. I welcome the Government’s commitment to a 25% reduction in deaths from cardiovascular disease and stroke by 2035, but without urgent action on stroke, that goal will not be met. A plan is needed to tackle three key factors: early detection, treatment and prevention.
There are almost 3,000 stroke survivors in my South West Norfolk constituency alone, and they are all working to rebuild their lives. The prevalence of stroke in my constituency is 473; given that one is the lowest prevalence and 543 is the highest, it is clearly a significant problem in my community. While I have the opportunity to do so, I also want to note the Stroke Association’s incredible work to support stroke survivors across the country.
Jim Shannon (Strangford) (DUP)
It is a pleasure to serve under your chairship, Mr Efford. I thank the hon. Member for Bury St Edmunds and Stowmarket (Peter Prinsley) for securing the debate and, like the hon. Member for South West Norfolk (Terry Jermy), I thank him for his service. I did not know he was a surgeon —I thought he was a GP—but whatever it was, I thank him. We are all indebted to him for his contribution.
It is great to speak in this debate as the Democratic Unionist party health spokesperson, and as an MP who has many constituents suffering from long-term health conditions. I frequently meet them to discuss the issues they face and, more often than not, the issue is benefits and help to fill in their benefit forms—I have a staff member who does nothing else but that. We are, then, face to face with those with complex and chronic long-term conditions. It is important to come here and make the case for them.
I declare an interest as a type 2 diabetic. Believe it or not, this thin young man—he is not young no more, by the way—used to be 17 stone. He is now down to just over 13 stone. Whenever I was told I was diabetic, the doctor was very clear that I really had to do something. A sweet trolley was going by the table—I remember that well; it has stuck in my mind all these years—and he phoned up to tell me. I went to see him because I thought there was something wrong, and there was something wrong, but thank goodness it was not what I thought it was at the time. He said, “You’re diabetic. The one good thing is that you’ve got a heart like an ox.” That was perhaps the one good thing out of it all.
I lost weight and was able to control my diabetes for four years or thereabouts, but then it got worse. I am now surviving with nine tablets in the morning and five at night. That keeps the condition subtle and manageable. This is not about me, but I wanted to tell that story because many people who are diabetic do not know they are. We always talk about early diagnosis, as the hon. Member for Bury St Edmunds and Stowmarket and others will know.
Tom Gordon (Harrogate and Knaresborough) (LD)
It is an honour to intervene on the hon. Gentleman. I am the chair of the all-party parliamentary group for diabetes and I want to emphasise the point about early detection. A family recently got in touch with me who tragically lost their daughter because she had not been identified as a type 1 diabetic and ended up in diabetic ketoacidosis. Does the hon. Gentleman agree that we need to do more to identify people and screen them for chronic, lifelong conditions?
Jim Shannon
If I could ask for one thing in this debate, it would be that—it is important.
I should have welcomed the hon. Member for Wellingborough and Rushden (Gen Kitchen) to her position; apologies for not doing that at the beginning of my speech. It is a real joy to see her there. It is better than whipping, I am sure she knows. This is two debates in two days running in which we have had Parliamentary Private Secretaries and, in this case, a Whip in the place of Ministers. I wish her well in her role today.
Many of the people I meet every day have diabetes, dementia, Alzheimer’s, multiple sclerosis, Parkinson’s, osteoporosis or chronic obstructive pulmonary disease. COPD has been more prevalent this last while than it has been in the past. It is an accumulative disease, of course—it comes at the end of a person’s life, unfortunately —and it catches up with people, in many cases. It is not just about the long-term physical conditions; it is the depression, the anxiety and the mental health effects, as well as the pressure of life. The physical pressures are part of it, but the mental pressures come off the back that. Many of the people I speak to have complex needs, and might have one, two or perhaps three of those conditions, which adds to the issue.
Ahead of the debate I met representatives from the Cystic Fibrosis Trust and spoke to them about the effect of cystic fibrosis on people. This week, I celebrate the people, like the trust, who have responded to cystic fibrosis by trying to find a cure. CF is a chronic, life-limiting genetic condition without a cure. It affects more than 11,000 people across the UK, with approximately 500 of those diagnosed back in Northern Ireland. I meet some of them regularly in my constituency. For those living with the condition, medication and general health must be considered when planning the simplest of projects or activities—even getting out of bed, for goodness’ sake, or going down the stairs or making breakfast. Going shopping is a no-no for most of them, and interaction with family is another issue. Being unwell can interfere with work and education every day. Research has highlighted the intense financial costs of the condition, which causes an average loss in income of nearly £6,800 a year.
This is not a direct attack on the Minister, but I have to make a point about the potential changes to the guidance on welfare and personal independent payments. I have raised before how the changes will impact people with certain health conditions who are on benefits such as PIP. I know that the Government are trying to get people who want to work back into work. Some people with these conditions cannot work, of course, but for people with other conditions there are days that they feel good, and days that they do not. They cannot regulate themselves and say, “I’m going to work Monday, Tuesday and Wednesday of next week,” because the fact is that they do not know how they will feel next week. They may not be able to get out of bed. The Government need to look at flexibility in the PIP process. That probably means that a person cannot do every job that they would like to do, and is restricted. It might be that they have to do some of their work from home. When they look at changes, the Government need to consider that.
The Government must commit—this is my absolute red line in the sand—to scrap the four-point rule for personal independence payments, which disproportionately harms people with conditions such as Parkinson’s and CF by failing to account for conditions that tend to fluctuate. That is the very issue I am trying to put forward. As I said, the cost of some of these conditions is financially challenging for many. Aside from the loss of PIP payments, it is also important that a safety net is provided by increasing the age of transition for young people who are currently eligible for disability living allowance but transferring to PIP. These are not issues that the acting Minister will understand, or respond to positively, in a focused way, but it is important to feed these issues into the process so that when Labour comes up with a way forward, it understands the issues.
I wish to speak briefly about the Government’s national cancer plan, which is extremely important for people living with cancer and the care they receive. The plan states that more care will be shifted from hospitals to local communities. Earlier today, the hon. Member for Wokingham (Clive Jones) asked the Minister for Secondary Care a question on the health and social care statement, and expressed disappointment at not hearing anything about cancer in the statement. The Government need to focus on cancer, including the early diagnosis of the disease and how quickly the process can move forward to ensure that people get treatment.
Back home in Northern Ireland, general practitioners are referring people for cancer treatment, and only 35% of those people have been seen. What a disappointment. That is not the Minister’s fault—it is a devolved matter, so it is the responsibility of the Minister back home—but if 65% of people who are diagnosed with cancer are not getting treatment, my goodness me! That comes to the point that the hon. Member for Eastbourne (Josh Babarinde) made about his constituent who had to wait two and a half years—how long are people waiting to get treated? Sometimes the delay in treatment means that the person does not survive and passes away. What a tragedy that they did not get the response they needed at the time that they needed it. We need to be ever mindful that the care of people who require long-term cancer care is tailored to them and structured in a way that suits them and makes them as comfortable as possible.
It is wonderful how the NHS has advanced, and how the cures for cancer have advanced. Although 50% of the people in this room will get cancer, 70% of us will hopefully survive. Is it not marvellous how the NHS has progressed and how the research into finding the cure for diseases has marched on?
One in two people with a serious disability or other long-term condition, such as diabetes or heart disease, say that it is now harder than ever to get a diagnosis, and some people may have the complex issues I referred to earlier as well as cancer. Too many opportunities to support people are being missed. I look to the Minister for a response, and for her to say that the Government will do what they can, through the legislature, to provide support for people with long-term health conditions.
So many people across this nation are suffering and we must do more to ensure that their lives are made as easy as possible. I look to the Minister for a very positive answer. I hope that I have not given her a difficult time; that was not my intention. I try to do things in a respectful way, and hope my questions have not been too hard to answer. They are straight from the heart, and from the heart of us all, because we are here to work on behalf of our constituents. The stories that I bring to this Chamber are those of my constituents, and the hon. Member for Eastbourne brings the stories of his constituents. The hon. Member for Leicester South (Shockat Adam) told us three or four different stories about vision, which is not something we hear about often, but those are the true, everyday experiences of his constituents. We need something in response to that.
When it comes to the answers, perhaps we could have a better working relationship with the devolved Administrations. I am ever mindful that health is devolved in all three of them, but there could be concerted plans. Whenever I first came to this place, we had a United Kingdom of Great Britain and Northern Ireland diabetes plan that was agreed by this Parliament and by all the regions and all the Administrations. Sometimes, we need to do things collectively. I always put forward the advantages, and this great nation—this United Kingdom of Great Britain and Northern Ireland—is great because of all the people who make up the component parts: the Scots, the Welsh, the Northern Irish and, of course, the English.
Ruth Jones (Newport West and Islwyn) (Lab)
It is a pleasure to serve under your chairmanship, Mr Efford. I was a bit anxious, because I do not think I have ever followed the hon. Member for Strangford (Jim Shannon) before, and people are normally leaving as he sits down. But there we are.
I congratulate my hon. Friend the Member for Bury St Edmunds and Stowmarket (Peter Prinsley) on securing such an important debate. He clearly demonstrated why he was the best person to bring this issue forward, given his years of experience.
I declare an interest: I was a physiotherapist for 32 years. I was also used to dealing with long-term neurological conditions such as stroke, MS and Parkinson’s, and respiratory conditions such as asthma and COPD. They are all really important. Of course, I also dealt with long-term musculoskeletal conditions such as arthritis.
For the sake of balance, I should say that my daughter is a resident doctor. I had to mention her, otherwise she would tell me off. As people can imagine, we have a very balanced debate about whether a doctor does better than a physiotherapist. We have a lot of interesting debate about that.
I must thank Versus Arthritis, representatives of which I met earlier this week to talk about various conditions and the economic impact of arthritis. They reminded me about this debate. I was late asking to speak because it had completely passed me by.
It is really important that we acknowledge the fact that, as other hon. Members have said, there are many people in this country living with long-term conditions and living very successful lives. We must make sure that we enable them to carry on in that way.
Arthritis impacts over 20 million people in this country, which is a lot of people. Whether it is osteoarthritis or rheumatoid arthritis, nearly one in six of us is living with arthritis. Arthritis affects all ages, not just the elderly, as we tend to assume, and effects children, too. Juvenile chronic arthritis is well known, and at least 10,000 children are currently living with that condition.
The issue is not only diseases and the way they affect people’s mental health, or other factors, but the economic impact, as we have heard clearly from other hon. Members. Some 2.8 million people may be economically inactive due to long-term conditions. After mental health issues, musculoskeletal issues are the second biggest reason why people are economically inactive. That means a tremendous loss of revenue to the Treasury.
There is also a feeling of worthlessness, and people’s mental health going down and down. One of my ladies had MS. She said: “What really creases me is my children have to help me, instead of me helping them.” That really affected her mental health. Reliance on others is one of the biggest issues. There are lots of aids, gadgets and gizmos that can help people to live independently, but they need to know about them. There can be long waits for assessment, treatment or surgery, during which time people’s long-term conditions can deteriorate. We need to ensure that we educate people with these conditions; knowing what their condition is makes it is all the more easy to manage. Knowledge is power here.
We need individual, tailored help. It is not enough to say, “You have osteoarthritis of the hip—you do this.” We have to tailor the programmes to ensure that the individual is very much a part of them, as my hon. Friend the Member for Bury St Edmunds and Stowmarket said. It is all about putting the person at the centre of the care plan. They are the most important person.
Obviously, I am going to say that exercise and management of the physical condition is key—I am a physio, so I would, wouldn’t I?—but it is important that people do not just curl up in a ball in the corner and think, “That’s it; my life is over.” They can still go on to have worthwhile lives with a long-term condition.
Osteoarthritis happens to the best of us. I look at people’s hands and I can see that they are a bit arthritic-y; I look at the way people walk and can see that, yes, they have a hip or knee problem. Having the disease does not make it inevitable that our function goes down. It is important that we manage the outcome and ensure that people can exercise and maintain their physical fitness.
The Minister will be pleased to know that, as a Welsh MP, I am not going to be making asks of her—I do welcome her to her place and congratulate her—but I hope that she listens to the asks made by my English colleagues and talks to her colleagues in the Department. As the hon. Member for Strangford mentioned, the PIP changes are coming, and we are hearing about welfare reforms. Those are important, and I understand the need for reform, but at the same time we must take account of the variability of people’s conditions, and the assessment process must be done correctly first time. We save an awful lot of time and money on appeals if we can get it right first time, and that is what everybody wants.
Finally, long-term conditions are here, but they can be managed, in partnership between the individual and the services all around. Bring it on.
Olly Glover (Didcot and Wantage) (LD)
It is a pleasure to serve under your chairship, Mr Efford. I follow other hon. Members in congratulating the hon. Member for Bury St Edmunds and Stowmarket (Peter Prinsley) on bringing this vital topic to the House and sharing his insight from his many decades of medical practice as well as the tribute that he paid to his father’s—he clearly comes from a family of strong medical pedigree. He talked about the potential for a boost of more than £109 billion for the economy. He also spoke about the wheels starting to come off, but I say to him that there is no sign of that happening in his case: I have heard him make valuable contributions using his medical experience in many debates in the House.
This topic is important. Analysis from the Office for National Statistics conducted during 2019 and 2020 highlighted that almost half of the UK population reported having a long-standing health problem, with the four most common chronic conditions in the UK for men and women being allergy, high blood pressure, low back disorder and depression. The Health Foundation has found that more than 9 million people in England are projected to be living with a major illness by 2040—an increase of 2.5 million compared with 2019. A third of those surveyed in 2024 did not feel supported to manage their long-term health condition.
Hon. Members have brought out some important themes in the debate. They have talked about the mental health and economic impact, and the importance of social, community and volunteer care, as well as care in hospitals and health facilities. They have talked about the importance of integrating care and ensuring that appointments are co-ordinated to avoid people being pushed from pillar to post in our excellent but sometimes complicated national health service. They have also all highlighted the critical importance of prevention, screening and early diagnosis and detection, as well as the need to reduce waiting times to increase survival chances. A number of hon. Members also highlighted concerns about the benefit system and personal independence payments, and I am sure we all very much look forward to hearing from the Minister on that point.
The hon. Member for Leicester South (Shockat Adam) shared some very powerful stories from his time as an optometrist, including the impact of sight loss on people’s physical and mental health. He highlighted the potential to save between £8 billion and £13 billion by tackling mental health and wellbeing impacts.
The hon. Member for Scarborough and Whitby (Alison Hume) spoke powerfully about endometriosis—I have a friend called Emma who is also dealing with that condition—and highlighted that two thirds of people expect to live with long-term conditions. My hon. Friend the Member for Eastbourne (Josh Babarinde) spoke powerfully about his constituent Andy, who has a benign tumour and functional neurological disorder. My hon. Friend laid out how the NHS and the care system have not always been able to meet Andy’s needs locally, despite their good intentions. The hon. Member for South West Norfolk (Terry Jermy) spoke emotionally and powerfully about how his father’s stroke was detected as a result of a car crash, which paradoxically saved his life, and he also told us how strokes are the fourth most common cause of death and a common cause of disability.
The hon. Member for Strangford (Jim Shannon) talked about the importance of access to benefits. I pay tribute to his ox-like heart. He mentioned a number of long-term conditions, including type 2 diabetes, COPD, cystic fibrosis and cancer. The hon. Member for Newport West and Islwyn (Ruth Jones) talked about her physiotherapy background. It is so good to have so many Members who bring their past health and medical background to this House. She highlighted that one in six people are affected by arthritis and she quite rightly reminded us that long-term conditions are experienced not only by older people but by people of all ages.
My constituent, Terry, has a range of long-term health issues, some spanning more than 20 years. There is little to no co-ordination of his care. He has had doctors from multiple hospitals and specialist centres working on medical care, with no one named person in charge and in control. Therefore, there is sometimes difficulty resolving conflicting medical priorities.
This week is national Diabetes Week. Retinopathy is a serious diabetic complication that can cause blindness, and until recently it was the leading cause of blindness in the working population. Regular eye screening is key to detect this condition. My constituent, Carolyn, has written to me to express how difficult it is to access this essential service in Oxfordshire. A new service has been contracted by NHS England—for as long as it is here—to do that work with far fewer centres. Making screening more difficult to access will meant that there will be people who find it too difficult to access that important service.
My constituent, Jess, has been struggling with endometriosis for 14 years because of misdiagnosis. As a result, her condition has progressed and worsened, which could have been avoided with better informed doctors and greater awareness. In the UK, diagnosis for the condition takes an average of nearly nine years, and one in six women who have endometriosis have to leave the workplace because of it.
As Members have said, the personal independence payment scoring system is not fit for purpose. My constituent, Sally, has progressive MS. She scored 12 points and was rejected, but someone with a different disability scored eight points and was approved. That is because of the proposed “four points in one activity” rule, which can punish people with complex whole-body conditions just because their needs are spread across multiple areas. My constituent was unable to work for a number of months, but did not qualify for PIP. That highlights the importance of making sure that our disability benefits system is fit for purpose. It must recognise real human needs and not just view people as numbers in a system.
The UK should be one of the healthiest countries in the world with our long history of grassroots sports, high-quality food production and world-leading medical research, but under the previous Government, the UK only became sicker, and it now lags far behind its international peers. That is why the Liberal Democrats want the new Government to take urgent action to support people to live healthier lives. They should start by reversing Conservative cuts to public health funding and investing in community services, so that everyone can see a GP within seven days.
We must also end the crisis in social care, which is a disaster for people with long-term conditions and for our NHS. I repeat our call for the current review into social care to be concluded this year, not in three years. We have had many reviews into social care. We do not need further reviews; we need action. We are pressing for better social care for disabled people, including free personal care and more support for family carers, such as through more respite breaks and paid carer’s leave. We would also give everyone a new right to flexible working, and every disabled person the right to work from home if they want to unless there are significant business reasons why that is not possible.
We would make it easier for people with long-term conditions and disabled people to access public life—including the world of work—by, for example, adopting new accessibility standards for public spaces, improving the legislative framework for blue badges and incorporating the UN convention on the rights of persons with disabilities into UK law. There is much work to be done to raise employers’ awareness of the Access to Work scheme, simplifying and speeding up the application process, introducing adjustment passports to record the adjustments, modifications and equipment that a disabled person has received and ensuring that Access to Work support and equipment stays with the person if they change jobs.
As I mentioned, social care is critical to ensuring that people with long-term health conditions are properly cared for, recognising that hundreds of thousands of people are stranded in hospital beds because they are waiting for capacity in the care system. To that end, this is Carers Week, and the Liberal Democrats are campaigning to empower care users and to support care workers and the millions of unpaid carers looking after loved ones, some of whom we have heard about this afternoon. We would create a social care workforce plan, establish a royal college of care workers to improve recognition and career progression, and introduce a higher minimum wage for carers.
Boosting public health and helping people to recover from mental ill health will be critical to achieving progress, as will tackling chronic fatigue and ME. A number of hon. Members highlighted the importance of the better use of data and technology to understand health trends and improve care. I very much look forward to hearing what the Minister has to say on those topics and others covered by hon. Members.
Dr Caroline Johnson (Sleaford and North Hykeham) (Con)
It is a pleasure to serve under your chairmanship, Mr Efford. I congratulate the hon. Member for Bury St Edmunds and Stowmarket (Peter Prinsley) on securing this important debate. I declare an interest as an NHS consultant paediatrician. In my clinical work, I have seen at first hand the impact that chronic conditions can have not just on the health of individuals but on their families, their carers and their wider communities. These are conditions that can shape daily life in profound and enduring ways.
In some respects, the increased prevalence of long-term conditions is a success story for the medical fraternity, because some conditions that previously would have led to a patient’s death can now be managed effectively for a longer period of time, and people can continue to live happy, healthy and fulfilling lives. There is no silver bullet for tackling such conditions, but effective interventions and systems can improve quality of life, enable independence —we have heard about the importance of that—and reduce avoidable healthcare costs. Such interventions require a co-ordinated, whole-system approach, bringing together local authorities, NHS trusts, public health, education, social care and the voluntary sector.
I am glad that the Government are talking about a move away from reactive and acute-based care towards prevention, rehabilitation and supported self-management in the long term. I note that the hon. Member talked about care on Teesside some years ago. As someone who grew up on Teesside, I remember the Carter Bequest hospital—I do not know whether his father had anything to do with that—which was the local community hospital providing community care for many local residents.
We increasingly see patients living with not just one long-term illness but multiple long-term illnesses, known as multi-morbidity. That provides challenges, because sometimes the medication that one would ideally provide a patient for condition A is complicated because they also have condition B, for which they are taking something else that would interact with that medication. A patient might also need an operation but not be able to have it because another condition makes the anaesthetic risk too high, so the management of the second condition might have to be suboptimal as a result of the first condition. Some people have more than two conditions.
One of the challenges that people with long-term conditions will face is staffing and workforce. I notice that the Government have decided to cancel, or at least significantly reduce the availability of, level 7 apprenticeships, which train our specialist nurses in advanced clinical practice, our district nurses and our community nurses. Will the Minister talk to her colleagues in the Department for Education about how there can be a move towards community care and prevention if they are going to make it more difficult to train the people who would provide that care?
The hon. Member for Eastbourne (Josh Babarinde) talked about the delay in follow-up appointments. I have seen that myself. One of the challenges is that when one is under pressure to meet the 18-week pathway and there is no similar pressure on follow-up appointment timings, the consultant’s clinic inevitably ends up with more new patients and fewer follow-ups. The follow-ups get pushed back, often for many months. How will the Minister’s team ensure that the pressure to meet the 18-week pathway does not cause chronic illness to be covered less well than it is now?
I was also interested in what the hon. Member for Newport West and Islwyn (Ruth Jones) had to say about exercise and lifestyle. I see a lot of children with varying conditions in my clinics as a paediatrician, and I have been amazed by how fresh air and exercise, diet and hydration, sleep, and not spending hours on computers, particularly in the evening and through the night, can make a whole range of medical conditions better. We know that the same is true of adult care in some cases. While it is not the cure for all conditions—of course it is not—in some cases it can help people to live better with the conditions that they have. I am interested that in some cases people are allowed only a few physio appointments before they get referred back to their GP. Perhaps longer courses of physio treatment could help people a little more.
Multimorbidity was recognised as a priority in the previous Government’s health and care White Paper in 2022. Community diagnostic centres opened in order to play a vital role in providing quicker access to essential tests, dealing with the backlog left by the covid pandemic. There are two centres near my constituency, in Grantham and Lincoln. I visited the one in Lincoln recently, which has had very good feedback from constituents and is providing a great service. Can the Minister confirm that community diagnostic centres will continue to be well funded following the spending review?
The previous Government launched a major conditions strategy in 2023, aiming to address six key areas—cancer, heart disease, musculoskeletal disorders, mental ill health, dementia and respiratory disease—but the current Government have paused work on this strategy. They came to power saying that they had a plan. They stopped the plan that we had, because they wanted to think of their own, which is fair enough. But we are now three weeks out from the first anniversary of their election, and still this magic plan has not appeared. I say to the Minister that this is too long to wait for people who are unwell. Can she, at the very least, commit that the 10-year plan will be published before we have lost one year in which the Government could have started delivering it?
Musculoskeletal conditions are particularly common long-term conditions, affecting around 20 million people in the UK—that is a third of women and about 30% of men. They are the second most common cause of economic inactivity after mental health, and take a considerable toll. I thank advocacy organisations such as Versus Arthritis for their tireless campaigning on this issue. They have highlighted how these conditions disproportionately affect women and those living in deprived communities.
The recent cuts to the personal independence payments proposed by the Government have disproportionately affected people with MSK conditions. Have the Government conducted an impact assessment? My concern with the PIP changes is that they were announced to meet an economic target, rather than being properly thought through. Can the Minister confirm whether they have been properly thought through? Has an impact assessment been conducted, and if so, will she ensure that it is published so that we can all study it in some detail?
Mental health should be treated as a core component of long-term care. People with long-term conditions are two to three times more likely to experience mental ill health. Research shows that people who are confident in managing their long-term conditions have not just fewer A&E visits and hospital admissions but better mental health. What concrete steps are the Government taking to improve mental health provisions specifically for those with long-term conditions?
Rehabilitation can be just as important to health outcomes as medicine and surgery. As was mentioned earlier in the context of strokes, some people have very good stroke rehab care, but for others that is less of the case. Rehabilitation, particularly early rehabilitation, is very important. Providing timely rehab and self-management advice would significantly reduce the number of people diagnosed with health conditions in their 40s and 50s, for example, being pushed out of the workforce, which drives both income and health inequality.
Is improved access to community rehabilitation for people with long-term conditions part of the Government’s plan to shift from hospital to community care, keeping people out of hospital and in work for longer? I know that the plan is not published yet, but perhaps the Minister knows. Long-term conditions will define the health and social care agenda of the next decade. That requires a joined-up strategy across healthcare, the Department of Work and Pensions, and social care, and for the Government to support the most vulnerable and maximise the quality of life for all our constituents who suffer from long-term conditions.
Gen Kitchen (Wellingborough and Rushden) (Lab)
It is a pleasure to serve under your chairmanship, Mr Efford. It is my first time speaking from the Front Bench, so please bear with me if I get my papers mixed up. I thank my hon. Friend the Member for Bury St Edmunds and Stowmarket (Peter Prinsley) for securing this debate, and for speaking so passionately on the subject, using his decades of experience of caring for patients in the NHS. I also thank all the other Members for their insightful contributions, and the Backbench Business Committee for granting this debate, especially because it is taking place during Diabetes Week. We have had more than 10 meaningful contributions, and I wish to respond to them individually. I have noted them all down, and if I do not get to them all, I will ask the relevant Minister to respond.
My hon. Friend the Member for Bury St Edmunds and Stowmarket is concerned about economic inactivity, hospital-to-community care, the digital transition for patients, and research and development. I have, in my pack, full answers for my hon. Friend.
The hon. Member for Leicester South (Shockat Adam) spoke passionately about sight loss and his time as an optometrist, as well as about macular degeneration and Charles Bonnet syndrome.
Rachel Gilmour (Tiverton and Minehead) (LD)
My office is supporting a vulnerable, elderly constituent, who has multiple sclerosis and suffers nervous breakdowns, having also battled hip cancer and undergone a hip replacement. Does the Minister agree that the failure to provide people with social care and early-intervention support can often expose individuals to a cascade of further suffering, and of course increases the strain on our health services?
Gen Kitchen
I agree, and I will come to comorbidities and some of the strategies in the 10-year plan later in my speech.
My hon. Friend the Member for Scarborough and Whitby (Alison Hume) spoke about endometriosis. I was very sorry and dismayed to hear about her constituent Angela Tiernan, who has endometriosis in her chest cavity. I assure my hon. Friend that urgent action to tackle gynaecological care is taking place through the elective reform plan, and we are having significant successes in that area.
I thank the hon. Member for Eastbourne (Josh Babarinde). I was also dismayed to hear about his constituent Andy’s benign brain tumour. I was particularly dismayed to hear about his treatment, and the transfer of services to the community. The hon. Member rightly asked about the administration from care to community. I assure him that further work on the national neighbourhood health implementation programme will come after the 10-year health plan. I see that issue all the time in Wellingborough and Rushden, as he does in his constituency. As a semi-rural community, we have very little in the way of community healthcare, so I am also pushing that forward. I will ask the relevant Minister to respond directly to him about Andy’s case.
My hon. Friend the Member for South West Norfolk (Terry Jermy) gave an impassioned and personal speech about his father’s stroke. I am grateful to him for highlighting and raising awareness of the F-A-S-T action that people can take if they think that someone is having a stroke. I reassure him that the NHS is actively working to provide access to 24/7 thrombectomy services across England and Wales.
I thank the hon. Member for Strangford (Jim Shannon) for his speech. As he said, health in Northern Ireland is a matter for the Northern Ireland Assembly, but I assure him that the Secretary of State is regularly engaging with his counterpart across the sea on all the issues that the hon. Member outlined, which were many. He told his personal story of diabetes, and spoke about COPD, cancer, cystic fibrosis and many other conditions. I share the sentiment that it is marvellous that so many people will now survive cancer. As he may know, my father is currently undergoing treatment for his terminal diagnosis. I reassure the hon. Member—and it gives me some hope—that the national cancer plan is coming.
We had a lovely intervention from the hon. Member for Harrogate and Knaresborough (Tom Gordon), who is also the chair of the all-party parliamentary group for diabetes. I thank him for his work on diabetes awareness.
I thank my hon. Friend the Member for Newport West and Islwyn (Ruth Jones) for her many years of service as a physiotherapist, and I thank her daughter for her many years of service as a doctor. My hon. Friend rightly raised arthritis and all the great work that she did as a physiotherapist. I am sure that she is aware of the great work that the National Institute for Health and Care Research is doing with Versus Arthritis in funding dedicated UK MSK translational research. She will also be aware that the National Institute for Health and Care Excellence has published expert guidance on early diagnosis to speed up that process. She will know that the Department of Health and Social Care and the Department for Work and Pensions are committed to supporting disabled people and people with long-term health conditions. A range of support is available already, including some that joins up the health and employment support systems. I agree that we need to get it right first time, because a system that has an over 90% appeal approval rating is not getting it right first time.
The hon. Member for Didcot and Wantage (Olly Glover) and I spent a lot of time together on the Planning and Infrastructure Bill Committee; I am glad to be able to finally respond to him on things. I was very sorry to hear about his friend Emma and his constituents Terry and Jess, who have a range of health conditions. I was particularly dismayed to hear that Terry had no one named person in his multidisciplinary team. That should not be happening.
The hon. Member for Sleaford and North Hykeham (Dr Johnson) asked many questions, which I have noted down. If she does not get the answers in my speech, I will press the relevant Minister to write to her. She asked about training and apprenticeships. To reassure her, a new workforce plan will be coming after the 10-year plan, and the 10-year plan will be coming in the summer. I would love a community diagnostic centre as well; in a semi-rural constituency, it is very hard to get care. I will press a Minister to write to her, following the spending review.
I pass on apologies from my hon. Friend the Member for West Lancashire (Ashley Dalton), the Minister for public health and prevention, who is passionate about improving care and support for people with long-term conditions, and had really looked forward to responding to this debate. Unfortunately, due to the medical emergency of a family member with a long-term condition, she is unable to be in Westminster this week, but she hopes to return to Westminster as soon as possible to write the letters that I have promised on her behalf.
This is a busy afternoon in the House for the Health Department, with my hon. Friend the Minister for Secondary Care currently representing the Government in a general debate on the fifth anniversary of the covid pandemic in the main Chamber, and my hon. Friend the Minister for Care currently serving on the Mental Health Bill Committee. I am pleased to be here to respond on their behalf to such an important debate, and I hope that my remarks demonstrate that improving support for those with long-term conditions is a priority for this Government.
Over 15 million people in England have long-term health conditions, and many people live with two or more. Every one of us has a constituent living with a long-term condition; even some of my colleagues in this place who have shared their stories today have long- term conditions. Given that the prevalence of long-term conditions generally increases with age, the number of people with such conditions in our society will only get bigger, as new treatments and technologies keep us alive for longer. Let me be clear: that is to be celebrated. It is a wonderful and amazing thing to happen, but it is critical that we have the health architecture in place to manage those changes.
That is why building a health service and care system fit for the future is central to this Government’s mission. Yesterday, my right hon. Friend the Chancellor of the Exchequer set out the multi-year spending review, which prioritises health, with a record investment in the health and social care system that will improve treatment, support and outcomes, and help those living with long-term conditions. The Government are providing £29 billion more in day-to-day funding in real terms than in 2023-24, and the largest-ever health capital budget, with a £2.3 billion real-terms increase in spending over the spending review period.
The spending review puts the NHS on a sustainable footing by cutting the waiting lists so that by the end of the Parliament 92% of patients will start consultant-led treatment for non-urgent health conditions within 18 weeks of referral, delivering on the Prime Minister’s plan for change and commitment to prioritising people’s health. The settlement also supports the shift from analogue to digital, with a total investment of up to £10 billion in NHS technology and transformation between 2026-27 and 2028-29—an almost 50% increase from 2025-26.
Colleagues will know that we have undertaken the biggest ever conversation about the NHS since its creation. We have received more than 270,000 contributions and had almost 2 million visits to our online portal, a significant number of which were from people with long-term conditions. We will ensure that their voices are heard in the 10-year plan. The plan will deliver three big shifts to ensure the NHS is fit for the future: from hospital to community, which we have spoken about a lot this afternoon; from analogue to digital, which was also mentioned a couple of times; and from sickness to prevention. All three are relevant to improving the diagnosis, care and management of long-term conditions in all parts of the country.
We will see more tests and scans in the community, in high street settings, to reduce the need for people to take multiple trips to hospital to get diagnosed—a particular issue in Wellingborough and Rushden, because we do not have a hospital or a bus service. We will see better joint working in neighbourhoods between primary care, pharmacies, community healthcare, such as district nurses, and social care to help people to manage multiple long- term conditions at home. That will help them access the right self-care professional support so that they are not passed from service to service, and will reduce the need for emergency hospital admissions. Again, that is brilliant for Wellingborough and Rushden, as I am sure it is for all hon. Members’ constituencies.
We will see better access to technology that helps people to manage their health conditions in their own home, such as apps and wearable technologies, to reduce the need to go to hospital or other healthcare settings. We will have better, joined-up access to healthcare records, as my hon. Friend the Member for Bury St Edmunds and Stowmarket suggested, to ensure that those working in health and care are better able to support patients in planned and emergency care, and that patients feel confident that the clinicians who are treating them know about their conditions.
There have been many mentions in the debate of the changes to welfare and economic activity. We recognise that people with long-term conditions face multiple challenges in trying to remain in work. Long-term sickness continues to be the most common reason for economic inactivity among the working-age population.
Alison Hume
I congratulate my hon. Friend on her turn speaking from the Front Bench. DWP analysis suggests that people with long-term conditions such as arthritis are more likely than most to be affected by the changes to PIP. Does she acknowledge that taking away PIP from people with long-term conditions such as arthritis, which can fluctuate and vary, could be devastating?
Gen Kitchen
I acknowledge that those with long-term health conditions such as arthritis will rightly be very worried about what is happening, considering that only a Green Paper, rather than a Bill, has been published. I assure my hon. Friend that the Department of Health and Social Care and the DWP are committed to supporting disabled people and those with long-term health conditions. There is already a range of support that is online and working, but we want those who are in work and can stay there to do so, and we want people to get back to work. Those measures include joining up the health and employment support around the individual through employment advisers, NHS talking therapies, individual placements, support in primary care and WorkWell, as well as work coaches and disability employment advisers at the jobcentre. That will get people back to work if they can, and keep working people in work.
We have a range of specialist initiatives to support individuals. Things currently online include WorkWell, and Connect to Work is coming online as we speak. We are also mobilising eight place-based trailblazers to reduce economic inactivity in places where we can see that it is really key.
On elective care, our plan for change is clear that our immediate priority on health is to reduce elective waiting lists to meet the NHS constitutional standard that 92% should wait no longer than 18 weeks from referral to treatment. We have hit that pledge already—more than 2 million more elective care appointments have happened early—and we have now exceeded it by delivering over 3.5 million more appointments.
Gen Kitchen
Thank you. In fact, the waiting list has been cut by over 200,000 since we came into office.
Another topic touched on a lot was social care, its effective use and access to it. Effective and accessible social care is crucial for people with long-term conditions.
Dr Johnson
There is a question that I have been wondering about. Baroness Casey is doing a report for the Government on social care, but she is also doing a report on child abuse. We were told initially that those reports would run consecutively, but they appear now to be running concurrently. I do not necessarily expect the Minister to be able to answer the question now, because she is standing in for somebody else, but it would be helpful if she could get us a written answer on what proportion of Baroness Casey’s time is currently devoted to the Home Office, and what proportion to healthcare.
Gen Kitchen
I was coming on to Baroness Louise Casey’s report to the Prime Minister. I will try to get an answer from the Departments she is working with. Hon. Members will be aware that we have launched the independent commission into adult social care as part of our critical first steps to delivering a national care service. It is chaired by Baroness Louise Casey and reporting to the Prime Minister. The commission will make clear recommendations for how to rebuild social care systems to meet the current and future needs of the population, but I will make sure that Ministers write to the hon. Lady on her specific question.
We also had a small discussion on unpaid carers and how crucial they are for individuals with long-term conditions. These unpaid carers, often family members or spouses, do vital and essential work that helps people to manage their long-term conditions and also helps the health service. Lord Darzi’s independent review of the national health service highlighted the need for a fresh approach to supporting and involving unpaid carers, to improve outcomes across the board for carers and those they care for. Those findings are being carefully considered as part of our 10-year plan to reform and modernise the NHS. We continue to shape our plans to reform adult social care, including through the national care service.
We cannot underestimate the toll of living with one or more long-term health conditions. The hon. Member for Tiverton and Minehead (Rachel Gilmour) made an intervention about the mental health support that is needed for long-term conditions. Living with one or more long-term conditions can put significant stress on an individual’s mental wellbeing and can lead to stress, worry and depression—all of which come to our constituency doors a lot. Two thirds of people with a common mental health problem also have a long-term physical condition. That is why the NHS is prioritising the development of NHS talking therapies to include a focus on people with long-term conditions. These services bring together mental and physical health providers to work in a co-ordinated way to achieve the best outcomes for all.
I feel that I have been speaking a rather long time, so, to conclude, I once again thank my hon. Friend the Member for Bury St Edmunds and Stowmarket, for securing the debate, and all those who have spoken. The debate has been extremely wide ranging and covered conditions from across the spectrum, many of which I cannot pronounce. I hope that Ministers will be able to write back to hon. Members and reassure them on some of the questions they have raised today.
It is understandable that we have covered so many topics, given the sheer number and breadth of long-term conditions and the multitude of challenges they pose for individuals, their families, their communities and the healthcare system. For that reason, as I said, I have not been able to cover in full the well-informed points that were made throughout the course of the debate. However, my hon. Friend the Minister for public health and prevention has committed to writing to all hon. Members who have raised specific concerns today.
Peter Prinsley
I thank all who have contributed to this interesting discussion. I particularly thank my hon. Friend the Member for Wellingborough and Rushden (Gen Kitchen), who has acquitted herself extraordinarily well and should be congratulated. It is quite obvious that many of our fellow citizens are depending on us. It is also obvious to me that the politics of healthcare really do matter. We have an opportunity to do something about this, and we must seize that opportunity, because I believe that is one of our great missions. I thank everyone very much for coming to the debate this afternoon.
Clive Efford (in the Chair)
My congratulations to the hon. Member for Wellingborough and Rushden for filling in ably for the Minister.
Question put and agreed to.
Resolved,
That this House has considered long-term conditions.