Westminster Hall

Thursday 20th November 2025 Westminster Hall

Thursday 20 November 2025

[Valerie Vaz in the Chair]

BACKBENCH BUSINESS

Unpaid Carers: Inequalities

Thursday 20th November 2025 Westminster Hall

10:54

[Anna Dixon (Shipley) (Lab)]

I beg to move,

That this House has considered inequalities faced by unpaid carers.

It is a pleasure to serve under your chairship, Ms Vaz. First, I will note my entry in the Register of Members’ Financial Interests: I am chair of the all-party parliamentary group on carers, which is supported by Carers UK—an organisation that celebrates its 60th anniversary this year. I thank the Backbench Business Committee for granting time for this important debate to take place on Carers Rights Day, which was established 25 years ago to raise awareness of the rights to which carers are entitled. It does an excellent job of drawing attention to the rights that carers have, as well as helping carers to navigate those rights and be able to exercise them.

I have committed my career to securing better care and support for older and disabled people and their carers. I was privileged to serve as chair of the Archbishops’ Commission on Reimagining Care. As part of that work, I heard loud and clear how carers face unrelenting demands and can feel isolated, unsupported and undervalued. The system that carers face is complex, time consuming, rigid and confusing. Getting care and support is often a fight, and many carers are exhausted.

As an MP and together with colleagues, some of whom I am pleased to see here today and others of whom were not able to make it, I have sought to speak up for carers and have enjoyed welcoming carers into Parliament to share their stories. Just yesterday, Anna—another Anna—came down; she is a Bradford City fan and she shared some nice stories about her caring experience, which I may come to later. I have also had the pleasure of visiting Carers’ Resource, which is my local carer support organisation. I am sure that colleagues here will want to join me in thanking it and other organisations across the country that provide invaluable support to carers.

Of course, many people who work in Parliament as MPs and staff are carers, and it is great that more people are speaking up about their own experiences. Caring is personal for me, too. My grandmother suffered life-changing injuries in a road collision. My mum cared for her for nearly 30 years, never returning to her own career as a doctor. My mum did my grandma’s shopping and banking and took her to the doctor’s, to church and on days out. Thankfully, there were others who helped out; they brought meals, played Scrabble and kept her company. Thanks to the care and support that she received, my grandmother Freda lived a full and fulfilling life.

I have seen at first hand the incredible work that unpaid carers do, often unnoticed and at great cost to themselves. Carers are often invisible, unheard and unappreciated. I pay tribute to the 5.8 million carers in the UK. I hope that, through this debate, we can let the millions of unpaid family carers up and down the country know this: we recognise you and we are grateful for all you do.

This matters to us all. At some time in our lives, we will need either to provide care or to be cared for. According to Carers UK, the average person has a 50-50 chance of caring for a family member or friend by the age of 50. Indeed, almost half the UK population have provided unpaid care at some point in their lives. Yet many people do not identify as carers. They see it as part of being a parent, wife or daughter—as looking after someone or helping out a loved one.

I have met carers at every age and stage of life and from all cultures and races. They include Ruth, a parent carer whose child has special educational needs; Nussrat, who cares for her mum with dementia; Michael, who cared for his wife with Parkinson’s until she died and well into his own old age; Ann, in her 70s and caring for her adult son with learning disabilities; and Farzana, a young carer who cared for her mum throughout her time at school, but was recognised as a carer only when she got to university.

Sadly, there is often a cost to caring. Unpaid carers face inequalities in their health and finances, and often also additional barriers to work. I will briefly set out some of those inequalities and what I hope the Minister will say about how the Government will address them, because they need to.

I will take health inequalities first. Unpaid carers face significant health inequalities as a result of the mental and physical toll of providing care. They are more likely than non-carers to have experienced a long-term physical or mental health condition, disability or illness. In addition to caring often being physically and emotionally demanding, carers also find it more difficult than most people to access care for themselves. In the words of one woman who is a long-term carer for her parents:

“It was great seeing Dad improve, but it came at the expense of my own physical health and emotional stress…We always put ourselves right at the bottom when it comes to our own needs.”

All these issues are not only harmful to individual carers; they also put a strain on the NHS. What can be done?

First, it is vital that the NHS identifies carers and helps them to access healthcare for themselves as well as for their loved ones. I hope that the NHS, through the delivery of its 10-year plan, takes the opportunity to transform how it interacts with unpaid carers. Improvements could include: better data linkage with the Department for Work and Pensions to identify carers; using digital technology and remote consultations to make it easier to access healthcare from home; investing in a programme to improve carers’ mental health; and preventing carer burnout and breakdown by funding short-term breaks for carers.

Unpaid carers also face significant financial inequalities. According to Carers UK’s “State of Caring 2025” report, published today, 1.2 million unpaid carers across the UK live in poverty—400,000 in deep poverty—and four in 10 carers do not know what benefits they are entitled to. About six in 10 unpaid carers provide a staggering 50 hours or more of care per week, so they often have to give up work and rely on benefits to make ends meet. Research also suggests that the employment gap between working-age carers and non-carers was 13%. In the words of one woman who gave up her career to become a full-time carer,

“My finances are shot to pieces…and there’s no end in sight.”

We know that carer’s allowance is a very important benefit. However, it is too low—just £83.30 per week if someone provides at least 35 hours of care a week. Moreover, my understanding is that those carers in receipt of a state pension do not receive additional financial support as a carer, despite their having additional costs.

Sadly, many carers who have been juggling work and care have fallen foul of complicated benefit rules about the earnings limit, and they have built up debts due to overpayments by the DWP. I hope that the Minister will be able to provide reassurances today that the independent review into carer’s allowance overpayments, led by Liz Sayce, will be published soon, together with the Government’s response to it. I hope that the Government say in their response that they will implement swiftly and in full the recommendations of the report. I also hope that those recommendations will include writing off overpayment debts, clear, transparent and accurate information about earnings rules, and a less complicated system for claimants in the future.

I was really pleased to see that the Minister for Social Security and Disability, my right hon. Friend the Member for East Ham (Sir Stephen Timms), delivered on the commitment he gave me during a debate on the Universal Credit Bill: that carers will be represented in the review of the personal independent payments working group. Given that PIP is a gateway benefit to carer’s allowance, carers must have a voice in shaping the proposals to reform it. It is vital that we value the contribution of unpaid carers and ensure that their own financial security is not jeopardised by their decision to care.

I will touch briefly on work, which is the third main area of inequality for carers. Unpaid carers encounter significant barriers in the workplace. It is estimated that 5 million people juggle work and care in the UK, which equates to one in seven people in every workplace. Balancing work and care can be stressful, so it is perhaps not surprising that one in six carers give up work or reduce their working hours so they can care for others.

For a former headteacher who was a carer for his wife, the support from his employer was crucial. He said that

“without the support I received from my employer, it would have meant finishing work. The immediate financial situation of losing both our incomes would have been devastating.”

Earlier, I mentioned Anna, who works for HSBC. She has talked about the difference that the support she received at work made to her when her husband had a stroke, and her and her family’s lives were turned upside down. She is now a carers champion in the workplace, supporting others in a similar situation. Her bosses at HSBC recognise that that was not just a kind thing to do; it also made business sense, as part of a strategy to retain talent and enable people to perform at their best.

It was great to see the “Keep Britain Working” review, the so-called Charlie Mayfield review, recognise the significant impact that providing unpaid care can have on employees’ health, wellbeing and ability to remain in work. I hope that the Minister can assure me that the Government will take it forward.

A statutory entitlement of five days’ unpaid care leave was secured through the Carer’s Leave Act 2023, for which I give credit to my colleague, the hon. Member for North East Fife (Wendy Chamberlain). Some employers already go further, such as TSB, a member of Employers for Carers, which is now a network of over 200 organisations. TSB provides its employees with up to 70 hours of paid leave each year. One in 10 employees with caring responsibilities has taken advantage of that. Employees who are carers know that they can take that time off if they need to and have the confidence to stay on in work.

Katie, one of the TSB employees who is a carer, said:

“I know of carers who don’t have policies in place at their workplaces and are faced with the additional stress of considering unpaid leave. I’m grateful that TSB supports me with flexible solutions to help me find balance between work and caring for my lovely mum.”

Not only do carers benefit from this policy, but TSB does. It says that the policy has had a positive impact on its bottom line and on retaining staff who have caring responsibilities in the workplace.

I want to turn to some of the things being done to support workers. I was pleased to speak with the Minister for Employment Rights and Consumer Protection, my hon. Friend the Member for Halifax (Kate Dearden), about the barriers that low-paid workers face in taking unpaid leave. I welcome the fact that the Government yesterday published the terms of reference for their review of carer’s leave. I hope that one of the practical things that comes out of that review is a new statutory right to five days of paid carer’s leave a year to support more people balancing employment and unpaid care to remain in work. In the meantime, I urge the Government to work with employers to maximise take-up of the existing right to unpaid carer’s leave and to continue to promote good practice with regard to supporting carers in employment.

The door must be kept open for the carers who leave work to care full-time to return to work. Caring responsibilities are the second leading cause of economic inactivity among the over-50s. As the Government deliver their reform in the “Get Britain Working” White Paper, they must ensure that tailored employment support for carers is available through jobcentres. Closing the carer’s employment gap will ensure that carers are better off and provide a huge boost to economic productivity.

I hope that I have made it clear that unpaid carers face inequalities in health, wealth and work, sometimes with devastating consequences. Carers need more support. I am proud of what the Government are already doing for carers: the rise in the carer’s allowance earning limit in last year’s Budget, setting up the independent review into carer’s allowance to hopefully right that past wrong, and the Employment Rights Bill, with its increased rights to flexibility and enhanced rights to sick pay. As I have just said, I welcome the announcement of the review of unpaid carer’s leave. I hope that the Minister can tell us more about the activities of the inter-ministerial group on carers, which I believe is now up and running again.

However, there is more to do. As part of the independent commission into social care, led by Louise Casey, I would like to see a more ambitious new deal for carers—one fit for the 21st century that recognises the enormous contribution that millions of people make each day by providing the unpaid care that their family and friends need. I would like to hear how the Minister will ensure that the NHS, local authorities, social care providers, employers and the benefit system will work together to deliver a bolder package of support for unpaid carers.

Let us show the millions of unpaid carers that we care about their health, financial wellbeing and ability to work. We care enough not only to say, “We see you and we thank you”, but to take action and provide meaningful support so that they can care as an act of love and not of necessity and give without suffering consequences themselves. This Carers Rights Day, I urge the Government to commit to tackling the inequalities that affect millions of carers across the UK, without whom many of us would not be able to live a full and happy life or be surrounded by love as we reach the end of our lives.

[Several hon. Members rose—]

[Valerie Vaz (in the Chair)]

I suggest a very informal five-minute limit, so that, hopefully, everyone can get in.

13:44

[Wendy Chamberlain (North East Fife) (LD)]

It is a pleasure, as always, to serve under your chairship, Ms Vaz. I thank the hon. Member for Shipley (Anna Dixon) for securing this important debate in honour of carers’ day-to-day rights, and for her work in the all-party parliamentary group on carers. I declare an interest as an honorary vice-president of Carers UK and a trustee of the board of Fife Carers Centre; both are incredible organisations. I also want to recognise other organisations that provide support in this area, include Sheffield University’s Centre for Care, the Carers Trust and Fife Young Carers, which provides support to young carers in my North East Fife constituency and beyond.

Unpaid care is part of almost all our lives, whether we recognise it or not. I am no exception. When I started campaigning for the Liberal Democrats, and then became an MP under the leadership of my right hon. Friend the Member for Kingston and Surbiton (Ed Davey), who is a carer himself and a prominent activist—in fact, I almost once described him as my carer—I became truly involved with the fight for the rights of unpaid carers. As a newish Back-Bench MP, it was an incredible opportunity, and it was also quite fun and exciting to be able to get a law passed: the private Member’s Bill that became the Carer’s Leave Act 2023.

Looking back now, what I remember most is the amazing people I met during that time in North East Fife, and throughout the country—just a handful of the 5.8 million unpaid carers, impressive in their resilience, love and thoughtfulness. I was moved by what was behind that resilience and humour: the tiredness, strain and financial difficulties, as well as the constant worry of thinking about someone else.

I intend to use my time to reflect on the 2023 Act and what more needs to be done. It is disheartening that, in the two and a half years since the Act was passed, evidence suggests that things are still getting worse. Research by Carers UK, “State of Caring 2025”, which the hon. Member for Shipley referred to, shows that 49% of carers have had to cut back on essentials; in 2023, that figure was 34%, already elevated from 25% in 2022, and it was just 13% in 2021. This is not the result of bad luck or the same impact from the cost of living crisis as we all see; the rate of poverty among unpaid carers is 50% higher than in the rest of the population. This is clearly the outcome of structural inequalities that the Government need to address.

There are some other things that the Government can do immediately to ease the financial burden on unpaid carers, particularly those in receipt of carer’s allowance. I pay tribute to the long work of Baroness Pitkeathley on behalf of unpaid carers, both in the other place and beyond. On Tuesday, she asked the Minister of State at the Department for Work and Pensions in the House of Lords when we can expect the publication of the independent review into carer’s allowance overpayments. I would be most grateful for some further detail on that from the Minister and colleagues in the DWP, other than “by the end of the year”, given that it is only four weeks until the House rises for Christmas recess. When in that period can we expect the report to be published, and will there be time for parliamentary scrutiny of it? The overpayments scandal has affected thousands of people across the UK. The last thing that unpaid carers, and indeed the MPs representing them, want is a written statement hurriedly published in late afternoon on 18 December.

As we are still awaiting publication of the review and the Government’s response to it, I will set out some of the reforms needed to end the financial inequalities experienced by unpaid carers. The carer’s allowance earnings threshold must be pegged to the minimum wage, so that no unpaid carers in work ever find themselves earning “too much”, simply because the Government made it so. The rules on what unpaid carers can earn must be made clearer, and DWP staff must be trained better to prevent future inadvertent overpayments. Of course, the Timms review of personal independence payments must make sure not to disadvantage unpaid carers. I should acknowledge that my constituents in Scotland are now in receipt of the equivalent carer’s support payments.

Referring again to the Carer’s Leave Act, last night I attended the carers’ rights event in Parliament, where I was pleased to speak to a number of businesses that are already going above and beyond the provisions in the Act. They are doing that because they believe it makes good business sense. For them, it is about the psychological contract, improving employees’ loyalty and retaining them—staff retention is as important as recruitment.

I am pleased that the Government have published their terms of reference for the review of the Act. That has, in some respect, answered what was going to be my first question to the Minister. The bad news is that I have some other reflections on the back of yesterday’s announcement. The terms of reference published yesterday give a timeline for evidence gathering that started over a year ago, in autumn 2024. That is quite a lot of time for the Government to have been doing engagement and commissioned research before coming to Parliament or even announcing the review and what it aims to achieve. Will the Minister update us on what evidence and engagement has been secured to date?

There is a formal public consultation of 10 to 12 weeks to seek views. I know that unpaid carers, the networks that represent them and the organisations offering support will want to respond, but most of these structures are manned and run by volunteers or paid staff who are already stretched, and we know that unpaid carers have more than enough to deal with on a day-to-day basis already, and often feel guilty about the admin involved in their lives. Have the Government considered whether the 10-week consultation period will be long enough? What steps will they take to reach people and engage on the ground?

On the findings of the review, I have my suspicions, which I have raised with the Government before, that not enough businesses were made aware of the new right under the Act. I fear not enough businesses trained their managers, HR teams and employees about it, and I fear that the Government gave insufficient information to employers and businesses about their obligations. Without adequate communications, not enough unpaid carers knew to see themselves as carers or that they were entitled to the support. If it is going to be a paid leave right, if that is the direction of travel, we need to get better at those things. I want to say in words the Government will understand that I firmly believe paid carer’s leave supports the growth agenda and will help the economy.

One thing I have loved about joining the board of Fife Carers is seeing the impact on the local organisation and volunteers. The centre was shortlisted as a finalist for providing outstanding carer service at this year’s inaugural Carers UK awards. That is quite something for an organisation that started with just one part-time worker 30 years ago. The nomination recognised the value of the support the organisation provides, whether its hospital carer self-care kits or its carer support groups. I had the pleasure of attending one in Leven recently and people were not backward in coming forward to talk about the changes they want to see.

Whether someone is working and caring or caring full time, they will inevitably be exhausted. The “State of Caring 2025” report says that 74% of carers feel stressed or anxious, and 42% say their physical health has declined. We all need a break sometimes; carers need and deserve it more than most, but how are they to manage that when they have someone relying on them day in, day out? The answer is funded respite care. I am sure my hon. Friend the Member for Mid Sussex (Alison Bennett), my party’s spokesperson for care and carers, will mention that, given that she has a Bill before Parliament to ensure that unpaid carers are offered respite. I support that wholeheartedly. I hope the Minister can give us an update on that, too.

I am conscious of time, so I will end my remarks there. Inequalities exist and we have a responsibility here in this place to address them.

13:52

[Daniel Francis (Bexleyheath and Crayford) (Lab)]

It is a pleasure to serve under your chairship, Ms Vaz. I thank my hon. Friend the Member for Shipley (Anna Dixon) for securing the debate and support the asks that she has made of the Minister. It was a pleasure to join her, carers, Ministers and colleagues last night at the “State of Caring” report launch and it is a pleasure to support Carers Rights Day today.

No one expects to become a carer. It is not something we set out in our plans for the future or our lifetime goals. It usually happens because a loved one falls ill, or, as in my family, because a child has a complex disability, identified early on in life. The burden of care usually falls on women. It is absolutely right that we acknowledge that and discuss today the huge inequalities they face.

One of my children has quadriplegic cerebral palsy. My wife and I decided to give up full-time work in 2016, the year my daughter had 110 medical and physiotherapy appointments, to job share the care components at home while we both worked part time. I accept that the majority of the burden has fallen on my wife over the years. Although we have not been in poverty, it did at that point leave a subsequent hole in our finances, with difficult decisions about the things we could no longer do. Those are the decisions that so many carers make, and they have a wider impact on the economy.

My day started, as it does the majority of days, at 6.15 this morning. I was changing a 12-year-old’s nappy before getting her dressed, fed and putting her in a wheelchair ready for the school bus to come and collect her. There is complexity at the other end of the day, too. This afternoon and tomorrow night, my wife and I will be doing rotas, as we normally do, to work out who is doing the care at the other end of the day. Real pressures are caused by the shortage and affordability of paid carers to support the many families across the country that experience what we do daily.

I strongly welcome the announcement yesterday from the Department for Business and Trade on the terms of reference for the review of employment rights for unpaid carers, and the comments made by the Under-Secretary of State for Business and Trade, my hon. Friend the Member for Halifax (Kate Dearden), at last night’s reception. The review will allow engagement from carers, employers and trade unions to understand how the existing unpaid carer’s leave entitlement is working; to examine options for different models of paid carer’s leave; to consider the options and principles for additional interventions; and to identify options with low or no cost to business and the Exchequer, and the appropriate routes for implementation.

I thank my right hon. Friend the Minister for Social Security and Disability for visiting my constituency back in May, when he met representatives of local charities —Carers Support Bexley, Bexley Mencap, Age UK Bexley, Citizens Advice Bexley, Irish Community Services, Bexley Voice, Bexley Deaf Centre, Inspire Community Trust and Bexley Voluntary Service Council —to discuss the support they give to carers through respite, equipment provision and, notably, access to financial guidance. I have worked with those groups for many years, both as a councillor and a carer, and I thank them for all they do to support my constituents across Barnehurst, Bexleyheath, Crayford, Northumberland Heath and Slade Green. At that roundtable, they set out how they are trying to provide financial support and introduce new innovative ways of working, which I know the Minister will have taken away and be looking at in detail.

I also thank two other local charities, Crossroads Care South East London and Evergreen Care, for their work supporting my constituents, and I pay tribute to carers across my constituency. As a parent collecting my child outside the gates of respite care, I know those parents. I am not just their MP; I have worked with them for many years. They may bring their cases to me, but they are my friends and fellow carers, and I pay tribute to them for all they do in very challenging circumstances.

Lastly, I have a few asks for the Minister. I hear what my hon. Friend the Member for Shipley said about the cycle of issues facing carers. We were lucky because we were working part-time in occupations that paid enough of an hourly rate to keep us going, but carers can face a cycle of poverty. They can also face health conditions as a result of being a carer. I am still lifting a 12-year-old around my house, which is still not fully accessible; she will never walk. We need to face those issues burdening carers, and the support in the 10-year-health plan will help with that.

In Parliament, we are employers too. We have a good ParliCare network for parliamentary staff, but we must always be setting an example. In Parliament, and through the ParliCare network, we as Members and employers must do all we can to demonstrate that we will support carers and that we expect others in the country to do the same.

13:57

[Jim Shannon (Strangford) (DUP)]

It is a joy to serve under your chairship, Ms Vaz. I thank the hon. Member for Shipley (Anna Dixon) for championing the cause of unpaid carers so well, and congratulate her on how she has spent her time in this House. She is always making a name for herself on subjects important to her, such as carers—an issue that we all deal with every day. I also thank the hon. Member for Bexleyheath and Crayford (Daniel Francis) for telling us his personal story. Nothing illustrates a debate as well as a personal story, and the hon. Gentleman kindly and compassionately set the scene of what he and his wife do for their child.

This issue affects everybody in the United Kingdom of Great Britain and Northern Ireland. We are all aware that, without unpaid carers, our health and care system would collapse. If we had to pay for taxi services, all- night care and daytime care for those in need, we could never afford it.

The financial contribution made by unpaid carers in Northern Ireland is estimated to be some £5.8 billion annually, which is equivalent to 80% of the Department of Health’s budget. That is an increase of 42% over the last decade. Despite that massive economic value, many carers face significant financial hardship, with one in four living in poverty, rising to more than half for those not in paid employment. They are giving their lives to look after others, and they are living in poverty. Come on—that cannot be right. Juggling income and responsibility for care, their poverty is driven by the extra cost of caring and insufficient social security payments such as carer’s allowance.

Carer’s allowance is worth only £2 per hour—there is no way that could ever be a minimum wage—based on providing a minimum of 35 hours of care.

Young Lives vs Cancer has highlighted the fact that every year in the UK more than 4,200 children and young people aged under 25 are diagnosed with cancer—that is 12 per day—and sadly 10 of them die every week, making cancer the biggest killer by disease of children and young people in the UK.

In many cases, the parents or close family members of a child or young person who has been diagnosed with cancer will be their primary care giver throughout their illness and treatment—never mind the trauma that carers feel as they deal with someone who may not come out the other side. That is the reality of life. That is physically and mentally challenging for families, and the impacts of cancer and its treatment, along with the care needs, can last many years, given the nature of the disability.

The financial impacts of having a child with cancer include the loss of earnings. The families of children and young people with cancer face significant financial pressures and inequalities, which can start during the pre-diagnosis period but continue, and are most significant, following diagnosis. Many have to take time off or give up employment because of caring responsibilities. Seven in 10 households reported a loss of income and earnings because of having to take time to care for their child, or gave up work altogether because there was no other option. The average loss is around £6,000 a year, but for three in 10 households it is £10,000 a year. To try to meet caring needs, parents call on every source of leave and time off that they possibly can, frequently combining options until they are exhausted and, ultimately, the only option is unpaid time off or leaving employment.

The Minister is a kind Minister. I do not just say that; I mean it. We are all making a plea today on behalf of the carers. Yvonne in my office deals with benefits five days a week—sometimes five-and-a-half or six days a week—and the carer issue comes up all the time. We understand it well, and when we speak about it, we are speaking from experience.

In most cases, the carers of young cancer patients are eligible for carer’s allowance only once the child receives another form of benefit. For younger cancer patients, a young person receiving a personal independence payment or a child receiving disability living allowance is a gateway to their families receiving carer’s allowance. However, this leaves carers waiting months for support. There is a time period and a qualifying period, and I am asking that we get the money out as quick as possible. We should not drag our heels on this matter. A young person with cancer is eligible for PIP and DLA after being impacted by their condition for three months; this leaves the families of children and young people with cancer having to find and pay out nearly £5,000 extra in costs before their disability benefits are awarded.

Due to the immediate nature of the costs experienced by families, children and young people with cancer and their families should be entitled to access welfare benefits immediately. If we lose the unpaid care system, our NHS will collapse, and if we do not give families more support, they cannot sustain the situation. The choice seems clear: give more support and take away some of their financial problems and worries.

[Several hon. Members rose—]

[Valerie Vaz (in the Chair)]

Order. I have to impose a formal five-minute limit on speeches. We hope to start the winding-up speeches at 2.28 pm, and we want to get everyone in.

14:03

[Alison Hume (Scarborough and Whitby) (Lab)]

It is a pleasure to serve under your chairship, Ms Vaz. I thank my hon. Friend the Member for Shipley (Anna Dixon) for securing this timely debate, and for all her work to raise awareness of unpaid carers. It is a privilege to follow the hon. Member for Strangford (Jim Shannon), who is an unstinting advocate for his constituents.

Last night, I was honoured to sponsor a reception for Carers UK, which is celebrating an incredible 60 years championing unpaid carers. Like so many carers, I did not realise I was a parent carer until someone told me I was and suggested that I get a carer’s assessment. We assume that just because we are looking after a disabled child, caring comes with the package. That assumption can lead us into dark corners. Despite the statutory obligations on local authorities in respect of parent carers, councils are not required to report on how they are meeting such duties, and support for parent carers is not included in the Ofsted inspection framework for children’s services. Many marriages or partnerships break down under the strain of caring for a disabled child or children, and mine, sadly, was one of the statistics.

University of Birmingham research found that more than 40% of parent carers of disabled children have thought about suicide because of their caring role, and one in 12 have a plan for how to take their life. For fathers of a disabled child or children, becoming a parent carer can be incredibly isolating. Men can be less likely to seek help and more likely to suffer in silence. Combined with a higher propensity to smoke, drink, gamble and use drugs, that means that the health of male carers really suffers, and that has a significant impact on families, workplaces and communities.

A contributing factor to the inequality faced by unpaid carers is that 63% who are struggling financially have not accessed any financial guidance or resources in the past year. Improving access to financial guidance and simplifying benefit information on carers’ entitlements would really help.

The inspirational founder of Dads Behaving Madly, Graham Porter, told me that he started the support group in Scarborough as a safe space for dads with disabled kids, as there was a massive gap in support for men like him. What started with just Graham and a mate has grown to 70 members across the Yorkshire coast. The dads meet to have curries or breakfast; to go surfing or cold-water swimming; to do a bit of yoga; to watch Scarborough Athletic play; and to connect, support, laugh, cry and, with all that cold water swimming, shiver together. Graham says that when they are supporting dads and male carers, including non-binary dads, they are not just helping one person but strengthening entire families and communities. One member of the group told me:

“It’s not the big sweeping gestures, it’s the small simple things that keep you going and create a real friendship within the group. I think that’s what I’d been missing most as it’s very difficult to talk to other dads about SEN or children with additional needs, when either their children don’t have them or the dads have no interest in it.”

The Labour Government have just unveiled England’s first ever men’s health strategy, which aims to tackle the crisis in men’s mental health. Will the Minister comment on whether the Government have an ambition to develop a new carer’s strategy that improves not only the financial wellbeing and security of unpaid carers but their mental health? Will he join me in thanking Dads Behaving Madly, as well as mums, grandparents, siblings and all the other 5.8 million unpaid carers behaving variously across the UK, for their amazing contribution to our families, communities and country?

14:07

[Richard Foord (Honiton and Sidmouth) (LD)]

It is an honour to serve with you in the Chair, Ms Vaz.

The Office for National Statistics estimates that around 130,000 people in Devon provide unpaid care. That is roughly one in six Devon residents. To understand what that means in real life, I want to share the story of Emma Donovan from Sidmouth. Emma cares for both her parents: her mum who lives with Parkinson’s and dementia, and her father who is a veteran whose injuries have worsened with age. At the same time, she runs a non-profit, she works two part-time jobs, she volunteers as a Rotarian and she still tries to live a life of her own.

Through her start-up, In a Pickle Services, Emma provides hygiene and wellness packs to people experiencing homelessness, but because statutory support has fallen away, her organisation is having to restart an unpaid carers’ support group, inspired by the excellent Honiton Carers Support Group. The new group in Sidmouth will launch in January and will help unpaid carers to manage the day-to-day reality of caring. The average age of Sidmouth residents is 59, which means that it has one of the highest proportions of carers of anywhere in the country. Emma’s experience mirrors that of countless carers across Sidmouth, Seaton, Axminster and Cullompton: constant pressure, limited respite and a system that too often leaves people to cope on their own.

A recent report by Healthwatch in Devon, Plymouth and Torbay found that a third of unpaid carers provide more than 20 hours of care a week. That is sustainable only with proper support. The report highlighted poor communication, long waits for help and carers not being identified early enough. Many carers said that their mental and physical health is deteriorating because caring leaves them no time. Even when people do apply for help, carer’s allowance is paid only to those who prove that they provide at least 35 hours of care a week, and because it is an allowance and not a wage, it does not increase should the carer do more hours in a week than the minimum 35, which leaves some effectively receiving less than £2 an hour.

The Carer’s Leave Act 2023, introduced by my hon. Friend the Member for North East Fife (Wendy Chamberlain), was a major step forward, giving working carers up to five days of unpaid leave per year. But that is still not enough. We Liberal Democrats are calling for paid carer’s leave and guaranteed respite, so that people are not forced to choose between their jobs and those they love. Our wider package of reforms would raise carer’s allowance by £20 a week and widen eligibility, recognising that too many carers miss out.

People like Emma give so much to their families, their communities and to our country. They should not be left to struggle on their own. I thank the hon. Member for Shipley (Anna Dixon) for securing both this debate and the presence of the Minister. We look forward to hearing from him the latest on the Government’s plans to support carers.

14:10

[Jonathan Davies (Mid Derbyshire) (Lab)]

It is a pleasure to serve under your chairmanship, Ms Vaz. I thank my hon. Friend the Member for Shipley (Anna Dixon) for securing this important debate and colleagues for sharing their powerful personal insights. I fully acknowledge the work carried out by unpaid carers across my constituency and throughout the country more generally. Their dedication keeps families safe, our social security system afloat and our society humane. Their work—including that of children who are, unfortunately, carers too—deserves not only recognition but support from the Government.

Earlier this year, I met local unpaid carers, as well as the Derbyshire All-Age Carers Support Service and Healthwatch Derbyshire, to listen and learn about the issues that matter to unpaid carers in my Mid Derbyshire constituency. I met a woman who is caring for her mother. She told me there is a gulf between policy and reality when it comes to working carers. Carer’s leave exists, but it is not adequate for people who are already struggling financially, and too many carers do not even know that it is available. Those who do often forgo it because it does not cover their pay or because they are worried about their job security. Instead, they use annual leave or their limited number of sick days. That just is not right. This lady was the primary carer for her mother in a virtual ward during the pandemic, when she repeatedly faced security checks that treated her as an outsider rather than as a partner in care. We need systems that support this vital work rather than obstruct it.

Another woman I spoke to is an NHS worker who has been providing unpaid care for over 20 years. She told me that the NHS, an organisation with care as its very purpose, is itself inconsistent in the support it provides to staff with caring responsibilities outside their main work. I understand that as many as one in three NHS staff may be unpaid carers, yet career progression and role flexibility are not guaranteed for them. Too often they depend on the service in which they happen to work to get the allowances they need to undertake their caring responsibilities. That can be disruptive for managers but is essential for the person they care for.

Finally, I heard from another long-term carer. He has overcome many challenges, including faulty equipment, particularly catheters; an unresponsive district nurse team who did not always recognise his important role; and ambiguity about responsibilities when the dependant and the carer fall into different authority areas. He has not been able to take a holiday in 10 years, although that is a sacrifice about which he felt no regret—I found that particularly inspiring.

I came away from that meeting earlier this year in awe of the contributions that these people make day after day, often with no complaint. But they are in dire need of greater support and recognition.

I welcome the progress the Government made in increasing the carer’s allowance last April but, despite the very difficult circumstances the country finds itself in, I believe we should go further. I am also looking for the Government to lead us in clearer integration with local authorities and the wider care system. Carers would like employers to understand their work more consistently, and we can work on that across Departments. I would also like the Government to ensure more public visibility and recognition of unpaid carers, and a renewed focus on identifying unpaid carers. We need more information about the help available to them.

I again thank my hon. Friend the Member for Shipley for being a champion in this place for unpaid carers and her constituents, and for her excellent work in Parliament on this issue. I look forward to reconvening the constituents I met earlier this year, along with Healthwatch Derbyshire and the Derbyshire All-Age Carers Support Service, to report back what the Minister says today about their important work.

14:15

[Dr Ellie Chowns (North Herefordshire) (Green)]

It is a pleasure to serve under your chairship, Ms Vaz. I warmly thank the hon. Member for Shipley (Anna Dixon) for securing this vital debate to mark Carers Rights Day, and indeed everybody else who has spoken from the heart and made such important points. We all recognise that the care system is in crisis, and that unpaid carers play an essential role in supporting people who need care.

I welcome the fact that the Casey Commission, which has been mentioned already, is working—although, I suggest, perhaps not as fast as it needs to be. I am deeply concerned by the Government’s proposal that it should not report for another few years, because resolving the care crisis is a matter of urgency and political will. I am honoured to be the Green party representative on the cross-party talks; I would like those talks to be convened more frequently and to operate much faster, but in the meantime I look forward to welcoming the Casey Commission to my constituency next month as part of its evidence-gathering process.

I am currently engaged in a wide public consultation exercise, running a survey and holding listening exercises in my constituency. My team are visiting various care settings to gather people’s input. I will share the story of one constituent who contacted me a few days ago. She moved to North Herefordshire in 2022 from more than 100 miles away to care for her mother, who was elderly and declining. She left her entire life, moved in with her mum and got a part-time job at a much lower salary than she was used to in order to support her mother, who earlier this year was diagnosed with Alzheimer’s and vascular dementia.

My constituent was put in the position of going out to earn £12.21 per hour while paying £20 an hour for somebody to come and look after her mother. She put in an application in early April for carer’s allowance to support the costs of a paid carer, who enables her to keep doing her part-time job, but it was refused. She contacted the DWP in July: the Department said that a mistake might have been made and she was due a mandatory reconsideration. She chased the matter up again but, seven months after her initial request, she has still not had a response. She says that carer’s allowance is too little and takes too long, and that the criteria are far too limited—I could not agree more.

I leave the Minister with my constituent’s words:

“I don’t want to financially benefit from caring for my mum. I just don’t want to be pushed into poverty while I keep her out of hospital and out of a care home.”

She cares for her mum 24/7. When worked out by the number of hours, carer’s allowance is about 55p per hour, because it covers nighttime care as well as daytime care. Surely the least that unpaid carers deserve from us is a benefit system—a carer’s allowance system—that supports, recognises and works with them, enabling them to provide the vital care that keeps those people who need it out of hospital and care homes.

14:18

[Douglas McAllister (West Dunbartonshire) (Lab)]

It is a pleasure to serve under your chairship, Ms Vaz. My contribution will be brief. I congratulate my hon. Friend the Member for Shipley (Anna Dixon) on securing this debate to consider inequalities faced by unpaid carers. It was also my great pleasure to attend the parliamentary reception last night organised by Carers UK on the eve of Carers Rights Day—which is, of course, today. It is the 25th anniversary, and I believe this year’s theme is, “Know your rights, use your rights”.

To mark the occasion, Carers UK prepared a report highlighting the inequalities faced by the UK’s invisible army—the 5.8 million unpaid carers across our nation. I was struck by the figures in that new report revealing that one third do not know where to go for financial guidance and 41% are unsure what benefits they are entitled to as carers.

I am incredibly fortunate to have Carers of West Dunbartonshire in my constituency. It is a wonderful organisation that provides outstanding help, support and guidance to our unpaid carers—from opportunities to rest, talk and recharge their batteries to essential advice on how to break down the barriers to obtaining financial help, housing and the tailored resources they so desperately need.

However, I want specifically to congratulate Carers of West Dunbartonshire on its book launch last month, which I was privileged to attend—all proceeds go to the charity. The book, “Above and Beyond” by author Lynn Jolly, is reasonably priced, at just £10 a copy, and available in all good bookshops this Christmas. It is a collection of real-life short stories from carers who attend the West Dunbartonshire organisation. There is no better way to recognise the daily struggles of our carers, their love for the people they care for and their contribution to our society.

I thank all our West Dunbartonshire carers, as well as all the unpaid carers across our nation.

[Valerie Vaz (in the Chair)]

Hon. Members have been very disciplined. We now go to the Liberal Democrat Front-Bench spokesperson.

14:21

[Alison Bennett (Mid Sussex) (LD)]

It is a pleasure to serve under your chairship, Ms Vaz. I thank the hon. Member for Shipley (Anna Dixon) not only for securing this important debate on Carers Rights Day, but for all her work championing carers since her election to Parliament.

I welcome yesterday’s publication of the terms of reference of the employment rights for unpaid carers review, which suggests that the Government are looking in the right direction. However, as my hon. Friend the Member for North East Fife (Wendy Chamberlain) noted, the pace is not as fast as it could be—it has already been going a year—and the period of consultation may actually be too short, given the demands that carers and the people who support them face, as everybody in this Chamber understands. I hope this review will usher in paid carer’s leave, as it would make the biggest difference for those on the lowest wages, who cannot currently afford to take unpaid carer’s leave.

This year, the theme of Carers Rights Day is, “Know your rights, use your rights”. It is all about making sure, as hon. Members have noted, that the millions of unpaid carers who support loved ones through illness and disability, know that they have access to support and rights, such as carer’s assessments, carer’s leave and hospital discharge support.

In my Mid Sussex constituency and across the UK, hundreds of thousands of people are waiting for social care. Many are stranded in hospital beds simply because the support they need in the community is not there, which in turn puts immense strain on our already creaking NHS. That is why my Liberal Democrat colleagues and I are campaigning so passionately for a social care system that values care users, supports care workers and, crucially, recognises the millions of unpaid carers who quietly keep this country going.

The hon. Member for North Herefordshire (Dr Chowns) set out her frustrations, which we share, with the pace of the Casey review. It is worth noting that only one cross-party meeting has happened since the Secretary of State announced that review in January, and a second meeting has not yet been convened. Can the Minister advise us when we can expect to secure a second meeting?

[Wendy Chamberlain]

I want to express my thanks to Baroness Casey, who, although she has been appointed to this commission, is doing other work for the Government. I would not want that to go unrecognised when we are talking about the delays.

[Alison Bennett]

I wholeheartedly agree with my hon. Friend’s excellent point. It is regrettable that there seems to be only one person that the Government like to call on to do very important work across a number of different areas.

[Dr Chowns]

The hon. Lady and the hon. Member for North East Fife (Wendy Chamberlain) make very good points. I gently point out to the Government that it is not Baroness Casey’s job to convene cross-party talks. Political leadership is needed, and it should come from the Health Secretary himself. We do not need to wait for Baroness Casey to bring all the parties together—the Government need to do that.

[Alison Bennett]

I agree with the hon. Lady’s comments.

Unpaid carers, who are the focus of Carers Rights Day, do remarkable, difficult and emotionally demanding work every single day. They do it out of love, without recognition and, too often, without the support or rights that they deserve or should have access to.

As the spokesperson on care and carers for my party, this is something I say a lot, but it bears repeating: unpaid carers are the backbone of Britain’s care system. There are 5.7 million carers across the UK, and together they provide care worth an estimated £162 billion every year—almost the size of the entire NHS budget. For that to be the case, however, they make huge sacrifices. Every single day, 600 people leave their job to care for someone they love. If carers are expected to shoulder that vast responsibility, they must have rights. Those rights must be well known and easy to access, and must make a meaningful difference to carers’ lives. Today is about making sure people know and use their rights.

I am proud that my colleague and hon. Friend the Member for North East Fife changed the law with her Carer’s Leave Act 2023, which secured the right to unpaid time off work for carers. That legislation was an enormous step forward for the almost 2 million employees who balance work and caring responsibilities. I am also proud that Liberal Democrat campaigning helped to secure an increase in the carer’s allowance earnings limit in last year’s Budget, easing pressure on people who want to remain in work while caring. I recently tabled the Unpaid Carers (Respite and Support) Bill, which would guarantee regular respite breaks for unpaid carers—something that is not readily accessible across the country.

There is much more to do, however, and unpaid carers face inequalities on all fronts. On gender, women become carers earlier and more frequently than men, are more likely to provide care and more likely to work in part-time and lower-paid roles. On employment, carers face barriers to remaining in paid work, with large numbers reducing their hours or leaving their jobs. On health and wellbeing, caring drives significant and preventable health inequalities, with high rates of long-term conditions, worsening physical and mental health, difficulty accessing support, and greater impacts for women and those providing the most hours.

On poverty, there are currently 1.2 million unpaid carers in poverty and 400,000 in deep poverty, who struggle financially due to low carer’s allowance, a reduced ability to work and a complex benefits system. Young carers face substantial disadvantages in terms of education and future opportunities. Those spending more than 35 hours a week caring are far less likely to gain a degree or enter employment. That is why the Liberal Democrats want unpaid carers to have real financial support, including an increase of £20 a week in the carer’s allowance to bring it to £103.30. In next week’s Budget, should the Chancellor be minded to increase the minimum wage, I sincerely hope that carer’s allowance will be pegged to that increase.

We also want a review of the requirement of 35 hours’ care per week, which too often forces carers to make impossible choices. Critically, we want a taper on the earnings limit so that, if a carer’s earnings go above the limit even by a few pence, they do not immediately lose all their carer’s allowance. That is plain common sense. It is precisely because there is no such taper that the carer’s allowance overpayment scandal has been allowed to happen, with horrendous consequences for thousands of carers.

Carers deserve better. They deserve respect, they deserve support and they deserve rights that they can rely on and easily exercise. Carers Rights Day reminds us that rights are powerful only if people know they have them and feel able to use them. Too many carers do not know what they are entitled to; too many assume that support is not for them and too many are simply too overwhelmed to navigate unnecessarily complicated systems. That is why fantastic organisations such as Carers UK and Carers Trust are vital. They look out and speak up for these extraordinary carers to whom we owe so much.

On this Carers Rights Day, I close by echoing the words of the Princess of Wales, who urged us this week to restore

“the dignity to the quiet, often invisible work of caring…as we look to build a happier, healthier society.”

14:30

[Stuart Andrew (Daventry) (Con)]

It is a pleasure to serve under your chairmanship this afternoon, Ms Vaz. I am pleased to respond to this important debate on behalf of the Opposition, and I thank the hon. Member for Shipley (Anna Dixon) for securing it and for her long-standing leadership on carers’ rights.

I acknowledge the contributions made by hon. Members across the House this afternoon. They have spoken very openly about their personal experiences, which helps to bring alive this debate and these issues. I am conscious that the hon. Member for Bexleyheath and Crayford (Daniel Francis) talked about how much work he has to do before he even gets to work, which reflects what so many people across the country feel. As has just been said, unpaid carers are the backbone of our care system. They provide vital support to loved ones, often around the clock and with little recognition, and at great personal cost. This debate is therefore not just timely, but probably overdue.

Before entering Parliament, I spent over 15 years working mainly in palliative care, and much of that in children’s hospices—lastly at Martin House children’s hospice up in Yorkshire. I saw the extraordinary compassion, amazing resilience and sacrifice from unpaid carers every single day, whether from parents caring for their terminally ill children, many of whom had very complex needs, or relatives supporting someone at the end of their life—people managing both care and grief at the same time. I will always remember one parent saying they would consider it a good night’s sleep if they got up only eight times in the night to help their daughter, which gives an indication of how much work they do. As the hon. Member for Shipley said, so many carers end up giving up work because they have to provide that care. Sadly, so many relationships break down because of the pressures.

I now find myself having to care for my elderly father. I had to move him into my home, and I am now seeing at first hand the things people have to do. When I am here, I always worry, “Is he okay? Is there enough food and milk in the fridge?” I also watch every single move he makes. I once turned my back, for literally a minute, and he fell flat on his face. I realise that it was not my fault, but I cannot help but have those feelings of guilt.

I also pay tribute to the hon. Member for North East Fife (Wendy Chamberlain) for her amazing work on the Carer’s Leave Act. That really is important, and the cross-party support for it showed Parliament at its best. It is great that carer’s leave is now a day one right and that it can be taken flexibly, because that is what unpaid carers need. They need to be able to take that half-day, or full day, if they need it because, as we have heard, one in seven are juggling work and caring responsibilities. I thank the hon. Lady and my hon. Friend the Member for Gosport (Dame Caroline Dinenage), who I know would like to have been here today—she gave quite a bit of support during the Act’s passage—for encouraging the previous Government.

[Wendy Chamberlain]

I thank the right hon. Gentleman for his kind comments. Passing a private Member’s Bill is obviously more straightforward with Government support, which I had, so I am grateful to him and his colleagues.

[Stuart Andrew]

It just shows how, when Parliament works well, it works exceptionally well.

I want to repeat some of the comments that have been made. The Government have launched a review of the potential benefits of paid carer’s leave, with the conclusions coming at the end of the year, I believe. As others have said, that is welcome, but I am sure that carers would hope that there will be clarity and no delays.

I look forward to hearing the Minister’s response to some of the issues that have been raised in this debate, and to hearing whether the Government are genuinely open to acting on the review’s findings. A fair point has been made about the length of time that people have to contribute to that consultation, given the responsibilities that they have. We must ensure that the consultation is accessible. I was a critic of this when we were in government, but doing just online consultations means that those who are not digitally savvy can be excluded. It is important we make sure that is not happening.

As other hon. Members have said, the financial pressures on carers remain severe, with one in four unpaid carers living in poverty. The employment rate among carers is just 50%, compared with 75% across the general population, but with the right support an estimated half a million carers could return to work. That would not only strengthen their security but contribute to the economy, which is what we all want to see.

In fairness, it is not just the Government who have to act; there is a responsibility on employers, too. I saw in the hospices that some businesses took on our young adults despite their life-limiting conditions. The employers told us that what they got from those individuals was utterly amazing, and that they were really dedicated to their work.

The recent increase to the carer’s allowance earnings limit is a step in the right direction, for which I thank the Government. However, the Carers Trust has rightly called for a full review of carer’s allowance and the wider support system. I am keen to hear whether that is something the Government are considering.

I am also concerned that the level of respite support has been falling, and has dropped by 6% in local authorities in the last year alone. I am concerned about, and pay tribute to, the charities that offer so much respite support. I know, from my consultations with charities, that the rise in national insurance contributions has had an impact, and that they have had to reduce and scale back their staffing. That is a concern, and I hope we recognise the size of their contribution.

At the hospices at which I worked, it was not just about end-of-life care. Some of the most important care they provided was respite stays. Either the child came on their own so that the family might go on holiday, or the whole family came together, which gave them the opportunity to be a family again. The child who needed care was being looked after by the care team, which meant the parents could be parents again to the siblings, who often miss out in such situations.

[Jonathan Davies]

The shadow Minister is making a very powerful speech. He raises the issue of national insurance, and I know that change was very difficult in the last Budget, but it was to get over £20 billion into the NHS, which I hope will improve respite care. We saw huge cuts to local authorities under the last Government, and we are paying for that in different ways, including in Derbyshire. I hope we will be able to move beyond the national insurance thing and get better public services. Hopefully, we will even be able to reduce national insurance in the future, but it is right to contextualise that in the circumstances in which we find ourselves.

[Stuart Andrew]

This has been a really good debate so far, and I do not want to get into party politics, but the rise in national insurance contributions is having an impact on charities—it really is. The cost is about £1.4 billion. Charities have been a cornerstone of respite provision, and without them we would not have as many respite places as we need.

The other point I want to make is about the social care review. I went to those cross-party talks, and I was encouraged by the first meeting—it felt like all of us, representing our political parties, wanted the talks to succeed—but it is disappointing that we have not had another meeting since. I am concerned. Baroness Casey is an exceptional person. She has a huge amount to contribute, and she certainly left me with the impression that she is absolutely determined to find solutions to some of the issues in social care, but I am anxious that she has responsibilities for other issues, all of great enormity.

I hope the Minister can update us on when we might have another meeting. As the hon. Member for North Herefordshire (Dr Chowns) said, we do not have to be invited by Baroness Casey; we can be invited by the Secretary of State. I know that Baroness Casey is doing an enormous amount of work on this issue, but it is important that, politically, we try to find where we can agree. If we can introduce things earlier, that would be to the benefit of everybody in the country who needs care.

I say that because I want to be constructive in opposition. I recognise that some of these things are not easy to deliver. They are difficult issues, but they demand more than our sympathy—they demand action. I do not claim that we got everything right in government, but I am clear that carers need to know that we are all listening and are keen to respond and deliver when we can. Unpaid carers do not seek praise; they just want systems that they can rely on, policies that reflect their worth and services that offer real support.

Finally, this is not about just one Department—it is not just the Department of Health and Social Care. There are many other Departments. Having been a Minister, I know the structure of Government means that working cross-departmentally can sometimes be a challenge. Can the Minister update us on how that is going? I know it is a challenge, and I wish him well in any cross-departmental work that is happening.

Unpaid carers deserve fairness, support and action. I finish by saying to every single one of them: thank you for the amazing contribution you make every day, looking after others and being the backbone I mentioned at the beginning.

14:42

[The Minister for Care (Stephen Kinnock)]

It is a pleasure to serve under your chairship, Ms Vaz. I thank my hon. Friend the Member for Shipley (Anna Dixon) for securing this vital debate. I pay tribute to her for her career-long dedication to adult social care and so many of the issues we are debating today. I also pay tribute to all the powerful and moving contributions we have heard today, many about personal experience, engagement with constituents and the stories we hear every day about the pivotal role that unpaid carers play in our care system, which are truly inspiring and uplifting.

Every day, unpaid carers step up to sustain the health and wellbeing of millions of people across our country. Every day, they step up quietly and without expectation to support loved ones, neighbours and friends. I offer my heartfelt thanks, particularly on Carers Rights Day: thank you for the compassion, the commitment and the resilience you show.

As Minister for Care, it has been my priority to listen directly to unpaid carers through discussions with carers of all ages, including during Carers Week. I have heard at first hand the realities of balancing care, work, education and personal wellbeing. Those conversations have been moving, honest and often humbling. They have reinforced just how essential it is that we continue to recognise and support the people who provide so much care to so many, and who hold so much of our health and care system together.

As I said at the Carers UK “State of Caring” conference earlier this year, we have made genuine progress over the last three decades. The profile of the role of unpaid carers has undoubtedly grown, and awareness of their contribution is undoubtedly greater. Despite that, true equality of opportunity remains out of reach for far too many. My ambition is clear: that carers who want to work can do so without being penalised; that young carers can learn, develop and dream, just like their peers; and that caring must not lead to long-term damage to a person’s health, wealth or wellbeing.

The data shows the scale of the challenge: unpaid carers are 16% more likely to have multiple long-term health conditions, and providing just 10 hours of care a week can significantly reduce someone’s likelihood of being employed and increase their risk of loneliness. These pressures compound existing inequalities linked to gender, ethnicity, socioeconomic background or age. We must continue to shine a light on these disparities, listen to carers’ voices and design support that genuinely helps them to thrive.

The Government remain committed to ensuring that unpaid carers receive the right support at the right time in the right way. Under our 10-year health plan, unpaid carers will be recognised as partners in preparing personalised care and support plans. Their practical knowledge and experience will help to shape more responsive and realistic plans for the people they support.

Early identification remains key. Too many carers still go unnoticed and unsupported. We will increase the information captured across the health and care system, enabling earlier intervention and more tailored help. We will also introduce a dedicated “My Carer” section in the NHS app, which will allow carers to book appointments, access information and communicate more effectively with clinical teams. That will not only support carers but streamline interactions across the system.

Our shift towards a neighbourhood health service will increase the integration of health and care services, and it will bring multidisciplinary teams—GPs, nurses, social care professionals, pharmacists and others—closer to people’s homes. Working alongside unpaid carers, these teams will be better placed to deliver joined-up, community-centred support, focused on the health and care that people really need.

We know that caring can have a profound impact on mental health. That is why we are expanding access to talking therapies and digital tools, and piloting neighbourhood mental health centres, offering round-the-clock support for people with more severe needs.

[Richard Foord]

Can I ask the Minister what definition of neighbourhood he is using, and does it recognise communities such as market towns?

[Stephen Kinnock]

As a ballpark figure, we are looking at 50,000 residents, but we will be open to developing multi-neighbourhood infrastructure that would cover closer to something like 250,000 residents. It will depend, to some extent, on how it works in the 43 pilot sites in our neighbourhood health implementation plan. We do not want to have too many top-down diktats like the disastrous 2012 Lansley reforms; this is much more about a bottom-up, organic approach to developing a neighbourhood health service. Approximately 50,000 residents will be the starting point.

[Jim Shannon]

What the Minister is referring to is very positive; as always, I have a quick ask. The policy he is outlining seems very plausible and workable, so can I ask him to share those thoughts with the Northern Ireland Assembly and the Health Minister, Mike Nesbitt? I think that the two Ministers are in regular contact, so it could be done through that.

[Stephen Kinnock]

I will be very happy to do that. We have launched the 43 sites, so I would be happy to share the documentation on how we launched them and the terms of reference. [Interruption.] I can see the representative from my private office is taking notes.

[Daniel Francis]

I do not expect an answer now, but can I also ask the Minister to take away a point about the complexity of some of these disabilities? Sometimes people are under several different consultants in several different hospitals, perhaps for a neurological condition, for their sight, for epilepsy and so on. I am thinking about both the complexity of the different apps, and different parts of apps, used by different NHS trusts and hospitals, and the complexity of the distances travelled —it is the carer who manages all those aspects. How can we take that away and support the carer in managing the care of the person for whom they are caring?

[Stephen Kinnock]

I absolutely agree with my hon. Friend’s points; I think that neighbourhood health, as a strategy, addresses his points about both the proximity and complexity. By definition, through shifting from hospital to community, we are addressing the proximity point. The fact that neighbourhood health will be based on multidisciplinary teams creates the idea of a one-stop shop for the patient, where their complex needs are addressed in one place.

To ensure that local areas can meet their duties under the Care Act, the 2025 spending review allows for an increase of more than £4 billion in additional funding for adult social care in 2028-29, compared with 2025-26, to support the sector in making improvements. The Health and Care Act 2022 strengthened expectations around identifying and involving carers and ensuring that services are shaped by carer feedback.

NHS England is helping local systems to adopt best practice through co-produced tools, case studies and events such as Carers Week and the Commitment to Carers conference. Initiatives such as GP quality markers for carers, carer passports and digital proxy access are already making a real difference and increasing the number of carers who are identified in the NHS.

Balancing paid work and caring responsibilities remains a significant challenge, and too many carers risk financial hardship as a result. That should never be the case. Supporting carers to remain in or return to work is central to our plan for a modern, inclusive labour market. Employers benefit enormously from the skills, dedication and experience that carers bring. That is why in April we increased the carer’s allowance earnings limit to £196 a week—the largest rise since its inception in the 1970s—meaning that carers can now earn up to £10,000 a year without losing the allowance.

The Carer’s Leave Act, which came into force in April 2024, gives employees one week of unpaid leave each year to help to manage planned caring commitments. We are now reviewing how the Act is working in practice, listening to carers and to employers of all sizes. That includes exploring the potential benefits and implications of introducing paid carer’s leave. To ensure transparency, and as hon. Members have noted, the Department for Business and Trade yesterday published the terms of reference for that review and we will hold a public consultation in 2026 on employment rights for people balancing work and care.

Young carers make an extraordinary contribution, often taking on responsibilities far beyond their years. Our ambition is that every young carer should receive the support that they need to succeed at school and beyond. This autumn, we published key stages 2 and 4 attainment data for young carers for the first time—an important step in understanding and addressing the educational disadvantage that they face. Reforms across education and children’s social care will strengthen identification and support. Ofsted’s new inspection framework, introduced on 10 November, explicitly references young carers in the expected standards for inclusion, safeguarding and personal development.

Local authorities must identify young carers who may need support and assess their needs when requested. We strongly support the “No Wrong Doors for Young Carers” memorandum of understanding that promotes collaboration across children’s and adults’ services, health partners and schools. I encourage all local authorities to adopt it.

NHS England is supporting the identification of young carers through GP guidance and improved data sharing. It is also leading a cross-Government project, co-produced with young carers and voluntary, community and social enterprise partners, to support identification, strengthen support pathways and join up services across education, health and local organisations. Engagement workshops have already helped to shape the next young carers summit, in early 2026.

Our 10-year plan sets out strong foundations for change, and we are now fully focused on delivery. Baroness Casey’s independent commission will shape the cross-party and national consensus around longer-term reforms, including proposals for a national care service. As noted by the shadow Secretary of State, the right hon. Member for Daventry (Stuart Andrew), however, supporting unpaid carers requires commitment across Government. That is why I chair a ministerial working group, working closely with my counterparts at the DWP, the DBT and the Department for Education, to ensure that our policies reflect the realities of caring.

My hon. Friend the Member for Shipley and others asked about the Government’s response to the Sayce review. I can confirm that we will publish that response this year and I am receiving regular updates from DWP colleagues on that matter. Additionally, our research arm, the National Institute for Health and Care Research, is evaluating local carer support programmes to identify what works and where improvements are needed.

As we look to the future, prevention must sit at the heart of our approach. Too many carers reach crisis point before they receive help. That not only places huge strain on families, but leads to avoidable pressure on hospitals, primary care and social services. By intervening earlier—through better identification in primary care, strengthened community networks and improved signposting —we can ensure that carers receive the right support before challenges escalate.

[Anna Dixon]

I thank the Minister for his response. Given what we know about carer burnout and the need for short breaks, and given the data that suggests local authority funding cuts have resulted in less support being available, will there be work between the NHS—with its increased budget—and local authorities to look at how we can get back to having more breaks for carers?

[Stephen Kinnock]

There is a consistent message that comes through in my conversations with carers about the importance of respite and regular breaks. We know that they are not a luxury. When carers reach exhaustion, the wellbeing of the carer and the person they support is compromised. We are working with local authorities and integrated care boards to ensure that they meet their statutory duty for carers’ breaks and that provision is transparent, fair and personalised. I absolutely take my hon. Friend’s point: that duty is clear, written down and statutory; the question is about making it happen in practice. We must monitor that closely.

Addressing the inequalities faced by unpaid carers requires a cultural shift as much as a policy one. We must build a society that values care, where caring is recognised as a shared responsibility rather than a private burden, and where employers, communities and public services all play their part. Changing culture takes time, but we have already seen encouraging progress. Businesses are increasingly recognising the value of carer-friendly workplaces. Schools are becoming more aware of the pressures faced by young carers. Health professionals are finding new ways to involve carers as genuine partners. These changes—these shifts—matter, as they represent the foundations of a more compassionate and inclusive society.

As we continue this vital work, I remain committed to ensuring that the voices of carers young and old inform every stage of policy development. It is only by listening attentively, engaging meaningfully and responding boldly that we can continue to deliver the change that carers rightly expect. I hope that today’s debate has given everyone a sense of what the Government are working on and, once again, I pay tribute to all hon. Members who have spoken.

14:57

[Anna Dixon]

I thank all Members who have spoken in the debate, especially my hon. Friends the Members for Scarborough and Whitby (Alison Hume) and for Bexleyheath and Crayford (Daniel Francis) for sharing their moving personal stories and for all they do as parent carers. I also thank the right hon. Member for Daventry (Stuart Andrew), who is caring for his father. It is important that we, as Members, speak up about our caring.

I thank the Minister for his response. I and other Members will continue to push him to ensure that the Government deliver for carers. I thank all carers in my constituency of Shipley for all the love and care that they give 24/7 all year round, and the 5.7 million people in the so-called invisible army that has been talked about today. Let us make sure that they do not stay invisible.

Question put and agreed to.

Resolved,

That this House has considered inequalities faced by unpaid carers.

World COPD Day

Thursday 20th November 2025 Westminster Hall

[Clive Efford in the Chair]

15:00

[Jim Shannon (Strangford) (DUP)]

I beg to move,

That this House has considered World COPD Day.

It is a pleasure to serve under your chairship, Mr Efford. I thank the Backbench Business Committee for making time for this debate. I am always pleased to see the Minister in her place—she knows that—and we look forward to her answers to our requests on behalf of our constituents. I am also pleased to have other colleagues here, including the shadow Ministers for the Conservatives and for the Lib Dems, the hon. Members for Farnham and Bordon (Gregory Stafford) and for North Shropshire (Helen Morgan), and also my good friend, the hon. Member for Surrey Heath (Dr Pinkerton).

I am glad to be able to raise the issue of chronic obstructive pulmonary disease. Yesterday was World COPD Day, so I pay tribute to the wonderful work carried out by so many organisations and individuals to draw attention to the illness. We had an event here last night, which was well attended. The people in the Gallery are those who do the hard work for the all-party parliamentary group for respiratory health, which I chair. We had a great event last night with many excellent speakers.

I want to reflect on the organisations and individuals that attended last night to draw attention to the illness. Hugh McKinney is going to look at me and say, “You mentioned that lady again”, because last night one of our special guests was Shirley Ballas of “Strictly Come Dancing”. I could not dance if my life depended on it—I have two left feet—but that lady can. Last night she was not there because she is a judge on “Strictly Come Dancing”. She was there to tell the story of how she cares for and looks after her mum, who has COPD. There are two sides to the lady—the side we see on TV and the caring side. The previous debate was about unpaid carers across the United Kingdom, in all constituencies, and the work that they do. It was a pleasure to take part in that debate and to see so many there.

As chair of the APPG for respiratory health, I will cover a number of issues today around COPD. I will frame my comments around the latest initiatives and also the current policy direction. Hopefully we can try to marry those two together so that we can have a focus and a target to do better. To make that happen, of course, we need Government and ministerial support.

As always, I am indebted to Sarah Sleet and her wonderful team at Asthma and Lung UK for their outstanding help and ongoing support. Without their enormous help to me and the APPG that I chair, we just could not manage as well as we do. I also want to say a special thanks to Jonathan Fuld, the national clinical director for respiratory disease, for his expert advice and counsel. I pay tribute to the ongoing work of our expert stakeholder groups, which comprise senior clinicians, industry, professional bodies and other experts. We have Zoom meetings because that is the best way for us to come together from all over the United Kingdom and it means people do not have to travel. When we have our Zoom meetings we have fantastic contributions from all over the United Kingdom of Great Britain and Northern Ireland, and sometimes further afield.

I want to begin with a general point on the modern service frameworks. There is much to be thankful for in what the Government are doing and we want to focus on that as well, but there are also things that we want to ask for. Although the APPG warmly welcomed the initiative of the modern service frameworks, the Minister will not be surprised that we were disappointed that respiratory health was not included in the first wave. Respiratory health is an ideal candidate, I believe, as do others inside and outside the Chamber, for the next wave. What can the Minister do to include respiratory health in the next wave of the Government’s 10-year plan for health, which we very much welcome and are encouraged by?

The outcomes of COPD are widespread and have a huge impact on the NHS. I will give some statistics to show that. Sometimes, people hear statistics and are sceptical. I always think about “lies, damned lies, and statistics”, but the stats are important because they set the scene. Many times when we are looking at the objectives and targets for the NHS, we need the statistics before us, because they indicate the policies that hopefully the Government will follow.

Lung conditions, including COPD, are the largest cause of emergency hospital admissions, especially in winter, when respiratory admissions can increase by some 80%. These figures are worrying; we are in that season now, and we could see that figure. The rate of emergency admissions to hospital for COPD in England increased by 9% in 2024 compared with 2023; unfortunately, they are increasing consistently. That represents some 121,129 A&E admissions—significantly higher than in the previous year. Worryingly, the trends are upwards. I hope that the Minister, when she responds to the debate, can give us some ideas about how the Government can reverse those trends and reduce that figure.

COPD is the second most common cause of emergency admission in the United Kingdom, and 1.7 million people in the UK have been diagnosed with it. In my office, when we meet constituents, we help them with their benefits forms and try to put them on the pathway to get some help to deal with their health conditions. I have known many people over the years who, unfortunately, are no longer here today because COPD has taken their life. Others are on oxygen, just trying to survive every day. Again, that is quite worrying.

It has been estimated that there could be around 600,000 more people in the UK who are living with undiagnosed and untreated COPD. What can we do to identify those people and ensure that they understand what is happening to them, so they can get some help with the life that they will now lead? Lost productivity due to COPD is estimated to cost around £1.7 billion per year. There is a cost to every disease, but there is a real cost to this disease, and if we can diagnose and catch it earlier, perhaps we can reduce that sum.

My last point is about something quite worrying. Each year, around 30,000 people in the UK die from COPD. That is the reality experienced by some of my constituents I have met over the years, but who are no longer with us. The disease progresses so fast that people’s life expectancy is reduced. Deaths caused by respiratory diseases are more strongly linked to deprivation than deaths caused by any other major disease. People living in the poorest areas of the United Kingdom are five times more likely to die from COPD than those living in the richest areas. That is a real disparity, whereby people in deprived areas are more susceptible to COPD and their life expectancy is also reduced. I have another ask of the Minister: how can the Government address deprivation and its impact on particular areas, specifically when it comes to COPD?

Research from Asthma and Lung UK shows that someone from the poorest 10% of households is over two and a half times more likely to have COPD than someone from the most affluent 10% of households. That is a real disparity. If someone lives in an affluent area, they have 10% less chance of getting COPD than someone living in a deprived area.

We hope that the transition from hospital to community under the 10-year plan for the NHS will transform COPD outcomes in the most deprived areas. A survey by Asthma and Lung UK found that almost a quarter of people with COPD wait five years or more for a diagnosis, with one in eight of people with COPD waiting for over 10 years. Again, I have another ask of the Minister. How can we shorten the wait for a diagnosis of COPD? If we catch it earlier, we can reduce the impact on life expectancy and help with life conditions and how to reach a better level of care.

The same survey showed that only 9% of people with COPD in the UK were receiving good basic care. That is worrying. Again, as chair of the respiratory health APPG, it is one of the things that we hope to address. While the statistics are stark, the APPG also acknowledges and welcomes a huge amount of work undertaken by NHS England ahead of the winter months to relieve the pressure on the NHS. We are all here to make lives better, and not to make them worse, but sometimes we need to have a better idea of what needs to be done. The NHS can do much, but it cannot perform miracles. It can only do the best it can, so how do we help it to do so, given all the pressures it is under?

We commend the urgent and emergency care delivery plan, and Exercise Aegis, which will devolve accountability for winter readiness to the integrated care boards—probably a good idea. Under Aegis, NHS England will stress test winter preparedness by running seven regionally-led exercises. I ask the Minister for some detail on that, on what it means and how it will work—no doubt we are to hear that shortly. The initiative is welcome and a well thought-out plan, I believe—I am sure others will comment —that promises to deliver the regional outcomes that will make a huge difference. Only in the past few days have we realised that winter is coming—anyone who has not felt the cold must be wearing a strong and heavy coat—so will the Minister update us on the outcomes of the regional exercises and how they feed into the winter preparedness strategy?

We are busy in the APPG—Hugh and the team clearly do that for us—and recently we held a roundtable on the winter pressures in partnership with the Centre for Applied Respiratory Research Innovation and Impact—CARRii, to abbreviate all those words—which gave an outstanding presentation. Early next year, we will produce a short report, taking the outcomes of that meeting and the data from this year into account. We are happy to share it with the Minister, because I think it will be helpful when drawing up a better way to do things.

Key themes of the roundtable included an increase in vaccination rates—more focus on that has been because of, unfortunately, a slight reluctance to take up vaccination —and how we encourage that. At the Tuesday morning roundtable, with Lord Bethell from the other place, we had an opportunity to discuss how best to do that with those in the NHS, and with other companies and people who have a deep interest in the subject matter. Some of the ideas will be helpful for the future.

We need better infection control. COPD exacerbations are mainly driven by infections. How can we address and target that in the system? We must implement fully the five fundamentals of COPD care by the National Institute for Health and Care Excellence, which outline what effective management of care looks like, such as vaccination, smoking cessation and pulmonary rehabilitation. Recent analysis has found that expanding access to PR services to all eligible patients could result in £142.6 million of direct NHS savings related to reduced exacerbations, as well as a reduction of 194,000 bed days, 66,000 of which would be saved over the winter period.

Those figures cannot be ignored—at the end of the day, the NHS has to work within the figures, the money, it has available. When we look at the savings and the reduction in bed days, in particular over the winter period, we must try to do better. The final fundamentals are personalising self-management planning and optimising treatment for co-morbidities. Will the Minister please assure us that the NICE fundamentals of COPD care are being implemented consistently across the country? The Minister will know, because she is very knowledgeable and responsive to these issues, that the APPG strongly supports the 10-year plan and the three shifts, which are ideally placed to transform respiratory care and outcomes. Community delivery, especially, promises a great deal for improved respiratory outcomes by placing facilities closer to home. That is a better way to do it.

We welcome the work already under way to place respiratory services in community settings and the introduction of spirometry in all CDCs and community health services. This a really positive way forward. There is, however, evidence to suggest that not all patients receive spirometry tests. If we are going to introduce spirometry, we need to ensure that all patients can receive those tests. Will the Minister make sure that these tests be undertaken on all eligible patients?

Will the Minister also please look at the waiting lists for diagnostic testing and see whether they can be prioritised to test those at the highest risk first? That is a lot of asks—I have given the Minister and the shadow Minister a copy of my speech, so hopefully the Minister had all my questions in advance. I hate to throw around 20-odd questions at her in the space of an hour and a half and expect answers right away, but hopefully we can get those answers—I know that the civil servants who are here will work very hard to ensure that happens. Although it might be too late for this winter, perhaps that provision could be in place for people for next year.

We are also looking forward to the upcoming NICE guidance on the biologic therapies for COPD, which will be a complicated process. We will keep an eye on the implementation of these drugs when they are approved. The advancements in medicine cannot be ignored; it is really good to have them, and it is encouraging that we are living that bit longer now. We can now extend and improve the lives of people with diseases that would previously have killed them fairly young.

Finally, we have been looking at the incidental findings from lung cancer health checks. According to recent data, around 100,000 people who have been assessed under the targeted lung health check programme have been diagnosed with emphysema or symptoms of no recognised disease to date. What can be done to help those 100,000 and perhaps others facing those circumstances who have not yet been diagnosed?

Lastly, there is no onward referral from the lung health checks, and I think there should be. It would be helpful to have an assurance about how that could be achieved. I know that this is a complex area—it always is—and that lung cancer health checks are carefully targeted, particularly for those in our most deprived communities, who are least likely to be well served, but this provision would seem to fit perfectly in a modern service framework for respiratory health. So, I end where I began: I hope that this will happen sooner rather than later. I have made a lot of requests, but we are fortunate to have a Minister who responds in a way that gives us all encouragement. We have a real problem with COPD, and this debate gives us the chance to highlight the issue for patients. The winter pressures are on. I am pleased to see my friend, the hon. Member for Blaydon and Consett (Liz Twist). She is the co-chair of the APPG, and she will hopefully speak next. I look forward to hearing all the contributions, including from the shadow Minister, the hon. Member for Farnham and Bordon, and, ultimately, the Minister.

15:18

[Liz Twist (Blaydon and Consett) (Lab)]

It is a pleasure to take part in this debate with you as Chair, Mr Efford. I also thank the hon. Member for Strangford (Jim Shannon) for securing this important debate. He and I have worked together on the respiratory health APPG for some years now, and I know how committed he is to tackling this issue.

Like in many other places across the north-east, a great number of people—more than 2,500 people, in fact—are living in my constituency with the debilitating symptoms of COPD. In some parts of my constituency, the rate is almost twice the national average, and those are just the people we know about. Almost a quarter of those with COPD wait five years or longer for a diagnosis, and there are many more living with COPD who are undiagnosed and therefore untreated.

From the discussions I have with constituents who come to my local surgeries or contact my office, it is clear just how closely this condition tracks health inequalities. Nine in 10 cases are thought to be caused by smoking, which we know is associated with socioeconomic deprivation. Meanwhile, persistent exposure to damp and mould in poor-quality housing further contributes to and exacerbates lung problems. I have received messages from constituents receiving hospital care who are frightened to return to homes that they strongly feel are not safe places for them to be in. I have heard from others who struggle to walk long distances, for whom the reliability of public transport is a serious issue. This condition cuts across many areas of daily life.

The town of Consett in my constituency is well known locally for its freezing climate. We have had lots of snow in Consett this week, while I have been down here in Parliament. Although it is great to see people enjoying the snow, I know that such weather conditions make living with a lung condition even more challenging, leading to heightened admissions to hospital, as we heard from the hon. Member for Strangford. This debate is therefore timely and is a good opportunity to remind ourselves of the importance of improving access to diagnosis, treatment and care for people living with COPD.

The Government’s 10-year health plan has established the importance of prevention and care within the community. I am pleased with the progress we have made to tackle smoking prevalence through the Tobacco and Vapes Bill, and the progress made through Awaab’s law, which requires that problems of mould and damp are responded to quicker in the social housing sector. Locally in the north-east, our ICB performs well nationally for ensuring timely referrals to pulmonary rehabilitation services.

However, much more needs to be done nationally to ensure access to rehabilitation services. I know there is much more to do to ensure that all eligible patients have access to that treatment as well as biologic drugs. Both those interventions can make a huge difference to quality of life and reduce hospital admissions. I would be interested to hear the Minister’s views on the potential merits of a dedicated framework to bring those efforts together with work to expand early diagnosis, and on what more we can do to ensure that we catch and treat conditions early.

I thank Asthma + Lung UK and the APPG for respiratory health for their work in ensuring that COPD remains firmly on the agenda here in Parliament. My thanks go to constituents who have shared with their experiences with me, not just lately but over a number of years. I know just how devastating this condition can be, and I hope that we continue to work together to address the impact it has on our communities and people.

15:23

[Dr Al Pinkerton (Surrey Heath) (LD)]

It is a great pleasure to serve under your chairmanship, Mr Efford. I congratulate my dear friend, the hon. Member for Strangford (Jim Shannon), on securing this debate and on his long advocacy for both COPD and other respiratory conditions, which I know he does with his chairman for the APPG for respiratory health hat on. We thank him for all his work, and the vice-chair of that APPG, the hon. Member for Blaydon and Consett (Liz Twist), who spoke just before me.

As the hon. Members for Strangford and for Blaydon and Consett have both already said, COPD is the most challenging condition to live with. Many people go undiagnosed for far too long, believing their wheeze, cough and breathlessness is simply result of seasonal winter flu. But it does not go away; there is no cure, and when someone with COPD does catch something as common as the winter flu, it can rapidly escalate into other conditions, such as pneumonia. That is why treatment, early diagnosis and proper management are vital. However, a recent King’s College London report, carefully titled “A matter of life and breath”, revealed that COPD sufferers often feel like they live as second-class citizens in the UK—their voices go unheard. I know that the hon. Member for Strangford was involved in the launch of that report in Parliament back in May.

Respiratory illnesses are now one of the leading causes of hospital admissions in the UK, yet our healthcare system is still not optimised to support people with long-term conditions effectively. According to Asthma + Lung UK, there were 2,268,865 emergency hospital admissions for respiratory conditions in England between April 2024 and March 2025, a 23% increase compared with the year before. Worse still, in just the month of December 2024, more than 220,000 were admitted to hospital with breathing emergencies. That is not just a one-off; between April 2024 and March 2025, there were over 405,000 so-called bounce-back admissions, where people are discharged from hospital only to return to A&E within a month.

I have heard from numerous constituents of mine in Surrey Heath—not only those with COPD, but many others with chronic conditions—who frequently travel across the country for work or education. However, when they move, their medical records do not. Let us take the example of university students, who are not necessarily a high-risk population for COPD. They move between home and campus, yet they can be registered with only one GP surgery at a time. The result is delayed treatment, repeat diagnostics and even difficulty accessing the medication that they rely upon. The burden often falls hardest on those with complex conditions such as COPD, where timely diagnosis and regular specialist input can be life-saving.

I have a few key questions for the Government. First, do they agree that people with conditions such as COPD should not face the anxiety of being unable to access the right NHS specialist care, simply because they happen to live in the wrong part of the UK? Secondly, will they commit to stronger data sharing and a truly integrated, nationwide healthcare system, so that records follow the patient, not the other way around? Finally, what steps is the Minister taking to winter-proof the likes of Frimley Park hospital in my constituency, so that it can cope with additional demand and also provide support to those with diseases such as COPD that worsen in the colder months? People with COPD and other chronic illnesses deserve continuity of care, wherever they are living. Our NHS must be connected enough to deliver exactly that.

15:27

[Helen Morgan (North Shropshire) (LD)]

It is a pleasure to serve under your chairmanship, Mr Efford. I start by congratulating the hon. Member for Strangford (Jim Shannon), who is a friend of all of us in this House, on securing this debate and raising awareness of World Chronic Obstructive Pulmonary Disease Day, which took place yesterday. I thank him for his tireless campaigning for this cause, and for his excellent opening speech, which outlined the issues faced by COPD sufferers.

As we have heard, COPD is the name given to a group of health conditions that affect the lungs and cause breathing difficulties, such as emphysema and chronic bronchitis. Patients with COPD may face symptoms such as shortness of breath, a chesty cough, frequent chest infections and wheezing, which get progressively worse over time and may be exacerbated during the winter months. As someone who has had asthma from childhood, I know at first hand the fear, frustration and disruption to daily life that gasping for breath can cause. It is critical that there is a plan in place to manage respiratory disease, given that we may be facing a devasting winter crisis in the NHS once more.

The most recent data published by the NHS shows that there were over 1.17 million patients recorded by GPs as having COPD in England in 2023-24. The National Institute for Care Excellence warns that the real number of sufferers may be much higher, noting that previous Government research put the number at around 3 million in the UK, 2 million of whom remain undiagnosed. Approximately one in 10 adults over the age of 40 has COPD in the UK, at a cost of £2 billion a year to the NHS.

As the main cause of COPD is smoking, it is a highly preventable condition. I welcome the Government’s introduction of legislation to enable a smoke-free generation, but we must also consider those who have already started smoking and who are finding it hard to quit, or those who can circumvent the provisions of the Tobacco and Vapes Bill.

Smoking is much more common in deprived areas, as we have already heard, so COPD is also a stark indicator of social and health inequalities in this country. The Liberal Democrats want the new Government to take urgent action to support people to live healthier lives, starting by reversing in full the Conservative cuts to funding for public health, of which smoking cessation services are a critical part. I am sure all Members agree that prevention is better than cure, and helping smokers to kick the habit will not only reduce their risk of debilitating illness but will save taxpayers money in the long run. The cost of COPD is £2 billion per annum, and everyone benefits if fewer people require treatment for smoking-related illness.

Along with smoking, long-term exposure to air pollution may be a cause of COPD. The Liberal Democrats have pledged to reduce air pollution; to protect people, especially children, from breathing in harmful pollutants by passing a clean air Act based on World Health Organisation guidelines and enforced by a new air quality agency; and to improve public transport and active travel to reduce the harm caused by air pollution at home, school and work. I would welcome the Minister’s thoughts on those proposals, which would drastically reduce avoidable respiratory diseases.

The theme for World COPD Day this year is “Short of Breath, Think COPD”, and it aims to raise awareness of underdiagnosis and misdiagnosis of COPD. As I mentioned, there could be 2 million people undiagnosed in the UK who are missing out on essential treatment and advice on how best to manage their debilitating condition. NICE recommends that COPD should be suspected in anyone aged over 35 with a risk factor for COPD and symptoms of breathlessness, chronic cough, regular phlegm production, frequent chest infections in the winter, or wheezing.

The Liberal Democrats have called for anyone with a long-term health condition, including COPD, to have a named GP, which would improve the continuity and therefore the quality of their care. People with COPD consistently report difficulties accessing services that are essential to managing their condition, including GP appointments, specialist care and pulmonary rehabilitation. They also experience poor communication between different healthcare providers and inadequate follow-up after hospital discharge.

As we have heard, COPD patients are often left in the dark with inadequate information about their condition when they are first diagnosed. Better continuity of care in the community would surely help to overcome at least some of those issues. To achieve that, we need the Government to be much more ambitious in their plans to increase GP numbers. We need them to adopt Lib Dem plans to retain and recruit 8,000 more GPs over this Parliament to deliver that improvement in care.

We are also campaigning to improve the speed of new treatments by expanding the capacity of the Medicines and Healthcare products Regulatory Agency. We are also pressing for better social care, including for people with COPD who are struggling to manage independently. We would provide more support for family carers through initiatives such as the right to respite breaks, paid carer’s leave and an end to the cliff edge in the way that carer’s allowance is paid, so that no one is forced to pay back thousands of pounds because they worked an extra hour a week.

We would also help people who struggle to get into work because of their illness, with a new right to flexible working and the right to work from home unless there is a really good business reason why that is not possible. We would make it easier for people with long-term conditions, such as COPD and those with disabilities, to access public life, including the world of work, through a range of measures that allow better physical access and proper adjustment to the workplace.

Many people with COPD are at risk of a stay in hospital, and they are often unable to get home after that because of the crisis in social care, which is putting even more strain on the NHS. The Government established the Casey commission to find a cross-party solution to the social care problem, and I welcome that, but I have to report that despite a promising opening roundtable in September, there have been no further talks. Will the Minister update us on the progress of that work?

The winter presents an immediate problem. There are warnings of a particularly bad flu season, which is causing concern for everyone who is more vulnerable to respiratory illness, including those with COPD. My local hospital, Robert Jones and Agnes Hunt Orthopaedic hospital, and the Shrewsbury and Telford hospital NHS trust have already introduced some mandatory mask wearing to reduce the risk of transmission of respiratory disease in the hospital. That means that an effective vaccination programme is especially important this year.

I was concerned by news that covid vaccination eligibility has been significantly reduced. This autumn and winter, vaccination is being offered only to people over 75 and those with a weakened immune system. People with chronic respiratory disease, including COPD and asthma, have been excluded despite the clear risk—I speak from too many personal 2 am nebuliser experiences—that even a mild respiratory infection poses for them. Also excluded are the main carer for an older or disabled person, those who are in receipt of carer’s allowance or who are living with someone who has a weakened immune system, and, perhaps most surprisingly, frontline health and social care workers.

All those people remain eligible for a flu vaccine, and that is good. Even though covid is now considered to be a mild disease, time off for NHS and care workers when services are at their most pressured, as well as the significant risk of transmission to vulnerable patients, is concerning. Will the Government consider a review of the decision to restrict access to covid vaccines this year? Can the Minister provide statistics on the uptake so far of flu vaccines within different groups and outline what steps she is taking to ensure high levels of uptake among NHS and care workers?

In conclusion, COPD is a debilitating condition and, as with many conditions in the UK, there is something of a postcode lottery in the quality of care patients receive. I welcome the Government’s roll-out of the NHS RightCare COPD pathway and the National Respiratory Audit programme, along with plans to improve access to pulmonary rehabilitation. I would be grateful if the Minister updated us in her closing remarks on progress with those programmes, as well as answering my questions about vaccine roll-out, support for carers and the Casey commission, access to a named GP, and full restoration of the public health grant, including for smoking cessation services.

15:35

[Gregory Stafford (Farnham and Bordon) (Con)]

It is a pleasure to serve under your chairmanship, Mr Efford. I am grateful to the hon. Member for Strangford (Jim Shannon) for securing this debate the day after World Chronic Obstructive Pulmonary Disease day. He gave an excellent speech, although I think he was being characteristically modest when he mentioned his dancing ability—I am sure he is much better than he claims.

As we have heard, COPD is a group of conditions that too often goes unnoticed until it is dangerously advanced. More than 1.7 million people across the UK have a COPD diagnosis. However, NICE estimates that around 600,000 more are living with the condition undiagnosed, and indeed this afternoon we heard figures that are even higher than that.

I am fortunate to have a relatively low rate of COPD in my constituency, at about 1.46%, but that figure masks the variation within my constituency. Those differences are reflected across the country: rates are significantly higher in the north of England, and in the 10% most deprived areas the prevalence is nearly double. People living in the poorest areas are five times more likely to die from COPD than those in the wealthiest. Research from Asthma and Lung UK shows that the poorest 10% of households are more than two and a half times more likely to have COPD than someone from the most affluent 10%. As the hon. Member for Strangford rightly highlighted, this is, in every sense, a disease that tracks inequality. Where someone lives should never decide how long they live, yet for COPD far too often it does.

Before the pandemic, around 70% of people diagnosed with COPD said they faced barriers to accessing that diagnosis, and 14% were initially misdiagnosed—often told that they had a chest infection or a lingering cough. Some were simply sent away after raising concerns with their GP. However, the pandemic made a serious problem worse: Government figures demonstrate that already inadequate diagnosis rates plummeted, and they show little sign of recovering. As the hon. Member for Strangford mentioned, spirometry—the gold-standard diagnostic test—which has not returned to pre-pandemic levels, continues to be a problem.

The consequences of that pause are stark. There was a 51% reduction in diagnoses in 2020 compared with the year before, meaning that around 46,000 people missed out on a diagnosis in that year alone, and around 92,000 over the course of the pandemic. As the hon. Member for Blaydon and Consett (Liz Twist) said, late diagnosis means more advanced disease and higher mortality, more frequent exacerbations and quicker deterioration in quality of life. Those flare-ups can cause permanent lung damage and require long hospital stays. COPD is now the second largest cause of emergency hospital admissions, rising three times faster than general admissions.

The pressure on the NHS is enormous: an estimated £3.9 billion a year, including £1.4 billion for exacerbations alone. Lost productivity costs £1.7 billion, and reduced quality of life accounts for a further £2.2 billion. When diagnosis fails, costs rise, outcomes worsen and patients suffer the price of delay.

As the hon. Member for Surrey Heath (Dr Pinkerton) has rightly pointed out, late diagnosis is not the only driver of pressure. Asthma and Lung UK, formerly the British Lung Foundation, found that patients who received the five fundamentals of COPD care experienced fewer flare-ups and were better equipped to manage their symptoms, yet more than three quarters of respondents said that they were missing at least one part of that basic care. Those with the most recent diagnoses were the least likely to receive the full package, so the situation is getting worse, not better. Asthma and Lung UK notes that many people must effectively learn to navigate the NHS themselves to access the care that they need. That is not acceptable. These are people who are already struggling, and they should not have to fight the system as well as the disease.

Around 420,000 people in the UK may have had their working lives cut short by COPD. More than half of respondents to the Asthma and Lung UK survey said that their mental health had worsened since diagnosis, so we can and must do better. The NHS long-term plan includes commitments on respiratory disease, including for early detection and improved access to pulmonary rehabilitation. I would be grateful if the Minister updated the House on progress towards those commitments. This November, waiting lists continue to rise. We need a credible strategy to ensure that the NHS can manage the winter safely while maintaining high-quality care. We need a realistic plan to address the continuing backlog in elective and non-emergency care, and a targeted approach to address persistent gaps in respiratory services.

The national respiratory audit programme—formerly the national asthma and COPD audit programme—was launched in 2018 and is led by the Royal College of Physicians. It has been invaluable in identifying gaps and variations in care. As part of the programme, NHS England developed a best practice tariff for COPD, which is met when 60% of COPD patients admitted for an exacerbation receive specialist input after 24 hours and when all COPD patients receive a discharge bundle.

I have mentioned it before in the House, but one of my proudest career moments was working for the Getting It Right First Time programme. In 2021, our respiratory medicine report, published by Dr Martin Allen during the pandemic—it was, therefore, focused on the immediate problems—raised a number of issues. For example, pulmonary rehabilitation remains one of the most effective treatments available for COPD. Of those who complete the programme, 90% report better quality of life or improved exercise capacity. The long-term plan proposes expanding access by 2028. If achieved, that could prevent half a million exacerbations and avoid 80,000 admissions. As 2028 is not that far away, will the Minister update on progress towards those targets?

The NHS RightCare pathway provides a comprehensive framework for improving diagnosis, management and treatment. It highlights the importance of timely pulmonary rehabilitation and early intervention, so I welcome the Government’s rolling it out. Finally, tackling smoking remains fundamental. Between 2022 and 2023, there were around 400,000 hospital admissions attributable to smoking, and 16% of all respiratory admissions were smoking-related. Between 75% and 85% of COPD deaths remain linked to smoking, yet only around half of COPD inpatient services report having a dedicated tobacco dependency adviser. What are the Government going to do to improve that situation?

I call on the Minister to take urgent action, first by implementing a national strategy to raise awareness, strengthen early diagnosis and reduce risk factors such as smoking and air pollution; secondly, by ensuring that all COPD patients have timely access to treatment, pulmonary rehabilitation, and integrated health and social care support for patients and carers; and, thirdly, by committing to increasing research investment, and to introducing innovative treatments and transparent data-driven accountability to improve outcomes and reduce avoidable hospitalisations. We cannot keep treating COPD as a winter crisis when it is, in truth, a year-round emergency. The time to act is now.

The evidence is clear. Too many people remain undiagnosed, too many are diagnosed too late, too many do not receive the basic standard of care to which they are entitled and too many end up in hospital when their deterioration could have been prevented. We have the data. We have the clinical consensus. We have the pathways. We do not lack knowledge; we lack resolve. People living with COPD deserve timely, high-quality care and the support that they need to live fuller, healthier lives. It is within our gift to deliver that; let us not fail them.

15:44

[The Parliamentary Under-Secretary of State for Health and Social Care (Ashley Dalton)]

It is a pleasure, as always, to serve under your chairship, Mr Efford. I thank the hon. Member for Strangford (Jim Shannon) for securing this timely debate, as we mark World COPD Day. As hon. Members have clearly demonstrated in this debate, tackling COPD does not lend itself to one area of activity; that point was well made by my hon. Friend the Member for Blaydon and Consett (Liz Twist).

COPD is known to affect 1.5 million people in the UK but, due to uncertainties, that number, as has been stated, could well be much higher. Improvements are needed across society and the healthcare system to reduce the incidence of COPD and help people living with the condition—people like my mum, Margaret—to lead healthier, longer lives. Our 10-year plan is built around the recognition that widespread change is needed to shift from treating COPD to preventing it, to ensure that those living with COPD receive care in the areas where they live and to embrace new technology to diagnose COPD earlier. I reassure the shadow Minister that the National Institute for Health and Care Research welcomes all proposals for research, and I encourage researchers to submit proposals on COPD and similar respiratory conditions for consideration.

Before I speak about the actions we are taking through the plan and more broadly, I want to address the points about a modern service framework for respiratory disease. Frameworks for cardiovascular disease and severe mental illness and the first ever service framework for frailty and dementia will be developed first. However, there will be more—those are just the first three. The criteria for determining future frameworks will be based on where there is potential for rapid and significant improvements in quality of care and productivity. I assure hon. Members that respiratory disease will be considered alongside many other things as we bring forward more modern service frameworks in the future.

As has been said, smoking is the No. 1 preventable cause of COPD. The Tobacco and Vapes Bill will be the biggest public health intervention since Labour’s indoor smoking ban in 2007. The Bill also allows us to expand current indoor smoking restrictions to outdoor public places and workplaces. In England, we are considering extending smoke-free outdoor places to outside schools, children’s playgrounds and hospitals. Prevention will always be better than cure. As part of our health mission, we will shift the health system from treatment to prevention by tackling the social determinants of health. The public health allocations, including for smoking cessation, will be announced shortly.

In terms of vaccines, the primary aim of the national covid-19 vaccination programme remains the prevention of serious illness, hospitalisations and deaths arising from covid-19. The independent Joint Committee on Vaccination and Immunisation has advised that population immunity to covid-19 has been significantly increasing due to a combination of naturally acquired immunity following recovery from infection and vaccine-derived immunity. The focus of the JCVI-advised programme has therefore moved towards targeted vaccination of the two groups who continue to be at higher risk of serious disease, including mortality: the oldest adults and individuals who are immunosuppressed.

In line with the JCVI advice, a covid-19 vaccination is being offered to adults aged 75 years and over, residents in care homes for older adults, and individuals aged six months and over who are immunosuppressed. I do not have to hand the data on uptake for the Liberal Democrat spokesperson, the hon. Member for North Shropshire (Helen Morgan), but the Government’s vaccine strategy is being rolled out and is focused on stabilising and increasing vaccine take-up. I will write to the hon. Lady with an update on the data following this debate.

In terms of housing and air quality, the Tobacco and Vapes Bill is the first step, but it is only part of the action that we are taking to improve air quality. We are working across Government with the Department for Environment, Food and Rural Affairs to tackle air pollution and with the Department for Energy Security and Net Zero to fix housing and reduce damp and mould, both of which can exacerbate COPD, as hon. Members have said today, and make life much harder for people than it needs to be.

We are also working with the Department for Work and Pensions to support people with COPD to get back into and stay in work. In March, we announced in the “Pathways to Work” Green Paper that we will establish a new guarantee of support for all disabled people and people with long-term health conditions claiming out-of-work benefits who want help to get into or return to work. That will be backed up by £1.9 billion of new funding by the end of the decade.

Unemployment is worst in the most deprived areas of the country, and those areas have the worst health inequalities. COPD disproportionately affects people in deprived areas and we intend to address that. Yesterday, we announced the publication of our men’s health strategy, which includes our commitment to addressing entrenched health inequalities in ex-mining and industrial communities, where economic transition and occupational legacies have led to persistent respiratory and cardiovascular disease burdens. As part of the strategy, we will expand the existing respiratory pathways transformation fund initiative by investing an additional £1 million this year, through the Oxfordshire health innovation network, to develop targeted, case-finding initiatives in former coalfield areas. That will help us to identify the individuals who need support to access appropriate local services. We will continue to capture learning in the men’s health strategy “one year on” report.

The hon. Member for Strangford raised coverage of spirometry and the progress made to increase coverage of this diagnosis service in the community. I also assure the shadow Minister that we are shifting care from hospitals to the community, as it is one of the key pillars of the 10-year plan, and we are building on progress so far. The number of community diagnostic centres reporting spirometry testing capacity is growing and will continue to as more sites come online. So far this year, we have seen an increase in CDC spirometry testing of 2,000 tests a month—more than in the previous year.

Preventing and diagnosing COPD are two key areas we are making improvements in, but we also want to ensure that people with COPD have healthier lives. As highlighted by the shadow Minister, pulmonary rehabilitation is a key intervention to improve the health of people with COPD and reduce pressure on NHS hospitals. As he knows, we inherited very low rates of people accessing this service, and I want briefly to set out the action we are taking to change that.

We want to ensure equitable access to these services and reduce health inequalities. To address that, NHS England has published commissioning standards for pulmonary rehabilitation, setting out the benchmarks that high-quality services should aim for, while recognising that cardiac comorbidity is highly prevalent in patients attending pulmonary rehabilitation. In addition, the nine health systems across England have been awarded funding totalling £2.61 million through the pathway transformation fund to deliver innovative projects between October 2025 and March 2026, to drive system-wide transformation in asthma and COPD care. I confirm to the hon. Member for Strangford that reporting on the outcomes of the PTF projects will follow later in 2026.

It is vital that all screening programmes are evidence-based. That is why the Government are guided by the independent scientific advice of the UK National Screening Committee. Lung cancer screening has been very positive, particularly for deprived communities, and is growing year on year. I visited a programme in the north-west recently and saw the amazing work that they were doing to identify early-stage lung disease. It is an opportunity for many more people to be recognised and treated for lung conditions who previously were not receiving support. Where emphysema is found, the screening programme refers people to their GP. GPs have established clinical pathways for supporting people with COPD.

The hon. Member for Strangford is understandably interested in biologic therapies, which have also been mentioned by other Members. Biologic therapies for COPD will be commissioned by ICBs, should NICE approve them. The high cost of biologics means that a specialist approach by ICBs is needed, but we cannot pre-empt the findings of NICE, so we will wait to see the outcome of that.

I want briefly to cover the points made on winter planning. The NHS chief executive wrote to the NHS in September following the testing of winter plans, and set out key areas for learning for providers and systems. It included the need for robust plans to maximise vaccination rates and proactively to manage rising risk to COPD patients during the winter, including the optimisation of care and remote monitoring, greater emphasis on self-management and education, and strengthening community support. The actions being taken as part of winter planning, and the other actions I have set out today on smoking cessation and pulmonary rehabilitation, directly relate to the NICE fundamentals of COPD care. I hope that the totality of that work reassures the hon. Members for Strangford and for Surrey Heath that we are committed to NICE’s fundamentals being delivered across the country.

Too many people have had their lives cut short by COPD—people such as my cousin’s husband, Steve Ormerwood, who we lost to COPD far too young. His wife, Janet, his children, Adam and Joanne, his young granddaughter, Ada, and all our family feel his loss keenly. COPD is a lifelong condition, but it can and should be prevented. This Government take our responsibility to that goal with the utmost seriousness, as the cross-Government approach to that mission demonstrates. Equally serious is the need to ensure that those living with COPD, especially from communities that have been overlooked, are supported to live healthier and longer lives.

15:55

[Jim Shannon]

I thank all hon. Members for their contributions. I particularly thank the hon. Member for Blaydon and Consett (Liz Twist). She and I have been friends for ages and ages—so far back that I maybe had hair at that time. She underlined two issues: access to public transport, and how difficult it is for people to return home from hospital. She was keen to welcome the progress on the Tobacco and Vapes Bill and on access to drugs. She is no longer a Parliamentary Private Secretary, so she can now be active on the APPG—we are very much looking forward to having her energy back.

The hon. Member for Surrey Heath (Dr Pinkerton) also set the scene very helpfully. COPD never goes away; it escalates, so how do we address it? He said that there were 200,000 admissions to hospital due to respiratory ill health in the last year. He also talked about access to data and to medical care for COPD. It is sometimes a postcode lottery in the United Kingdom, and that has to change.

The hon. Member for North Shropshire (Helen Morgan) talked about chronic bronchitis and rehabilitation. She said that early diagnosis reduces the cost to the NHS. Shortness of breath means that there should be more checks for COPD. She said that anyone over 35 should get checked. That is very wise—we should all take note of that. She also referred to the Lib Dem ambition to recruit another 8,000 GPs, and she spoke about vaccination.

The hon. Member for Farnham and Bordon (Gregory Stafford) made an excellent speech—it was a real pleasure to hear it. He referred to the inequality and deprivation across the United Kingdom, and talked about how to do spirometry tests better. The pressure on the NHS is enormous. He said that pulmonary rehabilitation treatment is a key way of responding, and we very much welcome that. He also referred to other COPD interventions, and said that this is a year-round emergency.

I am very pleased to have the Minister here to respond to our requests. Anyone listening to her speech would recognise that she is keen, eager and energetic in giving us the answers that we are looking for. I am conscious of the look that you are giving me, Mr Efford, so I will be very quick. She said that her mother has COPD, and therefore this is a personal issue for her. She is as keen as all of us to see results. She set out the case for the prevention of COPD, and said it is the next disease to be considered in the respiratory service framework—hopefully in the next phase. I am looking to her to see whether the Government can deliver on that.

Prevention is better than cure. We must work harder to introduce a vaccination programme. The hon. Member for Blaydon and Consett referred to housing and air quality. We need a pathway to work so that those with long-term illnesses can come back to work. The Minister set out lots of positive things. She referred to deprivation, which we all know about. She spoke about spirometry care from hospital to the community, pulmonary rehabilitation, which is key to reducing COPD, and lung cancer screening—all good stuff.

I want to put on the record a big thank you to all those who participated, to Hugh, Will and the team in the Public Gallery for all that they have done, to you, Mr Efford, for your patience, and to the civil servants—they are not often thanked, but let us thank them for what they do.

Question put and agreed to.

Resolved,

That this House has considered World COPD Day.

16:00

Sitting adjourned.