Sepsis Awareness Month

Allison Gardner Excerpts

Tuesday 15th September 2026 Commons Chamber

[Mike Wood]

The hon. Lady makes a really important point. We know how these conditions can come round in a cycle. In order to break that cycle, we will need multiple years of vaccination.

The modern service framework contains a number of vital commitments, but I particularly welcome: action 4 on improving the audit and feedback of sepsis-related clinical data across trusts; action 5 on updating training for NHS staff, social care workers and unpaid carers; action 9 on optimising care pathways and expanding access to rapid diagnostics and specialist advice; action 11 on standardising digital specifications for early warning systems such as NEWS2; and action 12 on reviewing and addressing capacity gaps in critical and enhanced care.

A strategy on paper will not be enough to save a deteriorating patient on a cold winter weekend in an overcrowded emergency department. In the other place, my noble friend and our former colleague Lord Mackinlay of Richborough, who has spoken with enormous courage about his own life-altering encounter with sepsis, has repeatedly tabled written questions seeking clarity on how this framework will be delivered. Regrettably, the answers provided by Ministers in the Lords to date have been rather generic and vague, and lacking in operational detail. We cannot accept boilerplate responses on a condition that kills 48,000 people each year, so I have two direct questions that I hope the Minister will answer in her response to today’s debate. First, what are the specific milestone-driven timelines for the delivery of each of the actions set out in the modern service framework, and when will trusts and integrated care boards be expected to have these standardised pathways fully operational? Secondly, can the Minister assure the House that the Department of Health and Social Care is prepared to commit the dedicated investment required to make this framework work?

When we call for investment, we must be clear that funding sepsis care is not an open-ended cost. It is one of the most cost-effective investments that the Department can make. Sepsis currently places an enormous financial burden on the national health service and the wider economy. Too often, cases of missed or delayed diagnosis and treatment result in weeks of high-cost intensive care unit admissions, in emergency readmissions due to incomplete recovery, in complex surgical interventions including amputations requiring lifelong prosthetic and social care support, or in the permanent loss of working-age adults from the workforce. Investing in rapid bedside diagnostics, digital early warning systems, specialist outreach teams and structured post-sepsis rehabilitation can dramatically reduce the lengths of stay in intensive care, lower readmission rates and keep people in work. Early intervention is not only clinically imperative; it is economically sound, and the theme “Invest in sepsis—save lives” is a call for smart preventive healthcare investment.

[Dr Allison Gardner (Stoke-on-Trent South) (Lab)]

Prevention is key, and an estimated 20% to 30% of sepsis cases are urosepsis. I have just learned today from my campaign with Good Housekeeping magazine of a gentleman who lost his wife due to urinary tract infection-related sepsis. Does the hon. Gentleman agree that if we are to really tackle sepsis, we also need to look at infection sources and get better diagnostics and treatment for those, particularly for ones such as UTIs, that are still not properly focused on?

[Mike Wood]

Absolutely. Of course, some infections are almost unavoidable, but where infections such as UTIs can clearly be reduced with the right care and precautions, we must do everything we can to reduce those risks.

Every Member in this Chamber has constituents whose lives have been permanently transformed by sepsis. Some Members have been directly impacted or have watched as close family and friends have encountered sepsis. We know the speed with which it strikes, but we also know that with early detection, immediate treatment and high quality critical care, thousands of lives can be saved. We have the clinical evidence and we have the modern service framework. What we now need is clear delivery timelines, rigorous parliamentary accountability and the necessary financial backing to make this ambition a reality. If the Minister can deliver this and provide the resources and tools that the NHS needs to implement it, the modern service framework truly can be a turning point in the fight against this silent killer and the battle to save thousands of lives.

--- Later in debate ---

[Jim Dickson]

What the hon. Member and I have described is the mark of the man. Not only has he suffered that appalling setback in his life, come through it with huge brio and is an active Member of the other place, he has gone the extra mile to help others in the same predicament. I cannot thank him enough for the work he has done for those who have experienced sepsis and for my constituent John.

As Craig himself would say, sepsis remains something we do not know enough about, and what knowledge we have is not as widely known as it should be. I thought it would be helpful to remind all those present and anybody watching of the signs to look out for in adults, as set out by the UK Sepsis Trust: slurred speech or confusion; extreme shivering or muscle pain; passing no urine in a day; severe breathlessness; it feels like you are going to die; and skin mottled or discoloured. If you or another adult develops any of those signs, it is important to seek urgent medical attention.

John’s story highlights both the work we need to do to raise awareness of the early signs of sepsis and how we support those who have been diagnosed with it. There remains too little data on sepsis, with inconsistencies in the definitions used across the country. Office for National Statistics data indicates that sepsis was mentioned on the death certificate in 27,971 deaths in England in 2025, but that is almost certainly not the full story.

[Dr Gardner]

There is also the issue that the infection source is not recorded. Does my hon. Friend agree that we need to make significant improvements to this if we are to prevent sepsis? It is a slight repetition, but the lack of data collection worries me.

[Jim Dickson]

Absolutely. The data problems are much wider than simply understanding who has died with sepsis as a related cause and who has suffered sepsis at some point in the system. All the prevention and early diagnosis issues that my hon. Friend has highlighted go to the heart of the problems we have with data, and I hope the Minister will address that in her response.

I very much welcome the sepsis modern service framework, which was published last July and contains a much-needed plan to improve prevention, recognition, diagnosis, treatment and recovery for people affected by sepsis. It should mean that doctors are equipped to spot sepsis sooner and improve outcomes for patients like John and others who have been mentioned this evening. I hope the Minister will outline how the modern service framework will change the way the NHS supports John and others recovering from sepsis, so that the delays he has experienced in getting his prosthetics and the delays other people have experienced in the system become a thing of the past.

Health Bill

Allison Gardner Excerpts

Report stage
Monday 7th September 2026 Commons Chamber

[David Chadwick (Brecon, Radnor and Cwm Tawe) (LD)]

I rise to speak in favour of new clauses 133 and 134, which stand in my name. The new clauses would require the Secretary of State to work with Welsh Ministers to update the England and Wales cross-border healthcare statement of values and principles, and to bring forward proposals to place those principles on a formal legal footing.

For many people living along the border, cross-border healthcare is simply a fact of life. In Powys, at least 40% of people depend on hospitals across the border in England. Yet the framework governing how our two healthcare systems work together is based on a voluntary statement of values and principles dating back to 2018. We do not need to look far to see why the current arrangements need reform. Since last July, Powys teaching health board has been asking English hospitals treating Powys residents to treat them more slowly than patients from England as part of cost-cutting measures, despite the fact that they had always previously been treated as equals. The impact of that decision has been devastating. Many patients have had their waiting times increased to up to two years—forced to wait longer in pain, all while their conditions deteriorate.

It is not just me and the Liberal Democrats who have been sounding the alarm; providers on the English side of the border have resisted the arrangements because of concerns about the impact on patients. However, there seems to be little will to resolve the issue from either the Welsh Government or the health boards responsible. Meanwhile, patients are falling through the cracks. My constituents should not have to navigate the administrative boundaries between the NHS in England and NHS Wales simply to get the arrangements and treatment they need. Eight years after the statement of values and principles was introduced, the limitations of relying on a voluntary statement with no formal legal footing are clear.

New clause 134 would require the Secretary of State to work with Welsh Ministers to update that statement, reflecting the problems that cross-border patients face today. Crucially, it would also require the Government to bring forward proposals within two years to place those principles on a statutory footing. The border should never be a barrier to receiving healthcare. It is time to update and strengthen these principles and give cross-border patients the statutory protections they deserve, because I fear that cross-border healthcare will continue to deteriorate over the next couple of years.

Over the summer recess, I held a series of public meetings in response to plans by Powys teaching health board to cut the number of community beds, which will just mean that more people end up stuck in community beds on the English side of the border.

[Dr Allison Gardner (Stoke-on-Trent South) (Lab)]

This Government aim to shift the focus from treatment to prevention, and it is in that spirit that I have tabled new clauses 90 and 91, which would strengthen the frameworks around health inequalities and address the wider determinants of health.

New data from Health Equals reveals a shocking reality: there is a gap of up to 18 years in life expectancy between different parts of the UK, and indeed between nearby neighbourhoods. Health Equal shows that in my constituency just a golf course separates two areas with an average life expectancy gap of eight years and 11 months. Reaching old age is somewhat of an aspiration in my more deprived areas. Indeed, in the most deprived communities people spend an average of just 52 years in good health. The stark inequalities are driven not only by healthcare, but by the wider determinants of health, including poverty, housing, education, employment and the environment.

Within Stoke-on-Trent, healthy life expectancy at birth has fallen by 6.6% for men in the last decade. For women, the picture is even worse, with a 9.6% fall in healthy life expectancy to just 53.5 years over the past 10 years. This Bill represents a real opportunity to enshrine in law a statutory duty for the Secretary of State to go beyond reducing inequalities in NHS access and outcomes, and to reflect wider cross-Government goals for health improvement.

Our health is shaped by the world around us—the food we eat, the money in our pockets, the air we breathe and the home we live in. In other words, every part of Government has an opportunity to influence people’s health. The purpose of new clause 90 is to ensure that the Government take greater responsibility for improving the nation’s health. That includes mitigating any increase in health inequalities, such as those seen in my constituency. The new clause would make improving health a duty, placing prevention on the same footing as treatment.

But a stronger duty alone is not enough. That is why new clause 91 would require the Government to publish a new health improvement and inequality strategy within six months. The strategy would include long-term targets for adults and children, public reporting on progress, a duty on Ministers across Government to have regard to the strategy, and independent accountability arrangements. The Minister, who has worked very hard on the Bill—I commend her for her engagement—has alluded to the fact that pre-existing guidance and processes are in place, and these are designed to tackle health inequalities, and she is right. However, I argue that they are clearly not working, because health inequality has increased. I ask again what the harm would be of embedding this duty in the Bill to tackle the most fundamental issue in health across England: health inequalities.

These amendments have cross-party support, and I note that they are also supported by the Health and Social Care Committee. I thank Health Equals for its work on these amendments. Again, I thank the Minister for her engagement and urge the Government to consider accepting these new clauses.

I will briefly mention new clause 109, which also stands in my name. It was written by myself and Haris Shuaib, with whom I worked on the standard BS 30440 and a validation framework for the use of AI within healthcare. I previously worked with the AI and digital regulations service for NHS England, working with NICE, the MHRA, the CQC and the Health Research Authority. In the interests of time, I will say that in that duty I identified a number of accountability and regulatory gaps that certainly need further addressing. I ask that the Minister responsible for health tech meets me so that we can discuss these further. They partner quite well with new clause 108, which I had not spotted, so I apologise for not signing the amendment of my hon. Friend the Member for Liverpool West Derby (Ian Byrne).

[Charlotte Cane (Ely and East Cambridgeshire) (LD)]

In my constituency, only 40% of adults have seen a dentist in the past two years, and only 54% of children have seen one in the last year. The impact of that is that 12.5% of children in East Cambridgeshire have tooth decay by the age of five. We are in a dental desert, and it is incredibly difficult to get an NHS dentist appointment. When I talk to the dentists, the most frustrating thing is that it is the contract that prevents them from treating people, not their intentions.

The contract is based on units of treatment. For example, dentists tell me that if they do one filling, they just about cover their cost for the unit they get paid for. That unit covers up to three fillings, however, and at three fillings they are making a loss. Even more frustrating is that they get allocated units at the beginning of the year. Once they have used them all, they can get no more; yet they are aware that other local dentists have not used all their units by the end of the year, and they hand them back. Why is there no mechanism whereby those units can be given to dentists who have the capacity to do more work, so that more people can be treated? It is really frustrating to know that my constituents are struggling without a dentist, and that there are dentists in my constituency who are willing to treat them but cannot get funding to do that from the NHS. It is utterly shocking. That is why I support new clause 18 and other amendments that seek to make dentistry more available to people.

Infants, Parents and Carers Bill

Allison Gardner Excerpts

2nd reading
Friday 4th September 2026 Commons Chamber

[Dr Allison Gardner (Stoke-on-Trent South) (Lab)]

I have spoken in this House before about Stoke’s rates of infant mortality, which consistently rank among the highest in the country. In the latest data, the infant mortality rate in Stoke-on-Trent was 7.6 deaths per 1,000 live births, almost double the national average. It is a stain on our society that in 2026 a child’s chances of reaching their first birthday can be influenced by where they are born. Infant mortality is explicitly linked to socioeconomic deprivation and is a consequence of deep-rooted inequality.

Tackling our infant mortality rate is a goal that is deeply important to me, and I want to take this opportunity to tell the story of one of my constituents, Ashley Wilshaw—I will get upset—and the short life of her baby daughter, Chloe. It is upsetting, so if anybody who has experienced baby loss wants to step out, I am sure that Madam Deputy Speaker will understand.

Chloe was born prematurely, just before 26 weeks, on 28 April 2011. That may sound like a long time ago, but it is not to Ashley. She was, in her mum’s words,

“a settled, healthy and happy baby, a baby who knew what she wanted and fought so hard to be here.”

As a premature baby, Chloe was at high risk of necrotising enterocolitis, or NEC, a serious bowel condition that can become life-threatening without quick intervention. Chloe had received blood transfusions and had been given formula milk, which are both risk factors for NEC. Chloe began to show signs that something was wrong. She became pale and quiet, her body temperature lowered, her heart rate rose to 200 beats per minute, she struggled to breathe, she began vomiting profusely and she refused feeds. Her abdomen became hard and distended, and blood appeared in her feeding tube—a clear sign of a perforated bowel, which leads to sepsis.

Ashley did what any concerned parent should do—she asked questions, but she was not listened to. She was told that the blood was Gaviscon and that Chloe needed to continue being fed and medicated, causing Chloe agony. Ashley still was not listened to. When she persisted in raising concerns about Chloe, one nurse described her as an “over-the-top mother”. Chloe’s symptoms worsened. The investigations that may have identified the problem sooner were not carried out when they could have made a difference. Lactate levels were not checked. Blood gases were not carried out as appropriate. Scans focused narrowly on her lungs, and feeding continued despite signs of feed intolerance.

Tragically, little Chloe died on 4 June 2011, aged just 37 days old. Leaving behind a very traumatised mum who, 15 years later, still struggles every day with her mental health to cope with the memory of the unnecessary pain and death of her precious baby girl.

[Amanda Hack]

I thank my hon. Friend for giving way in such an emotional debate. Does she agree that looking after mothers before, during and after having a baby is vital, particularly when birth trauma or, sadly, baby loss is suffered?

--- Later in debate ---

[Dr Gardner]

I wholeheartedly agree. I have never experienced it myself, but I live in awe of how women keep managing to go, day to day, having had that experience.

After fighting for answers, Ashley finally achieved an independent review, which identified missed opportunities to detect and treat Chloe’s NEC earlier, alongside multiple instances of sub-optimal care. That review came after four earlier investigations, fought for by Ashley, that, by the trust’s own admission, had not been conducted to the required standard.

Finally, the Royal Stoke hospital has accepted the independent review and its conclusions in full. It has apologised to Chloe’s family and acknowledged that Chloe most likely would have survived had those opportunities to detect and treat her NEC not been missed. This is devastating, because at the heart of this case is a mother who knew that something was wrong; a mother who should have been listened to, and a baby girl fighting to live.

I must state that the Royal Stoke has made considerable improvements to its maternity services in recent years. At the time of Chloe’s short life, the maternity service was rated as requiring improvement, with safety rated as inadequate. However, after much work, self-reflection, culture change and process improvements, the service is now rated good. I had the honour of visiting and seeing the work of the amazing midwives. I commend the hospital for turning things around.

[Adam Jogee (Newcastle-under-Lyme) (Lab)]

My hon. Friend and constituency neighbour just acknowledged the massive improvements at the Royal Stoke hospital, and I join her in doing so because the impact on both my constituents and hers has been huge.

[Dr Gardner]

My hon. Friend was with me on that visit, and I am sure he remembers how impressive it was. Importantly, one of the areas highlighted in that service improvement was communication with families and the way that feedback and concerns are now heard and acted upon. Listening to parents is not an optional extra; it is part of delivering safe and effective care. I ask only now, 15 years after Chloe died, that the hospital finally forward the agreed settlement to Ashley. She wants to provide a caravan holiday home by the sea for parents who have experienced the loss of a child, to allow them time to grieve and rest from the trauma.

That brings me back to why the Bill matters. It calls for better support, guidance and information for parents and carers. In providing that support, we must recognise that parents know their children best. They know what is normal for their baby. They notice when something is changing. They may not always have the medical vocabulary to explain exactly what is wrong, but their observations are valuable. Their concerns should be acknowledged and considered and, where appropriate, incorporated into the clinical picture. Chloe’s case shows why that matters. Ashley saw that something was wrong; she raised concerns, she asked questions and she should have been listened to.

Even while contending with the grief of losing her daughter, Ashley has sought to ensure that another family does not experience what hers did, and to ensure that Chloe’s legacy lives on. Ashley has developed recommendations for dealing with NEC, which show exactly what better support and guidance are needed—practical recommendations grounded in her lived experience. I ask the Minister to meet Chloe’s mother Ashley Wilshaw and me to discuss the recommendations and the lessons that can be learned from Chloe’s case. In the interests of time, I will not go through them now.

I will never forget little Chloe Wilshaw or her brave mum Ashley. I hope Ashley has received some comfort from today. She has been listened to. I thank the Bill’s sponsor, the right hon. Member for New Forest West (Sir Desmond Swayne), for bringing this crucial Bill to the House, and my hon. Friend the Member for Washington and Gateshead South (Mrs Hodgson). I am honoured to support the Bill. With it, we may create a brighter future for all our children.

Wheelchair Provision: Independent Review Body

Allison Gardner Excerpts

Tuesday 21st April 2026 Westminster Hall

[Dr Allison Gardner (Stoke-on-Trent South) (Lab)]

It is an honour to serve under your chairship, Dr Murrison. I congratulate my hon. Friend the Member for Bexleyheath and Crayford (Daniel Francis) on securing this important debate, and on his excellent work across the board on wheelchair services through the APPG that he leads.

As vice-chair of the APPG for wheelchair users, this debate is incredibly close to my heart. The reason I became part of the APPG is that so many of my constituents were contacting me in desperate need of a new wheelchair or vital wheelchair repairs. One young lad, Noah, had long outgrown his moulded wheelchair to the point that it was becoming unsafe and causing him harm. When he went into hospital for spinal surgery, despite being well enough to be discharged, he could not leave for weeks because he did not have a safe wheelchair to go home with.

Disabled people, including children, with life-limiting conditions have been left waiting for up to two years to receive a new wheelchair. In the young life of a child such as Noah, that is unacceptable. They are left in pain in unsuitable chairs, and some of my constituents are unable to leave the house altogether because their chair has broken down. The long waits have affected my constituents’ physical and mental health, and have placed great strain on their carers.

Preston, the 19-year-old son of my constituent, Kelly Williams, was left with a collapsing wheelchair for six months before vital repairs were made, and it was a further four months before his wheelchair was eventually replaced. Preston lives with a progressive brain disease. He cannot walk or bear weight, and for almost an entire year he was forced to sit in an uncomfortable chair that was not fit for purpose. That is completely unacceptable.

When many of my constituents contacted AJM, the previous provider, there was a complete lack of communication and an all-round failure to consider their needs. I will name one more constituent among the many: an ex-Paralympic medallist, Ian Marsden, runs the risk of being bedridden because, if his broken wheelchair is not fixed, he is stuck. Having raised the issue with the ICB, I was pleased to see that it issued a performance notice against the provider in August last year, but the fact that enforcement action had to be taken raises serious concerns about contract oversight, risk escalation and safeguarding of disabled service users. The service went out to retender; a new provider has been appointed and is due to start, as my hon. Friend the Member for Lichfield (Dave Robertson) outlined. The contract was awarded on 24 February 2026.

I trust that lessons are learned, but a new contract means that wheelchair users in Stoke-on-Trent South will once again have to get used to a new system and possibly a service in a new location. I strongly encourage the ICB to be diligent in monitoring and reviewing the performance of the new contractor. Playing the blame game with previous providers, as AJM did, will not wash this time.

At this point, I will slightly veer off track to express the significant concerns regarding the changes to car mobility schemes, which were raised by my constituent Ryan. With those changes in mind, it is even more vital that we get wheelchair services right. Given the history and legacy of these issues, I strongly support an independent review body to oversee wheelchair provision and ensure that wheelchair users receive an outstanding service. The time is now, and I ask the Minister to act and fix this situation—it is bad in Stoke-on-Trent and Staffordshire, but it is a national issue.

--- Later in debate ---

[Dr Gardner]

I acknowledge the personal wheelchair budget, but constituents have raised with me that it does not fit the cost of wheelchairs nowadays. It does not quite match, so they sometimes have to use their own funds to get the wheelchair they need, which is not good enough.

[Dr Ahmed]

I totally agree with my hon. Friend. That is partly a reflection of the underfunding of aspects of the NHS over the past decade and a half. As she well knows, our party supports the NHS, and we have funded it with £26 billion of additional funding. That will clearly take time to filter through to the services that require the most.

The Government are also driving forward improvements for disabled people through our wider reforms to health and social care. The recently published neighbourhood health framework aims to improve health and care outcomes, and reduce inequalities through more convenient, personalised and joined-up care. It includes a focus on improving the diagnosis and treatment of people with long-term conditions, so that they feel more in control of their care.

In July 2025, the Government announced that we will develop a new plan for disability, setting out a clear vision to break down barriers to opportunity for disabled people. We are making more than £4.6 billion of additional funding available for adult social care in 2028-29 compared with 2025-26, to support the sector and make the improvements that we all crave. We have also established the better care fund, a framework for ICBs and local authorities to make joint plans and pool budgets to deliver better, joined-up holistic care.

This financial year, ICBs and local authorities plan to spend £440 million on assistive technology and equipment such as wheelchairs. We also continue to invest in support for home adaptations to enable independent living, with £723 million confirmed for the disabled facilities grant this year. The disabled facilities grant budget across 2025-26 and 2026-27 is £150 million more than the total budget across the previous two years, representing an 11% increase that exceeds inflation. The independent commission into adult social care, chaired by Baroness Louise Casey, is building consensus on the medium and long-term reforms required to create a social care system that is fit for the future, with the phase 1 report due this year.

I recognise the profound impact that delays in wheelchair provision are having on the quality of life of hon. Members’ constituents, and I am grateful to my hon. Friend the Member for Bexleyheath and Crayford for highlighting that today. He had a number of asks of me, to which I hope I have responded. I am cognisant of the work he has done and the personal attention he gives to these matters, and I offer him a meeting with Department officials in my office to go through them in greater detail. My officials will be in touch to arrange that.

I hope that the work, reforms and modernisation I have set out address the questions he has raised. I assure hon. Members that we take this issue extremely seriously, and remain committed to improving the lives of disabled people up and down our country.

Oral Answers to Questions

Allison Gardner Excerpts

Tuesday 22nd July 2025 Commons Chamber

[Ashley Dalton]

We are already delivering. As I have said, the Tobacco and Vapes Bill is making its way through Parliament at the moment. We are tackling the obesity crisis through tackling junk food advertising to children. We are working on school food standards, and we are also bringing in rules around planning for junk food establishments near schools. We are supporting people to make healthier choices when it comes to alcohol, and we are tackling air pollution, which particularly affects working-class communities. The list goes on and on, and I would be more than happy to give the hon. Member another list if he needs one.

[Dr Allison Gardner (Stoke-on-Trent South) (Lab)]

Urinary tract infections are estimated to impact on the lives of up to 5 million women and girls. In 2023-24, there were over 679,000 hospital admissions, and in 2023, 4,323 deaths. Outdated diagnostic techniques and inadequate treatment for acute UTIs results in the condition becoming recurrent and chronic. Better education of clinical staff and updated guidelines, diagnostics and treatments can help prevent the spiral of ill health that destroys so many women’s lives. Will the Secretary of State engage with me and other campaigners to recognise chronic UTIs as a condition and work to prevent this horrendous, pervasive illness?

[Ashley Dalton]

I thank my hon. Friend for her question and commend the work she has done on this issue and her wonderful contribution to the Westminster Hall debate that I responded to recently. It is a really important issue and something we are keen to explore further. The Secretary of State and I would be delighted to meet with her and other campaigners.

Rare Cancers Bill

Allison Gardner Excerpts

Report stage & 3rd reading
Friday 11th July 2025 Commons Chamber

[Dr Allison Gardner (Stoke-on-Trent South) (Lab)]

Stella Gilbert, née Forster, was a much-beloved wife, mother, grandmother and sister to my partner, Jim. She died of a rare cancer. Stella was great—my partner’s only sibling, a huge matriarch and, as we found out at her funeral, given to bossing her local vicar about. She had bile duct cancer, which affects approximately 2,000 people a year in the UK.

In the Bill’s terms, bile duct cancer is a rare cancer; the Bill classes rare cancers as those that affect no more than one in 2,000 people, and bile duct cancer affects 0.06 in 2,000. Worryingly, research suggests that that incidence is increasing. I am grateful that the Bill allows for some flexibility, because if bile duct cancer were to pop over that cut-off of one in 2,000, it would go into a different category. That flexibility is appreciated.

Guts UK states that the cause of bile duct cancer is unknown in six to seven out of 10 patients. It is a rare cancer that is increasing in prevalence, often with causes unknown, and nearly 3,000 people a year die from it. Would it not be better therefore not only to prevent this cancer from increasing in prevalence, but to make it even rarer and more curable? The Bill opens the door to that. It will allow for more focus on rare and less survivable cancers.

Research is crucial in tackling cancer, and I am heartened by this Government’s commitment to tackling all cancer types. A national cancer plan is due to be published following the NHS 10-year health plan, and the DHSC has committed more than £1.6 billion for research to the National Institute for Health and Care Research, which is quite rightly treating cancer as a major priority and allocating funding accordingly.

As an officer of the all-party parliamentary group on the less survivable cancers, I am particularly grateful for the commitment to tackling brain cancer, which I have heard a lot about in this place today, in partnership with organisations such as the Tessa Jowell Brain Cancer Mission and Brain Tumour Research. I also welcome the funding call for the brain tumour research consortium, which I read about recently.

I cannot stand in this place and debate a Bill on rare cancers and not mention pancreatic cancer, which is a relatively rare cancer and a less survivable one. It is the fifth biggest cancer killer in the UK. My mum, Breeda, died of pancreatic cancer. She fell ill on a Saturday, was diagnosed on the Sunday and was dead by the following Saturday. One week after that, my father died of oesophageal cancer—not a rare cancer, I believe, but a less survivable one. My sister’s mother-in-law, Doreen, also sadly passed from pancreatic cancer after a year-long battle. We are, indeed, surrounded by cancer. The APPG has addressed the issue of the early detection of such cancers, so we hope to one day hear fewer stories like my mum’s. I thank Pancreatic Cancer UK for its support.

I welcome the Bill, which offers an entirely reasonable set of steps for researching, reviewing and, I hope, enabling the development of so-called orphan drugs—like my hon. Friend the Member for Edinburgh South West (Dr Arthur), I dislike the term intensely. The appointment of a national specialty lead for rare cancers will be so helpful in and of itself.

In passing the Bill today, we will start the journey to a world where wonderful people, like Jim’s sister Stella, my mum Breeda and my sister’s mother-in-law Doreen, do not hear the words, “It is inoperable. It is too late to treat. There is nothing more we can do.” I thank my hon. Friend the Member for Edinburgh South West for introducing the Bill. I will vote for it today, in memory of Stella, Breeda and Doreen.

Terminally Ill Adults (End of Life) Bill

Allison Gardner Excerpts

Report stage
Friday 13th June 2025 Commons Chamber

[John Glen]

I have been very clear that I have tabled my amendments in a constructive way to reflect the will that the hon. Lady has expressed, but to recognise the meaningful dilution in the authority of the process and what can reasonably be amended to invigorate it, based on the principles that I think were intended at the outset.

I will revert to the point I was making about the judiciary. They have a commitment to uphold the law, and that should be the standard we are looking for when it comes to matters of life and death. The Judicial Appointments Commission already conducts appointments for all tribunals, including lay members. The Government’s impact assessment compared the panel to the mental health tribunal. All appointments to the mental health tribunal, including the non-legal members, are made by the Judicial Appointments Commission, so this would not be a novel function for it.

Let me move on to amendment 85, which would ensure that all members of the panel have to take the judicial oath if they have not done so already. If other amendments pass, amendment 85 would be necessary only for the non-legal members, and it is crucial for public confidence that the judicial oath is taken.

Amendments 83 and 84 seek to preserve an important element of the Bill as originally presented to the House. They would ensure that the most senior decision-making figure, the chair of the panel, is a High Court judge with all the experience, responsibility and professionalism that that implies. Under these amendments, all High Court judges would be automatically eligible. They would need to be currently serving or at least be below retirement age, and would have to be a judge of the highest authority and not a deputy judge. Members of this House and the public were originally told that this would be a safe Bill precisely because it would have a High Court judge. That was a persuasive promise, and I think there is a way to honour it, even in the new version of the Bill.

I will briefly mention the retirement age, because it is important. It used to be 70, but judges can now continue until they are 75. However, there is no age limit for members of the panel. If we are saying that an 80-year-old retired judge is still with it and is able to decide on matters of life and death, why are they too old to help clear the backlog of criminal cases? That seems to be a meaningful anomaly.

I have been very clear about the purpose of my amendments. I have tabled them in the spirit of trying to strengthen the Bill and return it to what was intended, so that it can meet the expectations of so many Members who supported it at an earlier point.

[Dr Allison Gardner (Stoke-on-Trent South) (Lab)]

I rise to support a number of new clauses and amendments to the Bill. The common thread running through all of them is a need to address some of the gaps in the safeguards and oversight. Should the Bill pass, I at least want to ensure that we improve its protections and remove some of the risks that it contains.

New clause 4 requires the chief medical officer to monitor the operation of the legislation, rather than depending solely on the assisted dying commissioner. Alongside the requirement for a High Court judge, oversight by the CMO was removed during the Committee stage. This means that, essentially, the assisted dying commissioner would mark their own homework. New clause 4 returns the safeguard of independent oversight, which is sensible given the significant concerns expressed by many experts and organisations, which were often neutral on the principle, but concerned about the Bill. They include the Royal College of Psychiatrists, the Association for Palliative Medicine, the British Geriatrics Society, the Royal College of Physicians and many experts such as Professor James Monckton Smith, a leading criminologist, Baroness Finlay, Parliament’s leading expert on palliative care, Sir David Haslam, former head of the British Medical Association and of the National Institute for Health and Care Excellence—my previous employer—and many more. All have expressed concerns, even when neutral on the principle of the adequacy of the Bill.

Hence new clause 4 requires an annual report to include

“information about the application of the Act in relation to—

persons who have protected characteristics, and

any other description of persons specified in regulations made by the Secretary of State.”

I fervently hope that that includes domestic violence victims.

Amendment 13 very sensibly adds the requirement that the commissioner appointment is not the sole remit of the Prime Minister at the time, by requiring the consent of the Health and Social Care Committee. This provides a safeguard against ideological and politically motivated appointments, and I would be very critical of anyone who would want to prevent that.

Amendment 15 addresses the significant concerns about the involvement of private—for profit—providers of assisted dying. There are concerns that, when there is a commercial relationship between providers, there will be a gaming of the system. That risks compromising the relationship between the co-ordinating doctor and the independent doctor. Likewise, the existence of such providers does not allay concerns about doctor shopping, as was raised in the previous debate. Hence amendment 15 will require private providers to be transparent and provide reports on service members, service numbers, costs and revenue.

In previous debates and in the public discourse I have found it very disconcerting that, in response to legitimate concerns, all that we have been offered—as we have seen today—are some promised, unspecified future regulations that will fix the gap—[Hon. Members: “Hear, hear!”]

[Naz Shah]

My hon. Friend is making a powerful point. Does she share my concern that most of our discussions today were thrashed out in Committee, and now we are being told that we have to leave them to the Lords, because we cannot fix the issues here? That is a really flawed process.

[Dr Gardner]

I entirely agree with my hon. Friend.

To expect MPs to improve the Bill without clarity as to what the regulations are or what they will be, and how the service will be delivered without rigorous regulatory oversight is fundamentally wrong.

Furthermore, the fact that the implementation of the Bill will be automatic in 2029—a general election year, incidentally—is not realistic when reflecting on the many areas that still lack detail. Hence I support amendment 42, proposed by my hon. Friend the Member for Newcastle-under-Lyme (Adam Jogee), which allows the Secretary of State to determine the appropriate date for the Bill to be implemented. This would allow time to make the NHS fit for purpose, to strengthen palliative care, and for Parliament to draft and scrutinise adequate regulations without being rushed.

Similarly, but fundamental to the society in which we live, amendment 12 protects the status of our most dear institution, the NHS. The Bill before us provides Henry VIII powers to amend the National Health Service Act 2006 without limit, which could include a specification of charges. If, as Labour MPs, we are committed to the NHS remaining free at the point of use, then amendment 12 is vital, as it will require any changes to the 2006 Act to be made by an Act of Parliament. The future is uncertain. We must build safeguards in the Bill to protect us from measures that fundamentally alter the fabric of our society.

Briefly, amendment 27 requires the MHRA to license the drugs used for assisted dying. Research has shown that painful and protracted deaths via assisted dying drugs are not uncommon, with deaths ranging from three minutes to 137 hours—nearly a week— with up to eight hours to lose consciousness. Furthermore, serious side effects disproportionately affect younger people. Amendment 27 will help to ensure the safety and efficacy of these substances.

I will close by quoting Sir David Haslam on how we balance some of the individual stories used on both sides of the debate with the good of society. As we know, NICE has to make the difficult decision to approve or not approve medications and treatments based on a cost and clinical effectiveness model. It is experienced in weighing up societal good—[Interruption.] I will be quick, Madam Deputy Speaker—versus the needs and wishes of individuals.

Chronic Urinary Tract Infections

Allison Gardner Excerpts

Wednesday 21st May 2025 Westminster Hall

[Dr Allison Gardner (Stoke-on-Trent South) (Lab)]

It is an honour to serve under your chairship, Sir Desmond. I am not well today for the very reason that we are here. I may need to sit down during my speech if that is okay. I am deeply grateful to the hon. Member for Sutton and Cheam (Luke Taylor) for securing this incredibly important debate. [Interruption.]

[Jim Shannon (Strangford) (DUP)]

This is a difficult subject for those who suffer from this condition. I will give an example in my speech, as one of my staff members suffers from it. We are deeply indebted to the hon. Member for Sutton and Cheam (Luke Taylor) for bringing this forward. It is important to hear personal stories from sufferers, such as the hon. Member for Stoke-on-Trent South (Dr Gardner), and that they are given the opportunity to express themselves on the importance of this issue to them personally and to all our constituents.

[Dr Gardner]

As hon. Members may have guessed, this debate is not only important to thousands of women across the country—according to the Chronic Urinary Tract Infection Campaign, about 1.7 million women suffer from chronic UTIs—but incredibly personal to me. I have suffered from UTIs as a result of menopause for more than 10 years, and received a diagnosis of chronic UTI in 2023.

I do not think many people realise how debilitating and excruciating chronic UTI can be. At my worst, I wondered how I could go on. I even changed from a beloved lecturing job to one at NICE because I wanted to change things from within, and it is why I am an MP now. I have tried almost everything; I was even considering—as a final step before the final, final step—having my bladder removed.

Although my NHS consultant gave me Hiprex—methenamine hippurate—thank God, which is life-changing for me, he finally shrugged his shoulders and said that I would just have to live with this condition. In desperation, I tracked down a specialist who worked in private practice. How lucky I was to have the money. I can confidently claim that Dr Catriona Anderson saved my life, which I do not say lightly.

Chronic UTIs can lead to hospitalisation—I have been twice—and sepsis and death. I have a long list of all the drugs that I am on, but I will not read it out. I believe this is another case of how women’s medical conditions continue to be misunderstood, under-researched and underfunded. To illustrate that point, there is a belief that UTIs are more serious in men than in women. I acknowledge that men’s physiology—men have a longer urethra than women—means that they are less likely to develop a UTI, although the possible presence of an enlarged prostate means that they may experience restrictive urine flows and develop a UTI. That is certainly the case in older men. Consequently, all men are recommended seven-day courses of antibiotics compared with the three-day courses that women are recommended. By the way, there are three antibiotics to treat UTIs. Trimethoprim and nitrofurantoin are the top ones, but I am allergic to them, so I am on cephalexin when I need it.

There is a lack of acknowledgement that poorly treated UTIs can lead to bacteria becoming embedded in bladders. Incidentally, a much shorter journey in women means that the diligence afforded to men is not afforded to women. In addition, women’s immune response to pathogenic bacteria in the bladder is oestrogen-dependent, and so it is also age-related. Lack of official recognition of chronic UTIs means that women do not receive treatment equal to what men. I am a molecular biologist, but I will not bore Members by setting out the different types of receptors in the urethral lining of the bladder.

I will further illustrate this point in simpler terms. A campaigner told me how her doctor, who repeatedly prescribed her three-day antibiotic courses for her chronic UTI, prescribed her husband, when he presented with a UTI for the first time, a month-long course, which would entirely clear the infection, of course, and minimise risk of recurrence. That says it all. Incidentally, chronic prostatitis is recognised by NICE.

As has been mentioned, for many women—approximately 70%—three-day courses will be sufficient, but for rest of women, three-day courses clear only some bacteria. Those that remain are relatively resistant; they then increase in population and there is recurrence. Essentially, repeated short courses establish a system of natural selection for resistant bacteria. It also means that the remaining bacteria then have time to invade the bladder and become embedded, finally leading to chronic UTIs. So, patients are stuck in a loop.

The use of the useless urine dipstick test, which is no more accurate than the toss of a coin, and of the midstream urine test, which is even worse, means that infections go undetected. As a result, no antibiotics are prescribed until the infection gets worse and, finally, a short course of antibiotics is prescribed. However, the infection is still not fully cleared, so the loop starts again. The infection then becomes embedded in the bladder wall and chronic UTI develops.

Short-term antibiotic courses often do not treat chronic UTIs, because dormant populations of bacteria exist within the bladder wall. Your life revolves around desperately trying to convince doctors to prescribe a course that you know will work for you. I am due to move house soon and I am petrified of having to move GPs, which would mean again starting this battle of trying to convince a GP to take me seriously. I understand concerns around antibiotic resistance and the medical hesitancy in prescribing longer courses of antibiotics. However, the solution is not to minimise antibiotic use; it is to get the diagnosis right, treat thoroughly, recognise the existence of chronic UTIs and prevent their development.

I am concerned by the lack of research and guidelines for diagnosis and treatment of chronic UTIs. We could prevent them all together if we get things right. I am particularly excited by the UTI vaccine, which is not currently available in the UK. Prevention of UTIs would not only save the NHS countless hours and money, but save people from living miserable lives.

In April, the Minister for Care said in a response to a written question:

“there are no current plans to train GPs and urologists on recognising the symptoms of chronic UTIs”.

Also, current NICE guidelines do not contain guidance for chronic UTIs. This situation must change. Too many women are being left in unbearable pain without a proper diagnosis or appropriate medication.

I will be very quick now, Sir Desmond; you have been very patient with me. About 50% of all antibiotics are prescribed for UTIs. However, each year there are thousands of deaths from UTIs and approximately 200,000 A&E admissions are due to UTI-related illnesses. The cost of UTIs to the NHS, as well as to people’s lives, is huge.

This issue is personal for me. It is also personal for the millions living with the pain, frustration and isolation of chronic UTIs. Will the Minister meet me and others, including campaigners, to discuss how we can improve diagnostic tools, develop guidance and ensure that people suffering from this condition receive the care that they deserve?

Thank you for your indulgence, Sir Desmond.

NHS England Update

Allison Gardner Excerpts

Thursday 13th March 2025 Commons Chamber

[Wes Streeting]

The hon. Gentleman makes a fair challenge on the bureaucratic nature of decision-making. We are working with Treasury Ministers and colleagues across Government to take an axe to that unnecessary bureaucracy. He will be absolutely fuming when he finds out who was responsible for it.

[Dr Allison Gardner (Stoke-on-Trent South) (Lab)]

I am conscious that my former colleagues at NHS England will be concerned about today’s announcement, but I am very confident that the Secretary of State will do all he can to support them. It is an inescapable fact that the 2012 reorganisation led to inefficient layers of management in the NHS, delivering poorer care and greater costs to the taxpayer. How does he plan to cut excessive layers of bureaucracy, get resources to the frontline and, crucially, deliver better care for the people of this country?

[Wes Streeting]

That is a brilliant question. We have put in place a transformation team, led by Sir Jim Mackey, which we will work with to start fundamentally changing the way the NHS works, by shifting more power, resources and responsibility out of Whitehall and closer to the frontline and the communities where decisions are made, and by getting rid of the unnecessary bureaucracy that drives patients and staff to distraction.

Hospice and Palliative Care

Allison Gardner Excerpts

Monday 13th January 2025 Commons Chamber

[Dr Allison Gardner (Stoke-on-Trent South) (Lab)]

Twenty years ago this month, both my parents died aged 60, of cancer. They died just one week apart, but that is where the similarities ended. My father died a horrible death, receiving very poor—if any—palliative care. My mother won the postcode lottery, if you like, and passed away in the Royal Stoke, in Stoke-on-Trent, where she received superb care and died a dignified death. I live with the twin legacies of those deaths. I stress to the Minister the importance of ensuring that trained palliative care staff are spread equally throughout the country. It is vital. It makes a difference.

Stoke-on-Trent has also won the postcode lottery in a way, with our excellent hospice, the Dougie Mac. Having merged with the Donna Louise children’s hospice, it now provides care for all people of all ages across north Staffordshire. It provides many innovative services, including a dementia care service and a rapid response ambulance service, which responds for patients at the end of their lives. Instead of taking them to A&E, they travel to the hospice. That saves the local hospital 350 A&E visits a year, saving on ambulances and saving the trust money. Unfortunately, the hospice does not receive any funding to help deliver that service. I want to take the opportunity to put on the record my thanks to the chief executive, who I spoke to at great length recently, to all the staff across both sites, in Blurton and Trentham in my constituency, for all the work they do, and to all the amazing volunteers in the shops throughout Stoke-on-Trent.

I welcome the Government’s commitment to funding hospices and the £100 million injection, but like everyone else I support ending the postcode lottery. We must end inequality in the delivery of service and we must provide a more sustainable model in future.