Health Bill

Andy McDonald Excerpts

Report stage
Monday 7th September 2026 Commons Chamber

[Shockat Adam (Leicester South) (Ind)]

I refer the House to my entry in the Register of Members’ Financial Interests. I am a practicing optometrist and an officer for the APPG for eye health and visual impairment.

Sight is precious and none of us would like to lose it—but, sadly, 2 million people in this country are living with some form of sight loss today. On the Department’s own projection, that figure will rise to 2.7 million by 2030. Every day, 250 people in the UK start to lose their sight—one person every six minutes. Left unaddressed, that number is set to more than double to over 4 million by 2050. We are witnessing a growing problem, which, sadly, the Bill does not treat with the urgency it deserves.

Tonight, I urge the Government to strengthen this legislation in some specific ways. On governance, clause 21 rightly ensures that ICBs reflect local political accountability, but it says absolutely nothing about clinical accountability. Optometrists have no guaranteed voice in the rooms where commissioning decisions affecting their patients are made. It would be unthinkable to build localised healthcare without GPs at the table. It would be equally unthinkable to do so without pharmacists. I say to the Government plainly: optometrists have the expertise, the infrastructure and the systems already in place to relieve pressure on our hospitals, yet this Bill says nothing about it.

I want to see eyecare—glaucoma monitoring in particular, along with the management of minor eye conditions—commissioned consistently by every ICB in England and not left to a postcode lottery. Optometry already has what I call the TAC effect: it is trusted, accessible and capable. Commissioning it properly would reduce unnecessary demand on emergency departments, freeing them to focus on genuinely specialist cases while improving patients’ access to specialist eyecare where they need it.

A recent report by the Association of Optometrists has found that right now, 780,000 people—the equivalent of the entire population of Greater Nottingham—attend A&E with eye problems annually, at an average cost of £145 to the NHS per A&E presentation. That is £113 million a year. At least seven out of 10 of those people with eye problems could be successfully managed in a community optometry setting with the right service commissioning. Those stats reflect a lived reality for many across our country. If the new Government want to make smarter decisions with public money, they must consider that.

Finally, I turn to the single patient record. Proposed new subsection (7) to clause 51 should be amended so that it explicitly includes optometry in the single patient record framework, ensuring that optometrists have appropriate access to relevant patient information.

This Bill takes real and welcome steps in many areas, but more than 2 million people have already lost their sight—a number that none of us wants to see double to more than 4 million by 2050. Fundamentally, seeing should be a right, not a privilege, so I ask the Government to look again.

[Andy McDonald (Middlesbrough and Thornaby East) (Lab)]

I rise as the chair of the all-party parliamentary group on spinal cord injury to speak to amendments 103 and 104, new clause 160 and amendment 105 in my name. I thank the Minister for meeting me during the passage of the Bill and for her subsequent letter. I also thank the Spinal Injuries Association for its support for the APPG and, crucially, for people living with spinal cord injury. These amendments are not about preventing reform; they are about ensuring that when responsibility for highly specialised services changes, patients continue to receive safe, equitable and nationally consistent care.

Spinal cord injury is a relatively low volume but complex lifelong condition requiring specialist expertise, rehabilitation and long-term follow-up. National commissioning exists to prevent fragmented services and postcode variation. If commissioning moves to integrated care boards, we need confidence that specialist workforce capacity, national standards and the sustainability of specialist centres will be protected. I therefore ask the Minister to clarify how those safeguards will work in practice, particularly around workforce, rehabilitation and geographical variation. I also seek clarity on whether spinal cord injury services will transfer to ICBs and what criteria will determine that decision.

Amendment 104 and new clause 160 would provide national assurance and parliamentary accountability for outcomes, access, workforce and geographical variation. Amendment 105 addresses the single patient record. Specialist charities provide vital practical and peer support after life-changing injury, even where they are not part of the clinical care. That is why this appeal is so resonant. If we can engage with those providers at that early stage, the outcomes will undoubtedly be improved. The amendment would allow referral, with patient consent, to approved condition-specific organisations sharing only necessary information.

I will not press these amendments to a vote today. I hope that the Minister will consider further safeguards and clarification during the Lords stages of the Bill. The care and access to support for patients dependent on specialist services should not depend on where those patients live.

[Karin Smyth]

I thank Members across the House for their contributions. As we would expect for a Bill of this size, it has been a wide-ranging debate, and I will not be able to address every single amendment, but I will try to cover them all in the time I have. If necessary, I will get back to people afterwards. As a Government, we know that what we have set out to do through this Bill is ambitious. We do not resile from that; we want to be ambitious. We are determined to make a real and positive change for people up and down the country who use the NHS, and throughout the Bill, we have remained focused on the key objectives. Those are to strengthen democratic accountability, strip back bureaucracy and empower patients.

Health Bill

Andy McDonald Excerpts

2nd reading
Monday 1st June 2026 Commons Chamber

[Andy McDonald (Middlesbrough and Thornaby East) (Lab)]

May I begin by welcoming the Secretary of State to his place and wishing him well in the responsibilities that he carries on behalf of patients, NHS staff and communities across the country? I welcome the Bill and its intention to improve patient care through investment, modernisation and better integration across the health service.

It is right to acknowledge the progress made on waiting times and waiting lists since Labour returned to government, with the overall waiting list falling significantly and long waits continuing to come down, but may I add my voice to those of others about the appointment of a chair for the Tees, Esk and Wear Valley inquiry? My right hon. Friend the Member for Ilford North (Wes Streeting) gave that commitment, which we were pleased to hear, but we have yet to see that chair appointed. If that could be given attention, we would be most grateful.

I remain concerned about the continuing impact of historic private finance initiative costs on NHS trust budgets, including the pressures facing South Tees hospitals NHS foundation trust in my patch. Too much money is still being diverted from frontline care. I regret that this issue remains unresolved.

The principal reason I rise today is as chair of the all-party parliamentary group on spinal cord injury. Last summer, the APPG’s inquiry into spinal cord injury services reached a clear conclusion: the evidence points to the need for more national co-ordination, not less. Spinal cord injury is a low-volume but highly complex condition requiring specialist pathways, lifelong rehabilitation and co-ordinated support, yet the inquiry heard repeated evidence of fragmented services, postcode variation, delayed rehabilitation and patients being lost within the system. The APPG therefore called for a national strategy and a modern service framework for spinal cord injury care. As we intend to hold a lived experience roundtable shortly, I invite the Health Secretary to come and meet people with spinal cord injury to hear their concerns about the proposed changes to commissioning.

We welcome the excellent constructive engagement from the Under-Secretary of State for Health and Social Care, my hon. Friend the Member for Washington and Gateshead South (Mrs Hodgson), and NHS England officials, but we remain deeply concerned about proposals to transfer spinal cord injury commissioning from national oversight to integrated care boards. Indeed, NHS England’s own evidence to the inquiry emphasised national standards, national quality metrics and nationally co-ordinated pathways, quality measures and oversight. If national consistency has not yet been achieved under national commissioning, what evidence demonstrates that transferring responsibility to multiple ICBs will improve outcomes or equity?

What is at stake is not abstract. When somebody sustains a spinal cord injury, their life changes overnight. They may require specialist rehabilitation, housing support, benefits advice, mental health support and long-term clinical care. Patients and families should not be left to navigate a fragmented system alone. That is why I welcome the ambition behind the single patient record and Diagnosis Connect.

Connecting newly diagnosed patients directly to specialist support reflects one of the APPG’s recommendations. Organisations such as the Spinal Injuries Association help people rebuild their lives after life-changing injury. I hope that Ministers will consider including spinal cord injury within the early phases of Diagnosis Connect.

The question is not whether structures change on paper; it is whether people living with spinal cord injury will experience safer, more equitable, more co-ordinated care. I hope that the Secretary of State will answer some straightforward questions. If NHS England accepts that national consistency has not yet been achieved, what evidence shows that localised commissioning will improve it? How will national standards, benchmarking and quality oversight remain coherent under a fragmented arrangement? Do the Government accept that spinal cord injury differs fundamentally from standard population health commissioning because of its low volume, high complexity and cross-boundary nature? What safeguards will prevent widening regional inequity, if accountability is dispersed across multiple ICBs?

The APPG’s inquiry concluded that spinal cord injury services require stronger national co-ordination and oversight, not greater fragmentation, and I hope the Government will reflect carefully on that evidence. This country led the world in spinal cord injury provision under the leadership of Professor Ludwig Guttmann after the second world war, with the remarkable work that he achieved. We need to return to those days of being pioneering and world-class. As a lawyer who previously practised in this area, I am afraid that over the past several decades services have deteriorated and gone backwards. We must restore those services and bring trust to people who so desperately want reassurance that there is a national system for them to rely on that will address their needs. We are currently not in that place at all. The Bill is an opportunity to address that, and I trust the Minister will take that on board.

[Madam Deputy Speaker (Judith Cummins)]

I call the Liberal Democrat spokesperson.

Postural Tachycardia Syndrome

Andy McDonald Excerpts

Tuesday 14th October 2025 Westminster Hall

[Cat Smith]

I thank the hon. Gentleman for his intervention; I recognise that a lot of hon. Members are here for this debate, more than I have ever seen for a 30-minute debate before. Hopefully, next time I make an application, I might be granted a bit more time. I am happy to take early interventions from colleagues, if anyone wants to make them.

[Andy McDonald (Middlesbrough and Thornaby East) (Lab)]

My constituent has contacted me about his daughter, who lives with PoTS and faces exhausting weekly travel for costly private IV treatment due to the lack of local NHS provision. They have now found support in York, but it is still far from home. Does my hon. Friend agree that the absence of national clinical guidelines and clear care pathways leaves too many families in that position, and that the Government should do more to ensure consistent and accessible care for people with PoTS, wherever they live?

[Cat Smith]

I agree with my hon. Friend; I will address that point later in my speech.

Oral Answers to Questions

Andy McDonald Excerpts

Tuesday 19th November 2024 Commons Chamber

[Andrew Gwynne]

NICE is reviewing its guidelines for the diagnosis, monitoring and management of chronic asthma, and an updated version is due to be published in late November 2024. I am happy to meet the hon. Lady to discuss it further.

[Andy McDonald (Middlesbrough and Thornaby East) (Lab)]

Women with spinal cord injuries face significant challenges in accessing core health services, including breast screening, cervical screening and gynaecological care. Research shows that women with disabilities, including spinal cord issues, are 30% less likely to attend routine breast screening appointments, in significant part due to the physical inaccessibility of the screening equipment. Will the Minister meet me and representatives of the all-party parliamentary group on spinal cord injury to discuss these unacceptable disparities and ensure that women receive the equitable and accessible care they deserve?

[Karin Smyth]

My hon. Friend highlights a shocking example of inaccessibility in these important services. I will make sure that the Department responds to him and that either me or a ministerial colleague meets him.

Hospice Services: Support

Andy McDonald Excerpts

Wednesday 14th June 2023 Westminster Hall

[Paul Holmes]

I agree with the right hon. Lady; we do. In my experience, the uplift that has been given to local NHS commissioning groups is simply not making it through to those end of life services. I hope we will see some recognition of that from the Minister, and I am sure she will enforce this, to ensure that the funding to local commissioning groups gets through to these services.

[Andy McDonald (Middlesbrough) (Lab)]

Will the hon. Member give way?

[Several hon. Members rose—]

--- Later in debate ---

[Paul Holmes]

The hon. Gentleman is absolutely correct. I only have to see Mountbatten local networks of fundraising and charity supporters, whether in charity shops or in fundraising roles. I am honoured that I may become part of that community—if I land on the ground safety, alongside Miles—but it will not end there. I will carry on fundraising for a fantastic cause.

When Mountbatten hospice wrote to me in January to outline those extraordinary energy costs, I was happy to write on its behalf to the Secretary of State. Unfortunately, the energy bill relief scheme and the later energy bills discount scheme did not ease the pressures, as the hospice was not eligible. Mountbatten still faces unsustainable pressure, as do hospices across the United Kingdom.

Of course, there are some people who ask whether a charity should not take the majority of its funding from its local community—from donations and contributions, rather than from Government funding. That is a fair question, but unfortunately it does not provide a solution, especially considering that community donations already support 70% of Mountbatten’s funding, which it has calculated to be the limit of what it can ask from people.

[Andy McDonald]

The hon. Gentleman is making an excellent speech. He is right about donations, but my local hospice, Teesside Hospice, is really struggling. I congratulate the hon. Member for Darlington (Peter Gibson) on his work in that respect. Is the hon. Member for Eastleigh (Paul Holmes) not describing a perfect storm? There is a statutory obligation on the NHS to fund hospices for medical care, but the NHS is entirely strapped. Can I divert him away from the solution of asking members of staff to tighten their belts even further? That is not an option. When we cannot recruit and retain, that is not the solution. We need a fundamental reset of the economic settlement.

[Paul Holmes]

I hope the hon. Gentleman has not taken from my speech that I am suggesting that staff tighten their belts. In fact, I am advocating that hospices be allowed to follow the NHS pay settlement model, and be funded properly to so do. I would say to the hon. Gentleman that the Government have put their hand in their pocket through the £1.5 billion uplift, although that is simply not getting through from the Department of Health and Social Care and local commissioning boards to the hospices. That is where the Government need to step in to a greater extent. Therefore, I ask the Government to take the issue seriously and to continue to treat the charity care sector with the priority it deserves.

Hospices do incredible work, and they represent spectacular value owing to the services they provide. We cannot allow that vital link in the care chain to be broken, or even weakened, particularly at this time. Evidence submitted to the all-party parliamentary group on hospice and end of life care’s report detailed how the covid-19 pandemic made fundraising even more challenging for hospices. Hospices experienced a massive decrease in income while facing unprecedented demand for their services. One hospice’s overnight sitting service had to end due to lack of funding to sustain it, which highlights how dependent those services are on charitable donations.

It is important to highlight the fact that the sustainability of the hospice sector continues to be tested due to the cost of living crisis. Some sort of long-term funding settlement for hospices would be in the interests of all concerned because 160,000 more people each year are expected to require palliative care by the end of 2040. Having sufficient staff and volunteer resourcing in the specialist palliative care field is essential. An ideal outcome would be the Government and the NHS working with the hospice sector to provide an ongoing financial settlement, with regular contractual reviews to ensure that the support that hospices receive is at least the minimum they require to keep services running. That should be directed to cover both staffing and energy cost rises.

Doing that would be in the best interests not only of hospices, because hospices play a vital role in reducing pressure on NHS services by providing bed space and crucial care capacity. The NHS can scarce afford to lose such space and capacity, particularly in the light of the current waiting lists, but lose them it may if action is not taken.

Mental Health Treatment and Support

Andy McDonald Excerpts

Wednesday 7th June 2023 Commons Chamber

[Neil O’Brien]

I will come to the point about waiting lists in a moment.

Let me complete my thoughts on prevention, which I think we all agree is important. There are 3.4 million pupils covered by mental health support teams in 2022-23, which equates to about 35% coverage of pupils in schools and learners in further education in England. We expect around 500 teams to be up and running by 2024, covering around 44% of pupils and learners, so it will be up from 35% to 44%. Over 10,000 schools and colleges now have a trained senior mental health lead, including more than six in 10 state-funded secondary schools in England. On prevention, the Government are also providing £150 million of capital investment in NHS mental health urgent and emergency care infrastructure over the next two years.

[Andy McDonald (Middlesbrough) (Lab)]

While the Minister is addressing the issue of young people, can I say that I have yet to hear any news from the Department as to whether there will be a public inquiry into the deaths of the three young women who died under the care of the Tees, Esk and Wear Valleys Foundation NHS Trust. Can he enlighten me on that?

[Neil O’Brien]

This is an extremely important issue that the hon. Gentleman is quite right to raise. We will be producing the results of the rapid review in the coming weeks, so he will not have to wait very long.

NHS Strikes

Andy McDonald Excerpts

Monday 6th February 2023 Commons Chamber

[Will Quince]

We do not, as yet, have the details of today’s and tomorrow’s industrial action, but we will certainly be able to publish that information in due course. I can tell the right hon. Gentleman, as I mentioned in my opening response to the urgent question, that over 88,000 appointments have been rescheduled so far and over 58,000 shifts have been missed. Of course I deeply regret that and wish that there was no strike action. [Interruption.] Of course I do.

If we had not accepted in full the independent pay review body’s recommendations, the right hon. Gentleman and others would have an argument to make to say that we had not, but we did accept them in full. We accepted them in full last year, too, despite them being over and above the evidence submitted by the Government in respect of affordability. That is why I look forward to the next independent pay review body process, and why it is so important that the unions and others engage with that process so that we get it right.

[Andy McDonald (Middlesbrough) (Lab)]

I have more than enough cause to thank my local NHS for the lifesaving treatment it has given me, but so has every single family in this country. Why do the Government not get it, as the public clearly do, that our health workers, like all public sector workers, are at the end of their tether? Get round the table to resolve these disputes and give them the proper wage rise they so desperately need and deserve.

Cancer Outcomes: Tees Valley

Andy McDonald Excerpts

Monday 16th January 2023 Commons Chamber

[Andy McDonald (Middlesbrough) (Lab)]

May I share in the warm words of tribute to Professor Bonner from the right hon. Gentleman, my constituency neighbour? Like me, he is very much aware of the superb, world-class work that goes on at the James Cook University Hospital’s oncology department. It has six linear accelerators with a lifespan of about 10 years, but half of them are now reaching the end of their natural life, and as they break down they are becoming less efficient. Does he share my plea to the Department of Health and Social Care and the Treasury to ensure that the necessary funding is made available to the James Cook University Hospital and the trust to carry on their vital, life-saving work for our constituents across Teesside and beyond?

[Mr Clarke]

I echo what the hon. Gentleman says about the importance of ensuring that our equipment is absolutely the best it can be. I had the privilege of seeing the new equipment at the James Cook’s interventional radiology department before Christmas, which was incredibly impressive. The hon. Gentleman is absolutely right that such investment is vital to ensuring that once treatment commences, people can get the best possible care.

NHS: Long-term Strategy

Andy McDonald Excerpts

Wednesday 11th January 2023 Commons Chamber

[Andy McDonald (Middlesbrough) (Lab)]

I do not know whether my hon. Friend is as horrified as I am by the juvenile and facile comments from the Conservative Benches, or whether he heard today on Radio 4 about the 600,000 people who every single month are waiting for four hours or more to get into A&E and be treated. As a direct result, horrifyingly, each and every month, hundreds and hundreds of people are dying needlessly in our country. That is on this Government’s watch. Should they not be hanging their heads in shame?

[Wes Streeting]

I wholeheartedly agree with my hon. Friend—avoidable and preventable. The Chancellor wrote an entire book about getting the number of preventable deaths down to zero, because that is where the figure should be, so to have 50,000 preventable, avoidable deaths reported is a badge of shame for the Government.

Worst of all, the height of the Prime Minister’s ambition is to stop making things worse. If we have 7.1 million people waiting for treatment, rather than 7.2 million people, apparently that is a job well done in the Prime Minister’s book. Our NHS needs to be rebuilt and renewed, but all he offers is managed decline. His five pledges have the bar set so low that even his predecessor could meet those promises.

If hon. Members want to know what real ambition and action look like, it is this: 89,000 more nurses; 44,000 more doctors; waiting times cut from 18 months to 18 weeks; 3 million more operations carried out each year; banning smoking in pubs; the largest hospital building programme in history promised and delivered; 100 new walk-in centres; GP appointments guaranteed within two days; free prescriptions for cancer patients; appointments with a cancer specialist within two weeks of referral; waiting lists cut to their lowest point in history; and patient satisfaction at its highest levels in history. That is the difference that a Labour Government make.

NHS Workforce

Andy McDonald Excerpts

Tuesday 6th December 2022 Commons Chamber

[Wes Streeting]

I thank my hon. Friend for raising that heartbreaking case. It is every family’s worst nightmare. All of us now know someone who is waiting for treatment. Many of us know someone who has called for an ambulance and waited for hours and hours—and, in some cases, given up on it and gone to hospital. I have spoken to ambulance service staff who, like many other staff across the NHS, feel a real sense of deep personal moral injury because they know that, despite their best efforts and busting a gut at work every single day, their best simply is not good enough because the system has collapsed. Ambulance turnaround times are not fast enough because A&E waiting times are too high. That is because people cannot see a doctor and the social care is not available, so the beds are full of people who are well enough to go home and would be better off at home. This is the problem in the NHS: the whole system is broken. I am afraid to say that political decisions made in this place by the Conservative party have led us to this tragic situation.

[Andy McDonald (Middlesbrough) (Lab)]

My hon. Friend is making an excellent case. At the James Cook University Hospital in Middlesbrough, the number of people still in hospital who could be discharged into social care amounts to three full wards. That is the situation that we have got to. It is a perfect storm, with ambulances queueing outside and people turning up at A&E because they cannot get to a GP. That will only ever be addressed if we also address staffing in our GP services to ensure that they can attract people who are offered Agenda for Change terms and conditions to alleviate the backlog. Does he agree that we need to invest in all the elements along that supply chain?

[Wes Streeting]

My hon. Friend is absolutely right. This is the tragedy of where we have got to on social care in particular. The Government have allocated half a billion pounds to alleviate pressure this winter, but not a penny of it has reached social care providers. Not a penny of it is currently being worked in action to try to deal with delayed discharges. I have no doubt whatsoever that one reason why it has taken so long from that commitment to getting money to the frontline is the constant churn of Ministers that we saw over the summer. The absolute circus that we saw in the Conservative party has had a direct impact on the competence of effective Government in this country. We now have ineffective Government, so even when the Government seek to do the right thing and allocate the resources, they cannot get the money out the door far enough because Ministers seem to change week in and week out.