Maternity Commissioner

Ben Coleman Excerpts

Monday 20th April 2026 Westminster Hall

[Tony Vaughan (Folkestone and Hythe) (Lab)]

I beg to move,

That this House has considered e-petition 751174 relating to a Maternity Commissioner.

It is a privilege to serve under your chairship, Sir Alec. The petition calls for the appointment of a maternity commissioner to improve maternity care for mothers and babies. I thank the petitioners, Louise Thompson and Theo Clarke, two formidable women and campaigners who have raised this issue relentlessly over several years. They have spoken powerfully, alongside many others, including the Birth Trauma Association, the MASIC Foundation, Make Birth Better, the Maternal Mental Health Alliance, Five X More and Mumsnet. I also thank the more than 153,000 people, including 203 of my constituents in Folkestone, Hythe and Romney Marsh, who signed Louise and Theo’s petition so quickly after it was launched.

We should remember that most births in the UK are safe, and I acknowledge and thank the NHS midwives, nurses and doctors on the frontline, and all those working across the health service, who do outstanding work to care for mothers and babies across our nation every day. However, at the same time, there are clear, deep-rooted and long-standing problems in our maternity and neonatal services, in connection with which I will mention four statistics.

First, the maternal death rate in the UK is one of the highest in western Europe, and UK stillbirth rates are also high. Secondly, the NHS currently spends more on payouts for medical negligence than on the entire frontline maternity service budget. That money should be going towards safer frontline care, not litigation. Thirdly, according to the Care Quality Commission’s latest national review of maternity services, almost half the maternity units it inspected between 2022 and 2023 were rated as “requires improvement” or “inadequate”, with only 4% rated as “outstanding”.

Fourthly, over the past two decades, we have seen a heartbreaking succession of maternity scandals. There was the same pattern across Morecambe Bay, Shrewsbury and Telford, East Kent—which serves my constituency—and now Nottingham: women raised concerns, saying that something was wrong and that they were in pain or frightened, but were not listened to. That failure to listen is a theme running through every major maternity report of the last decade, with around 750 recommendations across those various reports reflecting that failure, alongside the issues of unsafe care, toxic culture and weak oversight.

Unfortunately, those were the experiences of petitioner Louise Thompson, who advocated for a C-section but was denied it, resulting in a massive obstetric haemorrhage. My constituent Jo Page also experienced those systemic failures when her son was born at William Harvey hospital in Ashford some years ago. A birthing injury was misdiagnosed and she did not receive the right treatment and support for what was, in fact, a fourth-degree tear. As a result, she has suffered years of pain and indignity, cannot stand for long periods and needs to use the toilet frequently. She had to give up her career and cannot do normal activities, such as taking a flight to go on holiday. Her life has been utterly changed.

Jo now works with MASIC, which supports mothers with anal sphincter injuries, to run a support group for local women in Folkestone, Hythe and the wider Kent area. She also trains midwives and doctors to correctly diagnose tears, and was recently involved in the Sky News production, “Birth Trauma: The women who weren’t listened to”, which tells the traumatic stories of three mothers who were cared for in NHS England hospitals. Jo, you are truly inspiring, and I know that the whole House would join me in expressing thanks for all the work that you do for women up and down the country.

When I spoke to Jo last week, she told me that she continues to receive messages from women who have experienced misdiagnoses and did not feel listened to during their birthing experiences. Those women include a police officer and a social worker who had both been so badly injured during birth that they had to give up their careers, got into debt and suffered immeasurably. I am sad to say that, just last month, I was contacted by a constituent who experienced the same failings that they had read about in the Kirkup report into maternity services at William Harvey hospital.

When I spoke to petitioner Louise Thompson, she said that she is constantly hearing from women who have post-partum physical injuries and mental health issues, and has known people who have committed suicide following maternity service and post-partum system failures. She also spoke of the profound strain on partners, who must support a recovering mother, assist in caring for a newborn and continue to work, all at the same time. She pointed out that a third of women in the UK who give birth experience it as traumatic, and that every year between 4% and 5% of them develop post-traumatic stress disorder, which is around 30,000 women in total. The impact of trauma can last a lifetime, affecting a mother’s bond with her baby, her relationship with her partner, her ability to work and her long-term mental health.

Why is this happening? The petitioners believe that one key reason is a lack of unified leadership and consistency across maternal care in the UK, over many years. When petitioner Theo Clarke was the hon. Member for Stafford, she chaired the first ever birth trauma inquiry with the hon. Member for Canterbury (Rosie Duffield). They heard from 1,300 patients, including patients from marginalised communities, and from professionals about their experiences of maternity services across the four nations of the UK. The inquiry was prompted by Theo Clarke’s own traumatic birth experience, which she bravely and publicly spoke about in the House, describing it as:

“the most terrifying experience of my life.” —[Official Report, 19 October 2023; Vol. 738, c. 495.]

In submissions to that inquiry, mothers reported being mocked or shouted at, being denied the most basic assistance such as pain relief, and being left feeling “terrified”, “humiliated” and “ashamed”. The word “broken” appeared more than any other. The inquiry’s May 2024 report was called “Listen to Mums: Ending the Postcode Lottery on Perinatal Care”, and its 14 recommendations were headed by a call on the Government to publish a national maternity improvement strategy, led by a new maternity commissioner reporting to the Prime Minister. The petitioners believe that these measures would fill a void.

[Ben Coleman (Chelsea and Fulham) (Lab)]

I am most grateful to my hon. and learned Friend for calling this important debate. I am also very grateful to my constituent Louise Thompson for having the guts and the decency to parlay what was an absolutely horrible experience into a determination to make life better for women across this country and improve maternity services for everybody. I am very grateful for what she is doing—she is in Public Gallery today and I very much welcome her.

As my hon. and learned Friend may be aware, I am a Member of the Health and Social Care Committee. Recently, we produced a report on black maternal health and many of the issues that he has described today also emerged in that report. There is a huge amount to be done.

When it comes to making these changes and making them stick, I echo my hon. and learned Friend’s support for a national maternity commissioner to drive them through. However, if the Government are not minded to appoint a maternity commissioner, how else does he think we might get the drive and the determination to make the changes stick right across Government permanently?

[Tony Vaughan]

I thank my hon. Friend for his intervention, and I echo his comments about the petitioner Louise Thompson and her advocacy on this issue.

The petitioners’ analysis is that there has been a vacuum of leadership and accountability across the system. I know that the Government are considering how best to address that, and we will hear more from the Minister later about that; but whatever happens, there has to be a structural way of providing that leadership and avoiding fragmentation and different interpretations of different guidance documents across the system. We need clear systemic change to cure this, because it has been an ongoing problem for many years and so far no answer has been put forward.

The petitioner Theo Clarke told me a story that illustrates the point about the postcode lottery in maternity care, which the petitioners strongly believe would be prevented by measures to create expert national leadership and tighten up the rules. She told me that an obstetrician in London who she had spoken to recently told her that there are 87 different pieces of guidance that apply in maternity care. That does not sound like a framework; to many people, it sounds more like a large number of disparate documents, which leads to variations in interpretation between different areas. Theo Clarke’s strong view is that that leaves room for interpretation, which results in different approaches to care in different areas. In practical terms, that means that something as basic as training midwives in recognising and treating birthing injuries varies hugely between different areas.

My constituent who I spoke about a moment ago trains midwives on this issue, but that training is not available everywhere, and certainly not in the same way as delivered by MASIC.

Oral Answers to Questions

Ben Coleman Excerpts

Tuesday 14th April 2026 Commons Chamber

[Karin Smyth]

I was happy to announce the further expansion of CDCs this morning. We will continue to work to roll out these centres across the country. I am happy to discuss with the hon. Gentleman the proposals from his local ICB, if he wants to provide a bit more detail on that, as these centres are critical to getting down our waiting lists.

[Ben Coleman (Chelsea and Fulham) (Lab)]

Will the Secretary of State join me in welcoming the success of sickle cell bypass units in north-west London and across the country in reducing pressure on emergency departments, while improving care for sickle cell patients, who have historically been overlooked? Does my right hon. Friend recognise that the future of these units is threatened, and will he meet me to discuss the need for ongoing central funding, so that these vital and efficient services are not lost?

[Wes Streeting]

I congratulate the units on their work. I appreciate concerns about sickle cell services, which we must maintain. I am aware of some of the other challenges we have had to address in London, where we have got to a good place. It is so important that we work together—that Labour’s investment and modernisation works alongside NHS leaders and those promoting public health—and work with great Labour councils, like my hon. Friend’s.

Palliative Care

Ben Coleman Excerpts

Thursday 5th March 2026 Commons Chamber

[Ben Coleman (Chelsea and Fulham) (Lab)]

I am very grateful to my hon. Friend the Member for York Central (Rachael Maskell) for calling this vital debate.

As the right hon. Member for New Forest East (Sir Julian Lewis) did, I will talk about children, and I would like to start with Amy. Amy had Cockayne syndrome, which is a severe, fatal, multi-organ genetic disease. She lived with it for 28 years, and for much of that time her family felt utterly lost. They were navigating a health system that simply did not know how to help them. What changed everything for her was a specialist NHS clinical service, where she got a co-ordinated team who understood her condition. They knew her, and they became a genuine lifeline.

I met Amy’s wonderful mother, Jayne, and sister Louise on Monday at a rare disease day at St Thomas’ hospital, just across the river. I must thank Dr Shehla Mohammed and the Rare Disease UK team, including Dr Bob Sarkany, for a truly inspiring visit. Jayne told me when I met her that, if this specialist service had existed for Amy when she was diagnosed at the age of 14, so much would have been different and so much would have been easier.

Amy’s condition was rare, but her experience was not. Right now, there are 99,000 children in this country—babies, toddlers, teenagers—who are living with life-limiting or life-threatening conditions. Their families are navigating the same fear, the same confusion and the same desperate need for someone to show up and know what to do, but too often what they need just is not there.

We have recently been talking in this House about the Government’s very welcome new special educational needs and disabilities strategy, which promises to end the battles that disabled children and their parents face to get the support they need. That is exactly right, but it must apply equally to palliative care.

What does that support look like? This was mentioned by the right hon. Member for New Forest East. Children’s palliative care is not just about death or bereavement; it runs from diagnosis to the end of life. Sometimes, it runs from birth to early adulthood and beyond, and, yes, to bereavement. However, it is not about giving up. It is about making sure that, however long a child has, and it may be many years, they can live their life and their families can live their lives as well as possible.

The rare diseases centre at St Thomas’ hospital showed me what is possible when we get this right. It calls its multidisciplinary clinic a carousel, which is a nice word. It means that patients see every specialist they need in one appointment, rather than having to travel across the country trailing from hospital to hospital over months. That is great when it exists, but the problem is that, as has been said, children’s palliative care is planned, funded and provided inconsistently across the country.

That was confirmed by a report of the independent expert panel’s “Evaluation of Palliative care in England”, published last November. It was commissioned by the Health and Social Care Committee, of which I have the honour to be a member, along with my hon. Friend the Member for Birmingham Erdington (Paulette Hamilton). The report cites Together for Short Lives, which is the leading charity supporting seriously ill children and their families. It told the panel that more than a quarter of families today feel poorly supported, and that nearly one in 10 families feel altogether unsupported. In addition, only a third of existing paediatric palliative care teams are properly staffed, despite the National Institute for Health and Care Excellence guidance on staffing. The Government response to the report is encouraging. It commits to the modern service framework for palliative care and acknowledges that they must improve services for children. It will come as no surprise to the Minister that I and the Select Committee will be holding the Government to that, as we will integrated care boards across the country.

Within services for children who need palliative care, children’s hospices stand out as a beacon of what can be achieved. They are absolutely irreplaceable. They provide specialist nursing, symptom management, short breaks for exhausted families, and emotional and bereavement support. I hugely welcome the £80 million that the Government have given to children’s hospices over the next three years, so that they can plan ahead more easily, but hospices are scattered geographically. Most families access palliative care through the NHS, which is not providing this care consistently.

What needs to improve? I suggest that five things need to improve so that people get what they need, where they need it. First, we need 24/7 care. At the moment, families are alone at 2 in the morning and they do not know who to call. There have been pilots where hospices and NHS services work together to provide round-the-clock care at home, so it can be done. The NHS needs to adopt that model. Secondly, we have workforce issues. There are shortages of specialist nurses in paediatric palliative care and of properly trained generalists. That is a systemic problem, so I look forward to the NHS workforce plan, which I hope will specifically address children’s palliative care.

Thirdly, we need to consider neonatal palliative care. Neonatal deaths account for 41% of all childhood deaths. Just before Christmas, I had the unforgettable experience of visiting the neonatal unit at Chelsea and Westminster hospital in my constituency. Since 2015, it has run a most extraordinary national neonatal palliative care programme. It is on track to have trained every neonatal network in the UK from Chelsea and Westminster hospital by 2029. There has been a remarkable partnership at the unit between the NHS, the True Colours Trust and CW+, which is the hospital’s charity. I want the NHS to keep going with that.

Fourthly, we have patient groups. Their work, together with the NHS, can be life-saving. They need to be recognised and funded. Finally, as NHS England is abolished, we need to protect the roughly 80 highly specialised services on which the rarest and most complex cases depend. When NHS England goes, we need a national commissioner with the authority to fund these services nationally and to step in when local pressures threaten them.

I have set out a number of good examples, and there is real proof of what can work when the system wraps around families. Amy did not get that from the start. Jayne told me how different things could have been if she had. In future, I hope that we can make sure that every Amy—every one of those 99,000 children—gets the palliative care that they need.

--- Later in debate ---

[The Minister for Secondary Care (Karin Smyth)]

I thank my hon. Friend the Member for York Central (Rachael Maskell) for securing this important debate. We entered Parliament at the same time; we were immediately on opposite sides of the assisted dying debate, and we remain so. Although the Government are neutral, we have always articulated our concern around palliative and end-of-life care in many debates in this House. My hon. Friend has done a marvellous job of that today by bringing forward this debate.

I also thank all my hon. Friend’s colleagues on the commission on palliative and end-of-life care for the vital work they do as they continue to develop their third report. We are really grateful to all those who work or volunteer in the palliative care and end-of-life sector for the care and support that they provide to patients, families and loved ones at a time when they need it the most. As my hon. Friend the Member for Cannock Chase (Josh Newbury) said, everyone deserves a good death.

I commend the shadow Secretary of State for his contribution regarding his excellent experience in the sector; he made some really valuable comments. I have talked about this before, but I too come to this debate with experience. In 2008, I worked with clinicians around end of life and how to live and die with chronic obstructive pulmonary disease—a really unpleasant disease, if there is such a thing as a pleasant disease. I was made aware that people were talking about how to live with it, but no one was really responsible for working with patients and families on how to die with COPD.

I learned a lot about how we talk about death and dying in the health service and the care service, as well as the great work that our trainers and people do to support our clinicians about how best to die. That was really valuable for me when my own father died at home in 2010, supported by Macmillan and a fantastic community care team, which happened partly due to the training that I had and how I was able to articulate on behalf of my family. Things should not have to be like they are. That was 16 years ago, and it is really concerning that across the country people are still experiencing such poor care.

I see lots of that good care in my own local hospital, St Peter’s, which is doing some of the innovation that the shadow Secretary of State mentioned.

I want to reassure colleagues that the Government and my hon. Friend the Minister for Care, who leads on this work, are absolutely committed to creating a society in which everyone receives high-quality, compassionate care from diagnosis through to the end of life.

We have heard a lot about the role of hospices today, from my hon. Friends the Members for York Central, for St Helens South and Whiston (Ms Rimmer), for Birmingham Erdington (Paulette Hamilton), for Beckenham and Penge (Liam Conlon), for Cannock Chase, for West Dunbartonshire (Douglas McAllister) and for Bury St Edmunds and Stowmarket (Peter Prinsley), and from shadow Health Secretary, the right hon. Member for Daventry (Stuart Andrew). Although we recognise that the majority of palliative and end-of-life care is provided by NHS staff and services, we absolutely recognise that many hospitals do fantastic work in this area, and they face a challenging financial situation due to a range of pressures.

That is why last year we announced that we would support the sector with a record £125 million capital funding boost for those hospitals in England, to help them to provide the best physical environment for the people they care for. That money can be spent on fixing a roof, paying for double glazing or buying a new boiler. Although I take the shadow Secretary of State’s point that sometimes people are more willing to contribute to those sorts of things, I know too that finding the money to fund such repairs is what keeps those running the system awake at night, and this work also saves money in the long run, particularly on energy bills. The full £125 million has now been allocated to 158 eligible hospices by Hospice UK. My hon. Friend the Minister for Care has been touring the country to visit many of those hospices to see at first hand some of the good that the money is doing.

On top of that, we are providing around £80 million in revenue funding for children and young people’s hospitals over the next three years, as been said, giving them the stability they need to plan ahead—that was welcomed by the right hon. Member for New Forest East (Sir Julian Lewis). To reassure him, we absolutely recognise the different needs of children and their families in this work. A long-term commitment was a key demand from the sector, which faces a cliff edge in funding cycles every year. Children and young people’s hospices and integrated care boards have been informed of their allocations for the next financial year, and we intend to let hospices know about funding for future years once the process is complete.

We absolutely recognise that this money will not be a silver bullet, and many hospices still face pressing challenges. The need for palliative care and end-of-life care is also projected to rise in coming years with our ageing population, as we have heard. However, although around 75% to 90% of those at end of life would benefit from palliative care and end-of-life care support, only about 55% are identified as such in primary care. That is why NHS England recently wrote to all ICBs requesting an immediate update on the financial stability of hospices in their footprint and the steps needed to mitigate those risks. That will give us a clear national picture of any hospitals at risk of closure or significant service reductions and the potential impact on patients’ families and the wider urgent care system.

With regard to the wider system, neighbourhood health services and their development sit at the heart of our 10-year plan. We are building a service that will deliver more personalised care closer to where people live, empower people to lead healthier, independent lives where they can, and give them a genuine choice about how to access support. I want to reassure hon. Members that the NHS medium-term planning guidance identifies those at the end of life as a high-priority cohort in the implementation of neighbourhood health. I also say to my hon. Friend the Member for Newcastle upon Tyne East and Wallsend (Mary Glindon) that the workforce plan, when it comes forward, will reflect the move into neighbourhood services.

We have to move away from disjointed pathways, as my hon. Friend the Member for Worcester (Tom Collins) articulated so well in speaking about his terrible experience with his mother, and ensure a paradigm shift that looks at people holistically throughout the pathway, as my hon. Friend the Member for Bury St Edmunds and Stowmarket said.

I am the Minister responsible for reforms to the system architecture, and we are asking ICBs to do more. NHS England’s strategic commissioning framework makes it clear that we expect them to commission services in line with the current and future needs of the people they serve. We are moving away from ringfenced incentive budgets, and streamlining the incentives to focus more on the outcomes that we should all expect from our systems. Via the model ICB blueprint, we have made it clear that it is the mission of ICBs to reduce inequalities through a careful assessment of the quality, performance and productivity of existing provision. As we heard in today’s debate, we have to ensure that there are high standards and focused objectives. Next month, ICBs and NHS providers will create a new plan to more effectively manage the needs of high-priority people. NHS England is supporting commissioners to understand those needs, with a dashboard that brings together all relevant local data in one place.

There is currently a contracting mix in the sector, as we have heard today. When we support ICBs to commission more strategically, we have to start moving away from the grant and block contract models. That is why the Government are developing a landmark palliative care and end-of-life modern service framework, or MSF, for England. Palliative and end-of-life care has been variable across the country for far too long, but the modern service framework will put a floor under the kind of care that patients can expect, as we heard from my hon. Friend the Member for City of Durham (Mary Kelly Foy). Although it would not be right to pre-empt exactly what will be in the final MSF at this time, we are working closely with all stakeholders to ensure that everyone has access to the care they need in the right place and at the right time. As part of the MSF, we have invited colleagues from a number of organisations to engage with us.

[Ben Coleman]

Can the Minister confirm that the MSF will include targeted support for children who require palliative care?

[Karin Smyth]

My hon. Friend pre-empts my next paragraph; I thank him for his contribution.

As part of the development of the MSF, we will be looking at some of the important aspects of care that my hon. Friend the Member for York Central mentioned, such as early identification of need, care delivered closer to home by integrated generalist and specialist teams, and strengthened out-of-hours community health support, including a dedicated phone line. I assure the right hon. Member for New Forest East that children, parents and carers will be included in that endeavour. As my hon. Friend the Member for Chelsea and Fulham (Ben Coleman) said, the experiences of people like Amy inform such work. Let me say to my hon. Friend the Member for Alloa and Grangemouth (Brian Leishman) that the experience of Calum and the Turner family must not be repeated.

Hospices do an amazing job for people at the end of life, those with life-limiting conditions, and the whole community of family and friends who support their loved ones on that journey, including through bereavement support, as we have talked about today. The quality of care, the compassion and the love that hospices provide are second to none. We absolutely recognise that the sector faces challenges, and we are determined to work with all our partners to understand those challenges. We are not talking about spending more; we are talking about focusing on the money we have at the moment and spending it better. We are developing a values-based, outcome-focused financial model to reflect people’s experience of care throughout their lifetime. While there are no easy answers, we are supporting them with record funding and reform.

Medical Training (Prioritisation) Bill

Ben Coleman Excerpts

2nd reading
Tuesday 27th January 2026 Commons Chamber

[Wes Streeting]

We set UK medical school places based on future health system needs. We cannot control how many places the overseas campus universities create, whether they are UK-based universities or not. Prioritising those graduates in the way that the right hon. Gentleman suggests would undermine sustainable workforce planning. It would also undermine social mobility and fair access. Those campuses are commercial ventures; they receive no public funding and students are generally self-funded. The nature of prioritisation is that we set priorities, and these are the priorities that this Government are setting out. We must break our over-reliance on international recruitment.

As I have said, I am proud of the fact that the NHS is an international employer, and it is no coincidence that the Empire Windrush landed on these shores in 1948, the very year our NHS was founded. We are lucky that we have people from around the world who come and work in our health and care service. Since Brexit, however, under the last Government, we have begun to see something much more corrosive, with the NHS poaching staff from countries on the World Health Organisation’s red list because their own shortages of medical practitioners are so severe. The continued plundering of doctors from countries that desperately need them while we have an army of talented and willing recruits who cannot get jobs is morally unacceptable. If some Opposition Members want to defend that record and dismiss the morality argument, I would point out that that position is naive on economic grounds. Competition for medical staff has never been fiercer. The World Health Organisation estimates a shortfall of 11 million health workers by 2030. Shoring up our own workforce will limit our exposure to such global pressures without depriving other countries of their own home-grown talent.

[Ben Coleman (Chelsea and Fulham) (Lab)]

I congratulate my right hon. Friend on his excellent speech and the strong points that he is delivering. I associate myself with the remarks of my hon. Friend the Member for Stevenage (Kevin Bonavia) about Malta. As a member of the Health and Social Care Committee, I have also been approached by Queen Mary University. It seems to me that we should be approaching this with a sense of fairness, and if students have entered into a GMC-recognised course with the expectation of having priority access for foundation status, we should accept that those who are currently in training still enjoy that, even if we change the rules for people who enter those courses in the future. Is that something that my right hon. Friend will consider?

[Wes Streeting]

As I have said, the position we have set out is founded on fairness. The basis on which people have applied to these universities has made it clear that the universities cannot guarantee places and that overseas applicants studying at UK universities’ overseas campuses can still apply. There is nothing to prevent those people from applying, but when it comes to prioritisation, we are prioritising UK-trained medical graduates from UK-based universities who have undertaken their training here in the UK. I think that is the right priority to draw.

Obesity and Fatty Liver Disease

Ben Coleman Excerpts

Tuesday 28th October 2025 Westminster Hall

[Dr Chambers]

Fantastic. Hopefully it will improve people’s mental health—and if they leave halfway through, it will probably improve their physical health, too. That is a fantastic initiative.

Other Members have talked about the soaring rate of liver deaths, which has shot up in the last 20 years. The hon. Member for Worthing West talked about it costing the NHS £6.9 billion directly, and some studies show that it has cost the economy over £100 billion in other ways, such as from people being off work.

[Ben Coleman (Chelsea and Fulham) (Lab)]

I suggest to the hon. Member that one of the principal reasons that non-alcoholic fatty liver disease has shot up so radically in recent years is the increasing prevalence of food that is simply bad for people and is causing them damage—in particular, food that is high in fat, sugar and salt. For that reason, the Health and Social Care Committee, of which I am a member, is currently doing an inquiry on food. Does the hon. Member agree that the Government need to focus on making healthy food more affordable and accessible, and to tackle the advertising and marketing of so much of the unhealthy food that is out there?

--- Later in debate ---

[Dr Caroline Johnson (Sleaford and North Hykeham) (Con)]

It is a pleasure to serve under your chairmanship this morning, Mr Efford. I congratulate the hon. Member for Worthing West (Dr Cooper) on securing this important debate, and I thank the British Liver Trust and others who provided information and reading material in advance of today’s debate.

Fatty liver disease, as has been said, is often asymptomatic in its early stages. Even when symptoms do occur, they can initially be non-specific symptoms such as tiredness and feeling generally unwell. Initially, the fat deposits in the liver; in the next stage the fat causes inflammation, which causes metabolic dysfunction-associated steatohepatitis. It can then progress to fibrosis and then cirrhosis. As mentioned earlier, liver deaths have increased substantially in the last 50 years, but early detection can help to prevent them. What is the Minister doing to ensure that liver function tests and fibroscans are more available? Does she regret having to delay her workforce plan? Will that have an impact on the treatment of liver disease?

As many have said, fatty liver disease is caused by obesity. Two thirds of adults are now overweight or obese, but obesity starts in childhood. As an NHS consultant paediatrician, I have in my time seen a 12-year-old weighing 120 kg and a nine-year-old weighing over 90 kg—around three times the weight of an average nine-year-old. That has a serious cost in terms of life expectancy, taking three to 10 years off a person’s life. It also has an economic cost to the state of about £11.4 billion on the NHS, estimated at £75 billion per year when taking into account the wider economic factors.

We all know someone who has struggled with their weight and who has had huge success recently, including Members of this House who have talked about it in other debates, using Ozempic, Wegovy or Mounjaro. That is great, but do we want a future where a substantial proportion of the population are dependent on medication to maintain their weight?

[Ben Coleman]

If I may bring the hon. Member back to childhood obesity, does she agree that there is a serious problem with sugar being pumped into so much baby food? Does she therefore welcome what the Government have finally done after many years of the issue’s sitting unaddressed? They are giving the industry 18 months to take the sugar out of baby food and to stop marketing basically unhealthy products, which no one should buy, as healthy or healthier. Does she welcome what the Government are doing here?

[Dr Johnson]

I certainly think it is wise to ensure that people get off to a good start in infancy and that unhealthy products are not advertised as healthy if they are not, although the definition of healthy is somewhat elusive and difficult to pin down. It is also important that we do not routinely feed little babies under one high-sugar foods, although I do not want to see them fed artificial sweeteners, either. It is about making things less sweet, so the reformulation will need to be done carefully. That is my personal view.

Going back to the medications, we know they can be very helpful for some and can improve their health. They may be able to help with fatty liver disease as well, although they are not licensed yet. Can the Minister update us on when the Government expect applications to be approved and whether the NHS is ready to deliver for all eligible patients? We have heard about the prevalence and burden of the condition across the country and the number of people affected. What is she doing to ensure that the NHS is ready so that, when these drugs are licensed, it has the capacity, workforce and money to provide them?

We have seen that drug prices can change quite dramatically. In August, Eli Lilly announced a huge price increase for Mounjaro. What plans does the Minister have to guard against that? Will she update the House on negotiations on the voluntary scheme for branded medicines pricing and access?

We understand she is reviewing the National Institute for Health and Care Excellence quality threshold; when does she plan to reach a conclusion? We have seen investment in this country’s life sciences sector by companies such as Merck and AstraZeneca being withdrawn from the United Kingdom or paused due to the environment created by the Government. We need urgent action to support that sector. Will the Minister update the House on discussions she has had with industry and the Treasury on that?

Medications are part of the issue, but there are also surgical implications. Many people who have lost large quantities of weight require surgery for excess skin, which can cause further medical problems. What is the Minister doing to ensure there is an assessment of demand for post-weight loss surgery? Are surgeons and capacity available to deliver it where medically indicated?

As many have said, prevention is better than cure. We know that fewer than one in three people eat five portions of fruit and veg a day, and that that is falling. We also know that starting early is important and have talked about children and infants. What is the Minister doing to ensure that school food is healthy and good for children? What work is she doing with the Department for Education on food choices and preparation, particularly advice on food that can be made in advance or quickly? We know that many young people will become adults in households where there are two working parents, where one of the largest challenges is not just the money needed to buy food, but the time required after returning from work to prepare and deliver it to children before they do their homework and go to bed.

We have talked about reformulation. The soft drinks industry levy has reduced sugar per 100 ml by 47.4%, but I am concerned that is leading to an increase in artificial sweeteners rather than a reduction in the sweetness of the product, ultimately meaning that people are still hooked on the sweetness. What does the Minister think of that? Some hon. Members talked about the advertising ban on less healthy food. Will the Minister tell us why that has been delayed until next year?

Why have the Government added the brand exemption? Do they think the addition of the brand exemption will make it harder for new market entrants, compared with well established brands? If I whistled the short tune for one food brand—I will not—it would be immediately recognised, without further introduction. That would be more difficult for advertising new entrants to the market.

The 10-year plan talks about mandatory healthy food sales reporting. Will the Minister update us on what she defines as healthy? There are also mandatory targets on healthiness of sales. What does that mean and when will it be implemented? We understand there is a planned update to the nutrient profile. Some are concerned that the free sugars that that includes mean that items such as date paste will fall under unhealthy sugars. Will the Minister provide information on that? Has she made an assessment of the Conservative Government’s step of informing people by adding calories to menus? What effect has that had on consumption and food portion sizes in the restaurant sector?

Exercise is also important. We know that physical exercise strengthens joints, increases weight loss and helps in the reduction of diabetes, depression and dementia. The previous Government gave £1 billion to support the sports and leisure industry during the pandemic so that it could continue, and had a school sports action plan, guaranteeing at least two hours of PE and supporting after-school clubs.

The current Government have pledged £400 million for new sports facilities, but delivery of that money seems to be at a standstill. Will the Minister update us on that? Many grassroots sports facilities need that money. Will she also update the House on what the Government are doing to improve girls’ attendance in sports? We know that teenage girls in particular are not taking the advised amount of exercise.

In summary, we need an NHS pathway to detect liver disease in the early stages so that it can be treated; an NHS that is ready to deliver the new treatments that are becoming available; and action to tackle obesity to prevent liver disease in the first place. There has been an emphasis throughout the debate on what the Government can do to prevent obesity and on state culpability in that regard. It is important that people recognise that they have agency and do not need to wait for the Government to do something about this. People do not need to wait for the soft drinks industry levy or for changes to regulations. They have the agency to help themselves; they can do that.

[Ben Coleman]

Will the hon. Member accept that there is now a general body of opinion that it is time to stop blaming people for not having the willpower not to eat bad food when they are constantly bombarded with advertising and marketing? Some £6.4 billion a year will be spent by the food industry on advertising and marketing to people, and in many areas it is very difficult to get food that is both affordable and healthy. Is it not time to stop blaming people for being fat and to support them to tackle obesity in the ways that I and many of my hon. Friends here have described? Is it not time to stop sticking up for the food industry and to start sticking up for ordinary people?

[Dr Johnson]

I do not think it is sticking up for the food industry to suggest that people have agency over what they eat. I will give an example. I saw a very small patient—about five years old—who was very obese. I asked the mum what sort of things the child was being fed, and the answer was, “Well, Doctor, he eats lots of crisps all the time.” But there is a simple point there: where was he getting those crisps from? He was getting the crisps from the cupboard without asking, but the crisps did not get in the cupboard because the five-year-old put them there. It is a question of making sure that what is available is healthy and what is being fed to children is healthy.

I have seen even in the last few weeks patients who have low vitamin D levels, critically low vitamin B12 levels and critically low iron levels as a result of the diet that they are getting. It is not just a case of, “It’s all the Government’s fault. The state must make sure that everyone eats healthily.” People have a responsibility of their own as well. This is about working together.

There are wider policy impacts as well. The hon. Member for Chelsea and Fulham (Ben Coleman) talked about food pricing and food security. This Government want to cover Lincolnshire—the breadbasket of the UK, where a third of the country’s fruit and vegetables are produced—in glass solar panels. That is what his Government want to do, so there is a wider policy framework about food affordability. Food inflation is going up hugely under this Government, so they need to look in the mirror and see what they are doing to reduce food prices for people. We need to work together: it is a combination of what the Government can do and what the individual can do.

Suicide Prevention

Ben Coleman Excerpts

Thursday 11th September 2025 Commons Chamber

[Sojan Joseph (Ashford) (Lab)]

I am grateful to my hon. Friend the Member for Doncaster East and the Isle of Axholme (Lee Pitcher) for securing the debate, and I congratulate him on his very touching speech. The clear message coming from the House today is that suicides are preventable. Defeating stigma is essential, and the more that we can raise this issue in Parliament, the more we can do to help remove that stigma.

This Government inherited a mental health crisis. More than a million people who are in need of mental health support are not getting the care that they so desperately require. The suicide rate is now higher than it has been at any time in the 21st century. The pledge by Ministers to ensure that mental health gets the same attention and focus as physical health is an important one. It was talked about for 14 years when the Conservative party was in power, but there was little progress. I genuinely hope that under this Government things will finally change. With that in mind, will my hon. Friend the Minister update the House on the progress being made to tackle mental health waiting lists? Research from Rethink Mental Illness has shown that 12 times as many people have to wait 18 months or more for mental health treatment compared with the wait for treatment for physical health.

It is necessary to discuss mental health provision in this debate; after all, the link between suicide and mental illness is well established.

[Ben Coleman (Chelsea and Fulham) (Lab)]

Does my hon. Friend agree that we should also look at the impact on people’s mental health of online gambling, which is responsible for between 117 and 496 suicides a year—figures repeated in our Health and Social Care Committee report? My constituent Jack lost his son Arthur to gambling-related suicide aged only 19, after only six months. It is a tragic situation. Does my hon. Friend agree that gambling should be seen as a public health issue, that in future it should be regulated not by the Department for Culture, Media and Sport but by the Department of Health and Social Care, and that the DHSC should launch a public health strategy to tackle gambling as a cause of suicide?

[Sojan Joseph]

I agree with my hon. Friend that not all suicides are linked solely to mental health. I was about to say that various social issues need to be tackled as well. It is it is important that we do not see suicide prevention solely through the prism of mental health. Indeed, many of those who die by suicide have either had no contact with mental health services or shown no signs of mental ill health. It is also important to point out that not everyone who dies by suicide has a diagnosed mental illness. For those at risk of suicide, a complex range of individual, relationship, community or societal factors can be at play.

As the suicide prevention strategy makes clear, common risk factors that are linked to suicide include physical illness, financial difficulty and economic adversity, gambling, alcohol and drug misuse, social isolation and loneliness, and domestic abuse. Although addressing suicide prevention can include mental health, the strategy emphasises that it also goes well beyond these issues. If we see suicide prevention just as a mental health issue, those people in our communities who may not meet the criteria for a mental health diagnosis but are still in acute distress can end up being forgotten. Perceiving suicide just as a mental health issue also puts the responsibility mainly on mental health services, when in reality local authorities, employers, schools, the criminal justice system and wider society all have roles to play. When we talk about suicide prevention, we should therefore also talk about early intervention in schools, universities, places of work and community groups.

It is worth mentioning the great work done by charities—many names have already been mentioned. I congratulate the recently opened Ashford Safe Haven, which is based at William Harvey hospital. It offers a walk-in service every evening for people who are in crisis or feel they are heading towards crisis. A few months ago, I visited the safe haven and met some of the staff to hear about the support they provide and how they help to create staying well and crisis plans, as well as supporting people to access other services and organisations that may be useful to them. It is a great resource for people in our community and I hope that the East Kent hospitals trust is successful in its bid for funding for a round-the-clock walk-in service. Working with suicide prevention charities can complement the services offered by the NHS and bridge gaps in provision. We should also ensure that the health system becomes more effective in signposting the services that are offered by suicide prevention charities.

While I will always lobby for meaningful change in the mental health system, I also know that talking about suicide prevention just as another issue for our mental health services risks narrowing the conversation and excluding others who might need help. I hope that today’s debate has helped to make it easier for those watching who might need help now or in the future to get the right help at the right time.

Department of Health and Social Care

Ben Coleman Excerpts

Tuesday 24th June 2025 Commons Chamber

[Ben Coleman (Chelsea and Fulham) (Lab)]

I am grateful to my hon. Friend the Member for Birmingham Erdington (Paulette Hamilton) for her excellent speech and for securing the debate.

I am quite excited about Saturday week, not just because it will be my birthday on 5 July—[Hon. Members: “Hear, hear.”] Thank you so much—but because the national health service will be 77. Yes, it has survived that long. [Interruption.] I have survived slightly less long, I would like the House to think. Despite the years of cuts and chaos which have left the NHS broken, it is not beaten and we are rebuilding it. There is a huge amount to do, but we are making progress. After record funding in our first Budget, I am delighted that the spending review has put the health of our nation first. And, as touched on by colleagues, I am equally delighted that the Government are determined to reform how the NHS works to get a bigger bang for our buck and better outcomes for patients, because we need that.

We know we have masses to do. My hon. Friend set out many of the splendid things we have done so far, including getting waiting lists down to their lowest for two years, which is quite an achievement after only 11 months of this Government. On a more personal level, I am delighted that my constituency is benefiting directly from having a Labour Government. Charing Cross hospital has been given millions of pounds extra to upgrade vital infrastructure, including new MRI scanners, modernised operating theatres, better energy security and a big refurbishment of the ground and first floors, all under this Government. I also hugely welcome the new investment in GPs in my patch: the Cassidy medical centre, Ashville surgery, Palace surgery in Fulham and the Chelsea practice have all been earmarked for new funding under the Government to improve facilities and help provide better care.

Finally, I am excited by the possibilities of the new neighbourhood health service, which we are looking forward to in the 10-year health plan. Locally, I look forward to playing my full part in bringing together all the local health and social care practitioners, so that my residents get the better healthcare they have been waiting so long for and deserve. While I do that, I will also be working to ensure that we confront health inequalities and end the situation that we have now where people get less good access to health, less good treatment and less good outcomes simply because of their colour, what they earn or their disabilities. We must end that.

The spending review continues the work we have begun of repairing a health system that has been left bruised and battered, down but not out. Combined with the 10-year plan, we will be putting the nation’s health on a better path for the future and creating the change that people so vigorously voted for.

Incontinence

Ben Coleman Excerpts

Thursday 19th June 2025 Commons Chamber

[Ben Coleman (Chelsea and Fulham) (Lab)]

A big thank you to my hon. Friend the Member for Dudley (Sonia Kumar) for securing this extremely important debate. I was fascinated and not a little shocked to hear that this is the first full debate in the Chamber on this subject, and it is absolutely tremendous that we are talking about it, because we need to. As everyone has recognised, it is a subject that people rarely talk about, despite the fact that millions of people are affected by bladder and bowel control issues—I will try to use that phrase instead of the term “incontinence”, after hearing the point that my hon. Friend rightly raised; I was scribbling away when she said that.

For much too long, this issue has been treated as a private embarrassment—something to whisper about, not act on. I was struck by what she said about the number of people who got in touch with her, crying out for this subject to be discussed, and for us to take action. We need to take action, because as well as being a very important health issue, it is almost a social justice issue, and an issue of dignity. Far too many people and families face a daily struggle that has been quietly ignored.

As was said, it is estimated that one in three women in the UK experiences urinary control issues, but the issue affects men, too. It is important that men speak in this debate, and I am very pleased that the hon. Member for Dumfries and Galloway (John Cooper) did. As for my city, London, a recent survey for Prostate Cancer UK found that 54% of all male Londoners had experienced urinary control problems. More than one in four men—28%—experienced symptoms as early as between the ages of 18 and 25. That contradicts the widely held view that bladder conditions affect only older adults. Then, of course, we come to bowel incontinence, which is more closely associated with age: 15% of those aged over 85 and living at home are affected, and the figure is even higher for men and women living in residential and nursing homes.

Of course, we also have to think about bladder and bowel conditions affecting children and young people, and especially those with disabilities, whose voices are often the last to be heard anyway, and particularly the last to be heard on this subject. Disabled and other children with these conditions can miss out on education, friendships and an ordinary life because of a lack of basic provision. Families feel ashamed when they ask for help, because they think that no one else is facing the same thing. That brings us back to the importance of us discussing this matter in the House today. Many families face this issue; we need to make it safe to talk about it, and safe to ask for support.

As I say, bladder and bowel conditions are not only a health issue, but a social justice issue, and it is time we treated them as such, because that is not what happens now. Despite the evident human cost, and the prevalence of these conditions across society, support and services remain inadequate, and those affected and their families are left to scramble for help. They face stigma. They too often endure isolation, yet as my hon. Friend the Member for Dudley set out, there are simple, straightforward solutions that would make a huge difference to those who live with bladder and bowel control issues. We can start by destigmatising the issue; that is what we are doing today, as has been said.

At a national level, we need a public health campaign, led by the Department of Health and Social Care, that makes it clear that these conditions are normal, treatable and nothing to be ashamed of. Let me tell Members about one of the very few people in either House that I have heard talk about these conditions. I went to a meeting on assisted dying—one of many such meetings, which colleagues of all parties have been to—at which I heard from a disabled Member of the House of Lords, and other people who are disabled and wheelchair users. They spoke in a very matter-of-fact way about being incontinent—that was the word they used. They made it quite clear that it was perfectly possible to lead a normal and fulfilling life with that condition. When I was growing up, older people would say to me, “The one thing I dread above all is being incontinent— I think I’d take my life if that happened.” It was very inspiring for me to hear a Member of the other place talking about their situation, and talking about it released all of us from a particular challenge when it came to reflecting on assisted dying.

My hon. Friend the Member for Dudley mentioned Prostate Cancer UK’s Boys Need Bins campaign. There are others, including the End Bladder Shame campaign by TENA, the maker of incontinence products. These things show what is possible if people feel heard—but they need more support. Alongside a public health campaign, let us have more investment in infrastructure. That means more modern, accessible public toilets with clean, safe disposal facilities for men as well as women, which has been a long-standing request from charities like Age UK.

We need to make sure that every school—mainstream schools as well as specialist schools—has trained staff who can support children with bladder and bowel conditions, not as an afterthought but as part of their core pastoral care. We have a Minister from the Department of Health and Social Care on the Front Bench, but I hope she can pass on the message to her colleagues in the Department for Education that they should make sure school toilets are accessible, hygienic and inclusive, with disposal bins, locks and space—with dignity built in.

Finally, I would like to see us integrate bladder and bowel care into national health strategies. They should be a core part of NHS England’s work on long-term conditions, ageing and preventive care, not an afterthought. I look forward to that being reflected in the 10-year plan and, I hope, in the forthcoming men’s health strategy.

Better bladder and bowel care will save men, women and their families from stress, it will save children from shame and the feeling of being left behind, and, wonderfully, as my hon. Friend the Member for Dudley said, it will save public money. It is a public good, and if we take this seriously, it will make a huge difference to a lot of people’s lives. Let us give this issue the attention it deserves and do right by every person who has been living with these conditions in silence for too long.

[Several hon. Members rose—]

Oral Answers to Questions

Ben Coleman Excerpts

Tuesday 17th June 2025 Commons Chamber

[Stephen Kinnock]

The hon. Gentleman is absolutely right to point to the neglect and incompetence of the past 14 years. We are fighting to get NHS dentistry back to where it needs to be. An important first step, of course, is the 700,000 additional urgent appointments and supervised tooth-brushing programme, but long-term contract reform is what is needed, alongside the investment that will come through the spending review.

[Ben Coleman (Chelsea and Fulham) (Lab)]

According to the Trussell Trust, the impact of hunger and hardship on people’s health is driving an extra £6.3 billion in Government healthcare spending. What part is the Department playing in reducing hunger and hardship—and thus the related healthcare cost—in my constituency and across the country?

[Stephen Kinnock]

My hon. Friend is right to raise that important point. It is truly shameful that 4.5 million children in the UK now live in poverty. We are developing an ambitious strategy that tackles root causes, and we are already taking action. Alongside cross-Government work on free school meals, breakfast clubs and funded childcare, the Department is investing £56 million in Start for Life services and supporting healthy diets for 358,000 people through Healthy Start.

Dementia Care

Ben Coleman Excerpts

Tuesday 3rd June 2025 Commons Chamber

[Caroline Voaden]

I absolutely agree.

In 2023, Devon saw the closure of its dementia advice service after 10 years because of a cut in funding under the previous Government—a decision that left a significant gap in community support across the county. The service offered vital information, practical advice, and tips and strategies on coping with dementia, as well as signposting to legal and financial support, and the closure was a blow to many families already struggling to cope. It is a scandal that Devon’s integrated care board has neglected older adults by cutting a service that was designed to prevent early care home and hospital admission, and to ease pressure on primary care.

However, there is hope on the horizon. Devon has recently developed a new countywide Devon dementia strategy, which aims to bring about real and meaningful change for those living with dementia and their loved ones. Written in collaboration with over 40 organisations, it sets out what is needed in dementia care today and for the foreseeable future, and I commend them for their work. This strategy is vital, and so is the funding to support the measures it highlights. Dementia prevalence in the area covered by Devon’s ICB is expected to rise by 54% between 2023 and 2040, and by then, over 33,700 people in Devon will be living with dementia. Now is the moment to act, to ensure that this strategy is not just a document that sits on a shelf but becomes a driving force for better services, earlier diagnosis and more consistent support.

I would like to briefly share the story of one of my constituents, Michael, to illustrate why this is so urgent. Michael’s wife began showing signs of dementia six years ago and was diagnosed with moderate to severe Alzheimer’s nearly five years ago. As her symptoms worsened, her condition became more difficult to manage, and she was eventually sectioned as being a danger to herself. At that point, the NHS took over her care, and she is now in a home where she is receiving very good care. Michael has nothing but praise for his GP, the older people’s mental health team and his local hospital for their support. However, his experience has highlighted critical gaps in the system. He recalls the complete lack of day care facilities to provide respite before his wife went to hospital and the overstretched system that was unable to assess people quickly or provide necessary help, either at home or in day care.

[Ben Coleman (Chelsea and Fulham) (Lab)]

I am most grateful to the hon. Member for leading this debate so effectively and raising these important issues. She will be aware that three in four dementia carers have no alternative plans in place if they are unable to provide care. Many of them are terrified about what will happen to their loved ones if they are no longer there to provide care, and nine in 10 have already reached crisis point, with burnout and depression. Does she agree that dementia carers need to be fully supported to put alternative care arrangements in place? May I urge the Minister to implement a carers strategy that sets out carers’ rights and what support carers should receive when it comes to alternative provision?

[Caroline Voaden]

So many thousands of people are doing this care for free, at home, living under this burden and worrying about what will happen if they are no longer there. They deserve recognition and help to put those plans in place, in case something happens to them—that is crucial.

For many families, accessing respite care is a huge challenge. Caring for someone with dementia is often a 24/7 job and is utterly exhausting, yet unpaid carers like Michael are saving the country billions of pounds and are often doing so without the support they need. Michael echoes the calls I have heard in my own family for the Government to do more to support carers by ensuring they have access to regular respite care. We must also urgently examine the funding and availability of care homes that can support high-needs dementia patients.