Duchenne Muscular Dystrophy

Freddie van Mierlo Excerpts

Thursday 12th June 2025 Commons Chamber

[Chris McDonald]

I thank the hon. Member for that intervention. I am very pleased that he has intervened and I think the comment about a postcode lottery is exactly right. I noted, when I looked at the figures, that currently the Belfast health and social care trust is not offering the drug to lads in Northern Ireland, because it is claiming that it will cost £309,000 for 13 patients. That is different from the rest of the country by an order of magnitude, so I would be grateful if the Minister looked very carefully at the situation in Northern Ireland.

[Freddie van Mierlo (Henley and Thame) (LD)]

I thank the hon. Gentleman for securing this debate. I have been engaging with the Oxford NHS trust, which is not yet providing givinostat to boys in Oxfordshire. Its own business case suggests that it would cost less than £2,000 per boy and £66,000 in total for the 35 boys. Clearly, as a country, we should be able to afford such a sum. Does he agree that a hospital that wants to be world-leading should be providing it? Does he further agree that this is exactly the sort of thing we need Government intervention on, so that these boys can get treatment as soon as possible?

[Chris McDonald]

I do agree. I recognise the figures from the Oxford university hospitals NHS foundation trust. It is quoting around £2,000 per lad treated, which I understand is very similar to other areas of the country. I see that as quite a small amount of money for the 35 lives that could be saved.

Despite, as we have heard, givinostat being available for more than seven months, there has been a very inconsistent approach across the UK. A very small number of ambulant people living with DMD have so far received the treatment, and no non-ambulant boys have been treated with it yet.

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[Karin Smyth]

I thank my hon. Friend for that constructive suggestion. We need to wait to see how the NICE recommendation goes in July. With this disease and so many others, it is important to share learning and information, and trusts should be encouraged and supported in doing so. We will work with him on that constructive recommendation.

I understand my hon. Friend’s concerns about the fact that non-ambulant patients are not yet able to access givinostat, but it is important to note that the eligibility criteria for participation in the early access programmes have been determined by the pharmaceutical company. NHS trusts that decide to participate in the EAP must only provide treatment in line with the criteria, which state that patients must be ambulant. A clinical trial is being carried out by the pharmaceutical company to evaluate the safety and tolerability of the drug in non-ambulant patients, and to further explore the efficacy of the drug in this population. I know that for the patients and families affected, it will be disappointing to hear that there is no access to the drug for ambulant patients before a NICE decision, or for non-ambulant patients prior to clinical trials being concluded. I want to assure my hon. Friend that we have arrangements in place to support rapid access to new medicines.

[Freddie van Mierlo]

Will the Minister give way?

[Karin Smyth]

I will not; I want to finish in the time available, and I think Members want to hear the full response.

Outside of company-led EAPs, there are established routes for patients to get access to new, innovative medicines prior to them being licensed. The early access to medicines scheme, or EAMS, helps give people in the UK with life-threatening or seriously debilitating conditions early access to new medicines that are not yet licensed where there is a clear unmet medical need. EAMS is supported by key partners, including the MHRA, NICE and NHS England, and is a key part of this Government’s commitment to accelerating patient access to innovative, life-changing treatments, in support of the UK’s position as a global leader in life sciences. In fact, since the scheme launched in 2014, over 50 medicines, including for this disease, have benefited from being accessed early through EAMS.

The innovative medicines fund has also made available £340 million of ringfenced funding for the NHS to fund early access to medicines that NICE has recommended with managed access. Through this process, licensed treatments that demonstrate substantial clinical promise but still have significant uncertainty around their clinical and cost-effectiveness can be funded. Further evidence is then collected on the drug for a defined period of time. That is considered by NICE in determining whether the drug can be recommended for routine NHS funding.

The Secretary of State has been clear that if givinostat is recommended by NICE in draft guidance, NHS England should aim to work with the pharmaceutical company to provide early funding through the innovative medicines fund. This could potentially speed up access by up to five months, and the treatment could be funded as soon as this summer, if recommended.

This scope of this debate is wider than just access to new medicines. It is important to note that while rare diseases are individually rare, they are collectively common. One in 17 people will be affected by a rare condition over their lifetime. The UK rare diseases framework outlines four priorities, based on engagement with the rare disease community. They are: helping patients to get a final diagnosis faster, increasing awareness of rare diseases among healthcare professionals, better co-ordination of care, and improving access to specialist care, treatments and drugs. In England, we publish a rare diseases action plan annually. These detail the specific steps we are taking to meet the shared priorities of the framework. I am pleased to highlight the 2025 England action plan, which was published in February this year on Rare Disease Day. One such action is reviewing the effectiveness of early access schemes, such as the early access to medicines scheme, the innovative licensing and access pathway, and the innovative medicines fund. They are all designed to help make innovative treatments available earlier to patients who need them. We are specifically considering how well they support access to treatment for people living with rare diseases like Duchenne.

NHS England, NICE and MHRA will meet annually to continue to discuss progress on these schemes. These meetings will include representatives from patient advocacy groups and from industry, and clinical researchers, and the next one will happen in the summer.

Managing a complex rare condition can be challenging, and it often means interacting with many different specialists and providers of health and social care. It can mean travelling across the country to access highly specialist care from experts. All of that can add up to a significant emotional and physical burden, and it can deepen inequalities. Co-ordination of care can minimise this burden on patients and their carers, and it can ensure that healthcare professionals work together to provide the best possible care, as we have discussed this evening.

In the 2025 action plan, we have introduced a new action to incentivise providers to run clinics for multi-system disorders, in order to reduce the number of appointments and improve co-ordination of care for families. The NHS is also working to include the definition of “co-ordination of care” that is set out in the CONCORD—co-ordinated care of rare diseases—study in all new and revised NHS service specifications for patients with rare diseases.

I recognise how hard it is when patients want access to these new treatments. I also recognise the distress and worry it causes, not only to patients, but their families and friends. Hon. Members have articulated that well on behalf of their constituents this evening. The Government are committed to providing access to the most innovative medicines, but it has to be at a price that provides value for the NHS, and it has to be clinically safe and effective. That is why we are working hard with industry, NICE and MHRA to make that happen. I know that my hon. Friend the Member for Stockton North will continue to work with the Government and providers to make that happen. I am grateful for the opportunity to respond to this debate on such an important issue.

Question put and agreed to.

Attention Deficit Hyperactivity Disorder

Freddie van Mierlo Excerpts

Tuesday 10th June 2025 Westminster Hall

[Freddie van Mierlo (Henley and Thame) (LD)]

I beg to move,

That this House has considered support for people with ADHD.

It is a pleasure to serve under your chairship, Ms Jardine, and I thank the Minister for being here for the debate.

Allow me to take Members through what ADHD diagnosis and treatment looks like in Oxfordshire. Say a 14 or 15-year-old boy is exhibiting symptoms of ADHD. They find themselves easily distracted at school. Their high energy levels are coming through in all the wrong ways; they talk noisily through class and find it hard to sit still.

[Adam Dance (Yeovil) (LD)]

I thank my hon. Friend for securing this vital debate. Does he agree that one fantastic way to support young people with ADHD and their teachers is to have universal screening for neurodiverse conditions at primary school and to increase teacher training on such conditions?

[Freddie van Mierlo]

My hon. Friend has been a fantastic advocate for people with neurodiverse conditions and I wholeheartedly endorse his suggestion.

Imagine a young girl who works hard to mask her symptoms just to get through the day. Her GP refers her to child and adolescent mental health services, but the waiting list is so long that the service is functionally irrelevant. She knows that by the time she gets seen, she will be 18 and so kicked out of CAMHS and into adult mental health services. But since February 2024, Oxford Health’s waiting list for adult assessment has been closed. It is a dead end—there is no service. For all intents and purposes, the NHS does not exist. In Oxfordshire, there were 2,385 on the waiting list in March, while capacity is 26 assessments a month. That means the waiting list is seven and a half years long. It is no wonder the list is closed and has become meaningless.

But suppose you are one of the lucky ones with a diagnosis and a treatment plan: guidelines from the National Institute for Health and Care Excellence dictate that there should be an annual review of your condition. Your GP is told to continue to prescribe controlled medication, but then says they will do so only until your next annual review by a specialist. However, specialist reviews are not a commissioned service in Oxfordshire, so once someone hits this limit, their GP stops prescribing and their symptoms immediately worsen.

In July 2024, I started working on such a case—one of the first in my inbox. A constituent warned me that she was leaving CAMHS and would have no access to care. After her case was escalated to Oxford Health, it was negotiated with her GP that primary care would continue to prescribe until her next review was due. I had hoped that would buy us enough time to find a solution. In February, I was told by the Buckinghamshire, Oxfordshire and Berkshire West integrated care board that it would decide on reopening waiting lists for young people aged 18 to 25 in March. That would allow reviews for that cohort to take place again.

[Alex Easton (North Down) (Ind)]

I thank the hon. Member for securing this debate on a really big issue in Northern Ireland, where the waiting list for assessment is five years for children and eight years for adults. We have the added complication—I do not know whether this is the same in the rest of the UK—that schools will not accept a private diagnosis, so people are stuck. Something needs to be done for those who go down the private route so that their diagnoses are accepted at an earlier stage, rather than their having to go down the NHS route.

[Freddie van Mierlo]

The hon. Member makes an excellent point about the impact of going private. Far too many children—and the parents who pay—are forced into the private sector; the least we can do is make sure that that marries up properly with NHS provision.

March came and went, and only today I received a response from Dr Nick Broughton, the chief executive of the BOB ICB. He confirmed that the plan is still to fund a service for 18 to 25-year-olds, but he could commit only to a timeline of “Q3 2025”. I hope Members will forgive my scepticism about that coming to fruition. Again and again, dates for care have been pushed back, and they are contingent on everything going to plan. Luckily, my constituent is still getting the treatment she needs through the right to choose, but I understand that ICBs are going to be given the option to restrict that right—what happens then?

[Lisa Smart (Hazel Grove) (LD)]

My hon. Friend is laying out many of the issues that my constituents face. He talked about his constituent using the right to choose. A number of my constituents have taken that route and got a diagnosis, but they cannot access medication because of the shared care model. That is a problem my constituent Helen raised with me—it is having a massive impact, and her ability to pay is being stretched. Does my hon. Friend agree that the Government would do well to review the shared care model, so that those with an ADHD diagnosis can get the treatment they need?

[Freddie van Mierlo]

We absolutely need a review of how shared care works. If someone goes through a diagnosis and needs treatment for ADHD, or any other mental health or neurodivergent condition, the last thing they need is for barriers to be put in the way.

[Tulip Siddiq (Hampstead and Highgate) (Lab)]

The hon. Member is making an important speech on behalf of his constituent. He mentioned the diagnosis process; I have seen in my casework that constituents in hard-to-reach communities find it difficult to navigate the ADHD process, and some appeal to the wrong groups for advice and information. Ultimately, they end up on the waiting list for even longer, because the people they reached out to were not the right ones. Does the hon. Member agree that Government and local authorities need to work together to provide targeted information to marginalised groups and hard-to-reach communities, so that people do not fall even further behind their privileged peers?

[Freddie van Mierlo]

The hon. Lady makes a point about local NHS bodies working together with central Government. Where is the accountability? No one is taking responsibility for patients, and they are suffering as a result. In what world is the NHS running on its founding principles when it comes to ADHD? The alternative to non-existent ADHD services in Oxfordshire and across the country is fully private care. This is a two-tier system baked into how we do health.

I am not naive. The healthcare professionals I have spoken to tell me that they are overwhelmed by a sudden large rise in ADHD cases.

[Andrew Cooper (Mid Cheshire) (Lab)]

Is the hon. Gentleman aware of the recent review conducted by King’s College London that looked at evidence from 40 studies in 17 countries? It found no clear evidence of an increase in the prevalence of ADHD; rather, there was greater awareness and acceptance, which was likely to cause more people to seek help and diagnosis.

[Freddie van Mierlo]

The hon. Gentleman is right to point out that increased awareness of a condition naturally leads to an increase in the number of people seeking diagnosis. I believe the same was true of left-handedness when that became less of a taboo.

I am told that seeing every person who is on a waiting list could cost as much as £3 billion to £4 billion. We must therefore find a way to target urgent, psychiatrist-led care where it is most needed, and to triage early so that the most severe cases get support, along with those who are already taking powerful medication. To that end, I welcome and commend the Government on the launch of the taskforce in March 2024. From the discussions that I have had, however, I know that the communication with ICBs has not been good enough.

The initial data from the taskforce shows that an estimated 2.5 million people in England have ADHD, with more than half a million on waiting lists. To end this farce, we need a system that is adapted to manage the new volume of patients with appropriate levels of care. It does not help to say that there is an overdiagnosis of mental health conditions, as the Health Secretary has said; rather, we need to look at models that will diagnose and treat all patients using the most appropriate tool for their level of need. A good start would be to include ADHD in the 18-week pledge on first appointments. Currently, ADHD treatment is not considered a consultant-led area, even though GPs cannot diagnose. Waiting times should be defined by ICBs, with NICE guidance.

The consequences of getting it wrong are clear. ADHD is a leading cause of school exclusions, lower academic achievement and increased drop-out rates, and 25% of the UK prison population has ADHD, with untreated symptoms often driving impulsivity and crime. Untreated ADHD is also strongly linked to substance misuse, family breakdowns and severe mental health issues.

[Rachel Gilmour (Tiverton and Minehead) (LD)]

I speak as the mother of man who was not diagnosed with ADHD until he was 31. Fortunately for him, he has a very good employer who has made his life considerably easier than it might otherwise have been. However, I am appalled to have found out recently that great institutions such as the British Army, the RAF, the Royal Navy and the police actively discriminate against people with ADHD and simply will not employ them. Does my hon. Friend agree that that is simply outrageous? Will he join me in calling on the Minister to change that?

--- Later in debate ---

[Freddie van Mierlo]

I thank my hon. Friend for her powerful intervention and join her in that call.

For some constituents I have spoken to, it is simply a case of having access to a service that keeps their condition managed well, just as we provide for diabetes, thyroid conditions, hypertension and other chronic conditions. If we get that right, people with ADHD can get on with their lives, build families and bring in taxes for the Exchequer just like everyone else.

Before I finish, let me touch briefly on the severe ADHD medication shortage that so many Members have shown interest in. To my knowledge, the most acute need has now abated, and fortunately most of my constituents are getting the medications they need, but what plans do the Minister and the Government have so that it does not happen again? I look forward to the Minister’s response.

--- Later in debate ---

[Karin Smyth]

I will come on to shared care agreements. As the hon. Member says, this is a devolved matter, and I am focusing on support for issues facing ADHD services in England and what we are doing to support trusts to get back on top of waiting lists and improve access to services.

First, NHS England has commissioned an independent ADHD taskforce, which is working to bring together those with lived experience and experts from the NHS, education, charity and justice sectors. The taskforce is developing a better understanding of the challenges affecting those with ADHD, including timely and equal access to services and support. I can confirm today—I know that this will be of interest to many hon. Members—that the taskforce will publish its interim findings shortly, with a final report expected after the summer recess. The interim report will helpfully focus on recommendations that support a needs-based approach, beyond just the health system, in which people can access support based on their needs, not their diagnosis. The report will also set out recommendations for support to be provided beyond medication, and by healthcare professionals other than specialists.

Secondly, NHS England recently published an ADHD data improvement plan to inform future service planning, and on 29 May it published management data on ADHD waiting lists. Thirdly, it has been capturing examples from ICBs that are trialling innovative ways of delivering ADHD services and using that information to support systems to tackle waiting lists and provide support.

Fourthly, as part of the Government’s five long-term missions, we have launched the 10-year plan to deliver the three big shifts that our NHS needs to be fit for the future: from hospital to community, from analogue to digital, and from sickness to prevention. All those shifts are relevant to supporting people in all parts of the country with a range of conditions such as ADHD.

Fifthly, we are supporting innovation. Earlier this year, at a parliamentary event, many of us will have met innovators who are supported by NHS partners. I heard about the QbTest technology that complements the knowledge and skills of clinicians as part of the ADHD assessment process. I understand that 70% of NHS children’s ADHD services already use that technology, and the evidence suggests that it has a positive impact in making the assessment process swifter and simpler.

[Freddie van Mierlo]

Will the Minister comment on the fact that in Oxfordshire there is no commissioned service for the specialist reviews that NICE requires annually as a condition of being on the powerful medication? How can it be that someone can be started on medication but have no route to continue on it because they cannot get their annual review?

[Karin Smyth]

I am not aware of the detail of the pathway in the hon. Member’s ICB. I suggest that that is a matter for him to discuss with the ICB, which will have heard his question about how it is delivering those services on the ground.

Members raised issues around shared care agreements and the difficulties that people with ADHD are experiencing in accessing medication through such agreements, particularly when they have received a diagnosis through a private provider. It is the responsibility of secondary care specialists such as consultants, rather than GPs, to initiate treatment of ADHD. However, sometimes a shared care agreement, in which the GP takes over monthly prescriptions and routine monitoring once the patient is happy with their medication and dosage, can be put in place. The General Medical Council, which regulates and sets standards for doctors in the UK, has issued guidance to help GPs decide whether to accept shared care responsibilities for any condition. NHS clinicians need to be content that any prescriptions or referrals for treatment for any condition are clinically appropriate. All shared care arrangements are voluntary, so even where arrangements are in place, practices can decline shared care requests on clinical or capacity grounds.

If I may, Ms Jardine, I will take the opportunity to update the House on the supply of medicines, which has also been raised by colleagues; I understand that it was raised at business questions recently, too. The Government recognise the difficulties that some people have experienced with accessing ADHD medication due to medicine supplies. We know how worrying and frustrating those shortages are for patients and families. I am pleased to say that we have resolved many of the outstanding issues affecting the supply of lisdexamfetamine, atomoxetine capsules, atomoxetine oral solution and guanfacine prolonged release tablets. However, some specific manufacturers continue to have issues with methylphenidate.

We continue to work with manufacturers to resolve remaining issues. In fact, I met the medicine supply team this morning, as I do very regularly, to make sure we are on top of these issues as much as we can be. The team is working hard to make sure that the situation improves. Where issues remain, we are directing suppliers to secure additional stocks, expedite deliveries where possible, and review plans to support continued growth in demand for the short and long term. We have worked with specialist clinicians during this time to provide comprehensive guidance to healthcare professionals where there is a disruption to supply. We keep the Specialist Pharmacy Service website up to date with the latest availability of ADHD medicines. I commend it to people listening to the debate and to hon. Members. It also provides comprehensive guidance on switching to alternative treatments, supporting clinicians to make informed choices with their patients.

I can assure colleagues that, as the Minister responsible for medicine supply, I will instruct officials to keep a close eye on this issue, so we do not see any of the progress we have made undone. I plan to hold an event, hopefully in Parliament and possibly in the autumn, to keep updating hon. Members on this issue, because I know it is one that concerns us all.

In closing, I want to address the young people who may be watching or tuning into the debate at home. I know it is tough for many neurodivergent kids today. You might be stuck on a waiting list, suffering at school or struggling to find your medicine. We really do care about this. We are trying to get to grips with some of the problems we found when we came into office, and I hope you will start to feel that progress within the next few years.

Dementia Care

Freddie van Mierlo Excerpts

Tuesday 3rd June 2025 Commons Chamber

[Freddie van Mierlo (Henley and Thame) (LD)]

I congratulate my hon. Friend the Member for South Devon (Caroline Voaden) on securing this very important debate. There is hardly a healthcare issue so big that we do not talk enough about as dementia. Perhaps that is because it is one of the most feared diseases, for understandable reasons.

For decade upon decade—unlike cancer, for example—there has been very little tangible scientific progress, until recently. As the chair of the all-party parliamentary group on access to medicines and medical devices, I will focus my remarks on those treatments. Breakthroughs are coming through thick and fast, with the UK’s Medicines and Healthcare products Regulatory Agency approving two disease-modifying therapies in 2024 for Alzheimer’s. Those medicines chart a path to a time when Alzheimer’s and other forms of dementia are a treatable condition that can be delayed to the point where it is, for all intents and purposes, cured. That is incredibly exciting for families such as mine with a history of Alzheimer’s, and more is on the way.

More than 100 medicines are being investigated, so it is a matter of not if, but when new medicines come forward, yet the UK is not ready. The alarm has been raised, but no one is listening. The last Government were asleep at the wheel, and I fear that this Government are too. Moving from a system focused entirely on care to prevention and treatment will require a monumental shift in thinking that breaks down departmental silos and redistributes budget to treatment. We know that reversing brain damage is nigh impossible, but preventing it is not. That is why early detection and diagnosis are so critical.

Dementia begins without symptoms as early as people’s 40s or 50s. We need to identify those people before the onset of decline, but that requires a system with sufficient diagnostic capacity. That means improved GP waiting times, increased capacity at memory clinics and a massive increase in magnetic resonance imaging, positron emission tomography and lumbar puncture test capacity. The lack of capital investment in our NHS has left us dangerously exposed, with the lowest number of MRI scanners per capita in the OECD. The UK has 6.1 systems per million people. In Germany, the rate is 30.5. Emerging diagnostics, including the blood biomarkers being investigated at the Warneford in Oxfordshire, need to be embraced alongside getting the basics right.

The Government must also look actively at how the National Institute for Health and Care Excellence assesses new medicines in dementia. Both lecanemab and donanemab were approved by the MHRA and then rejected by NICE on the same day. That means the MHRA believes these medicines are safe and effective, but NICE believes them too expensive for the NHS, because it fails to consider the economic and social benefits, including savings to informal care.

Do we want a system where those who can pay privately for medicines that delay dementia get treatment, and those who cannot, do not? Even when a new therapy is approved by the MHRA, given the green light by NICE and by some miracle we have diagnostic capacity, patients still may not get their hands on it. Depending on how a new medicine is delivered, we may not have enough infusion capacity. If it is a pill, we will be in luck, but we cannot bank on that. The truth is that the NHS cannot cope with the innovation we all want in dementia. My message to the Government is simple: get ready.

I hope the Minister for Care will take note of one final point: please stop punting problems down to the ICBs. My recent written parliamentary question, asking what steps the Government are taking to increase the number of Alzheimer’s disease specialists, was answered by him yesterday, and he said:

“The provision of dementia health care services is the responsibility of local integrated care boards”.

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

The hon. Member is making a powerful speech, especially with that last point. Is he, like me, concerned that ICBs will have their funding cut by 50%? Dementia will be one of the many conditions that will suffer because of that.

[Freddie van Mierlo]

Like the hon. Member, I am incredibly frustrated that whenever I put concerns to the Minister, I get pointed towards the ICBs, and when I talk to the ICBs, they tell me to talk to the Minister. There must be responsibility within our system. The Minister has been in politics for longer than me, but I hope he will allow me to offer him a little advice. It is not the ICBs that the people of this country are angry with when it comes to not getting the treatment they deserve; it is the Government. They expect the Government to take responsibility, not pass the buck.

Mental Health Bill [Lords]

Freddie van Mierlo Excerpts

2nd reading
Monday 19th May 2025 Commons Chamber

[Dr Chambers]

My hon. Friend will not be surprised that I agree with her; she may as well have read the next bit of my speech. She is completely right. Farmers, those working in agriculture, military veterans and their families, mothers in the first year after childbirth, people living in poverty and the LGBTQ+ community are just a few of the groups that we know are at heightened risk.

We already take a proactive approach when it comes to physical health; we have targeted cancer screenings for at-risk demographics. We should take the same approach to mental health. That is why the Liberal Democrats have long called for properly resourced community mental health hubs, which could reach people before they reached crisis point. We are also calling, as my hon. Friend just did, for regular mental health check-ups at key life stages—for example, when someone has just given birth or just been discharged from the Army.

[Freddie van Mierlo (Henley and Thame) (LD)]

My hon. Friend is outlining the treatment options for patients. New medicines are also incredibly important, and groundbreaking research is happening at the Warneford hospital in Oxfordshire, a mental health hospital that is in desperate need of investment. Treatment options and new medicines go hand in hand, so does he agree that the Government should get behind the Warneford and invest in it?

[Dr Chambers]

I agree with my hon. Friend and thank him for his intervention.

Mental health MOTs could help to catch at-risk people early, so that we can start treating them before the problems develop further. I am sure that for all Members present mental health issues are among the top areas in our email inboxes and our correspondence. We receive emails from desperate parents of young people who are left on waiting lists for years throughout their schooling, and from adults falling between the cracks of an overstretched system. We should probably acknowledge that these are not anomalies. They are the symptoms of a system that is under immense strain. This long-awaited Mental Health Bill is a very welcome step, but it cannot be the only step, because at the heart of our approach must be the simple principle that prevention is better than cure.

Oral Answers to Questions

Freddie van Mierlo Excerpts

Tuesday 6th May 2025 Commons Chamber

[Karin Smyth]

I absolutely join my hon. Friend in recognising the importance of supporting women’s health throughout pregnancy and into parenthood on Maternal Mental Health Day. We are committed to improving the support available, and it will form an important part of our 10-year plan. We are investing £126 million in family hubs and Start for Life services, to support parents from pregnancy to their child’s early childhood, and we will continue to work with her on this.

[Freddie van Mierlo (Henley and Thame) (LD)]

I thank the hon. Member for Aylesbury (Laura Kyrke-Smith) for her question and the Minister for her answer. I am delighted to be forming the all-party parliamentary group for fatherhood. Will the Minister outline the steps that she will take to improve perinatal mental health for fathers?

[Karin Smyth]

I congratulate the hon. Member on taking forward that work. The Minister responsible will be happy to continue to work with him in any way possible to support that work on this important aspect of parenthood.

Hospitals

Freddie van Mierlo Excerpts

Wednesday 23rd April 2025 Commons Chamber

[Freddie van Mierlo (Henley and Thame) (LD)]

Hospitals matter to everyone, but hospitals falling apart help no one—not patients, not staff and not the economy. The Government have called the NHS “broken”. They rightly blamed the Conservatives, and criticised the NHS’s management under their leadership, so why are the Government now making the same mistakes?

Under the revised new hospital programme, the building of the Royal Berkshire hospital will not commence for another decade. There is little prospect of a new Royal Berkshire to serve the communities of Henley, Reading, Newbury, Bracknell and Windsor until the 2040s. Doctors who have worked in the NHS for over 30 years believe that they will never work in modern buildings. The cancer centre alone is 164 years old.

[Sarah Dyke (Glastonbury and Somerton) (LD)]

My hon. Friend talks of members of staff with long service. A former nurse with 40 years’ experience in the NHS recently contacted me. She took her husband, who has complex needs, into hospital, as he had a hand infection, and they were forced to wait for over 12 hours in a tiny cubicle with no ventilation. It pained me to hear that story. She worked so hard for the NHS, which she felt was down on its knees. Does my hon. Friend agree that this is a damning indictment of the state of our hospitals, and that we urgently need to pursue a major 10-year capital investment programme to get them back up to speed?

[Freddie van Mierlo]

My hon. Friend is right to point out the impact of the state of the NHS on the brilliant people who work there. My sister is a nurse in the Royal Preston hospital, and she tells me just how hard it is to walk past people who are being cared for in corridors. Every week at the Royal Berkshire, an operation is cancelled due to power cuts, water supply issues, broken lifts or malfunctioning temperature controls. Those are lost appointments and lost efficiency for the NHS. Floods and sinkholes plague the foundations of the Royal Berkshire hospital, which now requires relocation, and identified suitable sites are set to be put on the market at the end of this year. Further inaction by the Government will mean that those carefully laid plans and that funding will amount to nothing.

There are also hospitals that were never considered for the programme, as my hon. Friend the Member for Oxford West and Abingdon (Layla Moran) pointed out. I recently visited the Warneford hospital in Oxford, which gives in-patient care to patients with severe mental health conditions, including schizophrenia, personality disorders and psychosis. I was shocked by the conditions that patients live in. They are in tight spaces in dark rooms, and the infrastructure is Georgian. There were rooms that reminded me of recent visits to HMP Huntercombe. I said that rather nervously to the member of staff showing me around, worried that I might offend them. They gently held my arm and said, “Freddie, why do you think we showed you these rooms?”

Staff told me that cramped conditions make it difficult to take breaks during the day. One worker showed me their windowless cupboard office—hardly great for their own mental health. Staff also told me how working in Georgian buildings impacts the quality of their work. Sight lines in common rooms are obstructed by pillars; rooms are difficult to heat; and security is difficult to maintain. A new Warneford would cost a fraction of the price of a physical health hospital, and the Government promised to put mental health on the same footing as physical health, so why does the revised new hospital programme not include a single mental health facility?

Both the Warneford and the Royal Berkshire have been devastated by the Government’s lack of foresight. The cuts to hospital spending are a decision made to save money, but that is a false economy. Over the next 10 years, repairs to the Royal Berkshire hospital are projected to cost £400 million—a quarter of the cost of a new hospital. Add to that the many other neglected hospitals, and the loss is unthinkable. Proper investment in modern infrastructure is needed now.

In my constituency we have the Townlands Memorial hospital, which shows how good the NHS can be with modern infrastructure. Anyone who receives care there, whether through the Royal Berkshire NHS foundation trust or the Oxford Health NHS foundation trust, sings its praises. It hosts over 30 specialities and plans to expand further. Let us give our hospitals the chance to excel.

[Several hon. Members rose—]

National Cancer Plan

Freddie van Mierlo Excerpts

Tuesday 4th February 2025 Commons Chamber

[Andrew Gwynne]

I cannot even begin to think what it would be like to lose a child full stop, but to lose them to cancer would be horrific for their parents. I pay tribute to Lorraine for all the campaigning she has done on this. I am more than happy to meet my hon. Friend and Lorraine to talk about this, but the whole reason for putting the taskforce back on an operational footing is so that we can make the changes that she and Lorraine want to see.

[Freddie van Mierlo (Henley and Thame) (LD)]

Members across the House will be all too familiar with constituents reaching out to let them know that safe, effective new medicines are not approved by the National Institute for Health and Care Excellence. The Minister speaks of research and the need for access. Will he commit to being a critical friend of NICE, to ensure both good value for the taxpayer and good access for patients?

[Andrew Gwynne]

The hon. Gentleman makes a good point. NICE is there for a particular reason: to ensure that the drugs being developed are available on the NHS when they meet the required threshold. Of course, we want to ensure that as new treatments become available, they are available for British patients. The work that is being done with Moderna and other pharmaceutical companies will ensure that British patients have access to some of the latest treatments as they come through the pipeline.

Access to Primary Healthcare

Freddie van Mierlo Excerpts

Wednesday 16th October 2024 Commons Chamber

[Freddie van Mierlo (Henley and Thame) (LD)]

I very much welcome this debate. GPs are rightly pillars of our community—doctor remains one of the most trusted professions, perhaps unlike ours—but I want to mention some of the other key professions in the primary care sector, including practice nurses, who dedicate their lives to working on behalf of our residents.

Right now, practice nurses are working hard to deliver flu, covid, RSV and shingles jabs to many of our residents. They are the unsung heroes who keep primary care going, but their number is declining due to wage constriction. New nurses looking to boost their salaries often opt for hospital-based care because they can improve their pay packet with unsocial hours payments. Mental health nurses, healthcare assistants and social prescribers also provide essential services, and we must not forget receptionists, who bear much of the public’s frustration after 14 years of failed government. They have my thanks.

GPs are in crisis. The Tories let waiting times soar and failed to deliver a new framework contract for GPs in time, leading to industrial action. I am very concerned that in my area we have sleep-walked into a two-tier health system, with long waits for those who cannot afford private care and access for those who can. In Henley, we are seeing the first fully private GP practices and many people going for jobs with corporate insurance plans. There are now routinely four-week waits in places such as Thame, Benson, Watlington and Chalgrove, where we have seen significant housing growth. As my hon. Friend the Member for Didcot and Wantage (Olly Glover) mentioned, developer funds have been collected, but in Oxfordshire they are not being released in time to deliver the infrastructure that is needed.

I want to highlight the impact of those waits on some of the most vulnerable people. I recently spoke to my constituent Suzannah Windsburrow, a tenacious campaigner with learning difficulties, who highlighted to me just how important timely access to healthcare is for her. The collective impacts of a lack of access mean that people with learning disabilities die earlier than those without one—23 years earlier for men and 27 years earlier for women.

I very much welcome the Liberal Democrat commitments on health, and I encourage the Labour party to copy our manifesto—honestly, we won’t mind—including our commitments to ensuring that people can see a GP within seven days or, if it is urgent, 24 hours; to 8,000 more GPs; and to providing a named GP for people over 70. I also hope that Labour will copy our very important policy on delivering mental health professionals in schools.