NHS Continuing Healthcare

Iqbal Mohamed Excerpts

Wednesday 25th March 2026 Westminster Hall

[Ayoub Khan]

I absolutely agree. There is an unnecessary burden on families to start off with, and when the appeal process can take months and it is difficult for families to secure representation—they may end up representing themselves—that causes them further anxiety. I agree that there needs to be a review of the whole system, because it is a further bottleneck in an already very stressful situation for families. I will come to an example of a family I am trying to assist in that regard.

In many cases, decisions are overturned and the status quo is restored. We must be honest about what is driving this. It is the same culture of cuts and austerity, sweeping across this Government and the previous one, that is to blame for the crisis. Independent analysis shows that CHC spending decreased by 42% in 2024 compared with previous years, even as need continued to grow. That is not because people are suddenly less ill, but because access is being constrained.

Investigations have also revealed that private companies are being contracted to review CHC eligibility and, in some cases, to reduce care packages, raising serious ethical concerns about profit being tied to cuts in vital care provision. A system where decisions are not always driven by clinical need but by cost containment will inevitably fail to protect and care for some of our most vulnerable individuals.

My constituent Daniel has experienced the injustice of the CHC process at first hand. He suffers from severe learning difficulties, autism, anxiety and behaviour of distress, and is cared for by his elderly parents, Linda and Dave. In order to receive the proper care, Daniel is supported every day by six personal assistants, all of whom are being paid thanks to CHC funding. After an annual review in January last year, it was confirmed that his condition had not changed and therefore his funding ought to continue, and yet, since a spontaneous and unwarranted review of the decision, Daniel’s eligibility has been under excessive and unreasonable scrutiny. The reassessment directly contravened the national framework for CHC, which states that a full reassessment must be arranged only if there is

“clear evidence of a change in needs to such an extent that it may impact on the individual’s eligibility”.

The saga was concluded two weeks ago when, despite providing no clinical rationale for the “significant change” in Daniel’s medical needs, the care board revoked his funding, leaving his parents to foot the bill for his care. For more than a year, Linda and Dave have carried on their fight against the care board’s impropriety, which has understandably come at a great financial, emotional and personal toll, all while continuing to care for Daniel. Unfortunately, Daniel’s story is neither exceptional nor surprising. It shows how many of those reliant on Government support are being stripped of it in the blink of an eye.

The stories of Daniel and so many others show exactly what is wrong with the system. Since 2017, despite an ageing population and increasing complexity of need, the number of people eligible for CHC has fallen by more than 9%. Over the same period, the proportion of people found eligible after a full assessment has dropped dramatically, from around 31% to just 18.6%. That means that more people are being assessed, but fewer are receiving support.

For families, that often means a gruelling process, characterised by a mire of lengthy assessments, appeals, delays and uncertainty, at the most difficult time of their lives. Confusion, exhaustion and distress are mainstays of that process. Even for those who are fortunate enough to be granted CHC funding, it can be withdrawn upon review, leaving families in a state of permanent anxiety that they could be plunged back into crisis at any moment.

Behind every statistic is a family caring for a loved one with dementia, a neurological condition or even a severe disability—a family forced to give up work, drain their savings or even sell their home, all while navigating a system that is rigged against them from the start.

[Iqbal Mohamed (Dewsbury and Batley) (Ind)]

I congratulate my hon. Friend on securing this important debate. I wholeheartedly agree with him, in particular about his constituents who had the support that their child needed for many years, had an annual review that reconfirmed that that support was necessary, and then suddenly, out of the blue, faced a challenge by some new body or process. Does he agree that there should be a clear, transparent process that is easy to understand by families who go through it, that there should be clear checks and balances to ensure that families receive a fair hearing, and that, when support is agreed and secured, it should be maintained until the next formal review is required and the criteria and conditions have changed?

[Ayoub Khan]

I wholeheartedly agree. One of the difficulties in Daniel’s case was that an assessment found that there was no material change in the level of support that he required, but a reassessment was conducted subsequently, and the funding was then withdrawn. I met Daniel, and I felt so sorry for his parents, who are now struggling because of the withdrawal of the funding. It is shocking that someone can sit somewhere and make a desk-based reassessment of someone’s condition and then strip them of funding. I am confident that the family will ultimately secure funding, but the stress that they are going through is simply unacceptable.

I urge the Minister to review Daniel’s case. I recall writing to him on this very matter in July last year. He replied that the operational delivery of CHC is the responsibility of integrated care boards. Care boards do indeed have delegated autonomy to make funding decisions, but they must follow national guidance, and the Government have the power to act when those duties are breached. I would welcome the Minister’s reflecting on his stance on this matter. At the very least, will he meet me, Linda and Dave so that he can gain insight into how the system is failing people like Daniel? Caring for our loved ones should not be subject to a cliff edge or an all-or-nothing gamble. If we want to build an NHS fit for the future—one that delivers care closer to home and puts patients first—then fixing CHC must be a core part of that mission.

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[Iqbal Mohamed]

It is the responsibility of ICBs to administer and provide this support, but does the Minister share my concern and that of my hon. Friend the Member for Birmingham Perry Barr (Ayoub Khan) that the involvement of private contractors in eligibility reviews may not be appropriate? The ICB may feel that responsibility lies with the private contractor to guide it, rather than owning its decisions.

[Stephen Kinnock]

Of course, we want to see consistency and quality right across the board, regardless of who is actually delivering the work. If there are specific issues around private contractors that the hon. Gentleman can flag to me, perhaps he could write to me; we would be very happy to look into them.

We have committed to reduce the running costs of integrated care boards and to redirect that funding to frontline services. To deliver that, our 10-year health plan sets out that integrated care boards must focus on their role as strategic commissioners, ensuring the best possible value in securing local services that improve population health and reduce inequalities. However, NHS England has been clear that, although transformation is required, it must be carried out with clear safeguards in place to protect frontline responsibilities. Legal duties in relation to NHS continuing healthcare must continue to be met. This means that running-cost reductions should aim to make administrative and corporate functions more efficient. They are not there to change funding for direct care or statutory duties.

I acknowledge that integrated care boards have worked intensively to strengthen their plans for 2025-26, focusing on areas where efficiencies and savings can be made. I thank NHS England for working with integrated care boards to monitor spend against these plans. The Department is working closely with NHS England on how responsibilities will be delivered from April 2027 onwards, when—subject to the will of Parliament—NHS England will be abolished. Until those changes are made, the Department and NHS England will continue to carry out their respective statutory functions. In the interim, teams are increasingly working together closely under an interim joint leadership team, including on NHS continuing healthcare.

Fundamentally, addressing some of the issues that hon. Members have discussed today will require wider reform of the social care system. That is why Baroness Casey is chairing an independent commission into adult social care. The commission has a clear mandate to undertake the most comprehensive review of adult social care in a generation. With Baroness Casey as its chair, it will cut through the political stalemate, identify what the country needs and wants from adult social care, and support the Government in establishing a system that works.

Baroness Casey has made it clear that she will not wait until the end of the commission to recommend action where she sees fit to do so. Hon. Members may have seen her speech at the Nuffield Trust summit on 5 March. I thank her for setting out recommendations for immediate action on adult social care, which focused on three key areas: safeguarding, dementia and motor neurone disease. We will not waste time in taking those recommendations forward. We look forward to reviewing Baroness Casey’s phase 1 report, which is due later this year and will set out further recommendations to address immediate priorities for adult social care in this Parliament, laying the groundwork for long-term reform and setting us on the path to delivering a national care service.

In her recent speech, Baroness Casey rightly raised challenges with NHS continuing healthcare. We are carefully considering her reflections. I acknowledge existing tensions between integrated care boards and local authorities regarding NHS continuing healthcare eligibility decisions. Those decisions hinge on whether the support required by an individual is above the limits of what the local authority can provide. Integrated care boards must consult with the relevant local authority before making any decision about an individual’s eligibility for NHS continuing healthcare, putting individuals at the heart of the decision-making process.

However, I acknowledge that, in practice, it is not always straightforward to determine clearly who is responsible for meeting an individual’s needs, so we are working with NHS England to better join up support between the NHS and local authorities, exploring areas where good joint working is helping to improve outcomes for people accessing NHS continuing healthcare. Through the development of our neighbourhood health services, local authorities and integrated care boards are encouraged to consider how services can be reconfigured to focus more on prevention and early intervention, embedding new ways of working to set the direction of travel for future years.

I want all individuals who are eligible for NHS continuing healthcare to receive support in a timely manner, and I want the assessment process to be as smooth, clear and transparent as it possibly can be. We know that eligibility rates can vary from year to year, and across regions and integrated care boards. That variation often exists for good reasons, including differences or changes in the health needs of local populations or individuals over time. To check that the variation is warranted and justified, NHS England continues to monitor eligibility rates by undertaking detailed work to compare eligibility and referral rates between integrated care boards. When it identifies unwarranted variation between integrated care boards with similar demographics, it follows up and seeks to ensure coherence and consistency.

My Department is also engaging with local areas to explore current work on eligibility disputes, and how they address those challenges. There are no quick fixes, but we remain committed to supporting the sector to improve outcomes for individuals. I want to stress that while disputes between organisations are being resolved, individuals must never be left without the appropriate care and support.

There is a robust dispute resolution process in place for when a full assessment for NHS continuing healthcare has been undertaken and the person or people concerned disagree with the outcome. First, an individual or their representative can ask for a local review from the relevant integrated care board. All integrated care boards should have developed a local resolution process that is fair, transparent and includes timescales. Where it has not been possible to resolve the matter locally, an individual may apply to NHS England for an independent review panel to review the decision. Finally, if the original decision is upheld and there is still a challenge, the individual can make a complaint to the Parliamentary and Health Service Ombudsman.

I was very sorry to hear from the hon. Member for Birmingham Perry Barr of the difficulties that his constituents are experiencing, and I thank him for sharing the details of Daniel’s case. I would of course be happy to receive further representations from the hon. Member. Perhaps he could start by setting out in a letter what the issues are, and then we can make sure that appropriate action is taken.

I also know that concerns have been raised about the relatively low number of individuals who are ultimately found eligible for NHS continuing healthcare after they have been referred for full assessment. The threshold for initial referral by GPs, social workers and others is deliberately set low to ensure that anyone who may be eligible is fully assessed. For that reason, many individuals will not go on to receive NHS continuing healthcare. However, an assessment is also a gateway to other forms of NHS-funded support, such as NHS-funded nursing care and joint packages of care between local authorities and integrated care boards. My Department and NHS England continue to work with partners, including the CHC Alliance, Dementia UK, the Nuffield Trust and other sector bodies. We want to support integrated care boards in delivering national policy and guidance, including on how we can achieve better join-up between the NHS and local authorities.

I congratulate the hon. Member for Birmingham Perry Barr again on securing this important debate—and I thank all those who intervened in it—so that we can continue to focus on improving services for the people who need them most. I know that this is a very challenging and emotive topic for many families who are going through extremely difficult times, and I absolutely accept that sometimes controversial decisions are made. We need to ensure that in every one of those controversial cases there is transparency, clarity and coherence. I look forward to working with the hon. Gentleman and with Members across the House to ensure that, collectively, we achieve that goal.

Question put and agreed to.

Puberty Blockers Clinical Trial

Iqbal Mohamed Excerpts

Monday 23rd March 2026 Westminster Hall

[Iqbal Mohamed (Dewsbury and Batley) (Ind)]

It is a pleasure to serve under your chairship, Mr Mundell. This is a Government who have shown that they care for the safety and welfare of children. They supported the Online Safety Act 2023 to counteract harmful digital content and removed, albeit eventually, the punitive two-child benefit cap to reduce poverty. The Government have committed to halving violence against women and girls, and have banned the pre-watershed advertising of junk food on TV.

However, the trial flies in the face of the Government’s explicit mission to protect children from harm. It would expose children to severe and irreversible harm when viable, less harmful alternatives are available. Despite that, the Government are happy to permit a clinical trial that would give puberty blockers to 226 children. Research has shown that over 95% of children who start out on puberty blockers continue on to cross-sex hormones, while other research has shown that between 60% and 98% of children with gender dysphoria will outgrow that feeling and go on to live a normal, natural, healthy life in their born body.

[Rachel Taylor]

Will the hon. Gentleman give way?

[Iqbal Mohamed]

I am going to continue, given the lack of time.

The numbers are important. They mean that the Government are choosing to prioritise the interests of between five and 90 of the 226 children involved in the clinical trial at the expense of deliberately harming between 135 and 203 children, who will eventually come to terms with their birth sex. I ask the Minister, will the Government now confirm that the current pause—which I welcome and am grateful to the Government for—will remain in place unless and until all safety, ethical and scientific concerns are fully and transparently resolved?

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

It is a pleasure to serve under your chairmanship this afternoon, Mr Mundell. I must first declare an interest as an NHS consultant paediatrician. I thank James Esses for the petition and the thousands of people who have signed it, including many of my constituents, for enabling today’s important debate. I also thank the hon. Member for Caithness, Sutherland and Easter Ross (Jamie Stone) for leading the debate so well.

The petition asks the Government to cancel the puberty blockers trial and to safeguard vulnerable children. Perhaps it is worth considering whether clinical trials in children are a good idea in principle. The answer, of course, is yes. Children are not just small adults; they have different illnesses from adults, they present with different symptoms and respond differently to medication, and they require different doses at different ages. Properly designed clinical trials ensure that children’s medicines are safe and effective for them.

However, today we are discussing one particular trial: a proposal to give puberty blockers—gonadotrophin-releasing hormone analogues—to children, specifically for gender incongruence. Perhaps at this point it is worth considering why doctors and others prescribe medication; we do it to treat or cure disease, to treat or lessen symptoms and to aid in diagnosis.

What does this trial seek to do? On the face of it, it seeks to establish whether puberty blockers are a safe and effective treatment for gender incongruence. ICD-11 defines gender incongruence as:

“A marked and persistent incongruence between an individual’s experienced gender and the assigned sex”.

To suggest persistent incongruence with gender stereotypes is wrong could undo years or decades of rolling back gender norms. If it is not causing the person any distress, why would we want to treat it, especially when we know that most children, even those with gender dysphoria who do have distress, will get better without any puberty blockers?

Currently, there is no way to identify which children will persist with a trans identity as adults and which will not. The much-delayed data linkage study could help with that. It could enable more targeted interventions and may also provide information on the long-term outcomes for people who have taken puberty blockers in the past. However, the Government insist on pushing on with the puberty blockers trial anyway, before the data linkage study is complete. Why? In written parliamentary questions, Ministers have said that they expect the data linkage study to be finished by April 2027, so what is the rush?

What is the point of the treatment? It has been suggested that it helps transgender adults pass more easily as the opposite sex and potentially avoids surgical operations in adulthood, but how on earth can it be ethically, morally or medically right to treat a large group of children with risky medication to give cosmetic benefits to a much smaller number of adults?

There are also cosmetic risks to the treatment. The penis grows very little between the ages of three and 10 years. The use of puberty blockers restricts growth, meaning those with a persistent trans identity may struggle with having enough tissue for a vaginoplasty surgery, and those who do not have a persistent trans identity may struggle with normal intimate relationships.

As mentioned earlier, the Secretary of State has said that he has confidence in this trial. Now it has been paused, we can presume that he is not quite so sure. But can we, patients and the general public have confidence in this trial? There are certainly causes for concern. In fact, there are so many that I cannot speak of them all today, but I would like to speak of a few in the time I have available.

First, on the selection of patients, we have had a dramatic change in the demographic. There has always been a small number of children uncomfortable in their own bodies, but there has been a rapid increase, which is not fully understood, particularly among girls. Many of them are in care, some have autism spectrum disorders and many are same-sex attracted. We need to understand this before prescribing irreversible treatments.

We do prescribe—and I have prescribed—drugs that are high risk or potentially harmful to children. An easy example would be chemotherapy, but that is being given to save a child’s life; it is not used to pause a perfectly normal physiological process in a physically healthy child. The risks of these treatments have been listed today, but I will list just a few: fertility problems; idiopathic intracranial hypertension; demineralisation of bone density, leading to fractures; in some studies, an increase in depression and anxiety; and the long-term loss of sexual function in some patients. We have discussed consent. How do you get consent from a parent of a child—a boy or a girl at Tanner stage 2—about long-term sexual function and fertility?

On the design of the trial, it is said to be a randomised controlled trial. Well, it is, but that is a bit of a fudge, because instead of an actual randomised controlled trial where some patients receive puberty blockers and some do not, it has given some now and some slightly later, with a very short difference in the timing. The comparison group that does not have any puberty blockers at all is taken from a slightly different population, which introduces an unnecessary bias. The trial’s organisers have said that they are doing that because they think the children would get the drugs from elsewhere or from abroad, but that is not how we do medical trials. When I have raised this issue, Ministers have responded that it cannot be blinded, but blinding and randomisation are not the same thing. The trial is also far too short to provide data on long-term outcomes.

On the process of the trial, the hon. Member for Gower (Tonia Antoniazzi) raised questions about what children are being asked as part of this trial. Why is the trial proposing to ask children about their sexual experiences? Why is this helpful to the trial?

[Iqbal Mohamed]

Will the hon. Member give way?

[Dr Johnson]

I will not because I am aware of the time.

The Commission on Human Medicines’ report heard that, because trials of puberty blockers have been blocked, some clinicians are trying to use other drugs to limit puberty, such as spironolactone and cyproterone acetate. There have been reports that the number of prescriptions for spironolactone in 10 to 17-year-olds is going up. Could the Minister confirm whether that is the case and what the Government are doing to look into it?

The MHRA was happy with the process; now it is not. What has changed? None of the issues raised seem to have not been raised before. The Government are being secretive about it: in February, Ministers brought forward a written statement referencing an MHRA letter in November, but the Minister is refusing to publish it. I have asked Ministers whether they talked to MHRA officials about the trial before February 2026, and they will not answer the question. There was a letter between the MHRA and KCL; I asked when it was received, when the Department became aware of it and when Ministers became aware of its contents. They will not tell me.

What about the people controlling the trial? As has also been mentioned during this debate, Professor Jacob George has been recused from further involvement. According to the MHRA’s statement, this is “a precaution”, because of social media posts made before his involvement. Why have those who have made the opposite type of comment not been recused too? This will inevitably make members of the public think there is bias involved.

There is an oversight board. What has the Minister done to ensure that the clinicians and scientists on that board are impartial, and that it is balanced between both perspectives? The Tavistock trial was supposed to report to the MHRA, but it did not, seemingly with no consequence. There will be lay members on the board with lived experience; will one of those be a detransitioner, or will they all be people on one side? That would increase the perception of bias in this trial.

In summary, this is a trial of risky medication on healthy children, most of whose features of gender incongruence will resolve in time, given normal puberty. What is particularly worrying is that, at the end of this treatment, the trial has so many flaws that it is bound to be disputed, whatever the result.

To give this treatment, the lead clinician will need to think that there is a reasonable prospect of a patient benefiting from puberty blockers. Given all that has been said, how can any clinician believe that that is the case? I hope we can all agree that we do not need a clinical trial to know that helping a child to be at peace with themselves and their body is infinitely preferable to a lifetime of harmful medical intervention.

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[Karin Smyth]

I am not going to give way; I am going to get through these points.

The safety and wellbeing of children and young people have always been the driving consideration in every decision we have made regarding this trial, and always will be. That is why the trial sponsor has paused recruiting until these issues can be resolved. There have been calls today to cancel the pause, to continue with the pause and to cancel the trial, but the position is that the trial is paused until the issues are resolved, because we will not compromise an inch on safety. The trial will proceed only if the regulatory approval is reconfirmed. We will provide an update on the outcome of those discussions as soon as we can.

[Iqbal Mohamed]

Will the Minister give way?

[David Mundell (in the Chair)]

Order. I think the Minister has made it clear that she is not taking interventions.

GP Contract

Iqbal Mohamed Excerpts

Monday 16th March 2026 Commons Chamber

[Stephen Kinnock]

My hon. Friend is right that it is vital that ICBs have a clear understanding of their population health needs and their demographics. It is important that the ICB is ahead of that curve and taking decisions well in advance of a practice closing down so that a commensurate service is provided; that is a really important part of the ICB’s responsibilities. If he has specific examples where he feels that his ICB has not been delivering on that basis, he is welcome to share those with me.

[Iqbal Mohamed (Dewsbury and Batley) (Ind)]

I pay tribute to the GPs in Dewsbury and Batley and the surrounding villages. The Minister mentioned preventive health. What steps are the Government taking to support GPs in their treatment of patients with preventable or avoidable diseases through the prescription of exercise and healthy foods? Secondly, we talk about online access, which is welcome—my constituents welcome surgeries that offer appointments throughout the day—but how will the Minister support the digitally excluded who cannot get through at 8 am and do not have access to online applications?

[Stephen Kinnock]

On prevention, there are some really important measures in the contract: in essence, we are recalibrating the quality outcomes framework, which is the basis for payments to incentivise the actions that GPs take. By changing the QOF, as it is called, we can shift that in one direction or the other, and we have changed it to incentivise boosting childhood vaccination rates, particularly in those areas of the country where vaccination rates are worryingly low, and better care for patients living with obesity. That is about exactly the things the hon. Member just mentioned: prescribing, if you like, exercise regimes and advising on better nutrition. We are also changing the QOF to require GPs to share data with the lung cancer screening programme. Those are just three examples of what we are doing within the contract.

On online access, it is clear that there must always be three channels of access to a GP—walk-in, telephone and online—and that for an urgent matter it would be a walk-in or a telephone call. What has really worked is that online access has taken pressure off the telephone lines as people who do not have urgent requirements have been migrating online and using the NHS app—take-up of the app is also excellent—so we are moving in the right direction.

Type 1 Diabetes: Infant Testing

Iqbal Mohamed Excerpts

Monday 9th March 2026 Westminster Hall

[Iqbal Mohamed (Dewsbury and Batley) (Ind)]

It is a pleasure to serve under your chairship, Sir Alec. I join Members across the Chamber in paying tribute to Lyla Story, and I extend my deepest condolences to her family. No parent should ever have to endure the loss of a child. The courage and determination shown by Lyla’s parents, Emma and John Story, in relentlessly campaigning to prevent other families from experiencing similar tragedy is nothing short of extraordinary.

With more than 120,000 signatures nationally, including 165 from my own constituents in Dewsbury and Batley, the petition reflects a deep and urgent concern among the general public that no parent should go through what Lyla’s parents did. We have heard about the symptoms and the consequences. Diabetes UK estimates that about 35,000 young people and children have diabetes, 96% of whom have type 1 diabetes. We have heard that one in four cases are not detected until it is too late.

I will jump to my request of the Government, which, supporting John and Emma’s campaign, is to have a national public awareness campaign explaining the four Ts across TV, radio, social media, schools, nurseries, surgeries, pharmacies and health visitor packs. Countries that have run sustained awareness campaigns, such as Italy, reduced DKA at diagnosis from approximately 40% to under 10%.

My final request—I do not have much time—is to mandate the rule that children presenting to a GP with any symptoms of diabetes should receive at finger-prick blood glucose test. Although that is in the NICE guidance, it is not enforced.

ADHD Diagnosis

Iqbal Mohamed Excerpts

Tuesday 20th January 2026 Westminster Hall

[Iqbal Mohamed (Dewsbury and Batley) (Ind)]

It is a pleasure to serve under your chairship, Ms Vaz. I thank the hon. Member for Sefton Central (Bill Esterson) for securing this important debate.

Delays and problems relating to ADHD diagnosis are not just a marginal administrative issue, but a profound failure of our system to meet medical needs early, effectively and equitably. For too many children and adults, long waits for diagnosis can negatively shape their entire life trajectory, harming their educational attainment, mental health, employment prospects and personal relationships.

NHS estimates suggest that 2.5 million people in England have ADHD, including nearly half a million children and young people, yet demand continues to vastly outstrip capacity. In September 2025, over 60% of both adults and children had been waiting more than a year for an ADHD assessment.

In my constituency of Dewsbury and Batley, Rachel reached out to me rightly outraged at an 18-month wait for ADHD assessment, with Kirklees council working through a backlog from November 2022. Another constituent, Laura, has spoken about her difficulty accessing medication even after diagnosis. The pressure on councils has been increasing on all fronts, with funding decreasing at the same time over the 14 years of the previous Government. I am not blaming the councils, but they do need support.

[Adrian Ramsay (Waveney Valley) (Green)]

I thank the hon. Member for giving way. He makes the point very strongly that long waiting times mean that children are being left behind. As we have heard, it was revealed last week that many integrated care boards are capping the number of assessments without telling GPs or patients. Does the hon. Member agree that a child’s access to diagnosis and support should not depend on where they live or whether their parents can afford to go private?

[Iqbal Mohamed]

I completely agree. We hear the phrase “postcode lottery” a lot, and we should not have a postcode lottery in our country for access to essential healthcare and educational services. Everybody should have equal access to the support that is available to other people, without having to go private.

The consequences of these delayed assessments are stark. Families are pushed towards private assessments they cannot afford, entrenching a two-tier system that makes a mockery of the NHS’s spirit of free care at the point of use by rendering access contingent upon income.

The Justice Gap also reports that around 25% of prisoners have ADHD, with many entering the system having not been diagnosed. They are more prone to reoffending.

I will conclude to give time for other colleagues to speak. I urge the Government to look at this issue holistically, as mentioned by the hon. Member for York Central (Rachael Maskell), and provide support for children, adults and offenders. I believe that investment would render a greater return.

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[Dr Ahmed]

I thank my hon. Friend for her very valid point. It is important to mention that we expect that the prevalence review will align with the review that the Department for Work and Pensions is carrying out on employability and other issues affecting disability.

NHS England is working with ICBs that are trialling innovative ways of delivering ADHD services and is using this information to support systems to tackle ADHD waiting lists and provide support to address people’s needs. I understand that it is increasingly clear to patients and staff that the current highly specialist ADHD assessment model needs to evolve quickly. Moving to a more generalist service model could improve care and reduce waiting lists. That was one of the taskforce’s key recommendations.

[Iqbal Mohamed]

Approximately a quarter of the prison population—22,000, give or take—have ADHD. Will the Government commit to an impact assessment of what savings the Government could make, and how many people’s lives could be improved, by assessing people either before they commit a crime or after?

[Valerie Vaz (in the Chair)]

Order. The Minister knows that he has two minutes.

Puberty Suppressants Trial

Iqbal Mohamed Excerpts

Wednesday 17th December 2025 Commons Chamber

[Wes Streeting]

My hon. Friend is absolutely right. Given that I work for a former Crown prosecutor, I could not possibly disagree with her on evidence.

[Iqbal Mohamed (Dewsbury and Batley) (Ind)]

I thank the Secretary of State for his response to the urgent question. One thing we should all agree on is that the human rights of all, including trans people, must be protected and delivered by the Government and supported by us all. The reason we are here today is to discuss the risks and potential adverse consequences of the proposed pathways trial. The trial compares the timing of treatment initiation, rather than using a placebo. There is no arm that provides psychotherapy as a treatment option without puberty blockers, and there is no arm to assess children who do not receive any of those options. Will the Secretary of State consider ensuring that all the various arms and channels are tested as part of this trial to get a complete picture, rather than a partial picture, which may be misleading?

[Wes Streeting]

May I thank the hon. Member for the way in which he put his question? It is so important to emphasise that right across this House, there are many people who oppose this trial, but who do want to see trans people well supported and protected and to respect their identities. That is important for everyone to bear in mind.

The hon. Member talks about placebo. For obvious reasons in this case, a placebo would not be appropriate, because it would be very obvious whether a young person was receiving the real medication or the placebo, but the trial design has included a control group. The way in which the trial is established will help us to distinguish between the benefits of receiving or not receiving this particular medication, and there will be really close oversight of the impact on development, but he is right that we need to judge these things on the question of risk. That is what led Dr Cass to make her recommendation, and that is why I support it.

Terminal Illness: Mental Health Support

Iqbal Mohamed Excerpts

Wednesday 3rd December 2025 Westminster Hall

[Iqbal Mohamed (Dewsbury and Batley) (Ind)]

It is a pleasure to serve under your chairship, Sir Jeremy. I thank the hon. Member for Altrincham and Sale West (Mr Rand) for bringing this important topic for debate.

When we talk about mental health, we often picture everyday stress, anxiety or the long waits for talking therapies, but there is a group of people whose mental health needs are profound, urgent and too often invisible: people living with a terminal illness. That is not a topic that we often think about in the grand scheme of mental health provision, but the need for emotional and mental support in that medical situation is momentous—a need that I hope none of us here ever experience.

Mental health services and support in our country are at breaking point. More than 1.5 million adults in England—not necessarily suffering from a terminal illness, but just adults generally—are waiting for mental health support and treatment, and more than 500,000 children. Patients are eight to 12 times more likely to wait for mental health treatment than they are for physical health support. While waiting, approximately 42% of patients deteriorate and seek further assistance through A&E and other NHS services, increasing the burden on our already stretched NHS.

For people with a terminal illness, the situation is even grimmer and bleaker; it brings fear, grief, uncertainty and, for many, isolation. Those feelings affect not just the person who is diagnosed, but partners, children and family members, who carry the emotional weight of uncertainty and the news they have just received. Yet mental health support at the end of life is still inconsistent, still underfunded and still far too dependent on location and charity rather than on rights and entitlements. Right now, access to mental health support at the end of life is a postcode lottery—one of the most troubling parts of this whole issue. In some areas, people can receive specialist psychological support, family counselling or bereavement services as part of their palliative care; in other areas, those services simply do not exist.

Whether someone receives help often comes down to the resources of their local hospice, the strength of its fundraising base or the priorities of an overstretched local health system. That creates a deep and unacceptable inequality. Families in the most deprived communities—such as those in my Dewsbury and Batley constituency and in wider Kirklees—already at higher risk of poor health outcomes, are often those with the least access to emotional and mental health support at the end of life. Wealthier areas can sometimes raise the funds to keep services going; poorer areas cannot.

A person’s final moments should not be shaped by how affluent their postcode is or whether their local hospice can afford another counsellor that year. If we are serious about dignity in palliative care, then we must be serious about ending that inequality. Mental health support should be a guaranteed part of end-of-life care everywhere, not a privilege that depends on geography or charity fundraising.

A few weeks ago, I attended a meeting with Forget Me Not hospice in West Yorkshire here in Parliament with other MPs from Kirklees. Forget Me Not staff spoke powerfully about what it means to support people to live well until the end of life, and to die with dignity, comfort and emotional support. They welcome the recent £100 million capital funding, which will allow them to keep operating or to repair their facilities, but they are still short of revenue funding to maintain the staffing levels that they had. This coming year, they have had to cut £1 million from their budget, reducing the number of spaces available for treatment in their two hospices by 800 out of 2,100. The impact on Kirklees and my constituents is severe.

I believe that the Government guaranteed three years of funding for revenue costs for hospices, but £25 million is a drop in the ocean. I ask the Minister to set out what the Government will do to address the huge shortfall in funding for hospices across our country. Without that additional funding, hospices are reducing staff or cannot plan staffing beyond three years now—before it was for one year. They cannot provide specialist therapy or mental health provision with certainty. Yet hospices are the very places offering the kind of care our NHS simply cannot replicate: time, counselling, bereavement support and a community that wraps around the entire family. They are asked to do more every single year, with less stability to do it.

People with terminal illnesses need more than medication and pain management; they need psychological support to process what is happening to them. They need space to talk about fear, leaving family behind and loss of identity. Families—often the forgotten grievers—need support too. No one should spend their final months fighting for the counselling that might help them face the end of life with peace rather than fear. Believing in dignity at the end of life comes hand in hand with mental health support as a core part of palliative care that we should recognise in policy and fund in practice. We owe people living with terminal illness and their families who love them nothing less.

Mental Health Bill [Lords]

Iqbal Mohamed Excerpts

Report stage
Tuesday 14th October 2025 Commons Chamber

[Iqbal Mohamed (Dewsbury and Batley) (Ind)]

This Bill gives us a real opportunity to modernise mental health care and make sure that patient choice and fairness are at the heart of mental health services, but to achieve that, we must first confront the deep inequalities that still shape people’s experience of mental health care, particularly among ethnic minority communities, those facing economic hardship and young people. Like so many issues, the intersectionality between those factors means that some groups face particular challenges in navigating and accessing the help they need.

In Dewsbury and Batley, we see the human reality of that inequality. Rates of depression stand at 15.4%, higher than the national average, and schizophrenia is also more common locally, compared with other constituencies in the UK. Across Yorkshire and the north, mental ill health is consistently higher than elsewhere in England. NHS data and mental health organisations are clear that both ethnic background and wealth disparity play a major role in that gap. People in my constituency are more likely to experience a mental health condition, yet the funding for research and specialised services in the north remains lower. That means less support, fewer beds, and fewer opportunities to provide specialist care.

That is why I strongly support new clause 13, which requires every hospital to have a named person responsible for overseeing race equality in how the Mental Health Act is applied. Black people are still four times more likely to be detained under the Act and eight times more likely to be placed on a community treatment order. Without accountability, those injustices will continue. I also support new clause 35, tabled by the hon. Member for Sheffield Central (Abtisam Mohamed), which seeks to put limits on CTOs.

We must also do far more for young people. The new clause proposed by the hon. Member for Hertford and Stortford (Josh Dean) powerfully argues for giving under-16s a clearer say in their own treatment decisions. A mother told me how both of her daughters needed mental health support, yet she had to seek private care because local services were overstretched and not up to standard. She pointed me to the Good Childhood Report, which shows that the wellbeing of children in the UK is among the lowest in Europe. I also support new clause 28, which aims urgently to address the need to stop children being placed in adult wards or sent miles away from home for treatment. I welcome the work that West Yorkshire ICB has done recently to expand mental health services for older people, but we must match that ambition for children and young people. If those commitments cannot all be secured through this Bill, they must be delivered in the forthcoming Children’s Wellbeing and Schools Bill.

Glaucoma Awareness

Iqbal Mohamed Excerpts

Wednesday 9th July 2025 Westminster Hall

[Jim Shannon (Strangford) (DUP)]

It is a pleasure to serve under your chairship for the second time today, Mr Pritchard—I am getting a liking for it. I thank the hon. Member for Leicester South (Shockat Adam) for securing the debate. As my party’s health spokesperson, issues such as glaucoma are of great importance to me—the statistics show its prevalence. I would not have thought there would ever be a case in which the hon. Member for Alloa and Grangemouth (Brian Leishman) would be lost for words, no matter what might happen; that is meant as a compliment, by the way.

As it is Glaucoma Awareness Week, there is no greater time to consider this issue. I will start by describing the scale of the issue in Northern Ireland specifically, because that is what I want to highlight. Queen’s University undertook a study that found a 2.83% prevalence of glaucoma in 3,221 people aged 50-plus—I understand that rate is normal, compared with the rest of the United Kingdom—and that around two-thirds of those were undiagnosed. There is an issue to address: those who are undiagnosed. Northern Ireland currently has some 18,000 confirmed glaucoma cases. As I have said to the hon. Member for Leicester South—he knows this story—although my dad is dead and gone, when he was alive he lost his eyesight to glaucoma. Unfortunately—they were probably just not as good at managing it in times past—it crept up on him, and he lost his eyesight. My dad was very fortunate to have my mother to look after him, in every sense of the word. They loved each other greatly. It was never a burden to my mum to look after my dad. That was really important.

I was fortunate to secure a debate on glaucoma and community optometry just last year. The hon. Member for Leicester South made a fantastic contribution to that debate. I greatly admire his knowledge of optometry, and the job he did before he was elected. When he comes to these debates he brings that fount of knowledge, experience and examples, which we all appreciate. There is such an important link between our opticians and healthcare specialists who treat eye conditions such as glaucoma. Data from Specsavers highlighted that in 2023, some 30,000 referrals for glaucoma were made for people aged 40 to 60. Not all those people were diagnosed as such, but the fact was that there were some concerns, and the treatment for them was able to start.

I have some stats for Northern Ireland that I want to quote for the record. Regarding the adoption of innovative glaucoma technologies, such as iStent inject, two of the biggest eye surgery hospitals in the country—Altnagelvin area hospital and Belfast city hospital—now routinely offer such combined procedures to comorbid glaucoma and cataract patients. The focus is now on making sure that no glaucoma patients miss out on the opportunity to intervene in glaucoma at the time of routine elective cataract surgery. The advances are incredible at this moment in time.

As of March 2025—which has just passed—almost 50,000 people were waiting for ophthalmology outpatient appointments in Northern Ireland. That is a massive number, and the Minister in the Assembly back home really needs to take that on. In Northern Ireland, the prevalence of glaucoma in people aged over 50 is, as I said, comparable to other parts of the United Kingdom, and indeed other parts of Europe. The figures that we have seem to be relevant wherever we are in the United Kingdom, but also across the whole of Europe. Interestingly, around two thirds of people with glaucoma were not aware of their glaucoma, as the hon. Member for Leicester South said in his introduction. If that is generalisable from the study sample to the whole population, that rate is higher than in other comparable populations.

Glaucoma is the second most common reason for certification as sight impaired, or severely sight impaired, in Northern Ireland. On average, 13.1% of certifications are caused by glaucoma, although that varies a lot year on year. I want to tell the Minister what we are doing itenn Northern Ireland in relation to the iStent inject surgery. That is a massive, technological, medical, modern way forward. It is good to be able to report it in this debate.

[Iqbal Mohamed (Dewsbury and Batley) (Ind)]

Under the 10-year plan, the Government want to invest in the NHS and bring services into the community. There are examples of that around our country, and maybe in Northern Ireland. There are trusts in London with diagnostic hubs that better manage glaucoma. There are regions with community glaucoma services that have reported halving hospital referrals, improving access and saving millions. There are also pilots, such as in the Royal Devon’s Nightingale model, that reduce appointments from two hours to 30 minutes. Does the hon. Gentleman agree that investing, reorganising and having a joined-up service with advanced detection will save money for the Government and save people’s sight?

[Jim Shannon]

The hon. Gentleman is absolutely right. To be fair, the hon. Member for Leicester South was clear that there is an opportunity to advance greatly under the 10-year NHS plan to solve the problems. There are better ways of doing things and reducing waiting times.

We are fortunate to have two hospitals in Northern Ireland, the Altnagelvin area hospital and Belfast city hospital, where new treatment is starting and also where cataract operations can take place. Cataract operations also take place in Downe hospital, just outside my constituency. Optometrists have a key role to play because they can spot the early signs of glaucoma during routine tests. For patients with stable glaucoma, optometrists have a role in monitoring eye health and helping them manage their condition.

Ahead of this debate I was in touch with Glaukos on the steps that can be taken both nationally and within the devolved Administrations to improve the outcomes for those diagnosed with glaucoma. In his intervention, the hon. Member for Dewsbury and Batley (Iqbal Mohamed) made it clear that there could be great advances in glaucoma and for eye care and doing things better. Glaukos has educated me on the iStent injects that are implanted during cataract surgery or in a stand-alone procedure—the very things that the hon. Member for Leicester South referred to. These little stents unblock drainage and lower eye pressure with minimal risk or cost. Perhaps that is something the Minister could commit to looking at and engaging with as a means of treatment for those with glaucoma.

The Minister is always well versed on the technologies and advances. I know that when he replies to this debate he will give us some encouragement. I should say I am pleased to see the shadow Minister, the hon. Member for Hinckley and Bosworth (Dr Evans), in his place. I love doing debates with him. He and I share a passion for the subject matter. He brings a wealth of knowledge to these debates and I thank him for that.

To conclude, there are thousands and thousands of people living with the condition, but there will be thousands more to come. That is what we want to try to address. Ensuring affordable and accessible treatment is imperative. As I previously stated, and as the hon. Member for Leicester South who introduced the debate has stated, we must not underestimate the impact that our local opticians have in detecting these kinds of issues early on. I therefore urge people out there to prioritise their eye health while they can.

NHS 10-Year Plan

Iqbal Mohamed Excerpts

Thursday 3rd July 2025 Commons Chamber

[Wes Streeting]

My hon. Friend is absolutely right and it is brilliant to have her expertise represented on the Government Benches. She is right about the importance of physiotherapy, not just for improved and better-quality recovery, but for admission avoidance. I want physios and other allied health professionals to be at the heart of the neighbourhood health service, and I know that she will hold us to account to ensure we deliver.

[Iqbal Mohamed (Dewsbury and Batley) (Ind)]

I also welcome the statement and the 10-year plan, and I offer my full support for most of the elements. Staying focused on the positive, I hope to be permitted to raise three points.

First, Dewsbury and Batley is unfortunately one of the many constituencies with dental deserts. Dewsbury West, a ward with over 20,000 residents, has no dentist, so how will the 10-year plan and the Government address that for my constituents?

Secondly, I fully support the plans to move healthcare into communities. In Dewsbury, we have a local hospital in the heart of the community that, with the right investment, could serve many more. Will the Secretary of State confirm that the Government will build on what we have, rather than fragment it?

Finally, Dewsbury and Batley is home to a wonderfully diverse community, but has some of the most deprived neighbourhoods, with the associated healthcare inequalities. Will the Secretary of State agree to visit my constituency so he can hear from my constituents and healthcare professionals, and ensure that their challenges are addressed?

[Wes Streeting]

In that constructive spirit, I can assure the hon. Gentleman that those things are contained in the 10-year plan for health. These changes are only possible because people voted Labour and because we have a Labour Government. In that spirit, he can be assured that in the run-up to the next general election, I will be pounding the streets of Dewsbury.