Medical Training (Prioritisation) Bill

Jim Shannon Excerpts

2nd reading
Tuesday 27th January 2026 Commons Chamber

[Jim Shannon (Strangford) (DUP)]

As others will know, I have raised this matter a number of times in the Chamber. In Wales, for example, the health service pays students’ fees and trains them, and students then have an obligation to stay with the Welsh health service for a period of time. One of my constituents, whom I know well, did just that. She went there, received training and stayed there. What happened, of course, is that she met someone in Wales who she fell in love with, and now she wants to stay there, so we will lose her in Northern Ireland. The point I want to make is this: if paying the fees retains the staff in Wales, should we not also do that in Northern Ireland, Scotland and England? We could do so in this Bill.

[Lewis Atkinson]

There is some merit in the hon. Gentleman’s proposal, not just for medical training but across the clinical workforce. As Members have acknowledged, we pay significant sums of public money training clinical staff, but the graduates incur significant student debt. If a UK-trained undergraduate student decides to work abroad, the UK taxpayer will have invested a significant amount in their training, and that is then lost. It strikes me that there is an opportunity for the Government to think about the sort of incentive that the hon. Gentleman describes as part of wider workforce planning.

That is pertinent to my next point about the importance of the medical workforce reflecting our wider society, particularly the working class communities of the north-east of England. I want to ensure that a young person doing well at a state school in Sunderland has as much encouragement and access as anyone else in the country to study medicine and, crucially, progress through the ranks to the highest grades. We have heard some talk of international medical schools, but I can absolutely assure Members that there are not state school-educated kids in Sunderland thinking that they will pay privately to study in Grenada or anywhere else.

As the Secretary of State rightly pointed out, there have been welcome improvements on diversity in the NHS, but we often fail to consider socioeconomic background in that. The first line of the NHS constitution states:

“The NHS belongs to the people.”

But sometimes it can feel like it is staffed by a pretty unrepresentative slice of the people, particularly in medical roles.

In that spirit, I recognise the excellent work of the University of Sunderland medical school, which has placed widening access at the heart of its mission. Building on a 100-year history of wider clinical training, the school opened in 2019, shortly before the covid-19 pandemic—a period that starkly exposed our over-reliance on overseas recruitment and underlined the importance of growing our own workforce. By 2022, 47% of the University of Sunderland’s intake were local students, and it now ranks sixth in the UK for student satisfaction.

However, it is no good universities like Sunderland in my constituency doing excellent work on widening participation at recruitment stage if when we get to foundation training and specialty training those students are disadvantaged in competition. In my view, the Bill will help to ensure that talent nurtured by institutions like the University of Sunderland is retained and prioritised for the benefit of our NHS.

I highlight that medical schools such as Sunderland are increasingly placing a huge emphasis on training their medical students in a multidisciplinary environment alongside the trainee nurses and trainee pharmacists of the day, so that they are prepared to work in the multidisciplinary environment that our NHS rightly demands. I am not sure that all international undergraduate courses are always so advanced, so it is right to prioritise this UK-based training approach for the multidisciplinary ethos of the NHS in the future.

Other Members have mentioned the wide variation in specialist training fill rates, and GP recruitment has been mentioned as part of that. It is also worth saying that the national statistics about specialty training mask significant regional variations. The GP specialty training fill rate has been as low as 62% in the north-east of England, and as we have heard, over 73% of applicants for GP specialty training in 2023 were international. That has a disproportionate effect in regions like mine. My constituents want to have the confidence that there will be a stable GP workforce as part of our community for the long term. I cannot tell them in all candour that the status quo delivers that, so we must make changes of the type that the Bill sets out.

I hope that by introducing effective, regulated training pathways, the Bill will improve retention and strengthen workforce planning in our communities, including in areas such as women’s health, where training provision has not kept pace with rising demand. When I look at the shape of the NHS elective waiting list, it is no coincidence that some of the trickiest waiting time problems are in specialties such as gynae, where we have had recruitment and training challenges in recent years.

To close my remarks, I re-emphasise the link between capacity and demand, which I hope the Minister will touch on in advance of the workforce plan. Will she also say a little about the medical training review and the phase 1 report for NHS England and how the Government will work with that?

Dementia Support: Hampshire

Jim Shannon Excerpts

Wednesday 21st January 2026 Westminster Hall

[Liz Jarvis (Eastleigh) (LD)]

I beg to move,

That this House has considered dementia support in Hampshire.

It is a pleasure to serve under your chairship, Ms Lewell. We all know someone who has been impacted by dementia. My much-loved mum died in 2024 after a seven-year struggle with Alzheimer’s, so I know first hand what it is like to have to fight for the care and support that dementia sufferers need.

One in three people born today will develop dementia in their lifetime. Across Hampshire, more than 22,000 people are currently living with dementia. If national trends continue, that number is expected to rise to more than 31,000 by 2040. Dementia already places high pressure on families, the NHS and social care, and without decisive action that will only intensify. It is vital that we get the system right.

According to Dementia UK, 1,323 are living with dementia in Eastleigh, which is approximately 1.41% of the local population—higher than the national average.

[Jim Shannon (Strangford) (DUP)]

This is a massive issue for each and every one of us. The hon. Lady has referred to figures in her constituency, but given Northern Ireland’s ageing population, the figures there are expected to almost double, rising from 22,000 to 43,000 by 2040. That poses major challenges for health and social care. Does she agree that to be forewarned is to be forearmed, and that the Government must make preparations to deal with the growing numbers by implementing changes to the system right now?

[Liz Jarvis]

I absolutely agree with the hon. Member.

The average wait time for a dementia diagnosis in Eastleigh is 91.7 days, and post-diagnostic support is inconsistent and often inadequate. We must get to a position where dementia care is built around a clear, joined-up pathway that families can rely on from the very start and where a person can receive early diagnosis followed immediately by assessments, access to specialist advice, dementia-trained professionals and consistent points of contact, such as Admiral nurses. Drug treatments, where appropriate, home-based support, respite care and, where needed, smooth transitions into care homes, would all be part of one coherent system, not a maze of disconnected services. We need more support to stay at home and more support in the community, and family carers should be informed about available support and given greater access to regular respite. Diagnosis must be the gateway to timely, specialist and sustained support; too often it is not.

Domestic Abuse-related Deaths: NHS Prevention

Jim Shannon Excerpts

Tuesday 20th January 2026 Westminster Hall

[Jim Shannon (Strangford) (DUP)]

It is always a pleasure to serve under your chairship, Sir John. I thank the hon. Member for Stroud (Dr Opher) for securing this debate, setting the scene incredibly well and giving us all an opportunity to participate.

As always, I want to give a Northern Ireland perspective of what is happening. Unfortunately, the things happening in Northern Ireland are replicated, as shown in what other Members have said and what others will say after me. In some ways, things in Northern Ireland are even worse—the numbers of women being killed are at such a high level in proportion to the rest of the United Kingdom, and outpace what is happening elsewhere.

The Minister, who I am always pleased to see in her place, has a special interest in Northern Ireland, and because of that she will be aware of the stats, which are incredibly worrying. In Northern Ireland, the Police Service recorded almost 30,000 domestic abuse incidents in the 2024 to 2025 period, translating to roughly 85 incidents daily. Almost 18,500 of those became crimes, although many incidents do go unreported. Call volumes, particularly around Christmas, highlight a consistent challenge for victims seeking help. There are about 15 incidents and 10 crimes per 1,000 people, which puts the stats into perspective. Although that is a decrease on the previous year, those numbers are still incredibly jarring.

One of the worst times of the year, as we all know as elected representatives, is Christmas and the new year. There is a strain on relationships, whether it is a combination of financial and emotional pressures, or everything just building up at that time of year. The Police Service of Northern Ireland received 1,407 calls in the period from 20 December 2025 to 2 January 2026, seeing a peak of 116 reports on new year’s day. There is pressure on the PSNI back home, and on the police here, to respond to quite difficult issues. I know the Minister always tries to be responsive to our requests, so has she had the opportunity to speak to the relevant police in Northern Ireland, to get an idea of what they are doing and how we can help each other?

In June, we had the absolutely heartbreaking murder of a young mother of two, who was pregnant with her third child; the ripples are still felt in our community. Young Sarah Montgomery’s murder simply should not have happened, and more has to be done in those cases. Sarah was the 27th women to be murdered in Northern Ireland since 2020, and the level of domestic abuse calls indicate that this remains a central problem.

In Northern Ireland, health and social care is a very important partner in the domestic and sexual abuse strategy for 2024 to 2031, which designates domestic abuse as “everyone’s business”—and it is everyone’s business. Health settings are often the only safe and trusted environment where a victim can disclose abuse, as the hon. Member for Stroud mentioned. When a victim goes into a health setting, people run to support to them, and there is nobody looking over their shoulder or listening to what is going on, and they may have an opportunity to disclose what has happened. It is really important to have that strategy in place, and we have it in Northern Ireland.

I will underline the particularly worrying trends from the Christmas and new year period. At that time of year, accident and emergency units are under incredible pressure. Back home, we have had problems with hospital wait times and ambulances queued outside hospitals, and the domestic abuse issue is clearly in the middle of that.

Roughly 30% of domestic abuse starts during pregnancy, so midwives and health visitors are trained to conduct routine inquiry and ask about safety at home. They do that, and it has enabled the issue to be raised incredibly. To catch abuse early, we need to empower those workers to report any concerns and ensure that support is offered. It is essential that NHS departments work together, but the pressure on workers to fulfil their calls and do their paperwork is immense. So I believe that time must be factored in for staff to be able to smoothly report any suspicions. We must know that, in these awful cases, the Government and their Departments have done all that they could.

I want to be clear: murder by domestic abuse can never be the fault of anyone other than the perpetrator. However, in our communities we must all ask ourselves, “Was there something more that we could have done?” I support a UK-wide review by the Minister to ascertain how we can know that we have done all we can, to our utmost and even a bit more.

ADHD Diagnosis

Jim Shannon Excerpts

Tuesday 20th January 2026 Westminster Hall

[Bill Esterson]

It is good news that we are seeing some progress in my hon. Friend’s ICB. I profoundly hope that NHS staff in other ICBs around the country are watching this debate and will follow the lead of her ICB in improving the access that is needed.

[Jim Shannon (Strangford) (DUP)]

I commend the hon. Member for securing the debate. He has outlined the waiting lists, which are no better for us in Northern Ireland—they are over a year, and up to six years. The issue about early diagnosis is that every child with ADHD has a different level of ADHD. The diagnosis is really important because it enables the education system to respond for that child specifically. Does the hon. Member agree that for an educational programme to be tailored to a child, it must be absolutely right, which can be done only if there is early diagnosis?

[Bill Esterson]

Yes, I agree with the hon. Member. It is important to realise that everybody is different and that we all need different support. That is very true in school. When we call for diagnosis, we need to take great care around what we mean. Diagnosis is a means of getting support, getting the right treatment and getting the right medication, if medication is right—it is not right for everybody. ADHD is a spectrum and that individual, tailored support in school, and indeed in adult life, is an important part of what we are discussing.

Advanced Brain Cancer: Tissue Freezing

Jim Shannon Excerpts

Wednesday 7th January 2026 Westminster Hall

[Jim Shannon (Strangford) (DUP)]

It is a pleasure to serve under your chairship, Mr Western. I thank the hon. Member for Caerphilly (Chris Evans) for setting the scene so incredibly well, and the hon. Member for Mitcham and Morden (Dame Siobhain McDonagh) for all that she does—I was impressed by her contribution yesterday, and she equalled it today.

I think we all know someone who has been touched by cancer. The youngest daughter of a close friend of mine was diagnosed with glioblastoma last Christmas, and she died a few weeks later. At that time, the diagnosis was bleak, and the lives of my friend and his wife were changed forever. Bleak does not even come close to the sense of loss.

[Mr Campbell]

I have personal experience of a very young constituent who lost her father for the exact same reason. The trauma affects not just the immediate family, but close friends too, and it lives with them for years. Hopefully, we can see some progress both today and in the next few weeks, whenever the cancer issue is addressed in the main Chamber.

[Jim Shannon]

I thank my hon. Friend. That story makes today’s debate that bit more impactful for me and for us all. My friend is a veteran. He served in the forces with great courage. He has shoulders as broad as a rugby player. He is a man who could take on anything. He laid his life on the line for the freedom of everyone here. Yet, he could do nothing but watch—

[Dame Siobhain McDonagh]

The hon. Gentleman has been very kind to me in all these debates and has called me soft-hearted. If I am soft-hearted, that perhaps applies to both of us.

--- Later in debate ---

[Jim Shannon]

We are both soft-hearted, as many other Members in this Chamber probably are.

This man was so strong. When his wee daughter died, life became very focused on that; it will be always focused on that. I can understand how Owain’s law has come about, because families are determined to ensure that their devastation is not replicated, if one single thing can be done to prevent it. I thank those in the Public Gallery for being here.

What can we do? Owain’s law is an indication of what we can do. Tissue freezing preserves DNA. Without this key, simple and cost-effective step, patients cannot access the latest cancer treatments, diagnostics and research. There is a way forward.

As the Minister knows, I am always pleased to see her in her place. We are all very fond of her, and she understands things better than most—we all know the circumstances. I am looking forward to her response to the ask from the hon. Member for Caerphilly and from everyone else. To help end this preventable postcode lottery, hon. Members should please consider entering the current ballot for Health and Social Care questions, which closes today. If they can get their question in before noon today, that would be good. Next week, they would then have an opportunity to ask it on the Floor of the House, to help prevent more brain cancer patients in our constituencies from missing out.

In the NHS, most brain cancer patient samples are stored in paraffin wax rather than being flash frozen in medical freezers. When this happens, patients lose access to potentially lifesaving newer treatments developed using these samples, to more precise diagnostic methods and to advanced research, including future testing to find out whether a patient’s condition is genetic and likely to be passed on to their children. That is important in the lives we lead. Some conditions are hereditary; they come from our mum or dad—maybe our grandparents—down to us, and may pass on to those who come after us.

I thank Ellie’s campaign for giving me their paper before the debate, as it really does help us to understand things just that wee bit better. I know that the Minister has seen it and the three questions to her, so I do not need to repeat them—she is probably very aware of what they are. Those are the campaign’s requests.

I have a couple of requests of my own, which will not come as a surprise to anyone in the Chamber, and certainly not to the Minister. New research from the Tessa Jowell Brain Cancer Mission shows that access to tissue freezing varies dramatically between trusts, meaning that eligibility for advanced treatments can depend entirely on where a patient lives. A postcode lottery is preventing my constituents in Strangford in Northern Ireland from benefiting from more precise whole genome sequencing, personalised immunotherapy and cutting-edge diagnostic options. My constituents are not the only ones affected—everyone is affected.

I have received information indicating that, for just £250,000 to £400,000, every brain cancer patient in the UK could have routine access to tissue freezing by default, unlocking the treatments the Government have committed to delivering. The three questions from the Owain’s law campaign are the important ones, but can the Minister look at this issue? When we think about what we are trying to achieve in this debate, it is important that we have some goals. I know that the Minister always replies helpfully and positively to us.

In Northern Ireland, funding for freezing brain tissue is primarily tied to research initiatives rather than standard patient care. A local charity called Brainwaves NI is currently funding a pilot scheme at the Belfast health and social care trust and Queen’s University Belfast, which uses rapid nanopore sequencing. I do not pretend to understand what all these things are—I am not a medical person, just an MP who tries to represent his constituents when he can. That process requires specialised tissue handling, often involving freezing, to reduce diagnosis times from weeks to hours.

It is clear from all the contributions to the debate, including from those who have personal knowledge, that we do not need pilots but more equitable access to tissue freezing throughout the United Kingdom. I support the calls the hon. Member for Caerphilly has made so well on behalf of his constituents and indeed all the United Kingdom. Glioblastoma is a death sentence, but tissue freezing could change that. It is right and proper that we do all we can to see that change in all of the United Kingdom.

My last request is that the Minister liaise with the regional Administrations in Scotland and Wales, and particularly with the Administration in Northern Ireland and with the Assembly. Brain cancer affects us all; it does not stop at the border of Scotland and England or in the Irish sea. It is all of us together, so we need to work together to find a way of funding a cure for advanced brain cancer. With that, I look forward very much to the Minister’s response.

--- Later in debate ---

[Ashley Dalton]

I note my hon. Friend’s clarification, but with that in mind, we do know that it is important to diagnose all cancers as quickly as possible, and the diagnosis of brain cancers is equally important so as to start treatment as quickly as possible. To that end, the Chancellor announced further investment in diagnostics at the autumn statement as part of a £6 billion capital investment to deliver constitutional standards.

On genomics, I met the chief scientific officer for genomics yesterday to discuss how we ensure that the UK remains a world leader in genomics—which we are—and that we can apply genomics to improve cancer outcomes. We hope that our investment in diagnostics and pathology will mean that, in future, patients such as Owain will access a greater range of treatment options.

My hon. Friend the Member for Caerphilly and Ellie are entirely right to raise the importance of innovation, particularly for less survivable cancers such as brain cancer. The Government are proud to support the Rare Cancers Bill introduced by my hon. Friend the Member for Edinburgh South West (Dr Arthur). Next Friday, Baroness Elliott will move its Second Reading in the other place.

We will go even further to ensure that all patients with brain cancer have access to cutting edge clinical trials, innovation and lifesaving treatments. As part of our action, the National Institute for Health and Care Research announced the pioneering brain tumour research consortium to accelerate research into new brain tumour treatments across the UK. The NIHR is backing the consortium with an initial £13.7 million and more money to come this year. The world-leading consortium aims to transform outcomes for adults and children who are living with brain tumours and for their families, ultimately reducing the number of lives lost to cancer. As I confirmed yesterday, I will write to my hon. Friend the Member for Mitcham and Morden in detail regarding access to funding. I am happy to commit to seeking information and exploring how we can make access to funding much clearer and more transparent.

I am pleased to confirm that the national cancer plan for England will be published in just a few short weeks, in early February. It will focus on rarer cancers, including brain cancer, and will include further details on how we will improve outcomes and work with stakeholders such as the Tessa Jowell Brain Cancer Mission to do so. The plan will detail further action to speed up diagnosis and treatment in England, ensuring that patients have access to the latest treatments and technology and ultimately driving up survival rates.

[Jim Shannon]

I thank the Minister for her comprehensive reply to all our questions. In my contribution, I mentioned that Queen’s University Belfast and the Belfast health and social care trust are doing a pilot scheme, which I hope will benefit England, Scotland and Wales. Can the Minister ask her Department’s civil servants to take that on board?

[Ashley Dalton]

I am happy to confirm that I will ask officials to look into that, and to give me some advice on that pilot and on having a conversation with those running it about what we could learn from them. I thank the hon. Member for raising that question.

I will close by paying tribute to our late colleague and Member of the Senedd, Hefin David. Through tireless campaigning, he brought Owain’s story to the Senedd. My hon. Friend the Member for Caerphilly has now brought it to this place and I thank him for that. I look forward to working with him and other hon. Members to make 2026 the year that we shift the dial for patients with brain cancer.

Less Survivable Cancers

Jim Shannon Excerpts

Tuesday 6th January 2026 Westminster Hall

[Clive Jones (Wokingham) (LD) [R]]

I beg to move,

That this House has considered less survivable cancers.

It is a pleasure to serve under your chairship, Mr Efford. I declare an interest as a governor of the Royal Berkshire hospital; also, a family member has shares in a medical company. I am grateful to the Backbench Business Committee for allowing this debate, which I first asked for six months ago—[Interruption.]

[Jim Shannon (Strangford) (DUP)]

Whose phone is that?

[Clive Jones]

I apologise.

--- Later in debate ---

[Jim Shannon (Strangford) (DUP)]

It is a pleasure to serve under your chairship, Mr Efford. I thank the hon. Member for Wokingham (Clive Jones) for leading today’s debate. It is good to be here, because next week is Less Survivable Cancers Awareness Week, which starts 12 January. We often talk about cancer in general, but speaking as my party’s health spokesman, I believe it is important to shine a light on those that are less survivable, and what more we can do to support those whose world has been turned upside down by their impact. Those low-survival cancers are lung, pancreatic, liver, brain, oesophageal and stomach. These types tend to be diagnosed later and have a five-year survival rate that is often below 16%—so we need to really focus on this issue. That survival rate compares with 50% to 60% for all cancers. I am, as always, very pleased to see the Minister in her place. I know that she will reply with dedication and give us the responses that we seek.

To give a quick Northern Ireland perspective: 62% of people diagnosed with a less survivable cancer die within one year of diagnosis; 10,300 people are diagnosed with cancer each year in Northern Ireland, and there are around 4,600 deaths annually. Cancer survival in Northern Ireland lags behind that in many comparable countries, so for certain devolved regions, more must be done to ensure that access and intervention are at a parallel with what is seen in our counterparts across the United Kingdom.

As always, I put it to the Minister that we do this together and share our research and ideas, and look at how we can do better. Queen’s University Belfast does some fantastic work. Its Lung Shot project involves experts from Northern Ireland and the Republic of Ireland and has some £300,000 in funding to study oesophageal cancer, which is often described as a “forgotten” cancer. There are so many variations within the UK; these are found in differences in treatment timing and use across the United Kingdom. In Northern Ireland there is a longer average wait to start both chemotherapy and radiotherapy compared with other UK nations and countries abroad. Those patterns mean that patients in Northern Ireland, unlike those elsewhere in the UK, often start treatment later and receive key therapies less frequently than in higher-survival countries. We must invest in greater capacity for CT and MRI scanning and endoscopy to ensure detection. Nobody should be made to play a postcode lottery for their health.

To conclude, less survivable cancers do not have to mean less priority, urgency and hope. Behind every statistic is a person—a parent, partner, sibling or friend—whose life was cut short, not because their cancer was untreatable, but because it was found too late. If we are to do something, then we must ensure that there is the correct funding, research and incentives—not just for the mainland, but collectively for everyone throughout the United Kingdom of Great Britain and Northern Ireland.

Therapeutic Play and Children’s Healthcare

Jim Shannon Excerpts

Tuesday 6th January 2026 Westminster Hall

[Mr Bailey]

I agree with my hon. Friend, who is a leader in this area through his chairship of the APPG on play. We are all grateful for that, and for the significant impact he has made for his local hospital and for play more broadly.

[Jim Shannon (Strangford) (DUP)]

The Ulster hospital, which is near my constituency of Strangford in Northern Ireland, makes sure that there is no medical equipment in some of the rooms. That allows children to relax, play, read and draw, and helps to reduce the anxiety associated with hospital stays and treatment. The hospital also has a communal area for children and young people. Does the hon. Member agree that it should not be down to charitable donations to provide that; it should be down to the health trusts?

Puberty Suppressants Trial

Jim Shannon Excerpts

Wednesday 17th December 2025 Commons Chamber

[Madam Deputy Speaker (Ms Nusrat Ghani)]

We need a short question. I call Jim Shannon.

[Jim Shannon (Strangford) (DUP)]

May I thank the Secretary of State for all that he does? He deserves credit. A mother from my constituency phoned me this morning and said:

“Why is money being spent on this pathway when my child has been waiting for clinical support for 3 years and the waiting list is so long she may be moved to adult treatment? Why is Government prioritising the tiny few over the many? With our children’s mental health services at breaking point and parents at their wits end trying to get their child diagnosed”,

how do the Government look in the eyes of the parents with rare diseases whose drugs are not funded by the NHS when they are funding this trial?

[Wes Streeting]

I say respectfully to the hon. Gentleman, whom I like very much, and to his constituent, that it is because I have also had to look into the eyes of people in this community who have not received the right care and seen the deleterious impact it has had on their mental health and wellbeing. I have had to deal with parents who have suffered loss and bereavement. We have to make sure that we are doing the right thing by everyone. This should not be an either/or choice.

Palliative Care: North Derbyshire

Jim Shannon Excerpts

Wednesday 17th December 2025 Westminster Hall

[Mr Perkins]

I absolutely agree with my hon. Friend. It is important to say that a half-hour debate is primarily an opportunity for a single Member to raise something with the Minister, and to get a ministerial response, but as my hon. Friends the Members for Derbyshire Dales (John Whitby) and for Bolsover (Natalie Fleet) made clear, it is an issue that is felt incredibly passionately right across the north Derbyshire community. My hon. Friend the Member for North East Derbyshire (Louise Sandher-Jones) would also have been here if she was not on Ministry of Defence duty in Gibraltar. It is an issue that many of us feel passionately about.

It is important to get across that, in those meetings, we wanted to establish what exactly the ICB’s current funding was paying for and how that benchmarked against the overall level of funding that hospices were receiving in other areas, and to get an agreement on an interim level of funding to enable the hospice to continue providing the current level of care while a more detailed investigation into the current cost of care was commissioned.

[Jim Shannon (Strangford) (DUP)]

I commend the hon. Gentleman for securing this debate. I spoke to him beforehand to suggest a helpful intervention. He rightly said that fundraising is important for the hospice, but NHS funding never covers more than a fraction of the cost. There are four distinct hospices in Northern Ireland that provide instrumental support in terms of end-of-life care for those who require it. Does the hon. Gentleman agree that there must be a national minimum NHS funding level for hospice care to ensure that services across this whole nation are not depleting as a result of lack of funding?

[Mr Perkins]

I absolutely agree. One of the frustrations that many of us in Derbyshire have felt is that there is no clarity on what a reasonable level of funding is and what the expectation is. There are rumours flying left, right and centre. In the middle of all this, the staff, the patients and the fundraisers are left wondering who to believe and what the situation is. I hope that, when we hear from the Minister, we will learn more about that.

In the summer, the ICB produced a comparison with NHS-funded care in the south of the county in an effort to show MPs that Ashgate hospice was too expensive, but has now disowned that comparison. After several months of pretty unsatisfactory discussions at which the two sides never reached a settled position even on what was currently being spent, the move from Derbyshire to a three-county ICB model saw a sudden withdrawal by the ICB of any suggestion of interim funding, forcing the hospice to go ahead with plans to make redundancies.

Our hospices receive an average of just a third of their funding from Government via the NHS and are reliant on fundraising for the rest. The Government contribution fell dramatically under the 14 years of the previous Government, leaving the gap for charitable hospices to make up even larger. Year on year, hospices such as Ashgate have expended any fat in reserve and are now faced with intolerable financial pressures. In today’s debate, I am seeking to make the case for a more equitable funding settlement for all hospices to gain greater clarity about the particular situation in Derbyshire and see whether anything can be done to stave off these terrible service closures and nurse redundancies in an institution that provides outstanding palliative care.

Let me touch on the national context. Hospice UK published research last month showing that 57% of hospices ended the last financial year in deficit, with 20% recording a deficit of over £1 million. That is actually a slight improvement on the staggering 62% of hospices that recorded a deficit a year before, thanks to the emergency £100 million of additional funding provided by this Government. A health system that relies on a sector so chronically underfunded that 57% of hospices are in deficit to provide care is simply not functioning. The Government are right to make it a priority to assist hospices such as Ashgate to get back on their feet.

Although it is true that this crisis evolved under the previous Government and sat there on the ballooning list of things to do when this Government came to power, many hospices like Ashgate had spent year after year dipping into their reserves and had no fat left to cut when the Government’s welcome increase in funding was accompanied by the rising employer’s national insurance, the minimum wage increases and the NHS pay increase, which is obviously relevant to the wider health community. Many hospices are on the brink. I join the call of many other MPs from across the country for a more generous funding settlement that recognises the crucial role that hospices play in our health system.

Turning to the local situation, it is immensely frustrating to all the Derbyshire MPs, to staff, to unions and to local fundraisers that even at this stage there seems to be a lack of clarity about the current cost of care and how that benchmarks against hospices nationally. A letter I received yesterday from the ICB repeats the suggestion that it has offered to commission an independent review and provide some financial mitigation linked to specific and agreed service mitigations, funded up to £100,000. Indeed, the ICB repeats its view that those financial investigations will be necessary if sustainable solutions are to be found to funding palliative care. Ashgate’s view is that there is no lack of clarity about what money is being spent on, and that it demonstrated that to the ICB’s director of finance at a recent visit.

The situation seems largely unchanged since late October, but many staff face the threat of redundancy, and in the run-up to Christmas some have reluctantly and heartbreakingly chosen to leave the hospice. For any member of staff in any profession, a job being under threat before Christmas would be deeply worrying, but it is important to stress that nurses in the in-patient wards at Ashgate hospice are not just any members of staff. As we have heard from my hon. Friends the Members for Bolsover and for Derbyshire Dales, they provide support for patients and families at their very darkest hour, when all else is lost and all that remains is the comfort provided by the knowledge that a dying loved one is comfortable and cared for in a beautiful, high-quality and caring environment. The emotional strain on those nurses is huge, and the public empathy and affection for them is widely felt. Their professionalism and compassion is renowned, and the effect of the threatened job cuts on them has been devastating.

Although in-patient wards deal with far fewer patients than out-patient and at-home services, many see them as the front door of Ashgate hospice, but they face the biggest cuts: there is a plan to reduce palliative care beds from 15 to six. In response, there has been an outpouring of support for Ashgate hospice from the community. Nearly £250,000 was raised in just two weeks, including an incredible £50,000 from the owner of a Chesterfield-based business, Peter Kelsey. Those funds will allow the hospice to keep open two additional beds for another six months, and care for perhaps another 25 patients near the end of their lives.

Hundreds of my constituents have contacted me and my colleagues to voice their concerns about the situation at Ashgate hospice, and many have also written directly to the ICB to make the case. Despite the claims and counter-claims, there is now widespread distrust that urgently needs clearing up. The ICB continues to imply that Ashgate services are too expensive, although there has been no formal update following the director of finance’s visit to the hospice on 1 December. Staff and unions have been left confused and concerned about the implication that the finances are not straightforward, and remain frustrated about the process. They have questions about whether every step has been taken to reduce costs.

Staff at Ashgate have been alarmed at communications coming out of the ICB, which they believe undermine their reputation for professionalism and financial prudence. If trust in Ashgate’s ability to run its operations is diminished, it will have grave consequences for future fundraising.

What is not in question is that the care that Ashgate provides is outstanding and that, as of this new year, dozens of north Derbyshire’s most gravely ill patients, who would previously have been able to obtain a bed at Ashgate, will die either at home in less comfort, with family members put in intolerable situations, or in an acute bed in the local hospital sector, possibly at greater cost and in less comfort than was the case last year. I want all my constituents to receive the best end-of-life care possible, so it is hugely disappointing that palliative care patients in north Derbyshire will lose access to those beds, and that nurses at the hospices will be worrying about whether they still have a job.

I want to shed light on the distressing and unacceptable situation of service cuts and redundancies at Ashgate hospice, and I seek further clarity and transparency about the funding situation for palliative care in Derbyshire to see whether anything can be done to hold at bay cuts to services at Ashgate.

Although charitable income will always play a vital role in hospice care, allowing hospices to deliver holistic care that goes way beyond NHS provision, hospices need fair and consistent Government funding, which needs to be transparent and clearly linked to contracts. Crucially, it must reflect local need. Whether a person lives in Chesterfield, across wider north Derbyshire or elsewhere in the country, they and their family should have access to quality palliative care when they need it most. I would therefore appreciate hearing the Minister’s response on several points.

First, will he join me in lamenting the devastating cuts at Ashgate hospice? Does he agree that this situation, whereby in-patient palliative care services in north Derbyshire are being reduced, is unacceptable? Will he or his office intervene to ensure that Ashgate hospice and the local ICB reach a transparent and agreed position on the current funding situation, and examine how that position compares with national expectations about funding of palliative care?

More broadly, will the Minister set out the Government’s plans to ensure sufficient and sustainable funding for hospices in the future? Can he confirm whether he has any concerns about the cost of care at Ashgate hospice? If he cannot, will he get this matter on the public record, so that people across north Derbyshire can be confident that the money they have raised through fundraising—hard-earned money—is being prudently spent?

Does the Minister agree that, six months after the beginning of discussions locally, it is completely unacceptable that there is still a lack of agreement about exactly how much is being spent on care by the ICB and how much commissioned care the ICB is funding? Can he do anything to provide clarity about this situation?

Since 1988, Ashgate hospice has provided exemplary care to thousands of dying patients in north Derbyshire. It must go on. Its nurses deserve better than to lose their jobs and to worry about whether something else could have been done. I implore the Minister to ensure that the hospice sector is given the support it needs to play its crucial role, and that locally in north Derbyshire every avenue is explored to save jobs and beds at this wonderful institution.

Transgender People: Provision of Healthcare

Jim Shannon Excerpts

Tuesday 16th December 2025 Westminster Hall

[Jim Shannon (Strangford) (DUP)]

Will the hon. Member give way?

[Rachel Taylor]

I will make some progress, if I may. I am part-way through something that a trans person said, so it is not an appropriate time to intervene. They went on to say:

“I have personally used alcohol, cannabis, cocaine and self-harm to survive the last year and a half since referral and I have now been told I will have to wait several more months because of the backlog.”

[Jim Shannon]

I am reminded of last year when a mother came to me back home. Her son wanted to transition. The mother was under real pressure, as was the young boy. We tried to help as much as we could through the health system back in Northern Ireland. Does the hon. Lady agree that there is a journey not only for the young person who wants to transition, but for their parents? Everyone needs support to get them through that difficult transition.

[Rachel Taylor]

I thank the hon. Gentleman for his helpful contribution. Of course, parents need help and support through this process.

In 2022, a coroner ruled that a 20-year-old trans woman had died in part because of delays in accessing gender-affirming care after two and a half years on a waiting list. Trans people also struggle disproportionately with general healthcare. A third of trans and non-binary people, rising to almost half among people of colour, received no NHS or private support during pregnancy, compared with just 2.4% of cis women. Nearly one in three trans and non-binary birthing parents said that they were not treated with dignity and respect in labour, compared with just 2% of cis women.

According to TransActual, 60% of trans people surveyed had been refused care because they were trans. Hundreds reported that their GP refused to prescribe hormones, even when they had been recommended by NHS gender clinics. Participation in cervical screening is also significantly lower, with trans and non-binary people estimated to be up to 37% less likely to be up to date with appointments. This Labour Government are the right Government at the right time to tackle these issues.

I congratulate the Minister and the Secretary of State on the HIV action plan that was announced this month. I remember vividly the stigma and shame of an HIV diagnosis in the ’80s and ’90s, which often led to suicide, as the alternative was a death sentence and a life spent facing discrimination and abuse. This HIV strategy is groundbreaking and sets us on the right path to end new HIV transmissions. I applaud its commitment to ensuring that all prevention efforts target underserved populations, including trans people.

The Government pledged in their manifesto to ensure that trans people receive the healthcare and support they need. I welcome the review being led by Dr David Levy into adult gender services, and I hope it will bring forward strong recommendations to cut waiting lists, expand access and deliver timely, appropriate and sensitive care. I know that trans people and LGBT organisations have been awaiting its publication, so I ask the Minister: when can we expect Dr Levy’s review to be published?

In April 2025, the Secretary of State also commissioned NHS England to undertake an LGBT+ health evidence review. That review seeks to identify the barriers to healthcare for all LGBT+ people, from examining the poor treatment of lesbian couples seeking IVF treatment to looking at insufficient mental health support for LGBT+ people. The review is highly anticipated by the whole community. Therefore, I ask the Minister: is Dr Brady’s review still due to conclude in January 2026, and when can the public and parliamentarians expect to see it?

Although I applaud the Government’s work to improve healthcare for transgender adults, I know that reviews alone will not fix the problem. We need to know that these reviews will be followed by action. I know that getting this right matters to the Government, so I ask the Minister: what steps will the Government take to reduce discrimination and transphobia in healthcare settings?

Will the Minister commit to mandatory training for clinicians on the respectful and appropriate treatment of trans patients? Will the Government commit to significant sustained investment in trans healthcare, with reducing waiting lists and expanding local provision as urgent priorities? We must build a healthcare system rooted in science, not stigma, and in compassion, not fear. We must decide whether we want to be a society that listens to people, supports them and gives them the tools to thrive.

There is one final point I would like to make. Those who know me will know that I first got involved in politics in the 1980s when Thatcher was introducing section 28. That policy was intended to make people like me feel shame about who we were, and to reverse the progress that previous generations had fought for. I got into politics to fight that cruel law and everything that it represented.

I am a gay woman who grew up in the ’80s, so I know what it feels like to be told, “It’s just a phase. Maybe you’ll grow out of it. Maybe it’s not really who you are. Maybe there’s just something wrong with you,” so believe me when I say that I have heard it all before. LGBT people have heard this all before. We know what bigotry is when we see it, and we know that bigotry is back. Let us make no mistake: the people who are organising against trans people now are no different from the people who campaigned for section 28. They want to present parts of our movement as a danger to society and push them to the margins. I will never let that happen.

To all those in this room and in this House who are totally convinced that trans people are not real, that they are making it up, that it is TikTok, Reddit or foreign TV that has turned them trans, that somehow this is some kind of new phenomenon, let me assure you all that I have had trans friends for as long as I have been out. Trans people have always and will always exist.

To all those in this room who used to say warm things about trans people back when it was popular to do so but who decided when the wind changed that they would blow in the other direction, and to the Conservatives who in 2018 introduced an LGBT action plan promising trans equality but who now are quite happy to laugh along with cruel mocking jokes about trans people in front of the mother of a murdered trans teenager, we see you, and much like history condemns section 28, history will condemn you too. Meet trans people, talk to them, understand what they are going through and believe them, then we can all stop fighting our toxic culture wars and get back to doing what we as lawmakers are elected to do: make things better for every single one of our constituents—not some of them, all of them.