Cross-border Healthcare

Jim Shannon Excerpts

Tuesday 4th November 2025 Westminster Hall

[Jim Shannon (Strangford) (DUP)]

It is a real pleasure to serve under your chairship, Mr Dowd, as always. On behalf of us all, I look forward to your deliberations. I thank the hon. Member for Brecon, Radnor and Cwm Tawe (David Chadwick)—I think I pronounced that right—for securing this debate. [Interruption.] Did I get it wrong? My apologies; the Northern Ireland accent gives it away nearly every time. While we are one United Kingdom, it is always important to remember the differences that we have in devolved matters, and in healthcare specifically—especially in Northern Ireland, where we have witnessed major disparities. It is a pleasure to make a contribution on that.

I want to talk about a cross-border health scheme that was used in Northern Ireland some years ago before our official exit from the European Union—although it appears that we never exited—and when we were all in the United Kingdom. The scheme meant that patients in Northern Ireland who had been on health and social care waiting lists for two years or more could apply to receive private treatment in the Republic of Ireland and claim reimbursement from the Northern Ireland Department of Health. When I was a member of the Northern Ireland Assembly and in my early years here at Westminster, I saw numerous examples of hip replacements, knee replacements and cataract operations being done down south because the patients had waited two years. The payment for the scheme then came from us in Northern Ireland. There are systems that work.

I thank the hon. Member for South Antrim (Robin Swann) for his contribution. He will probably be embarrassed by this, but I want to put on record that he was a great Health Minister when he was in the Northern Ireland Assembly, and I thank him for that. I never heard anyone say a bad word about him—and I talk to plenty of people, by the way—so I would say that he is an example of a Minister who really worked hard.

I know of a couple of constituents who availed themselves of the scheme and to say that their surgery was life-changing is an understatement. The hon. Member for South Antrim referred to his son. One of my constituents had a hip replacement and one had knee surgery. They could have been waiting up to 10 years for that surgery in Northern Ireland if they had not been able to avail themselves of the scheme with the Republic of Ireland. Those are some examples of how strategies like these work; I listened to hon. Members’ examples of similar processes in their constituencies.

I want to talk briefly about the importance of medical records. I spoke to the Minister about that beforehand, and others have referred to it. Through working closely with universities, I have witnessed a few examples where a young person lives in Northern Ireland and goes to Scotland or England for university. When they come back to Northern Ireland three or four years later, healthcare professionals cannot access their information as there is no shared provision for medical records. I hope that the Minister will forgive me, but it seems illogical not to have a system that takes that on board.

One of my staff members who went to Chester to study was in that exact scenario around 10 years ago. She had to travel back to England and pay £50 for a printout of her records to take to her GP back home. We must not forget that £50 was a lot of money for a student 10 years ago. It might be expected that the cost has now gone way beyond that.

This debate is really important, so I want to make sure that other hon. Members get their five minutes as well. There are clear examples of where cross-border health initiatives work and are beneficial to supporting people who are faced with extensive waiting lists and serious conditions that alter their day-to-day life. I look to the Minister—as I always do, because she answers us and listens to our requests—for a commitment to ensuring that our constituents have access to the care that they need, whether it be cross-border or within our healthcare systems in England, Scotland, Wales and Northern Ireland. Furthermore, hon. Members have shared experiences of the medical records issue within our constituencies. When so many people travel to different parts of this nation to study, more must be done to ensure that their records can flow smoothly and without hassle. My goodness, Mr Dowd, a life without hassle—it would be a miracle.

Moles: Histological Testing

Jim Shannon Excerpts

Thursday 30th October 2025 Westminster Hall

[Dr Danny Chambers (Winchester) (LD)]

It is an honour to serve under your chairpersonship, Ms Jardine. I congratulate the hon. Members for South Norfolk (Ben Goldsborough) and for Isle of Wight West (Mr Quigley) on securing this debate. I wish the hon. Member for South Norfolk all the best in his treatment. I have to say, it was hugely brave of him and emotive to hear him talk about the journey he is going through at the moment, and to hear him paying such tributes to all the staff involved in his care. I also thank Zoe’s family for coming here today, because it cannot be easy to hear people talk about this disease after everything they have been through.

Many of us will know, some from personal experience, how frightening it can be to face a possible or actual cancer diagnosis. When words such as “biopsy” or “diagnostic tests” enter the conversation, that provokes deep concern, and yet those tests, as everyone has been reiterating, are absolutely vital. Early diagnosis is the single most important factor in improving survival rates. The sooner any type of cancer is identified, the sooner treatment can begin, and the more likely the outcome will be favourable. The tests are very important for people’s mental health, because sometimes the test is clear: a person knows that, and knows there is no need to worry unnecessarily.

In an ideal world, someone who notices a suspicious mole or mark would call their GP; be seen within two weeks, as set out in the National Institute for Health and Care Excellence guidelines; if necessary, a biopsy would be taken; and, if cancer was confirmed, treatment would begin within 62 days. In an ideal world, that treatment would be available to everyone, regardless of their postcode.

We know that is not the reality for everyone, either in Winchester or the rest of the country. We know GP access is a growing concern. In Winchester, I regularly hear from my constituents that they are waiting weeks for appointments, which means we are falling at the first hurdle. The second hurdle—treatment within 62 days—is just as worrying. In Winchester, in July 2025, only 73.6% of cancer treatments began within 62 days, well below the operational standard of 85%.

The truth is that, at almost every stage of the process—from initial concern to diagnosis and treatment—we are letting too many people down. It is one of the reasons that the Liberal Democrats have been calling for a two-month cancer treatment guarantee for a long time now: a new target so that 100% of patients will start treatment within 62 days. We must also replace ageing radiotherapy machines and expand provision so no communities are left in what have rightly been called radiotherapy deserts. We do not want anyone to have to travel hours and miles when they are feeling ill for lifesaving care.

The last Government’s decision to close the National Cancer Research Institute, which had co-ordinated cancer research since 2001, was a grave mistake. One oncology professor compared this to

“turning off air traffic control and hoping the planes will be fine”.

We owe it to patients and their families to build confidence in the system, and that means faster access to GPs, earlier diagnosis, better treatment, proper investment in research and a comprehensive long-term plan to boost survival rates. I really welcome all the comments about regulating the private medical sector to ensure they are taking biopsies, as well as the regulation of sunbeds.

[Jim Shannon (Strangford) (DUP)]

I wanted to be here at the beginning, but unfortunately I could not because I had other things to do in the Chamber. I declare an interest—like the hon. Member for South Norfolk (Ben Goldsborough), I am going to get one of mine done very shortly, but in Northern Ireland the wait list is 56 weeks. If it is red-flagged, it is five weeks. There is anxiety and stress for everyone—not for me, but for all the others—because it is not about me but everyone else. Does he agree that the NHS, wherever it may be in this great United Kingdom of Great Britain and Northern Ireland, needs to ensure that those who have melanoma and a biopsy get the urgency that is absolutely critical? The Minister is in her place—there is no better person to answer these questions than her—and I look forward very much to what she says. Does the hon. Member for Winchester (Dr Chambers) agree that a concerted campaign across this great United Kingdom of Great Britain and Northern Ireland to address those issues might be a way forward?

[Dr Chambers]

I totally agree with those comments.

I will finish by paying tribute to one of my friends from vet school, Polly Birch. She was diagnosed with a melanoma in 2016 and had it removed, but in 2017, a few months after giving birth to her baby girl, Ada, she discovered it was metastatic, and she passed away. Her final post on social media was beautiful and moving. A couple of days before she passed away, she said:

“Appreciate the people around you, adventure with them, buy less stuff and go out and experience the world…and look after the bees.”

Finally, and perhaps most poignantly, I will quote Mary Schmich:

“If I could offer you only one tip for the future, sunscreen would be it.”

Ageing and End-of-life Care

Jim Shannon Excerpts

Thursday 30th October 2025 Commons Chamber

[Jim Shannon (Strangford) (DUP)]

I beg to move,

That this House has considered the ageing community and end of life care.

I thank the Backbench Business Committee for selecting this subject for debate. I declare an interest as the son of Mona Shannon, who is 94 years young and resides in a nursing home near Killyleagh in my constituency. Along with most other middle-aged sons or daughters—in my case, maybe a wee bit more than middle-aged—I am acutely aware that time is marching on and so are my mum’s needs.

The wee five-foot-nothing lady who kept three six-foot sons under control is no longer to live alone, but she is as sharp as a tack and I am thankful for the wisdom she gives me when I visit her twice weekly. Indeed, I suspect that every Friday and every Sunday I get a wee bit of wisdom—and maybe a wee bit of a telling off. She always likes to know what happens in this House and I am able to tell her that, but she will also give me her opinion, which I never ignore—indeed, I probably keep to it as much as I can.

Those visits to the nursing home, coupled with the focus on assisted dying, have highlighted to me with greater effect the changes that are needed in how we handle our older generation and their needs. I have spoken with representatives of both Sue Ryder and Marie Curie not simply to highlight the difficulties that most of us will be aware of, but to offer some ways that we can improve.

I am pleased to see the Under-Secretary of State for Health and Social Care, the hon. Member for Glasgow South West (Dr Ahmed), in his place. He and I are becoming a bit of a tag team, because on three days this week he has been the Minister responding to the debates that I have been involved in. The shadow Minister, the hon. Member for Hinckley and Bosworth (Dr Evans), has been there as well, so he should not be left out.

According to Marie Curie, in the next 25 years in Northern Ireland—I know it is not the Minister’s responsibility, but I want to give the stats, because they are important— there will be 20,500 people requiring this type of care, which is a rise of 32%. That includes a doubling of need by those aged over 85. It is also projected that the number of deaths in the community in Northern Ireland could rise by 74% during that time. Approximately 60% of the cost of care delivered through the independent hospice sector in Northern Ireland is reliant on charity. That is unsustainable. A new palliative care strategy for Northern Ireland that takes account of demographic changes and associated requirements for service transformation and investment is urgently needed.

That is what is happening in Northern Ireland, and in the mainland, things are very similar. Marie Curie has highlighted that as the population ages, more people will be living with and dying with multiple complex conditions. Every week in my office, when it comes to assisting those of my mum’s generation—and perhaps some of my own—with benefits, I see people with multiple complex needs more than ever. It is not just one thing that people are suffering from, but a multitude of things.

By 2050, the number of people in need of palliative and end-of-life care in the UK will rise by 147,000 to over 745,000 every year, and that increase will be driven by a growth in the number of people dying over the age of 85. These are really important stats, and we cannot ignore them; indeed, I believe the Minister will be focusing on them. Around 90% of the people who die each year need palliative care, but one in four of them is missing out. Older people, and particularly those with a non-cancer diagnosis, are at risk of missing out on the palliative care they need at the end of life. Research indicates that most people want to receive care at the end of their life and die at home. Elderly people tell me that all the time—they want to be at home.

[Sir Julian Lewis]

I am grateful to the hon. Member for giving way; I know he is pressed for time. The charity Together for Short Lives points out that where children’s palliative care is concerned, there is wide variation across different regions in the country. Is he afraid that this applies to the ageing population as well—that there is no consistency in the amount of palliative care available?

[Jim Shannon]

I thank the right hon. Member for his intervention and for the wisdom that he brings to all the debates he participates in. The Minister is listening, and he is a good Minister, so I know he will come back with the response we hope to have.

How often have we listened to family members who are past themselves with exhaustion and guilt about how they are caring for their loved one and who feel unprepared and yet unwilling to let them go into nursing care? With more support, their lives would be easier and their loved one’s life happier. This knowledge is why I was not surprised to learn that almost £12 billion of public funds was spent on healthcare for people in their last year of life, 81% of which was spent in hospital, with only 11% spent on primary and community care.

Access to a 24/7 palliative care advice and support telephone line has been recommended as a minimum service requirement for nearly two decades, but research shows that very little has happened, which underlines the issue that the right hon. Member for New Forest East (Sir Julian Lewis) raised. Only seven of the 42 integrated care boards in England said they have a dedicated 24/7 single point of access to palliative and end-of-life care advice, guidance and onward referral to other services, when needed—those are all important factors.

Despite the introduction of a new legal duty for ICBs to commission palliative care services in the Health and Care Act 2022, the urgency and importance of ensuring that everyone has the best possible care and support at the end of life has yet to be recognised as a national priority. I hope the Minister will be able to provide assurance on this, because that is what Marie Curie wants, it is what Sue Ryder wants, and it is what every mum, dad and family member wants as well.

[Lee Pitcher (Doncaster East and the Isle of Axholme) (Lab)]

The day I get to intervene on such an amazing Member is a remarkable day. I live in a very rural area where there are places with real socioeconomic deprivation. I know for a fact that there is huge inequality in those kinds of areas when it comes to palliative care. Does he agree that the Minister and the Government need to look at how to reduce that inequality over the next 10 years?

--- Later in debate ---

[Jim Shannon]

The hon. Member is absolutely right. Politics aside, I want the Minister and the Government to do the job. It does not matter who the politician or the political party is; let us just give our people some hope. That is what I wish to see come out of this.

What assessment have the Government made of the need for a national strategy for palliative and end-of-life care? How will the Government ensure that palliative care specialists are included in neighbourhood health centres? What progress are the Government making on ensuring that every person with palliative care needs in the UK has access to a 24/7 support and advice line?

I believe that we can find a route towards an acceptable standard of life not simply for those who can afford private healthcare, but for all in our ageing communities. I understand that the Minister has a copy of my notes, and my seven points will be in there. To realise the 10-year plan objectives, which I have clearly said I support and want to see happen as soon as possible, palliative and end-of-life care must be recognised as a vital part of our health and social care system. Without making palliative and end-of-life care a priority for health reform, the Government will not achieve their bold ambition to provide more care in the community. I want the Government to achieve that ambition.

[Ms Julie Minns (Carlisle) (Lab)]

I spoke earlier to the hon. Gentleman to ask if he would take an intervention. When earlier this year my mum was placed on end-of-life care—she was put into the local hospital to receive that care—I had to repeatedly ask hospital staff to transfer her to our local, excellent Eden Valley hospice. It took three days for that request to be actioned. Does the hon. Gentleman agree that one change we could make is that, when someone in our hospitals is placed on end-of-life care, their families could be immediately apprised of the alternative provision that exists in our communities?

[Jim Shannon]

The hon. Lady is absolutely right—by the way, that is one of my seven points. We have spoken, but not exactly about that. The debate brings us together with our requests for the Minister and the Government; we are thankful for that.

Only 38% of those who died aged 85 or older received care from palliative care specialists, compared with 51.5% of those aged 65 to 84 and 59.3% of those aged 18 to 64. To the point made by the right hon. Member for New Forest East, most aged 18 to 64 spent most of their final months in a private home, but fewer than 50% of those aged 65 or older did so. One in seven people—15%—who died in hospital had been in there for less than 24 hours. When someone is coming to their last days, many complex needs are involved—there are also the problems for the family—but they will have to deal with two things in particular: pain, and probably breathlessness.

Almost two thirds of unpaid carers felt anxious most or all the time about the dying person’s illness or treatment. Shifting care from the hospital to the community would benefit older people, support the shift from hospital to community—analogue to digital—and prevent avoidable emergency care admissions. Those are all things that the Government must develop in a national strategy for palliative and end-of-life care.

The strategy must deliver on these seven points. First, an integrated whole-system approach is needed enabling patients at the end of life to move seamlessly through services as their health changes. Secondly, the Government must place palliative care at the centre of plans for neighbourhood health centres and ensure the inclusion of palliative care specialists. A key benefit of including palliative and end-of-life care in neighbourhood health centres will be the earlier identification of palliative care need and greater uptake of advance care planning.

Thirdly, the Government implement models of emergency and urgent care that can minimise avoidable accident and emergency visits. That would provide financial savings for the NHS as well as giving better care in a better system. That also comes to the input of the families, which is the very thing we all wish to see.

Fourthly, the Government need to strengthen the statutory guidance on the legal duty to commission palliative care services in the Health and Care Act 2022. Holding integrated care boards to account for the delivery of this duty must be part of that. Fifthly, we must introduce national quality standards for palliative and end-of-life care that must be met in all health and care settings. That would strengthen accountability while catalysing the 10-year health plan’s targeted shift from hospital to community for patients at the end of life. They must also support more equitable implementation of the vision set out in the ambitious national framework for local action.

Sixthly, there must be access to 24/7 support—the very thing being asked for—by creating a universal gateway to 24/7 specialist palliative and end-of-life care advice, guidance and support through NHS 111. In my constituency, we would say “yin, yin, yin.”

Seventhly, there must be a long-term, sustainable funding solution for palliative and end-of-life care that can reduce reliance on charitable fundraising and ensure parity of esteem for the NHS and non-NHS palliative care workforce. A transformation fund must also be created to invest in innovative and integrated models of care to meet different community needs. The Minister is probably saying, “My goodness, is it just seven points?”, but yes, I will stop at those seven, although I would like to comment on Sue Ryder if I may.

All of these stats can become figures on a page, but when I read them I think of the wee mummy lying on her bathroom floor after a fall, all night in tears; I think of my constituents who sob in my office, begging for help with their dying parent; I think of carers who are run ragged and know that a 15-minute call with that elderly person cannot possibly cater to their hygiene needs as well as feeding them; I think of district nurses who are late home because they would not leave their elderly patient upset after a wound change, and who made them a wee cup of tea and stayed for that comforting chat that time had not been allocated for.

Professor Jugdeep Dhesi, president of the British Geriatrics Society, said:

“Everyone should have access to high quality care until the end of their life, including palliative and end of life care when they need it. Sadly, this is not the case for many older people across the United Kingdom.”

Sue Ryder also asked me to highlight some issues. It is working to create a new ecosystem around palliative and end-of-life care, and to unlock hospital productivity through swiftly shifting care to the community in a progressive way that is sensitive to the resources available across the wider system, and focused on genuine collaboration at a local, place, and system level. The envisaged ecosystem would absorb patients from across the acute setting and increase referrals to community settings, helping our wonderful NHS to use its bed capacity more effectively, and relieving strain on the discharge system. The Sue Ryder model will shift care into the community by increasing hospice-at-home services and virtual wards, funded in line with national currencies and fast-track CHC reform. It is believed that this new approach to hospital care will develop dedicated care, alongside suites on NHS sites to provide compassionate, tailored care for those approaching the end of life, and to relieve pressure on hospital teams.

We must increase support for people in their own homes—that is what I want, what the hon. Member for Carlisle (Ms Minns) wants, and probably what we are all seeking. It is about expanding care in the community through partnerships, virtual wards, and increased hospice-at-home services to help more people die at home and reduce emergency admissions. We must aim to make full use of hospices’ expertise and space to support people with complex multi-morbidities and those in the last 1,000 days of life, preventing emergency admissions and helping people to live well.

I will keep to your timescale, Madam Deputy Speaker; I am coming to the end. The end of life is not a happy topic, but I believe it is a necessary conversation. We must open that conversation to ensure that people feel able to record their wishes for the end of life, so that more of their needs are met by the people involved in their care. We must ensure that there is information, and above all funding to deal with the growing pressure—the family issue that the hon. Member for Carlisle referred to—because how we treat the most vulnerable in our society is the measure that we will all be judged by.

I am no better than anybody else, but as elected representatives you and I, Madam Deputy Speaker, and everyone in the Chamber want to do the best for our people. Today we ask for the best for our people. I work alongside my mum to ensure that her last time on earth is the best we can make it, and I know I can safely say that it is the desire of this House and the Minister to provide that for every person in the United Kingdom of Great Britain and Northern Ireland. But we cannot do it without Government buy-in, or without help from the Minister, and from the Labour Government and those in power. The hospice sector is looking for a way to do things better, so I ask the Minister to join those who know this issue inside out, and find a route to help our ageing community and those in end-of-life care. That is also from Marie Curie, Sue Ryder and Professor Dhesi—all those people, and all of us as MPs on behalf our constituents.

Thank you for your time, Minister, and I look forward to your response.

[Several hon. Members rose—]

--- Later in debate ---

[Jim Shannon]

I thank all Members who have taken part in the debate, including the right hon. Member for New Forest East (Sir Julian Lewis), and the hon. Members for Carlisle (Ms Minns) and for Doncaster East and the Isle of Axholme (Lee Pitcher). The hon. Member for Shipley (Anna Dixon) brought her knowledge to the Chamber, as did the hon. Member for Weston-super-Mare (Dan Aldridge) and I thank him for that.

It is good news that we are living longer, but there is a cost factor and we understand that. The hon. Member for Weston-super-Mare referred to hospices holding the community together, and he is absolutely right. They are always there and always available, and it is good to have that. The hon. Member for Epsom and Ewell (Helen Maguire) reminded us that there is better care in our latter days, and that is what we all need to see.

I am very pleased, as always, to see the shadow Minister, the hon. Member for Hinckley and Bosworth (Dr Evans), in his place. I always look forward to the contributions he makes in debates and enjoy his company. He spoke about cuts across all hospice services and the impact of that, which cannot be ignored. He made a comment about how end-of-life care is provided in Japan. There are lessons we can learn from other countries, which is an important point that I had not thought of.

I thank the Minister for his positive, heartfelt and honest response. He referred to moneys in his speech—some £100 million for hospices and some £26 million for children’s hospices, which the right hon. Member for New Forest East also mentioned. We are seeing palliative care and end-of-life care being central to the Government’s 10-year plan. Not one of us in this Chamber will not welcome that plan; if it brings forward what our people want, it is the right plan. With that in mind, I thank the Minister and I thank you, Madam Deputy Speaker, for your patience.

Question put and agreed to.

Resolved,

That this House has considered the ageing community and end of life care.

GP Services: Melton and Syston

Jim Shannon Excerpts

Thursday 30th October 2025 Commons Chamber

[Edward Argar (Melton and Syston) (Con)]

Thank you for calling me, Madam Deputy Speaker, and through you I thank Mr Speaker for granting this important Adjournment debate. I congratulate the Under-Secretary of State for Health and Social Care, the hon. Member for Glasgow South West (Dr Ahmed), on his well-deserved promotion to ministerial office—it was in very short order, but it is very well deserved. I thank him for being present to respond to this debate tonight, because he has, as I have just indicated, a rather longer journey home to his constituency than I do back to Leicestershire. At the outset of this debate, I should put on the record that I am, of course, registered as a patient at one of the NHS GP practices in my constituency, which I may refer to in the course of this debate.

As every Member of this House will recognise, general practice is in many ways the gateway to the NHS for our constituents. It has the potential to do a huge amount more. Sadly, on some occasions the gateway to NHS services for our constituents is simply to go to A&E, rather than seeking to go to their general practitioner, or indeed rather than using—to the extent that it has the potential to be used—pharmacy as a first port of call, as people can see a pharmacist for some advice in the first instance. For the vast majority of people, though, it is the GP practice that is the route into the NHS and where people go when they are concerned about their health.

I am sure that all Members of the House would recognise the challenges and pressures faced by general practice irrespective of Government in recent years. There are a number of factors behind that. We should not forget the impact of the pandemic, with the changing patterns of attendance that followed it and the increased demand that came immediately after it. We are also seeing the consequences of an ageing population in our country, with people living longer with more chronic conditions.

We also see the increased pressure in many of our communities, irrespective of where they are in the country, that arises from increases in housing development that are not met with increases in the provision of key local infrastructure. This has been especially true in recent years in my constituency, where we have seen huge increased local development without that infrastructure. There is also the prospect of significantly more development.

I am going to talk primarily today about the particular issues in Melton Mowbray and the surrounding villages, as I have indicated to the Minister, as I am keen that he is able to give a pragmatic and helpful response for my constituents. I will also touch on some broader themes and on the provision of general practice in the village of Sileby in my constituency, which also faces pressure and challenges.

[Jim Shannon (Strangford) (DUP)]

I find in my constituency, and I think the right hon. Gentleman will find the same, that the extra responsibility of filling in forms, such as for personal independence payments, universal credit, employment and support allowance and disability living allowance, falls on the GP. Has he found that providing the evidence for those benefits adds even more to the already large workloads of GPs?

World Stroke Day

Jim Shannon Excerpts

Tuesday 28th October 2025 Westminster Hall

[Jim Shannon (Strangford) (DUP)]

It is a pleasure to serve under your chairmanship, Ms Vaz.

I thank the hon. Member for Twickenham (Munira Wilson), both for setting the scene and for sharing the story of her mum, because such stories always give a very honest and true perspective. My own mother is now 94. When she was 93, she had a number of transient ischemic attacks, or TIAs. I remember being in the ambulance with her and in the hospital as she waited to be admitted. Ultimately, unfortunately, it led to physical disabilities. Although she is compos mentis and really sharp in her mind, even at 94, physically she will never be able to do the things that she once did—so I understand, and I thank the hon. Lady for sharing her story.

World Stroke Day is a day that sticks out for so many people—we would struggle to find someone who does not know an individual affected by the impact of stroke. Of course there is more to be done, and I am very pleased to be here today to discuss that.

I welcome the Minister to his place; I understand that this might be the first Westminster Hall debate as a Minister. Last night, he was in an Adjournment debate in the main Chamber; today, he is in Westminster Hall, so he is seeing great things on the tour of Westminster, and I wish him well in all that he does.

Statistics from the Stroke Association highlight that every day in the UK another 240 people suffer the catastrophic impact of a stroke. Two thirds of people who survive a stroke find themselves living with a disability and six in 10 survivors rely on the help of a carer, often a family member or friend.

This year, World Stroke Day aims to focus on the truth surrounding post-stroke recovery. Whether it is a short-term or long-term process of physical, behavioural or emotional rehabilitation, it begins in hospital, but can be lifelong, requiring support for months or even years in the community through carers and family.

[Alex Easton (North Down) (Ind)]

Unfortunately, Northern Ireland, where the hon. Member and I live, has the second highest rate of stroke across the UK, with something like 4,700 strokes each year. Does he agree that we need to share best practice and research, which is emerging from certain parts of the UK, right across the board?

[Jim Shannon]

I thank the hon. Member for his intervention, and he is right.

Whether it is our lifestyle, what we eat, the way we live, or whatever it may be, it is really important that we address these things. Recovery can take years and some people find it completely life-altering. Over the past 10 years, there has been a 23% increase in the number of people who are registered with their GP for chest, heart and stroke conditions. The figures are serious. It is crucial that support is available to those who require it. Those organisations, which offer fantastic support to families, ultimately take on a large amount of caring responsibility—and therapy, whether it is physical, occupational or speech therapy, should be accessible and helpful to all.

In conclusion, I remind hon. Members of the importance of the FAST strategy—face, arms speech and time—which is imperative in noticing the signs of stroke. This World Stroke Day, let us focus on recovery care and giving people the support they need to rehabilitate, get back on track and learn to cope with their new normal. I urge the Minister to work with the regional Administrations of Scotland, Wales and Northern Ireland; these are things that we can do better together.

Obesity and Fatty Liver Disease

Jim Shannon Excerpts

Tuesday 28th October 2025 Westminster Hall

[Jim Shannon (Strangford) (DUP)]

It is a pleasure to serve under your chairship, Mr Efford. I thank the hon. Member for Worthing West (Dr Cooper), who is co-chair of the all-party parliamentary group on liver disease and liver cancer, for setting the scene incredibly well. I thank her for the detail and for her requests to the Minister. It is, as always, a pleasure to see the Minister in her place. I wish her well and I look forward to her answers. I also thank the British Liver Trust and the Foundation for Liver Research, which supplied me with a briefing that made clear the excellent work at the Roger Williams Institute of Liver Studies, which continues to drive world-leading research into metabolic liver disease to shape how it is diagnosed and treated.

Liver disease is a growing cause of premature mortality and lost years of working life in all four nations of the United Kingdom. It has been estimated that some 4,878 potential years of life were lost due to chronic liver disease in Northern Ireland. It is clear that the UK is in the midst of a liver disease crisis, to which the hon. Lady referred. It is as serious as that, and we should all take note. While premature mortality rates from other major diseases have fallen over the past two generations, deaths from liver disease have risen 400% since the 1970s. There are more than 18,000 deaths from liver disease and liver cancer each year in the United Kingdom.

[Clive Efford (in the Chair)]

Order. Members are asking that you speak into the microphone, Mr Shannon, so that they can hear you.

[Jim Shannon]

That has never been a problem in the past, Mr Efford. Do I need to lift it up to my mouth? I thought it was good enough to carry my voice; apologies if it is not. This would be the first time it has not worked.

Two thirds of adults are overweight or living with obesity, and one in three children are classified as overweight or obese when they leave primary school. Sadly, four in 10 children with obesity may already have liver disease. One in five people are affected by liver disease and liver cancer in the UK, and as many as 12% of those—more than 1 million people—go on to develop the more severe form of fatty liver disease.

The stats for Northern Ireland are unreal. That is not the Minister’s responsibility, but it gives a flavour for the debate. Some 64% of adults in Northern Ireland were overweight or obese, a marked increase from 23% in 2010-11. My goodness me—if ever we needed a reality check, that is one for us. Shockingly, Northern Ireland has the highest rate of overweight or obese primary 1 children in the UK, with 25.3% of children fitting that category. In my constituency of Strangford, 27% of year 8 children were overweight or obese. It is estimated that 70% of adults and 40% of children who are overweight or obese have fatty liver disease, so urgent work must be done to prevent this health crisis in the making.

Shockingly, 37 million extra sick days are estimated to be taken by people living with obesity, harming economic output on a massive scale—a figure of 1% to 2% of UK GDP as estimated by the Institute for Government. The NHS alone is expected to shoulder an estimated £10 billion per year obesity bill by 2050, with obese patients costing twice as much as those of a healthy weight. Reducing obesity prevalence by 10% could save £6 billion per year in the UK economy.

Let me tell a personal story. I am a type 2 diabetic. Some 16 or 17 years ago, I realised that I needed to drastically change my eating habits. I was 17 stone. To be honest, to put it very starkly, I was a big fat pudding. I realised that if I did not lose weight for my diabetes, I was going to be in trouble, so I reduced my weight quite substantially, by 4 stone. I have managed, by and large, to keep at that reduced level. First, it was down to stress but, secondly, it was down to Chinese takeaways five nights a week with two bottles of Coca Cola. That just does not work; when it is added up, you just get fatter and fatter. I took that away and tried to reduce my chocolate intake.

My hon. Friend the Member for East Londonderry (Mr Campbell) has said that he is reducing his sugar intake—well done to him; he does not need to, but it is definitely a good purpose to have. The point I am making is that not everyone can. For those who cannot, it is important to look towards the weight-reduction injections, to which I will refer in a moment. I have been able to control my diabetes for the last 10 years by tablets. I take nine tablets in the morning and five at night to keep everything under control.

Newly released weight-management drugs such as Ozempic and Mounjaro have been shown to reduce the weight of patients by an average of 5%, reducing the risk of a variety of health effects, including fatty liver disease. However, although those drugs are available for those who obesity and type 2 diabetes, they are not for those with fatty liver disease. Making that happen would be my one request of the Minister. If someone has a body mass index of over 40, and does not yet have those comorbidities, unfortunately they will not qualify.

There is a new generation of drugs targeting advanced fatty liver disease. Resmetirom has recently been approved by the US Food and Drug Administration and is expected to be approved in the UK within 12 to 18 months. Could the Minister give us an indication of where those drugs are in the system? Those new drugs—some of which improve liver function and some of which enable weight loss—can reverse fatty liver disease and must be made available in a timely fashion to save lives. The NHS needs to ensure that services are ready to support that, as previously no treatment has been available for those patients.

The UK faces a very challenging commercial environment for drug pricing. Lilly recently announced that it will increase the price of Mounjaro by as much as 170% in response to pressure from the US Government and historic pricing inconsistencies. My second question to the Minister is about what has been done to ensure that the price of drugs is reduced or kept controlled in a way that can make a difference.

Thirdly, I say to the Minister that ICBs must have an effective pathway for the early detection of liver disease. A new nationally endorsed pathology pathway to improve early diagnosis of liver disease is essential. Every community diagnostic centre should also have a fibroscan to assess fibrosis.

Finally, I say to the Minister that patients with advanced liver disease and cancer need access to weight management services in line with access for people with type 2 diabetes. This is a ticking timebomb, but there are scientific breakthroughs there to address it. I believe in my heart that the Government need to cut that wire and stop that timebomb now.

Regulation and Inspection of Funeral Services

Jim Shannon Excerpts

Monday 27th October 2025 Commons Chamber

[Simon Hoare]

I do agree. In many respects, the only bit of legislation on which we can rest a serious prosecution is the Burial Act 1857, which deals with the corpse post internment. It is silent on the corpse’s treatment from the point of death through to the point of either internment or cremation. There is an enormous vacuum in the rules and regulations that I think most fair-minded people would say needs to be filled.

[Jim Shannon (Strangford) (DUP)]

I commend the hon. Gentleman for securing the debate. This is the second Adjournment debate of his in which I have been involved in the last six months. He brings to the House subjects that are pertinent not just to North Dorset but to every constituency across the whole United Kingdom of Great Britain and Northern Ireland.

Does the hon. Gentleman agree that such an intimate and essential service for people at the most vulnerable times of their lives must be of the highest standard? We have wonderful funeral companies such as Clarke’s and Adair’s in my Strangford constituency, but we sometimes hear dreadful stories of horrific service. The fact that we regulate nail salons but not funeral services indicates that we need to consider ensuring a minimum level of service protection, and that the Government, and the Minister in particular, should at the very least instil some form of accountability into the process.

[Simon Hoare]

I fundamentally agree with what the hon. Gentleman said, as would the lion’s share of operators, because they are acutely aware of a crisis of public confidence in the sector’s ability to deliver.

NHS Workforce Levels: Impact on Cancer Patients

Jim Shannon Excerpts

Thursday 23rd October 2025 Westminster Hall

[Jim Shannon (Strangford) (DUP)]

It is a real pleasure, as always, to serve under your chairship, Mrs Hobhouse. I thank the hon. Member for Wokingham (Clive Jones) for raising this matter, which affects constituents in every part of this United Kingdom of Great Britain and Northern Ireland. I always admire the hon. Gentleman because of the personal experiences with cancer that he tells us about. I have heard about them from him personally, but also in this Chamber. His heart is for those with cancer, and those who suffer and need to find a cure. I congratulate him on all he does.

As the hon. Member for Harrogate and Knaresborough (Tom Gordon) mentioned, the Macmillan coffee morning was this morning. Macmillan put forward some recommendations this morning, and I wonder whether the Minister has had an opportunity to have contact with the group. Macmillan is always helpful—it is not here to catch anybody out—and it was putting forward positive ideas on how to do things better. Perhaps the Minister can indicate whether that opportunity has come forward.

In this life, there are not many things that I say I hate—when I use that word, I mean it—but I do hate cancer. I hate the devastating effect it has on people and families. I hate that children suffer and that their parents can only stand by and watch, as happens on many occasions. I hate that children are left motherless or fatherless and that nothing can be done. I hate having to deal with that dreadful disease. But most of all I hate that we cannot cure it—at least, not yet.

One of my requests to the Minister, who is always incredibly helpful, is on research and development. Statistically, one in two people we meet—half the people in this room—will have cancer; 50% will survive, and 50% will not. The research and development is so important for getting to the day when we find a cure. I know the Minister is committed to that, and I hope she can give us some idea what is being done on that.

Each of us in this place will have been touched by cancer. I think of my own dad. My dad has been dead now for 10 years, but he was a cancer survivor on three occasions. He put that down—as I would as well—to the skill of the surgeon, the care of the nurses and the prayers of God’s people, which helped him get out the other side.

We can argue about microwaves, about preservatives in food and about genetic or carcinogenic factors, but this debate is about ensuring that NHS workforce levels enable every sufferer to have the best chance possible to fight cancer. As the hon. Member for Wokingham and others who have spoken have said, we are not there just yet. There are insufficient NHS workforce levels in Northern Ireland—I know that that is not the Minister’s responsibility, but I want to give a flavour. Things are not that different there; what happens in Northern Ireland happens in England, Wales and Scotland. If cancer patients have delayed diagnoses and treatments, that can lead to potentially life-threatening consequences and increased anxiety. First, people are anxious about their health, and then they are anxious about how to pay the bills: “Do I get benefits? Can I get some help to get me through? Can I get my mortgage extended?” People have to face up to really life-altering circumstances, and unmet support needs as well.

Then we have the shortages in key roles, such as specialist nurses, radiologists and surgeons. Unfortunately, that means that treatment targets are frequently missed and patients do not receive the full support they require during and after treatment. The situation is worsened by growing waiting lists, increased workloads for existing staff and a lack of resources for both acute and community-based care.

The hon. Member for Wokingham spoke about pancreatic cancer. Many cancers are devastating, but pancreatic cancer is one of the worst. In the last 10 days, a young lady from Greyabbey, a village close to where I live, died of pancreatic cancer. She was 31 years of age, with a five-year-old son and a partner. I remember others. When pancreatic cancer is diagnosed, it is too late, because it has already taken effect and the body is already succumbing to that terrible cancer. That is why I go back to research and development. Will we find the cure for pancreatic cancer someday? Will we be able to diagnose it at an earlier stage so that we can give the treatment and help that are needed?

[Dr Arthur]

I know that this subject is important to the hon. Gentleman. Pancreatic Cancer UK is a fantastic charity. Unfortunately, he could not make this year’s Labour party conference in Liverpool, although he is always welcome to attend—Labour MPs go free, so he is welcome to join up. However, Pancreatic Cancer UK was there with scientists who are looking at a new diagnostic tool that, believe it or not, is based on a breath test. They can analyse a small particle in our breath to give an indication of whether there could be something that needs further investigation. That is a great example of how investment can help to save lives while bringing jobs to the UK. I am sure the hon. Gentleman will congratulate Pancreatic Cancer UK on all its work in this field, and on that little piece of progress.

[Jim Shannon]

I welcome the hon. Gentleman’s encouraging intervention. That is what it is all about. Of course, I attend my own party’s conference—I am not sure I would attend anyone else’s. Party conferences are a great opportunity to meet groups that are working hard, and they come to our conference too. That breath test is encouraging, and perhaps it will be part of the next stage of curing cancer, and particularly pancreatic cancer.

The target of starting treatment within 62 days of an urgent GP referral is not being met, with only 37% of patients receiving treatment within the critical window—those figures are from 2023. As of September 2023, some 545,000 people in Northern Ireland, which has a population of 1.95 million, were waiting for elective care. My goodness, is that not a scary figure? That issue is not the Minister’s responsibility, but it worries me when I consider it. It is the highest number on record. Waiting times for in-patient admissions and out-patient appointments, including for cancer patients, have increased dramatically since 2020.

There are shortages across multiple disciplines, including paediatricians, administrative support, pathologists, radiologists, chemotherapy nurses and palliative care staff. For example, while the number of clinical radiologists has increased, which is good news, the Royal College of Radiologists estimates that the workforce is still 50% smaller than is needed to meet demand. Yes, there have been advances, but we are not there quite yet. Current staff face extreme workload pressures, leading to a fear of missing early diagnoses, and also burnout for those whose commitment to help their patients is above and beyond what their wage packet might indicate.

We are not coping well. A constituent came to my office to ask why her first smear test results took 16 weeks to come back, and why she had to ring her GP on three occasions to get them. On her behalf, I had to email the doctor’s surgery and the health trust so that the biopsies were taken. It is easy to understand why her anxiety levels were through the roof. She now has to wait a further six to eight weeks to see whether she needs treatment. My goodness, it is little wonder that people are so worried, anxious and stressed.

The fact is that waiting times affect the mental health of even the young and the fit. If we are to give people the tools they need to win their health battle, as we need to, it begins with efficient diagnosis and treatment. We are not getting it right, and that is a fact. We can do better. Our constituents believe they are losing the battle before it truly begins, so what do we need to do? We need to bring our workforce up to par by ensuring that money in the NHS is spent appropriately and is not, to use an Ulster Scots word, frittered away.

I make a plea to the Minister for more research. I really believe that what we spend on research will be for the future and finding all the cures. If we go back a few years, only one in three people survived cancer; now it is one in two. That is an advance, and perhaps the day is coming when everyone can be in that place. I think of Queen’s University Belfast as one example. Its partnerships with medical companies to find cures are incredible, and those that it has found through its research are some of the best in the United Kingdom, if not the world.

To conclude, our NHS staff are second to none, but at times they seem to be working with one hand tied behind their backs, and that must cease. We must ensure we have sufficient funding to free them up to do the job and to fight cancer throughout this great United Kingdom of Great Britain and Northern Ireland—always better together.

Mental Health and Hoarding

Jim Shannon Excerpts

Wednesday 22nd October 2025 Commons Chamber

[Paulette Hamilton]

My hon. Friend raises a valuable point. I will come on to that later in my speech, but I absolutely agree that hoarding disrupts people’s lives.

[Jim Shannon (Strangford) (DUP)]

I congratulate the hon. Lady for bringing forward this issue. She is a dear friend of mine, and I always look forward to her contributions to this Chamber and Westminster Hall. I often think of a TV programme on this subject. Perhaps I did not always understand the obsessive behaviour of hoarding, but that TV programme opened our eyes to it, and helped us understand it. The makers of the programme not only showed the problem, but how to bring about a solution. That is what I always loved about the programme: it started off with a problem, but ended up with a solution.

[Paulette Hamilton]

The hon. Member is right, but this is not just about a solution. A number of people in our society are living with a mental health condition, and it needs to be treated. At the moment, there are no strategies in place, but I will answer his question as I go on. I thank him for his contribution.

Healthcare: Bolton

Jim Shannon Excerpts

Wednesday 15th October 2025 Westminster Hall

[Kirith Entwistle (Bolton North East) (Lab)]

I beg to move,

That this House has considered healthcare in Bolton.

It is a pleasure to serve under your chairship, Ms Lewell. I declare an interest as a member of the Women and Equalities Committee. Improving the quality of healthcare is a cause close to my heart, and I am pleased to be joined by my fellow Boltonian, my hon. Friend the Member for Bolton South and Walkden (Yasmin Qureshi). I would also like to highlight the work of my friend and neighbour, my hon. Friend the Member for Bolton West (Phil Brickell), who is unfortunately unable to join us today, but who I know has been strongly campaigning for a new neighbourhood health centre in Westhoughton, and I pay tribute to that work.

For too long, healthcare in Bolton has been treated as a technocratic policy area rather than a vital lifeline. My constituents are not concerned with acronyms or distant targets; they want answers to real, human questions: “Can I get a GP appointment when my child is ill?”, “Will my mum be seen in A&E within hours, not half a day?” and “Will my toothache be treated before it turns into an infection?” This is about fairness; it is about whether towns like mine get our fair share. My message is simple, and I will repeat it: Bolton must not be left behind—not in GP access, not in A&E rates and not in dentistry.

Everything I say today is drawn from the lived experiences of people in Bolton. Earlier this year, I held a local consultation on the NHS 10-year plan. The response was overwhelming. Boltonians care deeply about our NHS and, as a result, they brought ideas, energy and hope, as well as far too many stories of delays, confusion and dignity under pressure. I promised I would bring their voices here today and speak plainly about the state of healthcare in our town.

Let us be honest: by the time Labour came in last year, Bolton’s NHS was stretched to breaking point, with patients waiting, staff exhausted and services fraying. At Royal Bolton hospital, our A&E was among the worst performing in England-, at one point in the bottom 5%. Local residents were waiting 12 or 13 hours to be seen, with elderly patients on trolleys overnight and small children with high fevers stuck in crowded corridors. That was unbearable, and evidence of more than a decade of neglect. By the time of last year’s election, waiting lists were in crisis, with more than 600 people in Bolton waiting over 65 weeks for treatment—well over a year. Behind every wait was a life on pause: a knee that would not bend, a lump not yet diagnosed, a life put at risk.

That crisis did not happen overnight; it came from choices—14 years of underfunding, frozen capital budgets and ignored warnings about staff shortages. Public health budgets were cut by more than a quarter. That neglect hit towns like Bolton hardest, because when you start with older buildings, higher rates of illness and fewer GPs, cuts hit twice as hard.

Yet, despite it all, one constant kept us standing: our NHS staff. More than 6,000 people in and around Bolton hospital keep this town going. Nurses, doctors, porters, cleaners, therapists and paramedics turn up throughout winter crises and put up with buildings that are literally crumbling. I want to put on record my thanks to the many fantastic people I have met and particularly to Fiona Noden at Bolton hospital, Amy Rothwell at Bolton Maternity and Neonatal Voices Partnership, Leigh Vallance at Bolton Hospice, Carol Fielding and Steve Milward at Bolton Pulmonary Fibrosis Support Group and all the teams who care so deeply for their patients. They deserve more than our gratitude; they deserve a system that backs them.

Thankfully, because our staff and communities refused to give up, and because we now have a Labour Government repairing those years of neglect, there has been a real shift. Over the past year, Bolton hospital has become one of the most improved trusts in England for urgent care, the second most improved on the 12-hour A&E measure, and among the top 10 for the four-hour standard. Gone are the days of the regular 65-week waits. Cancer services are improving too. Bolton NHS foundation trust is leading the country on the 28-day diagnosis standard—a real credit to our cancer teams.

Of course, those gains were not luck; they came from investment, co-ordination and teamwork, and from Government backing alongside A&E staff, social care and our Greater Manchester partners. We have improved because we funded triage clinicians—expanding urgent care so that paramedics are not stuck in corridors—unblocked beds through better discharge planning and used modern data to keep patient flow moving. Improvements such as those show what happens when we have a Government who provide the support and resources we need. When Bolton is backed, Bolton delivers.

Of course, we cannot pretend that everything has been fixed within a year. Bolton hospital’s chief executive told me last week that winter illnesses have already begun, and my constituents are still living with the consequences of underinvestment. If we do not keep investing in beds, staff and modern systems, we will slide back. Even in recent weeks, I have heard from constituents about long waiting lists and poor communication. One constituent wrote to me after waiting nearly 10 months for an operation. Week after week brought new calls, promises and deferrals, with no clear explanation and no timeline held. Another constituent, who had received podiatry care for 20 years, found her care plan cancelled without notice after what was later described as “computer error”, leaving her housebound and in pain. That is not good enough. People deserve timely care and straight answers.

People also tell me about poor co-ordination across hospital, community and social care, delayed wheelchairs, patchy discharge planning and post-hospital support that does not arrive.

[Jim Shannon (Strangford) (DUP)]

I commend the hon. Member for Bolton North East (Kirith Entwistle) for securing the debate. Whether it be Bolton or Ballywalter, healthcare problems are the same for every one of us. The result of these issues is a lack of confidence in the system, which is harmful in itself. If someone says there is no point phoning the GP, because they cannot get an appointment, they cannot get early detection and intervention, and they will lose out. Does the hon. Lady agree that accessibility is the key to confidence and that that is where we need to start?