Terminally Ill Adults (End of Life) Bill

Jim Shannon Excerpts

Friday 13th June 2025 Commons Chamber

[Kim Leadbeater]

I have taken legal advice from Government officials to ensure that devolution is respected at every stage in proceedings. Where legislation that affects other jurisdictions needs to be amended, those conversations have already started and will continue.

[Jim Shannon (Strangford) (DUP)]

Will the hon. Lady give way?

[Kim Leadbeater]

No, I am going to make some progress, if that is okay.

The substances that would be used would not be new substances. As we know, assisted dying is available in many other jurisdictions, and there are substances that have been used safely and, in some cases, for many years. Their safety and efficacy has been proven around the world, but they do need to be treated differently, which is the purpose of new clause 13.

[Simon Hoare (North Dorset) (Con)]

Will the hon. Lady give way?

[Jim Shannon]

Will the hon. Lady give way?

[Kim Leadbeater]

I am going to make some progress.

However, it is most likely that these products are already licensed for other purposes. They could well be regulated through the Medicines and Healthcare products Regulatory Agency and within the Human Medicines Regulations 2012 for the purposes of the Bill, but it is important that time is given—

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[Kim Leadbeater]

Given what you have said, Mr Speaker, I will make some progress. [Interruption.] A lot of Members wish to speak today.

I now turn to new clause 14 and amendment 73. The new clause imposes a duty to make regulations prohibiting advertising of services related to voluntary assisted dying. This issue was discussed in Committee, following an amendment tabled by the hon. Member for West Worcestershire (Dame Harriett Baldwin). It was proposed that there should be no advertising of assisted dying services. I agree, and there was a consensus on that in the Committee. There were some issues with the previous amendment’s workability, so I gave a commitment to return to the matter on Report—hence the inclusion of this new clause. Amendment 73 provides that regulations under new clause 14 would be subject to the affirmative procedure, providing parliamentary oversight.

[Jim Shannon]

On the evidential basis, on page 15 of today’s edition of The Times there is a story about a gentleman who was born in South Africa and lives in Australia. He has come to London this week for this particular Bill in order to give his story. He was diagnosed with pancreatic cancer and told he had only two weeks to live: he lived for three years and one month, and he is still living. There is a growing evidential basis. He said that he was never afraid to die, but he says that he is afraid of the process of dying, and the hon. Lady is the initiator of that. Will she acknowledge the evidential basis and the importance of this subject? Does she realise that the evidential basis against this Bill is growing?

[Kim Leadbeater]

I thank the hon. Gentleman for the intervention, although I am not sure that it is relevant to the banning of advertising for assisted dying services, which I will try to stay focused on.

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[Sarah Olney]

I will not, if that is okay.

We were told that it was not practical to produce such an assessment until after Committee stage, as it would be necessary to assess the impact of amendments made in Committee.

The equality impact assessment was finally published five weeks ago. I have to say that I was pretty astounded. It does not recognise that certain groups in this country may have their lives prematurely shortened as a result of this legislation; instead, it concerns itself with the barriers that vulnerable people may face when trying to access assisted dying. I find that astonishing. Did the people who drafted the assessment not hear the speech of the hon. Member for Vauxhall and Camberwell Green (Florence Eshalomi) on Second Reading? She spoke with passion about how the underlying inequalities in access to healthcare experienced by those from black and minority ethnic backgrounds would be exacerbated if the Bill passed unamended. Did they not listen to the oral evidence that Dr Jamilla Hussain gave to the Bill Committee? She talked about her experience of working with racialised communities in Bradford and their fears of being pushed disproportionately towards an assisted dying pathway. Did they not listen to the testimony of Dr Miro Griffiths on the experience and concerns of disabled people—testimony that has been echoed by Baroness Tanni Grey-Thompson and the actress Liz Carr?

I find it inexplicable that the framing of the impact on vulnerable people should be the removal of barriers to accessing assisted dying and not, as it should be, the increased risk to their health and wellbeing that the Bill presents. I am concerned that we are thinking about the impact on vulnerable people solely with reference to those who are suffering a terminal illness with less than six months to live. We are not thinking about the impact on wider society of introducing a concept of lives not being worth living and how that might disproportionately affect our more vulnerable communities.

My new clause 19 and consequential new schedule 2 and amendment 88 seek to ensure that a comprehensive range of statistics are collected about those who seek and receive an assisted death, so that proper and complete monitoring of requests can be carried out. It is imperative that we get the most detailed possible picture of who is requesting an assisted death so that any patterns of disproportionality can be properly detected and addressed.

[Jim Shannon]

What assurances does the Bill give to the families of people with a disability, or those with mental health issues and those who are anorexic? I do not see any. Does the hon. Lady see any assurances for those who want to end their lives but suffer from those ailments?

[Sarah Olney]

I welcome that intervention. I spoke extensively about the Bill’s impact on anorexic people, and I am not satisfied that those concerns have been addressed.

I am pleased to support amendment 21 tabled by my good friend, colleague and constituency neighbour, my hon. Friend the Member for Twickenham (Munira Wilson), which has attracted support from across the House. It would require the Secretary of State to report on the impact that the Act has had on the healthcare available to those with palliative and end-of-life care needs. I am really pleased that the hon. Member for Spen Valley (Kim Leadbeater) has agreed to accept the amendment.

I am also pleased to support amendments 103 and 104 in the name of my other constituency neighbour, my hon. Friend the Member for Wimbledon (Mr Kohler). They seek to make all statutory instruments made under the Act subject to the affirmative procedure rather than the negative procedure. As it stands, the Act will come into force in four years’ time with no further scrutiny by MPs, yet a whole host of issues that have been delegated to the Secretary of State or have not even been considered will need to be legislated for after Royal Assent. As the Bill stands, the only way for Parliament to scrutinise those powers will be to call for a 90-minute debate on a motion that cannot be amended and will be voted on only if the Leader of the Opposition calls for a vote. Making statutory instruments subject to the affirmative procedure rather than the negative procedure would mean that the Secretary of State, whoever that is, can exercise the powers delegated to them only with the approval of Parliament. For an issue as sensitive and profound as assisted dying, I believe that to be an appropriate level of scrutiny.

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It is beginning to feel as if this were a deliberate tactic. “Keep things vague, do not make anything too real or tangible, and do not confront what this will mean day-to-day. Let’s just keep it light. Let’s keep it airy-fairy. Let’s keep it in the cloud of principle and, somehow or another, through benign intervention, good will accrue.” This is too serious an issue in which to place that faith, because it could be misplaced. That relies on us as Members of Parliament not to care—to switch off when we hear the words “secondary legislation”, something that we know can often be dealt with in five or 10 minutes in a Committee room, with 14 or 20 people selected by the Whips and no debate on the Floor of the House. This is not a niche issue for the Hansard Society or the Delegated Powers and Regulatory Reform Committee, and it would be a shame and a stain on this House and this Parliament if we were to nod through a Bill that gives us the idea that Henry VIII is the way to go.

[Jim Shannon]

Will the hon. Gentleman give way?

[Simon Hoare]

I will not; I am very conscious of time.

Madam Deputy Speaker, given that so many right hon. and hon. Members have been constrained in the length of their contributions because of your persistent cough—I say that not as a criticism—and that next week we have a lot of one-line Whips and the following week we have exactly the same, more time really should be given to the Bill. I do wish the Government had taken it on, not as a Government Bill but by finding Government time for Report on the Floor of the House. This is too serious an issue to have as many gaps and lacunae as this Bill has.

The founding fathers of the United States worked on the basis that the vague generalities of the constitution would always be adhered to, and that men and women of goodwill would adhere to it. I am pretty certain that they are now beginning posthumously, with the current incarnation, to wonder whether that is true. We should not be legislating to leave it up to Ministers to define regulations and decide how they come forward. We have Bills that have page after page after page which, when people ask themselves, “What is this all about?”, actually amount to very little. The amendments that have been tabled, and which I support, have been tabled in good faith, but I am afraid to say that, in trying to improve the Bill, they are trying to make a silk purse out of a sow’s ear.

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[Carla Lockhart (Upper Bann) (DUP)]

I rise to support and speak briefly to amendment (a) to amendment 77, tabled by the hon. Member for South Antrim (Robin Swann), and I will speak to new clause 13, amendment 96 and other amendments if time permits.

I was rather confused when I looked at the amendment paper a few days ago and noticed that amendments that would directly impact on Northern Ireland had been tabled. When last I checked, the Bill as a whole extended only to England and Wales, so I find amendments 76 and 77 perplexing. To be clear, health and criminal justice are devolved matters. The people of Northern Ireland elect their own Assembly to make precisely these sensitive decisions, including whether to legislate for assisted suicide, which is an issue of profound moral weight and cultural consequence.

[Jim Shannon]

My hon. Friend is right to pursue this matter. The hon. Member for Mitcham and Morden (Dame Siobhain McDonagh) said it earlier on: the NHS was formed by the Labour party and is of the Labour party. These amendments would ensure that the Secretary of State could overrule Assembly Members. In other words, 90 Members of the Assembly could make a decision, but the Secretary of State could overrule it—surely that is incredibly wrong. It flies in the face of the democratic process that we are here to uphold.

[Carla Lockhart]

My hon. Friend is absolutely right. On a constitutional basis alone, amendment (a) to amendment 77 is necessary, and I hope that hon. Members will feel they can support it.

Moving on to factors beyond the constitution, I am concerned that there is a dangerous absence of an adequate regulatory framework for lethal drugs under the Bill. At present, clause 25 gives the Secretary of State powers to approve lethal drugs, while clause 34 mandates the Secretary of State to make provision for prescribing, dispensing, transportation, storage, handling, disposal and record keeping, as well as enforcement and civil penalties. However, the fundamental issue of how these approved substances are actually approved remains alarmingly weak. The Bill defines “approved substances” simply as

“a drug or other substance specified”

by the Secretary of State in regulations. There is no explicit requirement for those substances to undergo specific, rigorous testing for their use in assisted dying.

When this issue was debated in Committee, I was disappointed to see good-faith amendments to engage, such as amendment 443, being dismissed.

Spending Review: Health and Social Care

Jim Shannon Excerpts

Thursday 12th June 2025 Commons Chamber

[Karin Smyth]

My hon. Friend makes an excellent point on mental health, which is of great concern to all Members. He is right that elective care and mental health are measured in different ways, but we are committed to supporting mental health services with 8,500 extra staff. We are making sure in particular that young people in schools are supported. We know that the situation has been terrible for young people in our country, and we will continue to provide that relentless focus.

[Jim Shannon (Strangford) (DUP)]

The Labour Government have committed more money to the NHS, and that has to be welcomed. For that reason, I thank the Minister for her statement today. The Chancellor yesterday announced some £50 million—this does tie in to health—for Casement Park. However, the Government were clear that that was dependent on funding from the Northern Ireland Executive. Does the Minister expect the Northern Ireland Executive to take extra moneys granted to the Northern Ireland Assembly through Barnett consequentials and divert them to a sports stadium? Are the moneys for the NHS ringfenced and protected? If not, how do I look parents in the eye in my constituency of Strangford, when their child cannot receive cutting-edge medical technology because money has to be found for a sports stadium?

[Karin Smyth]

The hon. Gentleman is an experienced parliamentarian, and he understands how the funding settlement for the Department of Health and Social Care is allocated through the Barnett formula to Northern Ireland.

Duchenne Muscular Dystrophy

Jim Shannon Excerpts

Thursday 12th June 2025 Commons Chamber

[Chris McDonald]

Yes, I do agree with that very timely intervention. In fact, the slogan of Duchenne UK is “Time is muscle”, and it is absolutely right that every day and every week makes a difference to these boys.

[Jim Shannon (Strangford) (DUP)]

I congratulate the hon. Gentleman on bringing forward this debate. He and I spoke about it the other day. I have some constituents who have had a brave few years with Duchenne muscular dystrophy. The problem is that the opportunity of this drug has never been there for them, but it needs to be. Up until now in Northern Ireland, Duchenne treatment has included corticosteroids, physical therapy and other supportive therapies, while access to newer treatments, such as vamorolone or givinostat, are being worked on—we in Northern Ireland have not had access to them either. It seems to be almost a postcode lottery. Does he agree that these drugs could give those young boys a life-changing opportunity that they would never have otherwise, and that, with great respect to the Minister, the Government need to move and ensure that they all get these drugs?

[Chris McDonald]

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

NHS Funding: South-west

Jim Shannon Excerpts

Wednesday 11th June 2025 Westminster Hall

[Steve Darling]

I agree that staff are the NHS’s most important asset and what makes it tick, which my hon. Friend is right to highlight.

[Jim Shannon (Strangford) (DUP)]

I am here to support the hon. Gentleman; I congratulate him on bringing this subject forward for debate. He is right to highlight issues with cancer care. It is the same for us back home: only a third of those referred by GPs begin treatment within the target time. Does he feel that there is money to be saved through the administration in the south-west trust area? If there is, perhaps that could help.

[Steve Darling]

That is very insightful. After being around medics for many years, I know the concern about the increase in managers. Equally, I know that integrated care boards, which I will come on to now, have real challenges with the savings that they are making. There is talk of merging ICBs, including, in the far south-west, a merger in Cornwall and Devon. Both ICBs are relatively challenged, and I fear that it could be a marriage of two bankrupts. Perhaps it would be better to look at a bigger footprint, including Somerset.

Breast Cancer Screening: Bassetlaw

Jim Shannon Excerpts

Monday 9th June 2025 Commons Chamber

[Jo White]

I thank my hon. Friend for that point. I have sympathy for her experiences and hope that she is now fully recovered. Yes, we must be conscious that women of all ages could have breast cancer, and awareness must be raised so that women continue to check their breasts for it.

What I do know is this: breast cancer screening and early detection save lives. The earlier that breast cancer is detected, the simpler and more effective the treatment is likely to be. Between the ages of 50 and 70, on a three-year cycle, women will get a letter in the post inviting them in for screening. A chance conversation last autumn with a local GP alerted me to his concern that the number of women attending Bassetlaw hospital for screening appointments had dropped dramatically. I asked the chief executive of our local hospital trust to investigate that, and he quickly came back with some worrying figures showing that attendance had dropped in recent times to below 50% of women invited for screening. This was either due to an appointment cancellation or a no-show on the day. NHS England data shows that prior to the coronavirus pandemic 78% of women in Bassetlaw and Doncaster were going for screening. The decline is dramatic and is not unique to Bassetlaw.

[Jim Shannon (Strangford) (DUP)]

I commend the hon. Lady for bringing this debate forward. I spoke to her before the debate and her concerns are those of us all, and that is why we are here—to try to make lives better. Across England, Wales and Northern Ireland breast screening coverage remained relatively steady over time until 2019, at an average of 76%, but following covid in 2019, breast screening coverage had decreased to 65% by 2022. The covid impact on breast screening is entirely worrying, as is the fact that most trusts are not back to pre-covid screen test rates. Does the hon. Lady agree that we need a co-ordinated approach throughout the United Kingdom of Great Britain and Northern Ireland to enhance screening rates? We look forward to hearing the Minister’s response.

[Jo White]

I thank the hon. Gentleman for his contribution and agree that it is worrying that only half of the trusts in England are meeting the national target of 70% of eligible women going for their screening, but next year we hit a milestone in that it is estimated that almost 1 million women will be invited for screening. I welcome the fact that NHS England is actively encouraging more women to book and attend their screening. Will the Minister provide more detail on that?

To be honest, in Bassetlaw I cannot wait for a national operation to kick in. Last month I launched the “Bassetlaw love your boobs, get them checked” campaign, supporting local women and encouraging women to go for their breast screening. I pay tribute to the wonderful Bassetlaw women who have been active in the campaign—women such as Liz Rew and Maria Charlesworth, who found lumps in their breasts and went for their screening. Barbara Baldwin and Claire Previn joined my campaign as they have had friends taken too soon by breast cancer; I do not want anyone else to have to go through that. Lynn Dixon from Bassetlaw had breast cancer in her family and was first diagnosed at the age of 36 after finding a lump, and she has just recently found another lump and was screened. This week she is facing further treatment for breast cancer. My thoughts and love are with Lynn right now. [Hon. Members: “Hear, hear.”] Jenny Bailey is a former NHS nurse and midwife in Bassetlaw who had her breast cancer identified following routine screening. The women from Bassetlaw are amazing, using their life experiences to join the fighting spirit, encouraging their friends, family and neighbours to get screened.

Yeovil Hospital: Maternity Unit

Jim Shannon Excerpts

Tuesday 3rd June 2025 Commons Chamber

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

I thank the Minister and my hon. Friend the Member for Yeovil (Adam Dance) for allowing me to speak, and I thank my hon. Friend for securing this important debate. The closure of Yeovil special baby unit and maternity unit has shocked many of my residents across Glastonbury and Somerton, as it did my hon. Friend. After the announcement, I immediately set up a petition to gather evidence of the strength of feeling regarding these vital services. Since then, I have been inundated with responses.

I begin by echoing my hon. Friend’s sentiments in thanking the staff at Yeovil for their incredible work and care. Rob from Limington, a resident in my constituency, told me that his family would not be a family without the work of Yeovil staff. That is a compelling piece of information. Somerset NHS foundation trust made the decision following a clinical assessment that services could not continue operating safely. That is a damning indictment.

[Jim Shannon (Strangford) (DUP)]

I commend the hon. Lady and the hon. Member for Yeovil (Adam Dance) on their campaign. To reinforce the point evidentially on the closure of Yeovil hospital maternity unit, the impact on the community will be great; it happened to me at Ards hospital, where GP services were overrun with the work that had to be done. Midwives complained that the impact on the community was great, and the effect was not just on the maternity unit, but on NHS services overall.

[Sarah Dyke]

The hon. Gentleman is absolutely right that the impact is not just within the county, but causes a huge knock-on effect on wider services.

The decision is a damning indictment of how our health services have been treated, and how they have been run into the ground following the Conservatives’ regular cuts. Residents in Glastonbury and Somerton are devastated, and are concerned that this six-month temporary closure could then become permanent. I have had many examples of residents contacting me, including Ben. He and his wife are from Martock, and are expecting their first child in September. They have planned a home birth with support from the Yeovil midwifery team. They can still access those services, but if complications arise, they will no longer be able to rely on Yeovil hospital services, which are only a 15-minute drive away. They will have to go a lot further, driving at least 45 minutes to access Taunton, Royal United hospital, Dorchester or Salisbury. There are so many unanswered questions, especially on how the closure will affect the capacity of Taunton’s Musgrove Park hospital, or Dorchester or Bath’s maternity units.

We need clarity now. Our residents deserve that. Will the Minister give us and our constituents that clarity, so that those who are looking forward to starting a new family or who are growing their family can know that the journey through their pregnancy will be safe and that they will have a family beyond that?

UK Health Security Agency: Porton Down

Jim Shannon Excerpts

Wednesday 21st May 2025 Commons Chamber

[John Glen (Salisbury) (Con)]

I am extremely grateful for the opportunity to bring the future of the UK Health Security Agency campus at Porton Down, in my Salisbury constituency, before the House again this evening. I say “again” because 15 years ago, on 22 June 2010, as an eager, newly elected, young MP, I raised the uncertain future of the institution in my first ever Adjournment debate. I did so again on 11 September 2013 and again on 24 June 2015, at the start of my second term as Salisbury’s MP.

In one sense, a lot has happened in the past 15 years, but sadly, in another sense, nothing has happened. The project to relocate to Harlow, in Essex, is apparently no closer to completion, but neither have the highly skilled workers at Porton Down been given any assurances that they can stay put. I know that this matter will concern you, Madam Deputy Speaker, given that a number of residents in your constituency of Romsey and Southampton North, which is adjacent to my constituency, will be working at Porton.

As the Secretary of State for Health and Social Care said in response to my oral question on 13 March, two months ago, this

“has been running around the system so long that is now used in a case study for senior civil servant recruitment.”—[Official Report, 13 March 2025; Vol. 763, c. 1295.]

As the House of Commons Library said in a note to me on 22 January this year,

“neither UKHSA nor the Department for Health and Social Care have published an account of this programme to date, nor published any formal reports setting out the current state of the programme.”

The National Audit Office published its report, “Investigation into the UK Health Security Agency’s health security campus programme”, in February last year. That report sets out the key facts on and decision points in UKHSA’s programme, including its history, the causes of the delays and the issues so far at the Harlow site. I will not rehearse all those this evening, but reading the report may be instructive for the Minister.

[Jim Shannon (Strangford) (DUP)]

I commend the right hon. Gentleman for securing the debate. I remember him bringing the matter before the House before; we have been in the House for the same amount of time, although he is much younger than me. Does he agree that replacing and modernising the UKHSA’s facilities through the programme is crucial to ensuring that the UK has the capabilities to identify, study and respond to the most dangerous pathogens in the world? Perhaps the way forward is to secure changes and to ask the Government to step in to assist the UKHSA to continue the crucial and excellent work that it already does.

[John Glen]

I am grateful, as ever, to the hon. Gentleman for his support this evening, and he anticipates some of the points I will make later on.

I want also to refer to the Public Accounts Committee, which opened an inquiry into the UKHSA health security campus last year. The Committee heard evidence from the outgoing chief executive Professor Dame Jenny Harries and Shona Dunn, the second permanent secretary, but it was unable to publish a full report owing to the Dissolution of Parliament and instead published its conclusions and recommendations in a letter in May last year. There is a lack of clarity over where we are with these plans, and my simple purpose today is to secure the Government’s assessment of where we are now, 10 months into the new Administration.

Since that Adjournment debate in 2010, four general elections have been fought and I have had five years as a Parliamentary Private Secretary and seven as a Minister in four roles, but since 2015 I have never been offered any briefing on the future of the facility at Porton and on whether that initial decision, given the events of recent years and a sixfold increase in the costs—rather more than inflation—will be followed through on. As the constituency MP, I am eager to get to the bottom of the matter, and in seeking an update from the Minister this evening—and I certainly do not hold her individually responsible, given that she has only been in post for just over 14 weeks—I do want to seek an understanding about the financial obligations of the programme.

Parkinson’s Disease

Jim Shannon Excerpts

Wednesday 21st May 2025 Westminster Hall

[Jim Shannon (Strangford) (DUP)]

I thank the hon. Member for Colne Valley (Paul Davies) for raising this issue. As Members are well aware, I have been a vocal opponent of the changes to PIP, and I will concentrate specifically on PIP issues, how they affect people with Parkinson’s, and why it is important that the Government are careful about what they do with the PIP benefit and money in relation to those who have this disease. When we consider the care that is needed for those who suffer from Parkinson’s, it is a perfect example of those who might well miss out on the care that they need the most.

The hon. Gentleman set the scene well in relation to the problems that come with Parkinson’s, and others who have spoken also referred to them. We can all rightly understand how the personal independence payment costs may overstretch local authorities and providers—the NHS on the mainland and our underfunded trusts in Northern Ireland. The entire purpose of PIP, of course, is not to compensate for the illness in some way; it is to help someone live with the practicalities of the illness. That is the purpose of PIP and why I support it. I am really concerned about what might happen.

PIP is not a supplement to keep people off work. It can help people in work, which is part of what the Government say the purpose is. PIP exists to help offset the cost of being sick or disabled and, as such, is an effective health intervention. A recent freedom of information request, however, found that 36% of people with neurological disorders were at very high risk of losing out on PIP. That could be even higher for people with Parkinson’s, as even if someone has scored four points previously in a “daily living” category, the rapidly fluctuating nature of the condition means that it is not guaranteed that that will be scored again.

We need to understand what Parkinson’s is, what it delivers and the importance of it. Without the financial support needed to help with the additional costs of sickness and disability, and with many households losing passported carer’s allowance, unmet need will likely transfer to local authorities, as part of their statutory obligations. I am concerned about the scenario the Government could find themselves in if they remove or reduce personal independence payments, and take away the carer’s allowance. The leader of the Liberal Democrats, the right hon. Member for Kingston and Surbiton (Ed Davey), said during Prime Minister’s questions today that a family could lose £12,000 a year; other calculations that indicate it could be £10,000 a year. The financial impact will be ginormous.

[Cameron Thomas]

I am glad that the hon. Member has brought this point up. Hon. Members have mentioned that there are 153,000 sufferers in the UK, 10% of whom rely on PIP. It is vital for them to live and work independently. I share the hon. Member’s concern that any reduction in sufferers’ access to PIP will not only have serious financial consequences but lead to a diminishment of their independence.

[Jim Shannon]

That sums up the thrust of my comments. I am really concerned by what the Government are pursuing and the impacts that it will have. This is coming from the people on the frontline—I would call them the people on the coal quay—who understand exactly what it means.

Equally, if people with Parkinson’s are no longer able to afford the extra heating needed to help with their debilitating muscle spasms, they are more likely to have a fall. That will increase hospital admissions and stays, as well as social care support for fractures and joint replacements that could have been prevented by making sure that people retain their moneys and do not see corners cut in their care. It is not just individual health outcomes that will be affected. With a quarter of councils in England saying that they are on the brink of bankruptcy and other providers across the UK being stretched, this policy could have devastating impacts on local services.

I will conclude with this point, because I want to keep to time, Chair. When we think about care for Parkinson’s patients, we must think of the effect of removing PIP from those people. I know that it is not the Minister’s responsibility, but I ask that he convey the concern that has been expressed in the debate to the relevant Minister in DWP and fight the fight to ensure that these people have the care that they need in the most cost-effective way possible.

Chronic Urinary Tract Infections

Jim Shannon Excerpts

Wednesday 21st May 2025 Westminster Hall

[Dr Allison Gardner (Stoke-on-Trent South) (Lab)]

It is an honour to serve under your chairship, Sir Desmond. I am not well today for the very reason that we are here. I may need to sit down during my speech if that is okay. I am deeply grateful to the hon. Member for Sutton and Cheam (Luke Taylor) for securing this incredibly important debate. [Interruption.]

[Jim Shannon (Strangford) (DUP)]

This is a difficult subject for those who suffer from this condition. I will give an example in my speech, as one of my staff members suffers from it. We are deeply indebted to the hon. Member for Sutton and Cheam (Luke Taylor) for bringing this forward. It is important to hear personal stories from sufferers, such as the hon. Member for Stoke-on-Trent South (Dr Gardner), and that they are given the opportunity to express themselves on the importance of this issue to them personally and to all our constituents.

[Dr Gardner]

As hon. Members may have guessed, this debate is not only important to thousands of women across the country—according to the Chronic Urinary Tract Infection Campaign, about 1.7 million women suffer from chronic UTIs—but incredibly personal to me. I have suffered from UTIs as a result of menopause for more than 10 years, and received a diagnosis of chronic UTI in 2023.

I do not think many people realise how debilitating and excruciating chronic UTI can be. At my worst, I wondered how I could go on. I even changed from a beloved lecturing job to one at NICE because I wanted to change things from within, and it is why I am an MP now. I have tried almost everything; I was even considering—as a final step before the final, final step—having my bladder removed.

Although my NHS consultant gave me Hiprex—methenamine hippurate—thank God, which is life-changing for me, he finally shrugged his shoulders and said that I would just have to live with this condition. In desperation, I tracked down a specialist who worked in private practice. How lucky I was to have the money. I can confidently claim that Dr Catriona Anderson saved my life, which I do not say lightly.

Chronic UTIs can lead to hospitalisation—I have been twice—and sepsis and death. I have a long list of all the drugs that I am on, but I will not read it out. I believe this is another case of how women’s medical conditions continue to be misunderstood, under-researched and underfunded. To illustrate that point, there is a belief that UTIs are more serious in men than in women. I acknowledge that men’s physiology—men have a longer urethra than women—means that they are less likely to develop a UTI, although the possible presence of an enlarged prostate means that they may experience restrictive urine flows and develop a UTI. That is certainly the case in older men. Consequently, all men are recommended seven-day courses of antibiotics compared with the three-day courses that women are recommended. By the way, there are three antibiotics to treat UTIs. Trimethoprim and nitrofurantoin are the top ones, but I am allergic to them, so I am on cephalexin when I need it.

There is a lack of acknowledgement that poorly treated UTIs can lead to bacteria becoming embedded in bladders. Incidentally, a much shorter journey in women means that the diligence afforded to men is not afforded to women. In addition, women’s immune response to pathogenic bacteria in the bladder is oestrogen-dependent, and so it is also age-related. Lack of official recognition of chronic UTIs means that women do not receive treatment equal to what men. I am a molecular biologist, but I will not bore Members by setting out the different types of receptors in the urethral lining of the bladder.

I will further illustrate this point in simpler terms. A campaigner told me how her doctor, who repeatedly prescribed her three-day antibiotic courses for her chronic UTI, prescribed her husband, when he presented with a UTI for the first time, a month-long course, which would entirely clear the infection, of course, and minimise risk of recurrence. That says it all. Incidentally, chronic prostatitis is recognised by NICE.

As has been mentioned, for many women—approximately 70%—three-day courses will be sufficient, but for rest of women, three-day courses clear only some bacteria. Those that remain are relatively resistant; they then increase in population and there is recurrence. Essentially, repeated short courses establish a system of natural selection for resistant bacteria. It also means that the remaining bacteria then have time to invade the bladder and become embedded, finally leading to chronic UTIs. So, patients are stuck in a loop.

The use of the useless urine dipstick test, which is no more accurate than the toss of a coin, and of the midstream urine test, which is even worse, means that infections go undetected. As a result, no antibiotics are prescribed until the infection gets worse and, finally, a short course of antibiotics is prescribed. However, the infection is still not fully cleared, so the loop starts again. The infection then becomes embedded in the bladder wall and chronic UTI develops.

Short-term antibiotic courses often do not treat chronic UTIs, because dormant populations of bacteria exist within the bladder wall. Your life revolves around desperately trying to convince doctors to prescribe a course that you know will work for you. I am due to move house soon and I am petrified of having to move GPs, which would mean again starting this battle of trying to convince a GP to take me seriously. I understand concerns around antibiotic resistance and the medical hesitancy in prescribing longer courses of antibiotics. However, the solution is not to minimise antibiotic use; it is to get the diagnosis right, treat thoroughly, recognise the existence of chronic UTIs and prevent their development.

I am concerned by the lack of research and guidelines for diagnosis and treatment of chronic UTIs. We could prevent them all together if we get things right. I am particularly excited by the UTI vaccine, which is not currently available in the UK. Prevention of UTIs would not only save the NHS countless hours and money, but save people from living miserable lives.

In April, the Minister for Care said in a response to a written question:

“there are no current plans to train GPs and urologists on recognising the symptoms of chronic UTIs”.

Also, current NICE guidelines do not contain guidance for chronic UTIs. This situation must change. Too many women are being left in unbearable pain without a proper diagnosis or appropriate medication.

I will be very quick now, Sir Desmond; you have been very patient with me. About 50% of all antibiotics are prescribed for UTIs. However, each year there are thousands of deaths from UTIs and approximately 200,000 A&E admissions are due to UTI-related illnesses. The cost of UTIs to the NHS, as well as to people’s lives, is huge.

This issue is personal for me. It is also personal for the millions living with the pain, frustration and isolation of chronic UTIs. Will the Minister meet me and others, including campaigners, to discuss how we can improve diagnostic tools, develop guidance and ensure that people suffering from this condition receive the care that they deserve?

Thank you for your indulgence, Sir Desmond.

[Jim Shannon (Strangford) (DUP)]

It is a pleasure to serve under your chairship, Sir Desmond. I commend the hon. Member for Sutton and Cheam (Luke Taylor) on his presentation of this debate on subject matter that some, such as the hon. Member for Stoke-on-Trent South (Dr Gardner), have personal experience of. Others, including me, have staff members who have had this condition, and some have family members who have had it—I understand that my friend the hon. Member for North Down (Alex Easton) has experienced that.

This is an opportunity to speak on behalf of sufferers in my constituency of Strangford and across this great United Kingdom of Great Britain and Northern Ireland. The NHS estimates that some 14 million people in the UK experience some form of urinary incontinence. That figure is expected to rise because of an ageing population with often very complex health issues. That is a fact of life. Those of a certain age—I am one of them—find that their health issues are multiple. That is the nature of age; it takes its toll.

Inadequate continence care can lead to serious complications, with urinary tract infections among the most common and concerning outcomes. NHS data showed that there were more than 1.8 million hospital admissions involving UTIs between 2018-19 and 2022-23. The majority involved patients aged 65 or older. The admissions include both those directly caused by UTIs and those for other reasons but where a UTI was also present. As a leading cause of emergency admissions, UTIs place substantial strain on NHS resources, while diminishing patients’ dignity, experiences and outcomes.

I wish to highlight that this issue affects both men and women, as well as children. The hon. Member for Sutton and Cheam referred to a three-year-old girl, so children are affected by chronic UTIs. A member of my office staff, one of our young girls, came to work with me when she was 16. She has been there for a long time, so I must be doing something right; she has not left me to go elsewhere where the money is better. Perhaps the conditions and the time off are better as well.

I understood the chronic pain that my staff member had, but also the need to be flexible at times—whenever she was not well, she obviously needed time off. She attended a fair few hospital appointments for a chronic UTI, and it was a very difficult time. She was on antibiotics for six months. I wondered, “Is that possible?” But in this case it was, because the infection was so chronic. Ultimately it cleared. Also, on 1 January this year she got married, so her life is going in the right direction now—thank goodness for that. The issue was exacerbated at the time by the difficulty of getting GP appointments and specialist referrals. The chronic pain just seemed to exist forever, even with the help of antibiotics. Eventually she got to the end of that six-month period and she is now in much better health.

I want to mention what we are doing in Northern Ireland, because obviously that will be part of any debate in which I speak. In Northern Ireland we have something, and perhaps the Minister will say to me in a few minutes, once I tell her what it is about, “Well, we’re already doing that.” If they are, that is good. I was very relieved when Northern Ireland rolled out the Pharmacy First scheme, especially as the scheme covers advice and treatment for uncomplicated urinary tract infections in the local pharmacy, so without having to wait for a GP appointment. If the Minister tells me that the Government have not done that yet, can I say that it is another Northern Ireland first? And if the Minister is not aware of it, may I say, to be helpful in this debate, that perhaps it should be done here as well?

The pharmacist may test the patient’s urine to help to determine whether a UTI is present. How does the scheme work? What happens when a person goes to their local pharmacy in Northern Ireland? In some cases, self-care advice may be all that is necessary. In other words, they will get a bit of advice. The pharmacist will find out what the symptoms are and explain the situation to the person, and perhaps will be able to respond fairly quickly. As I said, in some cases self-care advice may be all that is necessary, but the community pharmacist is also able to supply the patient with medicines to relieve pain—in some cases there can be chronic pain—and, if applicable, antibiotics. In all cases, women will be advised on what to do if their symptoms worsen or do not resolve.

The Pharmacy First UTI service means that women can be assessed and treated much sooner, without having to wait for a GP appointment—like the young girl in my office—for a month, two months, six weeks or whatever the case may be. Not only will patients not need an appointment, but community pharmacies are more likely to be open after normal working hours, at weekends and on bank holidays. Newtownards, my major town, has a number of pharmacies, which take turns staying open at the weekend; there is always access to a pharmacy in Newtownards and, indeed, other major towns in the Province.

The UTI management service expanded to more than 400 community pharmacies in 2024-25, following positive evaluation of the pilot, which involved 60 pharmacies and started in July 2021. That success convinced the Northern Ireland Department of Health to make the pilot bigger and showed that we could do more. Between March 2022 and April 2023, 3,500 women in Northern Ireland used the pilot service. Following assessment, more than 85% were diagnosed with a UTI and received appropriate advice and treatment from a pharmacist.

That is positive, but for those with chronic UTIs, like the hon. Member for Stoke-on-Trent South, the pharmacy does not cut it and the GP can only do so much. There are different levels of response: community pharmacies in Northern Ireland provide an automatic response to those who have a urinary infection, rather than a chronic UTI, but sometimes things are much more complicated.

The waiting list to be seen for a UTI in Northern Ireland is long, and the average waiting time for urology appointments varies significantly, depending on the health and social care trust and the urgency of the case. For example, in the Belfast health and social care trust, the wait in a red flag case—the most urgent—might be nine weeks, which is more than two months and far too long; a non-urgent case could wait 76 weeks, and a routine case could wait 180 weeks. Those are horrendous and completely unacceptable waiting times.

Throughout the United Kingdom of Great Britain and Northern Ireland, there needs to be access to specialised care, innovation, new and modern technology, and new ideas, rather than a six-month course of antibiotics and a hope for the best. Men, women and children need more, and it must be provided.

I look forward to the Minister’s response. She responded positively to last week’s debate, and I am sure that today she will again indicate her wish to make lives better. This debate gives her the opportunity to do so, and to help those who have been waiting so long for an end to their health issue. We can do better—and we must.

GP Services: Christchurch

Jim Shannon Excerpts

Tuesday 20th May 2025 Westminster Hall

[Sir Christopher Chope (Christchurch) (Con)]

I beg to move,

That this House has considered access to GP services in Christchurch.

It is a pleasure to serve under your chairmanship, Mr Dowd. This short debate was triggered by the perverse decision, announced last week, of the Dorset integrated care board to refuse permission for Burton surgery to reopen. The surgery is a premises in Burton village in Christchurch constituency, which has had a GP surgery for more than 30 years. The surgery was converted from a guest house. It has good car parking nearby and a pharmacy adjoining it, and is a well-loved community facility.

In 2007, the GP practice in Burton was amalgamated with Christchurch medical practice and became a branch of that practice. Then, in December 2023, patients were told that the Burton premises would be closed and all patients transferred to Christchurch medical practice in Purewell. I wrote to the integrated care board to express my concern at the impact that would have on the people of Burton. Although the ICB said that it was powerless to intervene because the surgery was only a branch, local residents were confident that another GP practice would acquire the premises and continue to provide GP services, because the building is in really good order: it has 11 consulting rooms and is a very attractive proposition for another GP practice. It was expected that it would be put on the open market for sale.

Much to everybody’s frustration, that did not happen. The owners of the practice decided instead to do a closed deal with a veterinary hospital based in Christchurch, which agreed to acquire the site, thereby excluding the possibility of another GP practice taking it over. However, one thing they had not thought about was that they needed to get planning permission for a change of use. The planning application was strongly opposed by local residents, backed by me, and it became a major issue in the general election campaign. Eventually, Bournemouth, Christchurch and Poole council refused the application on a series of grounds, the principal one being that

“insufficient evidence has been submitted to demonstrate that the loss of a community facility at this site would not result in a substantial decline in the range and quality of facilities and services available for local people.”

In essence, the local planners said that it was necessary to keep the surgery in Burton because removing it would take away an important community facility. If nobody else was willing to open such a community facility, I would not have been able to put forward this argument, but another practice has now purchased the premises and is willing and ready to open a branch in them. However, in order so to do, it had to apply to the integrated care board for permission. It did just that last November. Extraordinarily, it took months before a decision was reached—so long that I raised the issue in an oral question. The Secretary of State himself took it on board and, as a result, the ICB was pushed into having to make a decision on 23 April. As I understand it, the decision was made on 23 April, but was not communicated until some time afterwards.

In the meantime, and in anticipation that the application to reopen the branch was essentially a formality, South Coast Medical completed the purchase of the building and started the refurbishment. The plan was that it would reopen this summer. The ICB’s decision to refuse permission for the branch surgery to reopen is, in my view and that of my constituents and local residents, beyond belief. I appeal to the Minister to intervene on behalf of the 4,500 patients whom the ICB accepts would choose to re-register at Burton were the surgery to reopen.

Ironically, it is said that the cost of re-registering those 4,500 patients would be a significant burden on the health service. That is because people who are in their first year with a GP are thought to be more burdensome, so the GP gets paid a slightly larger amount for each of them. To describe the exercise of patient choice in that way—as a burden on the NHS—seems to me to be pretty wide of the mark.

After I heard the outcome of the application, I tabled a series of questions, one of which sought to establish how many people have been transferring from one practice to another in Christchurch each year, because I wanted to get a feel for that. The answer, from the Minister for Care, stated that the information is not available.

Some of the arguments made in favour of not allowing the surgery to be reopened, in answer to another of my questions, were based on the number of appointments already taking place in Christchurch. That prompted me to table a named day question on that subject. At about 9.30 am this morning I received a holding response, saying that the information relating to the number of appointments at surgeries in Christchurch over the past couple of years is not available, yet the ICB says that it used that very information to help it reach its conclusion. I hope the Minister will explain why the ICB, which I think is basically the custodian of all this information, so far has not decided to share that information with Ministers. Either it has the information or it has not been wholly open in suggesting that the information helped in its decision.

[Jim Shannon (Strangford) (DUP)]

Will the hon. Gentleman give way?

[Sir Christopher Chope]

I will not just at the moment, but I may do later.

This whole issue is a test case for the credibility of the new Labour Government’s promises about increasing access to GP services. In August 2024, after the general election, no one in government or in the NHS, including Dorset ICB, was suggesting that a GP surgery in Burton was not needed. Now that a serious plan to reopen the surgery is in place, without any capital cost to the NHS because South Coast Medical has acquired the premises using its own resources and does not need a grant, it is surely perverse that the ICB is arguing that such a branch surgery can no longer be afforded and that reopening it would adversely affect the financial viability of other practices in Christchurch.

I tabled questions on that issue as well. There is no evidence that other practices in Christchurch would be adversely affected, and I challenge the Minister to share with me, the House and my constituents the evidence that has been used to reach this decision. Will she also explain what can be done to appeal against the decision? It has been handed down by an unelected and unaccountable quango, or arm’s length body, which, among other things, has said to me in a letter that there have been no complaints about the quality of service being provided by the other main practice in Christchurch, which was operating the Burton branch and chose to give it up. However, there have been many complaints; I have fistful of them here, some of which I may refer to. Either the ICB does not open its post, or it is closing its eyes and ears to representations about issues relating to the availability of doctors, the importance of patient choice and the inconvenience of having to travel so far in a community that is not well served by public transport and where taxis are very expensive. If somebody is dissatisfied with the quality of service being provided by their general practitioner, they may wish to exercise their choice, and it is good to have some healthy competition, but all that seems to be being squeezed out by the integrated care board.

I will quote from a letter from Helen Yonwin, who writes: “Since the surgery closed last year in Burton and patients were transferred elsewhere, trying to get an appointment has been a nightmare. They seem to be unable to cope with the extra patients. The telephones are not always answered and it can take over 30 minutes to eventually get a response, only to discover that you are number 20-something in the queue. After a long wait to be told there are no available appointments, so ring again the next day, there are still no appointments, ‘But you can receive a telephone consultation from a GP’—but the next available slot is in four weeks’ time.”

That is not improving access to GP services, which is what the Government pledged. It is a levelling down and reduction in service. I hope the Minister will say that it is intolerable and unacceptable, and that for it to be condoned, if not supported, by the ICB is appalling.

[Jim Shannon]

Will the hon. Gentleman give way?

[Sir Christopher Chope]

I will just finish quoting from this letter: “If you are lucky enough to get an appointment, the next problem is getting there. Many people don’t drive or have a car, public transport is not easy for those with mobility issues, and taxis are expensive. If you do drive, another problem arises because parking is very limited.” It continues: “I cannot understand how it was stated that no complaints have been made. I and many others, in emails sent to the ICB, mentioned several issues, but I doubt any were noted.” That is a letter from one constituent; there are lots of others.

A new housing development has been approved in the locality of Burton; with some 700 new houses, there will inevitably be increased demand for GP services. Indeed, the developer, or the owner of the land, has already approached a surgery to see whether it would open a branch on the new estate. That will not be necessary if the branch to which I have referred is reopened.

I will quote from another letter. I will not give the person’s name because it refers to their condition, but she has multiple sclerosis. She says: “It’s so hard for me to get to the Purewell surgery even if you can get an appointment…I fell nearly two years ago, and I still haven’t had a proper appointment to see a doctor to see what’s causing my pain.” She says that she wants to have a choice.

Another person wrote: “I previously lived in Stour surgery’s catchment”—that is another surgery within the Christchurch constituency—“and they were amazing. I couldn’t fault them one bit. I then moved to Burton and was forced into this alternative provision.” She says that it is a nightmare to get hold of and that we should have a right to choose who we want as our GP. She also says, “Every time I’ve had an appointment, it’s been running 30 to 45 minutes late.” Reopening the local branch surgery would resolve those problems.

I hope that I have given a flavour of the strength of local feeling on this fraught issue. Somebody else wrote to me that not everybody wishes to complain publicly about the lack of service available from providers in the Christchurch medical practice, because they are worried about the consequences for them. I think that such concerns are irrational, but they are understandable.

[Jim Shannon]

I commend the hon. Gentleman for his campaign on this issue. It is what we expect from him, because he is very assiduous and very committed to his constituents. He has clearly laid out the issue. Does he feel that the main reason for the ICB’s not pursuing the case is finance? If it is, even with the proposed new housing, perhaps the Minister needs to look at the case personally to ensure that it is not being held back by anything that the Government are doing at this moment in time.

[Sir Christopher Chope]

The hon. Gentleman mentions the issue of finances. I tabled a written question about how much the health service has been spending on general practice in the Christchurch constituency. Again, rather surprisingly, the information is available only for the year ending 2023, so we do not have any information for 2023–24. Although I would not expect the figures for 2024–25 to be available, I certainly would have expected the total costs for 2023–24 to be available by now. The answer says that in 2022–23, some £17.5 million was spent on providing GP services in Christchurch.

The idea that the cost of transferring patients from one practice to another should be a decisive factor against the reopening of a branch seems extraordinary. It makes a nonsense of the argument that we must rein in our expenditure. While we are talking about the ICB’s expenditure, for the last several years I have been complaining that, at any given time in Dorset, under the ICB’s supervision, there are some 250 patients in Dorset hospitals who have no need to “reside”, as it is called. In other words, those people are in hospital but do not need to be there. Every day, that is 250 patients at a cost of between £500 and £1,000 each.

The same body is presiding over that scandal. It said last year that it was going to halve the number, but it has failed to do so—indeed, the number is just the same as a year ago. Instead of taking it out on the people of Christchurch and saying, “You can’t have access to a reopened branch surgery,” it should be looking at its own poor performance. As I have said to the Minister informally, the idea that Dorset ICB will somehow be amalgamated with other ICBs—creating even more bureaucracy, and making it even more remote from the people—is, again, farcical.

My final point—I want to give the Minister time to respond—is that, in answer to a written question, the Minister for Care said that as a result of what has happened in the last year, the number of patients in Highcliffe has increased by about 150. In Christchurch medical practice, the total number of patients has actually fallen; in the Stour surgery, it has increased; and in the Grove, it is about the same. To suggest, on those figures, that the financial viability of other practices in Christchurch will be threatened if this branch surgery is reopened seems to be without any justification. I hope that the Minister will be able to give a positive response, although I note that the Minister for Care is not responding to the debate.