Puberty Suppressants Trial

Nusrat Ghani Excerpts

Wednesday 17th December 2025 Commons Chamber

[Wes Streeting]

The shadow Minister asks, “Why?” There is a simple answer. It is because this was recommended by Dr Cass in the Cass review, which was commissioned by my predecessor, Sir Sajid Javid. I think that was the right thing to do, and it is why, when my predecessor brought forward the Cass review, I supported it in opposition. I certainly did not try to play politics with an extremely vulnerable group of children and young people.

I will tell the hon. Lady why. It is because, under the previous Government, those puberty-suppressing hormones were prescribed without proper oversight, supervision or safety, yet we did not hear a peep about that fact for years until Dr Cass, commissioned by Sir Sajid Javid—who deserves enormous credit—did the study, which was published and widely supported and which contained this recommendation. The Conservatives may have changed their tune in opposition, but I remember what they said in government when they published the Cass review and supported its recommendations, so I think their response now is a real shame.

The shadow Minister accuses me of inconsistency, so let me be clear. Am I comfortable that this clinical trial has undergone the proper process and ethical approval to ensure the highest standards and supervision? Yes, I am comfortable about that. Am I uncomfortable about puberty-suppressing hormones for this group of young people for this particular condition? Yes, I am—because of risks. It is why I was also uncomfortable when I upheld the temporary ban by my predecessor and then put in place a permanent ban. The reason I was uncomfortable with that, too, is because I had to look children and young people, and their parents, in the eye when they told me in no uncertain terms that that decision was harmful to them, as have many other clinicians who have opposed that decision.

Whatever my discomfort in this extremely sensitive area, the reason that I have made this decision is that I am following clinical advice and, as Health Secretary, it is my responsibility to follow expert advice. Had the Tavistock clinic faced such challenge and scrutiny a decade ago, we would not be in this mess. The Conservatives were right to commission the Cass review and they were right to accept its recommendations. I accept that there is now a difference on this particular recommendation, but I would urge Members not to walk away from the cross-party consensus we built behind that approach but to build on the work that Dr Cass has done.

Let me turn to the important questions raised by shadow Minister. There will be two groups within the trial, as well as a further control group of children and young people with gender incongruence who do not receive puberty-suppressing hormones. At least 226 participants are required in order to detect a statistically significant difference between the two treatment groups. However, this is not a target and no young person will find themselves on this trial because there is a drive to make sure that a certain number of young people are participating. In order for anyone to participate in this trial, it has to have the most robust clinical oversight from clinicians within the service, as well as national oversight and the consent of parents. It is only where young people will be deemed to benefit that they will be on this programme.

The shadow Minister asks about the data linkage study. That is important. The data linkage study will be undertaken, but when it is completed it will not provide us with the same evidence as this clinical trial. That is why Dr Cass made a distinction between this trial and the data linkage study.

The hon. Lady also asks about the motivations of those who withheld data. That is an extremely important question. It is utterly appalling that anyone in a position of responsibility in the NHS withheld data on a very vulnerable group of children and young people. I accept that there were many well-meaning people involved in these services at the Tavistock clinic, but the fact that Dr Cass found such a lack of rigour, such a lack of standards and such a lack of proper oversight is disgraceful. It is the clinicians who are well meaning and ideologically driven who have given me the most cause for concern in this whole debacle and who have done more harm to children, young people and the trans community than most other people who have taken part in this debate.

I appreciate the work that Dr Cass has done, and I am glad that she is in the other place, bringing welcome scrutiny. Were she not supportive of this approach, I might think again, but she has made her recommendation and given her support. I am following clinical advice. It is not comfortable, but I do believe it is the right thing to do, on balance.

[Madam Deputy Speaker (Ms Nusrat Ghani)]

I call Health and Social Care Committee member Danny Beales.

[Danny Beales (Uxbridge and South Ruislip) (Lab)]

The hon. Member for Sleaford and North Hykeham (Dr Johnson) asks, “Why?” Well, it is because trans people exist and their health needs exist. As the Secretary of State has clearly outlined, an independent review made a series of recommendations. There were clearly failures of healthcare, and a further recommendation was that a clinical trial should address this issue. I believe that the Conservatives supported the Cass review, but when it comes to implementing this part of it, they suddenly have collective amnesia about what Dr Cass recommended. Does the Secretary State agree that, in the absence of a trial, there will still be access to these drugs? We know that young people are seeking out private provision. They are seeking unregulated providers of these drugs, so is not a clinical trial both appropriate and the best and safest way of managing any potential risks?

[Wes Streeting]

The risk that my hon. Friend sets out was one of the considerations that I had to when weigh up—first when upholding the temporary ban, and then when making the ban permanent. I do worry that, outside of a trial, we may continue to see unsafe or unethical practice. I think we will be doing a service to medicine in this country as well as internationally if we have a high-quality trial with the highest standards of ethics, approvals, oversight and research from some of our country’s leading universities and healthcare providers to ensure that, for this particular vulnerable group of children and young people, we are taking an evidence-based approach to health and care.

[Madam Deputy Speaker (Ms Nusrat Ghani)]

I call the Liberal Democrat spokesperson; you have one minute.

[Helen Morgan (North Shropshire) (LD)]

I hope that everyone in this House can agree that medical treatment should always follow the evidence on safety and effectiveness. It is right that expert clinicians are building this evidence base and therefore right that the Government are seeking to run this trial, because it should be led by evidence and not by ideology.

Given that the numbers on the trial will be very small and the waiting list for talking therapies, which are so important for children and their parents, is very long, with hundreds of thousands waiting, can the Secretary of State explain how he will increase access to NHS talking therapies so people can get the help they need and deserve? In a field with so little research, will he confirm if the pathways trial will look at international best practice in order to take learnings from abroad?

--- Later in debate ---

[Wes Streeting]

Let me reassure my hon. Friend and the House that I am absolutely open to receiving representations and evidence from clinicians involved in the care of children and young people, with insight, expertise and data, including those who might be critical of the approach that the trial team is setting out or, indeed, critical that the Cass review included this recommendation. That is important because the many things that have gone horribly wrong in this area have included the silencing of whistleblowers and the silencing of rigorous debate and discussion.

We have to have this debate with due care and sensitivity for young people in this vulnerable group in particular and for the wider trans community, who feel extremely vulnerable in this country at the moment, including as a result of decisions I have taken as the Health and Social Care Secretary. We have to consider all of that in the round, but we must make sure that at all times we are following the evidence, that we are open to scrutiny and challenge, and that where we are making these finely balanced judgments, we are doing so with rigorous debate, testing the arguments, the evidence and the data. That is why I welcome the urgent question and this discussion.

[Madam Deputy Speaker]

I call Health and Social Care Committee member Joe Robertson.

--- Later in debate ---

[Wes Streeting]

I certainly do not need to be told what my responsibilities are on this. I always take responsibility for the decisions I take. I acknowledge the extent to which the hon. Gentleman and members of his party seek to weaponise this issue, and to personalise it. [Interruption.] We can simply refer back to his question and to the shadow Minister’s reference to the “Streeting trial”—if that is not personalising, I do not know what is.

I’ll tell you what: I will take an evidence-based approach. I have done that on this issue from day one. Had the Conservatives done so, we would never have seen the Tavistock scandal. We would never have seen puberty blockers dished out willy-nilly to children and young people in this vulnerable patient group. I have sought at all times, including when I sat on the Opposition Benches, to treat this debate with the care, sensitivity and humility it deserves, and not to be tribal in my interactions. I only wish this Conservative Opposition would take the same approach.

[Madam Deputy Speaker]

We are only at the start of this urgent question, so I ask Members to reduce the temperature in the Chamber.

[Rachel Taylor (North Warwickshire and Bedworth) (Lab)]

I thank my right hon. Friend for the care and sensitivity he has taken to this subject all along. It has been an undeniably difficult year for transgender people in Britain. I have spoken to young trans people who have been pushed to the brink of suicide by what they hear—that they do not have a right to exist, that they do not deserve rights, that they are legitimate targets for ridicule. We all in this House have a responsibility to lower the temperature and focus on their welfare, health and dignity.

King’s College operates the highest standards of safety. Does the Secretary of State agree that its expertise and rigour will support the wellbeing of participants and ensure that we get the robust evidence we need and that vulnerable children are no longer treated as political punchbags?

--- Later in debate ---

[Madam Deputy Speaker (Ms Nusrat Ghani)]

Order. I ask colleagues to keep their questions short and the Secretary of State to keep his responses on point. I call Health and Social Care Committee member, Josh Fenton-Glynn.

[Josh Fenton-Glynn (Calder Valley) (Lab)]

I hope we can all agree that the young people involved should not be used by anyone as a political football. Can my right hon. Friend please assure me that the process and trial will be clinically led, not defined by rhetoric—in this place or anywhere else?

--- Later in debate ---

[Madam Deputy Speaker (Ms Nusrat Ghani)]

Order. If hon. Members do not keep their questions short, I will not get everybody in. The answers need to be just as short.

[Wes Streeting]

I will try to do that, Madam Deputy Speaker.

We will ensure that young people get good access to wider evidence-led support. I have had to wrestle with the fact that some trans people enter adulthood without ever receiving any sort of healthcare, and I have been heavily criticised by those people in particular for some of the decisions that I have taken. We are working to reduce waiting times, as I have described.

My hon. Friend says that puberty blockers are reversible. We hear contrary views about that from Members across the House, some of whom say that puberty blockers are irreversible. The truth is that the evidence in this area is mixed, which is why we need to build a stronger evidence base.

--- Later in debate ---

[Several hon. Members rose—]

[Madam Deputy Speaker (Ms Nusrat Ghani)]

We need a short question. I call Jim Shannon.

[Jim Shannon (Strangford) (DUP)]

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

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

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

[Several hon. Members rose—]

[Madam Deputy Speaker]

I call Samantha Niblett for a short question.

[Samantha Niblett (South Derbyshire) (Lab)]

Trans people do not wake up at 18 suddenly trans; it starts before then. When we talk about protecting children, it means protecting trans children so that they can transition into adulthood knowing that they had parents and doctors who advocated for their needs. But this trial is not a prison sentence, so will the Secretary of State talk about whether people are entitled to withdraw from it if they change their mind?

NHS: Winter Preparedness

Nusrat Ghani Excerpts

Monday 15th December 2025 Commons Chamber

[Lee Anderson (Ashfield) (Reform)]

On a point of order, Madam Deputy Speaker. During the urgent question, the Health Secretary suggested that Reform UK were vaccine sceptics—that is not the case. I have had all my vaccines since being born, and I will continue to have vaccinations, including the flu jab. Is there anything you can do to encourage the Health Secretary to be a little bit more accurate with the facts?

[Madam Deputy Speaker (Ms Nusrat Ghani)]

Unfortunately, I am not responsible for the content of speeches made by Front Benchers or by Back Benchers. That is not a matter for the Chair, but the hon. Member has most definitely got his point on the record.

[Wes Streeting]

rose—

[Madam Deputy Speaker]

Does the Secretary of State wish to respond? Hopefully, we are not going to prolong the debate.

[Wes Streeting]

Further to that point of order, Madam Deputy Speaker. I just wanted to welcome the hon. Gentleman’s endorsement of vaccination. It is by far the most sensible thing he has ever said—that is a low bar, but he has cleared it, and I am very grateful to him. He might want to have a closer look at who his party platforms at its conferences, but that is not a matter for this urgent question.

[Madam Deputy Speaker]

We do not wish to prolong the urgent question.

Budget Resolutions

Nusrat Ghani Excerpts

Tuesday 2nd December 2025 Commons Chamber

[Several hon. Members rose—]

[Madam Deputy Speaker (Ms Nusrat Ghani)]

Order. As so many Members wish to contribute, the speaking limit has now dropped to three minutes.

--- Later in debate ---

[Shockat Adam (Leicester South) (Ind)]

I refer the House to my entry in the Register of Members’ Financial Interests. I welcome the Government’s abolition of the two-child benefit cap, but it should not have taken 16 months—it should have been the first act of a Labour Government.

I will speak first about the national health service. It is the jewel in the UK crown, but under consecutive Governments, millions of pounds of public money has gone to waste on interest payments for PFI schemes—that is money that should have been spent on frontline care or paying for doctors and nurses. PFI was a costly failure that lined the pockets of private consultants and contractors at the expense of NHS patients and staff. Now, it appears that the Government are planning to do the same again but expect different results.

Failed PFI schemes from the noughties, for three Leicestershire hospitals, saw the NHS sued for almost £30 million by the favoured consortium despite work not being taken and not a single hospital being built. Leicester’s three hospitals are still without any new buildings, as Ministers have pushed their development into wave 2, way beyond the original 2030 target, more than 30 years after the need was first identified. Coventry hospital, which was built, costs £1 million a week alone. The law was even changed to ensure that private contractors were paid before our NHS staff. Since the inception of PFI, around £60 billion of private money has gone into 700 PFI projects. In return, the Government will pay £306 billion. Those escalating costs eat into the NHS budget and leave less for frontline services.

Secondly, I will speak about private providers. As an optometrist, I have referred people for cataracts surgery because the waiting time is much shorter and it makes sense to do so, but unfortunately the transfer of taxpayer money to the private sector reduces resources for NHS services and ultimately limits its ability to treat patients effectively. The Government have apparently set aside £2.5 billion—and that is set to rise to £16 billion—for private services That is disappointing, as they could have used the Budget to expand NHS capacity by building new facilities, rather than buying out private sector clinics, but they did not. They could support local authorities and not-for-profit organisations to take over social care, but they have not. These are political decisions that have consequences in the long run.

Thirdly, I would like to speak about the deal with Palantir on data sharing that the Health Secretary is pressing ahead with. I have had patients contact me who are really concerned about data sharing. In fact, two of them wrote to me in the last week because they are really frightened that they have to opt out of this. It seems that our data is a commodity that is going to the highest bidder.

I would also quickly like to touch on hospices. I am running out of time, but LOROS hospice in my constituency is serving 1.2 million people in Leicester with only 18 beds—

[Madam Deputy Speaker (Ms Nusrat Ghani)]

Order.

--- Later in debate ---

[Several hon. Members rose—]

[Madam Deputy Speaker (Ms Nusrat Ghani)]

To make the final Back-Bench speech, I call Jo Platt.

[Jo Platt (Leigh and Atherton) (Lab/Co-op)]

The autumn Budget shapes the choices we make and the kind of society we want to build together. After 14 years of mismanagement, this Budget is about turning the page. It is about moving from uncertainty to opportunity, and about giving people the confidence that the Government are on their side. That is why I welcome the Chancellor’s autumn Budget. It marks the start of a series of measures that will make a real difference, such as helping with the cost of living, supporting our NHS and giving our communities the opportunities they need to reach their potential.

From our proud coalfield communities involved in the BCSSS scheme, who will finally receive the justice they deserve, to the 2,840 families in Leigh and Atherton who will benefit from lifting the two-child benefit cap, this Budget demonstrates that the Government are listening to communities like mine. It shows that the voices of ordinary people and the concerns raised in towns like Leigh and Atherton are being heard. I want to give special thanks to William Hancock, a local mineworker who fought tirelessly to support his fellow workers in getting the justice they deserve.

I was delighted when the Chancellor announced measures to tackle illicit activity on our high streets. For too long, fake shops and rogue traders have undermined confidence and damaged local pride. That ends now. Backed by £45 million over four years, the new crackdown will create a cross-Government taskforce, strengthen trading standards and give law enforcement the tools it needs to protect honest businesses. This is a direct response to the campaign I have led, alongside my hon. Friend the Member for Great Grimsby and Cleethorpes (Melanie Onn), to shut down dodgy shops and restore pride to our high streets. We do need to go further, but this is a huge step forward. It is the start of the change that our communities have demanded for so long.

This Budget is not the end; it is the beginning. Together we will rebuild trust, restore pride and create the kind of society that reflects the best of who we are. That is the future we promised, and that is the future we will deliver.

[Madam Deputy Speaker (Ms Nusrat Ghani)]

I call the shadow Minister.

--- Later in debate ---

[Jessica Toale]

I am sure that the Chancellor appreciates the hon. Gentleman’s input into the Budget, given that the public roundly rejected your approach to our economy just a year and a half ago.

[Madam Deputy Speaker]

Order. The terms “you” and “yours” should not be used, and interventions need to be short, so quickly get to the point.

--- Later in debate ---

[Simon Hoare (North Dorset) (Con)]

rose—

[Madam Deputy Speaker]

Order. The Minister is clearly not giving way to you, Mr Hoare, and the rest of us want to hear what he has to say.

[James Murray]

As the hon. Gentleman knows, Madam Deputy Speaker, I give way to him week in, week out in this place, so I know pretty much what he is going to say. I do not have much time, so I am going to make some progress. [Interruption.] The Opposition are very loud at the moment, but time and again there is deafening silence when they are asked to defend their record in government. They simply refuse to own up and face up to the damage they caused to our economy by slashing investment.

Our decision not to slash investment and to reject uncontrolled borrowing means that we have had to take fair and necessary choices on tax. We are being up front that those choices will mean everyone contributes more, but, as we promised last year, we are keeping taxes on working people as low as possible. We are doing that by reforming the tax system, increasing the rate of tax on property income and on those with £2 million-plus homes, increasing tax rates for online gambling while removing bingo duty, and ensuring that HMRC has the right technology for a modern, effective tax system. We are making the changes that the Conservatives always ducked, and we are keeping taxes on working people as low as possible.

When it comes to growth, the Chancellor has already beaten the forecasts once, with improved growth reported this year. We are determined to beat the forecasts in future years too, because we will not let the previous Government’s record hold Britain back in the future. We are backing entrepreneurs with tax breaks for businesses to scale and stay in the UK. We have secured hundreds of billions of pounds of private investment, and we are making sure that investment goes to every region and nation of the UK, so that everyone across the country feels the benefits of growth.

Families across the country plan how much to spend week in, week out. They budget, save and economise to stay on top of their household finances. We will hold ourselves to the same, and higher, standards when it comes to taxpayers’ money. We will always make sure that the Government live within their means and make every penny count. We have already begun to improve the efficiency of Government, saving £14 billion a year by 2029 through greater use of AI and automation, as well as reducing unnecessary bureaucracy and duplication through the abolition of NHS England.

At last week’s Budget, we set out our plan to make a further £4.9 billion of efficiencies by 2031, beginning by getting rid of police and crime commissioners, cutting the cost of politics and selling Government assets that we no longer need. This means we can make sure that taxpayers’ money—

--- Later in debate ---

19:52

Division 374

Question accordingly agreed to.

Ayes: 327

---

Labour: 315
Independent: 5
Green Party: 1
Your Party: 1

Noes: 182

---

Conservative: 90
Liberal Democrat: 59
Scottish National Party: 8
Independent: 5
Reform UK: 5
Democratic Unionist Party: 5
Plaid Cymru: 4
Green Party: 2
Traditional Unionist Voice: 1
Labour: 1
Ulster Unionist Party: 1

[Madam Deputy Speaker]

Order. Before I come to the next motion, I have been informed that certain Members are taking photographs in the Lobby while we are in session. Members know that taking photographs is strictly prohibited. The Members names have been given to me. I expect them to come and apologise before the evening is out. If any of those photos is published, there will be severe repercussions.

51. Inheritance tax (pension interests)

Question put,

That (notwithstanding anything to the contrary in the practice of the House relating to the matters which may be included in Finance Bills) provision may be made taking effect in a future year about the charging of inheritance tax by reference to benefits payable under a pension scheme on the death of a member of the scheme.

--- Later in debate ---

[Wes Streeting]

On a point of order, Madam Deputy Speaker. I have to confess a sin. Earlier today, in the debate on the Budget, I referenced the hon. Member for Clacton (Nigel Farage) and did not notify him in advance. This was particularly egregious because I was not very nice about him. With that in mind, and out of respect for the customs and conventions of this House, I would like to apologise to the hon. Member and put this note on the record. I have, of course, written to him in similar terms.

[Madam Deputy Speaker (Ms Nusrat Ghani)]

I am grateful to the right hon. Member for giving me advance notice of his putting this point on the record. I am not sure that it is a sin, or whether he will be absolved of it, but it has been noted.

Uckfield Community Hospital Surgical Unit

Nusrat Ghani Excerpts

Tuesday 25th November 2025 Commons Chamber

[Madam Deputy Speaker (Ms Nusrat Ghani)]

I call my constituency neighbour, Mims Davies.

[Mims Davies (East Grinstead and Uckfield) (Con)]

I start by thanking, through you, Madam Deputy Speaker, Mr Speaker for granting me this Adjournment debate. I know that it is unusual to allocate Adjournment debates to members of the shadow Cabinet, so I am grateful. I am delighted to be raising this important matter on behalf of my constituents. I appreciate it, and I hope that you, Madam Deputy Speaker, as my constituency neighbour, will appreciate it too.

Since July 2024, Uckfield community hospital has been entrusted to me as part of my changed constituency. It is one of two small but vital community hospitals in my area, the other being the award-winning Queen Victoria hospital in East Grinstead, which is going from strength to strength. We look forward to the completion of the community diagnostic centre in 2026. It is a buzzing, specialist community facility with great ratings and a vibrantly bright future. I thank all NHS staff in the various hospitals that cover my area, and the wider frontline staff who are there for us in times of need. As we approach the festive season, we are especially grateful to them.

So why do we have what feels like a fragile moment for the Uckfield community hospital? It has the same caring NHS staff and high ratings, but services have been taken from the site, including the formal site manager. Those removals give a sense of great unease. I will give a little history of the site, which, Madam Deputy Speaker, you will already know. A local benefactor back in the 1980s—Mr Arthur Hughes, a generous local farmer—gave the land and £1 million. The League of Friends then raised a further £1 million, which was matched by the NHS, for the people of Uckfield and the surrounding villages to see the facility delivered. The hospital was officially opened in 1993 by Her Royal Highness Princess Margaret. The bequest has the vital inclusion of an operating theatre. This can be found in the associated covenants, and it was especially for the small surgical aspects of local day care.

I have visited this fairly new, fresh-feeling, beautifully set and well-maintained community hospital on several occasions, and the welcome has always been warm and caring—local NHS staff taking great pride in their roles to support and administer to the local community. The League of Friends has long played an active part, and frankly a huge financial part, and has been a practical supporter of Uckfield hospital and the resident trust over the past years. Two examples recently include funding X-ray equipment to the tune of £186,000, and ultrasound machines at £60,000. It has not only supported the hospital, but offered extra funding to local GP surgeries, as it is the League of Friends’ philosophy that such funding benefits all local people.

The League of Friends has delivered plans to help upgrade the busy minor injuries unit on site. However, with the surgical unit now mothballed—in reality, it feels like it is closing—the uncertainty is just too much for the Friends. That is reflected in the emails that I have received in the past few weeks and months—even today, ahead of this debate. Local people are worried about the site. I hope that their fears will be allayed tonight.

The wonderful Linda Kenwood, the secretary of the League of Friends, has said poignantly:

“To be treated in this way is very upsetting.”

[Mims Davies]

It is a pleasure to receive an intervention from the hon. Gentleman in an Adjournment debate, and I completely agree. That is exactly what tonight’s debate is about, and I thank him for adding to it.

Without a dedicated Uckfield hospital manager to pull it all together, the site has become fragmented—that is the feedback that I receive continually. I have repeatedly heard that none of the individual trusts seems to interact for the wider good of the hospital site and its patients. I have previously written to the Secretary of State for Health on this matter, as I am concerned that if any fire or substantial incident was found at the site, who ultimately would be responsible for the site as a whole and for ensuring health and safety for all?

Let me take you back, Madam Deputy Speaker. I visited the hospital on 4 October 2024 to meet Danielle Gearing, a staff nurse, to see for myself the services offered at the hospital and to find out what was actually happening on behalf of my constituents. Along with the minor injuries unit, there was a full and varied range of out-patient clinics, including oncology, rheumatology, chemical pathology, dermatology, vascular, oral and maxillofacial and neurology, to name a few. Most of these clinics did include the consultant, registrar and quite often a clinical nurse specialist.

Yet that list does not include the other service providers and facilities on the site, such as the health visiting team, diabetes nurses, diabetic eye screening, heart failure nurses, dietitians, cardiac rehab, Parkinson’s nurses and MS nurses. Macmillan is there. Bowel screening is there. There is hospice outreach and the AAA clinic—providing abdominal aortic aneurysm screening—and the list at Uckfield community hospital goes on.

Danielle confirmed that it is a very busy out-patient department, which we hope will continue. We should not forget that at that point the hospital also had a GP surgery, a pharmacy and a mental health facility on the site. The ambulance service also runs a site close to this facility, as you will know, Madam Deputy Speaker. I will say more on the pharmacy situation shortly.

Out of the blue, in August 2024, the League of Friends received the following in a letter from Dr James Evans, a consultant in critical care and anaesthetics and medical examiner at East Sussex Healthcare NHS trust:

“I am writing to yourselves as a Consultant within East Sussex Healthcare Trust, and Deputy Divisional director of DAS, and as a Clinical Lead for Day Surgery.

I am hoping you will be able to help, and would be grateful if you could take some time to consider this email.

One of my roles is Clinical Lead responsible for the newly built Sussex Surgical Centre (SSC), which is looking to be functional in March 2025. This will be a surgical Hub aiming to improve day case surgery provision across the whole region and hopefully benefiting patients and staff in East Sussex.

Part of my role is related to equipment for the SSC, both ensuring we have the right stuff in place, and sourcing any essential items within a tight budget. Whilst engaged in this task, I have been made aware of some equipment within Uckfield Hospital that was kindly purchased by yourselves over the years. Some of this equipment is expensive and specialist, and extremely useful for the surgeons and whole…surgery team.

I know that equipment purchased by The Friends is intended for use solely within their Hospital, but I was hoping you may be able to consider making an exception at this time.

All of the equipment you have purchased (including a microscope, ultrasound machine and ECG machine) are incredibly expensive, but vital for the successful running of a DSU, and we are struggling within the constraints of our budget to purchase all of the equipment. As you know, the trust is in a dire financial position, and any help would be greatly appreciated.

The items in Uckfield would go a long way to facilitating the above and would be used on a daily basis within the SSC.

I am aware that I am asking a great deal from yourselves at this time but wonder if you may be open to further discussion on the subject.”

This, Madam Deputy Speaker, is literally taking the family jewels in plain sight. Chris Macve, chairman of the League of Friends of Uckfield community hospital, said of their concerns about the possible removal of services from our day surgery unit that they “as yet have had no official communication from East Sussex healthcare NHS trust.” There are still various unhelpful rumours and deep concerns about what was received in this letter from James Evans, and frankly there is still no clarity for the staff, the Friends and my constituents—and your constituents, Madam Deputy Speaker. For clarity, the Friends have said—this is what they know—that they “have not been told that this unit is fully closing, but you can understand our disbelief at the insensitivity and the lack of respect at receiving the news in this way. We have a perfectly good operating theatre at Uckfield, fully equipped and staffed, just sitting there doing virtually nothing.”

After a number of rumours increased on 7 October 2024, the hospital staff in the surgical day unit were told unofficially that the integrated care board had agreed to a six-month closure and that they should expect a meeting at the end of October or early November in 2024. As Members can imagine, this was a real shock and morale took a massive tumble. The pilot—the mothballing—began on 2 December 2024, just before Christmas last year, and I brought to the House my worries and concerns for my constituents at that time.

As Joe Chadwick-Bell, chief executive officer of East Sussex healthcare NHS trust, wrote at the time of the announcement:

“Uckfield DSU cannot safely support general anaesthetic or overnight care, and does not carry out surgical procedures on patients with a higher risk of complications, such as those with complex needs, certain disabilities, significant frailty and/or certain concurrent illnesses. In those cases, even day case procedures must be carried out in an acute hospital environment where the full scope of supporting clinical services is on site. Uckfield theatre sessions are not currently well used. The reason is partly due to the safety criteria mentioned above, but also partly because some of the procedures that we previously carried out at Uckfield are no longer commissioned by the NHS. It is also because advances in care mean many of those procedures no longer need day theatres, so are delivered in normal treatment rooms.

Over the course of the pilot, we will evaluate the impact of the changes and consider options for the future of day surgery at Uckfield. It is in all our interests to make the best use possible of what is a valued asset for the NHS in Sussex.”

This pilot is so unfair. Frankly, the surgical unit in Uckfield was condemned to not stand a chance—with no staff, no anaesthetists and treatment figures already manoeuvred by the East Sussex healthcare trust. That is the view of staff. Another blow to the staff at the unit came at the start of 2025, when Kamsons Pharmacy closed—and left, I understand, with some clouds over the terms of its departure. Frankly, why has this happened?

One year on, my residents are not taking this lying down. They have got together a local petition, which at present stands at 6,366 signatures. But it is the uncertainty that is causing local residents a great deal of stress and panic. I will be building on this petition after this debate. People need local services. They need family and friends nearby to help with operations, getting to the hospital and out of hospital, and they need care in the community—all of which this Government are committed to. My residents need answers.

I have had meetings, after much pleading, with three recent chief executive officers of the integrated care board: Adam Doyle, who personally promised me and my casework team updates in early August; Mark Smith; and the newly appointed chief executive officer of NHS Sussex, Karen McDowell, who I had the most recent meeting with last week. NHS England reorganisation and staff changes have left me and my casework team in the dark, just like my constituents under this Government, who I know are committed to local community services just as I am.

I stress again how important the day surgery unit is to providing local care. Uckfield hospital is a vital facility. It must not slip through our fingers. Its staff—some of whom have now retired or left in upset, anger and frustration—are worried. The CEO has kindly written to me since we met and said:

“I clearly heard the commitment of you and the local people for Uckfield community hospital, and am speaking to our commissioning teams who have been working with East Sussex healthcare NHS trust around their pilot specifically on day surgery but also—and likely more importantly—our terms working to develop neighbourhood care, and the potential for this asset within its work.”

I thank her for this letter and share it gratefully.

To recap for the Minister, a thriving surgical day unit has been mothballed. The manager of the hospital has been taken away and not replaced. Anaesthetists have been moved elsewhere and are not accessible. Patients are now directed to other surgical sites. Staff heard out of the blue of a six-month mothballing and were given roles miles away from Uckfield. The League of Friends’ assets have been stripped from the site. A year later, we are still in the dark, with no decision taken and no ICB head willing to put their head above the parapet. We need to know what comes next.

My well-loved hospital is a vital community service. Our town and area are growing at a rapid rate, with a significant amount of housing being built and due to be built. There is difficulty involved in getting around a rural area and there is an impact from the public having to get to Eastbourne.

Lots of people have moved from the coast and from London and have taken the opportunity to work locally, and they expect NHS services on the doorstep. That is why I am grateful to be in the Chamber this evening to ask the Minister to look at this vital matter for me and my constituents and to do all that she can. We need this facility to thrive, with the community hospital and its wide-ranging services backed to the hilt. Crucially, we want the Uckfield day surgery back doing what it should: operating.

[Madam Deputy Speaker (Ms Nusrat Ghani)]

The hon. Member for East Grinstead and Uckfield (Mims Davies) is a strong campaigner on behalf of Uckfield community hospital and its services, which my constituents in Sussex Weald will have used and would want to use, so I too look forward to hearing the Minister’s response.

Children with Serious Neurological Conditions

Nusrat Ghani Excerpts

Thursday 20th November 2025 Commons Chamber

[Ashley Dalton]

I am more than happy to do that. All too often, we have seen that the transition is a really difficult time, and as he points out, where services are perhaps not as joined up and cohesive for adults as they are for children, that is hugely jarring—a huge problem for families to navigate. We are committed to making sure that transition plans start early, involve families and ensure that continuity of care. Our goal is to make the process smooth and supportive, not stressful and fragmented.

Health is only one part of the picture. Children with serious neurological conditions often have special educational needs and disabilities, and their success depends on a joined-up approach across sectors. That is why the SEND reforms that the Government are working on are so important. We are moving towards earlier intervention, stronger inclusion in mainstream education, and better collaboration between health, education and social care. These changes will ensure that support is needs-led rather than diagnosis-driven, with clear accountability across integrated care boards and schools. By embedding mental health provision, improving workforce expertise and planning smooth transitions into adulthood care, we aim to deliver consistent, high-quality support that helps children to thrive and restores confidence in the system.

Caring for a child with a serious neurological condition can place enormous financial strain on families. The welfare system is designed to provide a crucial lifeline, ensuring that no family is crushed by the additional, often substantial, costs associated with their child’s condition. The Government provide support through a range of benefits, including disability living allowance, carer’s allowance, personal health budgets and local authority support, including respite care and equipment provision. Financial support is not just about money; it is about giving families the stability and security they need to focus on what matters most—their child’s wellbeing.

Our commitment to children with serious neurological conditions reflects the core values of our society: compassion, fairness and the belief that every child deserves the chance to reach their full potential. By improving healthcare access and providing comprehensive support systems, we are building a more inclusive and resilient future for all. We will ensure that no child or family feels abandoned, and that compassion and co-ordination define the care that they receive.

[Madam Deputy Speaker (Ms Nusrat Ghani)]

We have just checked the pronunciation of dorsal rhizotomy—hopefully I have not got it wrong either!

Question put and agreed to.

International Men’s Day

Nusrat Ghani Excerpts

Thursday 20th November 2025 Commons Chamber

[The Secretary of State for Health and Social Care (Wes Streeting)]

What a pleasure to follow the spokespeople for the Conservative party and the Liberal Democrats, the hon. Members for East Grinstead and Uckfield (Mims Davies) and for Mid Dunbartonshire (Susan Murray), whose contributions were very much in the spirit of what we have heard this afternoon. I can reassure both of them that the suicide prevention funding is not gone; it is devolved. This will be a challenge that we have to work through during this Parliament as we embrace devolution and set local authorities and health trusts free to spend as they choose. We will need to keep a focus to ensure that the emphasis on suicide prevention is not lost. I really welcome the challenge the hon. Members have brought and the spirit of it. I can confirm that we will be appointing a new men’s health ambassador, and I will keep the hon. Member for East Grinstead and Uckfield updated on that.

It is customary when beginning these debates to thank the Backbench Business Committee, as well as the hon. Member who opened the debate for their outstanding contribution, whether the speech was any good or not. I can honestly say, though, having been in this House for 10 years, that it is a rare moment to hear such a courageous speech as the one we heard opening this debate. We can be truly proud of my hon. Friend the Member for Cannock Chase (Josh Newbury). I hope his constituents know how diligently he fights for them every single day here. He is a conviction politician; he is prepared to speak truth to power and use his influence to get things done for his community. Just through his words today, he will have had such an impact on so many people he will never meet, but who will none the less draw strength from his courage.

I do not think anyone listening to the powerful contributions from right hon. and hon. Members today could fail to be moved by what we have heard—nor could they be anything but truly appalled by all the terrible dad jokes. I think the contribution from my hon. Friend the Member for Edinburgh South West (Dr Arthur) was truly the worst. I would like to get involved, Madam Deputy Speaker, but as is well known, I have absolutely no sense of humour—less sense of humour than Downing Street has for tolerating my jokes. I am not a fan of political jokes anyway, as too many end up getting elected. However, I did once hear of a Canadian politician who was popular with everyone—it’s probably not Trudeau. [Laughter.]

As I listened to the debate, two broad themes emerged. The first is how every day, many boys and men make wonderful contributions to our families, schools, communities and workplaces, and not just in jobs, roles and behaviours that are associated traditionally with masculinity and men, but in roles such as nurses, carers and primary school teachers. They have embraced a genuine commitment to equality—that no matter who someone is and where they are from, and whatever their background, sex or gender, they can grow up to be whoever they want to be.

As my hon. Friend the Member for Bolsover (Natalie Fleet) said so powerfully, the role of men and boys as allies, advocates, mentors and role models and their capacity for love, laughter and empathy inspire others, lift up our society, change lives and bring joy to those around them. I pay tribute particularly to two of the most important men in my life: my dad and his father, my grandad. For those who follow my family history, that is not the armed robber; it is the working-class east end Tory. I have to say that I have that in common with my hon. Friend the Member for Redditch (Chris Bloore), with his family heritage and political leanings.

Without those two men, I would not be standing here today. They have been a rock of stability and inspiration in life. My grandad was my closest friend and moral compass; my dad has been the rock of stability I needed, particularly when things were hardest in my childhood. I am lucky that both of my parents have always been in my life, but I must say that when I talk about being brought up by a single parent, the shorthand too often used in newspapers is “single mum”. As my dad often points out, he was the one who got the terrible teenage years and had to move out of the area to get me to move out before I hit the age of 30. I am very grateful to my dad, whom I love and admire very much.

We have heard powerful contributions today. I could not help but notice that almost everyone endorsed the Dad Shift campaign for greater paternity rights and leave. This Government are legislating for day one rights, but I know that the advocacy and representation that we have heard across the House will have been heard by my colleagues in Government. There will be a consultation, and I am sure that we have not heard the last of that.

None the less, for all the positivity, the second theme we have heard about today is an altogether less positive one. It is a startling reality that being and growing up as a man in today’s society can be very tough, especially for those from working-class backgrounds such as mine. My hon. Friend the Member for Loughborough (Dr Sandher) spoke powerfully about the economic injustice in our society, the poverty and inequality that add up to the pressures and strains, the educational disadvantage and the lack of security and opportunity that too often hold back people, and especially men and boys from backgrounds such as mine. Though I am proud to stand here today, proud of my working-class roots and proud of having beaten the odds that were stacked against me, the object of this Government—the object of the Labour party—has always been to change the odds for everyone and not just to have the exceptional few beat the odds. That is at the heart of this Government’s agenda.

I want to pay tribute to those who have brought this agenda to the mainstream. This debate is 10 years old, but I must remember and recall, back when it started, an awful lot of eye-rolling about whether it was necessary—including, I suspect, by me and others who wondered whether this was truly relevant. How wrong that sentiment was and how much of a brilliant riposte we have heard.

I pay particular tribute to my hon. Friend the Member for York Outer (Mr Charters) who spoke so powerfully at Prime Minister’s questions about the “dark cloud” that hung over him following the difficult birth of his and his wife’s first child. As he said, the strength of a man is about being open about his emotions. Sometimes, as we have heard so painfully today, those struggles become so overwhelming that men feel that the only way out is to take their own lives. When that happens, it is not just an individual, personal tragedy; it is like a nuclear bomb and the fallout hits everyone around them, as my hon. Friend the Member for Southend West and Leigh (David Burton-Sampson) spoke of so powerfully.

We know that that impacts men in different ways, from different backgrounds and in different sectors. During an interview on Fix Radio: The Builders Station yesterday, I was told that men in the construction industry are four times more likely to die by suicide. One of the biggest causes of stress and anxiety for tradesmen is tool theft. That is why I thank my hon. Friend the Member for Portsmouth North (Amanda Martin), who has been like a dog with a bone on that issue, with her campaign already delivering tougher punishments for the perpetrators of tool theft. Indeed, I promised Clive Holland, the host of Fix Radio, that I would pass on this message to the House. He said:

“I would love to stand up at that Dispatch Box and speak to all the people in Parliament…and I would grab them by the lapels and say, ‘Get it through…Just get it through. It’s crucial. We all need this industry. We’d still be living in caves without the skills of our industry’.”

He is absolutely right and that is why we are lucky to have my hon. Friend championing that issue on behalf of that industry.

The Government’s response to many of the issues raised in today’s debate is the country’s first ever men’s health strategy. It covers physical and mental health, and I am most proud that it was drawn up in partnership with men themselves, experts, men’s groups, charities and campaigners. We are all aware that politicians today are about as popular as tax collectors and traffic wardens, so we need wider allies and advocates, groups such as Movember, Men’s Sheds and Everton in the Community, which I had the pleasure of visiting last week. There are also campaigners such as Stephen Manderson, better known as Professor Green, and Clarke Carlisle, the premier league footballer, who use their own experiences with suicide and mental ill health to spread awareness and prevent that from happening to others. I also pay tribute to the journalists, such as the LBC philosopher king Tom Swarbrick, for talking about modern masculinity, the importance of male friendship and keeping the ties that bind us.

There are a number of ways in which we will act. First, by expanding access to support services; secondly, by helping men to take better care of ourselves; and thirdly, by ensuring that stigma is challenged and every man feels empowered to reach out for help. This is not just a plan; it is a call to action. It is not just about changing services and laws; it is about changing hearts and minds and culture, particularly in an online world of harms and radicalisation, as pointed out by my hon. Friend the Member for Watford (Matt Turmaine), as well as many positives, as identified by my hon. Friend the Member for Ribble Valley (Maya Ellis).

Half the battle for men and boys is to have the conversation in the first place, opening up the space to utter what are often the most challenging words: “I need help.” That is why our strategy meets men on their own terms and their own turf—partnering with the Premier League’s “Together Against Suicide” initiative; investing £3 million in community-based men’s health programmes; workplace pilots with EDF to support workers in male-dominated industries; support for minors; and new research to help us tackle the biggest killers of men, including rising cocaine and alcohol-related deaths, as well as taking action on gambling, as my hon. Friend the Member for Dartford (Jim Dickson) exhorted us to. On prostate cancer, I will keep the House updated as we await the recommendations of the National Screening Committee. I heard the representations today, particularly from the hon. Member for Wokingham (Clive Jones) and my hon. Friend the Member for Leyton and Wanstead (Mr Bailey).

Our aim is to create a society where men and boys are supported to live longer, healthier and happier lives, where stigma is replaced by understanding and where every man knows that his health matters. As we heard so powerfully, including from some of this House’s most outstanding feminist campaigners, like my hon. Friend the Member for Walthamstow (Ms Creasy), this is not an either/or. This is not a choice between men and women; it is the recognition that while women’s health inequalities have sexism and misogyny layered on top of them—something that we as men must take responsibility for tackling, too—men and boys do face challenges when it comes to our education, employment, health, wellbeing, life chances and opportunities.

As we heard so powerfully, especially from my hon. Friend the Member for Portsmouth North, it is not as if the women out there do not care about their sons, dads or brothers—quite the opposite. Similarly, we care about our mums, sisters, daughters, nieces, friends and colleagues. There are differences between the sexes—there are differences in how we are impacted by and contribute to the society around us—but we are born equal, and we have a responsibility to stand together to make sure that we create a rising tide that lifts all ships. A healthier, happier, more equal and more just society is what this strategy will help to bring about, and it is why this debate has been so wonderfully powerful.

[Madam Deputy Speaker (Ms Nusrat Ghani)]

As the Secretary of State mentioned brothers, it would be remiss of me not to mention my five brothers—this will give Hansard a run for its money—Basharat, Nasim, Rasalat, Nazir and Imran, and obviously my husband David. Those wonderful men in my life have enabled me to be in this Chair today. I call Josh Newbury to wind up.

Jhoots Pharmacy

Nusrat Ghani Excerpts

Wednesday 15th October 2025 Commons Chamber

[Stephen Kinnock]

I agree with everything the hon. Gentleman has said. It is completely and utterly unacceptable if a business such as Jhoots is not paying its staff. If there are indeed these reports that controlled drugs are not being handled properly, I would strongly recommend that any mishandling of drugs be reported to the General Pharmaceutical Council, which regulates pharmacy professionals and premises, so that appropriate action can be taken.

The hon. Gentleman asked about the payment of staff. Pharmacy staff are vital parts of the NHS part of what a pharmacy does. Pharmacy staff provide vital services to our communities and should be paid according to their contracts; any failure to do so is completely unacceptable. Of course, pharmacy staff are employed not by the NHS, but by the businesses they work for, so any dispute between staff and a pharmacy business should be raised with the Advisory, Conciliation and Arbitration Service, ACAS. I am also in touch with the Pharmacists’ Defence Association—the PDA—which is doing important work representing its members. I will be meeting them soon as well. Of course, we have responsibility for the NHS part of the work, but it is up to individual businesses to ensure that their employees are treated fairly.

The hon. Gentleman rightly mentions the review of suitability to operate, and we are now looking at that across the board. We are looking at the role of the General Pharmaceutical Council and what is taking place with ICBs taking contract action. Where there is no sign of improvement and pharmacies continue to be in breach, the next escalation is to strike them off the pharmaceutical register, which takes some time, because certain pharmacies—I am not going to name names, but I am sure the hon. Gentleman can imagine who—are trying every single thing they can to appeal, push back and stop the actions that we are seeking to take, which is elongating the process. However, I want to be clear: if there is clear breach and action is not taken to remedy that breach, pharmacies will be struck off the pharmaceutical register.

[Madam Deputy Speaker (Ms Nusrat Ghani)]

I call our very own pharmacist, Sadik Al-Hassan.

[Sadik Al-Hassan (North Somerset) (Lab)]

Thank you, Madam Deputy Speaker. As a pharmacist for nearly 20 years and the MP of North Somerset, I have the dubious pleasure of having two Jhoots pharmacies in the town of Portishead in my constituency. I cannot say two operating pharmacies, because they have shuttered their doors, with reports of them not having paid their bills, their rent or their staff. As a pharmacist, I know that this affects the perception and view of community pharmacy up and down the country. What plans do the Minister and the Department have to ensure that bad actors in the pharmacy space—as Jhoots, in my opinion, appears to be—are dealt with more quickly and effectively under new legislation?

[Madam Deputy Speaker (Ms Nusrat Ghani)]

Order. Questions should not be statements.

[Stephen Kinnock]

I pay tribute to my hon. Friend’s direct professional expertise and experience as a pharmacist. He is right to point to the fact that the regulatory framework is not as strong as it needs to be. I have spoken with officials in my Department who have worked in the pharmacy sector for many years, and they have never seen behaviour like this before. It is quite unprecedented. Nevertheless, it is shining a light on the fact that we do not have a strong enough regulatory framework. We need to look at the way that business owners are regulated. There is strong regulation of pharmacists and pharmacy staff such as technicians, but business owners are not regulated as strongly as they could and should be.

My hon. Friend is right that speed is also important, which is why we need to look at ways of fast-tracking particular cases where there is clear breach, because sometimes the appeal process can be very slow indeed. We are looking at all of this in the round, and I have commissioned urgent advice from my officials to see how we can beef up the regulatory framework.

--- Later in debate ---

[Madam Deputy Speaker (Ms Nusrat Ghani)]

I call the shadow Minister.

[Dr Luke Evans (Hinckley and Bosworth) (Con)]

Only this weekend, the National Pharmacy Association chief executive, Henry Gregg, said that he is concerned that

“reports of Jhoots Pharmacy branches across England failing patients risks damaging community pharmacy’s reputation and could imperil its ability to secure a good 2026-27 funding settlement.”

Communities across the country have been left without functioning pharmacies. Doors have been locked without notice, patients have arrived to find no pharmacist, no prescriptions and no stock, and staff have gone unpaid and been threatened with the sack. Jhoots Pharmacy faces allegations of not paying wages, having premises repossessed and serious regulatory breaches. The General Pharmaceutical Council has already intervened several times, yet for many patients it is too late—they simply cannot get their medicines. This is not an isolated business failure; it exposes a deeper fragility in the community pharmacy network on which local people depend for basics and often lifesaving care.

I have four questions for the Minister. First, when was NHS England first made aware of these closures, and has the Minister met the Jhoots leadership? If not, why not? If he did, what was the outcome? Secondly, has the Department assessed how many people have been left without local pharmacy access as a result of Jhoots’s actions, and what is the Minister doing to remedy this, considering it is happening across the country? He mentioned ICBs, but there are several involved. Thirdly, what mechanisms exist to ensure continuity of care when a contractor collapses or walks away? Again, he mentioned ICBs, but is there a national contingency plan? Finally, will the Government now review whether the current model, under which chains are expanding rapidly through acquisition and debt, is fit to safeguard community pharmacies in the long term? Linked to that, can the Minister definitively confirm that the funding settlement has not been compromised?

The 10-year NHS plan states that it wants to move more care into the community, yet it is completely missing a delivery chapter on how to achieve that. At the same time, we have issues such as Jhoots. I hope the Minister will be taking steps to investigate this issue in its entirety and to safeguard against this type of incident happening again, and will spell out the delivery aspect of the 10-year plan.

--- Later in debate ---

[Stephen Kinnock]

I pay tribute to my hon. Friend’s work on the Select Committee. NHS England is assessing the situation and preparing contingency plans in case Jhoots becomes insolvent. Such plans involve working with other local pharmacies and dispensing GP practices to ensure that patients continue to have access to medicines. Continuity of care, as she rightly points out, must be at the heart of our response, and we are working at pace to ensure that is protected.

[Madam Deputy Speaker (Ms Nusrat Ghani)]

I call the Liberal Democrat spokesperson.

[Helen Morgan (North Shropshire) (LD)]

May I first thank my hon. Friend the Member for West Dorset (Edward Morello) for raising this appalling issue? Pharmacies are at the heart of our communities and are relied upon by millions. They are under increasing pressure across the country, where we are seeing irregular opening hours and unannounced closures. Families living in communities that rely on Jhoots pharmacies, such as those in the constituency of my hon. Friend and many other parts of the country, will be deeply concerned that they and their loved ones could be about to be left without medicines that they desperately need. Staff have been placed in an intolerable situation.

The National Pharmacy Association’s chief executive has said, as we have heard, that Jhoots risks damaging the reputation of community pharmacies. The Government urgently need to grip this issue and ensure that patients and the staff of these pharmacies are not being let down. Will the Minister and the Secretary of State agree to meet all the Members in this place whose communities are affected by potential closures? Will he update the House at the earliest opportunity as to what steps he is taking to stabilise the crisis in community pharmacy across the country? Is he confident that integrated care boards, which are distracted by 50% cuts to their budgets and top-down reorganisation, have the capacity to deal with this urgent situation as they head into planning for the next winter crisis?

--- Later in debate ---

[Stephen Kinnock]

My hon. Friend has put her finger on an issue within all this, which is that if we are looking to bring in other pharmacies to replace Jhoots or, indeed, to take over a Jhoots store, we cannot do that in the latter case until such time as there is an insolvency and that business is no longer a going concern. There is a process, set out in legislation, for opening new pharmacies. Potential new pharmacy contractors can apply to open in an area and evidence how a new pharmacy can provide benefits for patients, but it is a challenge for them to make such a case if a Jhoots pharmacy is still listed as open and providing services. It is something of a Catch-22 situation. We first have to resolve the issue with Jhoots and take the necessary action, and then we can see where we are with potential gaps in the market.

[Madam Deputy Speaker]

I call the Chair of the Health and Social Care Committee.

[Layla Moran (Oxford West and Abingdon) (LD)]

The case of Jhoots is clearly hugely unfortunate given the incredible work that community pharmacies do up and down the country for our constituents. I am pleased to hear the Minister say that this case will not negatively affect the funding settlement, but it is set against the backdrop of a very precarious sector where actors who want to do good by our communities and do a high-quality job often find that they simply cannot make ends meet, and bad actors find a way to move in. When the Committee looked last at this issue, the workforce was a key plank to why the sector is not sustainable. What update can the Minister give us on the inclusion of pharmacists in the workforce plan?

Mental Health Bill [Lords]

Nusrat Ghani Excerpts

Report stage
Tuesday 14th October 2025 Commons Chamber

[Richard Baker (Glenrothes and Mid Fife) (Lab)]

The Bill addresses fundamental flaws in our current mental health legislation in relation to the rights of people with learning disabilities and autistic people. I will focus my comments on new clauses 32 and 33, which I have tabled. They are also about vital rights within our mental health legislation and relate closely to the powerful comments made by the right hon. Member for Salisbury (John Glen) and by my hon. Friend the Member for Isle of Wight West (Mr Quigley).

New clause 32 would provide for mandatory independent care, education and treatment reviews for patients detained in long-term segregation. In her report, “My heart breaks”, Baroness Hollins highlighted the harms and sufferings that are so often associated with long-term segregation, and assessed how introducing care, education and treatment reviews can reduce the incidence and use of segregation. I very much welcome the provisions on reviews of care and treatment that Ministers have already included in the Bill, but it has now been demonstrated that independently-chaired reviews are making a real difference and lead to inappropriate long-term segregation being challenged and addressed. The human impacts are substantial. New clause 32 would make such reviews a requirement when someone has been placed in segregation for 72 hours.

New clause 33 seeks to introduce a new level of scrutiny in cases where patients with autism or learning disability have been detained for more than five years. I believe there is a very strong case for an additional check and balance when people have been under detention and compulsory measures for so many years. I understand that the latest data for England shows that 350 people with a learning disability or autism who are currently in in-patient units have been detained there for more than 10 years.

In a previous role, I provided advocacy for the family of a young man, Kyle, who has a learning disability. He is a patient in the State hospital in Carstairs in Scotland, but his family live in the north-east of Scotland. His mother and grandmother have to make a round trip of nearly seven hours to see Kyle for visits which have in the past been restricted to a single hour. Kyle was convicted of no crime when he was admitted to Carstairs in 2009. He has been there for 16 years. The toll that this has taken on his family has been horrendous. The situation is devastating for them, and there is no end in sight. Although it is a case for the Scottish mental health system, it has provided me with an insight into what many people with learning disabilities and their families will be experiencing in England today, and the limitations of mental health tribunals in dealing with these issues.

People with learning disabilities have been losing their liberty for years because of their disability; this is a human rights emergency. It is clear that we have to do far more to prevent these situations from happening. The Bill will help to do that with its welcome measures on prevention, but where these cases are happening now, I believe there should be an additional level of scrutiny—an extra check and balance so that after so long, someone with the right level of authority and expertise can challenge providers to do better and to ask the question, “How can it be that someone has lost their liberty and their right to a family life, because we cannot make their care and treatment work in a community setting?” Although I very much welcome the introduction of the care, education and treatment reviews, I believe we should go further in these circumstances. That is why new clause 33 would make provision for notification to the Care Quality Commission when someone has been detained for more than five years.

This is an excellent Bill. It will do so much for the rights of people with learning disabilities and autism, but there are several areas where I hope the Minister can outline what further ambitions the Government have to ensure that our mental health system is fit for purpose and based on human rights.

[Madam Deputy Speaker (Ms Nusrat Ghani)]

To squeeze in a few more Back Benchers, the speaking limit is now three minutes.

[Layla Moran]

This is a long-overdue and very welcome Bill, but frankly it will not even touch the sides of what most of our constituents and communities need when it comes to the wider mental health landscape. I support many of the amendments to improve it, not least those laid by my hon. Friends on the Liberal Democrat Benches. I need to make a couple of quick points, because we want the Bill to succeed.

The Minister will know that since December the Health and Social Care Committee has been conducting an inquiry into community mental health services, because we recognise that unless we start tackling these matters upstream, we will not achieve the Bill’s aims. For so many, it feels like they are walking through an NHS desert: they simply cannot get the appointments they need; they do not feel supported; and no one can navigate this complex system.

Just a few weeks ago, while still on maternity leave, I decided to have a keeping-in-touch day and the Committee decided to visit an oasis in this desert—the incredible Barnsley Street neighbourhood mental health centre in Tower Hamlets. Unfortunately, the centre is one of only six pilots set up to this level across the country, but we heard some amazing stories of how people had been diverted away from in-patient mental health units by an approach that truly puts the patient at its centre. It was inspiring. However, we heard from the centre that its funding will not continue beyond April. It is only just starting to gather the data it needs; system change is desperately needed in this space, but the concern is that the system will change without robust data behind it. My question to the Minister is, will the centres be funded beyond April? If not, how can the Department make decisions about the system based on data that does not represent a full calendar year?

I also want to speak in support of amendment 9. I pay tribute to Cyril and Dianne whose son Leon suffered from schizophrenia for many years and sadly completed suicide in January 2019. He was let down by community mental health services. Leon’s mother, Dianne, saw the illness get worse and worse, and when she tried to re-refer him into the system after he had been detained, she was told, “Computer says no.” This Bill will improve the lives of families like Dianne and Leon’s, because Dianne’s pleas would have been heard under the new nominated persons provisions. Amendment 9 would be an extra step, ensuring that the plan is shared with parents and carers—with the nominated person. I pay tribute to those who have campaigned so doggedly for the inclusion of nominated persons in the Bill.

--- Later in debate ---

[Madam Deputy Speaker (Ms Nusrat Ghani)]

I call Jen Craft to make the final contribution. All those who have contributed to the debate should make their way back to the Chamber.

[Jen Craft (Thurrock) (Lab)]

Thank you very much, Madam Deputy Speaker—I will be as brief as possible. I will speak to new clause 37, which stands in my name and which seeks to support the Government in ending the scandal of the inappropriate detention of people with a learning disability and/or autism. I declare an interest as the chair of the all-party parliamentary group on learning disability.

Currently, a learning disability or autism, in and of itself, can be grounds for detention under the Mental Health Act. As we all know, this is an absolute scandal—something from a previous age that should be a source of moral shame to everyone in our community. The Bill seeks to address this by removing autism or a learning disability, in and of themselves, as criteria for detention under the Mental Health Act. That offers a lifeline—a light in the tunnel of darkness that a number of people who are detained under the current Act face.

However, the impact assessment for the Bill states that the proposed changes to the detention criteria in clauses 3 and 4

“will only be switched on when systems are able to demonstrate sufficient level of community support”.

The families and carers of those have a learning disability or autism and who are detained under the Mental Health Act, and the organisations that support them and people who advocate for them, know that too often this vulnerable group of people are pushed to the bottom of a list of competing priorities, and very often slide off it.

We know that this Government and the Department of Health and Social Care have a number of competing priorities to deliver on, and the concern for people who fall into this bracket under the legislation is that their concerns just will not be addressed and that this absolute scandal will continue in perpetuity. People who have a learning disability or autism will be detained because our community services just are not up to snuff; we have so categorically failed them that the only thing we can think to do is to lock them away from society.

--- Later in debate ---

[Stephen Kinnock]

I am really struggling for time. I am sorry, but I cannot take any more interventions, because it is not fair to Members who have tabled amendments.

Amendments 41 and 42 would prevent children with competence from choosing a step-parent or kinship carer as their nominated person if that is the most appropriate person for them. A nominated person can be overruled or displaced if acting against the child’s best interests. Parents will always maintain their rights under the parental responsibility.

Many amendments concern statutory care and treatment reviews designed to help to ensure that people with a learning disability and autistic people receive the right care and treatment while detained and barriers to discharge are overcome. Reviews will happen within 28 days of detention, and at least once a year during detention. This can be more frequent, depending on needs. Patients’ families and advocates can request a review meeting at any point. In respect of new clause 32, we have consulted on making some restrictive practices, including long-term segregation, notifiable to the Care Quality Commission within 72 hours.

Let me now deal with amendments 14 and 26 and new clauses 31 and 37. I acknowledge the importance of having a clear plan to resource community provision for people with a learning disability and autistic people to implement these reforms. We have committed ourselves to an annual written ministerial statement on implementation of the Bill post Royal Assent. Following conversations with my hon. Friend the Member for Thurrock (Jen Craft), we will work with stakeholders, including people with lived experience, to shape our road map for commencing changes to clause 3. The written ministerial statements will give updates on progress, as well as setting out future plans. It is not possible at this stage for us to commit ourselves to the specifics of implementation and community support, which depend on the final legislation passed, future spending reviews, and engagement with stakeholders to get implementation planning right.

As for the concerns raised by my hon. Friend the Member for Shipley (Anna Dixon) about the detention criteria in the Bill, it is vital that the work “likelihood” is included in those criteria to set clear expectations of what clinicians need to consider. However, we are clear about the fact that our intention is not to set a threshold for detention. Under the new criteria, a harm does not have to be likely to justify detention. The criteria require likelihood to be considered holistically, alongside the change, nature and degree of the harm.

I know that the shadow Minister, the hon. Member for Hinckley and Bosworth (Dr Evans) is keen for me to deal with the question of public safety. The key point is that there are detention criteria in clause 5, which makes a clear reference to harm either to the patient or to other persons. That is clearly a consideration of public safety, and we therefore believe that amendment 40 is surplus to requirements.

I trust that, on the basis of the assurances I have given, Members will be content not to press their amendments and new clauses.

[Madam Deputy Speaker (Ms Nusrat Ghani)]

Zöe Franklin, is it your pleasure that new clause 2 be withdrawn?

[Zöe Franklin]

I beg to ask leave to withdraw the motion.

Clause, by leave, withdrawn.

New Clause 26

Duty to establish carer liaison service

“(1) The Mental Health Act 1983 is amended as follows.

(2) In Part X (Miscellaneous and Supplementary), after section 133 insert—

“133A Duty to establish carer liaison service

(1) The managers of every hospital providing services under this Act must establish and maintain a dedicated carer liaison service.

(2) A service established under this section must provide—

(a) support to unpaid carers when a patient for whom they provide care is—

(i) awaiting admission to hospital for treatment under the Act;

(ii) receiving treatment in hospital under the Act;

(iii) set to be discharged from a hospital where they had been receiving treatment under this Act;

(b) timely and accessible information regarding the discharge of the patient they care for, including details of—

(i) the patient's discharge plan; and

(ii) aftercare arrangements under section 117 of this Act;

(c) support for unpaid carers to identify their own needs and connect to relevant local services for post-discharge support, including local authority adult social care services, general practitioners, and local carers' centres;

(d) facilitation of effective communication and collaboration between unpaid carers and the patient's multidisciplinary clinical team regarding the discharge process;

(e) assistance to unpaid carers in developing or updating a carer's support plan in the context of the patient's discharge, including guidance on—

(i) their rights to assessment and support as carers

(ii) their participation in education or employment;

(iii) available counselling services;

(iv) support in planning for emergencies in relation to the patient;

(v) benefits for the carer and patient; and

(vi) other forms of local support; and

(f) services to ensure that the perspective of the unpaid carer, as a key provider of support, is considered during discharge planning, where appropriate and with due regard to patient confidentiality and consent.””—(Dr Chambers.)

This new clause would require hospitals to establish a dedicated liaison service for the carers of patients detained under the Mental Health Act.

Brought up, and read the First time.

Question put, That the clause be read a Second time.

--- Later in debate ---

[Madam Deputy Speaker (Ms Nusrat Ghani)]

Order. Before I ask for the next decision, I remind colleagues in the Chamber that once the doors are locked, Members should not be forcing themselves through the doors to either Lobby.

--- Later in debate ---

[Stephen Kinnock]

I beg to move, That the Bill be now read the Third time.

Since the Mental Health Act 1983 was passed, and since it was updated in 2007, attitudes towards mental health have shifted dramatically, and our understanding has grown, but the law has been neglected. That is why this Government were proud to announce this Bill in our first King’s Speech, fulfilling our manifesto commitment and taking the first steps towards ensuring patients are consistently treated with dignity and respect—promise made, and promise delivered.

It is clear that adults and young people with mental health issues have been let down for years, which is why we are transforming the current mental health system through our 10-year health plan, including through recruiting more than 8,500 additional mental health workers, delivering more NHS talking therapy appointments than ever before, increasing the number of mental health crisis centres, and providing access to a specialist mental health professional for every school in England.

Today, we are another step closer to delivering the reforms to dealing with people with severe and acute mental health disorders, a step closer to strengthening and clarifying the criteria for detention, and a step closer to better supporting clinicians to make the right decisions around appropriate care and treatment, including community treatment orders. We want to make sure that patient choice and patient needs are at the heart of decision making. That is why we are introducing these reforms to enshrine in law measures such as the clinical checklist, the use of advance choice documents, the role of nominated persons and the expansion of advocacy services.

We are increasing the scrutiny and oversight of compulsory detention. We are making sure that those patients who are detained have a clear path to recovery and to discharge. We are introducing statutory care and treatment plans for all patients, so that their needs are met both during and after their hospital stay. To reduce reliance on in-patient care and ensure that people with a learning disability and autistic people get the right support, we are limiting the scope for detention. We are also introducing a package of measures to improve community support, including statutory care, education and treatment reviews and dynamic support registers. We are introducing stronger safeguards for people who lack capacity or competence to consent to treatment—a potentially highly vulnerable group. Those patients will receive a second opinion-appointed doctor at an earlier stage in their treatment.

This Bill has been the product of years of work predating this Government, and it is right that we thank hon. Members and peers for their scrutiny and support over many years. We should particularly note the work of the former Prime Minister Baroness May for launching the independent review that paved the way for this legislation, along with the review chair, Sir Simon Wessely, and his vice-chairs, Steven Gilbert, Sir Mark Hedley and Baroness Neuberger.

I thank Members who served on our Public Bill Committee, including the Chairs, and the clerks and all the parliamentary staff who have worked hard to ensure that the Bill was subject to the proper scrutiny while ensuring smooth and quick passage. I also thank the Joint Committee on Human Rights and particularly Lord Alton for its report and recommendations. I am grateful to the devolved Governments for their support during the Bill’s passage and to the Welsh Senedd and Northern Ireland Assembly for granting legislative consent. I thank the Bill team, my private office and all the officials and stakeholders over numerous years who have worked hard to get this legislation to where it is today.

Above all, thanks go to those with lived experience who have bravely shared their personal experiences with us through the independent review, through our consultation with stakeholder groups and through Members across both Houses. The Bill is the product of sustained effort over a number of years. That work will continue following the Bill’s Royal Assent, but none the less it is an important moment to acknowledge and pay tribute to those who have got the Bill to where it is now.

The work continues as we look to implement the legislation. The first priority once the Bill gets Royal Assent will be to draft and consult on the code of practice. We will engage closely with people with lived experience and their families and carers and with commissioners, providers, clinicians and others to do that. Much has been done, but there is much more to do. This Government are delivering on our commitment to modernise the Mental Health Act, and the work begins now to deliver that change on the ground. The Bill will of course now go to the other place, and I thank peers for their previous extensive consideration. I hope the noble Lords will be able to agree to the changes made in this House, so that the Bill can make swift progress to Royal Assent. I commend this Bill to the House.

[Madam Deputy Speaker (Ms Nusrat Ghani)]

I call the shadow Secretary of State.

[Stuart Andrew (Daventry) (Con)]

I want first to recognise and thank everyone for the constructive debates we have heard here and in the other place throughout the Bill’s passage. In particular, I thank the shadow Minister, my hon. Friend the Member for Hinckley and Bosworth (Dr Evans), for everything he has done on the Bill, especially in Committee. I pay tribute to my hon. Friend the Member for Runnymede and Weybridge (Dr Spencer) for his expertise, whose involvement with the Bill began before he was elected to this place. I also pay tribute to my right hon. Friend the Member for Salisbury (John Glen) and my hon. Friend the Member for Farnham and Bordon (Gregory Stafford) for their thoughtful contributions.

This is clearly an important and emotive issue, and the respect and sensitivity that have been shown by all sides is a testament to this House. Since the election, we have said that we would not oppose for the sake of opposition. While we have rightly asked tough questions of the Government, we have done so with the best interests of patients at heart, because everybody here wants to help and support vulnerable people better—those patients with the most severe and complex mental health needs. This Bill, which started under the previous Government—I pay tribute to former Prime Minister Baroness May for that—and continued under this Government, will achieve that. We welcome efforts to improve the patient’s voice and involvement in their own care, to ensure that patients receive effective and appropriate treatments, to minimise restrictions on liberty so far as is consistent with patient and public safety, and to treat patients with dignity and respect.

Although we are disappointed that opportunities to strengthen the Bill further have been missed, especially in public safety and the protection of vulnerable children, we listened closely to what the Minister said and to his assurances on action, for which we thank him. We will of course continue to push on these matters, not on party political grounds, but because doing so is the right thing for patients.

We are very disappointed that the proportion of health spending on mental health has been reduced. We welcome the Government’s continuation of our work looking again at how we treat and protect people with the most severe mental health illnesses, so that we can improve the safety, treatment and dignity of patients and the wider public, and ensure that our laws remain relevant and proportionate in the modern world. The Government must now turn their words into action and deliver on the commitments that they have made.

I thank everybody again for the constructive way in which they have dealt with the Bill. We are pleased to support its Third Reading. We hope that it will bring improvements for those we all care about: the patients.

[Madam Deputy Speaker (Ms Nusrat Ghani)]

I call the Liberal Democrat spokesperson.

Suicide Prevention

Nusrat Ghani Excerpts

Thursday 11th September 2025 Commons Chamber

[Several hon. Members rose—]

[Madam Deputy Speaker (Ms Nusrat Ghani)]

As colleagues can see, over 10 Members are hoping to speak. We need to begin winding up by 4.30 pm, to let the Front Benchers contribute, so unfortunately I will have to set a time limit of four minutes to ensure that everyone can get in. I call Liz Twist, who chairs the all-party parliamentary group on suicide and self-harm prevention.

--- Later in debate ---

[Amanda Hack (North West Leicestershire) (Lab)]

I thank the Backbench Business Committee for granting this debate and my hon. Friend the Member for Doncaster East and the Isle of Axholme (Lee Pitcher) for securing it and for making his opening remarks in such an amazing way. We heard the devastating numbers and the personal experience of the impact that suicide has had on our communities and on ourselves. These people were important to us and, I hope, by discussing this difficult subject not only can we offer comfort and support, but provide the hope that we can put in place improvements to prevent someone else from taking their own life.

I want to speak about two friends: my childhood friend who lost her dad to suicide when we were just in our teens; and one who made the decision to take his own life just a couple of months ago. It was not until my friend’s funeral in July that I reflected that while those suicides were more than three decades apart, the similarities between the two men who made that decision were stark. They were both men in their early 50s, successful and running their own businesses. They were amazing family men who were well respected in their work and in their social circles. Yet they still both made that ultimate decision to take their own lives, leaving those left behind to unpack their grief and sorrow with the overriding question: “Why?”

In the face of such loss, we often search for answers—something to help us make sense of the silence and the unanswered questions. While no single explanation can ever truly account for an individual’s decision, patterns begin to emerge when we look more closely at the broader picture. We can look at age and gender, and the risk of suicide is highest among men aged between 45 and 54. It is three times more common among men than women—a gap that only continues to grow. We can look regionally too. Between 2021 and 2023, the east midlands had a suicide rate of 11.3 deaths per 100,000 people, placing us above the national average and making us the fifth highest of the English regions. We also need to look nationally, and we have to create some hope.

Local authorities develop strategies to prevent suicide, but the funding for voluntary services has, sadly, gone awry in recent years. We need the much more important national debate. We can look at the limits of existing mental health support and the reality that nearly a third of people who die by suicide are in contact with mental health services in the 12 months leading up to their death.

Those are of course important insights, but they are just insights, just statistics. We have to search for answers to this difficult question. Although we might never know why someone decides to take their own life, what matters is what we do with the information that we do know. We know that we have to build resilience for young people in schools, teaching our young people how to promote good mental health and wellbeing in themselves. We need to equip people with the language to talk about how they feel, the confidence to ask for help, and the tools to support themselves and each other through the inevitable challenges in their life. We can also look to our local organisations, such as the Leg Up Project in my constituency. Its core philosophy is about building resilience, and tackling loneliness and isolation.

The Government’s commitment to transform mental health service with 24/7 neighbourhood mental health centres is a fantastic start, but it will mean nothing if we are not giving people the tools that they need to communicate to get themselves there in the first place. Prevention of deaths by suicide will come from continued conversations, a growing understanding of the mental health landscape and hearing the voices of those whom we have lost and those of us struggling now—those voices are the ones that truly matter.

[Madam Deputy Speaker (Ms Nusrat Ghani)]

We now come to the Front Benchers, and I call the Liberal Democrat spokesperson, Dr Danny Chambers. We have three doctors on the Front Benches.

--- Later in debate ---

[Dr Evans]

I thank the hon. Lady for all the work she does with the APPG. I am looking holistically at the different parts of what we are trying to do in this space. I have already outlined all the funding that the previous Government put in, and I will come on to some of the other problems, such as the national insurance rise, because she will know that they will have a devastating impact.

At the time, the Minister also stated:

“We will be evaluating the impact of the fund, and the services that have been provided by the grant-funded organisations. Learning from this evaluation will help to inform…the Government’s mission to reduce the lives lost to suicide.”

Could the Minister provide further details about that evaluation, such as when it will be completed and whether the Government would reconsider their decision to end the grant funding if the results show that it has had a positive impact in supporting suicide prevention?

Charities were not exempted from the increase in employer national insurance contributions in the Budget. That has significantly hampered their financial situation. We just have to listen to what the Samaritans said in response to the spending review last year:

“The reality is that funding for suicide prevention has dwindled down to next to nothing. To deliver our life-saving work, charities are reliant on donations—on the generosity of the public. And this is even more precarious at a time when many people across the country are facing economic hardship.”

I point that out not to score political points, but to draw attention to the fact that the Labour Government need to set a direction and plan to deal with the leading killer of men and women under the age of 30.

In closing, I want to recognise that yesterday was World Suicide Prevention Day. Every year, 720,000 people across the world take their own lives. The theme this year was, “Changing the Narrative on Suicide”. It calls on us all to challenge harmful myths, reduce stigma and foster open, compassionate conversations about suicide. That leads me to where I started: if men do not know their value, if they do not know they have someone to confide in and if they do not truly believe that we care, we will not break the cycle, we will not make a difference and, ultimately, we will not save lives. That is the challenge laid before society, this House and, ultimately, this Government.

[Madam Deputy Speaker (Ms Nusrat Ghani)]

I believe we have a new Minister, Dr Zubir Ahmed—congratulations on the promotion and welcome to the Dispatch Box. Just in case you need to know, we have been touched by young male suicide in my constituency of Sussex Weald, so I will be listening closely to your response.

--- Later in debate ---

[Madam Deputy Speaker (Ms Nusrat Ghani)]

That was incredibly powerful.

NHS Pensions: Frontline Patient Care

Nusrat Ghani Excerpts

Thursday 17th July 2025 Commons Chamber

[Karin Smyth]

I thank my hon. Friend, who is a superb advocate for his constituents. I met him again yesterday as he advocated for services in his constituency—that is the focus of Labour Members. He is absolutely right; as I said in my statement, this is part of the overall mess that we inherited from the Conservatives. As I said in my previous response on this issue, the problems outlined by Lord Darzi are wide and deep. It is still shocking, after a year in government, to be faced with the level of disaster that was left to us after a complete abdication of responsibility for sorting out the problems. We will continue to focus on getting more of the appointments that people so need and on reducing waiting lists, which is what our constituents expect.

[Madam Deputy Speaker (Ms Nusrat Ghani)]

I call the Liberal Democrat spokesperson.