(1 day, 12 hours ago)
Written StatementsI am today announcing the publication of the new pandemic preparedness strategy, outlining the UK Government plan for improving our pandemic preparedness capabilities between now and 2030.
The covid-19 pandemic was the most significant crisis that we have faced in generations. It touched every aspect of our lives, and its impacts continue to be felt across our communities. It showed that a future pandemic is one of the most profound threats to our society.
The UK is already a world leader in life sciences. Building on our strengths and the huge amount of work that has taken place since the pandemic to improve preparedness, the 2025 UK Government resilience action plan set out a new national approach to resilience, based on continuous assessment of readiness and mobilising the whole of society.
This strategy, which is backed by investment of around £1 billion for health protection during the current spending review period, is a demonstration of our resolve to protect the health of our nation, safeguard our economy and minimise the unequal impacts that pandemics can bring. It sets out the improvements that we will make to our health system response capabilities, and how they underpin a whole-of-Government and whole-of-society approach. It builds on the lessons identified from the covid-19 pandemic and is shaped by the findings of the UK covid-19 inquiry and indicative findings from Exercise Pegasus, the largest non-military exercise ever to take place in the UK. The exercise tested the Government’s ability to respond quickly and effectively during a prolonged crisis, with a full report to be published in the winter of 2026.
The covid-19 pandemic demonstrated the crucial importance of Governments across the UK working together while also respecting, and taking full account of, devolved areas of responsibility.
In support of a joined-up approach to preparedness, all four nations endorse the principles of preparedness set out in the strategy, while individual nations will have their own plans to implement their preparedness.
These principles include protecting those most at risk, with Governments committing to tailoring their capabilities to protect all communities and aiming to deliver an effective and equitable response to pandemics.
The strategy contains commitments across a number of areas that outline how the UK Government will improve pandemic preparedness, many of which have been informed and shaped by the initial findings of Exercise Pegasus. They include to:
Take a dynamic approach to ensure access to vaccines and therapeutics, and address the perceived barriers to the development of novel vaccines and therapeutics for priority pathogens.
Develop the ability to rapidly develop diagnostics for a broad range of pathogens, with scaled up in-house capacity for laboratory testing and whole genome sequencing.
Develop UK manufacturing capacity for vaccines, therapeutics and diagnostics.
Further strengthen surveillance systems to be comprehensive, activation-ready and drawing on diverse sample groups across settings and communities, so that we can detect threats, understand disease spread and enable the analytical capability to act effectively and equitably.
Replenish PPE stockpiles, refine plans for mobilising and distributing PPE, and prepare a cross-Government model for procuring and prioritising the distribution of PPE to critical workers in a pandemic.
Strengthen Government co-ordination mechanisms, drawing from early findings of Exercise Pegasus, including through regularly reviewing and exercising response plans. Guidance will be put in place for local responders.
Publish evidence reviews on the effectiveness of community protection measures and build a suite of measures to support decision making and prioritisation.
Expand communication channels for and improve our understanding of how to make communications relevant to different communities, and strengthen guidance provided to different sectors.
Review the data capabilities needed to support decision-making and evaluate the impacts of pandemic response measures, and enhance data sharing capabilities to enable faster and more transparent information sharing between organisations and with the public in a pandemic.
Co-develop an adult social care pandemic action plan to respond to future threats with sector partners. As part of this, we will focus on how best to support the wellbeing of those with care and support needs and how to improve the resilience and preparedness of the adult social care workforce.
Strengthen the flexibility and resilience of the healthcare workforce, improve the NHS baseline capabilities to manage infections, and develop plans to minimise the risk of cross-contamination across services and maintain continuity of routine care during pandemics.
By integrating our health, security and scientific capabilities, we will protect the NHS, safeguard our economy and save lives.
[HCWS1458]
(2 days, 12 hours ago)
Westminster HallWestminster Hall is an alternative Chamber for MPs to hold debates, named after the adjoining Westminster Hall.
Each debate is chaired by an MP from the Panel of Chairs, rather than the Speaker or Deputy Speaker. A Government Minister will give the final speech, and no votes may be called on the debate topic.
This information is provided by Parallel Parliament and does not comprise part of the offical record
It is a pleasure to serve under your chairmanship, Mr Dowd. I congratulate my hon. Friend the Member for Ipswich (Jack Abbott) on securing this very important debate. I am honoured to respond to it on behalf of my hon. Friend the Minister for Secondary Care, who unfortunately cannot be here today—this area of policy would normally fall under her portfolio.
I want to start by thanking Monica for sharing her story with us today through her MP and—as we heard—friend, and for being with us today in the Public Gallery, along with a large number of women who are suffering from this most painful and debilitating condition. Monica’s distressing experience highlights that we still have more work to do to ensure that all women with endometriosis can access the care they need.
As we have heard, for too many years women with endometriosis have felt unheard or dismissed and have been left to cope alone. We recognise the wide impact the condition has on education, work, family life and wellbeing, as well as on mental health, as the hon. Member for Eastleigh (Liz Jarvis) said, and we acknowledge that that is unacceptable.
This year’s Endometriosis Awareness Month theme is “endometriosis doesn’t wait”. That highlights the urgent need to reduce diagnosis times, improve care and address the impact of this debilitating condition. The Government are not waiting: we have already taken action to ensure that women with endometriosis have access to the services that they need. Many women spend years seeking answers, as we have heard today, being misdiagnosed, having symptoms minimised or being passed from service to service. The experience highlighted by all hon. Members who have spoken in the debate and by Endometriosis UK’s recent report underlines why earlier diagnosis and consistent, compassionate care must be central to our approach.
That is why we have introduced Jess’s rule, requiring GPs to reconsider diagnosis where symptoms persist, as the shadow Minister, the hon. Member for Hinckley and Bosworth (Dr Evans) mentioned. We are also rolling out Martha’s rule, giving in-patients in acute hospitals in England the ability to initiate a rapid review of their case by someone outside their immediate care team. Those measures will help ensure that women’s concerns are not dismissed.
Those were the words that the Minister’s colleague read out in the previous debate, but I have no gripes about the Department saying the same thing. My question is about Jess’s rule and its interaction when there is a single point of referral. There will be a rub between GPs who say that someone needs to be seen because they might have a diagnosis of endometriosis and the system saying that those patients will be bounced back. I would be grateful if the Minister could clarify what that rule will look like in practice, because endometriosis is a good example to demonstrate it.
I was going to come on to what the hon. Gentleman said about that, as well as his request for an update on women’s health hubs. I will take the opportunity to write to him about that update and his specific question on how referrals will work. I am aware that colleagues have raised issues with referrals and, as the hon. Gentleman says, endometriosis will be a good example of whether that system is working as it should. I do not have the answer to hand, but I commit to writing to him on that.
We are also expanding access to diagnostic services. Community diagnostic centres are being rolled out countrywide for women on gynaecological pathways. Last month, 106 centres offered out-of-hours appointments so that women could get vital tests around work and caring responsibilities.
We are modernising how specialist care is delivered. In September, we announced the new online hospital NHS Online, which will be unconstrained by geographical boundaries. It will better align clinical capacity with patient demand so that patients will be seen and triaged faster. Earlier this year, we confirmed that menstrual problems, often a sign of conditions such as endometriosis, will be among the first nine conditions available for referral from 2027. Details are being worked through ahead of next year’s launch. Additionally, we are supporting integrated care boards to expand women’s health services at neighbourhood level, building on the successful pilot of women’s health hubs, so that good practice is spread and services are improved everywhere.
NHS England is currently updating the service specification for severe endometriosis, which will improve the standards of care for women with severe endometriosis by ensuring specialist endometriosis services have access to the most up-to-date evidence and advice. That will be published in due course.
The Minister is being very generous in giving way, and I wish her extremely well in her new post. On the point of the reconstruction of how services work, as mentioned by my hon. Friend the Member for Hinckley and Bosworth (Dr Evans): could the Minister undertake to do work, for people like my constituent Eleanor, so that there is a reduction in A&E visits because the other services are working? It is in the interests of the integrated care board to deliver these changes.
Yes—I or my colleague in the Department will undertake to look at that and ensure the hon. Lady receives a response.
In response to questions on data and research raised by my hon. Friend the Member for Hampstead and Highgate (Tulip Siddiq), and the hon. Members for Strangford (Jim Shannon) and for Bath (Wera Hobhouse), the Department, through the National Institute for Health and Care Research, has commissioned several studies focused on endometriosis diagnosis, treatment and patient experience. At present, the NIHR is funding six active research awards, totalling an investment of approximately £7.8 million. That includes a new £2.3 million award on the effectiveness of pain management for endometriosis, starting this month.
In response to the hon. Member for Strangford asking the Department to engage with health Ministers in the Northern Ireland Executive to discuss any learnings, best practice and areas to improve, I commit to do that. That is a great suggestion.
The hon. Member for Bath asked me about the Women and Equalities Committee inquiry into reproductive health conditions. I am grateful for the work that Committee is doing and welcome its report on that important topic. The Department will be issuing an official response to the report’s recommendations in due course.
Research has already led to new treatments being made available, including NICE approval of two pills to treat endometriosis, relugolix and linzagolix—oh, to have the skill of a doctor in pronouncing these complicated drug names! Those drugs are estimated to help around 1,000 women with severe endometriosis for whom other treatment options have not been effective.
No one should have to put up with chronic pain, which is one of the most common symptoms of endometriosis. The renewed women’s health strategy is under development, so I cannot say exactly what will be included, but the published strategy will set out the actions we are taking to improve women’s experiences, including around pain. As part of our engagement informing the renewal of that strategy, we held a roundtable on women’s experiences of pain, chaired by Baroness Merron and attended by women with lived experience and by expert organisations. That roundtable is informing our work to renew the strategy.
Better care also depends on better understanding. Improving public and healthcare professionals’ awareness of endometriosis will reduce the stigma, of which a number of Members spoke, and will ensure that symptoms are recognised rather than normalised or dismissed. In response to the concern of my hon. Friend the Member for Hampstead and Highgate about DWP training for assessors, I commit to write to the DWP to make that very point.
In response to the hon. Member for Chichester (Jess Brown-Fuller) and the Liberal Democrat spokesperson, the hon. Member for North Shropshire (Helen Morgan), the General Medical Council has strengthened women’s health representation in training. Since last year it has required UK medical graduates to pass the medical licensing assessment, encouraging a better understanding of common women’s health problems. That assessment includes topics on women’s health, including endometriosis.
Women’s health is also built into the Royal College of General Practitioners’ curriculum for trainee GPs, which brings together educational resources and clinical guidance to support primary care teams. Clinical guidance has been strengthened, too: NICE updated its endometriosis guidelines in 2024 to support more consistent decision making and faster routes to specialist input. NICE is working with the NHS to ensure the adoption of this best practice for endometriosis care, including access to approved medicines.
Research indicates that women’s experiences of healthcare are not uniform, as we have heard, and particularly that outcomes can vary sharply between different communities. Ethnically diverse women with endometriosis can encounter additional hurdles in getting a diagnosis and appropriate support. We will not accept those disparities as inevitable. Our ambition is for a fairer Britain, where people live well for longer and spend less time in ill health, and where women, whatever their background, can rely on high-quality care.
My hon. Friend the Member for Erith and Thamesmead (Ms Oppong-Asare) has just appeared, and under parliamentary conventions is not allowed to intervene, so I rise to say that she is hosting a screening of a BAFTA-winning film about endometriosis and the experiences of women in the Jubilee Room at 4.30 pm, if anyone is interested.
That was an excellent intervention, I have to say; I am glad that we will all be out of here in time to go and enjoy that. For the ladies and gentlemen in the Gallery, do not worry: it is free entry and no invite is needed. I thank my hon. Friend the Member for Erith and Thamesmead (Ms Oppong-Asare) for all she does on women’s health. She has led the way, more than most in Parliament, on the issue in her time here. That is recognised, and I thank her for it.
We are hopefully shifting the centre of gravity of care from hospitals to communities, with neighbourhood services designed around local need. Earlier this month, we published a neighbourhood health framework, setting out three reform agendas for ICBs, local authorities and civil society to deliver the aims of neighbourhood health. We have done this to improve services for people who need routine healthcare; to improve proactive care, including maintaining and developing access to women’s health services; and to deliver better alternatives to hospital care.
Adam Dance
Ami is at home watching, and thanks everyone for speaking, but one of the things she said would help her is continuity in seeing the same GP. As we heard earlier, it took 22 years for her to be diagnosed. The other issue she faces is that she cannot have children, and raising the limit for fertility treatment would be helpful. Will the Minister arrange to meet Ami with me?
I am grateful to the hon. Gentleman for bringing the details of Ami’s case to us. Waiting 22 years for a diagnosis is shocking, and I suppose it would have been very difficult to have continuity of care over such a long time, but I take on board the point that he makes. When we—myself included—go to the GP, we often see a different person every time. As I said, this is not my brief, so I will feed his request for a meeting back to the Minister for Secondary Care. I cannot promise on her behalf, but we have heard his request.
The framework I was just outlining provides clarity and consistency, supporting joined-up partnership between ICBs and local authorities, working together to develop locally led neighbourhood health plans. This will hopefully address some of the concerns raised by the hon. Member for Yeovil (Adam Dance) about continuity of care.
Since coming into office, this Government have delivered over 5 million extra appointments in our first year; reduced the numbers on gynaecological waiting lists by over 24,000 women; and given women easier access to the morning-after pill, free of charge. A lot done; a lot more to do. We have made strong progress in turning the commitments in the last Government’s women’s health strategy, which the hon. Member for Hinckley and Bosworth highlighted, into tangible action. Our renewed strategy will set out how this Government are taking further steps to improve women’s health as we deliver the 10-year health plan. It will address gaps from the 2022 strategy, and go further to create a system that listens to women, tackles health inequalities and makes progress on conditions such as endometriosis.
Renewing the strategy will help identify and remove enduring barriers to high-quality care, such as long waits for diagnosis, and will ensure professionals listen and respond to women’s needs. I thank my hon. Friend the Member for Ipswich for bringing forward this important debate, and all hon. Members for sharing so many of their constituents’ stories. I give special thanks to Monica and all the women who are in the Public Gallery to bear witness and push us to do more. We have heard them, and I commit to doing what I can to ensure that their efforts have not been in vain.
(2 days, 12 hours ago)
Westminster HallWestminster Hall is an alternative Chamber for MPs to hold debates, named after the adjoining Westminster Hall.
Each debate is chaired by an MP from the Panel of Chairs, rather than the Speaker or Deputy Speaker. A Government Minister will give the final speech, and no votes may be called on the debate topic.
This information is provided by Parallel Parliament and does not comprise part of the offical record
It is a pleasure to serve under your chairmanship, Sir John. I thank my hon. Friend the Member for Rossendale and Darwen (Andy MacNae) for securing a debate on such an important issue. I am grateful to him for opening the debate during SUDC Awareness Month, a time dedicated to remembering children who have died suddenly and without explanation.
I also thank my hon. Friend for sharing Frankie’s story; it was profoundly moving to hear about it, as it was to hear all the contributions this morning. I want to acknowledge the courage of Frankie’s family in turning such devastating loss into a call for understanding and change. Frankie was clearly a much-loved little boy, as are all the children who are lost to SUDC, and no family should have to live with unanswered questions about why their child died. I am grateful to Frankie’s grandfather and SUDC UK for their determination in making sure that unexplained never means unexamined. I recognise the importance of the leadership, co-ordination and clarity that they are asking for.
It is important to me that we strengthen our understanding of SUDC and ensure that families can access the right support when they need it. This Government set out an ambitious commitment to raise the healthiest generation of children ever. To achieve that, we must ensure that families receive the best support and advice on all matters relating to child health, including SUDC.
I thank all hon. Members for their powerful and moving speeches and interventions today. I turn to some of the specific issues raised. I recognise the calls from a number of Members for a national plan. That is why we are strengthening pathology services, ensuring high-quality bereavement support and a growing research base. As that works progresses, we will continue listening to families, clinicians and researchers about where further improvements are needed.
My hon. Friend the Member for Doncaster Central (Sally Jameson) asked me about bereavement leave, and made a very strong case. I will commit to raising that with Department for Business and Trade Ministers as a priority. I will also raise the issue of police and paramedic training, which my hon. Friend the Member for Altrincham and Sale West (Mr Rand) raised, with the relevant Departments and Ministers. Both my hon. Friends raised very important issues.
My hon. Friend the Member for Warrington South (Sarah Hall) asked about the implementation of the recommendations in the paediatric and perinatal pathology workforce report. I will write to her on that, and on the four points she called for in particular.
I thank my hon. Friend the Member for Rossendale and Darwen for highlighting that information on SUDC was taken down from the NHS website. Parents who have lost a child to SUDC should be able to access the advice and support that they need. I have already asked my officials to investigate that and explore opportunities to include signposting on the NHS website.
No family should ever have to experience the loss of a child, as so many of us in this Chamber today have. It is vital all of us have access to compassionate and timely support when the worst happens. The child death review process ensures that every child’s death is understood sensitively and thoroughly, and is vital in helping families to understand what happened to their child. While bereavement support is commissioned locally to reflect the needs of each community, there is clear national best practice that sets out that every bereaved family should have a key worker to guide them through a time of inconceivable loss and heartbreak. That key worker helps to provide clarity, information and kindness, and helps families to access further sources of support where needed. We also encourage anyone seeking help to contact their GP, who can also guide them to appropriate services.
I also want to thank some of the wonderful organisations and charities across the country, such as SUDC UK, the Lullaby Trust, Cruse Bereavement Support and the Good Grief Trust, which provide exceptional support to families experiencing this devastating loss. Alongside that, the National Bereavement Alliance has published updated voluntary service standards to support continuous improvement in the quality of care. Putting the needs of children and their families first is at the heart of everything I will do in my role as a Minister. We will continue working with partners to ensure that bereaved families receive the compassion and support they deserve.
As we have heard today in detail, pathology waiting times can add to the distress experienced by families at a critical time when they need answers quickly. As was highlighted by the hon. Member for Mid Sussex (Alison Bennett), who speaks for the Liberal Democrats, there is a nationwide shortage of paediatric pathologists in England and Wales, which can affect the time taken to complete pathology testing following a coronial post-mortem. To address that, NHS England has launched a national programme to strengthen perinatal and paediatric pathology services. The Government have made more than £2 million-worth of additional funding available to increase post-mortem capacity. That has increased training posts and the number of trainee doctors and new pathologists.
Alongside that, genomic testing for SUDC is available through the NHS genomic medicine service. Decisions about whether genomic testing is appropriate are made after the post-mortem and through careful discussions with specialist multidisciplinary teams. NHS England closely monitors how genomic testing is delivered across the country, so that it can spot where services differ and work with local teams to improve services. That helps to ensure families can benefit from high-quality, consistent services where they live. Taken together, these steps will help to ensure that families receive timely, high-quality investigations at moments of profound difficulty, while supporting the workforce who deliver this critical service.
As hon. Members have said, SUDC remains an under-researched area, and I agree that we must do more to deepen our understanding. The Government remain open to funding high-quality research into SUDC through the National Institute for Health and Care Research, and we welcome applications on any aspect of child health, including SUDC.
For example, I thank my hon. Friend the Member for Rossendale and Darwen for raising the great work of Bristol University in hosting the national child mortality database and child mortality analysis unit. The Government’s support for the national child mortality database has already made a meaningful difference by bringing together national-level data on all child deaths in England and allowing a far greater understanding of deaths in children over the age of one.
I am encouraged to see that, building on that foundation, the University of Bristol has secured funding from SUDC UK for the Pioneer SUDC study. This will help to shape future research questions and contribute to deeper learning in this under-explored area. As this growing body of evidence develops, it will allow experts to identify where research can have the greatest impact and where gaps remain, including in areas such as febrile seizures. I thank my hon. Friend for raising that area today, because it is definitely one we need to look at.
On research, I will make a plea for Queen’s University Belfast, as I always do in such debates, because it does incredible work. It is not the only university that does so; many universities across this United Kingdom do so as well. Will the Minister engage with Queen’s University Belfast and other universities to ensure that the necessary research can be achieved and thereby save lives?
Yes. I thank the hon. Member for his very moving speech; he often moves me to tears in moments such as this. I will take that away, and ask my officials to look at the work of Queen’s University Belfast, because he makes a very important point.
The shadow Minister, the hon. Member for Sleaford and North Hykeham (Dr Johnson), made a couple of points. I will write to her on the Government’s responses to recommendations, because it is a valid point and one that we should be aware of in future. On the point about ICBs making services more effective by cutting duplication and making sure we have the right people in the right places to deliver quality services, that is something I will also be paying particular attention to, as the Minister with responsibility for children’s health.
My point was less that mergers of ICBs would make services more efficient, but more that that is leading to services being cut, which may make them less good, and that the principle that CDOPs look at the local area is diluted if the local area becomes very large.
I take on board what the hon. Lady says. When I write to her on the point about responses to recommendations, I will elaborate further on that point, having made sure that I have understood it correctly.
Lincoln Jopp
The Minister is very generous with her time, and I am grateful to her for that. She welcomed the research funded by the SUDC UK in Bristol, but I do not think we have heard any commitment to Government-funded research into this area. Will she clarify whether she will take that forward?
I think I may have mentioned some Government-funded research, but I will commit to write to the hon. Gentleman on that point, rather than try to guess what I may have said.
In closing, I again thank my hon. Friend the Member for Rossendale and Darwen for bringing forward this debate, and all hon. Members for their heartbreaking speeches. Those of us here today who have had the privilege of taking part in this debate will never forget them and the names of the children either: Frankie, Miranda, Jack, Louis and Harry—as well as all the other precious children who we have lost to SUDC. The names, families and circumstances mentioned today are all in Hansard now forever. I want to thank all the families in the Public Gallery for being with us today and for their campaigning for change, research and better support.
A number of Members here today recognise that drive because it is what drove us here ourselves. I take on board the plea from the hon. Member for Spelthorne (Lincoln Jopp) to ensure that we see progress and do not all find ourselves back here in a few years’ time having the same debate. We will continue to work with clinicians, researchers, charities and—above all else—families to deepen our understanding, strengthen the support available, and ensure that every child’s death is fully examined and that their life is never forgotten.
Thank you, Minister. Before I call on Andy to wind up, I echo the thanks to all Members for contributing to this important debate. I also particularly thank all those who have taken time to attend in the Public Gallery. Thank you so much.
(3 days, 12 hours ago)
Commons ChamberThank you, Madam Deputy Speaker. I beg to move, That this House agrees with Lords amendment 1.
With this it will be convenient to discuss:
Lords amendments 2 to 27.
Lords amendment 28, and Government amendments (a) to (c) consequential on Lords amendment 28.
Lords amendment 29, and Government amendments (a) to (c) consequential on Lords amendment 29.
Lords amendments 30 to 123.
Before I address Lords amendment 1, I would like to take this opportunity to pay tribute to my predecessor, my hon. Friend the Member for West Lancashire (Ashley Dalton), for her work on the Bill and the wider prevention agenda. I also extend my thanks to Baroness Merron for her work in the other place, ensuring that the Bill was expertly steered through the legislative process.
This is a landmark Bill, and I am honoured to have taken on responsibility for it as the House considers the amendments made in the other place. Creating a smoke-free generation is the most significant public health intervention since the ban on smoking in public places in 2007, under the last Labour Government. Tobacco claims around 80,000 lives every year, and in England it is responsible for a quarter of all cancer deaths. Someone is admitted to hospital almost every minute as a result of smoking, and up to two-thirds of deaths among current smokers can be attributed directly to smoking. Those are not abstract figures; they represent lives cut short by an entirely preventable harm.
The Bill also takes decisive action to tackle the rapid rise in the use of vapes and other nicotine products, particularly among young people, protecting a new generation from nicotine addiction. All the amendments to be considered today have been accepted by the Government, starting with Lords amendments 1, 2, 39 and 40, which change the parliamentary procedure for age verification regulations from negative to affirmative in England and Wales, and in Northern Ireland. The regulations will set out how retailers may ensure compliance when verifying a customer’s age. The changes were made as a result of a recommendation from the Delegated Powers and Regulatory Reform Committee, which the Government accept.
I have always wanted to give way to the hon. Member for Strangford (Jim Shannon).
Well done, Minister—it has been a joy to see the hon. Lady’s elevation to the position she now holds, and I wish her well. Is she aware that Lord Dodds, a DUP Member of the other House, continued to push for changes to age verification in the Bill, and that my party’s primary motivation for the amendments was retailer protection? Without strict parliamentary scrutiny of age verification rules, small businesses will face disproportionate burdens compared with large supermarkets, and the moving age restriction, which rises by one year every year, makes manual verification increasingly difficult for shopkeepers over time. Has the Minister had the opportunity to address that issue, as it concerns many people?
We do not intend to place undue burdens on retailers. Indeed, it should be easier because there is one only date that anyone will have to remember when verifying somebody’s age, which is 1 January 2029. It should be a lot easier as nobody has to do any complicated arithmetic in their head any more. I thank the hon. Gentleman for his intervention.
Lords amendments 3 and 4 provide a narrow exemption to the Bill’s ban on vape vending machines, allowing them to be used in adult mental health settings in England and Wales, and only in areas “wholly or mainly” for patients. That aims to support adult in-patients who may face limits on accessing vaping products used to manage nicotine addiction. The Government remain committed to the wider ban on vending machines, to prevent children and young people from being able to bypass age restrictions on vapes and nicotine products. However, we are aware that adults with long-term mental health conditions have a much higher smoking prevalence than the general population, and ensuring that adult in-patients are able to access vapes from vending machines supports smoking cessation.
Lords amendments 6, 7, 9 to 18, 20, 25, 27, 29 to 31, and 92 to 102 relate to the creation of a licensing scheme in England, and allow for the licensing authority to enforce the future scheme in addition to trading standards. The change was made in response to feedback from local government stakeholders that such a measure would strengthen the scheme and help it to be managed more efficiently following its introduction. Lords amendments 21 to 24 and 28 allow the proceeds from the £2,500 fixed penalty notice for licensing offences in England and Wales to be retained by local authorities for enforcement purposes. The Bill previously required them to be returned to the consolidated fund after costs were deducted. That aligns with the Bill’s approach to allow local authorities to retain proceeds from the £200 fixed penalty notices. Local authorities will be able to reinvest proceeds into strengthening enforcement of the Bill, and help to tackle the illicit market.
May I, too, welcome the Minister to her post, and say how wonderful it is to see her leading on this important work? On a point of clarification, I am sure the measure she mentions will be welcomed by local authorities. Certainly the experience in my area is that there are hotspots where local authorities struggle with enforcement on a range of issues, whether that is antisocial behaviour, noise, or other activities. Will the measure apply to all local authorities, or just those in some parts of the country? It would be wonderful if it is all local authorities.
As far as I am aware, it is all local authorities—I am getting an affirmative nod from the Box, so I am happy to give my hon. Friend that reassurance.
The Government have also tabled amendments (a) to (c) consequential on Lords amendments 28, and amendments (a) to (c) consequential on Lords amendment 29, to correct an error arising from changes made on Report in the other place. Without these amendments, trading standards officers in Wales would lose the ability to issue certain fixed penalty notices for a short period. The amendments resolve that issue and ensure consistency of approach between England and Wales.
On the Bill’s ban on advertising vape and nicotine products, Lords amendments 72 and 106 to 109 create a specific defence and provide additional clarity for businesses, ensuring that they can promote non-branded vaping and nicotine products where that is done in an arrangement with a public health authority for public health reasons. It was always the Government’s intention to allow public authorities to continue to promote effective smoking cessation tools, and these amendments strengthen that. I am pleased that we can provide reassurances to healthcare professionals that they can continue to promote smoking cessation materials in agreement with public health authorities.
There are also a number of more technical Lords amendments—71, 104, 105, 110 and 123—relating to advertising. They ensure that the policy works as intended by ensuring consistency of approach, and by taking account of changes to other legislation. They support the implementation and enforcement of the advertising provisions in the Bill.
The issue of filters has been raised throughout the passage of the Bill, both in this House and in the other place. Action on filters has been proposed by parties from across the political spectrum, because of concerns about environmental harms and harms to health. However, parliamentarians have advocated for restricting filters in a number of different ways. Lords amendments 32 to 34, 37 and 38, 42 to 48, 51 to 59, 62, 77 and 78, and 103 therefore contain a suite of powers that will enable secondary legislation to regulate filters, should evidence suggest that this is necessary. Regulations could ban filters in the future, or regulate their packaging, advertising and display. The evidence on the effect of filters, including their direct health impact, is still emerging, so no decision has been made on the use of those powers. The Government will look to consult on using the powers only if we think that there is sufficient evidence to justify action.
Jim Allister
On the review of the Bill, can the Government give an absolute guarantee that all its parts will apply to the whole United Kingdom, and particularly Northern Ireland? We are still, alas, subject to the EU’s tobacco directive, which many believe conflicts with a key part of the Bill. If that aspect of the Bill is overturned in Northern Ireland, will the Government commit to legislating to ensure that it does apply across the whole UK?
We are content that the measures in the Bill, which are intended to apply to Northern Ireland, are compatible with the obligations under the Windsor framework. I hope that answers the hon. and learned Gentleman’s concern.
We hope that the review will be a clear demonstration of the Government’s commitment to monitoring progress against our smokefree ambition. Finally, Lords amendments 5, 8, 36, 41, 60 and 61, 63 to 76, 79, and 81 to 88 are technical amendments, some of which are consequential to the commencement of several other Acts. They also improve consistency in drafting across the Bill.
I encourage all Members to support all the amendments. These are meaningful changes that strengthen the Bill and respond to concerns raised by Members across the House and in the other place. The Government amendments tabled today will return to the other place for consideration, and I look forward to their timely agreement, and to the Bill completing its final stages.
Ms Julie Minns (Carlisle) (Lab)
Before I begin my brief speech, may I say how good it is to see my hon. Friend the Member for West Lancashire (Ashley Dalton) in the Chamber? We owe her a debt of gratitude for both introducing the Bill and piloting it through the House. She leaves behind—I was going to say large shoes, but that seems a bit rude—significant shoes to be filled, but I know they are shoes that the Under-Secretary of State for Health and Social Care, my hon. Friend the Member for Washington and Gateshead South (Mrs Hodgson), is more than capable of filling, and I am very glad to see her in her place this evening.
I wish to speak briefly about Lords amendments 11 and 61, which, as we heard from my hon. Friend the Member for Falkirk (Euan Stainbank), clarify what we mean by a “relevant enforcement authority” and, in particular, clarify the duty that will be placed on that relevant enforcement authority to consider annually whether it is appropriate to carry out a programme of enforcement action. As has been said, we acknowledge, and know, that vaping can support adults who want to move away from smoking, but we nevertheless cannot ignore the rapid rise in youth vaping and the growing presence of illegal, non-compliant and counterfeit vapes and cigarettes in all our communities. That is why a robust, mandatory licensing framework is so urgently needed. The Bill will give the Government the power to introduce such a framework, and that can only be strengthened by a requirement for licensing authorities to consider annually the programme of enforcement.
Contrary to what the hon. Member for Windsor (Jack Rankin) seemed to suggest, one of the strongest arguments for licensing is its ability to combat the sale of illegal cigarettes and vapes on our high streets. Local authorities and enforcement bodies have warned repeatedly that rogue sellers are flooding the market with untested, high-nicotine, incorrectly labelled or counterfeit products, and my constituency is no exception. Just a few weeks ago, Cumberland council trading standards seized 6,000 illegal cigarettes in raids, and that was in addition to the £20,000-worth of illegal tobacco and vapes seized last summer. The introduction of on-the-spot fines of up to £2,500 and the ability to revoke retailers’ licences entirely are therefore welcome.
Mandatory licensing will also make it much easier to shut down dodgy shops that knowingly stock or distribute illegal vapes and cigarettes. Under the new framework, any premises found storing, displaying or supplying unregulated products will lose their licences, because licensing applies not just to the act of selling, but to the possession of regulated products for retail purposes. This means that enforcement officers will no longer have to rely on repeated seizures or warnings; they will have a fast, lawful route to closing down problem retailers for good.
In short, mandatory licensing is not just another layer of regulation; it is a powerful tool to crack down on illegal vapes, remove bad actors from our high streets, and support safer and more responsible retailing. More important, it will give local authorities the powers they need to shut down dodgy shops quickly, decisively and permanently. I therefore welcome both the Lords amendments and the Bill as a step forward to cleaning up our high streets and ensuring that we have a healthier, happier country.
With the leave of the House, Madam Deputy Speaker, I would like to place on the record my sincere thanks to all Members who have contributed to this thoughtful and constructive debate, and throughout the Bill’s passage in this House. It has been a real privilege to take it through this stage, following in the elegant and tiny footsteps but great ability of my hon. Friend the Member for West Lancashire (Ashley Dalton), who, along with our colleague Lady Merron in the other place, has done sterling work.
I am so grateful for the engagement of colleagues across the House, and for the shared commitment to improving public health and protecting future generations. As Members are aware, smoking remains the leading preventable cause of death, disability and ill health in this country. Despite significant progress, 5.3 million adults were still smoking cigarettes in 2024, and while tobacco remains the greatest threat, owing to its unique harms, we are also seeing a rapid rise in the use of vapes and other nicotine products, particularly among young people, creating a new generation at risk of harm and addiction. That is why this Bill matters, and why the action that we are taking today is so important.
Let me now turn to the points raised by hon. Members, who were small in number but mighty in their contributions. The shadow Minister, the hon. Member for Hinckley and Bosworth (Dr Evans), made an excellent speech, and I enjoyed hearing his thoughts—but he is not listening while I am talking about him.
The Parliamentary Secretary to the Treasury (Torsten Bell)
She is trying to be nice to you!
I am trying to be nice, and the shadow Minister is ignoring me, but I really enjoyed listening to what he said about being a practising doctor, and about his concerns which made it so apparent that we had to do something about this. I am sure that, having got here, he is proud to have played a part in getting this legislation on to the statute book, for those very reasons. He asked me about the illicit market. The creation of a smokefree generation will prevent people from ever becoming addicted to smoking in the first place. When the age of sale was increased from 16 to 18, 1.3 million more people could no longer to be sold cigarettes, and would, in theory, be in the market for illegal cigarettes. In practice, the number of illicit cigarettes consumed fell by 25% between 2005-06 and 2007-08.
The Bill takes bold action to strengthen enforcement and crack down on rogue retailers. We are investing up to £10 million of new funding in trading standards annually until 2028-29 to tackle the illicit and under-age sale of tobacco and vapes, and to help enforce the law. That funding is being used to boost the trading standards workforce by hiring 120 apprentices across England. The illicit tobacco strategy establishes a cross-Government taskforce, enhancing the ability of His Majesty’s Revenue and Customs to disrupt organised crime. Between April 2015 and March 2023, over 10 billion cigarettes on which UK duty had not been paid were seized by His Majesty’s Revenue and Customs and Border Force. The hon. Member for Windsor (Jack Rankin) asked about the illicit market, so I hope that addresses some of his concerns.
The shadow Minister asked about an appropriate balance. The Bill rightly takes strong action against youth vaping while recognising the important role that vapes play in helping adult smokers to quit smoking. The Government have been cautious to strike the right balance between reducing the appeal to children and ensuring that vapes remain an accessible tool for smoking cessation. That is why the Bill provides powers to tackle the appeal of vapes to children through elements such as packaging, display, flavours and device features. However, in order to avoid unintended consequences for adult smoking rates, the scope of restrictions will be carefully considered and consulted on.
I am glad the Minister has addressed many of the questions that I posed. One was about the designation of vape-free places, and I think there is consideration of what that will look like. How will the Government approach that? I would welcome it if she could at least set out the framework of what she might think about in her new role.
That is being looked at, and I can write to the shadow Minister with the details as we progress. I will commit to doing that.
I welcome the Minister to her place and congratulate her on her new role. She has a hard act to follow, but I am sure she will be brilliant in her job. Could she say what metrics the Government will use to measure whether the Bill successfully reduces youth vaping?
I will definitely write to my hon. Friend, rather than just guess, but I suppose that we will see fewer young people vaping—the numbers should go down. To quote chief medical officer Chris Whitty, as someone did in an excellent speech earlier:
“If you smoke, vaping is much safer; if you don’t smoke, don’t vape.”
That is what we want the message to be, but I will commit to writing to my hon. Friend about how we will follow the metrics.
I come to the contribution from my hon. Friend the Member for City of Durham (Mary Kelly Foy), who asked about the levy. The measures in this Bill to reduce the use of tobacco are world leading. Given that the Bill will create a smokefree generation, and that we have a proven and effective model for increasing tobacco duties, we do not think that introducing a new, bespoke levy is the best way forward.
My hon. Friend also asked about advertising. We must stop the advertising and promotion of products that risk addicting a new generation to nicotine. The Bill delivers on this Government’s manifesto commitment to stopping the blatant advertising of vapes to children while continuing to support adult smokers in quitting. She said that it would be appropriate for nicotine pouches to be in scope of the ban on advertising, and I can commit to that.
My hon. Friend the Member for Chatham and Aylesford (Tristan Osborne) made a very thoughtful contribution, which sadly was followed by a not-so-thoughtful contribution from the hon. Member for Windsor. He and the hon. and learned Member for North Antrim (Jim Allister) called this a “socialist Bill”, but I remind the House that it started its life under a Conservative Government, and was lost in the wash-up prior to the general election.
I will finish responding to the hon. Member’s ideological arguments. This is not about liberty or choice for smokers. Up to two thirds of deaths among smokers can be attributed to smoking; three quarters of smokers wish they had never started; and the majority want to quit. That is not freedom of choice. The tobacco industry took away their choice by addicting them at a very young age.
Jack Rankin
I thank the Minister for her implied compliment to the Leader of the Opposition, who voted against this Bill on Second Reading when the previous Prime Minister brought it forward. She voted against it because the Bill does not respect the proper relationship between the state and the individual, and does not deliver equality under the law, so we will take that as a compliment in the new Conservative party, which is being refreshed in an authentically conservative direction.
The freedom to be addicted—I think that is what the hon. Member has just defended. I am sure that those on his Front Bench will take note of that. He also asked me about smokefree places. No smoker wants to harm people, but they do so through second-hand smoke, as we all know. On 13 February, the Government published our consultation on “free from” places. As we have previously set out, this Government are consulting on making outdoor public places smokefree and free from heated tobacco, including children’s playgrounds and spaces outside a number of health, social care and educational settings. Children and medically vulnerable people who visit such places should not be exposed to harm through no choice of their own. Additionally, we are consulting on making areas outside playgrounds and schools vape-free. With regard to indoor spaces that are currently smokefree, we are consulting on making the majority free from heated tobacco and vape-free. The consultation does not consider extending the proposals to outdoor hospitality.
Moving on to the excellent speech from my hon. Friend the Member for Falkirk (Euan Stainbank), I can confirm that, for smoking cessation purposes, flavoured vapes can still be promoted by businesses if they have an agreement with public health authorities. We recognise that vape flavours are an important consideration for adult smokers who are seeking to quit smoking, which is why the Government recently committed to consulting on regulating flavour descriptors as a first step before considering broader restrictions on flavoured ingredients.
The hon. Member for South Antrim (Robin Swann), in his really good speech, mentioned concerns about Northern Ireland. The Bill is UK-wide and has been developed in close partnership with the Scottish Government, the Welsh Government and the Northern Ireland Executive. We are content that the measures in the Bill, which are intended to apply to Northern Ireland, are compatible with the obligations under the Windsor framework, as I said earlier. The UK Government notified the EU’s technical regulation information system—TRIS—that certain provisions in the Bill relate to Northern Ireland; this is a standard process, not an approval process. Certain EU member states issued opinions setting out concerns about the compatibility of the smokefree generation policy with EU law, and it is not unusual for member states to submit opinions on TRIS notifications. For instance, several member states recently wrote to France when it proposed a ban on nicotine pouches, despite several other member states having already introduced such a ban.
The Government have provided a comprehensive response to the opinions that we have received, which sets out the strong public health justification for the policy, and explains why the smokefree generation policy complies with EU law as it applies under the Windsor framework, and the European Commission has now responded, noting our response. This concludes the TRIS process. I hope that answers some of the hon. Gentleman’s concerns.
We had really good contributions from my hon. Friends the Members for Dartford (Jim Dickson) and for Carlisle (Ms Minns). If I have not answered any of their questions because I was not quick enough to write stuff down, I commit to writing to both.
I very much hope that this House will support all the amendments under consideration, and that the Governments amendments will return to the other place for due consideration. I hope that this landmark Bill can complete its passage shortly, and that we can move forward with delivering a smokefree UK.
Lords amendment 1 agreed to.
Lords amendments 2 to 28 agreed to, with Commons financial privileges waived in respect of Lords amendments 21 and 22.
Government amendments (a) to (c) consequential on Lords amendment 28 made.
Lords amendment 29 agreed to, with Commons financial privileges waived.
Government amendments (a) to (c) consequential on Lords amendment 29 made.
Lords amendments 30 to 123 agreed to, with Commons financial privileges waived in respect of Lords amendments 32 to 34, 37, 38, 43 to 48, 51 to 59, 62, 77 and 78.
National Insurance Contributions (Employer Pensions Contributions) Bill: Programme (No. 2)
Motion made, and Question put forthwith (Standing Order No. 83A(7)),
That the following provisions shall apply to the National Insurance Contributions (Employer Pensions Contributions) Bill for the purpose of supplementing the Order of 17 December 2025 (National Insurance Contributions (Employer Pensions Contributions) Bill: Programme):
Consideration of Lords Amendments
(1) Proceedings on consideration of Lords Amendments shall (so far as not previously concluded) be brought to a conclusion three hours after their commencement.
Subsequent stages
(2) Any further Message from the Lords may be considered forthwith without any Question being put.
(3) Proceedings on any further Message from the Lords shall (so far as not previously concluded) be brought to a conclusion one hour after their commencement.—(Imogen Walker.)
Question agreed to.
(2 weeks, 3 days ago)
Westminster HallWestminster Hall is an alternative Chamber for MPs to hold debates, named after the adjoining Westminster Hall.
Each debate is chaired by an MP from the Panel of Chairs, rather than the Speaker or Deputy Speaker. A Government Minister will give the final speech, and no votes may be called on the debate topic.
This information is provided by Parallel Parliament and does not comprise part of the offical record
It is a pleasure to serve under your chairmanship from the Dispatch Box, Sir Alec. I thank my hon. Friend the Member for North Ayrshire and Arran (Irene Campbell) for opening this important debate, following the petition related to funding for infants to receive type 1 diabetes testing and routine care. I am grateful to all hon. Members who have taken part and for all the heartfelt speeches that we have been privileged to hear.
I am not surprised at all that the petition received 120,000 signatures after it was started, following—as we know—the tragic death of two-year-old Lyla Story from diabetic ketoacidosis mere hours after seeing her GP. I was deeply affected when I heard that a child so young had been taken so cruelly by a condition as common and manageable as type 1 diabetes. I thank and pay enormous tribute to Lyla’s parents, John and Emma Story, who have campaigned so passionately and powerfully at a time of such unimaginable grief. It is truly inspiring, and we hope that it will help to ensure that no other families will suffer as they have. I am so sorry, and I offer Mr and Mrs Story my deepest sympathies. No child or their family should be let down in this way.
We have started to make improvements to raise awareness, and this debate forms a very important part of that. During World Diabetes Day in November 2025, NHS England made a big push to raise awareness of the four Ts, which, as we have heard today, are the main symptoms of type 1 diabetes: thirst, tiredness, thinning, and an increased need to go to the toilet. This work was channelled via social media and a cascade to clinical networks, as well as by updating the nhs.uk pages to make them clearer. A RightCare toolkit was also published by NHS England, which is designed to support integrated care systems to design, plan and deliver high-quality treatment and care for children with all types of diabetes.
I warmly welcome the Minister to her place. I should declare that I was diagnosed with type 1 diabetes at the age of three, so I cannot begin to imagine the pain that Mr and Mrs Story, and other affected families who are in the Public Gallery or watching this debate online, have felt—particularly my constituent Levi, who lost her beloved son Eli at the age of two after five misdiagnoses of viruses and infection. Will the Minister undertake to ensure that future guidance will be drafted to emphasise to clinicians that infections and viruses can be not only a symptom, but sometimes a trigger of type 1 diabetes, so that clinicians will have, we hope, the understanding to avoid the tragic losses that we have heard about today?
I thank the former Secretary of State for Health for her important intervention. I was not aware that she was type 1 diabetic herself, and the case of Levi that she mentioned is so pertinent to what we are discussing. Mr Story has been working with NICE, and that guidance is currently being updated. As the right hon. Member says, it is so important to get that information out there, so that all GPs are brought up to date and know that infections and viruses can be a trigger, so I thank her for that intervention.
The RightCare toolkit that is being brought forward also contains important information for clinicians in setting out what good quality diabetes care looks like for children and includes guidance on timely and accurate diagnosis. However, we recognise that more needs to be done, and that is why NHS England is working on how we can better support NHS staff to diagnose patients as quickly as possible and raise awareness of symptoms for parents and families.
Tom Gordon
The Minister is talking about how the toolkit will outline for GPs what good diabetes care looks like. That independent advocacy and scrutiny function often came from Healthwatch, which will be abolished in the changes to the NHS and rolled into DHSC. Can she outline how we will ensure scrutiny of services such as diabetes care, which have the patient voice at their heart?
If I may, I will write to the hon. Member on his important point, rather than giving a possibly unsatisfactory answer off the top of my head.
The NHS is exploring how IT can be better used to support GPs in making more accurate diagnoses. That includes how existing electronic patient record—EPR— systems could be used more effectively to provide prompts for GPs to consider type 1 diabetes when particular symptoms are added. I can update the House that clinical leaders in NHS England are also working with digital diabetes education providers to develop a primary care healthcare professional education module.
While we are working on options to improve type 1 diabetes diagnosis, a requirement for a mandatory finger-prick test for those presenting with possible symptoms of type 1 diabetes is difficult to enact and could not be delivered quickly. I hear the point made by the hon. Member for South Northamptonshire (Sarah Bool) in her excellent speech—many others also made this point—about how all GP practices should have the necessary equipment and finger-prick testing kits, and several hon. Members raised the issue of NHS funding for point-of-contact testing kits. I can reassure them that there is good clinician access to those tests. What we need to do is ensure that their use is at the forefront of clinicians’ minds when the symptoms present, which is exactly what Mr and Mrs Story called for in their petition.
One Member raised the abolition of NHS England. I can reassure Members that, as part of that change process, policy functions will transfer into the Department as appropriate. Clinicians follow clinical guidelines set out by NICE, which are advisory and not mandatory. They are not mandatory because they are designed as evidence-based advice to inform rather than to replace clinical judgment, allowing for tailored care for individual patients. Guidelines cannot cover every unique patient scenario, and clinicians must therefore maintain responsibility for treatment decisions.
Tom Gordon
I thank the Minister for being so generous with her time. Before entering this place, I worked for Breakthrough T1D, and one thing that came up all too often was that clinicians did not feel that they had the funding to give people the treatment they needed. The Minister makes the point about giving them independence, but does she acknowledge that if they do not have the funding to do that, the guidance falls at the first hurdle?
That might be a fair point on some treatments more widely, but funding is not an issue for the finger-prick test—it is very affordable for the NHS, and I am told that funding is not the issue on the point we are debating today. I am pleased that NICE has been able to respond very quickly to Mr and Mrs Story. It has engaged with them in detail and listened to their concerns about how the guidance could be clearer.
I am very pleased that NICE has recently said it will update the guidance and guidelines on the diagnosis and management of type 1 and 2 diabetes in children, to raise the prominence of the risk of diabetic ketoacidosis in children with undiagnosed diabetes. I understand that the conversation Mr Story is having with NICE is ongoing, and that NICE is also considering an update to the adult guidance in due course. I know that Mr Story has raised further recommendations with NICE to improve that guidance. I am sure NICE will be considering it very carefully.
I would like again to put on record my admiration for the huge effort and determination of Mr Story in campaigning to raise awareness and advocating for improvements. The updating of NICE guidance is tangible proof of his efforts; his time has not been wasted.
I recognise that the immediate issue raised is point-of-care testing, but I should update the House in saying that, more broadly, we are also funding the delivery of research to develop and test novel approaches for diagnosing type 1 diabetes earlier and more accurately through the NIHR. That includes an investigation of the use of a new home test for type 1 diabetes in children and young people. Studies are also identifying ways to improve the diagnosis of type 1 and 2 diabetes based on genetics, making prediction more accessible and more effective.
We are also supporting the delivery of research into type 1 diabetes treatment, again through the NIHR. That includes supporting a new UK-wide type 1 diabetes cell therapy clinical trials network. The aim is to ensure all people with the condition gain access to the latest cutting-edge treatments as early as possible. The NIHR’s research delivery network is also supporting the delivery of a study that aims to identify infants at risk of developing type 1 diabetes, and to study new treatments with the aim of preventing the development of the condition.
In addition, following the publication of NICE’s guidance recommending the use of hybrid closed loop systems as a treatment option for type 1 diabetes in children, the NHS began a five-year roll-out of HCLs in 2024. For those who are not familiar with that technology, an HCL acts as an artificial pancreas that lets a person’s insulin pump talk to their continuous glucose monitor. I am sure that adults in particular with type 1 diabetes are very aware of HCLs, but the use of HCLs in children under 19 has now increased from 36% in 2023-24 to 70% in 2025-26. That is significant progress in making that life-changing technology available to more children and young people.
Returning to the issue of diagnosis, the NHS is exploring how IT can be better used to support GPs in making more accurate diagnoses. That includes how existing electronic patient record systems could be used more effectively to provide prompts for GPs to consider type 1 diabetes when particular symptoms are added. I can inform the House that clinical leaders in NHS England are working with digital providers of diabetes education to develop an education module for primary care healthcare professionals.
A few Members mentioned screening, so I would like to take this opportunity to set out the Government’s position. Although we know that screening for antibodies would sadly not have helped Lyla, screening tests may help to improve our ability to identify those who are most likely to develop type 1 diabetes in future. We are guided by the independent scientific advice of the UK National Screening Committee, as it is vital that screening programmes are evidence-based and evidence-led. The committee does not currently recommend screening for type 1 diabetes, due to a lack of evidence.
However, the committee received a submission, via its 2024 open-call process, to consider screening for autoimmune type 1 diabetes through blood testing. Once NICE has published its recommendation on the drug teplizumab, which is expected this year, the National Screening Committee will consider whether a fresh review of the evidence for type 1 diabetes screening should be undertaken.
In addition, NHS England is looking carefully to see what further improvements might be made to the red book and to support increased awareness for parents and families so that they can see what the symptoms of type 1 diabetes are. I know that was an important part of the petition.
In closing, I thank all those present for taking part in this very important debate, as well as our constituents—all 120,000 of them—who took the time to sign the petition and press us all on this very important matter. I hope that the work that is currently being taken forward across diagnosis and awareness shows the seriousness with which this issue is being taken.
I am pleased that John and Emma Story will be meeting the Secretary of State for Health tomorrow to discuss this further, along with their constituency MP, my right hon. Friend the Member for Kingston upon Hull North and Cottingham (Dame Diana Johnson), who is here for the debate. I am sure that will be a very emotional and powerful meeting for Mr and Mrs Story. I wish them well and, in closing, pay tribute to them again for everything they have done in Lyla’s name to try to ensure that no other family follows in their footsteps.
(2 months, 1 week ago)
Commons ChamberThe hon. Gentleman will have noted that we have committed to tie-ins for future dentists going through the training programme. It costs the taxpayer hundreds of thousands of pounds to train a dentist, and we believe it is absolutely right that a significant percentage of their time should be put into NHS dentistry.
In terms of improving access, in financial year 2023-24 there was a shocking £392 million underspend on NHS dentistry at a time when demand was going through the roof. I made clear that every penny allocated to NHS dentistry must be spent on NHS dentistry, and I am very pleased to report that we have got that underspend down to just £36 million. The decrease in the underspend is leading to an increase in NHS dentistry, but I accept that there is still a long way to go.
I also put on record my condolences to the family and friends of Colin Pickthall, the former Member for West Lancashire. As the current Member for that seat, it is my privilege to build on his legacy.
We are committed to furthering investment to unlock new treatments and improve outcomes for brain cancer patients, including by investing in cutting-edge equipment to improve access to samples for research. Individual pathology services in England maintain their own standard operating procedures, and they outline local capabilities and practices, but we are continuing to invest in England’s pathology networks to deliver productivity and transformation improvements.
I welcome the Government’s focus on improving survival rates for cancer, particularly in the forthcoming national cancer plan. Will the Minister agree to attend the campaign for Owain’s law event here in Parliament on 3 February and meet the families, who will have travelled from across the country to brief Members of this House on the urgent importance of fixing the current tissue freezing postcode lottery?
We are determined to ensure that everyone who receives a brain tumour diagnosis, regardless of where they live, has access to the latest treatment options. I look forward to meeting Owain’s wife, Ellie, later this month to hear more about their story and the next steps on this topic.
(5 months, 1 week ago)
Commons ChamberI am very glad to be able to take part in this very moving debate and to follow so many excellent speeches as we once again mark Baby Loss Awareness Week, not least on behalf of myself and my story, and that of my beautiful baby Lucy, who I tragically lost back in 1998, but also on behalf of all the MPs in this place, women and men, who are not yet ready or able to stand and tell their story, as indeed I was not for so many years.
For almost 20 years I never spoke of my loss, and I never told anyone who did not know me back when it had happened, until I helped to set up the all-party parliamentary group on baby loss back in 2016, 11 years after I was first elected. That was along with a cross-party group of MPs, all of whom are no longer in this House, although Baroness Prentis of Banbury is now in the other place. I told them my story in the Tea Room, and I could point to the table that we sat around to share our stories through floods of tears. It was the first time I had spoken about it in any detail since it had happened two decades earlier. Baby loss was, and I think it may still be to a certain extent, the last great taboo that a lot of parents have to navigate their way through.
Not long thereafter, I was approached by one of the officers of the new all-party group regarding the private Member’s Bill introduced by the former Member for East Worthing and Shoreham, Tim Loughton. As those Members who were around at the time will remember, part of that Bill covered baby loss and the lack of any recognition for stillborn babies born before 24 weeks—what are, in law, still called late-term miscarriages. His private Member’s Bill tried to address this through what would become known as baby loss certificates. He had been approached by his constituents Hayley and Frazer, who gave birth to their son Samuel at 19 weeks. Tragically, he was stillborn, and they had been horrified to receive no official recognition and—even worse—to learn that their child was entered in the official records as a miscarriage, as indeed my Lucy was at 23 weeks and four days, just a few days short of the legal definition for recognition.
Tim also cited another tragic case, that of twins born either side of that 24-week threshold. One thankfully survived and was given a birth certificate, but the other—born just a day or so earlier on the wrong side of 24 weeks—tragically did not survive, received no official recognition, and was entered in the official records as a miscarriage. This felt grossly wrong to all those parents and to Tim, as it did to me and my husband when it happened to us. Tim set about trying to change the law, hence approaching me to see whether I would be brave enough to stand here—on the Opposition Benches as I was then—and tell my story, as it was so relevant to the case he was trying to make. Somehow, I managed to do it—it is all down on record for anyone to read or watch, so I will not repeat it today—and it involved an awful lot of tears. Those who have spoken today have somehow managed not to be in floods of tears. I did it, as lots of Members have done today, and I commend them all for sharing their heartbreaking stories. We should remember, though, that for every Member who bears witness in this Chamber, there are no doubt many more who are not yet ready to do so.
I was very proud of myself back in February 2018 to give mine and Lucy’s story in detail in that private Member’s Bill debate, and for my experience and Lucy’s all-too-brief life to perhaps have made a difference in helping to change the law and bring about the baby loss certificates, which are now much treasured by so many parents. It is something I am still very proud of.
After that debate and all the publicity it garnered, the right hon. Member for Godalming and Ash (Sir Jeremy Hunt)—who was Health Secretary at the time, and who I pay tribute to for everything he did—set up an official Department of Health expert working group, which Tim and I sat on, to consult on what a change in the law would look like and how the baby loss certificates would work. I was very glad when in February 2024, just before the election, the last Government announced the roll-out of the first ever baby loss certificates.
As welcome as those certificates are, I worry that there are still some unintended consequences, as there often are when first enacting new policies. I have been contacted by Catherine, whose much-wanted baby died at 12 weeks. Through the grieving process, she found comfort in knowing that she would get a baby loss certificate for her son Matthew. However, when she applied for that certificate, she found that she was not able to add her partner’s name to it, as he was registered with a GP on the Scottish side of the border. While relationships across the English-Scottish border are not common, neither are they unheard of. Catherine asked me to ask the Secretary of State—I am very happy that he is in the Chamber in person tonight—what steps could be taken to enable both parents’ names to be included on baby loss certificates where those parents are registered with GPs in different countries in the UK. I am sure that what I have described is an anomaly, and I hope the Secretary of State will address it in his response.
Due to time, I will leave my remarks there, Madam Deputy Speaker. I thank you for your grace.
I appreciate the hon. Lady finishing her remarks. Members will have noticed that I indulged the hon. Lady, but unfortunately after the next speaker I will have to reduce the time limit to four minutes so that I can get all Members in.
(11 months, 3 weeks ago)
Westminster HallWestminster Hall is an alternative Chamber for MPs to hold debates, named after the adjoining Westminster Hall.
Each debate is chaired by an MP from the Panel of Chairs, rather than the Speaker or Deputy Speaker. A Government Minister will give the final speech, and no votes may be called on the debate topic.
This information is provided by Parallel Parliament and does not comprise part of the offical record
I beg to move,
That this House has considered the first anniversary of the Hughes report on valproate and pelvic mesh.
It is an honour to serve under your chairmanship, Ms Furniss. It is a delight to see such a well-attended debate and a packed Public Gallery, as this is a very important topic. Last month marked the one-year anniversary of the publication of the Hughes report. Thanks to that report, we now understand what the potential compensation schemes for women and children impacted by the mesh and valproate scandals could look like.
I will briefly break convention to say how grateful I am for the passion and hard work of our Patient Safety Commissioner, Henrietta Hughes, who—gosh!—has not managed to get into the public Gallery. Somebody might want to tell her there is a spare chair. Can somebody make sure she is allowed in, because it is her report we are discussing? [Interruption.] There she is. I thank our wonderful Patient Safety Commissioner, who has thankfully now been let into the room.
It is great to see so many campaigners, who have been a great help and source of expertise and support to me over many years. I particularly thank Kath Sansom from Sling the Mesh, and Janet Williams and Emma Murphy from the Independent Fetal Anti-convulsant Trust, or In-FACT, as well as many more—too many to name.
I am also glad to see Charlie and Lesley Bethune, who have tirelessly campaigned on behalf of their daughter, Autumn. They have travelled all the way down from Scotland. Their MP, the right hon. Member for Dumfriesshire, Clydesdale and Tweeddale (David Mundell), cannot be here today, but he sends his sincere apologies. They would welcome an undertaking from the Minister and the UK Government to engage with those affected in Scotland, recognising that this is a UK-wide issue. Like so many others, they would also welcome progress on a response.
Every Member present will have a constituent who is affected by one of these health scandals. At least 7,000 children have been harmed by the drug valproate since it first came on to the market in 1973, with an estimated further 28 per month exposed to it, and at least 40,000 women across the country have been injured by mesh.
It is important to note that the actual figures are likely to be much higher due to a lack of awareness and many parents being reluctant to label their children. Putting an exact number on these things can therefore be extremely convoluted and difficult. Regardless, these are not just statistics: behind each number is the story of a woman who trusted a healthcare professional and was horrifyingly let down, a woman or a child who has been damaged irreversibly, a woman who has had to alter her life to accommodate for the physical, mental and financial toll of these scandals.
Susan Murray (Mid Dunbartonshire) (LD)
Does the hon. Lady agree that it is important that any inquiry and report looks into the fact that the products that were used, particularly in the mesh scandal, were properly licensed for the procedures they were used for?
Yes, I agree. That is a huge part of the problem, especially with regard to medical devices. The Cumberlege report looked into the medications, but also medical devices, which is what mesh comes under. Often they are put into use for one thing and then used for something else without any further testing or investigation. I agree with the hon. Lady that that has got to stop.
After all that these women, families and children have been through, compensation would help at the very least pay to their bills if they cannot work any longer, or help to ease the constant worry about how their child will be able to survive independently when they are gone. I have a constituent impacted by her mesh implant who is unable to work—like most of those affected—and therefore cannot afford the day-to-day necessities. She is in constant pain, suffers from post-traumatic stress disorder and has lost all trust in medical professionals. Compensation would not reverse her physical or mental pain, but it would at least make her life easier. There are thousands just like her, including my very own mam, who is now aged 80. I have spoken in detail about her journey previously. The damage to her body and health from mesh is something she says she will regret to her dying day, which I hope is still many years off, even though mesh has ruined her long-awaited and hoped-for retirement by ruining her health.
I congratulate my hon. Friend on securing this important debate. She is making an excellent speech. My constituent Susan Cole is in the Public Gallery. Her daughter was affected by sodium valproate. It is now 14 months since the Hughes report was published. The time for the payment of compensation is now. Does my hon. Friend agree that the Government could provide interim compensation even if they do not have the timeline for implementing in full the measures in the Hughes report?
I absolutely agree with my hon. Friend, and I commend him on all the work he does to represent his constituents. Interim payments were provided to victims of the contaminated blood scandal, as we know. Henrietta Hughes, the Patient Safety Commissioner, has detailed how to do it in her report. I ask the Government to look at that in detail when considering their response.
If the Government are not moved by the moral case in respect of these health scandals, surely they cannot deny the economic toll they have taken on our public and mental health services. Although compensation would require finding money in what we all appreciate is a very tough fiscal situation, if we do nothing we will still need to find money: one payment will be given directly to the women and children harmed; if we do not do that, another will be have to be made for the provision of mental health services, for the NHS and for out-of-work benefits. We have a decision to make and, for me and the thousands of women and campaigners, the answer could not be simpler.
I know from conversations with campaigners and constituents that the Government’s recent announcement on personal independence payments and welfare reform have caused anxiety for mesh and valproate victims who rely on those payments to survive. It is vital that we understand that the physical complications and illness caused by mesh and valproate are going to be with them for life, so they should not be forced into work if they cannot work.
I spoke to the hon. Member for Bridlington and The Wolds (Charlie Dewhirst) recently, and he told me about his constituent, Julie Robinson, and her family’s experience of sodium valproate. Julie’s daughter Samantha has been severely impacted by the epilepsy drug that was prescribed during Julie’s pregnancy. They both live in Market Weighton, in the hon. Gentleman’s constituency. He sends his apologies and asked me to raise the case of his constituent.
I hope Members will allow me to list the seven complications Samantha has following the damage done to her by valproate while in uterus. She has neurodevelopment issues, including autism; memory difficulties; speech and language impairments; hearing and vision problems; heart defects requiring major surgery; a cleft lip and palate that led to a year in hospital; dysmorphic facial features at birth; and fine and gross motor challenges. It is quite a list. These conditions have significantly affected Samantha’s health and education and will persist throughout her life. There are thousands just like Samantha who will require lifelong care, which will also affect her parents’ ability to work.
If a person can never work again because of mesh or valproate, they deserve support and to be treated with dignity. If they want to try to work, they should never be penalised or forced to go through reassessments and put under excessive anxiety or fear if it does not work for them and their family. Even prior to the welfare announcements, I have long argued for better education and empathy from the Department for Work and Pensions when assessing mesh and valproate victims. I hear from constituents impacted by mesh, for example, who would rather struggle financially than go through the gruelling and dehumanising process of explaining their condition and trying to claim the benefits they are entitled to. There needs to be proper and effective education among DWP staff about these health scandals, so that assessments are humiliation-free and quick for these women.
While the valproate and mesh scandals differ in the specifics of the cases, the crux of them and the flags that they raise remain the same. Both affect women; both exemplify what happens when there is a lack of honesty and communication about the risks of medical procedures; and both highlight the need for increased transparency on the payments made to health professionals. They show the damage that is done when profit is put before people, when big firms avoid accountability and transparency and when—I have to say it—medical misogyny is allowed to run rife. I intend to emphasise those points, which I imagine colleagues will also touch on.
Let us consider the valproate scandal. If warnings had been given at licensing, or in 1987, when Sanofi asked for information to be added to the patient information leaflet, the women and children impacted by valproate would not be in this position. Likewise with mesh, if women had been properly informed about the risks of adverse effects rather than being fed a false image, as my mam was, of “In and out; a quick 20-minute procedure that will change your life”—boy, did it change her life, but not for the better—we would not have thousands of women harmed on an irreversible scale.
Warinder Juss (Wolverhampton West) (Lab)
I thank my hon. Friend for securing this debate. Before I became an MP, I specialised exclusively in dealing with compensation claims on behalf of women who had suffered from the use of vaginal mesh. My hon. Friend is absolutely right that the mesh was sold to patients as a gold standard, and they were misled. Does she agree that a proper Government-backed compensation scheme will save the NHS money in the long run? As a solicitor, I was always conscious of the fact that, in pursuing these claims, it was ultimately the NHS that had to pay out the compensation and legal costs.
My hon. Friend makes an excellent point, which perhaps nobody else but him would have been able to make in this debate, so I thank him for it, and I do agree.
The people harmed by mesh and valproate did nothing other than trust a medical professional’s judgment. The very least we should do is offer them compensation to help them navigate their now damaged lives, which they have had inflicted on them, most horrifyingly, by our very own NHS.
The fact that the victims of these scandals are mainly women is no coincidence. I have recently spoken in this place about medical misogyny in our healthcare system, and some colleagues here were in that debate. I said then—and I say it again—that had the thousands of women impacted by these scandals been men,
“I do not believe that dismissal on such a scale would have occurred.”—[Official Report, 27 February 2025; Vol. 762, c. 499WH.]
We hear stories of women seeking advice from medical professionals, only to be told it is all in their head—that it is just their menstrual cycle or the menopause—or being gaslit into believing it must be anything other than the devices or medication they were prescribed.
Women not being listened to by medical professionals not only perpetuates structural misogyny; it endangers lives. It is so heartening to see so many male colleagues in this debate, because it proves that we can change things and that it does not have to be this way. Issuing compensation to these women would, at least and at last, confirm that they were right to be concerned and that they were not being hysterical—we know why it is called a “hysterectomy”—which is something women have been accused of for many hundreds of years when it comes to our health.
As well as medical misogyny, part of the defensiveness and dismissal stems from the huge sums given to the healthcare system by the industry, which creates bias. Knowing that that is the case is not enough: the UK needs to adopt sunshine legislation to ensure that this information is fully declared, in the same way that all of us in this room, as MPs, have to make declarations. That information should be presented via a centralised public database that is totally independent of industry. As we all know, sunlight is the best disinfectant, and we need to act now to prevent future scandals.
I am conscious of time, and colleagues will have a lot to say and experiences to share, so I will end my remarks by leaving the Minister with a few quick questions—sorry, Minister. Will she provide Members and campaigners here today, and the no doubt many victims of these scandals watching at home on the internet, with a timeline for when we can expect a Government response to the excellent Hughes report? If she is unable to do that today, will she commit to writing to Baroness Merron to ask for a timeframe?
Will the Minister explain what scope there is for the Government to implement a sunshine-style piece of legislation to ensure the transparency of payments made by industry to our healthcare sector? In the spirit of cross-departmental working, which I know the Government are committed to, will she write to the Work and Pensions Secretary for reassurance that victims of the valproate and mesh scandals will not be subject to reassessment and forced into work, given their physical and mental complications? Finally, in her new role, will she commit to meeting campaigners, many of whom are here today, to hear at first hand about the valproate and mesh scandals, if she did not do that in her previous role as a Back-Bench MP?
I thank the Minister in advance for her consideration, and I look forward to her answers. I will end with this: we have rightly seen compensation for the infected blood scandal, which I mentioned at the start of my remarks, the Post Office scandal and the Grenfell disaster. Those all involved innocent people whose lives were turned upside down, whether physically, mentally or worse, through no fault of their own. I fail to see how the mesh and valproate scandals do not meet the same criteria, and I encourage anyone opposed to compensation to consider that.
I remind Members that they should bob if they wish to be called in the debate. At this stage, there are a lot of you to get in, so we are limiting speeches to four minutes.
I sincerely thank everyone who has made the time to come along and speak on this most vital issue. They have all made such valuable contributions to this debate, and it is really heartening for me to hear such a great degree of consensus across the House that there is a wrong to be righted and that this new Labour Government have the opportunity to do just that.
There are so many hon. Members who would have liked to be here today. Indeed, while I was on my feet, my hon. Friend the Member for Harlow (Chris Vince) messaged to send his apologies, so I said I would make sure that was on the record. I thank the Minister; the shadow Minister, the hon. Member for Hinckley and Bosworth (Dr Evans); and the Lib Dem spokesperson, the hon. Member for Chichester (Jess Brown-Fuller) for listening and for their intelligent contributions. There is so much expertise on this issue across the House. If we cannot get this sorted, nobody can.
I am particularly pleased that the Minister apologised on behalf of the Government again so fully and movingly. She actually moved me to tears—I do not know about anybody else—but I am a bit soft in that regard. I hope she will agree to meet campaigners to continue this conversation, as I know Baroness Merron has done in the other place. I am sure that everyone watching both from the Public Gallery and at home will have appreciated the empathy and the understanding that the Minister has shown in this debate.
With a new Government, we have new opportunities and the chance to make a real difference to the thousands of women and children who were wronged through no fault of their own. We have all the information we need, thanks to the amazing Baroness Cumberlege and our fantastic Patient Safety Commissioner, to ensure that such scandals never happen again and that families are given compensation to help to rebuild their lives. We now have to act, as Members have said. I hope that this debate has highlighted to the Minister the urgency of that—I am sure that it has—and that she will have the conversations required to make this happen so that these wrongs can be righted at last and as soon as possible.
If Members are willing, I ask that they gather at the bottom of the stairs outside this Chamber to join campaigners for a photo to mark this occasion, and to spend a few moments talking to them.
Question put and agreed to.
Resolved,
That this House has considered the first anniversary of the Hughes report on valproate and pelvic mesh.
(1 year ago)
Westminster HallWestminster Hall is an alternative Chamber for MPs to hold debates, named after the adjoining Westminster Hall.
Each debate is chaired by an MP from the Panel of Chairs, rather than the Speaker or Deputy Speaker. A Government Minister will give the final speech, and no votes may be called on the debate topic.
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It is a pleasure to serve under your chairmanship today, Dr Huq. I thank my hon. Friend the Member for Hastings and Rye (Helena Dollimore) for securing this important debate, and for her excellent opening speech. There are so many things that I want to talk about, but for time’s sake, I will focus my remarks around the importance of women being believed by healthcare professionals, and the detrimental effect on women when that is not the case.
The UK has the largest female health gap in the G20, and that is attributed in part to the misdiagnosis of conditions in women. It is absolutely shocking that eight in 10 women in this country report not being listened to by healthcare professionals. Those discrepancies extend beyond the confinement of the consulting room; they actively reinforce beliefs among wider society that women’s symptoms, no matter how debilitating, are normal. That is likely to prevent so many women from seeking medical advice, ultimately putting them at risk. Therefore, that widespread problem does not just perpetuate systemic misogyny but directly impacts women’s health outcomes and endangers their lives.
Published in August 2022, the 10-year women’s health strategy for England included a six-point plan on how to improve health outcomes and the way that the healthcare system listens to women. No. 1 on the list was to ensure that women’s voices are heard. In the month of the first anniversary of the publication of the excellent Hughes report, there is no better time to speak on an apt example of what happens when women’s voices are not heard. As the chair of the all-party parliamentary group on first do no harm, mesh, Primodos, valproate, I campaigned for justice and compensation on behalf of the thousands of women who live with the consequences every day of what happens when women’s voices are not listened to. The mesh scandal in particular exemplifies that perfectly.
To set the scene, it is believed that 40,000 women in this country could be affected by mesh damage and complications, and 10,000 of those women have been left with disabilities, as the mesh has cut into their organs and nerves. I hear from mesh-impacted constituents who describe desperate situations of poverty, depression and isolation as a result. Many have lost their jobs, their marriages and their trust in a service that is supposed to be there for us when we are sick, not make us sick.
Perhaps even worse was the treatment of those women when they realised that it was the mesh that was causing their health complications. The women then report being gaslit, undermined and ridiculed when trying to sort out a mess they had no part in making, or even consenting to in most cases. Among the thousands of mesh-injured women is my own mam. I personally sat next to her at our local hospital and watched her be gaslit and undermined by her original surgeon when she first sought help with her pain and symptoms. Despite now having had her mesh removed by the wonderful Dr Suzy Elneil in London, the complications sadly do not stop there.
The way mesh attaches to our organs has been likened to the way that chewing gum gets caught in our hair, so it is almost impossible to fully remove it. As such, regardless of the removal, my mam, now 80, is still struggling and in her own words, will never be the same again. The important point is that had my mam and the thousands of others affected been men suffering horrendous pain as a result of a medical procedure, I do not believe that dismissal on such a scale would have occurred. Nor do I believe that compensation and recognition of the scandal would be such a painfully slow process.
Before I finish, I put on record my gratitude to my friend who recently retired from the other place, Baroness Cumberlege, for all her work on this issue. I will leave it there, as I am out of time.
(1 year, 1 month ago)
Commons ChamberI thank the right hon. Gentleman for that suggestion and will ask my officials to look into it. I am very keen that we maximise the latest advances in technology, genomics, life sciences and research to ensure that we identify people who are at risk of cancer, preferably before they develop cancer, so that we can get them on appropriate treatments where necessary and they avoid the pain and misery that cancer can bring.
On this World Cancer Day, will my hon. Friend the public health Minister tell me what efforts he is making to raise awareness of the signs and symptoms of ovarian cancer, such as a bloated tummy, lack of appetite or feeling full, tummy pain or needing to pee more often, in order to increase lifesaving early diagnosis?
I am very grateful to my hon. Friend for all the work that she has done on ovarian cancer since becoming an MP. She knows—the rest of the House might not—that I lost my mum to ovarian cancer. I was 19 when my mum died and she was only 50—my age today. She had a late diagnosis. They basically opened her up to perform a hysterectomy and the cancer had spread all the way through her body. They sewed her back up and she died at the end of a hospital ward two days later in pain and agony. Having awareness of those symptoms is so important. My mum was fobbed off by her GP, because she worked in a shop and lifted boxes. She had a bad back and was bloated and so on. The GP said it was down to her work, rather than erring on the side of caution and getting her checked out. We must ensure that women today are heard by GPs and, more importantly, that we err on the side of caution and get people on to treatment.