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Category: Health

  • Peter Swallow – 2025 Speech on the Mental Health Bill and Legislative Scrutiny

    Peter Swallow – 2025 Speech on the Mental Health Bill and Legislative Scrutiny

    The speech made by Peter Swallow, the Labour MP for Bracknell, in the House of Commons on 22 May 2025.

    It is an honour to present to the House the Joint Committee on Human Rights’ report into the Mental Health Bill. As Members will know, the Joint Committee is a cross-party body of both Houses, chaired by Lord Alton of Liverpool, whose remit is to examine matters relating to human rights within the UK, including through legislative scrutiny.

    Over the course of our inquiry into the Bill, we have examined legal frameworks and witness submissions and, crucially, heard from those with direct experience of the mental health system. As part of our inquiry, the Committee convened a roundtable with individuals who had experienced detention under the Mental Health Act 1983. Their testimonies were powerful, candid and often harrowing. They spoke of the trauma of being sectioned, the overuse of medication and restraint, and the disempowerment from being detained in facilities that too often felt isolating rather than therapeutic.

    Participants have since shared with us

    “how important this visibility was to them, to see their evidence truly listened to and shared publicly”.

    Hearing directly from people with lived experience was not just informative; it was essential. These conversations grounded our scrutiny in the realities faced by patients and families. The insights shared at that roundtable shaped our thinking and sharpened our final recommendations. As one participant told us:

    “lived experience matters. Using it to inform policy should be the standard, not a shock.”

    I take this opportunity to thank all those who contributed to the roundtable, often at the cost of revisiting past trauma. The Committee is also grateful for the expert work of the Committee’s legal counsel, particularly Alex Gask who led on this work, as well as Thiago Simoes Froio and Hafsa Saeed who led on the delivery of the roundtable event.

    It became clear over the course of our scrutiny just how overdue the Mental Health Bill had become. It will introduce substantial changes to the Mental Health Act, which provides the legal framework for the detention and compulsory treatment of people with “mental disorders”—an outdated term, but one that remains part of our law. The changes introduced by the Bill will bring our mental health legislation into the 21st century, strengthen patient rights and help end practices that bring more harm than good.

    When people hear about detention under the Mental Health Act, many instinctively think of those who have committed the most serious and violent crimes. They picture high-security hospitals such as Broadmoor, which happens to be located in my constituency. I have had the opportunity to visit Broadmoor. The work they do there is outstanding; it is vital, world-leading work that deals with some of the most complex and challenging cases in psychiatric medicine.

    Let us be clear, though: the reality of detention under the Mental Health Act is not limited to high-security hospitals or individuals convicted of serious crimes. Many people detained under the Act are not criminals. Many of them are children, young people and adults with autism or learning disabilities who are detained not because they pose a danger to others, but because the support they need in their communities simply is not there. This is not just inefficient, it can often be deeply traumatising and raises significant human rights concerns.

    That is why the Committee welcomes the major changes introduced by the Government’s Bill. It will end the detention of individuals under section 3 of the Mental Health Act solely on the basis that they are autistic or have a learning disability; tighten the criteria for detention and require decision makers to consider the nature, degree and likelihood of harm before deciding to detain; introduce the concept of a nominated person to replace the outdated nearest relative system; and remove police stations and prisons as places of safety for individuals in crisis. As stated in the evidence we received from witnesses, those are important, welcomed and long-awaited reforms. They reflect the breadth of the Government’s consultations and prove that the Government listened to the information they received.

    While welcoming the Bill’s direction of travel, the Committee believes that there are areas where the Government could go even further to provide enhanced protections for human rights. That is why, based on the evidence we received during the inquiry, we have recommended a few key amendments. First, we recommend a new clause to ensure that children detained under the Mental Health Act are accommodated on adult wards only when that is demonstrably in their best interests.

    Secondly, we recommend an amendment to clause 1 to include equity as a fifth guiding principle under the Act. This would refer specifically to addressing inequalities in treatments and outcomes on racial grounds in particular, and I welcome the Health Secretary saying on Second Reading of the Bill on Monday:

    “People from ethnic minority communities, especially black African and Caribbean men, are more than three times as likely to be sectioned.”—[Official Report, 19 May 2025; Vol. 767, c. 783.]

    In our report, we find that adding equity as a guiding principle would do more to address racial disparities.

    Thirdly, we recommend an amendment to clause 32 to shorten the review periods for restricted patients who are discharged into conditions amounting to the deprivation of liberty. The first review will be required within six months, rather than 12, and subsequent reviews will take place annually, rather than every two years.

    Those key amendments come amid a range of other recommendations. Recent case law shows that mental health patients in state-commissioned and funded but privately provided care do not come within the protection of the Human Rights Act. That loophole must be closed, and we recommend that the Government do just that.

    We also heard evidence that the question of when the Mental Health Act and when the Mental Capacity Act should govern a patient’s deprivation of liberty and treatment is far too complex and raises human rights concerns, not least because depriving a person of their liberty on any ground can be justified only if the legal basis is clear. We therefore recommend that the Government carry out an urgent review and provide the clarity that is currently lacking on this question.

    Another crucial area the Bill covers is the rights of children, who are particularly vulnerable when assessed or treated under the Mental Health Act. Many of the proposed changes to the law will be positive for children, including the introduction of an opt-out approach to receiving a report from independent mental health advocates, but we recommend that the Government consult on introducing a statutory test for assessing whether under-16s are competent to consent or to refuse consent to treatment—a cornerstone of compliance with a child’s human rights.

    The Committee also deems it vital that prisoners whose mental health makes holding them in prison unsuitable are transferred promptly to an appropriate setting. Keeping them in prison may result in human rights breaches. In our report, we welcome the introduction in the Bill of a statutory 28-day timeframe for hospital transfer. Relevant data should be collected and made available to monitor and help to ensure compliance with that standard.

    The Committee welcomes changes to restriction orders placed on a small number of offenders detained under a hospital order, but the Government should consider introducing more prompt and regular reviews by the mental health tribunal, to ensure that any loss of liberty is justified. Witnesses told us that, in the absence of effective support in the community, autistic people and people with learning disabilities could still end up in unjustified detention on other legal bases. The Government have stated that the change in the Bill will come into force only where there are strong community services in place, but it is vital that this does not delay the much-needed reform. We therefore welcome the Government’s commitment to provide a written ministerial statement annually to both Houses of Parliament setting out progress to date on implementation. On what more the Bill could do to improve the prospects of patients receiving timely care in the community, we also ask the Government to consider introducing an English equivalent to the right to a mental health assessment that applies in Wales.

    The report makes it clear that much more is needed to fix the broken mental health system in this country, and I know the Government recognise that as well. This is a small, targeted Bill, which will not change everything, but the changes it will introduce are significant and long overdue. The Government have committed to introducing mental health experts in every school, to set up Young Futures hubs and to recruit 8,500 more mental health staff. By focusing on community-based interventions and driving down waiting lists for mental health support alongside the welcome changes in the Bill, we can turn the tide and fix our broken mental health system, so that the human rights of all those with mental health needs are properly protected and they can get the support they need.

    I commend this report to the House.

  • Wes Streeting – 2025 Speech on Men’s Health

    Wes Streeting – 2025 Speech on Men’s Health

    The speech made by Wes Streeting, the Secretary of State for Health and Social Care, at Central Hall in Westminster, London on 13 May 2025.

    It is a genuine pleasure to be here alongside so many friends – people I don’t yet know, but people we want to work with.

    It’s great to have such a wide range of people and organisations represented around the room, who are creating spaces for men to fight loneliness.

    Encouraging open conversations about masculinity and providing positive role models for boys across our country.

    I want to thank you, Richard, for picking up this agenda and helping to force it into the mainstream.

    Society has been slow to wake up to the fact that a lot of men and boys are really struggling today, and you’re playing a big role in correcting that.

    And, as you alluded to in your remarks, making sure that this is a mainstream agenda and not one that is surrendered to the margins and the extremes.

    So, I’m looking forward to working with you and your institute as we begin to develop solutions to the inequalities and injustices that men and boys face in our country today.

    The truth is it can be quite tough to be a young man in today’s society.

    Lots of boys, particularly those from working class backgrounds like mine, are falling behind at school and are worried about their futures.

    The proliferation of toxic influences and content on social media is leading a lot of boys astray.

    A lot of content on social media that provided a real challenge for girls in terms of positive body image and what it meant to be a perfect girl or a woman in our society – those challenges are now applying to men and boys in similar if sometimes different ways.

    And all of this is contributing to a crisis in masculinity.

    Since taking on the health and social care brief in opposition 3 and a half years ago, I’ve been very outspoken about the fact that it takes 7 and a half years for women to receive a diagnosis for a common condition like endometriosis, or that a universal experience like menopause is still treated as if it’s a rare condition affecting alien species.

    And I feel just as enraged about the inequalities in men’s health, frankly.

    Men are living 4 years less than women.

    The gap widens if you just look at working class communities.

    Men are disproportionately affected by cancer, cardiovascular disease and type 2 diabetes.

    The tragedy is that many of these conditions are treatable and even preventable.

    Black men are twice as likely to die from prostate cancer as White men.

    And suicide is the number one killer of men under the age of 50, which was a fact so shocking that I nearly fell off my chair when I first heard it and actually asked for the statistic to be checked. And the fact that it’s now more commonly cited should not make the fact itself less shocking or outrageous.

    Nothing frustrates me more than when men’s health and women’s health are pitted in opposition to each other, as if by focusing on the men’s health strategy, we are in any way detracting from the work we’re doing on women’s health.

    This is not an either or.

    It very much has to be hand in hand, and we will address both.

    And it also does a disservice to lots of women in our society, as if somehow women don’t care about their fathers and grandfathers, their brothers, their sons, their nephews any less than we care about our mothers or grandmothers, our sisters.

    It’s really serious.

    So I actually think that we are all in this together, and we will succeed as a society if we’re working together to tackle the injustices and inequalities that affect men and women.

    There’s a common problem across the NHS that women’s voices are not heard, and women are not listened to.

    When it comes to men, I think the problem is often we’re more reluctant to speak up in the first place.

    One in 3 men have never had a conversation with a brother, father or grandfather about their health.

    The same number would prefer to suffer in silence than go to the doctor about their mental health.

    So, I think we’ve got to teach men from a young age that it’s okay to feel, to hurt and to ask for help.

    Doing so doesn’t make you any less of a man.

    And I think that making sure this generation of young men and boys are aware of that fact is how we make them less likely to channel their emotions into anger, aggression or depression.

    This is all why we’re doing the first ever men’s health strategy.

    I announced this last year at the Emirates Stadium to coincide with Movember, alongside a large number of men’s groups and organisations, charities and men’s health ambassadors.

    It was a great event, but one of the things that came out of it on the day and since has never ceased to amaze me. And that is just how many people said, “thank you”.

    That’s not just because as a politician, it’s rare for someone to say thank you.

    I mean, to be fair, we’ve got to give people something to be grateful about.

    But, actually, I was saying to people, look, you can thank us when we’ve done something.

    All I’ve done is say we’re going to have a strategy.

    We hadn’t even launched the call for evidence at that point.

    When we’ve done something, when we’ve had an impact and we’ve started to change those statistics and change things about their lives and futures.

    But actually the pushback I got was, no, actually, we’re genuinely grateful because we’ve been fighting for this for so many years and haven’t had a hearing, let alone someone being prepared to launch a call for evidence that will lead to a strategy.

    And that tells us something about the extent to which men’s health has been overlooked, and particularly men’s mental health.

    So we launched our call for evidence for the men’s health strategy in April, and I was about to say, I want to ask everyone who hasn’t responded yet to do so and spread the word further.

    But actually, we have been really overwhelmed and really struck by just how positive and engaged such a large number of organisations have been.

    But nonetheless, we want to make sure we engage as many men, as many organisations and as many different types of men and different parts of the country from different communities as we have.

    Which is right.

    We have to look at the data and we will take an evidence-based approach.

    But as we know, statistics paint a picture to an extent, but what we also need to do is understand the story that we want to tell.

    We’re talking about the experience of men and boys today and how we’re going to make it so much better, so we could do with more insight as well as data, especially from those grassroots organisations in this room and beyond, in a range of communities across the country, whether on physical health or mental health, whether we’re talking about White men or Black men, whether we’re talking about class inequality as well, which is at the heart of a lot of mental health. Any serious attempt to address mental health must confront these inequalities head on.

    So, we’ve got our work cut out for us. Doing is a lot more important than talking.

    We’ve done the easy bit, in my view.

    We’ve committed to having a strategy to making a difference and making sure that we’re proud of the impact.

    But in order to be successful, this isn’t just a challenge that government can address.

    This is about government playing its part, but working in partnership with civil society, with businesses, with all of us as citizens to try and tackle what are a wide range of challenges and problems facing men and boys.

    And that’s why this gathering is really important to me, the department and the government, because we need to do this with you rather than to you. And with this level of enthusiasm, this level of energy, we genuinely think we can do something impactful that we’ll be able to look back on for the rest of our lives with pride, knowing that we were prepared to confront the problems and the challenges head on, and make sure that boys growing up in this country today, whoever they are, whatever their background, can achieve their fullest potential and look forward to a life well lived, rather than experience the deep anxiety and despair far too many boys in our country are experiencing today.

    So thank you very much in advance.

  • Wes Streeting – 2025 Speech at Unison’s Annual Conference

    Wes Streeting – 2025 Speech at Unison’s Annual Conference

    The speech made by Wes Streeting, the Secretary of State for Health and Social Care, in Liverpool on 9 April 2025.

    Good morning conference.

    Let’s start on a point of agreement.

    The killing of 15 health and rescue workers in Gaza was an appalling and intolerable tragedy.

    Healthcare workers in any context, in any part of the world, should never be a target.

    The international community, or indeed any actors in any conflict, all have a responsibility to protect health and humanitarian aid workers and also to protect innocent civilians.

    And it’s clear that in Gaza, as well as in other conflict zones around the world at the moment, the international community is failing and failing badly.

    So I want to say, as a Unison member, I strongly support the sentiments expressed by our Healthcare Executive.

    But on behalf of our government, we want to see a return to an immediate ceasefire.

    We want to see aid in, people out of harm’s way, an end to this bloody conflict and a state of Palestine alongside a state of Israel, and the just and lasting peace that Israelis and Palestinians deserve.

    I also have to say, having been to the West Bank with Medical Aid for Palestinians and seen first hand the work that they do supporting the health needs of Palestinians across the occupied Palestinian territories, they do brilliant work.

    And I would fully endorse the sentiment of the motion in supporting them, and each of us putting our hands in our pockets to do that.

    I’m proud to be here today as the first Health and Social Care Secretary to address a UNISON conference since Andy Burnham did 15 years ago—and proud to do so as a UNISON member.

    My first ever parliamentary debate in 2015 was with UNISON, opposing the abolition of the NHS bursary. Since then, I’ve spoken on countless UNISON platforms across my time as Shadow Schools Minister, Shadow Child Poverty Minister, and Shadow Health & Social Care Secretary.

    But today is different. This is the first time I speak to UNISON not as someone discussing what a Labour government should do, but what we are doing—delivering real change to transform society and improve working people’s lives.

    Last July was historic. Labour returned to power with a thumping majority—only the fourth time in our history. It was a result made possible by UNISON’s support for Keir Starmer: helping to change the party, change the government, and now change the country. That victory brought 74 new UNISON MPs into Parliament, including Katrina Murray, Melanie Onn, Mark Ferguson, and my own PPS, Deirdre Costigan. Three UNISON MPs are now in the Department of Health and Social Care: Stephen Kinnock, Karin Smyth, and me.

    We’re delivering the change people voted for. It’s not easy—and I know you’ll have questions and challenges. But we’re ready to engage. UNISON has always been a critical friend to Labour. The “critical” part is just as important as the “friend” part.

    In the past nine months, nothing has shaken my conviction that we will get the NHS back on its feet and build a National Care Service worthy of the name.

    Take Southport, for example. On July 29th, a senseless, mindless attack left children and adults bleeding, some dying, in a community centre. NHS staff responded with extraordinary courage—from paramedics and porters to receptionists and surgeons. But what happened next filled me with rage. Racist thugs attacked Filipino nurses, a Nigerian care worker’s car was torched, and GP surgeries had to close. These are people who came here to care for us. They represent the best of Britain.

    Violence against NHS staff must end. One in seven NHS workers have suffered abuse. That shames us all. So today, I’m announcing mandatory national recording of incidents, data analysis to protect the most at-risk, and requirements for NHS trust boards to report on progress. Zero tolerance. Campaigned for by UNISON. Denied by the Tories. Delivered by Labour.

    Too often, NHS staff are trained at great public expense, only to be driven out by poor treatment. Some end up working in Canada or Australia. We must retain talent and respect staff—through training, flexible working, and fair pay. That’s why we’re implementing a new digital system to fairly apply the Job Evaluation Scheme. A fair day’s work for a fair day’s pay. Campaigned for by UNISON. Denied by the Tories. Delivered by Labour.

    I owe my life to NHS staff who treated me for kidney cancer. I’ll never be able to repay that debt, but I’ll try. You were there for me—I’ll be there for you.

    We have a ten-year plan. The Conservatives left us with record waiting times and low satisfaction. Our mission: get the NHS treating patients on time, and reform it for the future.

    We’ve engaged more than a million people in the biggest NHS consultation ever, including 3,000 staff meetings. The result, to be published this spring, will outline three goals:

    • Shift care out of hospitals and into the community;

    • Modernise the NHS with digital tools and technology;

    • Build a preventative health service to tackle major killers.

    This isn’t the staff’s fault. But we can’t fix it without you. I know how hard it is to fight a broken system. But help is coming. My message: stay and help us rescue it. We’re turning it around.

    In nine months, we’ve already:

    • Given NHS staff an above-inflation pay rise;

    • Ended the resident doctors’ strikes;

    • Invested £26 billion in health and care;

    • Made the largest investment in hospices in a generation;

    • Agreed the GP contract with £889 million in new funding;

    • Reversed a decade of pharmacy cuts;

    • Delivered 2 million extra appointments—seven months early;

    • Diagnosed 80,000 suspected cancer cases early;

    • Cut waiting lists for five months in a row.

    On social care, we’ve delivered the biggest-ever increase to carers allowance—£2,300 extra a year—and introduced fair pay agreements as part of Labour’s Employment Rights Bill. That’s the first step in building a National Care Service.

    And today, I can announce the first universal career structure in adult social care: four new job roles and millions in training investment.

    Keir Starmer said his ambition is for his sister, a care worker, to be treated with the same respect as her brother, the Prime Minister. With Labour, she will be.

    But we carry a huge responsibility—not just to NHS users, but to prove that the NHS can still deliver. On its 75th anniversary, most Britons were proud of the NHS. But 70% thought “free at the point of use” won’t survive the next decade.

    Right-wing figures like Kemi Badenoch and Nigel Farage want to change that. Farage wants insurance-based models and to charge patients. Over my dead body.

    We will always defend the NHS as a public service—free when you need it, no matter who you are.

    Tories and Reform are willing us to fail. But the future of our party and our health service are bound together. The stakes are high. But the prize is huge: an NHS where workers are respected and patients get the care they deserve.

    We can look back one day and say: we were the generation that rescued the NHS from its worst crisis and made it fit for the future.

    Change has begun—and the best is still to come.

  • Keir Starmer – 2025 Speech on the NHS

    Keir Starmer – 2025 Speech on the NHS

    The speech made by Keir Starmer, the Prime Minister, at the South West London Elective Orthopaedic Centre, Epsom on 6 January 2025.

    A happy new year to you all!

    I hope you had a refreshing Christmas break.

    I do recognise and realise that for so many people in the NHS, those words ‘Christmas’ and ‘break’ don’t very often go well together.

    So before I say anything else – can I just say to all of you, and through you to all of your colleagues who work in the NHS. Thank you.

    Thank you for the service to our country. And for the countless lives that you save and change – every single day. A massive thank you to you.

    Now, this year of course is the 80th anniversaries of VE and VJ day.

    And on the 8th of May and the 15th of August we will come together to celebrate the greatest victory of this country and the greatest generation that achieved it.

    It will be a wonderful moment – and we intend to do them proud.

    But what that generation knew is that the strength and prosperity of a nation rests on the security of working people.

    And that the fundamental job of government is to deliver that security so working people can realise their aspirations and drive a country forward.

    And so for this Government that is what this year is about, what next year is about, what every waking moment is about.

    The goal of our Plan for Change. And this year – we will deliver.

    And let me tell you there is no institution more important for the security of our country than the National Health Service built by that generation eight decades ago now.

    It’s the embodiment of British values and humanity.

    Fairness and equal respect.

    But look at it now. And I’m looking at the staff here.

    Because the feeling of record dissatisfaction.

    Millions of people – waiting, waiting, waiting on waiting lists.

    Their lives on hold.

    The potential of the country, if you like – blocked.

    So 2025 is about rebuilding Britain.

    And rebuilding our NHS is the cornerstone of that.

    We will protect the principles we all cherish and that you all work to every day.

    Care – free at the point of use.

    Treatment according to need. Key principles.

    But to catapult the service into the future.

    We need an NHS reformed, from top to bottom.

    Millions of extra appointments signed, sealed and delivered with the plan we are launching today.

    National renewal in action.

    You know, people have long said we couldn’t do this.

    The wallowing in a fatalism about the potential of this country.

    The change we can deliver for working people.

    Well – this plan is a comprehensive rebuttal of that mindset.

    A National Health Service that treats patients more quickly. That is closer to their lives.

    Gives them a level of convenience that they take for granted in nearly every other service they use every day.

    Just think about, every day, with just few swipes of their phone millions of people buy food or clothes for their family. They book holidays. They even find love!

    There’s no good reason why a public, free at the point of use, NHS can’t deliver that kind of convenience.

    In fact – it must.

    And we talked about some of these this morning. We need an NHS hungry for innovation as you are at this centre.

    That is the only way to face up to the challenges of the future.

    The wonder of us living longer and longer.

    And with that hunger – together we will save countless lives.

    Improve care from where it is now, beyond belief.

    Do not doubt this can be done.

    A system like ours with vast amounts of patient data, with scale, with the extraordinary resilience of our NHS staff.

    We are well-placed for the AI revolution in healthcare.

    Trust me – that is coming.

    And Britain is a world leader.

    So we can do this.

    But first – we must confront the reality of what is needed.

    Because the NHS can’t become the national money pit.

    Productivity can’t bump along 11% lower than it was before the pandemic.

    Working people can’t be expected to subsidise the current level of care with ever rising taxes.

    That is the price of ducking reform – and I won’t stand for it.

    I believe in public service, I believe in the NHS, I will fight for it – day and night. But I will never stand for that.

    And look as many of you will know, and as we talked about this morning – my wife, my sister, my mum.

    They all worked or work for the NHS. And as you know nobody works in the NHS for an easy life – you know that and I know that.

    Indeed, I’ve said many, many times before – I wouldn’t be standing here in front of you today if it wasn’t for the NHS.

    Because my Mum had Still’s disease – she was diagnosed when she was eleven. And one of the things she was told was that she would never have children.

    Well the NHS never gave up on her. And that’s why I’m standing here today, so thank you to the NHS – as every family has a story like that to thank the NHS for.

    And every day, in this hospital and throughout the service NHS staff give their all to save lives and look after the families of other people.

    And then just get up the next day and just to do it all again. Every single day.

    So when I think about what they’ve been through over fourteen years.

    It makes me angry.

    I am angry – that you are working harder and harder yet the system just isn’t delivering results that we need for patients or for staff.

    That is the cut and dry argument for reform.

    And it’s not just about money.

    At the budget we invested over £25 billion in the National Health Service.

    A record amount, and rightly so over £1.8 billion since July on cutting waiting times – alone.

    And that’s investment that will deliver 40,000 extra appointments every single week, picking up on some of the techniques that you are using here.

    And that’s an outcome that is wanted by everyone. Wished for by everyone. But it’s only possible because of the difficult choices we confronted.

    But let me be crystal clear that money will not be used, not as it has been in the past just to paper over cracks.

    That’s the definition of the sticking plaster politics that we were elected to change.

    No, this is the year we roll up our sleeves and reform the NHS.

    A new era of convenience in care. Faster treatment – at your fingertips. Patients in control. An NHS fit for the future.

    It’s not just about giving patients greater flexibility over appointments or leveraging the power of the NHS App.

    And we are doing to do that.

    But there’s a bigger principle here.

    It’s about unlocking the huge untapped potential if we organise services around patient control.

    And you see it with Martha’s Rule which was really important.

    It’s about a shift in the balance of power away from a passive deference to doctors and towards patients being able to get that second opinion.

    Play a greater role in deciding their care and treatment.

    And the early results of Martha’s Rule are in.

    Lives of some of the sickest patients in our care:

    Transformed, extended, saved.

    And so it’s a rule that’s now being recognised as a potentially groundbreaking innovation.

    So look – across the NHS we will put patients in control of their care.

    And to meet that demand we will also move care closer to their lives.

    Shift treatment away from hospitals and centres.

    And deliver more care at their GPs, in their community, in their home.

    And you gave me some brilliant examples of what a difference that makes – shifting care towards people’s communities and their homes this morning when we were walking through what you do right here.

    Because as you know – this will make a massive difference to waiting times.

    If we can get more GPs consulting immediately with specialists. Diagnosing even more quickly than that will avoid an extra 800,000 unnecessary referrals and appointments – every single year.

    Another game-changer – community diagnostic centres.

    We will open them, more of them – and they will be seven days a week, twelve hours a day.

    So that if you need a scan or an X-ray, you get it done much more quickly – and at your convenience.

    That alone – will deliver 440,000 extra tests and scans every year.

    We’ll also let patients with long-term conditions monitor themselves at home. Give them the technology to do that.

    That will cut another half a million unnecessary appointments.

    We’ll also reform funding incentives.

    Focus our investment on what will actually cut waiting times.

    Far too much money is wasted on inefficient care. That has to stop. Because we can’t afford it.

    Artificial Intelligence will help us here as well.

    I’ve seen it in action at the hospital I was at the tail end of last year.

    AI-enhanced stethoscopes that can tell, literally in a heartbeat whether you’re at risk of cardiac failure.

    And just think about that.

    A patient saved, in an instant.

    From a possible future that they may have had, where they collapse, possibly more than once.

    Rushed, on trolleys, into acute services in a hospital. All of that avoided because AI was able to pick it up much earlier.

    Think of the impact not just on the individual patient, the person that might happen to, and of course their families, but also on the NHS.

    Artificial intelligence is a technology with almost unlimited power to cut waste, speed things up and save lives. And with this plan – the NHS will harness it properly.

    And finally – to cut waiting times as dramatically as possible our approach must be totally unburdened by dogma.

    Working people would expect nothing less.

    So today – I welcome a new agreement that will expand the relationship between the NHS and the private healthcare sector.

    Make the spaces, facilities and resources of private hospitals more readily available to the NHS.

    That’s more beds, more operations, more care – available to the NHS. Treating patients – free at the point of use. Targeted – at where we need them most.

    A partnership – in the national interest. Cutting waiting times, working for you. Delivering our plan for change.

    I know some people won’t like this, but I make no apologies.

    Change is urgent.

    I’m not interested in putting ideology before patients and I’m not interested in moving at the pace of excuses.

    All through this project that we have been involved in people have been saying – slow down…

    “You won’t win in every nation in Britain…”

    “You won’t deliver that plan…”

    They’ll say it again this year – I have no doubt about that.

    It’s that anthem of decline.

    But they’ve been wrong at every stage so far and they’ll be wrong again.

    Because this year – we will show that Britain can. We can change our country.

    Politics can be a force for good.

    We can unite the NHS behind a plan for reform.

    An NHS that is faster, easier and more convenient with waiting times – cut.

    Patients in control.

    Technology – at your service.

    And outstanding care in your community.

    That is the change we will deliver.

    Another step along the road to a country and a people…

    Strong, secure, confident.

    That the future will be better for their children.

    Thank you.

  • Kieran Mullan – 2024 Speech on the Terminally Ill Adults (End of Life) Bill

    Kieran Mullan – 2024 Speech on the Terminally Ill Adults (End of Life) Bill

    The speech made by Kieran Mullan, the Conservative MP for Bexhill and Battle, in the House of Commons on 29 November 2024.

    Today the focus is rightly on Back Benchers, so I will limit my remarks and—mindful of your advice on time, Mr Speaker—I will not be taking any interventions.

    It is not for me to make the case for His Majesty’s Opposition, because we have not taken a collective view, and, like many other Members, I have struggled greatly with this decision. I do not believe there is a perfect choice to be made today, just different versions of imperfection, and my time working as a doctor in A&E has made me sympathetic to both sides of the argument. I have seen the pain in the eyes of relatives who want to ease the suffering of their dying loved ones, but I have also held the hand of frail elderly people, forgotten by their families, feeling themselves to be nothing but a burden. When we reduce it to its core, we are facing a difficult dilemma.

    Access to assisted dying could reduce suffering for the terminally ill. That is a choice that some people would like to have, and some people would make that choice without any undue pressure. If we vote against this Bill today, they will not have that choice. I caution against avoiding facing up to this hard moral reality by arguing that whatever people may fear about dying can always be managed by modern medicine. For all that it can achieve, modern medicine cannot achieve everything. We have heard examples today of the worst illnesses that do more than cause pain. The hon. Member for Bury St Edmunds and Stowmarket (Peter Prinsley) and my hon. Friend the. Member for Hinckley and Bosworth (Dr Evans) described dying from a catastrophic bleed that takes a person’s life in a panicked final moment.

    Of course, the treatments we may use to help people with pain often rob them of what they may sincerely feel to be their own independence and dignity. Some people may not want to spend their final days in a drug-induced state of semi-consciousness to manage their pain. Those minded to vote against the Bill should give that the greatest possible consideration. I do not think that the Bill’s opponents can deny it, any more than its proponents can deny that if this law is passed, it will represent the crossing of a significant legal, societal and moral Rubicon. Every other expectation that we have of the state is for it to help to extend and protect life, but we will instead be asking the state to procure the medicines, provide the staff, and sign off through the courts a process that is designed to lead—and will lead—to someone’s death.

    A deep respect for the sanctity of life is not the preserve only of religious thinkers. Opponents of the Bill place great weight on that consideration. They argue that once we accept that the state and its citizens can play a proactive role in causing death, the debate will shift from whether it should do that at all to how and when it should. It may be that we pass this legislation and no other in future, but those who have the utmost concern about even the possibility of an expanded Bill may vote against this one as the surest way for them personally to prevent that from happening.

    The Mother of the House, the right hon. Member for Hackney North and Stoke Newington (Ms Abbott), argued that coercion is not limited to the selfishly motivated relative directly pressuring a vulnerable person. It can be as simple as knowing that people in the same position as oneself could and did choose to die. Some Members worry that people will then ask themselves not just “Do I want to die?”, but “Should I want to die?”

    So where does this leave us? All of us can make a sensible and reasonable case for our positions, and even point to care and compassion, as we see it, in support of our view. Taking all this together, I think it means that one thing more than anything else should be our guiding principle today: we should, above all else, vote with great humility, and with respect for each and every vote cast in whichever direction. I want to direct that sentiment to the country at large. There are passionate campaigners on both sides of the debate, with their own perspectives, who fear greatly the outcome today if it turns out not to be the one that they want. I say to them that as well as being MPs, those voting today are also sons, daughters, brothers, sisters, parents and grandparents. Each Member will have in mind what they would want for their families and themselves.

    Our final decisions will come at the end of a great deal of thought and careful consideration. As the hon. Member for Vauxhall and Camberwell Green (Florence Eshalomi) said, if people listened closely enough today they will have heard us all speaking with one voice—the voice of passion, for those people and causes that we are trying to aid with our vote, even if those people and causes are different. That passion represents this House at its very best. That should not be forgotten. I hope that it is something on which we can all agree.

  • Vikki Slade – 2024 Speech on the Terminally Ill Adults (End of Life) Bill

    Vikki Slade – 2024 Speech on the Terminally Ill Adults (End of Life) Bill

    The speech made by Vikki Slade, the Liberal Democrat MP for Mid Dorset and North Poole, in the House of Commons on 29 November 2024.

    We do not need to choose between palliative care and supporting those who want to make their deaths better. It is so fantastic to hear Members from every part of the Chamber with a shared commitment to funding more palliative care, and I hope that the Secretary of State and his team hear that and will go further, knowing that they have our support in investing more. But until they do, we cannot condemn those who are at the end of life to terror, loneliness and being forced into horrible circumstances.

    I have been concerned by some of the comments in the debate, so I re-read the Bill as I sat here. It has been suggested that mental health conditions would be included, but they would not—under clause 2(3). It was also suggested that people might not be offered surgery or other treatment, but they must, under clause 4(4). It is also worth noting the suggestion that a person being coerced could be protected by disclosing to the very family that might be coercing them. The provision for a witness in clause 5(2)(c)(ii) and the period of reflection would allow the independent person to be present at the appropriate time.

    I have already shared publicly my own family’s death journeys—and I wear them on my jacket—but today is not about them. Today is about all those people who need this Bill. Last night I read the book “Die Smiling”, about Nigel’s journey to Dignitas. It ends with his final journey and a Facebook post, prepared before he made that agonising 20-hour journey to Switzerland with his wife and children. It moved me to tears. However, most people cannot afford that option. Most do not want to put their families at risk of prosecution; they want death on their own terms.

    Gary lives in my constituency, and he asked me to tell the House his story of dying with liver cancer. He knows that the end stages will be brutal, and he wants to decide when enough is enough. He me:

    “Death does not worry me at all. Dying a slow death with my dignity stripped away terrifies me. So when my time is right I will kill myself—alone and afraid. My sick dog will not have to die alone and afraid, but I am forced to do so. I want to die on my terms. How can this be right?”

    Tracie, who was a palliative care nurse, told me:

    “I’ve witnessed many end of life patients and I cannot say hand on heart that many of those patients had a peaceful death. I left palliative nursing as the emotional trauma became too much. There are neither the range of medication or symptom relief treatments available for many of the harrowing things people are forced to go through in their last days and weeks of their life.”

    This Bill is about compassion and humanity, and we must listen to the voices of dying people.

  • Rosie Wrighting – 2024 Speech on the Terminally Ill Adults (End of Life) Bill

    Rosie Wrighting – 2024 Speech on the Terminally Ill Adults (End of Life) Bill

    The speech made by Rosie Wrighting, the Labour MP for Kettering, in the House of Commons on 29 November 2024.

    I rise to support this incredibly important Bill. Like many hon. Members, I have been contacted by hundreds of constituents on both sides of the debate. I have been moved by their personal stories, which bring home the impact that this legislation could have on them and their families, and I want to put on record my thanks to everyone who has contacted me. I fundamentally believe in the right to choose at the end of life, and that is what the Bill is about: giving dying people a choice on how they die. Anyone who does not want an assisted death can choose not to have one, and anyone who wants the reassurance of an option has it.

    My constituents’ stories and the stories shared by hon. Members today have shown me that it is truly unacceptable to maintain the status quo. Without a change in the law, terminally ill people will continue to face the end of their lives with a very limited range of options. Some will travel abroad for help to die, but that is only an option for those with the financial means to do so. Choice at end of life should not be an option only for those who are financially stable or desperate. Death should be peaceful and pain-free, and the Bill gives us the opportunity to make that a reality. There is no doubt in my mind that the Bill, so carefully considered by my hon. Friend the Member for Spen Valley (Kim Leadbeater), would be an improvement for the lives and liberties of my constituents and those across the UK who are terminally ill. I urge Members to give it a Second Reading today.

    I want to end with the words of one of my constituents, who wrote:

    “We have some amazing care givers in this country who provide the most compassionate care in the most difficult of circumstances & that gives great comfort. But I feel no-one should be forced to know how the book ends when they are only part way through it without having the choice of putting it down and choosing one with a better ending.”

  • Ruth Jones – 2024 Speech on the Terminally Ill Adults (End of Life) Bill

    Ruth Jones – 2024 Speech on the Terminally Ill Adults (End of Life) Bill

    The speech made by Ruth Jones, the Labour MP for Newport West and Islwyn, in the House of Commons on 29 November 2024.

    It is an honour and a privilege to speak in the debate and to follow so many hon. Members who have made such powerful contributions. I thank my hon. Friend the Member for Spen Valley (Kim Leadbeater)—no longer in her place—for all her work on the Bill; colleagues from across the House who have worked together so collegiately; my constituents who have written to me in their hundreds; and the experts who shared their views with us.

    Everybody in the Chamber wants a good death, but at the moment palliative care across the UK is chronically underfunded, mostly paid for with money raised by charities and a postcode lottery. I pay tribute to all the hospices that are working around the clock and doing an amazing job on very stringent budgets, especially St David’s Hospice and the Hospice of the Valleys, which do amazing work. However, we have to remember that although we are talking about people with very powerful stories—some of whom are here today—we legislate for all, and that means ensuring that our legislation is safe and future-proofed.

    I have concerns about the Bill on issues such as presuming consent. My worry is that if the door is opened with this Bill, it will then be widened, as it has been in places such as the Netherlands, Belgium and Canada. These things will happen.

    More than 65 private Member’s Bills were passed in the last Parliament. Not one of them had more than one sitting in Committee, where the average length of debate was 35 minutes; and just over a quarter had any amendments made to them at all. My hon. Friend the hon. Member for Spen Valley has said that she is willing to extend it, which I welcome; I will be pressing her on that to ensure it is safe. If the House votes to carry the Bill forward—I will be voting against it—scrutiny will be crucial at all points of its passage.

    We have talked about terminal illness today, but intractable pain is something that people live with every day. That is another issue. In my 30 years as a physiotherapist, I have seen good deaths and bad deaths. We all want to ensure that we get the best for our constituents, so we need to ensure that end of life care is sorted. This has been a good debate, because we have talked—I have certainly talked to my family. My lovely mum of 89, who is disabled, housebound and widowed, said, “It’s all very well talking about assisted dying, but we need to talk about assisted living as well, because that is most important.” Quality of life is crucial here.

    We need to ensure that we are here to legislate for all, which is why I will vote against the Bill today. I am grateful for the opportunity to explain.

  • Jim Allister – 2024 Speech on the Terminally Ill Adults (End of Life) Bill

    Jim Allister – 2024 Speech on the Terminally Ill Adults (End of Life) Bill

    The speech made by Jim Allister, the MP for North Antrim, in the House of Commons on 29 November 2024.

    This is not an easy subject, nor should it be, because this is a matter of the taking of human life—the taking of human life, sanctioned by the state.

    Our nation, through many wonderful charities and through Government, reaches out compassionately to those who are threatening suicide. They are urged to use the services of the Samaritans and to get all the help they can. I cannot square the circle where the state would then move to itself sanction suicide—indeed, to facilitate and, in fact, to promote suicide. And to do that in respect of those who are intrinsically the most vulnerable in our society. Anyone who gets a diagnosis of terminal illness is, by reason of that, obviously vulnerable. Many, in consequence, suffer depression and other difficulties, so they are among the most vulnerable in our society. Being vulnerable, they are among those most liable to fall under the foul influence of coercion.

    Coercion comes in many forms. Anyone who has listened to domestic abuse cases will know that it can be very insidious, invasive and persuasive, because the coercer has the constant ear of those they wish to coerce. Add into that mix the fact that that person might feel a burden. We have all heard old people say, “I am a burden on society. I am a burden on my family.” Even when they are told, “No, caring for you is not a chore, but a privilege,” they still think they are a burden. If in that background—that matrix—there is still the pernicious influence of coercion, then the thought that people reach a reasoned, considered, independent opinion is a fallacy.

    It is those people that this House should be protecting above all, but this Bill does not protect people in that situation. Oh, we are told, “two doctors and a judge”. The judge does not have to, but he might decide to hold Zoom call with the applicant, but he is not to know if sitting in the corner of the room, out of camera shot, is the coercer. Where is the protection in that?

    I say to the House that this issue cuts to the very quick of our fundamental duty to be the protectors of the most vulnerable. There is no part of the state’s function to be promoting or assisting the end of life for people who could be in that condition, and we will never know how many are in that condition, so I cannot and will not vote for the Bill.

  • Catherine Fookes – 2024 Speech on the Terminally Ill Adults (End of Life) Bill

    Catherine Fookes – 2024 Speech on the Terminally Ill Adults (End of Life) Bill

    The speech made by Catherine Fookes, the Labour MP for Monmouthshire, in the House of Commons on 29 November 2024.

    I thank my hon. Friend the Member for Spen Valley (Kim Leadbeater) for the incredibly sensitive and thoughtful way she is conducting the passage of the Bill, consulting widely with terminally ill people and their families, medical staff, lawyers, faith leaders and those on both sides of the debate.

    I have two very personal stories about why I support a change in the law. Last year, my dad’s health took a turn very much for the worse. He had sepsis, kidney failure and heart disease and had lived with Addison’s disease for almost 50 years. He was given the dreaded news that he only had a few months left to live. I would not have wished his last few weeks upon anyone. He was in agony and suffering—his breathing was difficult and he was in such pain. I struggled to see him suffer so much, but the nurses, doctors, carers and my incredible step-mum were all without fault and, thankfully, his palliative care was excellent. He was able to die at home with me, my sister and my step-mum by his side. Seeing him suffer so terribly convinced me that we need a change in the law so that people who are terminally ill have a choice.

    My second story is from Australia where my brother lives. My wonderful sister-in-law Kelly sadly died of liver cancer that developed into bone cancer. She had a fractured left arm, pelvis and sacrum, and had cancer in her spine. At 54, Kelly was far too young to die. Her cancer was particularly painful and unforgiving. As she lived in Victoria, she was able to register for assisted dying. For her, it was incredibly comforting to know that if, and only if, she needed to, she could stop the suffering. She did not need it in the end, but she did have the option. In her darkest days—her fearful days—that brought her and my brother incredible peace of mind.

    I heard similar stories of suffering in the hundreds of emails sent to me by constituents over the course of the past few months. People want and deserve access to both the best palliative care and a choice if they are terminally ill. The protections and evidence underpinning the Bill are strong. I was there for my dad’s final week when he was in so much pain, and I was there right at the end holding his hand. What a privilege to be with him at the end and to see him through. In memory of my dad and of Kelly, I support the Bill and urge all those across the House to support it, too.