Stephen Kinnock
MP for Aberafan Maesteg · Labour · United Kingdom
“I thank the shadow Secretary of State for her kind words and look forward to our exchanges across the Dispatch Box. I am ready to engage with her on getting the maximum benefits for the people of Wales.”
“I thank the right hon. Lady and look forward to working with her. My understanding is that there were challenges around the helicopter capability. Decisions were taken by Natural Resources Wales some time ago to change the way that the tendering for helicopter capability works. We certainly need to look at that.”
“I thank my right hon. Friend for his question. Like him, I pay tribute to all those involved in the collective and heroic response to the wildfires.”
“I thank the right hon. Lady for her question. Many of the ideas coming forward for devolving power right across our United Kingdom, beyond Cardiff Bay and Holyrood, are very exciting, and I look forward to exploring them with her.”
“Just to be clear, this is not about staying out of the issue; it is about respecting the devolution settlement, but being prepared to work constructively where we can in partnership with the Welsh Government. The hon.”
“I know about and welcome the right hon. Gentleman’s strong connections to Wales. I recognise the connectivity benefits that WSMR’s proposal could deliver, particularly for passengers in Wales and the west midlands.”
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“I will not, therefore, give a Government view on the merits of any individual amendments in terms of their policy intent, as defined by the Member who tabled them, as that is rightly a matter for the House to decide. I will instead focus my remarks on amendments that the Government deem to give rise to significant workability concerns, and those amendments that have been tabled by my hon. Friend the Member for Spen Valley with technical drafting support from the Government, which have been developed to ensure that the Bill is technically and legally workable. While I will not give an assessment of all the amendments tabled by other Members, I ask the House to note that they have not been drafted on the basis of advice or with technical drafting support from officials.”
“Thank you, Mr Speaker, and I thank Members across the House for their excellent contributions to the debate. As Members will know, the Government remain neutral on the passage of the Bill, promoted by my hon. Friend the Member for Spen Valley (Kim Leadbeater), and on the principle of assisted dying, which we have always been clear is a decision for Parliament. I therefore begin by clarifying that I am speaking in today’s debate as the Minister responsible, jointly with my hon. and learned Friend the Member for Finchley and Golders Green (Sarah Sackman), for ensuring that the Bill, if passed, is effective, legally robust and workable. She and I were pleased to be members of the Bill Committee, again to provide advice on the workability and technical effectiveness of the Bill as it went through detailed line-by-line scrutiny.”
“I will just make a little progress. Amendment 60 may similarly prevent access to an assisted death for those residing within a care home or hospice, if that care home or hospice decided it would not allow such assistance on its premises.”
“Cases considered by the panel are civil matters, and as such it would not be usual practice for the criminal standard of proof to be applied to their decision making—and it is a very high bar. The provision would also impose additional standards on the assessing doctor that fall outside the usual framework for medical decision making.”
“I turn now to the amendments tabled by other Members on the subject of procedure, safeguards and protections that the Government have assessed may create workability issues if voted into the Bill. New clause 7 would limit the number of times two doctors can be jointly involved in the assessment of a person seeking assisted dying to three times within a 12-month period. In situations where there is a limited pool of doctors in any geographical location or area of medicine, that could limit access to assisted dying and create inequalities in access. New clause 9 would require the co-ordinating doctor, independent doctor and assisted dying review panels to apply the criminal standard of proof that requires them to be satisfied beyond reasonable doubt.”
“Amendment 58 clarifies the duty on the Secretary of State to make through regulations provisions for training about reasonable adjustments and safeguards for autistic people and those with a learning disability. That remedies previously unclear wording in the Bill. Amendment 60 is required to make provision for circumstances where the independent doctor dies or, through illness, is unable or unwilling to act as the independent doctor. Amendments 67 and 68, tabled by my hon. Friend the Member for Spen Valley, clarify that an approved substance can be self-administered using a device should the individual be unable to self-administer without one. Amendment 91 gives effect to amendment 273, which was accepted in Committee, by ensuring that data will be recorded in the final statement to ensure coherence within the Bill.”
“I thank the right hon. Gentleman for that intervention. As I say, the Government do not take a position on the policy intent that my hon. Friend the Member for Spen Valley has set out. I would simply observe that if somebody has been in a home for a considerable period of time, that home is then considered to be their home. As such, any action to take them out of that home could engage article 8 of the ECHR, on the right to family life. I now turn to the procedure for receiving assistance under the Bill, including safeguards and protections. First, I will speak to the amendments that have been tabled by my hon. Friend the Member for Spen Valley with technical workability and drafting advice from the Government.”
“That may be subject to challenge under various international agreements, including the United Nations convention on the rights of persons with disabilities and article 14 of the European convention on human rights, which prohibits disability discrimination. Amendment 102 would introduce a requirement that “the registered medical practitioner must ensure that the person has no remediable suicide risk factors which pose a significant risk to their life” before holding a preliminary discussion under clause 5. The terms “remediable suicide risk factors” and “a significant risk to their life” have not been defined, so the amendment may be difficult to operationalise.”
“As a Minister at the Dispatch Box, with the Government being neutral, I am not commenting on the policy intent of the Bill. What I am saying is that the new clause could create significant uncertainty. For example, it is not clear how the standard it introduces would interact with the definition of “terminal illness” set out in clause 2, which requires that a person’s death “can reasonably be expected within six months”, as it is not clear whether “reasonably be expected” fits within the balance of probabilities threshold or is beyond reasonable doubt. Amendment 101 would exclude any person with a learning disability, including people with Down syndrome, from a preliminary discussion about assisted dying unless they raise the subject themselves, irrespective of whether they would otherwise be eligible.”
“I thank the hon. Lady for her intervention. She may have noted the comment from the hon. Member for Bexhill and Battle: approximately 500 amendments were tabled in Committee, and approximately one third of them were accepted. There was a pretty robust process for looking at whether amendments were acceptable, and the Government were involved in commenting and advising on all of them.”
“Similarly, there is no precedent for the Attorney General, His Majesty’s Procurator General or the Treasury Solicitor to intervene in a case in the way that is envisaged, as their roles are to act on behalf of, or provide advice to, the Government, and not to represent a specific argument. In the Government’s view, there are no existing public bodies that are well suited to undertaking this adversarial role.”
“The amendment does not specify who is to be on the clinical panel in situations where the co-ordinating doctor is neither a GP nor a consultant. Similarly, there is no provision for whether the clinical panel is to make its decisions unanimously or by majority. Amendment 48 would require significant changes to the functions and focus of the bodies that are proposed to present arguments to the panel as to why a certificate of eligibility could not be granted. Where an official solicitor acts as an advocate to the court, their purpose is to assist the court on a difficult or novel point of law, not to perform an adversarial function.”
“I will make some progress, if I may. Amendment 87 would require the co-ordinating doctor to “take all reasonable steps” to establish whether a first declaration had previously been made, so it may slow down the process for accessing assisting dying. Amendment 45 would significantly impact the operability of the Bill. It would duplicate the role of the assisted dying review panel, and place an additional burden on the co-ordinating doctor to convene the clinical panel. It would also require additional NHS and social care resources, particularly palliative care consultants. That could slow down a person’s access to an assisted death, because there is no requirement on when the panel must be convened, and it could take some time to set up, given the demands on health and social care professionals.”
“Clause 15 sets out the process that the panel must go through. It includes a right for the panel to request information and input from a range of potentially interested people. Clause 15(4)(d) appears already to cater for the intended effect of the amendment in the name of the right hon. and learned Member for Kenilworth and Southam (Sir Jeremy Wright).”
“I hope that these observations have helped them in their consideration of the amendments that have been tabled.”
“In the absence of a new definition, the Mental Capacity Act may continue to apply by default. That would, of course, diverge from the familiar concepts in the Mental Capacity Act, which could create confusion for practitioners. The stated intention of amendment 14 is to exclude a person who would not otherwise meet the definition of “terminally ill” if the person meets that definition solely as a result of voluntarily stopping eating or drinking. Our assessment is that the amendment risks introducing uncertainty over a person’s eligibility for assistance under the Bill. However, the substantive question is a policy choice for Parliament. Recognising the intent of the amendment, we do not believe that it would render the Bill unworkable. Once again, I thank all hon. Members for their contributions.”
“The Government’s position on the relevant clause is that the panel has to be satisfied that the correct steps have been taken, and there is not evidence of the points that the right hon. and learned Gentleman has made. Our view is that the intended effect is already catered for in clause 15. Amendment 38 would exclude from being provided with assistance a person who is not already terminally ill, as defined under the Bill. The reference to “standard medical treatment” is unclear. This could cause further uncertainty around eligibility, given that treatment could be individually tailored to each patient and their needs. Amendment 81 would remove the requirement that any references to capacity in the Bill are to be read in accordance with the Mental Capacity Act 2005. That would effectively remove the definition of capacity in the Bill.”
“I am pleased to tell my hon. Friend that we have recruited over 1,500 additional GPs since October through an investment of £82 million, helping to fix the front door to the NHS. Today we have announced £100 million to unlock new capacity and more appointments in GP surgeries. We have also launched a red tape challenge and scrapped unnecessary targets in our new GP contract to cut down on bureaucracy and free up time to spend with patients.”
“I absolutely share the frustrations of my hon. Friend and his constituents. The investment made today was in response to GPs telling us that they needed more space; the investment will lead to more capacity and better access and outcomes for his constituents. Today’s announcement was only possible thanks to the decisions made in the October Budget, which were opposed by every party opposite. The choice is clear: investment in our NHS with Labour, or cuts with the Tories and Reform.”
“The hon. Lady raises what sounds like an extremely interesting scheme. She will know that we have a strong commitment in our 10-year plan to shift from hospital to community, and indeed from analogue to digital. The digital aspects of that scheme sound very interesting, so I would be more than happy to take further representations from her.”
“My hon. Friend is an outstanding campaigner on this issue, as I am sure everybody across the House is aware. She will know that the NHS England accelerator pilots have shown how improved IT connectivity and a single point of access can speed up eye care referrals and allow more patients to be managed in the community. That is a great example of the shift we want to make from analogue to digital. We are developing the 10-year health plan with input from the public, our partners and health staff, and that of course includes the eye care sector.”
“My hon. Friend is right that early intervention is crucial, and the interface between the high street and secondary care is a vital part of that. That means having a joined-up eye health strategy. The 10-year plan will have that joined-up strategy at its heart. She will be pleased to know that, since July, ophthalmology waiting lists have dropped by 24,000, so change has begun. There is still a long way to go to dig us out of the mess left by the Conservative party, but it is thanks to the decisions that the Government have made, opposed by Opposition parties, that we are beginning to see that change gaining traction.”
“I think that the right hon. Gentleman is referring to the single point of access digital technology, which is game changing in terms of improving the interface between high street and secondary care. It is probably worth reminding him that the question is about eye care. We are absolutely committed to single point of access technology, which we believe can be game-changing technology and is a vital part of our shift from analogue to digital.”
“Although the independent sector clearly has an important role to play in tackling waiting lists and backlogs, we will not tolerate any overpriced or sub-par care, and we will not tolerate any distortion of patient choice. The recently published partnership agreement between NHS England and the Independent Healthcare Provider Network commits to ending incentives that can lead to that, and to supporting equal access and genuine choice for all patients. We are working together to deliver on that.”
“ICBs are responsible for the commissioning of these services, which are clearly extremely important, and the early intervention side of eye care is particularly important. I would be more than happy to look into that issue with the hon. Lady’s ICB if she wrote to me and made further representations.”
“We are already rolling out our manifesto commitment of 700,000 extra urgent dental appointments per year. These appointments are available across the country for those experiencing painful dental issues such as infections, abscesses or cracked or broken teeth. We are committed to reforming the dental contract and making NHS dentistry fit for the future.”
“The hon. Member is right to say that the dental contract is fundamentally flawed and needs reform. I met representatives of the British Dental Association on 8 April, and had a productive discussion with them about dental contract reform. Officials from the Department of Health and Social Care are working hard with the BDA and other stakeholders to develop a dental contract that works for patients, for dental professionals and for the public purse. I will of course keep her and the House updated. I know this issue is of huge importance to the country, and to every Member of this House.”
“There is no perfect payment system. We have to look at the issue around units of dental activity, and at options around capitation and sessional payments, and come to a conclusion about what works and about how to ensure that everything that we commit to NHS dentistry is spent on NHS dentistry. We are in a mad situation in which, although demand for NHS dentistry is going through the roof, we have an underspend every year on the contract. We have to fix that. It will take some time to work that out with the British Dental Association and other key stakeholders. What is tragic about this situation is that the Conservatives had 14 years to fix the situation and left it in a terrible mess.”
“The Government have launched a scheme to provide 700,000 urgent dental appointments. There are 57,500 allocated to my hon. Friend’s integrated care board. He will know that ICBs are responsible for commissioning primary care services based on the needs of the population, but I know that he is a strong campaigner for his constituents. I understand that his dialogue with his ICB on this matter has been positive and constructive, and I am sure that he will continue to fly the flag.”
“My hon. Friend will know that we have hired 1,500 more GPs, which will help with access. We have also renegotiated the contract, so there will be online booking systems in every practice in the country, and we have changed the contract to incentivise continuity of care in order to bring back the family doctor. There is a suite of reforms coupled with investment, which I hope will deliver for my hon. Friend’s constituents.”
“As the hon. Lady knows, we now have a commitment to providing 700,000 more urgent dental appointments. Those who do not have an NHS dentist can call 111 and will be prioritised. We are very clear that every integrated care board has a target within those 700,000 appointments, and if they are not hitting that target, we will want to know why.”
“I pay tribute to my hon. Friend for improving support for ADHD and recognise the valuable perspective that she brings through her lived experience. This Government inherited a broken NHS, with too many people facing long waits for an assessment. NHS England’s ADHD taskforce is looking at how support for people with ADHD can be improved. I look forward to reading its report, and I recently had a very productive meeting with the director of that taskforce.”
“I give the hon. Member that assurance. We have been clear that every ICB has a target, and that was transparently published, and we will be monitoring it. I am holding regular meetings with officials to check that every single ICB is on track to hit those targets. If ICBs are not on track to hit those targets, we will want to know why.”
“We have, in fact, relaxed the rules on ARRS so that a mental health worker can be employed by the PCN. My hon. Friend is absolutely right that that is an important part of stepping from hospital to community, but there is more we can do on that. We continue to do whatever we can to ensure that mental health and GP surgeries are actively integrating.”
“After years of neglect, this Government have agreed with the sector a record uplift to £3.1 billion for 2025-26 for this vitally important front door to our NHS. We are also supporting pharmacies to operate more efficiently, including enabling hub and spoke dispensing between all pharmacies later this year. I am pleased to say that the legislation for that has been laid. What a contrast that is with the previous 14 years. I am also pleased to see that the National Pharmacy Association has withdrawn its view on taking collective action. We are moving in the right direction, but there is still a lot more to do.”
“I pay tribute to my hon. Friend, who is a qualified physiotherapist, and who is right to refer to the value of community care. I would be happy to meet her to discuss the important issue that she has raised.”
“As I said earlier, we are giving pharmacies a record 19% uplift to £3.1 billion, and I am pleased to confirm that of all the sectors in the NHS they received the best uplift in the 2025-26 settlement. We have also maintained the pharmacy access scheme, which provides £19 million to support pharmacies in areas where there are fewer of them, including the rural areas that the hon. Gentleman mentioned.”
“It is a matter of profound regret that so much of that legacy has been undone over the past 14 years, but the people of Manchester don’t just want us to look back in anger; they want us to get on with the job of building homes, fixing the NHS and putting more money in people’s pockets. My right hon. and learned Friend the Prime Minister has spoken about the “class ceiling” that prevents children from getting ahead. I look forward to working with my hon. Friend the Member for Manchester Rusholme to shatter the class ceiling that hangs above his constituency and mine. Question put and agreed to.”
“More capacity will be available for people in working-class areas of the country and for women stuck on waiting lists for gynaecological care. Where we can treat working people faster, we will, and we will make no apology for doing so—working-class patients in this country deserve the same choice, control and convenience as the wealthy expect—and I am delighted that waiting lists have been falling now for six months in a row. The previous Labour Government did so much to reduce inequality: lifting millions of children out of poverty through Sure Start; giving a lifeline to working families through child tax credits; creating the minimum wage; and fixing the NHS after almost two decades of under-investment.”
“The Bill contains powers to extend the ban on smoking indoors to certain outdoor settings to reduce the harms of second-hand smoking, particularly around children and vulnerable people. Over the past 14 years, a two-tier health system has emerged in our country. People who can afford it are increasingly going private to skip the queue, while those who cannot are left behind. We are determined to end two-tier healthcare in this country, so whether someone is the richest or the poorest person in Manchester, they get timely, quality treatment that is free at the point of use. Our elective reform plan will see more NHS patients able to choose to be treated in a private hospital, where there is capacity, paid for by the state.”
“In December, the Government published the revised national planning policy framework for local authorities, which gave them stronger, clearer powers to block new fast food outlets near schools and where young people gather. This will stop the relentless targeting of children and young people by the fast food industry. I am delighted that just last week, the Tobacco and Vapes Bill passed its Second Reading in the other place. Smoking is a scourge on deprived communities and contributes to poverty, ill health and a lower life expectancy. Britain is leading the world through landmark legislation to break the cycle of addiction and disadvantage by gradually ending the sale of tobacco products across the country.”
“That includes working groups focused on how care should be designed and delivered to improve healthcare equity, alongside ensuring that access to healthcare services is effective and responsive. We look forward to updating the House once the plan is published in June. Proximity to fast food outlets is strongly associated with obesity. Kids living in the most deprived communities are in proximity to twice the number of fast food outlets compared with wealthier areas. Nearly 3,500 schools across the country now have a major food outlet within 400 metres; that is 1,000 more schools than 10 years ago. We have an outstanding mayor in Andy Burnham. Devolution gives him and other leaders in Greater Manchester the freedom and flexibility to set priorities locally.”
“That is chaired by the Prime Minister, who is lending his weight and authority from the centre of Government. We have a laser focus on addressing the social determinants of health in a truly strategic way, and addressing the wider determinants of health to improve healthy life expectancy for all, while halving the gap in healthy life expectancy between different regions of England. We are prioritising prevention, shifting more care into the community and intervening earlier in life to raise the healthiest generation of children in our history. Addressing healthcare inequity is a core focus of our 10-year health plan to ensure that the NHS is there for anyone who needs it whenever they need it. We have established 11 working groups to take forward policy development that will feed into the plan.”
“A baby boy born in the Manchester royal infirmary can expect to live for just over 75 years, which is four years less than the English average. A baby girl born in Manchester can expect to live to the age of about 79 and a half, which is also four years less than in England as a whole. My hon. Friend raises some issues that are not within my Department’s remit, including housing, knife crime and fly-tipping, but I completely understand why he has done so, because the determinants of ill health are wide and it is much more than a single factor that predicts healthy life expectancy. The Government know that we cannot address the challenges we face in the north-west with each Department in Whitehall siloed one from another, so we are taking a whole-of-Government approach to tackling inequalities through our health mission.”
“Friend the Member for Manchester Rusholme mentioned from my own constituency. I am responding not just on behalf of the Government, but as an MP from a constituency with some of the highest levels of deprivation in the United Kingdom. I agree with my hon. Friend that the levels of inequality between the better-off and worse-off in our country are a national scandal. Fourteen years of austerity measures and stagnant wages have disproportionately affected lower-income households, exacerbating both income and regional disparities. Places such as Manchester and Port Talbot have borne the brunt. The life expectancy for Mancunian men and women is significantly worse compared with their compatriots in the rest of England.”
“I congratulate my hon. Friend the Member for Manchester Rusholme (Afzal Khan) on securing this important debate. Before I begin my remarks, I would like to pay tribute to some of the stellar charities that are working to reduce health inequalities: the Health Foundation, which is leading the way with its Health Equals mission; the People’s Health Trust, which is providing funding and support to left-behind communities; and the BHA for Equality, which was founded in 1990 to address the lack of quality information and services for black communities in Manchester. I am responding on behalf of the Minister for Public Health—the Under-Secretary of State for Health and Social Care, my hon. Friend the Member for West Lancashire (Ashley Dalton)—but I am more than happy to take this debate because I recognise many of the issues that my hon.”
“That is why when the hospitals with reinforced autoclaved aerated concrete were brought into the NHP in 2023, even the last Government had the sense to admit that nine schemes would have to be delivered past 2030 in order to prioritise the RAAC hospitals. Perhaps most shocking of all, the funding for the programme was due to run out a month ago, with no provision whatsoever for future years: the money simply was not there. The programme was built on nothing more than false hope, dodgy claims and disingenuous press releases.”
“To put it simply, there were not 40 projects, they were not all new and many of them were not even hospitals. The spin around the programme was widely questioned and challenged before the general election, but nevertheless we were truly shocked by what we found on entering the Department of Health and Social Care. The programme was hugely delayed, by several years more than had already been revealed by the National Audit Office. There was no credible plan to deliver the building projects, let alone to deliver them all in the next five years, and there was not even enough construction capacity in the UK to build all the hospitals in the new hospital programme by 2030.”
“and learned Friend the Prime Minister. I thank the Liberal Democrats for using their Opposition day to address a matter of vital importance for so many Members, including many colleagues right across the Chamber and their constituents. I sincerely hope that the Liberal Democrats will work with us on solutions, not on soundbites, because we need to be realistic about the problems we face and serious about how we tackle them. The new hospital programme was announced by the last Government to much fanfare in October 2020, with a promise to deliver 40 new hospitals by 2030. We were told that there was a plan and a timetable, and we were glibly assured that it was fully funded, but from the outset it was clear that there were not 40 new schemes—some were just refurbishments or extensions.”
“I am glad you recognised me from the Chair, Mr Speaker. I have lost some hair since we last spoke. I beg to move an amendment, to leave out from “it” to end and insert: “also notes that the Chancellor has announced new fiscal rules to ensure capital budgets can no longer be cannibalised, with transfers from capital to resource budgets not permitted; recognises that the previous Government left a New Hospital Programme which was unfunded, unrealistic and undeliverable; welcomes that the Government has taken action to review that Programme and has published the New Hospital Programme Plan for Implementation, to put the Programme on a sustainable footing; supports the Government’s investment in the Plan, which will increase to up to £15 billion over each consecutive five-year wave, averaging around £3 billion a year from 2030; and further supports the work being done to bring forward construction of the reinforced autoclaved aerated concrete replacement schemes wherever possible, to ensure that patient and staff safety is prioritised.” The amendment on the Order Paper is in the name of my right hon.”