Dr Simon Opher
MP for Stroud · Labour · United Kingdom
“We must not say that things are getting worse, because I believe they are slowly getting better. As so many have said, we need to fix social care. We could have a system whereby the community is responsible for a patient as soon as they are ready for discharge.”
“I thank my hon. Friend the Member for Tooting (Dr Allin-Khan) for securing this debate and for her years of work in the A&E at St George’s. Emergency care is in crisis in the NHS, and corridor care is just an overspill because we cannot cope. That is because we are doing a few things wrong that we could remedy. I work as a GP.”
“That is absolutely true. We need to look at all the ways of reducing demand on GPs and, therefore, on A&E departments—that is what my speech is totally involved in—and pharmacies have a really good role to play. There is another thing here, which was noticed in the doctors’ strike.”
“We also need GPs to be assessing emergencies up until 10 o’clock at night to relieve the pressure on A&Es. There are a couple of other things. I have said about getting more experienced doctors involved earlier in the process, but we also need to invest in scanners—so many people in A&E are waiting for tests before they go home.”
“Dementia fluctuates, so just because someone has seen a slight increase in confusion, that does not mean that they need a whole batch of tests. We need to treat dementia more holistically. Polypharmacy—that is old people on loads of drugs—causes about 10% of admissions, so let us reduce that. We need good end-of-life care.”
“In Stroud alone, in four years, the number of over 90-year-olds went up 29% in just that short period of time. We have an enormous cohort of very elderly and frail people. Secondly, as we have heard, we have a lack of beds due to delayed discharge—I will not say any more on that.”
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“One of the most important things is to get clean water to people. There are about 250,000 cases of acute malnutrition in children this year, as well as 37,000 cases in pregnant and breastfeeding women. Violence against women and the effects on reproductive health have led to a 41% fall in births in Gaza, as well as a high number of maternal deaths, miscarriages and newborn mortality. We have seen strikes on maternity wards and the destruction of Gaza’s largest in vitro fertilisation clinic, wiping out 5,000 embryos. Premature births have also sharply increased, with one in five newborns requiring intensive neonatal care. Respiratory infections, acute watery diarrhoea and skin infections are widespread.”
“I thank my hon. Friend for a point well made. It is even more basic than that: we need to allow medicines into Gaza, which are not currently being transported. Other items such as prosthetic limbs are also very important, so the border needs to open up. Humanitarian aid, not just medical aid, is needed in Gaza. We need to open the borders and allow relief in. In a sinister development, snipers seem to be targeting specific areas of the body, such as the brachial plexus, damage to which causes long-term disability, and the sciatic nerve in the leg, damage to which causes permanent paralysis. I know that war is evil in many aspects, but we should call out that cynical approach. Public health is incredibly important for people in the Gaza strip: 89% of water, sanitation and hygiene infrastructure has been destroyed or damaged.”
“I thank all the speakers who have contributed to what has been a very passionate debate. I have spoken to many British doctors who have worked in Gaza, and what we are presenting here—the sabotage of the healthcare system—is real. It is going on now, and we must deal with it rather than brushing it under the carpet and blaming Hamas.”
“I absolutely agree. We must get to the bottom of those things because they must not be allowed to happen again. I propose that the Minister talks to Ministers in the Department of Health and Social Care about us, as a nation, providing healthcare to people in Gaza as much as we can. That is something that I have discussed with that Minister. We must be positive here and try to relieve the suffering of Gazans, because everything I have heard has been appalling. I thank all Members and the Minister. Question put and agreed to. Resolved, That this House has considered Government support for the healthcare system in Gaza.”
“Impcross, a company in my constituency of Stroud, is the sole supplier of flight-critical parts to the Typhoon aircraft and a key supplier for the Vanguard submarine fleet. It is on the verge of collapse, and His Majesty’s Revenue and Customs is filing to wind it up, after the owners were prohibited from selling their business on the grounds of national security and sovereign capability. What support is the Secretary of State offering to critical suppliers that are struggling financially, and will he meet me to discuss what steps we can take to support this company?”
“I commend the speed with which my right hon. Friend has brought this legislation to Parliament. I have been a GP trainer for 25 years. Fifty per cent of GP trainees are international medical graduates, and there has been some disquiet from them. Will he reassure our international medical graduates that they are welcome and treasured in the health service?”
“To conclude, after years of failure and the neglect of our home-grown talent, this Government are taking action so that our doctors can train, stay and serve the communities that need them most. I urge Members to support the Bill.”
“Although we need to prioritise UK graduates, we must not put off international graduates from coming and helping us to deliver a new NHS. I would like to make another point about medical training. Postgraduate medical training goes through a process, and it is important that we recalibrate this so that the number of training spots exactly matches the number of our medical graduates. That is particularly true for anaesthetists. There are bottlenecks in anaesthetics training, and if we could relieve those bottlenecks, we would get more anaesthetists training and could start to bring down our waiting list. However, that will involve a decent workforce plan, which I understand we are developing, and proper planning for the future, so we can get our waiting lists down and deliver a better NHS for everyone.”
“I would like to give a shout-out to my Stroud GP trainers group, who visited Parliament last year, and also to the 8,000 GP trainers in this country, who do a fantastic job, often going above and beyond their responsibilities. I would like to mention international medical graduates—I have had a number of them. At the moment, 50% of those training in the UK are international medical graduates—I understand that in Teesside the figure is 100%—and we are depending on these people to provide some of our general practice. I have had fantastic trainees from India, Spain, Germany and Algeria, who have all become fantastic NHS GPs. As I have said, we must ensure that they are welcome and treasured in the NHS, because they constitute a large body of GPs in our system.”
“My favourite went to New Zealand and is staying there, although I keep trying to entice her back by saying how great it is that the NHS is improving. GP training is unique. It involves 18 months in general practice in a one-on-one apprenticeship-type system, and I think the system in the UK is one of the best in the world. It teaches continuity of care for patients, and it also teaches the skills that are bringing back the family doctor. This is about the doctor being the gatekeeper to the NHS, and also protecting the patient against the NHS and from over-investigation. In fact, I always think an MP is bit like a GP, because a GP has to know a little about absolutely everything, which is the same for an MP.”
“I will keep this short, because many of my points have already been made. I think that there are two main problems. The first is about priority for our medical graduates. To be honest, I was a little bit surprised when, about a year ago, I found out that they are not prioritised. That clearly is not reciprocated around the world, and we need to change it. The other problem is our training numbers. If we are training medical students up to graduation, we must ensure that the number training fit into our postgraduate training, because otherwise it is crazy, which is the situation we find ourselves in. I have been a GP trainer for about 25 years, and many of the doctors I have trained as GPS have gone off to Australia.”
“T9. In Stroud, we have secured £90,000 in funding for a scheme that places employment social prescribers and occupational therapists into GP practices. They support people who are out of work and in receipt of benefits to return to employment, improving their health and reducing their reliance on welfare. Will the Minister consider rolling out that model nationally, recognising that work is often the best cure for sickness?”
“Finally, we must have a comprehensive whole-health plan for the NHS and tackling domestic abuse and violence against women and girls. That must cover primary care, mental health, maternity and accident and emergency services—and I would like it to be published by 2027 at the latest.”
“In terms of funding, the £5 million a year from the Department of Health and Social Care is a good first step, but we need quite a lot more than that to bring this service to the fore. In conclusion, if we are serious about preventing domestic abuse and the deaths that so often follow it, then the NHS must be properly equipped to play its full role. There are three points that I would like to make. The first is on funding, and around training and investing in services that will really help in domestic abuse. Those steps to safety are key because it must be simple for women to access those services. It is also important that wherever a woman presents to the NHS, that the person they present to is trained to detect domestic abuse and aware of what is available for that woman.”
“We need a more integrated approach and it needs to be part of an appraisal process so that every doctor, nurse and healthcare worker is aware and trained in domestic abuse—but without it being made mandatory so that it does not simply become a course that people must go on, but is instead properly integrated into the service. Last of all—and this seems incredible in this day and age—we need to share data between all of the health services, for example, A&E, GPs and mental health. We often do not get any information from mental health. It is important that we get that data sharing up to speed because domestic abuse can present in many different situations in the NHS and it is important that everyone is aware of the risks.”
“For example, the receptionists in primary care are often aware of the people coming in. They need training to detect domestic abuse so that they can inform the doctors. It is a whole team approach, with pharmacists, nurses and physiotherapists also needing to be trained and aware of the signs and symptoms of domestic abuse. That training should be essential for everyone, but I want to step back from mandatory training. Many people in the health service find that irksome and a tick-box exercise. I do not want domestic abuse training to simply be a tick box where someone goes on an hour-long course every year and that is it.”
“It is usually men that perpetrate abuse and they often abuse at least five times, so it is important to catch them the first time and institute really good treatment and management for them. There are often drugs, alcohol or mental health issues behind their problems, so we must deal with that before they continue to abuse. Although that is controversial, I think that is incredibly important as well. What do we need for the whole of our health strategy? We need things to be co-ordinated. There is a suggestion that we have domestic abuse co-ordinators for a group of GP practices. As I said, I think we need to have leads in general practice, with one person leading who can keep up to date and keep reminding the other members of staff that that is really important. When we are training in primary care, it is important to train everyone.”
“It is really important, particularly in practices, to have a safeguarding or domestic abuse lead who is totally up to date with what is available, because quite often services change and GPs themselves are not on top of that. So that is important as well. Can I also stress the importance of women’s refuges? In Stroud we have a fantastic refuge. It does not advertise itself, for obvious reasons, and the people working there are simply amazing, supporting women who have difficulties, and often their children as well. It is inspiring to see the work they do, and it is important that those services are available immediately if women feel in danger. Can I also make a plea for support for the perpetrators of abuse?”
“Often women present to the health service with different symptoms, but that is a cry for help, which we must recognise. What do we need to do to support those women? One thing I am delighted about is the concept of steps to safety. The Department of Health and Social Care will roll out a domestic abuse and sexual violence referral service across integrated care boards, giving GPs the tools and ability to identify and refer victim-survivors to support. What is important is that it is a simple service with one number. If it is not simple, it will not be used by health services, and that is incredibly important. It is also important that we make use of existing resources. I visited the sexual abuse centre at Gloucestershire Royal hospital recently. It is a fantastic resource with really well-trained staff who are available 24/7.”
“Women who are being abused often present with symptoms of depression caused by domestic abuse, so we need to ask those women whether anything is going on at home. Female survivors of domestic abuse are three times more likely to develop mental illness. There are also other high risk periods, such as when women are pregnant and they often have poor outcomes in those situations. We must also be aware, across the health service, that women might disclose domestic abuse. Health visitors are in an ideal situation to hear about that type of thing and must be aware of that potentiality. In A&E, women often present with overdose, and underneath that there is domestic abuse. Midwives are often presented with this, as are mental health workers, and even gynaecology services as well as social services.”
“We must recognise that presentation straightaway, and there are ways we can recognise it. Sometimes the woman in question will present with a partner and not feel comfortable talking about the situation. I often ask the partner to leave the consultation and I speak to the woman individually, which can be an effective way to find out exactly what is happening. We need to be aware that women in this situation are often nervous and walking on eggshells. We also have to recognise that often there are physical injuries, often of different ages. We sometimes see women presenting in sunglasses to cover up a black eye, for example. The health profession must recognise all those symptoms. As I have said before, there are very high rates of mental health problems.”
“It says about one woman: “She had gone to the GP a few days before her death as she couldn’t take any more. She was only offered antidepressants. On the day of her murder when I spoke to her, she said they are not helping and she had had enough. She said the GP knew her situation but yet again she was failed there.” That shows that simply giving out antidepressants is not the right strategy. We need to build support around women subjected to domestic abuse. Often, they present with mental health issues and will not give any details of their abuse. One thing that I teach GPs in training is that there is something called a hidden agenda. Women particularly will present to the GP but they will not say that they are being abused; they will have other symptoms.”
“For too long, support services have been unable to support victims and survivors effectively. They have been without sufficient resources and, in too many cases, women and girls have not been able to access the support they need. Therefore I welcome the Government’s supporting victims through the largest ever investment of £550 million in victim support over the next three years and an additional £5 million each year from the Department of Health and Social Care. I would like to say a few things about how GPs specifically are often the first port of call, and how presentation to GPs is incredibly important for recognition of this issue. I shall quote from Killed Women, an organisation for bereaved families of women who have been killed by men in the UK.”
“It is really about recognition of domestic abuse and getting referral services that are easy to understand and well known in practice. If we are serious about preventing domestic abuse, we must be serious about the role of the NHS—not just in primary care, but across all mental health services, across maternity services, through emergency departments and through community care. It has to go right across the NHS and not just primary care. This is really a debate about making sure that we do not miss chances and that we provide meaningful intervention when people present with signs of domestic abuse. The Government have committed to delivering on our promise to halve violence against women and girls by 2029, and I welcome the comprehensive strategy to tackle that.”
“I declare an interest: I am a working GP and sometimes need to deal with these issues. On average, five people a week die as a result of domestic abuse in this country. Now, there are actually more suicides related to domestic abuse than homicides. Behind each of those statistics is a life lost and a family devastated. In far too many cases, there has been repeated contact with health services and there have been moments when the health service could have intervened. The NHS is the most consistent point of contact for people living with abuse. Each year, about half a million people seek support from the NHS in relation to domestic abuse and 85% of them ask at least five times before they receive effective support. That is not because clinicians do not care.”
“I beg to move, That this House has considered the role of the NHS in preventing domestic homicides and domestic abuse-related deaths. It is a pleasure to serve under you, Sir John. I am grateful to the Backbench Business Committee for giving me the opportunity to open a debate on the role of the NHS in preventing domestic abuse and dealing with it when it presents to the NHS. I thank my hon. Friend the Member for Lowestoft (Jess Asato), who, since we secured this debate, has been appointed as the violence against women and girls adviser to the Department of Health and Social Care. I think we shall hear from her later. I also place on the record my thanks to Standing Together Against Domestic Abuse, IRISi, Respect and, from my own constituency, Stroud Women’s Refuge, which have really helped me with this speech.”
“I know that my hon. Friend is invested in trying to help women subject to domestic abuse. Coercive control is very important as it often stops women presenting to healthcare workers. As I have said before, one key thing as a clinician is that we have to be brave and ask the man to step out so that it is possible to have a proper conversation. They can often resist that and can get violent as well. It is important that we take a brave view on this to protect women in general. To conclude, if we get those three things right—funding, recognition, and a comprehensive and integrated care service—we can move forward to a service that repeatedly sees and recognises abuse and immediately steps in to stop it. That is the shift I am calling for in this debate, and it is one that could save many lives.”
“I thank the Minister and all those who spoke and brought their fantastic experience of this really difficult problem. Let me say two very simple things. We need to imprint on healthcare workers the idea “Think domestic abuse”, so that we do not miss it. If someone presents, we must have in the back of our minds the question, “Is this domestic abuse?” That will help to identify victims much earlier. After that, we need to enable them to be referred in a simple and effective process that brings them support immediately. I thank everyone here, and you, Sir John, for chairing the debate.”
“I am a bit surprised by the mock rage coming from the Opposition, given that, over the past decade and a half, thousands of pubs have closed. I thank the Minister on behalf of Stroud publicans for agreeing to review the system so that we can get a really practical solution for pubs. Can I confirm that all business rates, including those on the high streets, will be reviewed, so that we can have a proper level playing field with the out-of-town institutions?”
“In Stroud, we have 4,000 council houses; we need at least double that. Will the Minister look again at the constraints that councils are under and see whether the Government can enable them to build more council houses?”
“Friend said, reduced need for anaesthetics and shorter procedure times because the child is enjoying themselves playing. I thank my hon. Friend for bringing this subject forward for debate—I will say no more.”
“I will be very brief. I thank my hon. Friend the Member for Leyton and Wanstead (Mr Bailey) for securing this fascinating debate. All play is therapeutic, and I emphasise that the Government have put £18 million into new playgrounds. My constituent Tom Williams is a proponent of adventure play, which is incredibly good for kids. It reduces anxiety, it burns more calories than sport and, crucially, it provides a digital detox and improves community cohesion. As a GP, I always had a big box of toys in my room. To examine a child, I had to play with the child; otherwise, they would scream their head off. Therapeutic play must be part of GP training in every way. The thing about therapeutic play is that it reduces the trauma, as we have heard; it actually results in fewer cancellations and, as my hon.”
“On international medical graduates, I commend the Secretary of State. It is something we have discussed in the past, and bringing forward emergency legislation is absolutely crucial here, so I thank him for that. I also want to mention trainers in the NHS. I can reassure the Conservatives that we will make this happen. I have been a GP trainer for 25 years. We will work to make this happen; that is what we do in the NHS. I have many resident doctor friends who do not like this action. Can we urge those doctors to talk to their fellows and try to call off this strike? It is not generally well supported among resident doctors, and it is something that we can change.”
“School leaders in socially deprived areas are almost 50% more likely to report being unable to find specialist arts teachers, and one in four schools does not have the funding to run creative GCSEs at all.”
“I beg to move, That this House has considered creative education in schools. It is a pleasure to serve under your chairmanship, Mr Stuart. I welcome the Government’s curriculum and assessment review, which recognises the need for a broad and balanced curriculum and recommends the removal of the English baccalaureate, allowing greater space for arts subjects. At present, far too many children do not have access to these opportunities. Research from the Arts and Minds Campaign reveals that participation in arts subjects at GCSE has fallen by 42% since 2010, even though 90% of young people want to study a creative subject. The decline is sharpest in the most disadvantaged communities.”
“I totally agree. In fact, there is evidence that creativity outside is even more effective for people than inside. This is clearly about access to natural spaces. I am chair of the all-party parliamentary group on creative health. There is really strong evidence that creativity reduces mental health problems in children.”
“The lack of art subjects has contributed to this pandemic of mental health problems. The Southbank Centre just across the river is doing a project as we speak around introducing creativity to children who are on the child and adolescent mental health services waiting lists. It will be quite exciting to see whether that can make them better as well.”
“It is interesting that creativity is particularly important for children with special educational needs. Indeed, there is some evidence that including creativity can actually make them attend school on a more regular basis. I have visited loads of schools in Stroud over the last 18 months, and one common theme has been the rise in mental health problems in young people, who are under countless assessments and the pressure of living in a 24/7 social media world. I do feel that this is pushing a lot of children to the brink, and that creativity may be a way of repairing that. One in five young children has a probable mental health condition, and this figure is rising every year. As a GP, I have been using art to treat mental health in children and adults for about 26 years, quite often with really spectacular results.”
“That has been transformative for many children. There are other examples, such as the fantastic Big Noise in Scotland. Some big organisations, including the Royal Liverpool Philharmonic, the English National Opera and the Royal Opera House have big programmes that reach into schools. There is some evidence that they can teach the teachers, which is one of the problems I will explore.”
“I want the Minister to join me in a campaign to make teaching children how to play musical instruments available in every primary school. I shall talk a little bit more about music. In Stroud, schools such as Bussage primary school are leading the way by making sure that every key stage 2 child has exposure to musical education. Last week, we had a roundtable in the House of Lords with a group called Rocksteady, which takes rock music into local schools. I was really impressed by what I heard. Not only were the effects of the group’s work really impressive, but there was a measurable reduction in pupil absence rates. It had an effect on the whole school, and made everyone feel better. In Gloucester, we have the Music Works, where quite deprived children can learn how to DJ, to play the drums or guitar, or to sing.”
“I know that my hon. Friend is incredibly supportive of the developments in Reading. I commend him on that. Because I am a scientist, I thought I could provide some reasoning on why the creative arts can help. They help on three different fronts. Biologically, they can influence physiological symptoms of anxiety—they reduce anxiety. Psychologically, they can improve self-expression, confidence and, probably most important, self-esteem. That is because often when we do a creative thing, we feel that it came out a little bit better than we anticipated. It is the same for children. There is good, strong evidence that the creative arts build self-esteem in children, and in social terms, they build connections and a sense of belonging.”
“If we are serious about tackling inequality, we must rebuild creative opportunities into the heart of every child’s school experience.”
“As a result, children’s creative futures are increasingly dictated by family income, not by talent or passion. It is already mandatory that looked-after children are provided with free musical instruments. Should that be extended to those on free school meals? Could we use the pupil premium for music lessons? Libraries can lend instruments easily and musical hubs provide the organisational ability to spread teaching through a school. Groups such as the Ed Sheeran Foundation and the Nicola Benedetti Foundation are supporting music education, and we could perhaps use them more, particularly with less advantaged children. Creativity should never be a postcode lottery. It should not be a luxury for families who can afford instruments, lessons, dance shoes or even theatre trips.”
“Despite Tash’s excellent work over the last 12 years, funding is a challenge all the time. I urge the Department for Education to meet her and discuss how we can continue to fund that programme. One of the main barriers to creativity in education is that teachers are not qualified or do not have experience of teaching the creative arts. The less creativity there is at a school, the less likely the teachers are capable of teaching it. One third of school leaders cannot find specialist teachers, for example, so big national organisations may have a role to play in taking them under their wing, showing them how to teach and giving them the confidence to teach. That is one big problem. Another problem is cost. Half of all parents cannot afford extracurricular arts activities.”
“Recently, I met Tash Alexander, the inspirational director of Head Held High, which ran a comedy and performance workshop for teenage students in London schools; I also met one of the graduates, Ro. What really struck me about the programme is the way it uses creative expression to build confidence, especially among children who do not always thrive in more traditional learning environments. One aspect of creativity and the arts is that they often really suit people who do not get on very well at school. They are made to feel a failure, whereas actually they can make fantastic artworks or music. We must give them that opportunity. That is the real power of a creative education—it reaches young people differently and gives them a space to discover who they are.”
“My hon. Friend has made exactly the point I was coming to about the role of music hubs. There are 43 music hubs in the UK, delivering something like half a million lessons and interventions up and down the country. Their reach is incredible, taking in about 90% of schools, although there is an issue in that they sometimes charge for their lessons, which I shall come back to. I welcome the upcoming launch of a new national centre for arts and music education, to support the delivery of high-quality arts education in schools and ensure that high-quality arts education is open to all. I would welcome further information from the Minister on the plans for that establishment. Creativity in education does not just mean musical or visual arts.”
“I would like them to expand the arts in the curriculum and offer all children in primary schools musical instrument teaching by the end of this Parliament. For the sake of our young people’s wellbeing and our future creative industries, we must restore creativity to its rightful place in our schools.”
“That is very true, and it comes back to the capabilities and confidence of the teachers, particularly in smaller schools. My children all went to smaller schools and they were lucky to have an inspirational music leader, but not every school has one. We can go further; we could have a world-class curriculum, but it cannot be world-class if we sideline the arts. All schools need the resources, staffing and flexibility to deliver meaningful creative education. I believe that the curriculum review provides that flexibility. To finish off, I have requests of the Minister. I would like the Government to consider funding free music lessons for all less well-off children, and teacher training in the arts for all teachers.”
“I thank the Chancellor for investing in our community care. In Stroud, the two beating hearts of our community—GP surgeries and our village pubs—reduce social isolation. Today, the publicans are meeting at Stroud Brewery to discuss the impacts of business rates. May I invite the Minister to discuss how we can help our pub landlords—perhaps over a pint?”
“I invite the Minister for Energy Consumers—the Under-Secretary of State for Energy Security and Net Zero, my hon. Friend the Member for Inverclyde and Renfrewshire West (Martin McCluskey)—to back my campaign and issue a call for evidence. Question put and agreed to. Ordered, That Maya Ellis, Irene Campbell, Paula Barker, Andy McDonald, Cat Eccles, Christine Jardine, Paul Davies, Fleur Anderson, Amanda Hack, Luke Myer, Steve Darling and Dr Simon Opher present the Bill. Dr Simon Opher accordingly presented the Bill. Bill read the First time; to be read a Second time on Friday 16 January 2026, and to be printed (Bill 340).”