Dr Beccy Cooper
MP for Worthing West · Labour · United Kingdom
“Its population is older than average—even though I am not older than average—frailty is increasing, multiple long-term conditions are common, emergency admissions are correspondingly higher, recruitment is harder and deprivation exists alongside affluence.”
“I thank my hon. Friend the Member for Tooting (Dr Allin-Khan) for bringing this timely and important debate to the Chamber. As we have heard, corridor care is one of the clearest signs of wider pressures across urgent and emergency care services, including rising demand, delayed discharge and constrained hospital capacity.”
“We have talked about the back door, but I really want to talk about the front door. Members will be unsurprised to hear that, as a public health doctor, I know that prevention is a corridor care policy.”
“I thank my hon. Friend for those excellent remarks, and I agree wholeheartedly. As I have said, corridor care is a symptom, and our challenge is to identify the underlying causes, rather than simply measure the symptoms.”
“Every prevented stroke, every smoking cessation intervention, every warm home, every child who grows up healthier and every patient supported earlier in the community means one less avoidable admission to an already overcrowded emergency department, such as that of my hon. Friend the Member for Tooting.”
“I agree 100%. My hon. Friend the Member for Doncaster East and the Isle of Axholme (Lee Pitcher) has already talked about his role in the water, sanitation and hygiene all-party parliamentary group. Access to water is an absolutely essential health determinant.”
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“We have talked about the back door, but I really want to talk about the front door. Members will be unsurprised to hear that, as a public health doctor, I know that prevention is a corridor care policy. The Government need to ensure that investment in prevention and public health is recognised as part of the solution to reducing corridor care. We have to reduce the flow of avoidable illness into our hospitals in the first place, and that means tackling smoking, poor housing, air pollution, obesity, loneliness, poverty and delayed access to community care. Corridor care begins long before a patient reaches an accident and emergency department.”
“Its population is older than average—even though I am not older than average—frailty is increasing, multiple long-term conditions are common, emergency admissions are correspondingly higher, recruitment is harder and deprivation exists alongside affluence. All these things contribute to the pressures that we have discussed during the debate. University Hospitals Sussex NHS foundation trust is in my constituency. As we have discussed, NHS England’s data is not completely useful in many instances, but it is the best that we have. I have had a look and, on average, the four emergency departments in the trust are seeing 65 patients in their emergency department corridor care service each day. In their general and acute wards, they have corridor care for 39 patients each day. That is not insubstantial.”
“I thank my hon. Friend the Member for Tooting (Dr Allin-Khan) for bringing this timely and important debate to the Chamber. As we have heard, corridor care is one of the clearest signs of wider pressures across urgent and emergency care services, including rising demand, delayed discharge and constrained hospital capacity. As so much has already been said, I want to focus my remarks on a couple of areas. As an MP for a coastal community, I want to make it clear to the Minister that when we are looking at these pressures, we need to acknowledge the additional pressures facing specific communities. Coastal communities tend to have older populations and poorer health outcomes. Worthing West sits within one of England’s coastal communities.”
“Every prevented stroke, every smoking cessation intervention, every warm home, every child who grows up healthier and every patient supported earlier in the community means one less avoidable admission to an already overcrowded emergency department, such as that of my hon. Friend the Member for Tooting.”
“I thank my hon. Friend for those excellent remarks, and I agree wholeheartedly. As I have said, corridor care is a symptom, and our challenge is to identify the underlying causes, rather than simply measure the symptoms. It is what happens when demand, delayed discharge, workforce shortages, social care pressures and preventable ill health collide in one place. Stakeholders that I speak to—and, I am sure, stakeholders that colleagues across the House speak to—repeatedly call for public health investment, stronger community services, social care capacity and the prevention of avoidable admissions.”
“I welcome the decision to provide protection for key multilateral health organisations, and I am proud that the UK has made ambitious commitments to the Global Fund and to Gavi, the Vaccine Alliance—institutions with a proven ability to deliver vaccines at scale and to reach communities that fragmented programmes often cannot. The Government are also right to recognise that countries want autonomy, not dependency, and that our role should be to help to build resilient health systems that countries themselves can sustain and own. That is the right long-term objective.”
“When every major donor retreats at the same time, there is no one left to step into the gap, and yet the challenges we face today do not stop at national borders. Conflict, climate change, forced displacement, pandemics and antimicrobial resistance affect us all. Investment overseas is increasingly an investment in our own security and prosperity here at home. Global health provides perhaps the clearest example of why this matters. Viruses do not stop at passport control. The first line of defence against the next pandemic is not at Heathrow or Dover, it is in strong public health systems thousands of miles away. Our national health service and the health security of people across Britain depend on a global health system that works effectively for everyone. That is why I welcome aspects of the Government’s approach.”
“It is a pleasure to serve under your chairmanship, Mr Efford. We meet at a moment when the global aid system is under extraordinary pressure. I thank the right hon. Member for Dumfriesshire, Clydesdale and Tweeddale (David Mundell) for securing this incredibly important debate. Current projections suggest that cuts to international aid could contribute to as many as 14 million additional deaths by 2030, including 4.5 million children under the age of five. That is the human cost of dismantling the world aid architecture at speed. The United Kingdom is not alone in reducing aid spending—the United States, France, Germany and Canada are all scaling back their commitments—but that does not make our choices less significant; it makes them more significant.”
“The lessons of Ebola, covid-19 and antimicrobial resistance are ultimately the same: we cannot isolate ourselves from global threats, and the cheapest crisis is the one that we prevent. Ministers have described these decisions as exceptional measures taken in difficult fiscal circumstances. I recognise those pressures, but we have a responsibility to keep people safe, including people here in the United Kingdom. We are weakening the protection of some of the world’s most vulnerable communities, and in doing so we are undermining our own health security here in Britain. For those reasons, I urge my Government to look again. We need a credible, serious and urgent plan to restore aid spending, not only because it is the right thing to do but because it is in our national interest.”
“The NHS benefits enormously from healthcare workers who trained overseas before coming here to serve patients across the United Kingdom, which we sometimes forget in our conversations about immigration. It has been estimated that the UK has saved about £14 billion by relying on health professionals educated and trained elsewhere, and many of the countries from which those workers come are themselves grappling with fragile and understaffed health systems. That is not a windfall; it creates a responsibility. We have a duty to invest back into the health systems from which we have drawn so much expertise, not to withdraw support at the very moment that those systems are under increasing strain.”
“The continent bears about a quarter of the world’s disease burden while possessing only 3% of the global health workforce, yet bilateral aid to Africa is facing a 56% reduction—the steepest regional cut across the entire ODA budget. Multilateral institutions will of course continue to play an essential role, but we should not be so naive as to believe that they can absorb cuts of that scale without consequences. The consequences are already becoming clear. In Malawi, an estimated 250,000 adolescents could lose access to family planning services each year. In Somalia, fewer women, girls and boys will be able to access lifesaving healthcare because of these decisions. Behind every statistic is a human being whose opportunities, health and future are being diminished. There is also a broader question of fairness.”
“The effectiveness of antibiotics underpins modern medicine and protects countless lives every day. Our NHS depends on those medicines continuing to work. Recent outbreaks of serious infectious diseases remind us just how much rests upon them. As we have just been reminded, health does not exist in isolation. Clean water, good nutrition and quality education are health interventions by another name. For example, children whose mothers have received a secondary education are far more likely to be fully vaccinated. Although I welcome the prioritisation of healthcare spending, we cannot ignore the reality that in practice many of the programmes being cut are health programmes, too. Nowhere is that more evident than in Africa.”
“That is why, to be honest, the decision to withdraw support from the Global Polio Eradication Initiative and the Pandemic Fund is really quite disappointing. The Government’s own impact assessment warns that these choices increase the risk of disease outbreaks. We are closer than ever to eradicating polio, a disease that has blighted generations of children, and yet, potentially because of cuts to official development assistance, we are stepping back from that goal. I urge us not to. I am equally concerned about the dismantling of the Fleming Fund. Antimicrobial resistance may sound a little abstract, but it is not a distant or theoretical threat. Just ask anybody what they think will happen if their antibiotics do not work when they need them. It is one of the most pressing public health challenges that we face.”
“I agree 100%. My hon. Friend the Member for Doncaster East and the Isle of Axholme (Lee Pitcher) has already talked about his role in the water, sanitation and hygiene all-party parliamentary group. Access to water is an absolutely essential health determinant. Partnership and resilience building are incredibly important, but they cannot be the whole answer. A strategy designed to strengthen systems over many years does little for a clinic that is closing next month. Communities facing the loss of essential services are not reassured by a long-term theory of change, much as we love that in the development arena. They are worried about whether medicines will be available, whether healthcare workers will be paid and whether the lights will stay on. Withdrawal is fast, capacity building is slow, and people are falling through that gap.”
“Q7. It is great to see the NHS moving forward, with a reduction in waiting lists and improving relations with our junior doctors, my colleagues. However, in order to keep our NHS working well in the long term, we must get serious about prevention. Every year, more than 30,000 deaths in our country are attributed to poor air quality. Ella Kissi-Debrah’s mum knows this all too well; her little girl was just nine years old when she died as a direct result of air pollution. Seventy years on from the Clean Air Act 1956, will the Deputy Prime Minister support a much-needed update to this essential law, to protect the future of our NHS and to keep our children healthy?”
“The Ebola outbreak now spans 29 health zones across three eastern provinces and is a reminder to us all that infectious diseases do not respect borders. With global health funding under significant pressure, does the Minister share my concern that we risk undermining the early warning systems that ultimately protect people here at home? Can he set out what steps the UK is taking to maintain its leadership role in global security?”
“Health inequalities are driven by social determinants such as access to green spaces, which is directly associated with higher life expectancy. In my constituency of Worthing West, we have the lowest amount of green space per person in the country—less than a snooker table. Could the Minister set out how the Department is working across Government to ensure that this essential health determinant is being secured and increased across all areas of our country?”
“Finally, to guard against a focus solely on reorganisation, alongside this NHS Bill and as a key focus of the 10-year strategy we must have a whole of Government approach that recognises health as a strategic and shared asset—”
“In the discussions about proposed sites for neighbourhood health hubs, it became clear that the population needs of my constituency of Worthing West had not been entirely understood when considering sites: there is a large area containing several villages with an ageing population and limited access to transport, whose requirements had not hit the radar of the ICB. To be clear, this is not about blame—anyone who thinks that planning for population health needs is straightforward is welcome to sit the public health exams in epidemiology and statistics. Expertise is there to be used, and we should draw on it. I therefore suggest that we require a statutory appointment of a lead director of public health to represent the area covered by each integrated care board.”
“I turn to the role of public and population health in this NHS Bill. Public health must be front and centre to provide the right health services in the right place at the right time. At an ICB level, there is now an explicit requirement for population health considerations to be understood. Integrated care boards will be responsible for commissioning the vast majority of our local NHS services, so they need to know the population health need. That has been demonstrated in my ICB area of Sussex over the past couple of weeks.”
“It is over 20 years since I was a junior doctor, but I still remember my and my patients’ frustration when I once again had to ask them for their clinical history after they had already told it to the GP, the paramedic and the triage nurse. This endeavour has been tried several times before. The financial cost of NHS Digital and the litany of platforms, software and systems that have been tried and abandoned provide a wealth of lessons learned to ensure that it is successful this time—which, let us face it, is long overdue. Public trust is very important for health data systems. We could consider new safeguards such as a public interest test for sharing data or bringing back requirements to report to Parliament. The NHS must ensure that the technical know-how is sound, as well as being fleet of foot.”
“I will try to keep my remarks brief. The NHS is one of the most unifying institutions in our country today. It is a huge employer, a major source of pride, and a safety net for us all at our moments of greatest need. We all know that it has been creaking under significant strain for some time now, so it is good to see new life and new energy in the 10-year plan. I welcome this Bill as a response to some of the purpose outlined in the strategy. A lot of the detail in the Bill has been covered by colleagues already and will doubtless be covered further in the Bill Committee, so I will limit my remarks to single patient records and the role of public health in the Bill. I am fully supportive of a single patient record finally being realised. Our health and care system should revolve around patients, rather than patients revolving around it.”
“I thank my right hon. Friend for freezing rail fares, which will indeed help to ease the cost of living for many commuters, such as my constituents in Worthing West, many of whom have jobs here in London or in Brighton. Southern has been rated the worst value for money rail operator in a national passenger survey. As we move to nationalisation of our service and finally see the back of Southern rail next month, will the Minister ensure that investment is available for key issues such as reducing overcrowding and improving the reliability and punctuality of our vital south coast services?”
“I absolutely agree that brownfield sites should be prioritised for development. On the NPPF, how can we further ensure that the right type of housing goes on brownfield sites? We are talking about social rent housing, and housing for older people who are rightsizing, and for first-time buyers; there is a huge shortage of that housing, across the country.”
“I am listening to the hon. Member’s arguments with great interest. I want to be clear about the argument he is making. We all greatly value British sports, but if it is synonymous with issues that are causing harm to our children and our population, should we not move those sports forward without allowing that harm to occur?”
“I absolutely hear what the hon. Member is saying and I reiterate that great British sport is incredibly important. In terms of current regulation, does he agree that we are not regulating nearly enough and that we are therefore putting people who watch these sports and see ubiquitous gambling advertising in harm’s way?”
“How successful does the hon. Gentleman think voluntary agreements have been? Given that the evidence suggests that we are one of the most unregulated countries in the world for gambling, does he not agree that more should be done through regulations that are not voluntary?”
“Emerging forms of advertising, including content marketing and influencer promotion, blur the line between entertainment and promotion, making risks harder to identify, particularly for younger audiences. I want to touch briefly on the conversation about legal and illegal markets. I absolutely hear the need to regulate illegal markets. It was a conversation that we had in the big tobacco world for years and years, and the answer is: it is not either/or; it is both. We have to regulate the legal industry and the illegal industry. Talking about one or the other will simply not solve the problem.”
“How do current advertising regulations reflect those facts? The short answer is not very well. The recent report by the APPG on gambling reform and Peers for Gambling Reform, as my hon. Friend the Member for Halesowen (Alex Ballinger) said, brings together academic research, clinical expertise and lived experience, and its conclusion is clear. The current system of regulating gambling advertising is not working. Gambling advertising is now pervasive across television, sport, social media and online platforms, reaching audiences far beyond its intended adult market. Evidence from the Gambling Commission shows that 79% of children and young people recall seeing gambling advertising across multiple channels.”
“That is now a widely agreed fact, and even the most libertarian colleagues would be hard pressed to make the case that advertising smoking as a desirable life choice is in the best interests of anybody. Alcohol remains more nuanced for many reasons. From a health point of view, while it is undoubtedly an addictive product that has the capacity to cause serious health harms and early death, it is also possible to enjoy alcohol and perhaps even benefit from the antioxidants in red wine. We recognise that and have produced guidelines on consumption levels. Gambling is an addictive product. That is an incontrovertible health fact, backed up by a large and growing body of evidence. However, as with alcohol, there is a spectrum of addiction across gambling products, which, again, is well evidenced.”
“Social media algorithms? Well, they are fodder for gambling promo. I would like everybody to try a thought experiment. I do not know whether this has been done before in Westminster Hall, but stick with me. Replay what I have just said about advertising everywhere in life—sports events, telly ads, children’s YouTube, social media feeds—but replace gambling with alcohol or smoking, and take a minute this evening to consider how it would feel if we were pushing booze and fags, particularly to children, at any and every opportunity with very little regulation. The fact is, of course, that that was pretty standard fare before public health took on big tobacco, with an increasing body of evidence that smoking is addictive and causes lung cancer.”
“It is a pleasure to serve under your chairship, Mrs Harris. It has been an interesting debate so far, and I thank the hon. Member for Bridlington and The Wolds (Charlie Dewhirst) for taking so many interventions. It was incredibly interesting to hear the discussion. I come at this issue from a particular point of view. I am a public health consultant and I have spent many years working with my colleagues to understand how big tobacco works—I put that on the record. This debate is both timely and important. We have reached a point in this country where the advertising of gambling products is so ubiquitous that it is almost unheard of to see a sporting event without it, a gambling-free advert break on the telly, or children’s YouTube watching that is not punctuated by colourful, cheerful ads for thinly disguised gambling opportunities.”
“Let me see if I can answer that, and the hon. Member can tell me if I have not. During our experience with big tobacco, there was a big illegal market—a black market. We brought in various rules and regulations, and we got our environmental health officers and Customs on it. We were absolutely able to look at the black market in tobacco alongside regulating the legal industry. It is perfectly possible to do. In the world of online advertising—the hon. Member referred to the wild west—we have to be very intelligent in how we look at regulation, but it is possible. It needs better brains than mine to figure out how to do it digitally, but it absolutely is possible. Moving on, evidence shows that one quarter of people who gamble have done so in direct response to advertising.”
“There is now a strong case for more fundamental reform, including a new Gambling Act that reflects the realities of today’s digital and highly commercialised gambling environment. Ultimately, this is a question of priorities: to protect public health, in particular for children and young people; or to allow the continued expansion of a system that contributes to harm. In summary, a famous gambling industry tagline is, “When the fun stops, stop.” I think that it is past time for us to acknowledge that gambling addiction is fun for no one, and exposure of our children to harmful, pernicious advertising from big gambling companies has to stop. I say to the Minister, there is no fun here; it is time to stop.”
“As we have heard, other countries, including Italy, Spain, Belgium, the Netherlands and Australia, have already introduced stronger restrictions based on similar evidence, The UK’s continued reliance on limited and voluntary measures has left it an outlier, rather than a leader in protecting public health. The Government already have powers under existing legislation, including the Gambling Act 2005, to take further action. The issue is no longer whether change is possible, but whether there is the political will to act decisively. Public concern is already there, with about two thirds of the public worried about the volume of gambling advertising and its impact on children.”
“Addressing gambling as a public health issue requires moving beyond incremental, industry-led measures towards clear, enforceable statutory regulation. Our approach continues to rely heavily on lacklustre and ineffective self-regulation. Despite existing restrictions, children continue to be widely exposed to gambling advertising across television, sport and social media. Parliament has previously taken a precautionary approach in areas such as tobacco, alcohol and junk food marketing, where there is credible evidence of harm. Gambling advertising meets the same threshold, given its demonstrated links to increased participation and harm.”
“Like tobacco, gambling is not just an issue of individual choice, but a product designed and marketed to drive addiction. What should we do? First, gambling advertising should be understood as a public health issue, not simply a matter of consumer choice or industry regulation. In fact, the World Health Organisation has called for restrictions on gambling advertising, marketing and sponsorship as part of a public health response. I am grateful that the Minister is taking the time to consider the issues on behalf of the Department for Culture, Media and Sport this afternoon, but I am of the opinion that gambling sits squarely in the world of health, alongside other addictive products, and the responsibility for it should be transferred to the Department of Health and Social Care.”
“I am a public health consultant, and I am still licensed to practise as a public health consultant. I am trained in epidemiology statistics, and I have passed professional exams on both. We have had email correspondence from the people the right hon. Lady mentions, and we have replied to that evidence, stating why the statistics that we are using are absolutely the best evidence that we have. I am happy to share the correspondence, if that is helpful. Gambling advertising is not passive, but a core driver of market growth. As we heard, the industry spends up to £1.5 billion to £2 billion annually on advertising, marketing and sponsorship. The cumulative effect is a system that embeds gambling into everyday life, increasing the likelihood and severity of harm.”
“The amendment would give councils a clear, evidence-based tool to assess the cumulative impact of adult gaming centres and to identify areas in which further gambling premises would undermine local licensing objectives, including vulnerability and clustering.”
“My area of Sussex is on the fast-track devolution programme. Although that brings challenges and inevitably means that we are still building parts of the plane while learning to fly, for my constituents and all Sussex residents, the devolution of power and resources has the potential to transform our area in health, education, housing, transport and sustainable economic development. Given the short time available to me, I will concentrate my remarks on Lords amendment 80, which would strengthen the ability of licensing authorities in England, Scotland and Wales to issue cumulative impact assessments or gambling impact assessments.”
“Creating a healthy democracy that has clear objectives and is properly resourced, alongside legislation that allows local government to protect populations from harm and to create healthy environments, is an integral part of this devolution Bill, and I very much welcome it for my area of Sussex and our country.”
“Once the impact of gambling impact assessments has been evaluated, we should make a decision on bringing forward legislation to remove “aim to permit” to give councils the right powers to protect and develop our local areas. Alongside that, as the impact assessments and “aim to permit” refer only to the opening of new centres, we must ensure that current licences are not being abused and that licensing codes are upheld. Lords amendment 80 speaks to the desire of national and local government to enact legislation that lets people thrive in the places where we live.”
“The “aim to permit” rule remains, and there will be a tension with gambling impact assessments, as it means that councils must still start from a presumption of granting licences, which limits their ability to respond to community opposition, high street saturation and local priorities, even in areas where there are clear concerns about overconcentration of gambling venues. The licensing committee of Worthing borough council recently turned down yet another request for a gambling premises on our high street, but that has now gone to appeal, and the presumption of “aim to permit” means that the balance of evidence is more difficult to hold, even with sound public health and local economic development arguments. We must therefore continue to develop our legislative approach in this area.”
“I wholeheartedly agree with my hon. Friend. Together with my hon. Friend the Member for Halesowen (Alex Ballinger) and the right hon. Member for Chingford and Woodford Green (Sir Iain Duncan Smith), I am an officer of the APPG on gambling reform, and we have been doing significant work to gather evidence on this issue over the past 18 months. The sad truth is that the highest numbers of adult gaming centres are predominantly found in our poorest areas. Areas of deprivation need investment, employment and development, not a drain on resources and an open door to the black hole of addiction. However, Lords amendment 80 is only the start of what we need to do in this area to create environments where our populations can thrive.”
“Following the publication of the Amos review, the Minister may want to consider the possibility of a maternity commissioner to carry out the work of the taskforce, but the primary driver of that decision must be the aim of embedding the progress that is being made now, and sustainably embedding across maternity services a safe, holistic, person-centred approach that can endure and adapt for many generations to come.”
“The best start in life campaign includes information on pregnancy, but we must ensure that maternity healthcare is fully embedded in the shift to neighbourhood care. Members should be in no doubt: we have talked about moving from hospital to community throughout the 20 years that I have been in public health and medicine, and we have yet to do it. So I am under no illusions that this is incredibly difficult, but the focus we have this time is welcome. Considering the improvements that have been made in my own area by University Hospitals Sussex; the significant steps being taken by the Government in establishing the taskforce led by the Secretary of State; and the investment in midwives and, more broadly, in women’s health and community-based care, I think that positive action is starting to take hold.”
“The women’s health strategy, published last week, recognises that women’s birth experiences and outcomes are a fundamental aspect of high-quality healthcare. Maternity services need to be embedded in a model that is based on relationships and wider care. That is essentially what health services live or die on: if we do not have good relationships and good wider care, our health services will struggle. How we organise our services also needs to change, and that is a core mission of our Government in shifting to community-based care and a neighbourhood health model. Some £200 million has been invested in the healthy babies programme to improve perinatal mental health, parent-infant relationships and infant feeding in 75 local authorities. That is part of the £900 million that has been allocated to Best Start family hubs.”
“The Health and Social Care Committee highlighted those issues in its inquiry, when we saw that black women in England continue to face disproportionately poor outcomes in maternity care and the highest maternal mortality rates. Babies born to black women are more than twice as likely to die in their first year, compared with babies born to white women—a fact that I find incredible in this day and age, as somebody who has worked in the NHS as a doctor and who is now a public health consultant. It is entirely unacceptable that that continues to be the case. The task, therefore, is accountability and co-ordination, and ensuring that evidence-based recommendations drive rapid improvement for women, their babies and hard-working staff.”
“The NHS has faced an estimated £27.4 billion bill for maternity negligence in England since 2019. That figure exceeds the total maternity budget for the same period, and reflects the devastating toll of preventable deaths and life-altering injuries to mothers and babies. There has been significant investment in increasing the number of midwives over the past 18 months under this Labour Government, with an extra 800 midwives recruited since December 2024, but that is not enough on its own. As we have heard so sensibly from my colleagues, there needs to be widespread system change and a continuum of care. We heard from my hon. Friend the Member for Clapham and Brixton Hill (Bell Ribeiro-Addy) about the issues around black maternal health.”
“The soon to be published Amos review recommendations, which we have heard about this afternoon, will undoubtedly provide a clear blueprint for the national maternity and neonatal taskforce to move things forward. But let us be in no doubt: as has been said, we have had 700 recommendations to date, and we probably know what will be in the Amos review, so let it be the last one. The tragic fact, despite the excellent improvements I have seen in my local area, is that between 2022 and 2024 the overall rate of maternal death in the UK was 20% higher than it was from 2009 to 2011, when the Government of the day set an ambition to halve the rate of maternal mortality in England. Although the life of a precious baby is priceless, clinical negligence does have a price tag.”