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Fly-tippers tend to vanish just as the mess gets traced back to them—much like Nigel Farage earlier this week. Closer to home, I led a community walkabout with the Friends of Outer Devonshire, alongside residents such as Emma Boyes and Kay Skinner, to look at fly-tipping hotspots in Eastbourne. Will the Minister commend them for their work, and outline what steps the Government will take to support them and their community to tackle fly-tipping once and for all?
It is a pleasure to serve under your chairship, Mr Betts. I thank the hon. Member for Strangford (Jim Shannon) for securing this debate to shine a light on an important but often overlooked issue. It is strange that many of the voices who mourn Britain’s declining influence are the first to say that we should spend nothing on issues beyond our own shores, and that the 0.7% commitment to development spending was a national indulgence that we can no longer afford. However, our influence never relied on hard power alone. Our leverage in the world comes from working with others and leading by example. That is what internationalism means, and that is why the Liberal Democrats believe that the commitment to international aid is not merely sentimental, but fundamental and strategic. It rests on the simple principle of equality: that we help those who need help most. I will not create a league table of suffering, but some groups bear a heavier burden in humanitarian crises. Older people, especially those who are disabled, are almost always among the most affected. When Hurricane Katrina struck New Orleans in 2005, 75% of those who died were over 60, despite older people making up only 16% of the local population. When the Great East Japan earthquake and tsunami struck in 2011, 56% of those who lost their lives were aged 65 or over. The world today is less stable than it has been in a generation. The Office of the UN High Commissioner for Human Rights found that since Russia’s full-scale invasion of Ukraine began in February 2022, older people have accounted for almost half of civilian deaths, where age could be verified. Older people, especially older women, remain at disproportionate risk, particularly in frontline areas. Given that we know all that, it is extraordinary that the FCDO confirmed cuts to precisely the funds that support the most vulnerable groups in humanitarian responses. The International Development Committee found that FCDO equality impact assessments expect ODA reductions to programmes with a strong focus on equalities to be severe. The Committee also heard that work on disability and inclusion in South Sudan specifically will cease altogether, which will have a direct impact on elderly people. UN figures show that more than 46% of people aged 60 or over live with a disability, and more than 250 million older people worldwide experience moderate to severe disability. In the UK, the House of Commons Library’s analysis shows that disability prevalence rises from 23% among working-age adults in the UK to 45% among adults over the state pension age, and 58% among those aged 80 and over. Therefore, when disability inclusion funding is cut in a humanitarian response, older people will be hit twice over. It is not an unfortunate side effect; it is a foreseeable and measurable consequence. I want to press the Government on the false choice they keep presenting between defence and development, particularly in the context of Ukraine. Official development assistance budgets are part of defending Ukraine. For example, they partly fund accessible bomb shelters and healthcare adaptions for people with mobility needs or age-related conditions. If we are serious about supporting Ukraine, are the lives of its oldest citizens not part of that commitment? Liberal Democrats reject the idea that we must choose. We have set out how defence spending can rise to 2.5% of GDP and beyond, through mechanisms such as defence bonds and a higher digital services tax on the largest technology firms—that is without hollowing out our aid budget. We advocate for the immediate restoration of ODA to 0.5% of gross national income, with a clear roadmap back to 0.7%. The American example in this is not one to follow. USAID has been gutted by an Administration that treats development spending as something somehow unpatriotic. Within the older age group, the situation of women reveals a heightened danger. Amnesty International’s submission to the UN independent expert on the enjoyment of all human rights by older persons documents this starkly. In north-east Nigeria, older women displaced by Boko Haram faced particularly severe discrimination and invisibility. They were often unsuccessful when they tried to petition simply to be added to food distribution lists. In Ukraine, women’s pensions are on average 30% lower than men’s, which is a consequence of shorter careers and interrupted employment caused by caregiving responsibilities. Older women also experience higher rates of disabling conditions than men of the same age, such as arthritis, osteoporosis and frailty. As a result, older women are disproportionately exposed to poverty when displaced. The social role played by women as caregivers, as mentioned by the hon. Member for York Central (Rachael Maskell), means that if they suffer, the impact is felt by the whole extended family. If they are left without income, accessible health care or a place in the food queue, the people who depend on their care feel it also. If the Government want to talk about return on investment in their development spending, this is exactly where that return is the greatest. Supporting older women is not a niche ask; it is a multiplier for entire households and communities. I am speaking for the Liberal Democrats, but of course it is not just us. Amnesty International has set out practical and deliverable recommendations. We must disaggregate humanitarian data by age, gender and disability, so that we can see who is being missed out. We must ensure that older people are not systematically excluded from livelihood and cash assistance programmes on the discriminatory assumption that they cannot work. The humanitarian inclusion standards for older people and people with disabilities, developed by the sector’s own age and disability inclusion consortium, already exist and are freely available. Will the Minister confirm whether the FCDO is using them, and if it is not, why not? To conclude, the Liberal Democrats believe that this Government do not need new evidence to act; they need to start listening to the evidence that they already have. They need to listen to their own equality impact assessments rather than commissioning them and then quietly setting them aside, as has happened all too often in previous rounds of cuts. They need to make use of the evidence-based inclusion standards that the humanitarian sector has already built, rather than trying to reinvent the wheel—or, indeed, ignoring them altogether. They also need to restore ODA, first to 0.5% of GNI, but with a published roadmap back to 0.7%, so that the targeted programmes reaching older people, and older women in particular, are not the first thing to be sacrificed when budgets tighten. I look forward to the Minister’s response.
There is no easy fix, that is for sure, but the loans are not coming from the bond markets; they are coming from British people. We are not imposing on or demanding on the bond market. That is the difference. Such bonds have been used successfully in the past.
I beg to move, That this House has considered Government support for the Lobular Moon Shot Project. It is a pleasure to serve under your chairship, Mrs Hobhouse. MPs from across the House are here today to mark the anniversary of the death of my constituent Dr Susan Michaelis, founder of the Lobular Moon Shot Project. I thank the Backbench Business Committee for finding time at very short notice in the parliamentary schedule for this debate. Unfortunately, that short notice has prevented many MPs who would have liked to have spoken today from joining us. Unfortunately, that was a necessity. Today is a sad moment because Susan is no longer with us, but it is also a time to celebrate what she has achieved. Susan was a remarkable woman. She was warm but incredibly stoic. At no time was that clearer than on her last trip to Parliament in the summer of last year, oxygen tank in tow. Determined but evidently suffering, Susan stood for 22 minutes in a silent vigil outside No. 10 Downing Street with fellow campaigners and lobular ladies around her. We all understood that Susan was in her last days or weeks, so to watch her husband, campaigners and fellow lobular ladies rallying around her, literally supporting her, was a sight to behold. In her haste to deliver her petition to No. 10 that day, Susan had forgotten her ID. She was distraught. All that effort would be wasted, as the rules were clear: no ID, no entry. But that, of course, was not Susan’s way. Susan, with our support, blagged her way past security. Susan was never one to take no for an answer. Not long after, Susan died—just days after her meeting with the then Health Secretary. It might seem odd to say, given that I met Susan when she was already very ill with the lobular cancer that she was campaigning to prevent, but I feel that I met her in her prime. It was immediately clear to me that this was a person with an unparalleled commitment to her cause. Despite her illness, Susan never looked for the sympathy vote. She was always calm and matter of fact. She led by example. It is a reminder that her cause, while not yet complete, is a worthy one, and with a champion to match. Susan’s first campaign was in fact not lobular breast cancer; it was aviation safety. She flew commercial aircraft in the Australian outback, one of the few female pilots to take up this challenge, and piloted the first all-female crewed Qantas flight. This was before contaminated cabin air ended her flying career in 1997. She spent the following decades building the evidence base on aircraft cabin air contamination, with a PhD, an MSc, peer-reviewed research and a leading role in her home country’s Senate inquiry into cabin air quality. Her focus in her final years was on lobular breast cancer, and it is on this endeavour that I was pleased to support her as her local MP. Susan was diagnosed with invasive lobular breast cancer in 2013. It was a one millimetre mark—no lump, no pain. Two mammograms and two ultrasounds told her that there was nothing to worry about. An MRI scan found 2.5 cm and surgery then confirmed 7 cm. That gap between what standard imaging can see and what is actually there is the heart of why lobular breast cancer needs its own research programme. It behaves differently. It is missed because it is different and it is currently treated exactly the same as the most common form of the disease, because the underlying biology has never been properly funded. In May 2023, with her husband Tristan, Susan launched the Lobular Moon Shot Project in Horsham. She built it from nothing into a campaign that has cross-party support in this House, a partnership with the Manchester Breast Centre and a research plan costing £20 million over five years. In June 2025, Susan travelled to Manchester to help launch the scientific programme that she had spent years fighting for. It was a programme that, of course, she knew she would never benefit from herself. Nine days later, Susan died. She never received a reply from No. 10 and never got a chance to make her case to the then Health Secretary. So today, I will again make the case to the Government on behalf of Susan, the 22 patients a day who are diagnosed with lobular breast cancer, and the 463 MPs who have publicly supported her campaign so far, which I believe is the highest number of MPs to publicly support any individual campaign. Every day, 22 women in this country are told that they have lobular breast cancer—that is over 8,000 a year. This is not a rare disease; in fact, it is the sixth most prevalent cancer in women.
I thank the hon. Member for his contribution and I very much agree. I also note that the right hon. Member for Makerfield (Andy Burnham), who is potentially our next Prime Minister, comes from Manchester, has visited the clinic and is already familiar with the campaign, so I am hopeful. As I was saying, lobular breast cancer is the sixth most prevalent cancer in women. That puts it ahead of melanoma cancer, ovarian cancer, brain cancer, kidney cancer and pancreatic cancer combined. Incredibly, there is still no specific treatment. Breast cancer as a whole costs this country over £3 billion a year. It takes around 11,200 lives annually, or the lives of roughly 31 women a day. Many of these are lobular cases, yet lobular breast cancer receives none of the targeted treatment that drives down mortality for other forms of this disease. Every woman who is diagnosed with lobular breast cancer is given the same drugs, the same protocols and the same guidelines as someone with an entirely different cancer. That is because the basic biology of lobular has never been established. It is this gap that the Lobular Moon Shot Project exists to close. We need £20 million over five years, which is just £4 million a year to crack the biology of this disease. That is not speculative research; it is a certain outcome. Other researchers in the UK and around the world can then take things forward to find targeted treatments, because this is a world problem and the world can find the solutions. Of course, there are many demands on Government funding and the national budget is always under pressure, but I think we would be hard pushed to find another project with such a relatively small need for such a big reward. This is a precise unfunded gap, and we already have a delivery partner in the shape of the Manchester Breast Centre, which is ready to begin this work. I will conclude by quoting Susan’s husband, Tristan, who is sitting behind me in the Gallery—it is strange that I have to speak these words rather than him, but that is the procedure of the House. He said: “The last overseas holiday Susan and I took together was to Easter Island, one of the most remote places on earth. Like so many people, I had always imagined the island’s famous stone statues—the moai—looking out across the Pacific Ocean. But when we arrived, we discovered something rather beautiful. Most of them face inland. We were told that they were positioned that way because they watch over their people rather than looking out to sea. Whether that is history, tradition or simply one interpretation, it touched us both deeply. Before we left, Susan found a beautifully carved wooden replica of one of the moai. We brought it home together, and today it sits in our house. Every time I look at it, I think of Susan. It reminds me that although she is no longer physically with me, her love, her courage and everything she stood for remain with me every single day. In my heart, I like to think she is still watching over me, just as those remarkable statues have watched over their people for generations. If Susan could stand in Westminster Hall today, she would not ask Members to remember her. She would instead ask you to remember the thousands of women diagnosed with invasive lobular breast cancer every year who still have no treatments designed specifically for their disease. That is why this debate matters. That is why the Lobular Moon Shot project matters. And that is why Susan’s legacy deserves not only our admiration, but our action. As Susan’s husband, I know she would have been deeply humbled that Members from every corner of this House have come together today to honour her life. She never sought recognition for herself. She simply wanted to leave the world a little safer, a little fairer and a little kinder than she found it. My sincere hope is that history will remember this debate not simply as a tribute to one remarkable woman, but as the day Parliament chose to transform admiration into action for future generations of women diagnosed with invasive lobular breast cancer. That would have been the greatest tribute we could ever have paid to Dr Susan Michaelis.”
I thank all hon. Members here present. Some really powerful points have been made. I particularly thank the Minister for his reply—I find it the most revealing reply of all that I have heard over the past year. Considering it is not even strictly his portfolio, I am very impressed. I hope that he or one of his colleagues will agree to follow up, because he has raised some very interesting points. I would like to consult with colleagues and follow up. We are getting an understanding of the processes within Government for making these decisions. From the outside, it is very frustrating. I cannot tell when the Government are stalling or when they are really doing something. I mean that in general; I am not talking about this particular subject. I have had a number of meetings with completely different Departments this week, as it happens, with Ministers. It is very hard to tell when we are just being fobbed off and when we are actually on a path to a solution. I have been in politics only a couple of years; forgive my naivety. I was very interested to hear what the Minister said and I felt he was more honest. I would really appreciate an opportunity to follow up either with him or his colleagues in the coming days. Finally, I must pay tribute again to Dr Susan Michaelis for all her work. This day is of course the one-year anniversary of her death. I also pay tribute to all the lobular ladies, who are campaigning not just for themselves, but for everybody. This is a worldwide problem; it does not just affect us. I pay tribute to them all and I thank everyone today. Question put and agreed to. Resolved, That this House has considered Government support for the Lobular Moon Shot Project.
I beg to move, That the clause be read a Second time. It is a pleasure to serve with you in the Chair, Dr Huq. The new clause would require the creation of a health data charter, and includes measures to protect data so as to ensure privacy and reasonable usage. Patients should be in control of their data. As we have discussed in previous sittings, we do not think that the Bill goes far enough to provide reassurances in that regard. Everyone agrees with the need for the single patient record, but there is genuine risk—one that I do not think anyone in this room wants—that it could be derailed over very understandable and reasonable data privacy concerns. Sufficient guardrails and transparency are key, especially for secondary uses of health data. As we have discussed on many occasions, trust is essential for the system to succeed. That is why we have tabled this new clause on a health data charter that would set out guiding principles for data sharing across the national health service, including for the single patient record. It would be led by data experts, as well as, importantly, clinicians and patient representatives. Ensuring that the voices of doctors and patients are heard is central to building trust and the widespread use of any data-sharing systems or technologies.
Hon. and right hon. Members on the Committee will understand that we are talking about a single patient record that we do not understand much about yet, because most of the detail will come later. This new clause is attempting to establish what guardrails we would like to see for the protection of patient data when the single patient record is brought into existence There are very genuine concerns about people’s health conditions becoming individually identifiable. If there is an individual in a single postcode with a rare condition, anonymising the data can essentially never happen. That is a genuine concern that people have. I hope that, when we get to Report stage, the Government will be able to give us a little more detail on what safeguards they intend to put in place over the use of that data. To that end, I do not intend to press this new clause to a vote, but I hope that the Government will take into account the concerns we have expressed about building trust and protecting data privacy, and will give us further reassurance at a later stage. I beg to ask leave to withdraw the motion. Clause, by leave, withdrawn. New Clause 11 Directors of public health “After section 7B of the National Health Service Act 2006 insert— ‘7BA Directors of public health Each integrated care board must, for the purposes of exercising any public health functions directed by the Secretary of State, appoint a lead director of public health.’”—(Dr Caroline Johnson.) Brought up, and read the First time.
I beg to move, That the clause be read a Second time.
New clause 12 would require the Secretary of State to publish an annual report about corridor care and to give evidence before a panel of affected patients and staff. In the main Chamber yesterday, we had a Backbench Business debate on corridor care, introduced by the hon. Member for Tooting (Dr Allin-Khan). There was a great deal of consensus across the House about the harm that corridor care causes to both patients and staff, and the requirement for urgency in dealing with that issue. I am not going to remake the same speech that I made yesterday on corridor care for the Minister’s benefit, because she heard it yesterday and there is little value in repeating it. What I will say is that it is important that there is an understanding at a ministerial level of the personal impact that corridor care has on patients and their families. That is the purpose of this new clause: to ensure that the Secretary of State is taking the concerns of patients and staff very seriously, hearing them at first hand and then reporting back progress to the House on dealing with the issue. At the moment, it feels as if every year we acknowledge the problem in the House, every winter there are statements on winter crisis and corridor care, and we never really seem to take any steps forward. The new clause aims to ensure that is no longer the case. New clause 56 is intended to give patients a right to be admitted to accident and emergency “within 12 hours from decision to admit”, and would require the Secretary of State “to introduce a scheme to achieve this.” We have discussed the legal right to admit and the legal right of patients on a number of occasions. I just want to clarify our intention, because it always raises some questions. The NHS constitution enshrines legal rights for certain things: for example, the two-week wait for a cancer referral to a specialist and the right to receive elective care within, I think, 18 weeks, if so referred. The other targets in the NHS are pledges; there is an aspiration for the Secretary of State to meet them, but it is not a right of the patient that the Secretary of State meets them. We think that 12-hour waits on corridors in hospitals merit the same urgency as cancer referrals, because they lead to awful outcomes.
New clause 56 speaks about the importance of creating capacity across the system, including social care, and about having regard to the outcome of Baroness Casey’s commission on social care to deal with the issue of capacity and flow through the hospital. We have discussed at length in Committee other amendments that would deal with the front door, in terms of GP access and trying to ensure that people are treated at first in the community, rather than ending up in A&E as a last resort. I wonder if the right hon. Gentleman would just acknowledge those points.
I will speak briefly to new clauses 12 and 56, about which we had quite a long debate this morning. Let me respond to a couple of questions. The shadow Minister asked about the role of Healthwatch in selecting the panel that would interrogate the Secretary of State, as we envisage in new clause 12, given that Healthwatch will be abolished by the Bill. She also asked about new clause 56, which would require the Secretary of State to have due regard to Baroness Casey’s final report. The shadow Minister said that those things are essentially inconsistent, but, considered as a suite of amendments, the provisions we have tabled are consistent. We oppose the abolition of Healthwatch; had that been successful, Healthwatch would still be there. We have also tabled new clause 60, which we will get to later and which would require Baroness Casey’s commission to report much more quickly. That is why that apparent inconsistency exists; I hope I have sorted that out for the shadow Minister. The right hon. Member for Melton and Syston, a former Minister, talked about capacity in the system as a whole and its impact on corridor care. His concern was that if we focus on corridor care, we will end up with more people being treated in ambulances, have longer ambulance handover times and very long ambulance wait times. He will know, having been the responding Minister to my first Adjournment debate, that ambulance wait times have been a significant problem where I live. I am pleased to say that they are becoming less of a problem, because the new management of the hospital have focused relentlessly on the A&E department and on ensuring that ambulance patients can be taken into it very quickly, or certainly much more quickly than they used to be. I recognise his concern, but I think it is a manageable one.
I think our new clause addresses that point. As I mentioned, my own hospital trust, Shrewsbury and Telford, has improved ambulance wait times simply by improving the flow through the hospital and addressing some of the issues. I recognise that our new clause does not deal with pharmacy availability at weekends and overnight, which I know is a critical issue in many hospitals; on Report, we will certainly tidy it up to ensure that it does, but I take the hon. Member’s point. My new clause would address the system-wide capacity issue that the hon. Member highlighted so carefully, both in last night’s debate and here today. We need more capacity across the whole system. Otherwise, we are just trying to push a lump in the carpet to a different place, but there will always be a lump somewhere. The new clause seeks to provide 6,000 more beds across the whole system, to allow flow through the system and to ensure that waits do not back up in the ambulance service, on corridors in A&E or outside wards, as they do currently. Critically, we should address the point about NHS pledges and rights. The constitution is broadly agnostic about the time people wait on corridors, but is not agnostic about the time it will take for them to get cancer treatment. That is an inconsistency and we should sort it out, because I think our constituents consider the two things equally important. I take the Minister’s point about new clause 12. I will not push it to a vote, but although trusts are held to account on their A&E performance, the missing piece is that the Secretary of State is not. That is what new clause 12 seeks to address, and I hope that the Minister will consider that on Report. I beg to ask leave to withdraw the motion. Clause, by leave, withdrawn. New Clause 14 Healthy life expectancy target “(1) Within six months of the passage of this Act, the Secretary of State must— (a) make regulations to set a statutory target for improving overall healthy life expectancy for the population of Great Britain, and (b) publish a cross-governmental strategy, renewed every 24 months, to set out how the target set by regulations under subsection (1)(a) will be achieved. (2) The strategy under subsection (1)(b) must be laid before both Houses of Parliament. (3) Upon publication of a strategy under subsection (1)(b) the Secretary of State must make a statement before the House of Commons regarding progress made towards the target set by subsection (1)(a).”—(Dr Chambers.) This new clause would require the Secretary of State to make regulations to establish a statutory target for healthy life expectancy in Great Britain and publish a strategy every two years setting out how this target will be achieved. Brought up, and read the First time.
The disquiet about the deal comes from the fact that the sums involved are huge—possibly £9 billion a year, or even more towards the back of the 10-year period—according to big companies in the sector. The Association of the British Pharmaceutical Industry was not involved in the negotiation of the deal; it was negotiated with the US. We fully support of the life sciences sector in this country, and there is a complex debate to be had about access to novel medicines for people with unusual and rare diseases, and about balancing that with everybody else’s access to volume services on the frontline, but that important discussion should be had by Parliament and the British people, not between a trade negotiator and Donald Trump’s White House. That is where our disquiet comes from, and it is why we tabled these new clauses.
It is an absolute pleasure to serve under your chairship, Mrs Hobhouse. I thank my hon. Friend the Member for Horsham (John Milne) for leading this important debate on Government support for the Lobular Moon Shot Project. On the first anniversary of her death, I want to pay tribute to Dr Susan Michaelis and her tireless campaigning. Today’s debate celebrates a legacy that continues to inspire researchers, clinicians, patients and parliamentarians alike. While the debate is about her story with lobular breast cancer, I would like to focus on what made her Susan. Although Susan was known for her campaigning on lobular breast cancer, she was so much more than that—something her loved ones, who are here today, know all too well. Susan was an Australian who grew up in Melbourne before moving to the UK in 2003. As a child, she had dreams of becoming a pilot, but because of the lack of women in the industry at the time she settled on working in the travel industry instead. However, she soon realised that she really did want to become a pilot, so she set about becoming a qualified commercial pilot. Her dream came true and she trailblazed as the co-pilot on the first all-female crewed flight for the Qantas Group. Susan also obtained a PhD at the University of New South Wales in Sydney in 2010. Her thesis was titled “Health and Flight Safety Implications from Exposure to Contaminated Air in Aircraft”. She was a researcher who devoted her career to improving public health and aviation safety, and her contributions towards aircraft cabin air contamination remain recognised today. In 2007, Susan and her husband raised concerns with the world’s leading jet engine oil manufacturers about crew and passenger exposure to engine oil decomposition products. While most ignored the issue, the French company NYCO investigated and confirmed that the fuel additives affected gene expression. As a result, NYCO developed a new, less hazardous jet engine oil, NYCO 940 SE. The oil received SAE approval in 2023 and US military approval for use in all NATO aircrafts in 2024. However, her legacy undoubtedly remains the Lobular Moon Shot Project and the change that she championed while knowing that she would not live to reap the benefits. Susan was diagnosed with lobular breast cancer in 2013 after a small 1 mm mark was noticed on her left breast. She had no lumps and had experienced no pain. Two mammograms and two ultrasound scans showed no cause for concern. However, an MRI scan suggested the presence of a 2.5 cm area of lobular breast cancer, which was later confirmed by a biopsy. Susan underwent a double mastectomy, and post-operative pathology revealed that the cancer actually measured 7 cm. That was much larger than what had initially been detected and was missed entirely by mammograms and ultrasounds. Had Susan been given regular MRI scans in the last 10 years before her diagnosis, her lobular breast cancer would have been detected much earlier. For all cancers, early diagnosis and effective treatment is essential to increase survival. Susan’s story tragically highlights how those challenges continue to be experienced by the millions of patients living with lobular breast cancer. Current NHS imaging techniques can fail to detect the disease accurately, which often leads to diagnosis at a later and more advanced stage. Unlike other breast cancers, lobular breast cancer tends to spread out in straight lines rather than amassing to form a firm lump. A patient is more likely to have a thickened area of breast tissue as a symptom, rather than the expected lump. That is what makes lobular breast cancer so difficult to detect during a physical examination, and when using imaging scans, such as mammograms and ultrasounds. Research indicates that MRIs, which can produce detailed images of the inside of the breast, offer improved detection and characterisation of lobular breast cancer. If Susan had been given a regular MRI scan in the 10 years prior to her diagnosis, there is a very real chance that her cancer would have been detected sooner. That would have reduced the risk of it metastasising and ultimately claiming her life. Susan also only received generic breast cancer treatments as there is currently no specialised treatment for lobular breast cancer. Susan underwent eight systemic treatments over the span of 12 years. That led to the lobular breast cancer spreading to her spine in 2021. A PET-CT scan was unable to detect the disease progression, but once again, it was detected on an MRI scan—something that is not available on the NHS. Lobular breast cancer accounts for one in seven—or 15%—of all new breast cancer diagnoses. It is the second most common sub-type of breast cancer. There are approximately 8,400 lobular breast cancer diagnoses in the UK each year. That amounts to 22 people being diagnosed every single day. More women are impacted by lobular breast cancer than cancers of the kidney, brain, pancreas, liver or ovaries. The impact of any cancer for both the patient and their loved ones is always devastating, and lobular breast cancer is no exception. We must better our understanding of this disease to improve treatment and outcomes for all those affected. It is unacceptable that this cancer has no specific treatments and is treated in the same way as the more common types of invasive cancer. The Lobular Moon Shot Project, created in May 2023 in Horsham by Susan alongside her husband, is striving to change that. The campaign is asking for the Government to invest £20 million over five years to understand the biology of the disease to enable targeted treatments. Alongside all my Liberal Democrat colleagues, I wholeheartedly support and will continue to support this very important project. The Liberal Democrats were the first major party to fully endorse this campaign. My right hon. Friend the Member for Kingston and Surbiton (Ed Davey) has written to both the Prime Minister and the former Health Secretary on Susan’s behalf, and our Chief Whip, my hon. Friend the Member for North East Fife (Wendy Chamberlain), has repeatedly raised this issue in the Chamber. Support for the Lobular Moon Shot Project has grown to 465 Members of Parliament, making it the most widely supported health campaign in Parliament. On 15 July 2025, the then Health Secretary, the right hon. Member for Ilford North (Wes Streeting), stated that he had instructed his chief scientific adviser to plan a path forward to understand the biology behind this cancer to make a difference to those affected. One year on, and with a new Health Secretary, this research project has still not got the green light. We cannot allow this to fall through the cracks. I urge the Minister and all Members here today, regardless of their party, to continue to advocate on this issue. Alongside supporting the work of the Lobular Moon Shot Project, the Liberal Democrats are clear: cancer must be a top priority for any Government, and the UK should be a global leader in cancer research and outcomes. The Liberal Democrats would introduce a guarantee that 100% of patients would be able to start treatment within 62 days from urgent referral. The Liberal Democrats would also recruit more cancer nurses so that every patient has a dedicated specialist supporting them throughout their treatment. To end, I once again want to honour the legacy of Dr Susan Michaelis and her Lobular Moon Shot Project. The contributions made here today show the continuing impact of her legacy, which inspires me, and everyone in the room and beyond. I once again ask the Minister to play his part in ensuring that Susan’s legacy continues for her and all those who have been and continue to be impacted by lobular breast cancer. Will he today commit to finding the £20 million to fund the research so that more people survive lobular breast cancer?
Thankfully, the Minister has clarified some of the issues that I was going to ask about. He says the Government are not necessarily looking to ringfence the £20 million, but are waiting for applications for research. The Lobular Moon Shot Project has already put forward some ideas on research. He has said that he stands ready to support the project, so I would just like some more specific detail. He says that we are waiting for applications for research, but does not what the Lobular Moon Shot Project has submitted or talked about fall within that?
I beg to move, That the clause be read a Second time.
New clause 14 is about healthy life expectancy. It would require the Secretary of State to make regulations to establish a statutory target for healthy life expectancy in Great Britain and publish a strategy every two years, setting out how the target would be achieved. New clause 79 would establish a public health committee and health creation unit to promote public health and cross-Government policymaking. New clause 80 would place a duty on all Ministers to consider health outcomes and the promotion of public health when exercising their duties. All three new clauses are closely related. Over the last 100 years, life expectancy in the UK has been increasing for a variety of reasons, including vaccination, improved hygiene and medical advances, but worryingly, between 2022 and 2024, it decreased by 1.8 years for men and 2.5 years for women. That is the first time it has decreased in a while. There is an 11.1-year gap between the highest and lowest life expectancies, which is partly due to demographics and different socioeconomic situations. Socioeconomic disparity is causing a very significant difference in life expectancy. We need wider whole-of-Government working to address the root cause of and contributing factors to ill health. DHSC, the NHS and social care deal with too much in silos, which is a problem across the whole of Government. There is too much siloed working. All Departments should be working with at least one eye on the health of the nation. That is what our new clauses seek to foster. A healthy life expectancy target would provide the basic metric for that aspiration, forcing wider thinking on prevention and ill health, rather than on waiting lists and hospital performance, as important as they are. New clause 80 would place a duty on all Ministers to consider health outcomes and the promotion of public health when exercising their duties. That should aim to focus the minds of non-DHSC Government Departments that have a central role to play in the promotion of good health and longevity, whether that be housing standards or environmental regulations. We included health protection—areas such as clean water, for instance—as well as health promotion, which includes areas such as active travel. New clause 79 would create a public health committee and a health creation unit to support its work, especially between Departments. This is an idea originally introduced under the coalition Government, designed to tackle obesity, alcohol abuse and other public health problems. Although we recognise that it was not perfect, given the Tories’ lack of engagement and spotty attendance, the desire to foster cross-Government thinking was definitely right.
Yes, I sat on the Tobacco and Vapes Bill Committee for six weeks, going through the legislation line by line. One of the most interesting things about that Bill is not only that it will improve public health and life expectancy, but that it is probably one of the single most impactful pieces of legislation in terms of improving inequality and especially socioeconomic health outcomes. So many of the disparities in life expectancy between wealthy people and those living in relative poverty are due to levels of smoking—it is not just smoking, but that is a significant factor. It is good of the hon. Gentleman to highlight that. During the coalition, the Tories recognised that the approach I described would send a powerful message that public health is the responsibility of all Government Departments. When it was scrapped, the then shadow Health Secretary, the right hon. Member for Makerfield (Andy Burnham), said that we could tackle Britain’s looming obesity crisis only if all Government Departments pulled together. We completely agree with that statement. New clause 79 tries to address some of the issues that occurred back then, including by placing requirements on ministerial attendance and giving the Liaison Committee oversight to drive accountability. I am sure the Minister will agree that greater cross-Government working is needed. What are the Department’s plans to support that? If we want to tackle the various public health crises facing our country, we cannot do so without proper cross-Government working. In my professional life, I was made an honorary lecturer at Bristol University veterinary school in the area of One Health, recognising that animal health, human health and environmental health are completely interlinked. It is difficult to improve one without looking at the factors that improve the others, and we need that kind of approach throughout all Government Departments.
I pay tribute to the Royal Army Veterinary Corps. It does good work in trying to eradicate rabies in countries with street dogs, as part of hearts-and-minds engagement. We can work public health into pretty much any Department.
Just to blow my own trumpet, my greatest academic achievement was getting correspondence published in Nature on the impact of conflict on antimicrobial resistance. It might interest Members to know that, in Ukraine, 80% of wounds have novel bacteria that are displaying multi-drug resistance, which has become a limiting factor in getting soldiers back on to the frontline. We are trying to reframe issues such as antimicrobial resistance as national security and defence issues, rather than purely public health issues.
I thank all Members for their contributions to the discussion. The hon. Member for Lichfield made the good point that a committee of 70 people may not be that efficient. He should come to the Lib Dem parliamentary party meetings, which are incredibly efficient. We have incredibly insightful discussions, which is what makes us such an effective force, so I would not knock a committee of 70 people. I appreciate the Minister’s acknowledgment of the important of cross-party work for public health. I beg to ask leave to withdraw the motion. Clause, by leave, withdrawn. New Clause 15 Impact of trade deals on the NHS “(1) Any trade negotiation which would require NHS spending or funding to exceed £100 million must be laid before Parliament by the Secretary of State in the form of regulations subject to the affirmative procedure. (2) Before laying regulations under subsection (1) the Secretary of State must publish an impact assessment about how the trade negotiation will affect NHS frontline services and patients.”—(Dr Chambers.) This new clause would require any trade negotiation which would require NHS spending or funding to exceed £100 million to be laid before Parliament by the Secretary of State in the form of regulations subject to the affirmative procedure. Brought up, and read the First time.
I beg to move, That the clause be read a Second time.
New clause 15 would require that the Secretary of State lay before Parliament any trade negotiation requiring NHS spending or funding exceeding £100 million, in the form of regulations subject to the affirmative procedure. New clause 76 would require that the arrangement between the United States and the United Kingdom on pharmaceutical pricing be laid before the House to be voted on. The Institute for Fiscal Studies has indicated that, by 2036, the UK-US pharmaceuticals deal will have cost as much as £9 billion. That money could be transformative for the NHS. It could be put towards ending corridor care, as the Committee discussed earlier, or towards hiring thousands of ward staff, buying countless radiotherapy machines and starting to deliver high-quality care and help at home for the elderly and disabled. To make matters worse, Trump’s ambassador hauled in the head of the National Institute for Health and Care Excellence—the expert independent body that considers value for money in the NHS—to rebuke him over his opposition to the deal. It is utterly outrageous that a British public servant has been dressed down by a foreign regime for putting the interests of British patients and the British taxpayer first. It is crazy that billions of pounds of NHS funding is being spent to placate Trump, at the expense of the patient wellbeing. We want to support the British life sciences sector. That should be a domestic matter for the UK Government to address holistically, through negotiations with the sector; it should not be dictated from Washington. Hiking payments for medicine is the wrong approach for patients who badly need investment in frontline staff, hospitals and equipment. The lack of transparency over the full cost has already created great uncertainty in the sector, and it is astonishing that such a major decision will be made without the say of the British people via a vote in Parliament. The Government refused even to publish an assessment of the impact of the deal, which has raised suspicion and caused some to think that something is being hidden. Through the people who elected us, this House—not the White House—decides on matters of national importance. The Liberal Democrats have tabled these new clauses to allow the House to have a proper vote on the deal.
I thank the Minister for her comments. It is good to hear cross-party recognition of how important the life sciences sector is in the UK, to universities and businesses as knowledge transfer partnerships. This is a huge opportunity not only to improve the health of the nation and the treatments available, but to boost the economy. We will withdraw new clause 15, but I thought the hon. Member for Isle of Wight East spoke extremely well about his concerns relating to the trade deal.
I appreciate that. Just to reiterate, I am talking specifically about the trade deal with the United States, not about every single trade deal. We completely accept that primary legislation is not necessarily the best way to scrutinise a trade deal, but given the lack of options at the moment, we must use every political mechanism available to create transparency.
I am grateful to the shadow Minister for that intervention. Unless something changes significantly by the time we get to vote on new clause 76, which I understand will not be today, we will press it to a vote for transparency’s sake, but we will withdraw new clause 15. I beg to ask leave to withdraw the clause. Clause, by leave, withdrawn. New Clause 16 Duty to promote the health and wellbeing of carers “After section 14Z44 of the NHS Act 2006 insert— ‘Duty to promote the health and wellbeing of carers (1) Each integrated care board must exercise its functions with a view to improving and maintaining the physical health, mental health, and wellbeing of carers within its area. (2) In exercising its duties under this section, an integrated care board must have regard to— (a) reduction of health inequalities experienced by carers, (b) prevention of deterioration in carers’ physical and/or mental health, (c) involvement of carers in decisions relating to the care of persons for whom they provide care, and (d) the need to ensure carers are able to access appropriate preventative and other health services and support. (3) An integrated care board must take reasonable steps to ensure that NHS bodies and providers of NHS services within its area— (a) consider the health and wellbeing needs of carers in care planning and discharge processes, (b) involve carers appropriately in decisions relating to care and treatment, and (c) provide carers with information about support available to them for their health and wellbeing. (4) In preparing a Joint Forward Plan, an integrated care board must include— (a) an assessment of the health and wellbeing needs of carers within its area, (b) steps the integrated care board proposes to take to improve outcomes for carers, and (c) measures for reducing inequalities experienced by carers. (5) In this section, “carer” has the meaning given by section 10 of the Care Act 2014 and includes a young carer within the meaning of section 96 of the Children and Families Act 2014.’”—(Dr Chambers.) This new clause would introduce a duty for integrated care boards to promote the health and wellbeing of carers. Brought up, and read the First time.
I beg to move, That the clause be read a Second time.
I will speak to new clauses 16, 17 and 18 together. They relate to the duty on integrated care boards to promote the health and wellbeing of carers. Certainly, as the Liberal Democrat spokesperson for mental health, and having been a carer myself—like many people in this room—I have a particular interest in the mental health of carers. Sometimes we forget that, as well as the patient, the carer also needs a huge amount of support, as what they do can be very draining. Unpaid carers are essential to the sustainability of the NHS and social care system, but carers consistently experience poorer physical and mental health outcomes than non-carers, and frequently struggle to access support for their own health needs. There are approximately 4.7 million unpaid carers in England. They provide support valued at an estimated £152 billion annually—equivalent to the annual NHS budget. Evidence consistently shows that unpaid carers experience worse health outcomes than non-carers. The GP patient survey 2025 showed that 72% of carers report a long-term condition or disability compared with 61% of non-carers. The Office for National Statistics reports that one in four adults providing unpaid care described being in “not good health”, compared with one in five adults who are not providing unpaid care. The probability of reporting being in “not good health” was higher for people providing more hours of unpaid care. Some 49% of unpaid carers reported at least one adverse health effect from providing that care. Low mental wellbeing was more common among unpaid carers, at about 20%, than among those not providing unpaid care, at 15%. An academic study analysing GP patient survey data found that, for those caring for more than 50 hours a week, the health impact of being a carer is equivalent to losing 18 days of full health every year. A study has also found that carers cancel medical treatments and appointments because nobody is available to step into their caring role, and that, because of their caring responsibilities, carers cannot find appointments at times when they can attend. A more targeted approach to support unpaid carers could help to prevent the onset of deteriorating carer health and wellbeing as a result of their caring roles. Although ICBs have broad duties relating to population health and inequalities, there is currently no explicit statutory duty requiring ICBs to improve the health and wellbeing of unpaid carers specifically.
I thank Committee members for their contributions. The hon. Member for Isle of Wight East spoke particularly well and emotively—I know that he worked for Dementia UK before entering Parliament. My mother was a carer for my father, who had dementia, and my sister and I gave her respite care, although probably not enough of it. I know that many Committee members will have been in a similar situation, as it is a common disease, and it is becoming increasingly common. I also thank the Minister for her comments and reassurance. The hon. Member for Bury St Edmunds and Stowmarket made a point about children being carers. I sat on the Mental Health Bill Committee last year, and to give an example of how impactful such Committees can be, it is now a requirement, as a result of the Committee’s consideration, to identify whether mental health patients have children who are carers. That was not the case before, and we appreciated the Government engaging with us on that issue. It is often teenagers who care for adults with severe mental health issues, but they were not even identified before, so they could not be given the support they required. That has changed now, and it is fantastic to see that, through Committee scrutiny, we can make a tangible difference to people’s lives. I will not press new clauses 16 and 17 to votes, but the Liberal Democrats do think that it would be sensible and impactful to establish a national respite care scheme, so I will press new clause 18 to a Division. On new clause 16, I beg to ask leave to withdraw the motion. Clause, by leave, withdrawn. New Clause 18 National Respite Care Scheme “(1) Within six months of the passage of this Act, the Secretary of State must establish a National Respite Care Scheme. (2) The scheme under subsection (1) must make provision for— (a) a local authority carrying out a carer’s assessment under section 10 of the Care Act 2014 to be required to consider whether a carer is able to take sufficient breaks from their caring responsibilities. (b) unpaid carers to receive support to take breaks from their caring responsibilities to— (i) maintain their physical and mental health and emotional wellbeing, (ii) participate in work, education, training or recreation, and (iii) participate in family and community life. (c) a carer to receive appropriate support if a local authority carrying out an assessment under subsection (2)(a) determines that a carer is unable to take sufficient breaks from caring. (3) Under subsection (2), ‘support’ may include— (a) replacement care for the cared-for person; (b) respite services; (c) any other steps a local authority considers appropriate as support. (4) The Secretary of State must provide sufficient support to local authorities to ensure the scheme under subsection (1) is delivered in every local authority. (5) For the purposes of this section ‘unpaid carer’ has the meaning given by section 10 of the Care Act 2014 and includes a young carer within the meaning of section 96 of the Children and Families Act 2014.”—(Dr Chambers.) This new clause would require the Secretary of State to establish a National Respite Care Scheme. Brought up, and read the First time. Question put, That the clause be read a Second time.
I beg to move, That the clause be read a Second time. New clause 28, tabled in the name of the Chair of the Health and Social Care Committee, my hon. Friend the Member for Oxford West and Abingdon, extends the powers of the first-tier tribunal so that, when it determines an appeal, it may order that education, health and care plans must include health and social care needs and provision, rather than just making recommendations on those matters. I am sure all Members are probably in a similar situation in that EHCPs, in their various forms, are one of the main reasons we get contacted by constituents; they certainly fill up my inbox. Following the Education Committee’s report, “Solving the SEND Crisis”, which identified significant gaps in accountability and engagement from the DHSC and health services in the special educational needs and disabilities—or SEND—system, the Health and Social Care Committee held a one-off evidence session to build on those findings, looking at the delivery of the health aspects of EHCPs. The Health and Social Care Committee followed up a recommendation that the Education Committee had made that the powers of the SEND tribunal service should be extended to allow it to issue binding recommendations to health services, not just education providers. SEND tribunals are independent national tribunals that decide appeals against local authority decisions about the special educational needs of children and young people, including decisions made about an EHCP. Currently, they can make binding recommendations in relation to education provision, but not in relation to health and social care needs. The Education Committee argued: “This would ensure that when a failure to deliver a health provision specified in an EHC plan occurs, health bodies are legally obligated to take corrective action.” When the Health and Social Care Committee raised that with witnesses in its evidence session, several were supportive of placing this duty in legislation, although they noted that it would require other reforms to workforce and commissioning arrangements to be successful. New clause 28 would provide a level playing field between education bodies and ICBs, so that ICBs are also under a legal obligation to comply with recommendations from SEND tribunals.
I thank everyone for their comments. I thank the Minister for her reassurances on the seriousness of this issue. Given that we are waiting for the response to the report, I beg to ask leave to withdraw the motion. Clause, by leave, withdrawn. Ordered, That further consideration be now adjourned.—(Emma Foody.)
I welcome the Secretary of State’s mentioning an update to the Veterinary Surgeons Act 1966; after 60 years, it is much needed to make the Act fit for purpose to regulate new business structures and paraprofessionals such as physios, and to protect the title of veterinary nurse. Could we have an assurance that, with the change of Administration, the update will remain a priority and will not be kicked into the long grass? It is much needed right now.
It is well recognised that people who inflict deliberate pain, injury or violence on animals are more likely to be involved in domestic abuse, yet if someone is prosecuted for deliberately injuring an animal, they are prosecuted under animal welfare laws, meaning that their conviction is unlikely to show up under the domestic abuse disclosure scheme. Will the Minister look at how we can change the recording of such offences, so that people who deliberately harm animals are likely to be reported as being at risk of committing domestic abuse against people?
It is a pleasure to serve under your chairship, Mrs Hobhouse. I thank my hon. Friend the Member for Horsham (John Milne) for securing this important debate. I pay tribute to everyone who has campaigned tirelessly on this issue. When I met the Lobular Moon Shot Project team in April, their determination to improve outcomes for patients was unmistakeable. The debate is also an opportunity to remember Dr Susan Michaelis on the first anniversary of her passing. After being diagnosed with invasive lobular breast cancer in 2011, Susan devoted her final years to advancing research into this awful disease. In 2023, she founded the Lobular Moon Shot Project, and in December 2024, many colleagues and I spoke in a Westminster Hall debate to echo the project’s call for greater investment in lobular breast cancer research. I hope that the Minister this afternoon will be able to give us some idea of whether the Government listened to us all those months ago and whether they are listening today, because very little appears to have changed. Invasive lobular breast cancer is the second most common type of breast cancer, with between 7,500 and 8,000 people diagnosed every year in the UK. That is around 22 women every day. Despite accounting for around one in seven breast cancer diagnoses, this form of the disease remains under-researched with no specifically designed treatment. As a result, patients are often treated with therapies known to be less effective for lobular tumours, increasing the risk of metastatic disease, greater toxicity and poorer outcomes. That is not inevitable. With targeted research, outcomes can improve. The Lobular Moon Shot Project is calling for £20 million over five years to fund lobular-specific research. In the grand scheme of things, £20 million over five years is not a lot of money, and that investment would deepen understanding of the disease, support the development of targeted therapies, and improve diagnosis and treatment for thousands of patients. Without it, progress will remain far too slow. The project estimates that 3.75 million people worldwide will be diagnosed with invasive lobular breast cancer over the next decade, making need for action so very urgent. The investment also represents good value. Modelling by the Lobular Moon Shot Project suggests that preventing or delaying metastasis in even a relatively small number of patients would more than offset the proposed £20 million investment through reduced treatment costs. I know that many across the cancer community are eagerly awaiting the Government’s workforce plan. Can the Minister update the House on when it might be published? In closing, I urge the Government to support the Lobular Moon Shot Project and commit £20 million to improve research, diagnosis and treatment for invasive lobular breast cancer. I also once again pay tribute to Dr Susan Michaelis, without whose tireless campaigning, I doubt we would be here today debating this issue or pressing for the change that so many patients and families deserve.
In 2025, sewage was dumped into the Ashridge stream, Emm brook, Barkham brook and the River Loddon in my constituency. Residents are thoroughly fed up with Thames Water’s repeated pollution and lack of accountability. Will the Government introduce mutual ownership of water companies, professionally managed, to put customers and the environment first?
Too many abusers escape justice in court, leaving victims, including my constituents, without proper justice. In May, I called for the mandatory involvement of independent domestic violence advisers in the family court process. In response, the Under-Secretary of State for Justice, the hon. Member for Derby North (Catherine Atkinson), said: “It cannot be warm words; there needs to be action.”——[Official Report, 21 May 2026; Vol. 786, c. 37WH.] What steps have the Government taken to make independent domestic advisers mandatory in family courts, to help deliver justice?
I congratulate the Government on recognising the state of Palestine. That recognition was long overdue, but a state needs territory, and its citizens need safety and security. The state of Palestine and its citizens do not have either. Gaza has been devastated by Prime Minister Netanyahu’s military action, which has widely been called out as genocide. Many of Gaza’s residents have been killed or injured, and the survivors have lost family and friends, homes, health services, businesses and jobs. Meanwhile, in East Jerusalem and on the west bank, so-called settlers, who are better described as terrorists, are threatening, injuring and even killing people to take Palestinian land. The Israeli Government take no action to prevent this; indeed, they openly encourage the settlements. Members of the Israeli Security Cabinet have even stated that their goal is to make a sovereign Palestine unviable. We have to prevent that, because a two-state solution is the only way to achieve peace in that part of the world. The Government have confirmed that the settlements are illegal, so now they have to go further. Like many Members here today, I have had reams and reams of emails about this issue, and my constituents have called on me to ask the Government to take more action. As well as using diplomacy, which I am sure we are doing, we must make the settlements economically unviable, so I call on the Minister to ban all trade in goods and services with these illegal Israeli settlements.
Iran is continuing to hold the global economy to ransom through its reckless strikes in the strait of Hormuz—we all agree on that. Meanwhile, Donald Trump’s continuing tit-for-tat retaliations risk dragging the whole region back into a full-blown conflict. This would threaten the lives of citizens across the middle east, while heaping even more economic harm on millions of British people already struggling with the spiralling cost of living. Donald Trump has claimed that the war has been a huge success, but in reality it has been a costly humiliation for the President. Will the Minister confirm what steps the Department is taking to get both sides back to the negotiating table? Are we working with our reliable allies to secure a diplomatic resolution? Will the Minister also update the House on the status and health of Craig and Lindsay Foreman, who are still imprisoned in Iran? Will the Minister recognise their detention as arbitrary and will he refer the case to the International Court of Justice? Will the Minister confirm that after the National Security (State Threats) Bill was passed yesterday, the Government will move immediately to proscribe the Islamic Revolutionary Guard Corps, the exporter of Iranian terror?
On behalf of my hon. Friend the Member for Bicester and Woodstock (Calum Miller), I thank the Secretary of State for advance sight of her statement. As we have come to expect of all major international summits, NATO’s meeting in Ankara was taken over entirely by Donald Trump’s tantrums and threats. He restated his claim that Greenland should become American, threatened the withdrawal of all remaining US troops from Europe, and once again lambasted allies for not joining his and Netanyahu’s calamitous war in Iran, which has upended the world economy and worsened a spiralling cost of living crisis for millions across Britain. That is no way to conduct international diplomacy. Did the Prime Minister make it clear to Donald Trump that his threats against Greenland are totally unacceptable? However, there were some positive moments from the summit. NATO allies reaffirmed support for Ukraine, and the Prime Minister announced plans for the development of a new deep strike capability with our European partners. Will the Secretary of State outline how exactly the UK will provide its share of the £37 billion of funding for that capability? Even before that new commitment, as has been pointed out, the Government’s own defence investment plan delivered only just over half of what military chiefs deem necessary for our national defence. Together with the Secretary of State’s colleagues in the Ministry of Defence, will she consider how defence bonds could be used rapidly to support the UK’s contribution to that initiative, bolster the confidence of our allies and send a clear signal to our adversaries? Have these plans been drawn up together with the Ukrainians? They have shown with incredible effect how deep strike capability can be developed fast and much, much more cheaply than £37 billion. On defence funding, the Prime Minister discussed the possibility of collective financing and procurement models as a critical way to generate cheaper loans for military programmes and support greater interoperability. Will the Secretary of State update the House on whether any progress was made at the summit to bring together the existing Defence, Security and Resilience Bank and our own multilateral defence mechanism into a single European rearmament bank? Finally, the Secretary of State mentions El Obeid in Sudan and the thousands of lives at risk. The UK has the power to act, so will she proscribe the RSF, as has just been done with the IRGC? Will she suspend all UK arms sales to the UAE, given its role in arming the RSF?