Showing every spoken contribution, including 5,578 under 12 words. Hide short remarks
My hon. Friend refers to significant penalties. Ofcom has levied fines over the past few years, but that is clearly not leading to improvements in the service. Does my hon. Friend agree that it feels as though Royal Mail is treating these fines as part of the cost of doing business, and seeing it as cheaper to pay the fine than to address the problem?
It has been an incredibly hard few months for Cleveland. Local people are not interested in point scoring, but they do want answers. Cleveland has the highest recorded crime rate in the country, yet the latest Home Office data reveals that it has 17 fewer police officers than it had a year ago. Can the Minister explain why?
Illegal car cruising is a real blight on communities, causing noise pollution and terrifying local communities, including pedestrians and legal road users alike, on private and public roads. Will the Minister look again at the legislation to see whether this particular crime—it is a crime—can be penalised in a different way? At the moment, the generic legislation for antisocial behaviour is not catching enough people and is not a deterrent.
Let us not sugar-coat this: the contract has been a complete flop. Yes, it was awarded under a past Government, but now it is under the current Government—but of course the Prime Minister is setting the standard of not playing the blame game, although I have heard a lot of that today. What my constituents want to hear is when this will be sorted out. Ministers have talked about a recovery plan in April—fail. They talked about a recovery plan in June—fail. They talked about a recovery plan in September —fail. There has been failure after failure after failure. Will the Minister answer the question put by my hon. <span id="41" class="column-number" data-column-number="41"></span>Friend the Member for Kingswinford and South Staffordshire (Mike Wood), and tell us whether Capita will be given any other Government contracts? Will my constituents be compensated? This Government wanted to be in government, so now that they are, may I ask when the Minister and the Government will take responsibility for this, take control of the contract, and get it sorted out, because my constituents are suffering?
I thank the Minister for advance sight of the statement. Over the weekend, we heard yet another policy announcement made through the media, with the Prime Minister taking time out of his very busy reality TV schedule to brief the press that he will apparently end rough sleeping by Christmas. That is a laudable aim, which I think will be shared across the House by parties of all colours—I am sure everyone in this country wants to see rough sleeping fixed as an issue once and for all—but the pledge reminds me of a similar one, made almost a decade ago, in 2017, by the then Mayor of Greater Manchester, to end rough sleeping in that city region by 2020. Again, it was a nice idea, sold in a nice, upbeat way, but sadly it did not reflect the reality. Rough sleeping still exists in Greater Manchester; in fact, the numbers have risen from 2021, and the rate even doubled in 2025-26. The Prime Minister may be in his new job—and perhaps he took inspiration from another reality TV programme, “The Traitors”, to kick out his predecessor with the help of his new Chancellor—but the Labour party is not new in government. It has been in charge now for well over two years, exactly the same period during which rough sleeping has continued to rise in Greater Manchester. The Prime Minister asked us to judge him on his record as the Mayor of Greater Manchester, so that is precisely what we are doing. Failure in Manchester is one thing, but on a national scale the numbers are even bigger. So far, the Prime Minister has said that he will put another £432 million of taxpayers’ cash towards this approach, bringing the total commitment to £874 million. The Government themselves estimate that there are around 4,000 rough sleepers on an average night, which means the policy will cost in the region of £200,000 per rough sleeper. Will the Minister confirm that and tell us where all the money will go? At the same time, the Prime Minister refuses to rule out tax rises or to upset his left-wing Back Benchers by cutting benefits, so the Government need to be honest about where all this money will come from. He has talked about bringing hope, he talks about positivity, and we all know his fondness for “good vibes”, but what really matters is the delivery and the detail. In the past, the Prime Minister has failed to deliver on this issue precisely. He talked a good talk, he made the grand promises, <span id="54" class="column-number" data-column-number="54"></span>but he could not keep them on rough sleeping. We see this time and again from Labour Members, because they believe they can solve a problem just by throwing more money at it, as if money grows on a magic money tree. They need to accept that it is not their money; it is taxpayers’ money—taxpayers who are increasingly being squeezed for all that they have; taxpayers who deserve to know where their hard-earned cash is being spent and that it is being spent wisely. I am sorry, but taxpayers are being completely let down by this Labour Government. The deficit is out of control, and rather than making the necessary cuts, they are coming back with even more spending commitments. We have a Budget later this week, and the Conservative party has been clear that the Chancellor must use it as an opportunity to properly deliver for working people across the United Kingdom. The benefits bill has to be cut, the tax burden needs to be eased on businesses and workers, and the net zero nonsense that makes our electricity and heating more expensive has to go. Of course, all of us on this side of the House want to see rough sleeping ended, but that will only be achieved through action, not through empty promises made by a Prime Minister with a track record of failure on this issue. We need to see delivery. When this Labour Government pledge to deliver, they fail to deliver. Perhaps the Minister can remind me how they are getting on with building the 1.5 million new homes they promised to build, as housing supply and rough sleeping are clearly linked. Why should anyone believe that they can deliver when the Prime Minister has repeatedly failed on this precise issue? When the Labour party fails—as it always does, every time it is in government—it is always someone else’s fault. It is always someone else’s money. Labour Members can come out with all the pledges and promises they want, but at the end of the day it is the British people who have to pay for their repeated failures.
I beg to move, That this House has considered e-petition 751472 relating to prostate cancer screening. It is a pleasure to serve under your chairmanship, Dr Murrison. I begin by thanking David James, director of patient projects and influencing at Prostate Cancer Research, for creating the petition, and the 101,932 people who supported it, including 195 in my constituency in the Scottish Borders.
I am grateful to my hon. Friend for making that point. It is a testament to the importance of the issue not just to her constituents—given the number who signed the petition—but to all our constituents who signed it that so many see the need for the Government to address this matter. All the charities do important work in the area.
I will make some progress, if I may, to develop a few arguments. I will take a couple of interventions, but I am conscious of the number of colleagues who are keen to speak. The petition argues: “Targeted screening for all high-risk men should be the starting point for building a screening programme that can ultimately protect all men.” It also questions the decision to offer screening exclusively to men with BRCA1 or BRCA2 genetic variants. Since the petition was launched, the UK National Screening Committee recommendation has narrowed, and the Government have now accepted screening for a a smaller group than the petition sought. The questions for us today are: who should be included? Why have other high-risk groups been excluded? And what evidence would justify widening the programme? Prostate cancer is the most commonly diagnosed cancer in men in the United Kingdom. More than 68,000 men are diagnosed annually, with over 12,000 dying from the disease each year. Patient survival hinges heavily on when it is diagnosed: if it is at stages 1 or 2, nearly 100% of men survive for five years or more, whereas if it is at stage 4, only about half live for five years or more.<span id="2WH" class="column-number" data-column-number="2WH"></span> Sir Chris Hoy, Scotland’s most decorated Olympian, knows this better than anyone. He was diagnosed in 2023, in his 40s, after a scan for shoulder pain. He had no prostate cancer symptoms at all, yet by then the cancer had spread to his bones and was terminal. His father and grandfather both had prostate cancer. Under the programme that the Government have now accepted, a family history like his would not, on its own, qualify a man for screening. Last year, the broadcaster Dermot Murnaghan was diagnosed with stage 4 prostate cancer and, sadly, died in July this year. He said that he “fell through the gaps”, having assumed that the regular health checks he received would include a PSA—prostate-specific antigen—test. They did not. His message to other men was simple: “Get the test. Insist on the test.” Risk is not evenly distributed—age, family history, genetics and ethnicity all matter. One in eight men will develop prostate cancer during their lifetime, with the proportion rising to around one in four for black men. That is why the petition argues for screening to begin with men already known to be at greater risk.
The right hon. Gentleman makes an important point. I will come on to the importance of ensuring that we get a UK-wide approach, because there are subtle differences among the devolved nations. The UK Government decision to accept the UK NSC’s final recommendation in England—to provide a PSA test every two years to men aged 45 to 61 with pathogenic BRCA2 variant and a relevant family history of breast, ovarian, pancreatic or prostate cancer—is a significant step forward, and roll-out is expected from 2027. BRCA1 carriers, however, are excluded, and BRCA2 carriers must also meet the family history criterion. The Department of Health and Social Care estimates estimates that only around 1,500 men in England will be eligible, and acknowledges that most prostate cancer cases will therefore fall outside the programme. The final recommendation also falls well short of what Members from across the House have called for. In November 2025, a cross-party letter signed by more than 120 MPs, hand delivered to the Health Secretary by my right hon. Friend the Member for Richmond and Northallerton (Rishi Sunak), called on the Government to act for the men at greatest risk: black men; men with a family history of prostate, breast or ovarian cancer; and BRCA1 and BRCA2 carriers. Its message was clear: perfection must not be the enemy of progress. The concern raised by those MPs reinforces the central question that the petition addresses: is the current screening programme too narrow?
The hon. Member makes an important point about awareness and the challenge in rural areas. I will come to that later in my speech. I am pleased that my right hon. Friend the Member for Richmond and Northallerton is present, having done so much to advance this issue. As Prime Minister, his Government backed the £42 million Transform trial, providing £16 million of Government funding to examine different approaches to prostate cancer screening. For the benefit of Members who are not aware, Transform is the largest prostate cancer screening trial in two decades. Designed and led by Prostate Cancer UK, with Government funding through the National Institute for Health and Care Research, it is comparing combinations of PSA blood tests, fast MRI scans and genetic saliva tests to find the safest and most effective way to detect prostate cancer before it becomes incurable. Crucially, it is designed to include far more black men than previous trials. With further Government funding announced this year, it is now worth around £60 million, and its first-stage results are expected before the end of 2027. My right hon. Friend has since become an ambassador for Prostate Cancer Research and has called for a targeted national screening programme for the groups most at risk. Prostate Cancer Research says that the final UK NSC recommendation “falls short of what is needed”, arguing that too many high-risk men remain outside the programme.
The hon. Member is right. There is so much work and research going on in this area, and it is imperative that the Government acknowledge that work and react once more informed evidence becomes available. The petitioners argue that the UK NSC has “fixated on potential harms” and underweighted the benefits of earlier detection, but there are good reasons why screening programmes face a higher evidential threshold. A raised PSA level does not by itself diagnose prostate cancer, but can cause anxiety and lead to further investigation. Screening can also result in overdiagnosis and unnecessary treatment, which can cause lasting harms. Prostate Cancer Research challenged the draft modelling, arguing that it relied too heavily on older evidence and did not adequately <span id="4WH" class="column-number" data-column-number="4WH"></span>reflect modern MRI-led diagnostic pathways. The UK NSC says it considered those criticisms and updated its modelling before reaching its final recommendation.
My hon. Friend makes a crucial point about the importance of testing centres being available in rural areas, and about how community-based testing centres link into the NHS and the research that is being carried out. There remains significant disagreement about the scale of harm. The UK National Screening Committee estimates that for every 1,000 men offered screening, up to 20 could be overdiagnosed, while around two lives are extended. Analysis by Prostate Cancer Research of more contemporary, MRI-led studies estimates that, roughly, for every two lives saved, three men are overdiagnosed. The updated Cochrane review published in May found that for every 1,000 men screened, PSA-based screening is likely to reduce prostate cancer mortality by around two deaths, while questions about overdiagnosis and treatment-related harms remain. When I met researchers from the Transform team, they highlighted an important nuance: MRI has reduced unnecessary biopsies, but it has not yet been shown that those diagnostic advances sufficiently reduce overtreatment. Questions also remain about how organised screening would interact with the PSA testing that is already taking place, and about screening black men, with the UK NSC saying it has insufficient evidence to determine “whether screening would cause more good than harm.”
My right hon. Friend makes an important point. My ask is that the Government continue their engagement, but also keep assessing the evidence and information coming forward, so that patients are given the best possible opportunity for survival. The uncertainty around screening matters the most for black men, as one in four will develop prostate cancer and they are around twice as likely to die from it, but rather than being offered screening, they are being invited to take part in a trial. Transform has received up to a further £18 million to directly test several relevant questions, and to ensure that if stage 1 of the project is successful, all eligible black men aged between 45 and 74 will be invited to stage 2. Researchers told me that useful stage 1 evidence should be available before the long-term trial is complete, and will be fed back to the UK NSC.<span id="5WH" class="column-number" data-column-number="5WH"></span> As the MP for the Scottish Borders, I want to highlight Scotland’s experience. The Scottish Prostate Cancer Initiative, supported by Sir Chris Hoy, Sir Tom Hunter, Professor Sir Chris Evans and Kenny Logan, aims to offer free PSA tests to 25,000 men aged 40 to 80 during 2026. Sir Chris described the initiative as “a major step forward for prostate cancer testing.” In May, 313 men were tested in Hawick and 515 men were tested in Galashiels, meaning that across two days 828 men in my constituency were tested. The initiative is not an NHS screening programme, but its community-based model may offer useful lessons about access, uptake and reaching men who might otherwise be missed. That matters, because inequalities remain stark. Analysis from the NHS, National Services Scotland and Macmillan Cancer Support found that men in the most deprived areas had a 98% higher risk of death from prostate cancer than those in the least deprived areas. I hope the Minister can address several points. First, will she commit to independent expert scrutiny of the UK NSC modelling, and to publish the findings and the Committee’s response in full? Secondly, as stage 1 of Transform produces significant new evidence, particularly on the screening of black men, will the Government ask the UK NSC to review its recommendation? Thirdly, how will the NHS proactively identify eligible BRCA2 carriers, particularly men whose genetic risk is not already known? Fourthly, what lessons on improving access to testing can be drawn from community-based initiatives in Scotland? Fifthly, what discussions has the Minister had with the Scottish Government and the other devolved Governments to ensure that a man’s access to screening does not depend on which side of the border he lives on? Finally, what will the Government do to make sure that the many men who fall outside the programme know they can ask their GP for a PSA test and receive clear, balanced information when they do?
That is a key point, because not everybody who is diagnosed with prostate cancer will necessarily need further treatment. Some people will not die of prostate cancer but will die with prostate cancer. The challenge for the Government is getting the balance right between when it is appropriate to test and treat and when it is not. I am conscious that many Members want to speak, so let me conclude. Screening is not simple. Finding more cancer is not automatically the same as saving more lives, but legitimate concerns about overdiagnosis should not prevent us from asking whether advances in diagnosis <span id="6WH" class="column-number" data-column-number="6WH"></span>have changed where the balance now lies. More than 100,000 people have asked Parliament to consider targeted screening for men at higher risk. Since they signed the petition, targeted prostate cancer screening has entered policy for the first time. That is an important first step. The question now is how and when the boundary should move as the evidence develops. The evidence I heard when preparing for this debate points both ways. Earlier detection could save lives, but questions remain over whether modern screening can reduce past harms. The Transform trial should help to provide the answers. When it reports, the Government must be ready to act quickly; that is what the petitioners asked for and what I hope the Minister will commit to. I look forward to hearing from her and from colleagues.
I thank David James, the petition creator, and Prostate Cancer Research for leading the campaign so effectively. That so many colleagues decided to contribute to this debate is a sign of its success. I thank all colleagues, who spoke passionately, albeit briefly, about the importance of the issue. Some shared very moving experiences, either personal or on behalf of their constituents. I thank the Minister for her response. It is important to have reassurance from the Government that they will be led by the evidence. The Minister said that she will consider further evidence that emerges from the research, but it is important that the Government do more than consider the evidence; they must be led by it.
My right hon. Friend is absolutely right. It is important that the people involved in the campaign and those trying to ensure that men are saved from this terrible disease have some certainty. If the Minister wrote to me with a timetable for when the Government expect to respond and deal with the issue, I could share that with colleagues who participated in this debate. Last, I thank the team at Transform. They do tremendous and inspiring work, and, ultimately, they will save the lives of more men. <em>Question put and agreed to.</em> <em>Resolved,</em> That this House has considered e-petition 751472 relating to prostate cancer screening.
Mears, acting for the Home Office, is acquiring properties to accommodate asylum seekers in small, rural communities in the Scottish Borders, where GP surgeries, schools and transport are already stretched. Scottish Borders council tells me that it is not being properly consulted by either the Home Office or Mears before these properties are acquired. Will the Minister <span id="20" class="column-number" data-column-number="20"></span>meet me, together with representatives from Scottish Borders council, so that we can discuss how engagement can be improved?
Will the Minister give way?
Like many MPs across the House, I have a number of constituents who have been affected by this issue. I thank the Minister for her comprehensive response, but there is an issue that concerns me more than anything. When the procurement process happens, it seems that officials come to us and assure us that a series of decision points have been gone through, and that the options before us are the best ones available—as a former Minister, I recognise that. However, when these things go wrong, nobody is individually accountable. What would the Minister say to our constituents, who are alarmed at the fact that nobody is apparently responsible for such a dire outcome?
As the Secretary of State set out, the order introduces a new public interest test for mergers, enabling Government intervention where a transaction could threaten continuity of telecoms services. I think the objectives to protect critical infrastructure, safeguard public services and ensure that vulnerable customers are not left without connectivity will be supported across the Committee. However, the context for the order is a specific case concerning BT, TalkTalk and the 2.5 million customers involved—including, BT informs me, 5,000 in my North West Norfolk constituency. It also highlights regulatory gaps when a company in this sector may simply fold, and the need to protect customers. We will not oppose the order, but it raises important questions about the speed of the process, the potential impact on competition and, importantly, investor sentiment. I welcome the fact that the Secretary of State thought it appropriate for her to come to the Committee, which underlines the concerns that are shared across parts of the sector. Let me turn first to the speed at which the intervention notice and the statutory instrument have come forward. As the Secretary of State said, she issued the notice on <span id="5" class="column-number" data-column-number="5"></span>5 October. The Competition and Markets Authority was then given only 10 working days to consider the transaction. Interested parties in a dynamic sector had only a few days to make representations on a detailed transaction. There is a concern that the transaction will further entrench BT’s significant role in the retail and wholesale markets. The Competition and Markets Authority has completed the phase 1 report, but we do not know what is in it or whether the Secretary of State will judge that a phase 2 study is appropriate. Can the Secretary of State confirm that adding this intervention power to the Enterprise Act through the order will provide the Government with a basis to override any competition concerns raised by the CMA or other parties? Of course, vulnerable consumers and public services need to be protected. Having worked in the telecoms sector a little while ago, when T-Mobile was still a retail brand in the UK, I am a little surprised that existing legislation, general conditions and other Ofcom powers could not have been used in this scenario. Can the Secretary of State assure the Committee that all alternatives were looked at? Outwith the order, is she looking further at this point and at how a supplier of last resort regime could be introduced, with reference to models from other essential services? Clearly, the transaction raises competition issues. Given the comments that were made when the intervention notice was issued and the approach taken with the order, the Government risk creating the impression that the outcome has effectively been decided in advance, limiting the ability of the competition authority to discharge its role in full. We should be very careful before setting aside competition implications for wider public interest considerations, particularly when the goal set by the Secretary of State—avoiding the loss of service—has been achieved. Clearly, we want to avoid any precedent where financial distress enables further market consolidation without appropriate scrutiny. How do the Government intend to reassure inward investors that the principle of encouraging competitive markets and investment remains to the fore? Can the Secretary of State assure other players in the sector that she will consider seriously the competitive impacts that may have been raised by the CMA—they have certainly been raised by a number of companies that have spoken to me—when she decides what the next steps are? Is she confident that the CMA had sufficient opportunity, in only 10 working days, to fully assess the implications of the transaction? Can she indicate when she might respond to the referral? We support the objective of the order in protecting consumers and maintaining vital telecoms services; however, we also support effective competition, proper scrutiny and confidence in the independence of the process. I therefore look forward to the Secretary of State’s response to the concerns and questions I have raised.
It is a pleasure to serve under your chairmanship, Dr Murrison. I congratulate my hon. Friend the Member for Berwickshire, Roxburgh and Selkirk (John Lamont) on securing the debate and speaking on behalf of the Petitions Committee. I thank all Members who have spoken powerfully and in a considered manner, whichever side of the argument they are on, and the 100,000-plus people who signed the petition, including the 198 from my constituency. My thoughts go out to all those in my constituency and across the country who are affected by this terrible illness. In November 2024, I supported Cancer Testing South—run by one of my constituents—at a free screening event in Bordon. I took a PSA test myself. It was quick and simple, and it gave me peace of mind. It showed how important it is to make testing accessible and to reach men who might never otherwise consider it.
I thank my hon. Friend for the work of her constituents in that important area. I must also recognise the previous Government’s work, particularly that of my right hon. Friend the Member for Richmond and Northallerton (Rishi Sunak)—whose commitment has continued beyond his time in office, as we have seen today—and that of my noble Friend Lord Cameron of Chipping Norton and my right hon. Friend the Member for Braintree (Sir James Cleverly). With Prostate Cancer UK, we as the Conservative Government committed £42 million to launch Transform, the largest prostate cancer screening trial in the world. I welcome some of what the current Government have done, but important questions remain about access to testing, identifying men at highest risk and how evidence will translate into policy. First, on PSA testing guidance, as raised by my hon. Friends the Members for Hinckley and Bosworth (Dr Evans) and for Huntingdon (Ben Obese-Jecty), the guidance setting out the right of men over 50 to request a PSA test was withdrawn earlier this year. The Government say that policy has not changed and attribute the concerns to “misinformed media coverage”, yet a written answer in September confirmed that no impact assessment was undertaken because there was “no change in policy to assess.” If the policy had not changed, why was the guidance withdrawn? And how was it established that the change had no impact without an assessment? On 21 October, the Government said that “officials continue to work with NICE”, which does not clarify whether the changes to the clinical knowledge summary were discussed. Prostate Cancer Research has asked the Department to confirm that higher-risk men can still access a PSA test once informed of its risks and benefits. As of 14 October, it has had no reply. Will the Minister confirm clearly that those men can access testing?<span id="22WH" class="column-number" data-column-number="22WH"></span> Secondly, on support for those at the highest risk, I of course respect the committee’s independence while it reviews the evidence, but the Government can take practical steps in the meantime. Prostate Cancer UK has called for GPs to inform black men and men with a family history of their elevated risk and to offer them a PSA test. What will the Government do to improve access for such men now, rather than leaving them to wait years for the wider review? Thirdly, on identifying BRCA2 carriers, an estimated 13,000 men carry that variant, yet most have never been tested and do not know. <em>The Telegraph</em> reported that only about 1,500 men will be invited for testing next year. How will the programme reach the wider population whom it is meant to benefit? The committee’s consultation document stated: “DHSC analysts are undertaking an exercise to estimate the cost of identifying new BRCA variant carriers.” Has that work been completed? Will it be published? What will the Government do to identify men who carry the variant without knowing it? Fourthly, on Transform and the NSC model, the committee will work with SCHARR—the Sheffield centre for health and related research—to update its modelling in the light of the trial’s findings, in particular for black men. It will also examine risk algorithms and biomarkers, including the Stockholm3 test, and whether family history can be more tightly defined. That work of course matters, but its impact depends on how quickly findings inform decisions and whether the public can see what is happening. Will the Minister commit to publishing by January of next year a dated programme for updating the model, covering the biomarker review and family history work, and reporting to this House every six months? Will she set a named decision point for black men, tied to the results of Transform’s first stage so that reconsideration does not default to the next scheduled review in 2029? What evidence will trigger a change to that model, and will independent experts be given access to it on terms similar to those NICE offers for medicines so that the assumptions can be tested? Finally, I have some questions about how the value of screening is judged. Since April, NICE has been able to approve a medicine for advanced prostate cancer at up to £35,000 per quality-adjusted life year—a threshold raised as part of the trade deal with the United States. The screening committee judged earlier detection against a figure of £20,000. Why does the NHS now appear to value treating late-stage prostate cancer more highly than preventing it? Will the committee’s forthcoming methods guide bring the two thresholds into line? In conclusion, I recognise the committee’s concerns about the harms of population-wide PSA screening, including overdiagnosis and treatment, and the uncertainties in the evidence for black men.
My hon. Friend is a great champion for his constituents, especially on this issue but on others as well. He is absolutely right that while the committee is making its evidential findings, there is nothing to stop the Government promoting a number of these ways to make sure that those at highest risk are getting treatment as soon as possible. Cancer Research UK has highlighted the risks too. As my hon. Friend said, screening must be evidence-led, but Transform exists to address the limits of existing evidence, and improvements in testing and MRI-led pathways offer ways to improve how men are assessed, as many Members have mentioned. Uncertainty must not be the end; it must lead to research and progress, not delay. The former shadow Health Secretary, my right hon. Friend the Member for Daventry (Stuart Andrew), set out the position of His Majesty’s Opposition last August. He said we would “back the latest evidence and research to ensure patient care remains at the heart of testing guidance.” That is clearly the right approach: act where the evidence supports it, accelerate research where questions remain, and be clear about when decisions will be made. Men must not be disadvantaged by circumstances beyond their control. One may have no family records because his father died young, for example; another may simply want to discuss his risk with his GP. As my right hon. Friend said, no man with potential prostate cancer symptoms should be denied a test because of poor family records. To conclude, His Majesty’s loyal Opposition support targeted screening for men at highest risk, Transform and the committee’s evidence-led approach. But we need clear guidance from the Government on PSA testing, practical support for men at the highest risk, a credible plan to identify BRCA2 carriers and a dated timetable for the model, with independent scrutiny of it and transparency about how Transform will shape policy. I hope the Minister will address those questions directly now; if not, will she write to me and set out clearly what patients can expect next?
<Question HRSContentId="{EEC1C563-6922-4520-83B6-290177342DCA}">1. <QuestionText HRSContentId="{D97E76CD-6172-4CBB-A77F-B0BE592B5BDD}">What proportion of people arriving in small boats were removed in 2025. </QuestionText></Question>
If small boat crossings were down by enough, the Government would not have to stand up asylum camps at places such as Ministry of Defence Bicester site A, which is just over the Oxfordshire border from my constituency. With 85,000 small boat crossings since the general election, the situation is at crisis point. MOD Bicester site A does not even offer value to the taxpayer; new modelling shows that over three years, the cost would come in at £385 per person per night—nearly double that of the equivalent asylum hotels. Will the Home Secretary actually get on and deport those who have come to our country illegally, rather than using sites like MOD Bicester site A?
Cheshire constabulary was named the best police force in England and Wales for the highest charge rates for crimes against women and girls—specifically, sexual offences, violence against the person, stalking and harassment. The chief constable, under whose leadership this has happened, is retiring next week. Will the Minister join me and fellow Cheshire MPs in congratulating him on his dedicated life of service, and is she, like me, surprised that the police and crime commissioner for Cheshire did not seek to extend the chief constable’s tenure when he offered to remain in service?
Can the Minister clarify something for me? Over the weekend, it was revealed that criminals released early from prison under Labour’s appalling Sentencing Act 2026 were provided with tents, because no accommodation was available for them. Those are criminals who are now out on the street and homeless. Can the Minister let me know if some of the £874 million for homeless people goes to finding accommodation for those early-release criminals? If there is no accommodation for those criminals, where is the accommodation coming from for homeless people?
Many in this House will know my previous position, but I will use my speech to talk about things I understand and things I do not. I understand why there is such a drive to pick up the screening programme. The numbers have been stated explicitly, and I understand why the Government are citing the evidence from the committee to make sure that this is measured. If there is a test that says someone may have cancer 75% of the time but does not pick it up 15% of the time, that is a matter of concern, especially when we read the statistics about 12 men in 1,000 tested being overtreated. Nobody has talked about what being overtreated means; it means a man who is perhaps 56 and asymptomatic suddenly suffering erectile dysfunction, though he never had a cancer that needed treatment. These are important points, and it is right that we expand the trial to understand more about what is going on.<span id="10WH" class="column-number" data-column-number="10WH"></span> Here is what I do not understand, which I will put to the Minister. The guidance for GPs has changed: formerly, when a man who was asymptomatic and over 50 requested a PSA, they could get it. We have a test that is not very good, and it is hard enough to get men in to see a doctor, but what are they most concerned about? Cancer. I have had those conversations; they understand the risks and still want that test. Why have the Government changed that, when their own consultation says: “There was no simple way of knowing from the data whether a PSA test had been done because of a patient’s request for one, a GP’s concern about a patient’s symptoms, as part of post-cancer treatment follow-up, or active surveillance”? The Government do not even know why PSA test access was changed. That is important. If a man goes in to ask for a PSA test, given everything he knows, he should have the right to that test until we get further information to tell him otherwise, because if I was that GP, I would be worried he would ask for my General Medical Council number and my name.
Will the Minister give way on that point?
Is the Minister therefore saying that a 52-year-old patient who understands the risks on both sides and wants their PSA has the right to get it, or is it the GP’s decision? The GP could deny it on a clinical basis even if the patient wants it. That is the change that people are worried about. Could she explain that point?
Order. Colleagues will note that the debate is vastly oversubscribed, and we will not be able to get everybody in. There will be a two-minute time limit on speeches and Front-Bench speeches will begin at 5.28 pm.
Order. I call Alistair Strathern.
All right. I call Peter Prinsley.
I thank Members for their timekeeping and call Perran Moon.
Well done, everyone; we got all the Back Benchers in.<span id="19WH" class="column-number" data-column-number="19WH"></span>
Back in March, following a growing number of complaints from people across my constituency, I led a Westminster Hall debate on Royal Mail’s performance. It was well attended, like this evening’s debate, and it focused on the fact that while prices have continued to rise, the standard of service has declined, undermining public trust in Royal Mail, an institution that has been around for 500 years. I know this is a theme that will come up repeatedly this evening. Unfortunately, seven months later, I am still hearing the same complaints and constituents are still experiencing completely unacceptable delays. It is time for this House to act and for us to turn these debates into real action. It has been reported to me that people in Pinhoe in my constituency are receiving letters only once every two to three weeks, and I have heard similar accounts of households elsewhere in my constituency—Exmouth, Budleigh Salterton, Woodbury and Lympstone—going weeks without a delivery before receiving large bundles of post all at once. I know that many Members will have households in their constituencies who have had the same experiences.
I thank the hon. Member for his intervention and—to raise a point made by the hon. Member for Redditch (Chris Bloore), who introduced the debate—this is not on the posties at all; the posties do a fantastic job. From the numbers for Royal Mail, it looks like asset stripping is going on, so we can understand why those posties are having a difficult time. There may be a perception that letters are no longer particularly important, but that is far from the case, especially in areas with elderly populations such as my constituency.
I completely agree, and I think we will have a lot of consensus in the debate this evening, as we did in my debate in March. Royal Mail clearly says that it is now a parcel company that still delivers letters, and that is an issue that affects countries very close to us. Denmark has PostNord, which has operated for about 400 years, and they are going through the exact same problems as us. We have the universal service obligation, and we really need to work on that to make sure it is fit for purpose and there are repercussions for not fulfilling those roles.
Again, we will find consensus here. I have a very mixed constituency with some really urban areas and some very rural areas, and there is a significant disparity in service delivery. When we think about the reasons why, we realise that it takes more time for posties to go out and deliver in some areas, which costs more money, and for a company that is stripping back quite significantly, we can understand why those problems arise. Going back to the point about those who have been waiting for NHS correspondence, financial documents and other time-sensitive information that they rely on, a constituent has told me that letters relating to their cancer treatment have been arriving late. For patients already facing the anxiety and uncertainty of cancer treatment, the added worry of not receiving important medical correspondence is completely unacceptable. For those people, many of whom do not use email or online services, these delays can have particularly serious consequences. I would like the Minister to address, if possible, a Royal Mail product called economy access mail. It is a non-time sensitive product, and organisations like the NHS and local councils will use it because it is the cheapest option, but they are not informing their customers that they are using it and that that is why correspondence arrives late more often than not. Particularly frustrating is the repeated cycle my office faces whenever we raise these concerns with Royal Mail, and we have heard very similar experiences tonight about poor communication. My constituents should not have <span id="92" class="column-number" data-column-number="92"></span>to be reaching out to their MP just to receive their post, nor can we keep having the same debates in this House without seeing any meaningful improvement. We have discussed some of the numbers, but according to Royal Mail’s latest quarterly performance figures, just 81.8% of first-class letters in the EX postcode of my constituency were delivered within the next working day, against a local target of 87%. Again, I could go into all the numbers, but I am sure that many other Members will be raising them. All this should be considered in the context of a first-class stamp now costing £1.80. My constituents are paying for a first-class service but too often receiving something considerably worse. I recognise that Royal Mail faces significant challenges. We are going through technological change on a level we have not seen over the last 500 years, and there are financial implications for businesses trying to operate in that environment. Letter volumes have fallen, operating costs have increased and the business model needs to be modernised. Royal Mail recently informed me that it has begun implementing a new delivery model at Exeter, which it says is going to improve output and save costs, but they are just commitments at the moment and after years of missed targets the public can be forgiven for wanting to see results rather than another improvement plan. It is important to look at the numbers to understand what is really happening. Royal Mail made a loss of £400 million three years ago and £200 million a year after and a £14 million profit last year. We have been seeing lots of fat being cut out of the business, from normal business operations that can cut away that fat, but we have cut into the muscle now, and it is starting to look a lot like asset-stripping. As I made clear in my previous debate, none of this criticism should be laid at the feet of the postmen or postwomen.
We have yet more consensus. This is where we have to really dig into the universal service obligation and make sure that there are significant penalties if Royal Mail does not do what it has signed up to do and what we have asked it to do as a company.