Health Bill (Seventeenth sitting)
House of Commons · Public Bill Committees · 16 Jul 2026 · 596 speeches · Official Report
The Committee consisted of the following Members:
Chairs: Sir Roger Gale, Dr Rupa Huq, † Emma Lewell, Sir Jeremy Wright
† Argar, Edward (Melton and Syston) (Con)
† Brackenridge, Sureena (Wolverhampton North East) (Lab)
Chambers, Dr Danny (Winchester) (LD)
Daby, Janet (Lewisham East) (Lab)
† Foody, Emma (Cramlington and Killingworth) (Lab/Co-op)
† Irons, Natasha (Croydon East) (Lab)
† Johnson, Dr Caroline (Sleaford and North Hykeham) (Con)
† Joseph, Sojan (Ashford) (Lab)
† Kyrke-Smith, Laura (Aylesbury) (Lab)
† Morgan, Helen (North Shropshire) (LD)
† Prinsley, Dr Peter (Bury St Edmunds and Stowmarket) (Lab)
† Robertson, Dave (Lichfield) (Lab)
† Robertson, Joe (Isle of Wight East) (Con)
† Smyth, Karin (Minister for Secondary Care)
† Stafford, Gregory (Farnham and Bordon) (Con)
† Twist, Liz (Blaydon and Consett) (Lab)
White, Jo (Bassetlaw) (Lab)
Sanjana Balakrishnan, Rob Cope, Committee Clerks
† attended the Committee
Public Bill Committee
Thursday 16 July 2026
(Afternoon)
[Emma Lewell in the Chair ]
Health Bill
New Clause 50
Delivery plans for transformative technology commitments
“(1) The Secretary of State must, within 12 months of the date on which this Act is passed, publish a delivery plan for each of the transformative technology commitments set out in subsection (2).
(2) The transformative technology commitments referred to in subsection (1) are the commitments made in the document entitled ‘Fit for the Future: the 10 Year Health Plan for England’ published in July 2025 (or any successor document) in respect of-
(a) data quality and interoperability, including-
(i) the development of the Health Data Research Service and,
(ii) the use of NHS data for research and innovation;
(b) artificial intelligence, including-
(i) the deployment of AI tools across NHS clinical and administrative functions,
(ii) the development of an AI strategic roadmap, and
(iii) the establishment of a regulatory framework for AI as a medical device.
(c) genomics and predictive analytics, including-
(i) the expansion of genomic testing, and
(ii) the use of predictive analytics for earlier diagnosis and personalised treatment;
(d) wearable technologies, including the commitment that wearables will become standard in preventative, chronic and post-acute NHS treatment;
(e) robotics, including-
(i) the expanded use of robotics in surgery,
(ii) continuous monitoring,
(iii) rehabilitation, and
(iv) prosthetics.
(3) Each delivery plan published under subsection (1) must include-
(a) a description of the specific commitments being delivered, with reference to the relevant passages of the 10 Year Health Plan;
(b) a timetable with milestones for delivery of each commitment;
(c) the funding allocated or to be allocated to support delivery, including the source of that funding;
(d) the NHS bodies, government departments and other organisations responsible for delivery of each element of the plan, and the accountability arrangements in place;
(e) the regulatory steps required to enable delivery, including any changes to the regulatory framework for medical devices, AI or data, and the proposed timetable for those steps;
(f) the workforce implications of delivery, including any training or upskilling requirements;
(g) the steps to be taken to ensure deployment of each technology across different regions and patient groups; and
(h) the metrics against which progress will be assessed and reported.
(4) The Secretary of State must lay each delivery plan before Parliament on the day on which it is published.
(5) The Secretary of State must publish, and lay before Parliament, an annual progress report on implementation of each delivery plan, including-
(a) progress against the milestones set out in the plan;
(b) any revisions to the timetable or funding and the reasons for those revisions;
(c) an assessment of equity of access to the technologies covered by the plan; and
(d) any new barriers to delivery identified and the steps being taken to address them.”- (Dr Caroline Johnson.)
This new clause would require the Secretary of State to publish a delivery plan for the transformative technological commitments set out in the 10 Year Health Plan.
Brought up, read the First time, and Question proposed (this day), That the clause be read a Second time.
Question again proposed.
It is a pleasure to serve under your chairship, Ms Lewell. As the shadow Minister, the hon. Member for Sleaford and North Hykeham, said before the break, technology is a game changer. It is a key enabler of our 10-year health plan and a modern NHS. This new clause follows the plan’s five big bets, the transformative technologies key to NHS improvement: data to deliver impact; AI to drive patient power and productivity; genomics and predictive analytics for pre-emptive personalised care; wearables to make care real-time; and robotics to support precision. To require those diverse areas to be subject to a cohort of plans to be laid before Parliament, and to make them subject to perpetual monitoring by Parliament, would be to legislate for micromanagement. One of the priorities of tech delivery is that it needs to be agile. The new clause would inhibit that. Parliament does not usually have a role in overseeing delivery plans for specific elements of NHS technology. Adding in new reporting structures is unnecessary bureaucracy that would slow down delivery of the technologies and their impact on patients. In some areas, we already have arrangements in place to underpin delivery, via legislation approved by Parliament. The Health and Care Act 2022, the Data (Use and Access) Act 2025 and related legislation have established a framework for mandatory information standards, which can set the technical and data requirements to ensure interoperability. Along with our 10-year plan,...
New Clause 51
Regulation of NHS managers and leaders
“(1) The Secretary of State must, within the period of 12 months beginning with the date on which this Act is passed, make an order under section 60 of the Health Act 1999 (regulation of health professions etc) conferring on the Health and Care Professions Council the functions necessary to establish and maintain a barring system for senior NHS managers and leaders.
(2) An order under subsection (1) must make provision for-
(a) a barring list of individuals who are prohibited from holding senior management positions in NHS bodies as a result of a finding of serious misconduct;
(b) a duty on senior NHS managers and leaders to ensure that patient safety concerns raised by staff are properly investigated and responded to;
(c) a process for the investigation of complaints and the making of barring decisions, including a right of appeal; and
(d) the scope of persons to whom the barring system applies, which must include at minimum board-level directors and their direct reports within NHS bodies.
(3) Before making an order under subsection (1), the Secretary of State must carry out a statutory consultation in accordance with section 60(4) of the Health Act 1999 and must lay a draft of the order before Parliament under the affirmative resolution procedure.
(4) The Secretary of State must publish, within 6 months of the date on which this Act is passed, a timetable for-
(a) the laying of the draft order required by subsection (1);
(b) the completion of the statutory consultation required by subsection (3);
(c) the establishment of the NHS Management and Leadership Standards by NHS England or its successor body; and
(d) the establishment of the College of Executive and Clinical Leadership committed to in the 10 Year Health Plan.
(5) The Secretary of State must lay the timetable published under subsection (4) before Parliament.
(6) In this section-
‘NHS body’ includes any NHS trust, NHS foundation trust, integrated care board, or special health authority;
‘senior management position’ means a position as a board-level director or direct report to a board-level director of an NHS body, and such other positions as the Secretary of State may specify by order;
‘serious misconduct’ means conduct that has caused, or risked causing, harm to patients or has materially undermined public confidence in the NHS, and includes conduct involving dishonesty, failure to act with candour or wilful disregard for patient safety.”- (Dr Caroline Johnson.)
This probing new clause presses the government to explain why the Health Bill does not include provision to implement the statutory regulation of NHS managers, and to commit to a timetable for bringing that regulation into force.
Brought up, and read the First time.
I beg to move, That the clause be read a Second time. The new clause is a probing amendment. The aim is to press the Government to explain why the Bill does not include provisions to implement statutory regulation of NHS management, as they had said they would, and to commit to a timetable for bringing the regulations they promised into force. I am an NHS consultant paediatrician and am regulated as such by the General Medical Council. The GMC regulates doctors, the Nursing and Midwifery Council regulates nurses and midwives, and different bodies represent other professionals in the health service-but not managers. The Government said that there would be such a register. I know that there are many excellent managers-the Minister was one-but as in every profession, bad apples need to be identified and managed appropriately. The Times has reported that senior bosses at Leeds teaching hospital NHS trust asked consultants and nurses to work in ways that lie outside the national service recommendations. We have also heard from Donna Ockenden that of the 66 former senior staff members in Nottingham she approached, only 35 agreed to be interviewed. The former Secretary of State for Health and Social Care, the right hon. Member for Ilford North (Wes Streeting), has said that he finds it “unconscionable that people who worked for the NHS would deny them”- the families- “an honest account of what went wrong”. Establishing a register would be the first step in ensuring that bad apples...
May I put on record my thanks to all the excellent managers in the NHS? I am not sure whether I raised the bar, as the hon. Lady said, but it was a great career and one that I enjoyed very much. It is a difficult job, and we want to support managers in future. We cannot deliver our 10-year health plan without them. That is one of the reasons why we have already established a leadership college to support their development, as we committed to doing.
Does the Minister agree that managers in the NHS sometimes get a very bad press from the medical profession? I believe that to be wholly unjustified.
I thank my hon. Friend and the shadow Minister for their comments about NHS managers. I agree that they often get a bad press, and often from politicians as well. We cannot run the health service without both clinically and non-clinically trained managers, so we need to ensure that they have the right support to do their difficult job. My experience is that when the partnership with clinicians works well, it is really powerful. I have certainly learned a lot from working with some fantastic clinicians in my career. We are absolutely committed to introducing a statutory barring system. We will do that by introducing secondary legislation within this Parliament to enable the Health and Care Professions Council to operate that barring system. We intend to do so as part of the planned secondary legislation to modernise the framework that governs the Health and Care Professions Council. Changes to this legislation are subject to a statutory three-month consultation period, in addition to which this legislation will be novel and complex. It will require extensive stakeholder engagement to ensure that we develop a barring system that is proportionate and operates efficiently alongside existing frameworks, codes of practice and other regulation governing the work of NHS senior leaders. For those reasons, a 12-month timeline to bring forward the section 60 order is unfeasible. The new clause also sets out prescriptive duties on the content of the section 60 order; we would not wish...
I beg to ask leave to withdraw the motion. Clause, by leave, withdrawn. New Clause 52 Access to dental provision: Dental deserts “(1) Within six months beginning on the day on which this Act is passed, the Secretary of State must establish a scheme to improve access to dental provision (‘the Scheme’). (2) The purpose of the scheme is to end dental deserts. (3) A dental desert is defined as any local authority area with fewer than ten active dental practices per 100,000 people. (4) The scheme must make provision to support integrated care boards to- (a) guarantee emergency access to an NHS dentist, (b) provide free dental checks up for- (i) children, (ii) mothers within one year of having given birth, (iii) pregnant women, and (iv) low-income households, and (c) guarantee dental appointments for persons commencing- (i) surgery, (ii) chemotherapy, or (iii) transplant procedures. (5) The Secretary of State must, before publishing the scheme, issue a reformed dental contract. (6) The Secretary of State must, within six months of the establishment of the scheme, publish a dental workforce plan to support delivery of the scheme.”- (Helen Morgan .) This new clause would establish a scheme to support integrated care boards to end dental deserts. Brought up, and read the First time. Q uestion put, That the clause be read a Second time.
New Clause 56
Accident and Emergency: waiting times
“(1) Within six months beginning on the day on which this Act is passed, the Secretary of State must make provision relating to Accident and Emergency Department admission.
(2) Provision under subsection (1) must include the requirement for every patient to be admitted into an Accident and Emergency Department within 12 hours of approval of their admission being made.
(3) The Secretary of State must establish and implement an Accident and Emergency Scheme (‘the Scheme’) to support NHS hospital trusts to achieve the requirement set out in subsection (2).
(4) The Scheme must consider-
(a) creating safety-net social care beds,
(b) increasing step-down care,
(c) publishing a dedicated accident and emergency care workforce plan, and
(d) mandating a qualified clinician is present in every Accident and Emergency waiting room.
(5) The Secretary of State must have due regard to the final report of the Independent Commission on Adult Social Care in establishing the scheme.”- (Helen Morgan.)
This new clause gives patients a legal right to be admitted into A&E within 12 hours from decision to admit and requires the Secretary of State to introduce a scheme to achieve this.
Brought up, and read the First time.
Question put, That the clause be read a Second time.
New Clause 57
Duty as respects waiting times for women’s health
“In the National Health Service Act 2006, after section 1CC (inserted by section 6 of this Act) insert-
‘1CD Duty as respects waiting times for women’s health
The Secretary of State must exercise functions in relation to the health service with a view to ensuring that average waiting times for the diagnosis and elective treatment of conditions primarily affecting women do not exceed the overall average waiting times for NHS diagnosis and elective treatment.’”- (Helen Morgan.)
This new clause would ensure that that the average waiting time for diagnosis and treatment for elective conditions for women’s health issues do not exceed the average wait time for wider NHS elective treatment.
Brought up, and read the First time.
I beg to move, That the clause be read a Second time.
The Chair
With this it will be convenient to discuss the following: New clause 58- Inquiry into women’s health outcomes - “(1) The Secretary of State must, within six months beginning on the day on which this Act is passed, commission an independent inquiry into women’s health provision and outcomes in England. (2) Any inquiry established under subsection (1) must consider- (a) the causes of- (i) poorer health outcomes, and (ii) disparities in patient safety for women, (b) the effectiveness of existing commissioning arrangements in meeting the needs of women, and (c) recommendations to assist the Secretary of State in discharging the duty to reduce inequalities in health outcomes under section 1C of the National Health Service Act 2006. (3) The Secretary of State must lay a report on the findings of the inquiry before Parliament within the period of 12 months beginning with the day on which this Act is passed.” This new clause would establish an inquiry into the poorer health outcomes faced by women. New clause 104- Implementation of the Women’s Health Strategy - “(1) The Secretary of State must, within 90 days of the date on which this Act receives Royal Assent, publish a women's health implementation plan (the ‘implementation plan’) setting out how the commitments in the document entitled ‘The Renewed Women's Health Strategy for England’ published on 15 April 2026 (or any successor document) will be delivered. (2) The implementation plan must include, in particular- (a) a timetable...
New clause 57 would ensure that the average waiting time for diagnosis and treatment for elective conditions for women’s health issues does not exceed the average waiting time for wider NHS elective treatment. New clause 58 would establish an inquiry into the poorer health outcomes that women face. In communities up and down the country, we have seen the devastating toll taken by the various and sustained failures to invest in and deliver better women’s health. Vital services remain understaffed and underfunded, while women and girls are going without the care they need. In 2022, we welcomed the first women’s health strategy, which promised to “listen more carefully to women, close gaps in care, improve research and tackle inequalities.” Those were all vital goals, but three years on, the problems remain stubbornly in place: long waits for gynaecology treatment, patchy access to services, women reporting that they are not listened to, pain not taken seriously and conditions diagnosed too late. Medical misogyny is a perverse and unacceptable norm in the health sector. Women are not offered pain relief when they need it. The side effects of treatment and drugs on women in particular are far too often overlooked and under-researched. More research is needed to improve medical and reproductive products for women. In addition, about half a million women are waiting for gynaecology treatment across the country. We just cannot keep failing women in this way. The current average...
I rise to discuss new clause 104, which stands in my name. The Labour Government’s general election manifesto made a bold pledge: “Never again will women’s health be neglected.” The Government have been in power for two years, and I am not convinced that they are doing all they can for women’s health. The latest NHS statistics show that waiting lists are rising under this Government. The trend is particularly acute for gynaecology services. More women are awaiting admission to hospital for gynaecology treatment or procedures than in July 2024. How does that square with the Government’s ambition to improve and prioritise women’s health? We talked this morning about fracture liaison services, which is another treatment that would predominantly have benefited women if the Government had kept their promise and rolled it out as they said they would. The previous Conservative Government commissioned the Hughes report. The Labour Government have repeatedly pledged to address the issue at the earliest opportunity, but when will the Minister respond to the women who have been waiting so long? The Government published their renewed women’s health strategy in April, but where are the timelines, steps and milestones to deliver and implement improvements to women’s health? Where is the plan to reduce gynaecology waiting lists? Where is the timetable for delivering on long-acting reversible contraceptives, for example? I have no doubt that the Minister has a desire to improve outcomes for...
Hon. Members have brought to the Committee a really important discussion about women’s health. I am very happy to have that discussion, because the Government are committed to prioritising women’s health. That is why I am so proud that we published a renewed women’s health strategy earlier this year. I say in response to the Liberal Democrat spokeswoman, the hon. Member for North Shropshire, that we renewed the strategy partly because-to be absolutely fair to the Conservative party-we agreed with much of what it put in place under its women’s health strategy. We did not see the need to start it from scratch, so to speak. There had not been a men’s health strategy, so they are very different propositions. Much of the direction had been covered, but the implementation had not. On the point made by the hon. Member for Sleaford and North Hykeham, we wanted to go further and faster and acknowledge some things, as the former Secretary of State did, about medical misogyny, as well as the need to renew that strategy. I fully agree with new clause 57 that women should get equal access to high-quality elective care. We are committed to tackling the long waits for services primarily affecting women; I am acutely aware that women can wait disproportionately longer for a wide range of treatments, although none solely impacts women more than gynaecology services. The Government recognise that injustice. That is why we have implemented measures to improve gynaecology services and women’s...
I am suddenly cast back to 31 years ago, when I was choosing my subjects for the final year of my history degree. One of the early modern history papers was provocatively entitled “Women and other deviants”. It was called that to draw attention to the fact that, despite making up 50% of the population, women are often treated as a minority group. I sincerely hope that we are not still in that situation, but women’s issues clearly still need addressing. I will take the Minister at her word, but I will keep pressing her on this issue as we go through the course of this Parliament. I beg to ask leave to withdraw the motion. Clause, by leave, withdrawn. New Clause 66 Puberty blockers ‘(1) Within three months of the passage of this Act the Secretary of State must make regulations which ensure that puberty blockers may not be prescribed, dispensed or supplied to persons under 18 years of age for the purposes of treatment related to gender dysphoria, gender incongruence or a combination of both, in the United Kingdom. (2) These regulations must ensure that such drugs cannot be given out or used as part of clinical trials for the treatment of gender dysphoria, gender incongruence or a combination of both, unless that trial has specifically been approved by a resolution of both Houses of Parliament. (3) For the purposes of this section, puberty blockers means- (a) a “gonadotrophin-releasing hormone (‘GnRH’) analogue” which means a medicinal product that consists of or contains...
I beg to move, That the clause be read a Second time. New clause 66 relates to the prescription of puberty blocker drugs, also known as GnRH agonists. A first rule of medicine is “Primum non nocere”-first do no harm. That is what this clause seeks: to make sure that harm does not come unnecessarily to children. It is required because the Government are sponsoring a £10.6 million trial to put 226 physically healthy children on puberty-blocking drugs. That is being done despite the fact that the Health Secretary claims he feels “uncomfortable and uneasy” at the prospect. There are lots of questions that need to be answered. The minimum age for this trial is 11 years old for girls and 12 years old for boys, despite the Medicines and Healthcare products Regulatory Agency having recommended a much older group. When my hon. Friend the Member for Fylde (Mr Snowden) asked why in a written question, the Minister gave a holding answer. Is that because the Government do not know or because they do not want to say? I am not convinced that the trial will produce the answers the Government want. Apparently, they are asking the question of whether puberty blockers benefit children who have questions over their gender and who will later go on to have a trans identity in adulthood. The challenge is that we do not know which of the children who have challenges with their gender during puberty will go on to have such an identity in adulthood, so we are essentially doing a trial on a large...
It is a pleasure to serve under your chairmanship, Ms Lewell. I had written a 25-page speech for this debate, but to the disappointment of my researcher-and probably the delight of this Committee-I do not intend to read out all 25 pages. [ Interruption. ] There are cries of “Shame!” from my own side, but I accept that there are a number of amendments and new clauses to get through. My stated objection to the puberty blocker trial is also well known and on the record, so I do not wish to detain the Committee for too long. I want to pick out five areas where I think there are problems. They are why I support new clause 66, tabled by my hon. Friend the Member for Sleaford and North Hykeham. My first point can be summarised as: “Don’t repeat a mistake to find out whether it was a mistake.” Thousands of children have already received puberty blockers through the former Tavistock pathway, and my view is that, before exposing a whole new cohort, the Government should complete the long-promised data linkage study to establish what happened to those children. That is probably the core argument. Secondly, if the Government rightly say that the drugs present an unacceptable safety risk, how can it be ethical to give them to children in a trial? It must still be an unacceptable safety risk, whether it is for the general population of those who wish for it or for the people in the trial. The Government banned routine prescribing because of the safety concerns, yet propose administering...
Does it concern my hon. Friend that the person who raised the concerns about the trial then recused himself from further involvement in it?
It did. If memory serves, that question was raised-although I cannot say more because it was in private. I do have concerns that the professor who was in charge and raised those concerns at the MHRA was recused. I cannot discuss the details of that, but it could show that there was a bias in the selection of the people who were pushing the trial forward. I am not saying that there was bias, but I think that, on an issue of such importance, the perception of bias is almost as bad. We need to be very careful about that. Either way, I think the trial is wrong for the five reasons I have outlined. The key reason is the moral and ethical issue, and my hon. Friend the Member for Isle of Wight East raised it in both the Health and Social Care Committee and the Chamber: it is clearly morally wrong to experiment on children just for the sake of experimenting. The fact that there is no evidence does not mean that we should put children through a trial to see whether the evidence exists.
Usually, I say that I am grateful that a discussion has been brought before the Committee and that I am happy to have it, but it is unusual to have a discussion on a clinical trial in a political environment. I stand to be corrected, but I do not think that there has ever been a clinical trial subject to a parliamentary vote. There has been an Opposition day debate about this, in which many issues were rightly aired, so we will not spend much time discussing it this afternoon. The safety and wellbeing of children and young people is paramount. Children’s healthcare must always be led by evidence and expert scientific and clinical advice. We all know that that was not the case in some of the instances at the Tavistock over time, in the late 2010s. We pay tribute, as we have done several times, to the then right hon. Member for Bromsgrove when he was Secretary of State for Health-in 2022, he finally took action on that particular service and what went on there, commissioning Dr Hilary Cass’s review, which we supported on a cross-party basis, for the health, safety and wellbeing of children. Hilary Cass’s interim review in 2022-which bears reading, for those who have not read it recently-found the evidence for the service model and the clinical base to be woefully lacking. In the 2010s, that was allowed to continue for a long time, but fortunately started to be stopped in 2022. Ever since, we have had cross-party agreement in support of Dr Cass’s review. She found that the...
A couple of points. Does the Minister recognise that the cancel culture associated with much of the work in this area, and in looking after those vulnerable groups of children, means that the tendency among those who get involved is to have a particular view? How has she worked to ensure no bias among those on the committee involved in producing the trial? Does she recognise that by choosing a cohort of children-226 of them-to do this experiment on, she is selecting a group of children of whom most will have a gender incongruence that will get better by itself? There are two effects of that. First, these children will have unnecessary treatment. Secondly, even if there were in theory a benefit to the small group of children who would have persisted in a trans identity, that would affect the reliability of the results; therefore, whatever the results, people would think them unreliable.
I think that was yet another addition to the hon. Lady’s speech. Initially, she asked whether I recognised the cancel culture in this area. I have already alluded to, absolutely, recognising that what occurred in the 2010s at the Tavistock and around was not acceptable. Under the stewardship of the Conservative party of the NHS and so on, it took until 2022 to start rectifying that situation in order to give good treatment to children and young people. She is herself a clinician, so I am somewhat surprised at her. Noting what I set out, I am surprised that she does not recognise that a clinical trial has never-I stand to be corrected-been subject to a vote in Parliament, whereby politicians who are not experts have a say; but we can come back to that.
Will the Minister give way?
I am going to move on. Noting what I have set out, having such a vote would set an uncomfortable precedent that would be likely to significantly compromise the value and reputation of UK research, as well as creating an inequity unique to individuals with gender incongruence or gender dysphoria. For those reasons, I ask the hon. Lady to withdraw the new clause.
I am not aware of any clinical trial that has provided potentially extremely harmful medication to children who have a self-limiting issue and who are physically healthy, to change their physically healthy bodies by changing puberty or anything else to a physiologically abnormal state from a physiologically normal one. These are children going through normal, physically healthy puberty. Their normal puberty is being stopped. I think the trial is badly designed, and I wish to press the new clause to a vote. Question put, That the clause be read a Second time.
New Clause 72
Surrey & East Hampshire: Dental appointments
“(1) Within one year beginning on the date on which this Act is passed, the Secretary of State must ensure that there is adequate provision of NHS dentistry in Surrey & East Hampshire.
(2) ‘Adequate provision’ under subsection (1) means -
(a) access to urgent dental appointments for any person with an urgent need, and
(b) improved access to routine dental appointments.
(3) The Secretary of State must explain any failure to meet the requirement set out in subsection (1) at a public event in the local area.”- (Helen Morgan.)
This new clause places a duty on the Secretary of State to ensure there is adequate provision of NHS dental appointments in Surrey & East Hampshire.
Brought up, and read the First time.
I beg to move, That the clause be read a Second time. I thank my hon. Friend the Member for Guildford (Zöe Franklin) for tabling the new clause. She has asked me to speak about dental deserts in Surrey and East Hampshire, the area that she lives in and represents. The new clause places a duty on the Secretary of State to ensure that there is adequate provision of NHS dental appointments in Surrey and East Hampshire, and allows us to raise once again the shocking state of dentistry in this country. As we have discussed on many occasions, more than 5 million children did not see a dentist at all in 2025-that is a stark reminder of what we mean when we talk about dental deserts. We have heard that DIY dentistry has become normalised, which is pretty horrifying. People are using pliers to extract teeth and superglue to reattach crowns, or attempting to fill cavities with household adhesives. Beyond those obviously shocking Victorian scenes, DIY dentistry is very risky and has, tragically, led to deaths from sepsis. That is all because people cannot get an NHS dental appointment and cannot afford a private one. The last Conservative Government pushed dentistry to the brink, and children and parents in particular are paying the price of that neglect. That is a national shame-one that we must fix. As I mentioned, my hon. Friend the Member for Guildford tabled the new clause to highlight the issues in her part of the country. Surrey and East Hampshire is not the worst place in the...
Unlike that of the hon. Member for Guildford, my constituency covers both Surrey and East Hampshire, so I welcome the focus that new clause 72 places on our local area. Constituents regularly raise with me their concerns about seeing an NHS dentist. As I have announced a number of times in this Committee-although I have not checked today, so may not be true any more-there is not a single dentist in my constituency taking on adult or child NHS patients at the moment. For many people, the challenge is not simply one of convenience; it is about being able to access timely care when they need it. Good oral health is an essential part of overall health, and we cannot allow dentistry to become an afterthought in our healthcare system. The ability see a dentist for routine check-ups, preventive care and urgent treatment helps to reduce pressure elsewhere in the NHS by dealing with problems before they become more serious. The new clause rightly highlights the need both for urgent appointments and for improved access to routine NHS dental care. Prevention is at the heart of a sustainable healthcare system, and regular access to dental services plays an important role in achieving that. I welcome the accountability that the new clause seeks to introduce. In places where there are persistent challenges in accessing services-so-called dental deserts-local communities deserve transparency about what action is being taken and why improvements have not yet been delivered. As I have...
Welcome to another rerun of the 2010s -happier times for the Opposition. Sometimes they do not remember what happened, and I have to remind them-and every now and then, they remind us. This is a really important issue, not only for the hon. Member for Guildford, who tabled new clause 72, and the hon. Member for North Shropshire, who moved it, but for all our constituencies. It has been a huge priority for this Government. The Secretary of State will continue to have a duty to promote a comprehensive health service in England. In addition, clause 4 provides for an amended duty for the Secretary of State to reduce inequalities in access to services across England. However, we also recognise that practical action is needed to secure access to urgent and routine NHS dentistry care. As the Committee has discussed, that is why the Government have prioritised a number of improvements over the past two years. Last year, ICBs commissioned additional urgent dental care appointments, and there is now an urgent care safety net across the country. In April 2026, we introduced a requirement for NHS dental practices across England to deliver a set proportion of their contract as urgent care. Supported by increased payments for dentists delivering that care, that made it easier for patients to get prompt support through the NHS. We are committed to reforming the NHS dental contract by the end of this Parliament-something that could have been done at any point in the past 14 years. As a...
My hon. Friend the Member for Guildford has specifically requested that I press the new clause to a vote because she feels so strongly about the issues in her area. Question put, That the clause be read a Second time.
New Clause 76
Arrangement between the United States of America and the United Kingdom on pharmaceutical pricing
“(1) The Arrangement between the United States of America and the United Kingdom on pharmaceutical pricing may be ratified only if-
(a) a Minister of the Crown has laid before the House of Commons a copy of the Arrangement, and
(b) the Arrangement has been approved by a resolution of the House of Commons on a motion moved by a Minister of the Crown.
(2) Before tabling a motion under subsection (1)(b) the Secretary of State must publish and lay before the House of Commons an impact assessment on the potential effects on the health service of implementation of the Arrangement.”- (Helen Morgan.)
This new clause would require the Arrangement between the United States of America and the United Kingdom on pharmaceutical pricing to be brought before the House for a vote.
Brought up, and read the First time.
Question put, That the clause be read a Second time.
New Clause 77
Medical Disinformation
“(1) The Secretary of State must, within 6 months beginning on the day on which this Act is passed, publish a strategy on anti-vaccine and medical disinformation (‘the Strategy’).
(2) The strategy must consider-
(a) support for medical professionals to build trust and engage with persons who are anti-vaccine,
(b) support for medical professionals and NHS leaders to engage with anti-vaccine councillors or officials in local authorities,
(c) investment in public messaging to combat medical disinformation, including engagement with trusted online influencers,
(d) outreach campaigns focused on communities who are sceptical about vaccinations,
(e) introducing criminal liability for those, including online influencers and politicians, who profit from medical disinformation, and
(f) a new verification requirement for any social media account claiming to be a medical professional.
(3) The Secretary of State must lay a copy of this strategy before Parliament upon publication.”- (Helen Morgan.)
This new clause places a duty on the Secretary of State to publish a strategy to combat anti-vaccine and medical disinformation.
Brought up, and read the First time.
I beg to move, That the clause be read a Second time. The new clause would place a duty on the Secretary of State “to publish a strategy to combat anti-vaccine and medical disinformation”. We increasingly see the impact of anti-vax and medical disinformation. Lower vaccination rates have been recognised as a growing threat to public health this year, and in February the NHS launched a new vaccination campaign following concerns about the declining uptake of measles, mumps and rubella vaccinations. Disinformation, including anti-vax conspiracy theories, is dangerous and leads to increased levels of preventable illness. The leader of Reform UK has platformed prominent anti-vaccine conspiracy theories at his conferences, and Reform UK needs to be held accountable for its role in this. It is amplifying and importing the conspiracy theories and outright dangerous views of the US President and Robert F. Kennedy. The leader of Reform UK has refused to condemn Donald Trump’s medical conspiracy theories, including unfounded claims about autism and paracetamol. Those views have had a very real effect in the US, undermining and hollowing out important scientific and medical institutions to the detriment of the nation’s health.
Does the hon. Member agree that the invention of vaccination by Jenner centuries ago is the single most important medical invention we have had in this country?
I absolutely agree. My mother and grandmother both had polio, which nobody would expect to experience in this day and age. That same grandmother’s sister died of diphtheria, and her father had smallpox. That was all just over 100 years ago, so it was not too long ago that people were experiencing what we now consider to be antiquated and unthinkable diseases. The vaccination programmes that have been brought in over the past century have undoubtedly been game-changing for public health, not least for people growing up with working-class backgrounds, as my family would have been. That is why it is so important to deal with the disinformation that allows unscientific and dangerous anti-vax views to be communicated convincingly to the wider community.
I agree with the hon. Member that people with power, especially those with political platforms, have used it to spread misinformation about vaccination. Some medical professionals working in our hospitals and the NHS-doctors and nurses-are also against vaccines. Can the hon. Member explain how we can tackle that issue?
It is really important not to blame people who have seen convincing information online or have been given convincing information by people who ought to know better-including at political party conferences. We need to battle the source of that information and ensure that accurate, factual information is available and communicated to everyone in an accessible way by people they trust. That is key to all this. As I have said before, ostracising or ridiculing people who have been given information in a very convincing way is not the way to resolve this problem. We need to tackle it in an understanding way by communicating the facts sympathetically and accessibly. It is important to note that concerns about vaccinations are not exclusive to a single group of voters. There is significant vaccine hesitancy across some ethnic minority communities and in hard-to-reach places across the country. We must do more to support doctors, nurses and the NHS to fight fiction with facts, or the long-term health of the country will suffer. That is what new clause 77 seeks to do. There is some great local work being done, but there needs to be a joined-up strategy to combat all aspects of disinformation, because a nice social media video telling people to get their jab will not beat it. Now that Reform UK has a greater presence in our local government, NHS leaders will have to handle more and more difficult conversations with anti-vax and conspiracy theorist councillors, and they deserve support...
The hon. Member has brought up an important topic. The Government absolutely recognise that inaccurate information can undermine confidence in vaccines, which are so important. We are already taking a multi-pronged approach to addressing that through national communications, support for healthcare professionals and the ongoing monitoring of emerging narratives. The evidence is clear that, although it is a risk, misinformation is not a primary cause for people not to take up the offer of vaccinations. Rather, practical barriers such as access to services, socioeconomic factors and levels of awareness play a more significant role. We are already acting to reduce those barriers, with targeted action to improve access, strengthen communications and support frontline staff. A new statutory strategy focused solely on disinformation would risk narrowing our approach when a broader, evidence-led response is required. For those reasons, we do not consider the new clause to be the right approach. I recognise much of what the hon. Member says about access to information, but we want to maintain a wider approach. On that basis, I respectfully ask her to withdraw the new clause.
I thank the Minister for her response. I think it is important that we keep an eye on the power of medical misinformation or disinformation, and expand that consideration to things such as therapy chatbots. It is not just an online problem, but an AI problem-it is not just malign influences that cause the problem. I beg to ask to leave to withdraw the motion. Clause, by leave, withdrawn. New Clause 81 Minimum service levels “(1) Within six months beginning on the day on which this Act is passed, the Secretary of State must, by regulations, make provision for minimum service levels to operate in the NHS during periods of strike action. (2) Regulations under subsection (1) may repeal or otherwise amend provisions in the Employment Rights Act 2025, insofar as is necessary for the purposes of this section. (3) Regulations under subsection (1) must include provision for minimum levels of service by categories of NHS workforce staff, including all Agenda for Change staff but not doctors. (4) Regulations under subsection (1) may not be made unless a draft of the instrument has been laid before and approved by a resolution of each House of Parliament. (5) When minimum service levels are in operation under this section, the NHS must set minimum standards of acceptable service to be provided by the NHS during periods of strike action, including mitigating any effect on appointments, medical procedures, acute services, midwifery, surgical procedures, and any other matters that the...
I beg to move, That the clause be read a Second time.
The Chair
With this it will be convenient to discuss new clause 82- Strike action - “(1) It is an offence for medical practitioners to undertake strike action. (2) The Secretary of State may repeal or otherwise amend provisions in the Employment Rights Act 2025, insofar as is necessary for the purposes of this section.” This new clause would make it illegal for doctors to go on strike.
New clauses 81 and 82 stand in my name. As a doctor, I felt deeply uncomfortable with the morality of going on strike, with doctors leaving their patients to suffer in order to get more money for themselves. That is one of the reasons why the previous Government introduced minimum service legislation to ban strikes in essential services. We are clear that we would not allow doctors to go on strike, just as the police and the military cannot. These are key services and key people for the functioning of our country. Unfortunately, on 6 August, one month after entering office, this Government announced that they would repeal the minimum service legislation, leaving the safety of patients at the behest of union barons. Despite resident doctors having a 28.9% pay rise, we have seen damaging strike action across the NHS: the Minister wrote that the strike action has cost £1 billion since July 2024. The latest round of strikes in April 2026 led to the cancellation of almost 50,000 appointments, on this Government’s watch. Those are all patients who are waiting.
I am interested in what the hon. Member has to say about strike action. I was involved in trying to get the resident doctors’ strike stopped, but was unsuccessful for many months. I think she is talking about the principle of whether people involved in medical care should ever go on strike. If she were to apply the proposed measure to medical practitioners, would she introduce the same rule for nurses?
If the hon. Gentleman reads new clauses 81 and 82 together, he will see that one of them would require doctors not to go on strike, because they are involved in the clinical decision making across the piece, while the other would make provision for staff across the NHS to be on minimum service level provision. That is something that I maintained under the previous Government as well: I do not think that doctors should go on strike, in the same way that the police and the military do not go on strike. Medical professionals are key to the functioning of a hospital in a way that means they should not go on strike. Other staff within the hospital provide an extremely valuable and important service, but often several individuals provide that service, so it might be possible to say, “We can have three here rather than five today and still deliver most of the service.” Fundamentally, I do not think that it is morally right for doctors to go on strike, because in effect they are saying to people, “We know you’ve been waiting for your knee replacement for a year and we know your knee hurts, but we’re not going to do your knee replacement today, because we’re going to go on strike for more cash.” I just do not think that that is right. [Interruption.] I will take an intervention from my hon. Friend the Member for Farnham and Bordon.
My hon. Friend has just sat down. I was not sure whether she had finished her speech or was willing to take an intervention.
I will take an intervention.
Well-I just say carry on, that’s what I say!
Will the hon. Lady take another intervention, Ms Lewell?
The Chair
That is up to the hon. Lady.
I am very happy to take an intervention.
This is, obviously, a very interesting discussion. I agree-I actually do-that medical practitioners should not go on strike, but the question is whether that should be the law. I would apply the same question to nurses, a point that the hon. Lady has not answered.
For generations, it has not needed to be the law: doctors did not go on strike, because they recognised what would happen to patients if they did. Now that we know that doctors will go on strike, the landscape has changed. Consultants-I should say that I am an NHS consultant-have just balloted to go on strike, which will be fundamentally unsafe. The Government have a duty to keep people safe; first and foremost, that is the Government’s job. Doctors going on strike is fundamentally unsafe and should not happen. I agree with the hon. Member for Bury St Edmunds and Stowmarket that morally it should not need to be the law, but I think the evidence suggests that it does. New clause 82 would make it “an offence for medical practitioners to undertake strike action”, and would provide for the Secretary of State to repeal any necessary clauses of other employment regulations in order to do so. New clause 81 concerns the minimum service levels provided across the NHS. There are staff who provide an important and valuable service but whose jobs may not be clinical; for example, services may be able to run with slightly fewer porters if they want to go on strike. I hope that no member of NHS staff would want to go on strike. I hope they would want to make sure that patients were getting care, and I hope they would recognise that, in a universal service, they are essentially causing harm to the patients around them, who are their friends, their neighbours, the people who live on their...
Hopefully, this is a pleasure postponed. I rise to support new clauses 81 and 82, tabled by my hon. Friend the Member for Sleaford and North Hykeham. As legislators, we have a moral duty to ensure that patients are protected during times of disruption in the NHS. Nobody disputes the fact that NHS staff work incredibly hard. They absolutely do. The dedication shown by doctors, nurses, paramedics, midwives and all those who keep our health service running deserves enormous respect. Having worked in healthcare for pretty much all my career, including for professional organisations such as the Royal College of Occupational Therapists, I know at first hand how hard they work. Equally, we need to recognise that the NHS is not an ordinary service. Working for it is not like being a shop assistant, a bin collector or a tax inspector; in its importance to the health and safety of this nation, it is more akin to being a police officer or a member of our armed forces. It is an essential public service. When people are at their most vulnerable, whether that is because they are waiting for an operation, procedure or intervention or because they are in the process of having those interventions, they must have confidence that the care they rely on will still be there. The right to strike has to come with responsibilities. In the NHS, the consequences of industrial action are real: cancelled operations, delayed treatments, missed appointments and increased pressure on emergency services....
There have been interesting discussions on these new clauses. I recognise that the intention behind them is to reduce the impact on patients and NHS budgets when doctors take industrial action. That is an objective that we all support, but I do not agree that the new clauses are the best way to achieve it. I respect the shadow Minister’s professional background and the strong moral case she set out to explain why she does not feel it is appropriate. For a long time, as she says, doctors did not go on strike, but something changed in the industrial relations landscape roughly 10 years ago to start that process, that change of culture and that frustration that led doctors to strike. I listened with interest to the former Health and Social Care Secretary, the right hon. Member for Godalming and Ash (Sir Jeremy Hunt), reflecting on this issue recently-we’re all subject to podcasts these days, aren’t we? He spoke about those relationships at the time, and I think we should learn from that; it is very helpful to have those recollections. But something changed, and this has been the result. I pay tribute to my hon. Friend the Member for Bury St Edmunds and Stowmarket and many others of his vintage, if I can say that-
A fine vintage.
Indeed. They wanted to work with resident doctors to talk through a way to make progress without resorting to strike action, because that is a sign of failure in any system. On new clause 81, we are committed to reforming trade union legislation to bring it into the 21st century. We want to create an industrial relations framework that is fit for a modern economy, and workplaces that work for everyone. That is why the Employment Rights Act 2025 repealed the Strikes (Minimum Service Level) Act 2023. The previous legislation created a hostile environment, which was not conducive to good partnership working with trade unions or to settling disputes. On new clause 82, although strikes are hugely disruptive, a ban on a doctor’s right to strike is not the answer.
As I am sure the Minister knows, I have been a trade unionist since I started my teaching career some years ago. I have been involved in a number of industrial actions over that time, as a teacher and member of a trade union and as a trade union staffer. The driving force behind a significant majority of those industrial actions was not pay; it was often the safety of staff, the safety of sites, bullying managers or the inability to deliver an environment in which members felt they could deliver their best. Does the Minister agree that the ability to take industrial action is not always about money-grubbing or about pay? It is often about health and safety and about delivering the very best workplaces for our workers.
I thank my hon. Friend for bringing his experience to bear on this matter. I absolutely agree. New clause 82 stems from that resident doctors dispute. One of the first things that we did was to agree the 10-point plan with regard to the management in trusts. I have said before how truly shocking the working conditions are in many trusts not just for resident doctors, but for other doctors and professionals. There is no ability to take a break, have a rest or get away. Some of the equipment that they are dealing with is also shocking, as are the levels of the estate. Those are some of the many things that have driven and continue to drive poor industrial relations, along with the fact that there is no one to speak up for them.
The Minister says that if doctors want to go on strike, that is a failure of the system. The consultants have just balloted to go on strike. What failure in the system does she think has caused that?
I think I said that it is a failure of representatives on both the management side and the union side to agree a solution. That is what I meant by a failure of the system. Ultimately, strike action, as my hon. Friend the Member for Lichfield would attest, is a sign of the failure of good, conducive relationships and partnership working. That is why we never want to see it.
Constructive dialogue and co-operation with staff and trade unions is the best way to maintain industrial relations, in whatever area we are talking about. In that constructive spirit, I am pleased that we have seen the end of the long-running dispute with resident doctors, after they voted to accept the Government’s offer on jobs, pay and conditions. That is good news for patients, staff and the wider health service. I remind Members that striking workers are still subject to section 240 of the Trade Union and Labour Relations (Consolidation) Act 1992, which allows for criminal prosecutions for those who intentionally and maliciously endanger life or cause serious injury to a person by going on strike.
Ultimately, whether to take strike action is a decision for trade unions. At the same time, we want to work constructively with all unions to avoid disrupting services for patients. On the Opposition spokesperson’s point, it is disappointing that the consultants have balloted to potentially go on strike. Obviously, we will make every effort to work with them constructively, as we are doing with all service groups, to avoid that situation and to build an NHS fit for the future, which is something that we need to do with them in a constructive way. For those reasons, I ask her to withdraw the motion.
I understand the Minister’s interest in the balance between trade unions and patient safety. My personal view is that we should focus on patient safety. I am aware-anecdotally, to be fair-of examples of individual clinicians who were asked during previous strikes to come off the picket line to help and did not. I am also aware of many instances in which clinicians did, so it works both ways, but ultimately the Government’s job is to protect patients and put patient safety first. I will therefore press the new clauses to a vote. Question put, That the clause be read a Second time.
New Clause 82
Strike action
“(1) It is an offence for medical practitioners to undertake strike action.
(2) The Secretary of State may repeal or otherwise amend provisions in the Employment Rights Act 2025, insofar as is necessary for the purposes of this section.”- (Dr Caroline Johnson.)
This new clause would make it illegal for doctors to go on strike.
Brought up, and read the First time.
Question put, That the clause be read a Second time.
New Clause 83
Exemption from the Public Sector Equality Duty
“(1) Any organisation in receipt of public funding to provide health or social care services in England is exempt from the Public Sector Equality Duty (Chapter 1 of the Equality Act 2010) in respect of the provision of those services.
(2) The Secretary of State may make any regulations necessary to amend any other enactment as a consequence of subsection (1).” - (Dr Caroline Johnson.)
This new clause would exempt health and social care services in England from the Public Sector Equality Duty.
Brought up, and read the First time.
I beg to move, That the clause be read a Second time. In their final months in office, the last Labour Government introduced the Equality Act 2010. That consolidated several pieces of anti-discrimination legislation, which was welcome, but it also introduced a new public sector equality duty, requiring public authorities to have “due regard” to preventing unlawful discrimination and fostering equality of opportunity between groups. The public sector equality duty also requires authorities “to…encourage persons who share a relevant protected characteristic to participate in public life or in any other activity in which participation by such persons is disproportionately low.” Unfortunately, that has become a vehicle for social engineering. It was designed, I believe, to improve equality of opportunity, but it is being used to gerrymander equality of outcome instead. That can mean discrimination-against different groups of people, but discrimination nevertheless. That is clinically objectionable, because it means that health and social care staff may be recruited for reasons other than their clinical abilities, which are what we need and are most important. We have parts of the health service spending their time working on cultural learning classes and pushing paper around, rather than on patient care. We must get the health service back to basic healthcare, ensuring that it delivers the very best healthcare, free at the point of use, to all individuals based on their clinical...
With new clause 83, I think the hon. Member for Sleaford and North Hykeham would like to exempt organisations that receive public funding to provide health and social care services from the public sector equality duty. I do not agree with the intent of this measure. The duty under the Equality Act 2010 was designed to ensure that public authorities “have due regard to the need to…eliminate discrimination…advance equality of opportunity” and “foster good relations” in the exercise of their functions. That includes when designing and delivering services. It is not an unnecessary addition but part of good service design and delivery. The duty is not there to dictate a particular outcome or set of priorities for the decision maker; it is there to help decision makers understand and take account of the consequences of their choices. It ensures that issues of discrimination, equality of opportunity and good relations between different groups of people are not overlooked during complex decision making. That is why it is important for publicly funded providers of health and social care to have due regard to the duty. The public sector equality duty should always be applied in a proportionate way. It should not create an administrative burden. If a provider of health and social care is taking a decision that has little or no consequence to equality outcomes, it needs only to note that. It is for that reason that I ask the hon. Member to withdraw her new clause.
I wish to press new clause 83 to a vote. Question put, That the clause be read a Second time.
New Clause 84
Publication of data on avoidable deaths
“(1) The Secretary of State must publish every quarter the number of avoidable deaths where waits of more than 12 hours in accident and emergency departments was a contributory factor.
(2) The Secretary of State must make the data under subsection (1) available by integrated care board area.”- (Dr Caroline Johnson.)
This new clause would require the Secretary of State to publish data on avoidable deaths caused by waits over 12 hours in A&E departments.
Brought up, and read the First time.
Question put, That the clause be read a Second time.
New Clause 85
Patient safety recommendations: Government response
“(1) This section applies where the Secretary of State commissions a review or a report into a patient safety issue.
(2) The Secretary of State must-
(a) decide within six months whether they are going to implement each recommendation;
(b) publish a response to each recommendation with a clear statement of whether the recommendation is to be implemented; and
(c) publish a timeline for implementation of those recommendations which they have decided to implement.”- (Dr Caroline Johnson.)
This new clause requires the Secretary of State to respond to patient safety recommendations.
Brought up, and read the First time.
I beg to move, That the clause be read a Second time.
The Chair
With this it will be convenient to discuss new clause 98- Response to the Hughes Report: options for redress for those harmed by valproate and pelvic mesh - “The Secretary of State must, within 30 days of the day on which this Act is passed, publish the government’s response to the Hughes Report.” This new clause would require the Secretary of State to publish the government’s response to the Hughes Report within 30 days of this Act being passed.
The Minister will remember the evidence given earlier in Committee by my right hon. Friend the Member for Godalming and Ash, in our first sitting. As our longest-serving Health Secretary, my right hon. Friend focused much of his tenure on patient safety, and yet, as he made clear: “We are the world champion at doing inquiries and reports. Unfortunately we are also the world champion at allowing those reports to gather dust without anything actually happening.” -[ Official Report, Health Public Bill Committee, 16 June 2026; c. 30, Q52.] One clear example of that so far is the Hughes report. Twenty-nine months ago, Professor Henrietta Hughes published a report outlining redress for thousands of victims of the pelvic mesh and sodium valproate scandal. Time and time again, I and other hon. and right hon. Members have asked this Government when they plan to respond. Every time, the answer is, “Soon”, “At the earliest opportunity”, or, “We’re working on it”, but warm words are not enough to secure patient safety. Can the Minister confirm when she intends to publish the Government response to the Hughes report? Many patient safety recommendations prompt questions about the effectiveness of the Care Quality Commission, the national care regulator. The former Health Secretary claimed that it was not fit for purpose, and yet the Government have decided to bring HSSIB-Health Services Safety Investigations Body-within the CQC, as well as to add other measures, including events...
I declare that I am a member of the all-party parliamentary group on patient safety. Patient safety cannot be something that is discussed only after a tragedy has occurred. It requires a culture of accountability, transparency, and most importantly, action. That is why the new clause is such a sensible and important amendment to the Bill. It would not dictate the outcome of every review or every recommendation, but it would require the Government to respond properly. The new clause would create a straightforward expectation that when experts have identified changes that could improve patient safety, Ministers cannot simply leave those recommendations unanswered. The new clause pushes that forward, as recommended by my right hon. Friend the Member for Godalming and Ash. There must be a clear process and a clear timeline. Such a process and principle are closely connected with new clause 98 and the Government response to the Hughes report on those harmed by sodium valproate and pelvic mesh. Those are deeply serious issues involving people who have suffered life-changing consequences and have spent years seeking recognition and redress. Last week, I think, at the Health and Social Care Committee, I questioned the current Secretary of State on this matter, and his answer was equivocating, dissembling and, I am afraid to say, frankly unacceptable to those patients who have suffered from both those. He could not even tell me whether the response would be published by the end of...
I am grateful to the hon. Member for Sleaford and North Hykeham for bringing this discussion before the Committee again today. The safety recommendations are an important mechanism for improving services and securing better outcomes for patients. We support the aim of bringing greater clarity to the recommendations landscape, and we are already taking forward work in this area. The Dash review of patient safety across the health and care landscape found that a very high number of recommendations have been made to the NHS that often lack any cost-benefit analysis, which is why the 10-year health plan committed to giving specific responsibility for reviewing, analysing and taking forward recommendations to the national quality board. In line with the Dash review, work is progressing on a recommendations hub that will sit within the Department. The hub will include a repository to hold all national-level recommendations relevant to care quality, including safety, effectiveness and patient experience. It will provide an efficient system for co-ordinating, prioritising and overseeing recommendations made by the national quality board. The hub will record responsibility for implementing prioritised recommendations and, once fully operational, strengthen transparency and accountability for how they are taken forward, which is something I think we all welcome. This new approach will enable the NHS to focus on the actions most likely to enhance patient outcomes. Where reviews or...
The new clauses ask the Government to respond to recommendations on patient safety, and to say within six months whether they will implement them. As I said, we have been waiting several years for the Hughes report response. All new clause 98 would require is that the Secretary of State must, within 30 days of the Bill’s passage, publish the Government’s response to the report. That, in itself, is not immediately soon; it is 30 days after the Bill is passed, and it is still yet to go through the Lords and return to the Commons. The new clause would effectively provide a backstop or legal end date-it is still too far away-after which the Government cannot go any further. I will be very disappointed if the Government are not prepared to do that, so I would like to press the new clause to a vote. These people have waited long enough. Question put, That the clause be read a Second time.
New Clause 86
Referrals by general practitioners
“NHS Trusts and NHS Foundation Trusts must ensure that all general practitioners are able to directly refer patients to consultants.”- (Dr Caroline Johnson.)
This new clause would ensure that GPs must be able to refer patients directly to consultants.
Brought up, and read the First time.
I beg to move, That the clause be read a Second time. Advice and guidance services were an improvement. Previously, if a general practitioner wanted to refer someone to hospital, a consultant would triage the referral. Sometimes, the referral was not needed, so a message would be written to the GP saying, “I wonder if you’ve tried this” or “Could you give more information, please?” Improving that process was the advice and guidance service, which in many ways is beneficial. I am, however, concerned by the suggestion earlier in the year that advice and guidance will become a compulsory feature, and that only after advice and guidance has been received will there be potential for referral. Instead of a GP being able to refer to a consultant and a consultant being able to accept that referral, advice and guidance will have to be sought first. That will cause a delay in patient pathways and flow. It may mean that the date on which the person is added to the waiting list for an appointment is a couple of days later. That may slow things down and improve the figures, but I cannot see any clinical benefit from mandating it. There is also a concern that there would be what is called a diversion rate of at least 25% by March 2027 for at least 10 high-volume specialties. I am concerned about that. If someone gets to the point of being given a hospital appointment, that is because the clinician who saw them in primary care used their clinical judgment to decide that the patient needed...
I wonder whether the hon. Member’s experience mirrors mine. Many years ago, it seemed to be easy for general practitioners to ring me up. I often received telephone calls from general practitioners asking for advice about patients. As time went on, general practitioners became busier and busier and seemed to have less time to telephone consultants. When I started my consultant career, I spoke often to general practitioners, and by the time I got elected to Parliament and had to stop, I found that was a very unusual thing. Has her experience been similar?
I think we are all getting busier. As such, it is harder for clinicians in primary care to phone the consultant and speak to them, because both are busy and potentially seeing patients. I am not criticising the ability to have an advice and guidance service, because it is helpful. We do the same with specialists in tertiary centres, for example. One might send them a message asking a question. Advice and guidance is a good principle. My concern is that it would remove the ability for consultants to refer directly, introducing an unnecessary delay in the system. Are we questioning the judgment of clinicians? Why do we want to reduce the number of patients who get put on the list by a quarter? I recognise, as I am sure the hon. Member for Bury St Edmunds and Stowmarket does, that sometimes referrals could be better directed. There is a mechanism already for doing that, but new clause 86 reflects the fact that general practitioners should still be able to refer patients using their clinical judgment to a consultant. That may be someone who the patient has chosen to see or who the GP believes is right for the patient’s condition.
The other important fact is that more and more hospital referrals were not coming from general practitioners at all, but from other people working in the general practice such as nurses and physician associates, who are less confident in forming a clinical judgment.
If they are, they can use the advice and guidance service. The point is that when a general practitioner wants to refer his or her patient to a consultant on the basis of their clinical need, they should be able to. That is the purpose of the new clause.
As someone who previously set up a referral management service, I feel the need to join in this interesting clinical discussion while everybody else watches us for the next hour and a half, but I am not going to do that. Some interesting points have been raised. To add my two pennies’ worth to the point made by my hon. Friend the Member for Bury St Edmunds and Stowmarket, the change in practice is partly due to increased specialism among consultants, which makes it harder to refer. When we set up a referral management service in Bristol, two issues were the pressure on general practice and the use of locums, who were perhaps working temporarily in the area and did not know the full range of available community services. That was some 12 years ago, so greater support on advice and guidance is long overdue as we roll this out. At the end of the day, the aim is to support patients getting the right clinical care in the right place as fast as possible. We want patients to have timely assessment of their care needs and clear next steps in the right settings. GP referrals and support for GPs in making those referrals is crucial. The advice and guidance model, which allows GPs to seek rapid specialist input into a patient’s care without an initial face-to-face appointment, and the single point of access model, which will be rolled out in October, support GPs and hospital specialists to work together and make the best treatment plans for patients while reducing unnecessary referrals...
If the hon. Lady is correct, she will not be perturbed by the new clause, which simply says that general practitioners must be able to directly refer patients to consultants when clinical need requires it. I would like to press the new clause to a vote. Question put, That the clause be read a Second time.
New Clause 87
Prioritising British citizens for the UK foundation programme
“(1) The Medical Training (Prioritisation) Act 2026 is amended as follows.
(2) In section 4, after subsection (4) insert-
‘(4A) A person is within this subsection if they-
(a) are a British citizen, and
(b) hold a primary medical qualification from an international branch campus of a higher education institution in the United Kingdom.’” - (Dr Johnson.)
This new clause amends the Medical Training (Prioritisation) Act 2026 so that British citizens who have studied at international branch campuses of UK higher education institutions can be prioritised for foundation programme training places.
Brought up, and read the First time.
I beg to move, That the clause be read a Second time.
The Chair
With this it will be convenient to discuss new clause 113- Prioritising British citizens for the UK foundation programme (No. 2)- “(1) The Medical Training (Prioritisation) Act 2026 is amended as follows. (2) In section 4, after subsection (4) insert- ‘(4A) A person is within this subsection if they- (a) are a British citizen, (b) have indefinite leave to remain under the Immigration Act 1971, or (c) have settled status under the EU Settlement Scheme, and (d) hold a primary medical qualification from an international branch campus of a higher education institution in the United Kingdom.’” This new clause amends the Medical Training (Prioritisation) Act 2026 so that British citizens, people with indefinite leave to remain, or settled status who have studied at international branch campuses of UK higher education institutions can be prioritised for foundation programme training places.
New clause 87 would amend the Medical Training (Prioritisation) Act 2026 so that British citizens who have studied at international branch campuses of UK higher education institutions can be prioritised for foundation programme training places. Prioritising British students in the selection process would have been the right thing for the Government to do, but way the Medical Training Act has been drafted places British students who studied at international branch campuses of British universities at a disadvantage. On Second Reading of the Act, a Member spoke of a constituent who had been given “a formal guarantee that he would be at no disadvantage if he chose to study at the Malta campus.” -[ Official Report , 27 January 2026; Vol. 779, c. 801.] Another Member said that he had “representations from all quarters, both in the UK and in Malta, about the impact on Malta of this.” -[ Official Report , 27 January 2026; Vol. 779, c. 802.] My right hon. Friend the Member for South West Wiltshire (Dr Murrison) asked about “British students who for various reasons train at, for example, St George’s in Cyprus or St George’s in Grenada and who then want to come back and practise in our national health service”. -[ Official Report , 27 January 2026; Vol. 779, c. 803.] The hon. Member for Uxbridge and South Ruislip (Danny Beales) spoke of a constituent who was schooled and grew up here and was “given a guarantee by the university that she would face no disadvantage compared with students...
I appreciate the intention behind new clause 87, but the Government cannot support it. The Medical Training (Prioritisation) Act is designed to support a sustainable medical workforce that can meet population health needs and deliver the best patient care while reducing the UK’s reliance on an unpredictable international labour market. By creating a clear pathway for medical school to speciality training, we also strengthen domestic talent and improve retention. What matters is where a doctor is trained, not where they were born. Data shows that domestic graduates are more likely to stay in the country they trained in than those trained internationally. Doctors trained primarily in the UK are also likely to be better equipped to deliver healthcare that is tailored to the UK’s population, because they have a stronger understanding of UK-specific epidemiology and NHS practice. In addition, the Government set UK medical school places based on future health system needs. Student intakes and graduate outputs of overseas campuses are not included in our domestic workforce planning. If we prioritised British citizens for foundation training regardless of where they studied, it would undermine our aim to build UK-trained capacity while ensuring that we do not provide more foundation programme places than we need. I would like to emphasise-this is an important point-that prioritisation does not mean exclusion. Non-prioritised applicants can still apply for the foundation programme...
There are fewer than 100 students who are British citizens studying in Malta this year. Many of them have struggled to get a role on the foundation scheme. The Government have created a situation in which a British student doing a British degree at a British university with an overseas campus is put into the foundation scheme behind a foreign student studying here, or indeed in the same prioritisation group as a foreign student studying at a foreign university. That cannot be right, so I would like to push the new clause to a vote. Question put , That the clause be read a Second time.
New Clause 96
Report on dementia care
“(1) Within 12 months of the passage of this Act and every 12 months thereafter, the Secretary of State must publish and lay before both Houses of Parliament a report on-
(a) the provision of NHS care in relation to dementia.
(b) the provision of social care in relation to dementia.
(2) A report under subsection (1) must have regard to-
(a) any targets or standards set out in a national plan, guidance, or framework relating to dementia services, and
(b) any other information the Secretary of State considers appropriate.
(3) A report under subsection (1) must include-
(a) an assessment of variation in dementia services and outcomes between Integrated Care Board areas,
(b) information on workforce capacity, capability and training standards relevant to dementia care,
(c) information on access to ongoing post-diagnostic support services, including support for unpaid carers of dementia patients,
(d) information on continuity and coordination of care for people living with dementia, including access to a named professional responsible for coordinating support across services,
(e) outcomes and experiences for people living with dementia and unpaid carers, including crisis prevention, carer wellbeing, and experiences of joined-up care,
(f) progress on dementia prevention and risk reduction, and
(g) dementia research activity in the NHS.”- (Joe Robertson.)
This new clause would require the Secretary of State to publish an annual report on the provision of NHS care and social care in relation to dementia.
Brought up, and read the First time.
I beg to move, That the clause be read a Second time.
The Chair
With this it will be convenient to discuss New clause 97 -Publication of annual dementia care report- “(1) The Secretary of State must publish annually and lay before Parliament a report on- (a) the provision of NHS care in relation to dementia, and (b) provision of social care in relation to dementia. (2) In preparation of the report under subsection (1), the Secretary of State must have regard to targets, standards and outcome measures set out in national plans, guidance and frameworks relating to dementia services. (3) In preparation of the report under subsection (1), the Secretary of State may have regard to any such measures or information that they consider appropriate, including- (a) an assessment of any variation in dementia services and outcomes between integrated care board areas, (b) information on workforce capacity, capability and training standards relevant to dementia care, (c) information on access to ongoing post-diagnostic support services, including support for unpaid carers, (d) information on continuity and coordination of care for people living with dementia, including access to a named professional responsible for coordinating support across services, (e) outcomes and experiences for people living with dementia and unpaid carers, including crisis prevention, carer wellbeing, and experiences of joined-up care, (f) progress on dementia prevention and risk reduction, and (g) dementia research activity in the NHS. (4) The Secretary of State must publish...
It is a pleasure to serve with you in the Chair, Ms Lewell. These two new clauses, the latter of which is in my name, deal with the publication of an annual report detailing NHS and social care provision for dementia care and how the Government are performing against targets, standards and outcome measures set out in national guidance and frameworks relating to dementia services. I would like to thank three important charities working in this area: the Alzheimer’s Society, Alzheimer’s Research UK and Dementia UK. All three back the two new clauses. The data requested is imperative to ensuring that the Government can measure and monitor progress against relevant national targets, standards and guidance, including the new modern service framework on dementia, the forthcoming Care Quality Commission statutory guidance and outcome measures that may be set in future NHS operational planning guidance. That is crucial to improving transparency and accountability, allowing systems to see the full picture of dementia provision in England and highlighting challenge areas or inequalities. The Bill makes provision for the establishment of information systems to collect, analyse and publish health and care data that is in the interest of the health service in England. The clause fits into that and would require the collection of data on the provision of dementia services in health and social care. I do not propose to speak too long, but I do want to make a couple of remarks on the...
We largely agree with new clauses 96 and 97 and the comments of the hon. Member for Isle of Wight East. He cited some organisations: Alzheimer’s Society, Alzheimer’s Research UK and Dementia UK; hon. Members across the House have worked with them, and many other organisations in this field, and value the work that they do. The hon. Member rightly notes the work that they do to support the friends, families and carers of people with this disease, which is increasing in prevalence. He also commented on the importance of getting diagnosis earlier, and we are moving forward but we need to do so as fast as we can; I think we would all recognise that. I completely understand the rationale behind the new clauses and the urgency with which people want to have sight of the sort of information outlined in them, but we do not think that the new clauses are necessary. I will highlight why. Some of the data that would be requested by new clause 96, such as details of research in the NHS and reports of lived experience, is already available and often provided by our charity partners, as well as by others. The new clause would therefore lead to a duplication of work. Provision of the other pieces of requested information and the data collection required to produce the report required by the new clause would likely be very onerous, placing additional stress on an already overstretched sector, and would distract from the core task of improving dementia care. It would be especially difficult...
I beg to ask leave to withdraw the clause. Clause, by leave, withdrawn . New Clause 97 Publication of annual dementia care report “(1) The Secretary of State must publish annually and lay before Parliament a report on- (a) the provision of NHS care in relation to dementia, and (b) provision of social care in relation to dementia. (2) In preparation of the report under subsection (1), the Secretary of State must have regard to targets, standards and outcome measures set out in national plans, guidance and frameworks relating to dementia services. (3) In preparation of the report under subsection (1), the Secretary of State may have regard to any such measures or information that they consider appropriate, including- (a) an assessment of any variation in dementia services and outcomes between integrated care board areas, (b) information on workforce capacity, capability and training standards relevant to dementia care, (c) information on access to ongoing post-diagnostic support services, including support for unpaid carers, (d) information on continuity and coordination of care for people living with dementia, including access to a named professional responsible for coordinating support across services, (e) outcomes and experiences for people living with dementia and unpaid carers, including crisis prevention, carer wellbeing, and experiences of joined-up care, (f) progress on dementia prevention and risk reduction, and (g) dementia research activity in the NHS. (4) The...
New Clause 98
Response to the Hughes Report: options for redress for those harmed by valproate and pelvic mesh
“The Secretary of State must, within 30 days of the day on which this Act is passed, publish the government’s response to the Hughes Report.”- (Dr Caroline Johnson.)
This new clause would require the Secretary of State to publish the government’s response to the Hughes Report within 30 days of this Act being passed.
Brought up, and read the First time.
Question put, That the clause be read a Second time.
New Clause 99
Requirement for merit-based job allocations for doctors
“(1) The Medical Training (Prioritisation) Act 2026 is amended as follows.
(2) In section 1, at end insert-
‘(2) Applicants eligible under this section shall be prioritised based on merit, determined by reference to the applicant’s-
(a) qualifications,
(b) professional competence,
(c) clinical experience,
(d) skills, and
(e) ability to perform the duties of the post.’
(3) In section 2, after subsection (1) insert-
‘(1A) Applicants eligible under subsection (1) shall be prioritised based on merit, determined by reference to the applicant’s-
(a) qualifications,
(b) professional competence,
(c) clinical experience,
(d) skills, and
(e) ability to perform the duties of the post.’
(4) In section 3, after subsection (1) insert-
‘(1A) Applicants eligible under subsection (1) shall be prioritised based on merit, determined by reference to the applicant’s-
(a) qualifications,
(b) professional competence,
(c) clinical experience,
(d) skills, and
(e) ability to perform the duties of the post.’”
This new clause would create a requirement for merit-based job allocations for doctors. - (Dr Caroline Johnson.)
Brought up, and read the First time .
I beg to move, That the clause be read a Second time. Under the Government’s preference-informed allocation scheme, when a doctor is applying for a foundation post, they are allocated randomly to a job. They get to express a preference, but there is no work they can do to make them more likely to get where they want to be; there are no certificates they can earn, there is no research they can do, and there are no exam results they can get that would improve their chances. That is fundamentally wrong. The Government say that many people get their first choice, which is true. That is great for them, but it is not great for the people who do not get their choice and have no control over their future. We had a very good debate on this subject, attended by many people in this room, in January, and there was widespread agreement on both sides of the House that it was the wrong thing to do. The Minister said at the time that the Government would keep the system under review. Has the Minister reviewed the system? Does she believe that we should prioritise medical graduates with the most relevant qualifications, clinical experience and skills? Does she think that doctors should have the opportunity to have control over where in the country they work and what jobs they do? Should doctors be able to work harder, aim for better results or do additional activities in order to get themselves the job they want, or does she think it should all be done by a computer? I would be interested to...
I think the new clause refers specifically to the foundation programme-
Correct.
Does it actually say that in the new clause?
It would amend the relevant part of the Medical Training (Prioritisation) Act 2026, so that when people are put forward for these jobs in the foundation programme, it should be done on the basis of merit. At the moment, as the hon. Member is aware, it is done on the basis of random allocation-preference-informed allocation-which I think is wrong. I would be interested to know the Minister’s thoughts on the subject.
This is an area of some discussion, some of which we have heard, but we do not think it is necessary, where we are now, to put such a measure in primary legislation. The Medical Training (Prioritisation) Act establishes a statutory process for prioritising certain groups for training posts; it is not intended to change eligibility for training or the high standards that applicants must meet. Embedding some of these provisions in primary legislation would leave them inflexible to future workforce needs or standards of education and training. If Parliament wishes to change how recruitment processes themselves operate, that is best done outside legislation through established routes. The preference-informed allocation system was introduced in 2024 following stakeholder engagement, because the previous system was felt to be unfair and stressful for applicants, with a lack of standardisation across schools. Since its introduction, as I understand it, 82% of applicants have been allocated their first choice of foundation school this year, up from 71% in 2023. NHS England has committed to a review of the system, which will commence later this year. Prescribing the allocation method in legislation would pre-empt that review and limit our ability to make future changes to ensure that the system remains fit for purpose. On that basis, I ask the shadow Minister to withdraw the new clause.
The new clause deliberately says that applicants would be prioritised based on merit, and it gives examples of ways in which merit might be judged. I understand what the Minister says about some people getting the job of their choice, but the people who do not have no control over the process, and no ability to influence it through their own hard work and effort. That is fundamentally wrong in principle. Although I recognise that the current method was brought in as a result of consultation, I feel confident that the same consultation, done now, would reject it. We would like to vote on the new clause. Question put, That the clause be read a Second time.
New Clause 101
Plan to manage acquired brain injury
“(1) The Secretary of State must, within 30 days of the day on which this Act is passed, publish a plan for the management of acquired brain injury across England.
(2) A plan under subsection (1) must include but shall not be limited to-
(a) proposed government actions to prevent acquired brain injuries;
(b) proposed government actions to improve acute treatment for acquired brain injuries;
(c) a statement of priorities regarding the Secretary of State’s approach for rehabilitation and long-term support for persons with acquired brain injuries across public services delivered by-
(i) the Department for Health,
(ii) the Department for Education, and
(iii) the Ministry of Justice;
(d) proposals for data sharing between government departments, health care, and rehabilitation providers to improve patient-
(i) identification,
(ii) care,
(iii) support;
(e) a commitment providing 95% of people with complex needs with a personalised care plan by 2027;
(f) commitments for research into acquired brain injuries in sport;
(g) any proposed use of directions, guidance, financial assistance, incentives or other mechanisms to secure delivery of the plan’s objectives;
(h) workforce, diagnostic, digital and data requirements for implementation of the plan; and
(i) arrangements for monitoring, publishing and reporting progress against the plan.
(3) The plan under subsection (1) must be laid by the Secretary of State before both Houses of Parliament.
(4) The Secretary of State must, within 12 months of publishing a plan under subsection (1), and every 12 months thereafter until 2030, lay before Parliament a report on progress made against the proposals and commitments in the plan.”- (Dr Caroline Johnson.)
This new clause would require the Government to publish their action plan to manage acquired brain injury within 30 days of the passing of this Act.
Brought up, and read the First time .
I beg to move, That the clause be read a Second time. During a Westminster Hall debate in December, a Government Minister said: “In the coming months, in the first half of next year, I confirm that we will publish the acquired brain injury action plan”. -[ Official Report, 4 December 2025; Vol. 776, c. 472WH.] We are now in the second half of 2026. Members may be familiar with the charity Headway UK, which does phenomenal work to support people affected by brain injury, including people in my constituency. Headway has called for the Government to treat the plan as a priority, reiterating that every delay has real consequences and that survivors need support now. The all-party parliamentary group for acquired brain injury, which the hon. Member for Blaydon and Consett has done a great deal to support, has called for the Government to take action. So why is action not forthcoming? Why have the Government failed to deliver another policy on time? It is part of a pattern. The Government spent a year writing a 10-year plan. They spent another year working on a workforce plan, which still has not been published. It is simultaneously “imminent” as of 30 days ago and non-existent today. They are behind on the Hughes report, the modern service frameworks, universal 24/7 mechanical thrombectomy, fracture liaison services and more. The new clause would simply commit the Government to delivering on their promise to the 1 million people living with the effects of acquired brain injury. I...
I think all Committee members can recognise the importance of this issue. An acquired brain injury is a life-changing event for those affected, and for their families and loved ones. Its treatment involves co-ordination between primary, community, secondary and specialist care, and is personalised to the needs and life circumstances of the individual. Its effects are not limited to a person’s health: it can impact their journey through education, their employment prospects and so many other aspects of life. Because of that, they rightly expect coherent, joined-up support from across Government. Therefore, as we have discussed, we are working in partnership with eight other Government Departments, ABI charities, patient representatives and the NHS to develop an ABI action plan. We also continue to work closely with the United Kingdom Acquired Brain Injury Forum, which is the umbrella organisation for brain injury charities, as the plan develops and moves towards publication.
I am glad to hear that work is going on, but as the Minister may remember, work has been going on for a very long time-some Opposition Members may remember that past work. The issue is clearly important to people, so we need to see action-again, it is about how we get to that end. I would like to see some commitment from the Government. I recognise that the Minister is not in charge of the acquired brain injury strategy, but could she help us by referring the issue to the relevant Minister for an urgent discussion?
I thank my hon. Friend for her work on and commitment to this issue, as was highlighted by the shadow Minister. I thank her also for her work on the APPG and with organisations such as Headway, to which we pay tribute for its work supporting patients and the public, and for her work with Members of Parliament and the Government on getting this right, which is legion. My hon. Friend has made similar comments in the House. The Minister responsible is continuing to work on the action plan, which I will talk about as we continue our consideration. The new clause raises the issues of prevention, identification, acute treatment, rehabilitation, long-term support, care planning, workforce capability, data and research, all of which are being considered in the work being done across the eight Departments. The Government agree that there should be a plan, and the relevant Minister, to whom I will of course pass my hon. Friend’s comments, will be working on that. The question is whether the proposals in the new clause are best placed to ensure that any plan will be robust, sustainable and timely for the patients it is designed to serve. I say gently to the shadow Minister that I think they are not. First, setting an arbitrary 30-day timeline for publication risks causing either an unnecessary delay or a duplicate plan. Secondly, as I hope she will appreciate, we have engaged more widely than with just the three Departments named in the new clause. As I have said, as many as eight...
The Minister said that the plan is being developed with the pace that is needed, but it is not. It was due to have been published already, but it has not been. It was due to have been published, then a later promise was made, and now she is making another promise with an uncertain date. I just do not think it is good enough. A theme of our consideration this afternoon has been all the different things the Government have promised but have failed to deliver.
I too want to see a strategy-a strong strategy-and I will continue to talk about that, but will the hon. Lady acknowledge that the strategy has been talked about since before the general election? We needed to see action then, as we need to see action now.
Yes, I accept that it has taken too long, and that is the point. I assume that it must be ready to go, because the Minister has been working on having it published by the end of June, and we are in the middle of July. The Minister can inform us whether that is the case. We have reached a point where the Government keep saying “later”, “soon”, “imminent”, “in due course” and “working at pace”, but that is not helping to get this done. The new clause would force the Government to get on with it. That is what I think needs to be done, and that is why I will press it to a vote.
Question put, That the clause be read a Second time.
New Clause 104
Implementation of the Women's Health Strategy
“(1) The Secretary of State must, within 90 days of the date on which this Act receives Royal Assent, publish a women's health implementation plan (the ‘implementation plan’) setting out how the commitments in the document entitled ‘The Renewed Women's Health Strategy for England’ published on 15 April 2026 (or any successor document) will be delivered.
(2) The implementation plan must include, in particular-
(a) a timetable for delivering simpler access to long-acting reversible contraception (LARC);
(b) a trajectory for reducing the gynaecology waiting list and for reducing average diagnosis times for endometriosis;
(c) a plan for establishing the regional specialist centres for group-based women's health pathways, including contraception, heavy periods, uro-gynaecology and menopause; and
(d) measurable targets and milestones for each commitment in the strategy, including a baseline and timetable for delivery.
(3) The Secretary of State must lay the implementation plan before Parliament on the day it is published.
(4) In preparing the implementation plan, the Secretary of State must consult-
(a) the Royal College of Obstetricians and Gynaecologists,
(b) the Faculty of Sexual and Reproductive Healthcare, and
(c) patient organisations representing women affected by the conditions addressed by the strategy.”- (Dr Caroline Johnson.)
This new clause would require the Secretary of State to publish a women's health implementation plan setting out how the commitments in the document entitled "The Renewed Women's Health Strategy for England will be delivered.
Brought up, and read the First time.
Question put, That the clause be read a Second time.
New Clause 105
Self-care and health literacy in neighbourhood health plans
“(1) Guidance issued by the Secretary of State under section 14Z58 of the National Health Service Act 2006 as amended by section 24(4) of this Act (neighbourhood health plan) must require that every neighbourhood health plan includes arrangements for-
(a) supporting self-care and self-management, including by enabling people to manage minor and long-term conditions, and conditions that are self-limiting, themselves where it is safe and appropriate to do so;
(b) improving health literacy and ensuring that people living or working in the area have access to trusted, quality-assured information, advice and digital tools to support them in managing their own health and wellbeing;
(c) facilitating access to community pharmacy services, including pharmacy services that support self-care, the management of minor ailments and medicines optimisation;
(d) supporting patients to access the most appropriate level of care for their needs, including through patient-facing digital services connected to any system established under section 250E of the National Health Service Act 2006 (single patient record); and
(e) reducing avoidable demand on NHS services through the promotion of self-care and prevention.
(2) In preparing guidance under section 14Z58 of the National Health Service Act 2006 as amended by section 24(4) of this Act, the Secretary of State must have regard to-
(a) improving health literacy;
(b) the role of community pharmacy as an accessible point of contact for self-care support and health advice; and
(c) the contribution of digital tools and patient-facing services to enabling self-care, self-management and appropriate care navigation.
(3) The Secretary of State must, within 12 months of the date on which this Act receives Royal Assent, publish a self-care strategy for England (the ‘self-care strategy’) which must set out-
(a) the national framework within which neighbourhood health plans will be required to embed self-care and self-management, including the management of self-limiting conditions, as a core component of local health and care services;
(b) the steps the Secretary of State will take to promote self-care and health literacy as part of the prevention and early intervention agenda across the NHS;
(c) the role of community pharmacy in delivering the self-care strategy, including the services and information that community pharmacy is expected to provide in support of self-care;
(d) the role of patient-facing digital services, including any system established under section 250E of the National Health Service Act 2006, in supporting self-care, self-management and navigation to appropriate care;
(e) the steps the Secretary of State will take to reduce avoidable demand on NHS services through the promotion of self-care; and
(f) the measurable outcomes against which progress in implementing the self-care strategy will be assessed, and the arrangements for reporting on progress.
(4) The Secretary of State must lay the self-care strategy before Parliament on the day on which it is published and must review and update it at intervals of not more than three years.
(5) In this section-
‘neighbourhood health plan’ has the same meaning as in section 24;
‘self-care’ means the actions taken by individuals to maintain their own health, manage minor or long-term conditions, including conditions that are self-limiting, and prevent ill health, including through the use of over-the-counter medicines, health information and digital tools.”- (Dr Caroline Johnson.)
This new clause would require neighbourhood health plans to include arrangements for supporting self-care and self-management, including of minor and self-limiting conditions, and for improving health literacy. It would require guidance to the responsible local authority and integrated care boards to reflect these priorities, and would require the Secretary of State to publish a national self-care strategy setting out the framework, the role of community pharmacy and patient-facing digital services,
Brought up, and read the First time.
I beg to move, That the clause be read a Second time.
The Chair
With this it will be convenient to discuss new clause 106- Safe and proportionate reclassification of medicines - “Within 12 months of the date on which this Act receives Royal Assent, the Secretary of State must publish an assessment of- (a) opportunities to support self-care and prevention through the reclassification of medicines, (b) barriers to appropriate medicines reclassification within the current regulatory framework, (c) the impact of medicines reclassification on patient access, NHS demand and productivity, and (d) steps being taken to support a proportionate and agile regulatory framework for medicines reclassification whilst maintaining patient safety.” This new clause would require the Secretary of State to publish an assessment in relation to the safe and proportionate reclassification of medicines .
The Government’s 10-year health plan says that reducing hospital admissions is a key goal for the neighbourhood health service. These new clauses could help, because they would require the Secretary of State to support self-care and health literacy in neighbourhood health plans and to conduct a safe and proportionate reclassification of some medicines. Pressure on GPs continues to grow, with the total number of GP appointments reaching almost 377 million in 2025. The new clauses are designed to relieve pressure on the healthcare system and allow people to take back control of their healthcare. There are medicines that could be considered for reclassification from prescription-only to being available from pharmacists without a prescription, in the way that medication for migraines, for example, previously had to be prescribed but can now be bought with supervision from a chemist. How might measures to increase self-care or pharmacy care square with the Secretary of State’s duty to improve health inequalities outlined in the Bill? In addition, the new clauses might help neighbourhood health centres in rural communities to increase availability of medicines closer to people’s homes. I will stop there, because I know that we are running short of time. The principle is to give people the ability to take control of their own healthcare and to more easily access medications that are currently under a higher classification, where it is safe to do so.
On new clause 105, I can assure the hon. Lady that the Government are committed to supporting self-care. Community pharmacies already play a vital role by offering accessible advice and, where appropriate, over-the-counter medicines for minor ailments. Through Pharmacy First, patients can walk into a pharmacy or be referred by NHS 111, a GP or A&E for expert support, including access to treatment under the seven clinical pathways. That helps people get the right care quickly while easing pressures on other parts of the NHS. However, we do not think that it is necessary to specify health literacy and self-care in neighbourhood health plans. The neighbourhood health framework is clear that ICBs and local authorities should work together through health and wellbeing boards to develop locally led neighbourhood plans to improve local population health and reduce health inequalities. The framework sets out what should be included in those plans, and is clear that neighbourhood health plans should be informed by local joint strategic needs assessments. If local areas think they would benefit from having a greater focus on self-care and health literacy, they are of course free to do so. However, that is for them to decide, based on their understanding of the local area’s needs. That permissive approach recognises that local leaders know their communities best and are therefore best placed to determine how to meet the population’s needs. We are not setting a ceiling on what local...
New Clause 106
Safe and proportionate reclassification of medicines
“Within 12 months of the date on which this Act receives Royal Assent, the Secretary of State must publish an assessment of-
(a) opportunities to support self-care and prevention through the reclassification of medicines,
(b) barriers to appropriate medicines reclassification within the current regulatory framework,
(c) the impact of medicines reclassification on patient access, NHS demand and productivity, and
(d) steps being taken to support a proportionate and agile regulatory framework for medicines reclassification whilst maintaining patient safety.”- (Dr Caroline Johnson.)
This new clause would require the Secretary of State to publish an assessment in relation to the safe and proportionate reclassification of medicines.
Brought up, and read the First time.
Question put, That the clause be read a Second time.
New Clause 108
Duty to collect information: Deaths awaiting palliative care
“After section 14Z44 of the NHS Act 2006 insert-
‘Duty to collect information: Deaths awaiting palliative care
(1) Each integrated care board must collect data on the number of patients who died while waiting for end-of-life care.
(2) Data under subsection (1) must be held anonymised and published by the Department of Health and Social Care.’”- (Helen Morgan.)
This new clause would place a duty on ICBs to collect and publish data on the number of patients who died while waiting for end-of-life care.
Brought up, and read the First time .
I beg to move, That the clause be read a Second time.
The Chair
With this it will be convenient to discuss new clause 109- Hospices revenue funding - “The Secretary of State must ensure that any funding for hospices is allocated for three-year periods.” This new clause places a duty on the Secretary of State to ensure that funding allocations for hospices is made on a three year basis.
New clause 108, tabled by my hon. Friend the Member for Mid Sussex (Alison Bennett), will place a duty on ICBs to collect and publish data on the number of patients who died while waiting for end-of-life care. This is a fairly self-explanatory new clause, so I will keep my remarks brief. We know anecdotally that palliative care provision is very patchy across the country and can be something of a postcode lottery, and that many people who die in hospital would have preferred to die at home with the support of hospice outreach services or in a hospice itself. The new clause would ensure that we understand how many of those people there are and where they are located, so that we can consider whether hospice provision is appropriately provided in the right places. I hope the Minister will consider the importance of the new clause, which would allow us to have a much more comprehensive palliative care service across the country.
New clause 109, tabled in my name, is very simple, requiring hospice funding to be provided in three-year blocks. Hospices are struggling under the weight of the national insurance rise in the Government’s first Budget, so they would benefit greatly from having a bit more certainty over how much their funding will be from year to year. I am interested to hear the Minister’s response to the new clause.
This is a really important subject, as everyone approaching the end of their life deserves dignified, compassionate and high-quality palliative and end-of-life care. Hospices provide extraordinary care, and hon. Members are right to highlight the issues the sector faces. That is why the Government are committed to developing a modern service framework for palliative care and end-of-life care. The final framework will be published in the autumn. New clause 108 would require integrated care boards to collect and report data on people who died while waiting for end-of-life care. It would also require the Department of Health and Social Care to publish that information nationally. New clause 109 would impose a single statutory three-year funding period on hospice funding. Both new clauses are likely to be answered by work already under way or included in the modern service framework. On funding, we recognise that the sector faces a serious challenge, and the Public Accounts Committee found in March that integrated care board funding ranges from 0% to 80% of an individual hospice’s income, and that commissioning relies on grants and block contracts. There are also wider funding issues, such as the reliance on historic grants. The Government are acting on those issues, and we have provided around £80 million over three years for children and young people’s hospices, or at least £26 million a year to 2028-29, adjusted for inflation. We have also provided a separate £125 million...
I thank the Minister for her response, and I beg to ask leave to withdraw the motion. Clause, by leave, withdrawn .
The Chair
We now come to new clause 109 tabled in the name of Dr Caroline Johnson. I call Dr Johnson to move the new clause.
I would like to move the new clause. We see hospices in huge financial distress at the moment, and we need to get their funding on a more certain footing. New Clause 109 Hospices revenue funding “The Secretary of State must ensure that any funding for hospices is allocated for three-year periods.” This new clause places a duty on the Secretary of State to ensure that funding allocations for hospices is made on a three year basis. - (Dr Caroline Johnson.) Brought up, and read the First time. Question put, That the clause be read a Second time.
New Clause 112
Armed Forces Covenant Duty Reporting
“(1) Within six months of the passage of this Act, and every 12 months thereafter, the Secretary of State must publish a report on the extent to which the duty for due regard for health and social care matters under the Armed Forces Covenant established by the Armed Forces Act 2006 has been met.
(2) The report under subsection (1) must include an assessment of-
(a) the extent to which the health and social care needs of the armed forces community are being embedded in health and social care guidance, workforce training, and professional standards in the NHS,
(b) the impact of national schemes such as-
(i) the Veteran-Aware Trust accreditation,
(ii) the Veteran-Friendly GP Accreditation Scheme, and
(iii) the National Armed Forces Training and Education Programme on the provision of health and social care for the armed forces community,
(c) collaboration between devolved administrations and the Department for Health and Social Care regarding the delivery of health and social care for the armed forces community, and
(d) provision for data collection on the armed forces community's access to and experience of NHS health and social care.
(3) The report under subsection (1) must be laid before both Houses of Parliament.”- (Dr Caroline Johnson.)
This new clause requires the Secretary of State to publish an annual report on the extent to which the duty for due regard for health and social care matters under the Armed Forces Covenant established by the Armed Forces Act 2006 has been met.
Brought up, and read the First time .
I beg to move, That the clause be read a Second time.
The Chair
With this it will be convenient to discuss the following: New clause 110- Duty to promote the health and wellbeing of armed forces veterans - “After section 14Z44 of the NHS Act 2006 insert- ‘Duty to promote the health and wellbeing of armed forces veterans (1) Each integrated care board must exercise its functions with a view to improving and maintaining the physical health, mental health, and wellbeing of armed forces veterans 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 veterans, (b) prevention of deterioration in veterans’ physical and/or mental health, (c) the need to ensure veterans 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 provide veterans with information about support available to them for their health and wellbeing. (4) In preparing a neighbourhood health plan under section 24 of the Health Act 2026 an integrated care board must include- (a) an assessment of the health and wellbeing needs of veterans within its area, (b) steps the integrated care board proposes to take to improve outcomes for veterans, and (c) measures for reducing inequalities experienced by veterans.’” This new clause would introduce a duty for integrated care boards to promote the health and wellbeing of armed...
Under the previous Conservative Government, the NHS constitution was updated with a commitment to guarantee that “those in the armed forces, reservists, their families and veterans are not disadvantaged in accessing health services in the area they reside.” The previous Government also introduced the veterans’ strategy action plan, committing NHS England to providing millions of pounds for specialised support services. Ministers also introduced a single point for veterans to access mental health services and support. The previous Conservative Government also created an armed forces covenant duty. Today, we need to see the principles the covenant brought to life at all levels of Government. Only last week, I received an email from a constituent who has moved around because of her husband’s service in the armed forces and who was struggling to access specialist services for her child’s health as a result. That is why we need new clause 112, which would require the Health Secretary to report on how they are meeting the duties under the covenant. Members will know that I am cautious about mandating any more paperwork, but veterans are being let down. We need some accountability. That report would hopefully achieve that, so I commend the new clause to the Committee.
On new clause 110, the Government are proud of the courage and dedication of our armed forces. We must all play our part in upholding the armed forces covenant, including for our armed forces veterans. The original covenant was under a Labour Government; I was proud, as part of my commissioning duties in Bristol, to work with the Royal British Legion to implement that more than a decade ago, and the work continues. I am therefore sympathetic to the intention to promote the health and wellbeing of our armed forces veterans, but I can assure hon. Members that the new clause is not necessary. The Government’s vision for veterans is clearly set out in the veterans strategy, which recognises veterans as one of the UK’s greatest strategic assets. Furthermore, the existing armed forces covenant duty already places a legal obligation on integrated care boards to give due regard to the unique obligations and sacrifices of the armed forces when carrying out their statutory duties.
In terms of ICBs and their responsibilities to veterans, there are specialist veterans’ services around the country. One exists in my constituency, at the orthopaedic hospital in Gobowen, which has an excellent veterans’ centre. Yet the commissioning and payment for those services between ICBs is complex, messy and unnecessarily difficult. Would the Minister consider using the measures at her disposal to ensure that those things can happen more smoothly in the future?
I thank the hon. Lady for referencing that service in her constituency. I am not aware of the complications in the funding, but I will commit to getting back to her to understand that better, and I will see what the responses are from the commissioning function-I suspect it is a specialised one that falls between many different people. I am sure it has a long history, but I am afraid I am not directly aware of it, but I commit to getting a satisfactory response to her. The covenant duty is underpinned by two core principles: first, that disadvantages arising from membership of the armed forces community should, where possible, be removed; and secondly, that special provision may be appropriate for those who have given the most, such as the injured and bereaved. Beyond that, ICBs have a range of inequalities-related duties relevant to the circumstances of veterans. They include a duty to have regard to the need to reduce inequalities between persons in accessing health services and in outcomes achieved from those services; a duty to have regard to the wider effect of decisions, including inequalities relating to health and wellbeing and to the benefits obtained from the provision of health services; and the public sector equality duty, with which all public sector bodies must comply. Therefore, there is already a range of legal duties on integrated care boards to promote the health and wellbeing of veterans as part of the community the ICB serves. It is precisely because...
New Schedule 1
Pharmaceutical services: appeals etc
“1 The National Health Service Act 2006 is amended as follows.
2 (1) Section 130 (regulations as to pharmaceutical services: appeals, etc) is amended as follows.
(2) In subsection (2) for “First-tier Tribunal” substitute “relevant appeal body”.
(3) After subsection (2) insert-
“(2A) In subsection (2) “relevant appeal body” has the meaning given by section 158(9).”
3 (1) Section 132 (persons authorised to provide pharmaceutical services) is amended as follows.
(2) In subsection (5) for “First-tier Tribunal” substitute “relevant appeal body”.
(3) After subsection (5) insert-
“(5A) In subsection (5) “relevant appeal body” has the meaning given by section 158(9).”
4 (1) Section 154 (suspension) is amended as follows.
(2) In subsections (6)(b) and (c), (7) and (8), for “First-tier Tribunal”, in each place it occurs, substitute “relevant appeal body”.
(3) After subsection (8) insert-
“(8A) In subsections (6) to (8) “relevant appeal body” has the meaning given by section 158(9).”
5 (1) Section 155 (suspension pending appeal) is amended as follows.
(2) In subsections (4) and (6), for “First-tier Tribunal” substitute “relevant appeal body”.
(3) After subsection (7) insert-
“(8) In this section “relevant appeal body” has the meaning given by section 158(9).”
6 (1) Section 157 (review of decisions) is amended as follows.
(2) In subsection (1), for “First-tier Tribunal” substitute “relevant appeal body”.
(3) After subsection (3) insert-
“(4) In this section “relevant appeal body” has the meaning given by section 158(9).”
7 (1) Section 158 (appeals) is amended as follows.
(2) In subsections (1), (4), (5), (6) and (7), for “First-tier Tribunal”, in each place it occurs, substitute “relevant appeal body”.
(3) After subsection (8) insert-
“(9) In this section “relevant appeal body” means an NHS body specified by regulations made by the Secretary of State.”
8 For section 159 substitute-
“159 Pharmaceutical lists: national disqualification
(1) The relevant appeal body may impose a national disqualification on a person if-
(a) it removes the person from a pharmaceutical list, or
(b) it dismisses an appeal by the person against a refusal to include them in a pharmaceutical list.
(2) A national disqualification under this section disqualifies the person on whom it is imposed from inclusion in any pharmaceutical list prepared by an integrated care board.
(3) An integrated care board-
(a) must not include a person in a pharmaceutical list if the person is subject to a national disqualification under this section, and
(b) must remove from a pharmaceutical list any person who is subject to a national disqualification under this section.
(4) A person on whom a national disqualification is imposed under this section may request the relevant appeal body to review their decision to impose the disqualification.
(5) On a review, the relevant appeal body may confirm or revoke the disqualification.
(6) A person may not request a review before the end of the period of-
(a) two years beginning with the date on which the national disqualification was imposed, or
(b) one year beginning with the date of the decision on the last such review.
(7) See section 168B for an alternative power to disqualify a person from inclusion in the pharmaceutical lists (and other lists) on an application to the First-tier Tribunal.”
9 After Part 7 insert-
“Part 7A
Primary care: national disqualification
168B National disqualification orders
(1) The First-tier Tribunal may make a disqualification order in respect of a person on an application made in accordance with this section.
(2) A disqualification order is an order-
(a) disqualifying a person from inclusion in any relevant list, or
(b) disqualifying a person from inclusion in a description of relevant lists specified in the order.
(3) A disqualification order may be made only on an application by the person responsible for preparing a relevant English list and only if they have-
(a) removed the person in respect of whom the disqualification order is sought from a relevant English list, or
(b) refused to include that person in a relevant English list.
(4) Any such application must be made before the end of the period of three months beginning with the date of the removal or refusal.
(5) In this section-
“relevant English list” means-
(a) a pharmaceutical list,
(b) a list under section 147A,
(c) a list under section 91, 106, or 123, or
(d) a list corresponding to a list under section 91 prepared by virtue of regulations made under section 145;
“relevant list” means-
(a) a relevant English list, or
(b) a relevant Welsh list;
“relevant Welsh list” means a list corresponding to a relevant English list prepared by each Local Health Board under or by virtue of the National Health Service (Wales) Act 2006.
168C Effect of disqualification order
(1) A person responsible for preparing a relevant list-
(a) must not include a person in the list if that person is disqualified from inclusion in that list by a disqualification order under section 168B, and
(b) must remove from the list any person who is disqualified from inclusion in that list by such an order.
(2) In this section “relevant list” has the meaning given by section 168B(5).
168D Right to request review of disqualification order
(1) A person against whom a disqualification order is made under section 168B may apply to the First-tier Tribunal to review the decision to make the order.
(2) On a review, the First-tier Tribunal may confirm or revoke the order.
(3) A person may not apply for a review before the end of the period of-
(a) two years beginning with the date on which the order was made, or
(b) one year beginning with the date of the decision on the last such review.””- (Karin Smyth.)
See explanatory statement for NC23 .
Brought up, read the First and Second time, and added to the Bill.
Clause 68
Power to make consequential provision
I beg to move amendment 77, in clause 68, page 47, line 27, leave out from “to” to the end of line 28 and insert “the affirmative procedure”. This amendment ensures that all secondary legislation as a result of this bill is subject to the affirmative procedure.
The Chair
With this it will be convenient to consider clauses 68 to 72 stand part.
Amendment 77 is a probing amendment in the light of our previous discussions in Committee about the extensive powers that the Bill transfers to the Secretary of State. It would make all secondary legislation under the Bill subject to the affirmative procedure. I do not intend to press it to a vote, but I hope that the Minister will take into account the concerns that we have raised during these proceedings about the sweeping powers that the Secretary of State is taking on board.
I heard the Liberal Democrat spokesperson say that she will not press the amendment, but I would be sorely tempted to vote for it if she did so. This important amendment sums up a number of our concerns about the Bill, and the commencement amendments to follow are also appropriate. As the hon. Member will not press her amendment, however, I will not speak for long, save to say that I have enjoyed the past few weeks on this Committee. I hope that the Minister is still in place when we return in September. If she is not, I wish her very well and thank her for all her hard work, not just in this Committee, but in her role over the past two years.
I will respond to the hon. Gentleman in a moment, but first I will address clauses 68 to 72, as well as amendment 77, which was tabled by the hon. Member for North Shropshire. Clause 68 will allow the Secretary of State, by regulations, to make provision that is consequential on this Bill. Amendment 77 would amend that provision. The Government recognise the importance of parliamentary scrutiny of the significant changes proposed in the Bill. While the Bill contains some new regulation-making powers, the majority are existing powers that have been amended in the light of the abolition of NHS England. They will therefore be uncontroversial and consequential, so we consider it proportionate for the same parliamentary scrutiny arrangements to continue to apply in respect of those powers. However, where we are introducing new regulation-making powers, we have carefully considered what parliamentary scrutiny arrangements should apply. For example, any regulations that are made to facilitate the single patient record will be subject to the affirmative procedure, because we understand the importance of debating that issue in both Houses. Furthermore, any statutory instruments made under clause 68 that amend, repeal or revoke provisions made by primary legislation will be subject to the affirmative procedure and will need to be debated and passed by both Houses. I hope that the hon. Member for North Shropshire agrees that a blanket requirement for the affirmative procedure would be...
I echo the Minister’s thanks to the Clerks, House staff and others, as well as members of the Committee. Leaving aside the heat, I have also enjoyed our exchanges. I hope that the Minister has a good recess and that she does well in the upcoming reshuffle.
I thank the hon. Member for her kind comments. As the former Minister, the right hon. Member for Melton and Syston, recognised, I have been on the other side when considering a previous Bill. Opposition is hard work-the process is quite hard work on this side-and I commend Opposition Members for conducting that important scrutiny. I thank Members for their contributions and I think the Bill is stronger for those efforts.
May I associate myself with the Minister’s comments and thanks to everybody who has been involved in working on the Bill? I have also enjoyed my time on the Committee, despite the heat. I hope that the Minister remains in place when we come back on Report, because she is a hard-working and thoughtful Minister and it is a pleasure to stand opposite her in the House in my place as my party’s spokesman. I beg to ask leave to withdraw the amendment. Amendment, by leave, withdrawn. Clause 68 ordered to stand part of the Bill. Clause 69 ordered to stand part of the Bill . Clause 70 Extent Amendment made: 80, in clause 70, page 48, line 18, at end insert- “(2A) Section (Medical Devices Regulations 2002: mutual recognition agreements) extends to England and Wales and Scotland.”.- (Karin Smyth.) This is consequential on NC92. Clause 70, as amended, ordered to stand part of the Bill. Clause 71 Commencement Amendments made: 81, in clause 71, page 48, line 25, leave out “Section 63” and insert “The following”. This paves the way for Amendment 82. Amendment 82, in clause 71, page 48, line 26, at end insert “- (a) section 63 (Care Quality Commission: time limit for bringing proceedings); (b) sections (Regulations: reference to agreements and standards), (Medical Devices Regulations 2002: mutual recognition agreements), (Consultation about medicines and medical devices regulations), (Medicines and medical devices regulations: parliamentary procedure), (Medical devices: parliamentary...
Amendment proposed : 38, in clause 71, page 48, line 28, at end insert-
“(3A) The Secretary of State may not make regulations under subsection (3) commencing section (1) until the condition in subsection (3B) has been met.
(3B) The condition is that the Secretary of State has published an impact assessment in respect of the abolition of NHS England that complies with subsection (3C) (a "qualifying impact assessment").
(3C) A qualifying impact assessment must include-
(a) a quantified estimate, expressed in monetary terms, of the total transition costs of abolishing NHS England, including in particular-
(i) redundancy costs;
(ii) the costs of integrating data, digital and information technology systems;
(iii) the costs of reorganising and rehousing staff and functions; and
(iv) productivity losses during the transition period;
(b) a quantified estimate, expressed in monetary terms, of the ongoing annual costs of the restructured Department of Health and Social Care following the abolition of NHS England, including any costs falling on integrated care boards as a result of the transfer of functions to them;
(c) a quantified estimate, expressed in monetary terms, of the estimated annual savings arising from the abolition, including savings from the elimination of duplicated corporate functions and reduced administrative costs;
(d) a quantified estimate, expressed in monetary terms, of the net present value of the abolition, being the difference between the total costs under paragraphs (a) and (b) and the total benefits under paragraph (c) over a period of not less than ten years;
(e) a statement of the key assumptions underlying the estimates in paragraphs (a) to (d) and an assessment of the sensitivity of those estimates to changes in those assumptions;
(f) an assessment of the risks to the delivery of the anticipated benefits, including the risk of disruption to NHS functions during the transition period; and
(g) a statement of the methodology used to produce the estimates, including any data sources relied upon.
(3D) Before publishing a qualifying impact assessment, the Secretary of State must submit it for independent scrutiny to the Regulatory Policy Committee (or any successor body) and must publish the Committee's opinion on the assessment alongside it.
(3E) The Secretary of State must lay the qualifying impact assessment and the Committee's opinion before both Houses of Parliament.
(3F) Regulations to commence section (1) are to be made by statutory instrument and may not be made unless a draft of the instrument has been laid before, and approved by a resolution of, each House of Parliament.
(3G) A draft instrument under subsection (3F) may not be laid unless at least 60 sitting days have elapsed since the qualifying impact assessment was laid under subsection (3E).”. -(Dr Caroline Johnson.)
This amendment requires the Secretary of State to publish, and submit to independent scrutiny, an impact assessment on the abolition of NHS England, containing quantified cost and benefit figures, before making regulations to abolish the body.
Question put, That the amendment be made.
Amendment proposed : 39, in clause 71, page 48, line 28, at end insert-
“(3A) The Secretary of State may not make regulations under subsection (3) commencing section (1) until the condition in subsection (3B) is met.
(3B) The condition is that the Secretary of State has published a plan setting out how health services provided by or under arrangements made by NHS bodies are to work alongside and be integrated with the social care system in England (the "health and social care integration plan").
(3C) Before preparing the health and social care integration plan, the Secretary of State must have regard to-
(a) the recommendations made by the Independent Commission on Adult Social Care chaired by Baroness Casey of Blackstock (or any successor body undertaking that Commission's work) in any report published by the Commission before the plan is laid; and
(b) the need to reflect any such recommendations in the content of the plan so far as they are relevant to the interface between health services and adult social care.
(3D) The health and social care integration plan must include-
(a) a description of the structural and operational arrangements for joint working between NHS bodies and local authority social care services following the abolition of NHS England;
(b) proposals for how the transfer of NHS England's functions to the Secretary of State will affect the coordination of health and social care commissioning, including in particular the commissioning of services for people with complex needs spanning health and social care;
(c) arrangements for reducing delayed discharges from hospital attributable to the absence of suitable social care provision;
(d) proposals for how the funding flows between the NHS and the social care system, including NHS Continuing Healthcare, will be managed following the abolition;
(e) the workforce implications for the health and social care sectors arising from the abolition and the steps to be taken to address them; and
(f) a timetable for implementing the arrangements described in the plan.
(3E) The Secretary of State must lay the health and social care integration plan before both Houses of Parliament.
(3F) Regulations to commence section (1) are to be made by statutory instrument and may not be made unless a draft of the instrument has been laid before, and approved by a resolution of, each House of Parliament.
(3G) A draft instrument under subsection (3F) may not be laid before either House of Parliament until at least 60 sitting days have elapsed since the health and social care integration plan was laid under subsection (3E).
(3H) In this section-
“NHS body” has the same meaning as in the National Health Service Act 2006;
“social care system” means the system for the provision of care and support under the Care Act 2014 and services provided by local authorities in the exercise of their functions relating to adult social care.”.- (Dr Caroline Johnson.)
This amendment requires the Secretary of State to publish and lay before Parliament a plan setting out how health services will work alongside the social care system following the abolition of NHS England before using their powers for its abolition. The plan must address joint commissioning, funding flows (including NHS Continuing Healthcare), delayed hospital discharges, and workforce.
Question put , That the amendment be made.
Clause 71, as amended, ordered to stand part of the Bill.
Clause 72 ordered to stand part of the Bill.
The Chair
We now come to the final Question I must put-that I report the Bill, as amended, to the House. Normally, at this point, Members say nice things to each other, but we have already done that, so we can move on. Bill, as amended, to be reported.
Committee rose.
Written evidence reported to the House
HB127 Independent Healthcare Providers Network (IHPN)
HB128 General Pharmaceutical Council
HB129 Rethink Mental Illness
HB130 Eden Openly
HB131 Vsevolod Shabad
HB132 Federation of Specialist Hospitals
HB133 Royal College of Emergency Medicine
HB134 National Care Forum (NCF)
HB135 Voluntary Organisations Disability Group (VODG)
HB136 Professor Jo Knight and Professor Hedley Emsley
HB137 Pulselight
HB138 Doctors in Unite
HB139 National Network of Designated Healthcare Professionals for Children (NNDHP)
HB140 Women + s Cancers Patient and Public Involvement and Engagement (PPIE) Group, Cancer Research UK Cambridge Centre, University of Cambridge
HB141 Amgen
HB142 Mr Peter Bower
HB143 Headway UK
HB144 Intensive Care Society
HB145 General Medical Council
HB146 Citizens Advice Gateshead