Health Bill

Committee stage
Tuesday 3rd November 2026 Lords Chamber

Committee (2nd Day) (Continued)

20:56

[The Deputy Chairman of Committees (Baroness Garden of Frognal) (LD)]

My Lords, we start with Amendment 29. The noble Lord, Lord Shinkwin, will be taking part remotely in this debate. I remind the Committee that unless Members are leading a group, remote speakers speak first, after the mover of the lead amendment in a group. They may therefore speak to other amendments in the group ahead of Members who tabled them.

Clause 7: Education and training

Amendment 29

Moved by

[Baroness Gerada]

29: Clause 7, page 4, line 31, at end insert—
“(1A) In discharging the duty in subsection (1), the Secretary of State must ensure that education and training for persons employed in the health service in England includes training on recognising, preventing and responding to antisemitism and other forms of racism.”Member's explanatory statement
This amendment seeks to ensure that the workforce education and training duty transferred from NHS England will include training on antisemitism and racism, as recommended by the Lord Mann review (recommendations 32 to 36).

[Baroness Gerada (CB)]

My Lords, in moving Amendment 29 in my name I will also speak to Amendments 79, 258 and 259. I thank the noble Lords, Lord Hunt of Kings Heath and Lord Austin of Dudley, for adding their names. I also thank the noble Lord, Lord Mann, for his review of antisemitism and other forms of racism in the NHS, and the Government for accepting all 36 of its recommendations. These amendments do not seek to reopen that decision; they aim to ensure its implementation.

According to the 2025 NHS staff survey, as reported in the review of the noble Lord, Lord Mann, 13% of Jewish staff reported discrimination from managers or colleagues, compared to 11% from patients or the public. Jewish staff are the only group for whom discrimination from within the workforce exceeds that from patients. The review heard evidence that staff no longer wish to work in the NHS. This is unacceptable and must never be accepted as normal. The review also found that some Jewish patients are putting off the care they need. A consultation works only if a patient can tell their doctor about themselves without fear. When that trust goes, it is a question not only of equality but of patient safety.

For many years, I led the NHS’s Practitioner Health service, to which over 40,000 doctors, dentists and other healthcare staff turned for help with their mental health problems. My work has taught me that doctors who do not feel they belong become unwell, and doctors who become unwell leave—and we cannot afford to lose them. These findings concern Jewish staff and patients, but the principle at stake is far broader. A health service that makes any group of patients hesitate to seek care, or any group of staff feel unsafe at work, fails us all. That is why these amendments address antisemitism alongside every other form of racism.

Why bring them to this Bill? Much of the work required to deliver the review rests on guidance, contracts and programmes already owned by NHS England, even if the Bill transfers its functions elsewhere. Commitments that exist only in guidance can be quietly lost when the body that wrote them is wound down. These amendments will place the essentials in statute.

21:00

Amendment 258 is at the heart of the group. It would require integrated care boards and NHS trusts to have regard to the need to prevent antisemitism and all other forms of racism affecting patients and staff. It would also act to prevent staff conduct that amounts to support for proscribed organisations and respond effectively when racist conduct occurs, including by supporting those affected. The Secretary of State would report to Parliament every year on progress. I appreciate that the Minister might explain that the public sector equality duty already covers this ground. With respect, it does not. While it requires public bodies to have due regard to eliminating harassment and discrimination, it imposes no specific duty to respond to incidents and to support those affected, nor does it require any reporting to Parliament.

I recognise that the NHS’s existing equality frameworks are important, but they do not adequately address the particular challenges facing Jewish staff and patients. The workforce race equality standard compares the experiences of white staff with those of ethnic minority staff. As most Jewish staff identify their ethnicity as white, antisemitism is largely invisible in this data. Indeed, the finding I quoted earlier came from the NHS staff survey breakdown by religion, not from the standard.

The position for patients is even more concerning. The patient and carer race equality framework applies only to mental health services, while the health inequalities impact assessments carried out by NHS bodies depend on the quality of available data. Yet the NHS does not routinely record patients’ religion in any national patient dataset. Where this information is collected, it is generally done locally and inconsistently, whether on hospital admission for chaplaincy purposes or in certain GP and mental health records. We therefore have no means of identifying discrimination against Jewish staff other than through the staff survey and electronic staff record.

This creates a significant accountability gap. Jewish patients are therefore largely invisible in ethnicity-based assessments, as their religious identity is rarely captured in patient data. If we cannot identify where discrimination is occurring, how can we reasonably expect the NHS bodies to address it? That is precisely why Amendment 258 would require the annual report to include data broken down by religion as well as ethnicity. It is also why I hope the Government will act on the recommendation of the noble Lord, Lord Mann, to introduce Jewish and Sikh categories, which they say they are still considering. These are necessary steps towards ensuring that antisemitism is properly identified, measured and addressed across the health service.

Amendment 79 would ensure that the Secretary of State’s annual assessment of each integrated care board covers how well it has met that duty. Some boards, such as NHS Birmingham and Solihull, have already taken this on voluntarily and have been accredited with a RACE Equality Code quality mark, and I pay tribute to them. But accountability for race equality should not depend on which board happens to serve a patient’s area.

Amendment 29 concerns the education and training duty this Bill transfers from NHS England to the Secretary of State. It would require that training to include recognising, preventing and responding to antisemitism and other forms of racism, as recommendations 32 to 36 of the review set out. Some of this already sits in the NHS core skills guidance, but that guidance is owned by the body this Bill is winding down. If the duty moves, the commitment should move with it.

I want to say a word about what training should look like. Too much equality training has left antisemitism out altogether, or, worse, has placed Jews outside the protection it claims to offer. A tick-box module completed alone at a screen, in my experience, is unlikely to change behaviour. Again, in my experience of caring for doctors, attitudes change with time, and the space and time to reflect with one’s peers is needed. That is why the noble Lord, Lord Mann, called for quality assured content developed with subject experts and for its impact to be monitored and reported publicly.

The Government’s progress update confirmed that a new module covering antisemitism and anti-Muslim hostility is being finalised. Amendment 29 would secure this duty, and I would welcome the Minister’s assurance that the training will meet these standards.

Finally, Amendment 259 touches a part of my own profession directly. Every GP in England, myself included, must be on a performers list to practise. At present, conditions can be placed on a practitioner’s inclusion on that list on efficiency grounds but not on suitability grounds. Recommendation 26 of the review asked the Government to change that so it can address racist and extremist conduct directly. This is a modest amendment: it asks only that the Government tell Parliament within six months whether they intend to amend the regulations, and if not, why not.

These are probing amendments and I do not intend to press them to a vote, but I have four questions for the Minister. First, I welcome the Government’s first progress update, which was published on 27 October. However, it describes next June’s report as the final one. Will the Minister commit to continuing to report to Parliament every year after that, as Amendment 258 would require? Secondly, will the Government ensure that the NHS staff survey data on discrimination is published by religion as well as by ethnicity? Thirdly, will the Minister confirm that the consultation on protected characteristics data, planned for early 2027, will include Jewish and Sikh categories, as the noble Lord, Lord Mann, recommended? Fourthly, when will the Government amend the performers list regulations, as recommended in the noble Lord’s recommendation 26?

None of these amendments asks the Government to do anything that they have not already agreed to; they ask the Government to enshrine that acceptance in law. Jewish patients and staff need to know that the NHS is for them, and these amendments would help ensure that it is. I beg to move.

[The Deputy Chairman of Committees (Lord Russell of Liverpool) (CB)]

My Lords, I now call the noble Lord, Lord Shinkwin, to make a remote contribution.

[Lord Shinkwin (Con) [R]]

My Lords, I support Amendment 29 and other amendments in this group. I would like to say that it is a pleasure to follow the noble Baroness, Lady Gerada, but it is a mixed one. That is not a reflection on the noble Baroness but a reflection of my disbelief that we are even having to raise this crucial issue. But raise it we must. I thank the noble Baroness, and the noble Lords, Lord Hunt of Kings Heath and Lord Austin of Dudley, for giving your Lordships’ Committee the opportunity to consider it.

I say “disbelief” because I cannot imagine that those noble Lords who helped pass Labour’s Race Relations Act could ever have envisaged that, 61 years later, we should be debating whether it is necessary for the Government to take measures to counter the shocking anti-Jewish racism that scars our NHS, a founding principle of which is surely equality. As a lifelong patient who owes so much to the NHS, I would say that, for such a treasured institution to apply that principle in practice, the provision of healthcare must be made in an environment in which all feel safe and mutually respected, patients and staff alike. The reason why I believe this amendment is essential is that, sadly, some feel neither, on account of their Jewish identity.

I would hope that it is generally recognised that racism is wrong. What I am less sure about is that antisemitism is recognised as racism. Adolf Hitler was very clear: his virulent hatred of Jewish people was racist. Indeed, he was so passionate about his racism that he made it a central tenet of the Nazi creed, which, sadly, as we all know, underpinned and informed the Holocaust. Jews were to be murdered for the crime of being Jewish. It therefore strikes me as bizarre that anyone could either delude themselves or seek to delude someone else—on social media, for example—that antisemitism or anti-Zionism is somehow not racist. This is simply factually incorrect, which is why the recommendations made in the review of the noble Lord, Lord Mann, and the amendments in this group, are so important.

I wonder whether the Minister, in her response, can assure the Committee that the third aspect of training mentioned in the amendment—that of responding to antisemitism—will include reference to historical facts, such as: the fact that the Jewish people have a historical claim to the land of Israel; that Israel has a long, if broken, history; that biblical records about, for example, the construction of the temple of Solomon in Jerusalem, which is believed to have existed between the 10th and 6th centuries BC, bear testimony to this; that the Jews were dispersed from their homeland by the Romans almost 2,000 years ago; that perhaps no other race has been subjected to such extreme prejudice and barbaric persecution in the history of humanity; and that, given the history of how the Jewish people have been treated, Israel has learned that there is only one country on which it can rely to defend its interests—most recently in the face of the egregious fabrication that the tragedy of Gaza is a genocide—and that is Israel. In short, can the Minister assure the Committee that any training on the need to respond, and on how to respond, to antisemitism and other forms of racism will be informed by, not divorced from, factual historical context?

In conclusion, there is another reason why I support this group of amendments. I discovered only after he had passed away that my childhood orthopaedic consultant, who played such a vital part in optimising my life chances, fled for his life on the last Kindertransport to leave Prague before the Nazis closed the borders in June 1939. Records show that the family members he left behind were murdered at Auschwitz only 82 years ago—within the lifetime of some Members of your Lordships’ House. Hanuš Weisl lived with that memory for the rest of his life. I am not Jewish, but for me his memory will always be a blessing. It is in recognition of the debt I owe to him, and indeed that I believe many of us owe to members of our wonderful Jewish community—particularly those who have dedicated their skills and their lives to the NHS—that I support this important group of amendments. I hope the Government will give it the careful consideration it deserves.

[Lord Blencathra (Con)]

My Lords, the proposed new clause in my Amendment 279C would require statutory regulators of health and care professions to remove from their professional registers any practitioner found to have engaged in antisemitic behaviour or speech, as defined in my amendment. It would also make clear that removal from the register is a mandatory sanction and cannot be replaced by a lesser penalty.

The amendment is founded upon a simple principle: medicine depends upon trust. Every day, patients place themselves in the hands of doctors, nurses and other healthcare professionals. They disclose intimate details of their lives. They place themselves in vulnerable situations. They trust that they will be treated fairly, equally and without prejudice, regardless of their race, religion, ethnicity, nationality or beliefs.

That trust is not optional; it is fundamental to the practice of medicine. If patients lose confidence that they will be treated impartially, the doctor-patient relationship is damaged. If an entire community begins to doubt that healthcare professionals regard it as deserving of equal dignity and respect, confidence in the healthcare system itself is undermined. That is why racism has no place in medicine. That is why antisemitism has no place in medicine. That is why this amendment is necessary.

21:15

Some may ask why Parliament needs to legislate. Unfortunately, recent events have demonstrated the problem. We have seen healthcare professionals publicly posting material that repeats classic antisemitic tropes, promotes conspiracy theories about Jews, celebrates violence against Israelis or portrays Jews collectively as evil or uniquely malevolent. Let me quote four examples. These are not hypothetical; I have here the names of the individual doctors who made the comments. I will not reveal them to the Committee. I will not enter them in the record. But these are not hypothetical cases; they are real.

One consultant, a paediatrician, was suspended after displaying a placard associating the Star of David with words such as “rape”, “kill” and “lie”, and making repeated references to alleged “Jewish supremacy”. Regulators concluded that such behaviour risked undermining public confidence and causing patients to question whether they could receive fair treatment. Another doctor was suspended while allegations were investigated that included antisemitic conspiracy theories, support for terrorist organisations and repeated references to “Jewish supremacy”. The tribunal expressly noted concerns that patients might be discouraged from seeking treatment.

A further doctor was suspended after posting comments directed at Jews that were plainly abusive and antisemitic, alongside material invoking conspiracy theories about Jewish influence. In another case, a doctor who made social media posts joking about the gassing of Jews and expressing sympathy for Holocaust denial material was permitted to continue practising after regulatory proceedings. I think these are despicable people. I would not want them sticking an Elastoplast on me, let alone treating other patients.

These examples are not cited because the individuals held controversial political opinions. I am citing them because, in a democratic society, people are entitled to support Israel, support Palestine, criticise Governments and participate in political debate. This amendment is not about foreign policy, it is not about whether one supports Israel or Palestine, and it is not about criticism of the Government of Israel. The amendment concerns something entirely different: expressions of hatred, prejudice, conspiracy theories and collective hostility directed against Jews just because they happen to be Jews. It concerns conduct that would rightly be condemned if directed against any other ethnic or religious minority.

I should point out that the definition contained in the amendment is not a novel creation of my own. The wording is drawn directly from the definition and examples of antisemitism recently adopted and promoted by the Labour Government themselves. It is the Labour Party’s definition. It reflects long-established understandings of antisemitic hatred, including Holocaust denial, antisemitic conspiracy theories, demonisation of Jews as a people and holding Jews collectively responsible for the actions of the State of Israel. Therefore, I say that, if the Government accept that the behaviours I have described and the statements I have mentioned constitute antisemitism in public life, it is difficult to argue that healthcare professionals who engage in such conduct should nevertheless continue to hold positions that depend entirely on trust and confidence. If the definition is good enough for government policy, it should be good enough for professional regulation.

Again, I emphasise that these examples are not about political disagreement. We would not tolerate such conduct if it were directed against Black patients, Muslim patients, Hindu patients, Sikh patients or any other minority group—or Scots or hereditary Peers or women. We would not tolerate it in those circumstances. Therefore, we should not tolerate it when it is directed against Jewish patients.

The real test is not whether a particular Jewish patient can prove that they have received inferior treatment, because by that stage the damage has been done. The real question is whether a reasonable Jewish patient who discovers that their doctor has publicly expressed antisemitic views could still have confidence that they will receive treatment that is fair, impartial and free from prejudice. If the answer to that question is no, continued registration becomes incompatible with fitness to practise as a doctor.

This amendment is not primarily about punishment. It is about patient protection. It is about maintaining confidence in the profession. It is about ensuring that every patient can enter a hospital, clinic or GP surgery knowing that they will be treated solely according to clinical need and not through the lens of racial or religious prejudice.

The current regulatory framework allows a wide range of sanctions. My contention is that antisemitism should be treated like any other serious form of racism in a profession built entirely on trust. Healthcare professionals enjoy the same political freedoms as everyone else, and rightly so, but professional registration is not an unconditional right; it is a privilege. Society grants that privilege subject to certain standards. Just as we would not tolerate any doctor expressing racist hatred towards Black patients, or anti-Muslim hatred towards Muslim patients, we should not tolerate antisemitic hatred towards Jewish patients.

Let me make it clear that the overwhelming majority of doctors, nurses and healthcare professionals serve patients with distinction, compassion and complete impartiality. They, too, have an interest in ensuring that those who promote racial or religious hatred do not bring their professions into disrepute.

This amendment would protect not only Jewish patients but the reputation of doctors themselves. It seeks to establish a clear and consistent principle: if a healthcare professional is found to have engaged in antisemitic behaviour or speech, as defined in my amendment and by reference to the Government’s own definition, removal from the register should follow. The NHS cannot function without trust. Antisemitism destroys that trust. I commend my amendment to the Committee.

[Lord Hunt of Kings Heath (Lab)]

My Lords, following the review by the noble Lord, Lord Mann, I certainly hope that the regulators toughen up their act, and in accepting its recommendations the Government certainly expect them to. I agree with the thrust of where the noble Lord, Lord Blencathra, is coming from. Whether all discretion should be taken away from the regulators, I very much doubt, but it will be interesting to hear what my noble friend has to say on that.

In supporting the amendment tabled by the noble Baroness, Lady Gerada, I want to reflect on two points. First, I repeat what the noble Baroness said, which was striking, arising from the report of the noble Lord, Lord Mann. Drawing on the NHS staff survey, Jewish staff are the only religious group where discrimination from managers and colleagues exceeds discrimination from patients. This is a very serious indication of the stress and pressure on Jewish staff within the NHS.

I am afraid that, so far, the response from management has been pretty poor. We have seen that in relation to what we might call uniform policy. As the noble Lord, Lord Mann, described it:

“Examples such as the brandishing of badges, the display of uniforms on political marches or the co-branding of the NHS by staff or others with third parties has made it unclear what patients can expect from the NHS”.


Patients are entitled to be treated without seeing staff display any political leanings whatever or support for campaigns. Teachers are simply not allowed to do this. One has to ask, what is with NHS employers that they have failed to put across to their staff the behaviour that is expected of them?

The noble Lord, Lord Mann, clearly called for NHS England to review what we might call its uniform policy. It is not the standardised uniform, but what people wear and how they display it. My understanding is that that work is being undertaken, subject to consultation. I hope that, when it comes out, it is not going to be wiffly-waffly, leaving too much discretion to local employers. Now that the Government are taking this over—because I doubt it will be finished before 1 April next year—they should make it abundantly clear to NHS employers what should and should not be expected.

I know that Manchester has been cited as a very good example. As the noble Lord, Lord Mann, said, some trusts do not permit the wearing of political badges, of any item of clothing with a political message or of a uniform to political rallies. We need to see something firm about this so that employers are implementing what is required of them from the centre. For employers, this would be much easier than going through the agony of developing local policies that are subject to consultation and lead to variation. Patients and staff are entitled to be in an environment where somebody else’s political views are not displayed in a way which causes huge upset and concern.

[Baroness Manzoor (Con)]

My Lords, I understand and support the aims and sentiment behind this group of amendments—particularly Amendment 29 and 258. Any form of discrimination or racism is abhorrent. How one identifies oneself should not be a problem. Antisemitism is not acceptable.

It may be helpful to remind ourselves of some figures as, sadly, racism and discrimination remain embedded challenges within the NHS, affecting both staff and patients, as acknowledged by the noble Baroness, Lady Gerada. It is worth noting that 28.6% of NHS staff in 2024 were from ethnic-minority backgrounds. That was around 450,000 people, yet only 12.7% of senior managers came from those backgrounds. The 2025 NHS staff survey found that ethnic-minority staff were more likely to experience discrimination from managers and colleagues: that is 13.9% of ethnic-minority staff compared with 6.51% of white staff. Some 29.16% of ethnic-minority staff experienced harassment, bullying or abuse by patients and by the public, compared with 23.54% of white staff. It is important to further strengthen legislation as there are gaps.

The Equality Act 2010 prohibits racial discrimination, harassment and victimisation. However, significant weaknesses remain. The public sector equality duty requires organisations to “have due regard to” equality but does not guarantee measurable improvements. The NHS equality standards lack sufficient enforcement and meaningful consequences for persistent institutional discrimination. Will the Minister consider how the Government can strengthen this further, particularly as reporting, investigating and addressing racism remains inconsistent, with inadequate protections and support for whistleblowers? How will the Government address this? There is no sufficiently robust uniform accountability framework ensuring that perpetrators and senior leaders face consequences, as the noble Baroness, Lady Gerada, stated. Will the Government consider developing such a framework on all forms of discrimination? This would also support the 2026 review by the noble Lord, Lord Mann, which reinforces the need for stronger investigations, transparency and organisational accountability.

[Lord Patel of Bradford (Non-Afl)]

My Lords, I strongly support the intentions behind these amendments. Two practical issues are leadership and accountability, and the protection of those who speak out.

Tackling antisemitism and racism must be a clear responsibility of NHS leadership. These issues should be included in the performance objectives of every chief executive in the NHS—I have done this in the past. The boards would be required to monitor them and hold the executives and themselves to account. I am sure the CQC could incorporate this into its well-led reviews and make sure it happens. It is not enough to have policies and training programmes; we need to know whether they are making a difference and who is responsible when they are not.

Secondly, we must protect those who report racism or antisemitism. Too often, staff are reluctant to speak out because they fear the consequences for their careers or their relationships with colleagues. We need clear reporting arrangements, protection against victimisation and retaliation, and independent routes to raise concerns if senior managers themselves are involved. I hope the Minister agrees that we should hold boards and NHS chief executives to account and properly protect those who call this out.

21:30

[Lord Scriven (LD)]

My Lords, I just have a very quick practical suggestion to deal with some of the issues the noble Lord, Lord Blencathra, and others raised about staff neutrality, because that is what we are talking about. Would it not be wise, rather than going through a long process, to make it part of the NHS constitution that staff have to be neutral in how they deal with fellow staff and patients with whom they come into contact? I ask the Minister to consider that seriously when she reports back not just today but on Report. It is just a practical suggestion.

[Baroness Finlay of Llandaff (CB)]

I will be very brief in supporting that suggestion from the noble Lord, Lord Scriven. When I was listening to the debate, I was thinking about people who have told me about feeling discriminated against. They often do not declare their racial, religious or whatever view, because they are terrified of being further labelled and discriminated against. The noble Lord, Lord Shinkwin, spoke about the history of this for the Jewish people; there were lists of who was Jewish, particularly in the Netherlands, which were rapidly exploited to round them up with speed and persecute them further. That is a very deep-seated fear in a lot of these people.

The other fear is that, if they disclose that they have been discriminated against, they will be undermined in other forms that make their lives even harder. I can again think of other specific examples that have been brought to my attention. I commend this solution as a way forward.

[Baroness Pidgeon (LD)]

My Lords, this group of amendments is incredibly important. I thank the noble Baroness, Lady Gerada, for tabling most of them and for her powerful words about Jewish staff and patients, and their experiences in the data that she also presented. In different ways, all these amendments are trying to ensure that all parts of the NHS stamp out antisemitism and racism, and provide the right training on it, as recommended by the review from the noble Lord, Lord Mann.

I completely agree with the neutrality point that the noble Lord, Lord Hunt, raised about the uniform that staff wear. I recall that, several years ago, the Metropolitan Police had a huge issue with badges that officers started to wear as part of their support for charities such as Help for Heroes. That was ruled out of order, and they were not allowed to wear them. I think this is a similar thing, and there has been a sort of creep in uniforms over the years in what is acceptable or not. We need to make sure that all staff are seen to be neutral and behave neutrally.

The amendment on assessing the performance of ICBs is important in ensuring that trusts have a duty to prevent this and respond to it; it would ensure that that is integral to these organisations. The noble Lord raised a point about leadership. We on these Benches fully support the Mann review and the implementation of its recommendations, and my noble friend Lord Scriven’s practical suggestion about the NHS constitution is certainly a good idea worthy of consideration by the Minister. I hope the Government will look at how best to implement these amendments—as worded or in a different way—and I look forward to the Minister’s response.

[Baroness Cash (Con)]

My Lords, this looked like a very serious group of amendments on paper but, until we had this debate, quite how grave the current gaps are in the NHS did not really emerge. I thank the noble Baroness, Lady Gerada, for tabling her amendments and the noble Lords who spoke to them. I also pay tribute to the noble Lord, Lord Mann, for his review and to the Government for accepting the recommendations that Members from all Benches in the House appear to accept unreservedly.

I sympathise with and support the intent of every amendment in the group. I particularly support Amendments 79, 258 and 259, given the gaps they highlight and the urgent need to close them. Even in light of what the Government have accepted, it is quite apparent that shocking levels of antisemitism are continuing, and there need to be some urgent interventions to stop that.

I spoke quite recently in this House on Sir David Bell’s review of the levels of antisemitism in schools. It is really quite sad, and a shame for this country, that the review by the noble Lord, Lord Mann, shows the same pattern in the NHS. There is clearly a major problem and it is racism, plain and simple, directed at Jews. Too many institutions are tolerating it in a way they would never tolerate against any other group.

The facts are devastating. Community Security Trust recorded 3,700 antisemitic incidents in 2025—the second-highest total ever recorded. In the 2025 NHS staff survey, as we have heard, 13% of Jewish staff recorded discrimination from their own managers or colleagues. That is intolerable in your workplace. How can anyone possibly feel safe going about their day-to-day interactions? We have heard from a number of noble Lords this evening that Jewish people are the only religious group, the only ethnic group, for whom discrimination from colleagues is more common than discrimination from patients. The hostility is coming from inside the institution, and it is therefore beholden on us, debating this Bill, not to miss the opportunities to address this and close the gaps.

The Commission on Antisemitism found Jewish patients considering whether they should remove their religious symbols before treatment. Imagine feeling so unsafe in a healthcare setting, when you are at your most vulnerable, that you may have to consider concealing that about your identity. Patients who feel they have to hide who they are to be treated have lost trust in the NHS; they have lost faith that their doctors will do no harm—the first and basic premise of healthcare—and they have lost confidence that they will be safe.

The regulator has not done its job, which is why I support these amendments, even though the Government have actions in progress and even though they have accepted the recommendations of the review by the noble Lord, Lord Mann. Around 70% of completed appeals by the GMC against tribunals have succeeded, and we know that if the regulators are succeeding seven times out of 10, there is something fundamentally wrong in the disciplinary decisions.

I will not repeat what has been said by noble Lords in support of their amendments, but we should give serious consideration to the proposal from the noble Lord, Lord Scriven, so that we can address the fundamental issue here: a loss of neutrality and an overt willingness to attack colleagues and patients on the basis of their Jewish identity. My noble friend Lord Blencathra goes even further in his Amendment 279C, and I look forward to hearing the Minister’s response to that. He outlined the very serious reasons why he has asked for that, and those reasons and facts need to be addressed.

On Amendment 29 and training, I support the recommendation of the noble Lord, Lord Mann, that it is needed, but he was very specific in what he asked for. He called for the mandatory module, used by 1.5 million staff already, to be updated with quality assured content on antisemitism and anti-Muslim hostility. He added that subject experts should be consulted and that the training be monitored and reported on publicly to ensure it has the desired impact, but I have real reservations about the training that would be possible under Amendment 29, because as drafted it does not contain any of the noble Lord’s safeguards. That does not mean we should not consider or expedite the training that is needed.

The record of equality training in the public sector gives a good reason for us to take care. In 2020, the Government phased out unconscious bias training in the Civil Service after a review found no evidence that it changed behaviour, and some NHS anti-racism training has left out antisemitism entirely. Moorfields Eye Hospital’s compulsory anti-racism seminar was reported last year to have made no mention of Jews at all. Training built on theories of privilege has too often placed Jews among the privileged and therefore outside the protection it claims to offer. So, there are lots of types of training that will make the problem a lot worse. I would like to hear from the Minister what types of training and suppliers will be used, and what accountability and monitoring there will be for anything currently being developed.

It is very important to note that the noble Lord, Lord Mann, recommended mandatory training for the chairs and chief executives of NHS trusts within six months of his review, but the Government’s same statement in response to his review said that senior leaders would be invited to complete it by March 2027. I hope that the Minister will explain to noble Lords why a recommendation for mandatory training became an invitation to train, and when that training will be completed by all chairs and CEOs of NHS trusts, as recommended.

[The Parliamentary Under-Secretary of State, Department of Health and Social Care (Baroness Merron) (Lab)]

My Lords, I am most grateful to noble Lords across the House for their sensitive consideration of something that is very insensitive: antisemitism and other forms of racism. I know that the words spoken today—the sentiments and the commitments—will resonate across communities in a way that will make a difference, and I personally am most grateful for that. I also am grateful to my noble friend Lord Mann for his review and, indeed, to the former Secretary of State, Wes Streeting, for listening to the voices of those for whom the situation they have to live with day in, day out, is quite intolerable, and for commissioning that review. That set the tone.

As the noble Baroness, Lady Gerada, observed from the outset, we have accepted in full the recommendation of my noble friend’s review, and we are taking action to deliver. As was referred to, we provided our latest update last month. This work is continuing, and I understand that noble Lords are asking for more to be done. Indeed, there is no let-up, but we want to get this right, of course.

I will address Amendments 29, 79, 258, 259 and 279C together. We have all said this, but it always bears saying: there is no place for discrimination, antisemitism or racism in our NHS. As noble Lords have said, patients and staff and those associated with them must be free from all forms of racism and religious hatred—and, indeed, from the fear of that, as well as the actuality. That is at the core of these amendments and this debate.

I say to the noble Lord, Lord Shinkwin, that Ministers have asked all NHS bodies to adopt the IHRA definition of antisemitism. We are receiving a good response and will continue on that.

21:45

Turning to Amendment 29, I assure the noble Baroness, Lady Gerada, that we are taking forward work to strengthen leadership accountability and to improve the reporting and handling of racist incidents. The noble Lord, Lord Shinkwin, and other noble Lords picked up this point, and I will say a few words on enhanced workforce training in a moment. There will also be work on improving data collection and ensuring greater consistency across the health system, which I know is of concern to my noble friend Lord Hunt and other noble Lords.

To return to the noble Baroness, Lady Gerada, improving the data that we hold is key. We are developing the unified information standard for protected characteristics programme. That will improve the consistency and quality of data on protected characteristics, including ethnicity and religion or belief. That will apply both to patients and the workforce. The noble Baroness asked about the inclusion of Jewish and Sikh categories in data collection. That is not currently the case, as she is aware, but the consultation I have just mentioned will include reference to the possibility of including Jewish and Sikh categories, as she referred to.

The noble Baronesses, Lady Gerada and Lady Cash, and the noble Lord, Lord Shinkwin, referred to training meeting the right standards. The new NHS training module on equality, diversity and human rights is being finalised over the coming months. That includes content on antisemitism and anti-Muslim hostility, alongside—this is important—guidance on challenging prejudice and discrimination, because it should not be down to the affected groups to make that challenge.

My noble friend Lord Hunt talked about what I might refer to as physical displays of political leanings—for example, badges. We are looking at how we can provide clearer guidance regarding the issues that the noble Lord, Lord Mann, raised on staff uniforms, and new national guidance will be published on that.

The noble Baroness, Lady Manzoor, asked about a framework which reflects transparency and organisational accountability. The six mandated NHS staff standards which were introduced in July under the 10-year health plan are aimed at improving staff experience. They require employers to take sustained meaningful action not just to root out racism but to prevent it. We should apply ourselves to that as well.

I thank the noble Lord, Lord Scriven, for raising consideration of staff neutrality, as was also spoken to by the noble Baronesses, Lady Finlay, Lady Pidgeon and Lady Cash. We are clear that staff must demonstrate the core values of the NHS and demonstrate neutrality in the workplace. I would go further. I do not know that I would use “neutrality”; it is an issue of fairness, and “without fear or favour” might be the other expression.

[Lord Scriven (LD)]

My point about the important value of neutrality is this, and let me give an example. You might not be discriminatory: you have somebody who is Jewish, somebody who is Muslim, somebody who is Christian and somebody of no faith, and you treat them all equally, but you might have something on your body which is not neutral to two of them. You are therefore possibly treating that person differently, from their perspective. If neutrality and fairness is such an important value for the NHS, can the Minister go away and look seriously at making it a key component in the NHS constitution, because it is not there at the moment?

[Baroness Merron (Lab)]

I take that point and I certainly accept the spirit in which the noble Lord suggests it. I will take all the points that have been discussed away to see whether there is any way that we can work with it, rather than extending a debate on what neutrality means, because I know what the noble Lord is getting at. It is helpful that he has given thought to that.

On Amendment 258, NHS bodies are already subject to clear legal duties to prevent and address discrimination and racial harassment, alongside established responsibilities to tackle extremism and safeguard patients and staff. In a technical fashion, I certainly caution against adding further legal duties here because it would risk confusion about what we expect ICBs and trusts to do. I know that is not something that any of us would wish to do.

On Amendment 259, we have accepted the recommendation from the noble Lord, Lord Mann, to consider amending the performers lists regulations, which would enable conditions to be imposed on suitability grounds. We intend to amend the regulations, subject to consultation. The amendment is unnecessary as the Government are already taking forward the substance of it. It would also impose a six-month statutory deadline before the necessary consultation and consideration have taken place, whereas we have to allow sufficient time to make sure that any changes are legally robust, proportionate and workable. Nor would we wish to pre-empt consultation by committing in this moment to how particular forms of conduct should be addressed in the regulations.

On Amendment 279C, under NHS staff standards—which, as I referred to on the comments from the noble Baroness, Lady Manzoor, were launched on 6 July—employers must take sustained and meaningful action to prevent and root out racism. NHS organisations will be measured on this through the national oversight framework. In addition, I say to the noble Lord, Lord Blencathra, that regulatory processes are already in place to which all registered healthcare professionals are subject. Regulatory fitness to practise processes allow concerns about misconduct to be investigated. They allow evidence to be considered and the appropriate regulatory action, which could indeed include removal from the register, to be determined in each case. The Professional Standards Authority for Health and Social Care acts as an independent body in this regard to make sure that regulators apply the right sanctions. Where it considers that a decision does not provide sufficient public protection, it has the powers to refer the decision to the courts for consideration.

In drawing this together, I assure the noble Baroness, Lady Gerada, the noble Lord, Lord Patel of Bradford, and your Lordships’ Committee that we are ensuring that ICBs and providers are fulfilling their duties. The key means to do that is through performance assessments. I gently caution against adding additional criteria to the current approach, because it is important that assessments have sufficient flexibility to adapt to the evolving role of ICBs as strategic commissioners, which, after all, is at the heart of the Bill.

[Baroness Barker (LD)]

I thank the noble Baroness, Lady Merron, for that very detailed and thorough answer. Can I just check that, in the midst of what she said, she made it clear that NHS staff and NHS providers are under a legal obligation to ensure that all the protected characteristics under the Equality Act are treated properly and with respect?

[Baroness Merron (Lab)]

They should absolutely have regard to the law in respect of protected characteristics. That is the fullest answer I can give at this moment.

[Baroness Gerada (CB)]

My Lords, I am grateful to noble Lords who have spoken and to the Minister for her assurances. I just want to make a few very brief comments, because I am aware of the time.

I was struck by the noble Lord, Lord Shinkwin. If I heard him correctly, his orthopaedic surgeon was on the last Kindertransport out of Prague. Our own noble Lord, Lord Dubs, was also on the last Kindertransport from Prague, as was my father-in-law. Such are the coincidences that happen in this life.

I am not Jewish, but I have been subject to antisemitism. I suspect that is because people assume I am Jewish. I have been left fearful, hurt and angry, with all those emotions and not knowing where to take them. If I experience that, I can see that my Jewish colleagues experience it in spades. I work in the NHS, and I can tell noble Lords that antisemitism has become normalised. Although the figures we have seen—13% and 11%—are pretty awful, I suspect it is considerably higher than that. It has become almost de facto that one can abuse Jewish colleagues, although not necessarily Jewish patients because you are subject to greater regulatory forces. Certainly, in the last 12 to 18 months Jewish staff have been subjected to quite appalling behaviour from colleagues with whom they work. Antisemitism has been normalised and almost accepted.

Nevertheless, I thank the Minister. I hope that the training does not become a tick-box exercise and includes the issues that we heard about from the noble Lord, Lord Shinkwin. I may wish to return to this issue on Report, but at this stage I beg leave to withdraw the amendment.

Amendment 29 withdrawn.

Clause 7 agreed.

House resumed.

House adjourned at 9.57 pm.