Summer Health and Resilience

Caroline Nokes Excerpts

Wednesday 9th September 2026 Commons Chamber

[Mr Adnan Hussain (Blackburn) (Ind)]

When I bumped into the Secretary of State yesterday, I made clear the urgent need for investment in the Royal Blackburn hospital. I have seen shocking and undignified scenes in the corridors throughout the year. Having spoken to the hospital’s executive team, it is abundantly clear that the hospital is serving a population far, far beyond the capacity for which it was originally built. I welcome the building of new homes across east Lancashire, but does the Secretary of State accept that, unless we extend the hospital’s estate and workforce, this crisis will get worse? Health inequalities across Blackburn are already among the worst in England—

[Madam Deputy Speaker (Caroline Nokes)]

Order. I am sure the Secretary of State has the gist of the hon. Gentleman’s question.

[Yvette Cooper]

I thank the hon. Member for raising this issue. We have invested an additional £29 billion in the national health service this year, and we have also recruited thousands more doctors, nurses, midwives and mental health workers. It is important that investment goes in. Alongside that, we also now have the major new hospitals programme. In addition, the £1.5 billion I announced today is part of a £6.75 billion fund to improve existing facilities where there are safety issues, in order to ensure that the NHS has the facilities it needs.

Health Bill

Caroline Nokes Excerpts

Report stage & 3rd reading
Tuesday 8th September 2026 Commons Chamber

New clause 81 proposes a single named co-ordinator bringing together information on financial support, employment rights for parents and carers, and signposting to relevant charities and support as part of a written plan for the family. This would cut away repetitive bureaucracy and mean that parents are no longer left to their own devices in trying to figure out a way through the challenges their families face in these situations. It is a simple duty, but one that could make a massive difference. At one of the most difficult times imaginable in a family’s life, it would ensure that they are no longer simply left to navigate an overwhelming and unfamiliar system alone. Childhood illness is traumatic enough. We should do everything we can to stop it.

[Madam Deputy Speaker (Caroline Nokes)]

Order.

[Clive Jones (Wokingham) (LD)]

I would like to speak to new clause 137. Cancer Research UK estimates that, in the six months since the national cancer plan was published, over 168,000 people were diagnosed with cancer in England. The number of those diagnosed is at a record high and this is projected to continue. Almost one in two of us will get cancer in our lifetime, and no one in this country is untouched by the disease. I welcome the Government’s ambition to improve cancer outcomes in the national cancer plan. Alongside my amendment to the Health Bill, my current private Member’s Bill seeks to guarantee that the Government make progress towards delivering these targets and are held to account by Parliament on that.

Over the past five decades, cancer survival has more than doubled because of lifesaving research, earlier detection and cutting-edge treatments. However, in the last decade progress has slowed, and the 10-year cancer survival index was better in the early 2000s than in the 2010s, so we are in danger of going backwards. The national cancer plan commits to meeting cancer waiting times targets by the end of this Parliament. The previous Government failed to do that, and I really hope that this Government will manage it. It is also important that these targets are met, alongside a full range of commitments in the plan.

The Health and Care Act 2022 required the Secretary of State to include cancer outcome objectives in the annual mandate set by the Secretary of State for NHS England, and those outcome objectives explicitly took priority over other cancer objectives. I have tabled this amendment because the current Health Bill abolishes that mandate, including the previous statutory requirement for cancer outcome objectives to be prioritised over other cancer objectives, and a similar duty has not been replicated elsewhere in the Bill.

With the removal of the statutory requirement to prioritise cancer outcomes over other cancer objectives in the health system, there is a very real concern that progress on cancer outcomes risks being deprioritised amid the competing priorities of a Department facing many external pressures. I am therefore seeking assurances from the Minister that, despite the disruption of the ongoing merger and the removal of the cancer outcomes clause, progress on delivering the transformation laid out in the national cancer plan will be delivered, and that it remains a priority for the new Prime Minister and the new Secretary of State. I ask the Minister to guarantee that the capacity needed to drive forward this essential work on cancer is protected.

[Madam Deputy Speaker]

Order. I call Kate Osborne.

[Kate Osborne (Jarrow and Gateshead East) (Lab)]

If I may begin on a personal note, just three weeks ago I had a second operation on my back, and I wish to put on record my sincere thanks to the staff who cared for me, from the clinicians who treated me to everyone involved in my care and recovery. [Hon. Members: “Hear, hear.]

Too often our access to healthcare depends on our postcode. That postcode lottery is stark in a number of areas, but nowhere more so than with IVF. As chair of the APPG on fertility, I have raised this issue repeatedly with Ministers. I again invite Ministers to attend our fertility roundtable tomorrow and to commit to ensuring that every ICB follows, at the very least, the NICE guidelines on access to IVF and fertility treatment.

We must strengthen the role of voluntary, community and social enterprise organisations in neighbourhood health planning and NHS commissioning. Voluntary organisations understand the barriers to care for hard-to-reach communities and often have trusted relationships with communities that statutory services struggle to reach. We see that particularly clearly in HIV and AIDS provision. Voluntary organisations have been fundamental to the UK’s response for decades, through prevention, testing, peer support, tackling stigma and supporting people living with HIV. I am extremely grateful to the National AIDS Trust for working with me on the new clauses, and I thank Ministers for their constructive engagement. Members of the LGBT+ community must have trust in healthcare providers, and community groups bridge that gap when needed.

New clauses 142 and 143 would actively harm vitally needed healthcare. The provision in new clause 142 has already been rejected in Committee, and we see it for what it is: an opportunity to attack some of the most vulnerable in our society. Access to much-needed healthcare has already been paused in the UK, and if access to treatment for gender dysphoria is now to be dependent upon additional research, the pathways trial must go ahead without further delay.

The provisions in new clause 143 were also rejected in Committee and are another attempt to vilify. The amendment fails to recognise the framework already in place to ensure that single-sex services are provided where they meet the requirements of the Equality Act. Neither the code nor the Supreme Court judgment mandate the provision of single-sex facilities. Providers must still consider whether the service falls within an exception within the Equality Act, whether single-sex provision is proportionate, what the impact might be on trans people, and what mitigation might be necessary.

I welcome the 10-year health plan. We have made great strides in repairing the damage done to our NHS—

[Madam Deputy Speaker (Caroline Nokes)]

Order. I call Sir Bernard Jenkin.

[Sir Bernard Jenkin]

I would very much have liked to have discussed the medical devices questions arising from the Bill. The Minister made an incredibly short speech about that important matter. It is quite clear that these provisions are part of the covert dynamic alignment with the EU and the covert rejoin agenda being pursued by the Government. It raises all sorts of constitutional questions, but those are not for today.

I will concentrate on HSSIB. I rise to support amendments 1 to 4, which would remove the abolition of HSSIB from the Bill. The Government have singularly failed to make the case for removing this crucial safety investigation function. It did not exist until recently, and now they want to scrub it out. I suspect that is because too many people in the health system do not like being held to account by an independent investigative body.

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I was fortunate to get NHS speech therapy this summer, but not everyone is. That is why new clause 117, backed by the Royal College of Speech and Language Therapists, calls on the Secretary of State to publish a strategy tackling waiting times and unequal access to speech and language therapy. To do this job, we all rely on our voices, so I urge the House to support new clause 117.

[Madam Deputy Speaker (Caroline Nokes)]

That brings us to the Front Bench. I call the Minister.

[Karin Smyth]

We have genuinely had a wide-ranging and thoughtful debate, and I want to try to address all the points that have been raised. I think there is broad agreement across the House on the goals that we are seeking to achieve with the Bill: safer care, better outcomes and a stronger voice for patients. Every patient deserves safe and high-quality care, every community deserves to have its voice heard, and everyone should be able to access the care they need, when they need it. The question before us is how best to deliver those ambitions.

In general, we do not believe that the current landscape works, and that better outcomes are always achieved through new reporting requirements, additional layers of statutory process or more bureaucracy. Instead, we are committed to devolving responsibility and to empowering leaders in the NHS, while also holding them directly accountable, so that the NHS is focused on delivery and improving care.

I will begin with Healthwatch. I think there is broad consensus that we want to see patient voices heard strongly at every level of the healthcare system—it is something that all MPs feel strongly about, dealing with constituents as we do. Hearing the patient and user voice results in better decisions in a system that is designed around them—a system that is better able to correct when things go wrong.

Our ambition is to ensure that insight and experience from patients, service users and communities is part of commissioning and service planning decisions, rather than being held at arm’s length and outsourced. Our ambition is that this is done effectively everywhere. It is about strengthening the power of patients’ voices inside the NHS, where decisions are taken, not silencing criticism of those decisions. Within our approach, integrated care boards and local authorities will be expected to engage with people in their areas and will have a statutory duty to obtain their views.

That is a core part of the new strategic role of ICBs, and it involves transparency about what people have told the system, what the system has done in response and how learning is shared across partners. ICBs will be held to account if they do not demonstrate those elements. However, we have heard the strength of feeling in this place and in Committee, and as the Bill moves to the other place, I can commit to working closely with colleagues across this House and in the other place in order to review these provisions and ensure that our approach sufficiently empowers and devolves to local populations. We all want to ensure that the changes deliver for patients and service users, building public trust and ensuring that their voice is embedded in the care they receive.

Health Bill

Caroline Nokes Excerpts

Report stage
Monday 7th September 2026 Commons Chamber

[Several hon. Members rose—]

[Madam Deputy Speaker (Caroline Nokes)]

Order. After the next speaker, there will be a four-minute time limit, but I will not reduce it further than that.

[Tom Gordon (Harrogate and Knaresborough) (LD)]

I would like to start by welcoming the commitment from the Minister at the Dispatch Box to bring forward a maternity commissioner, and by thanking my hon. Friend the Member for North Shropshire (Helen Morgan) for her tireless campaigning on this issue. When I worked for her many years ago, I was all too aware of the scandal at the Shrewsbury and Telford hospital NHS trust, after sitting in on surgeries with her. Indeed, in my own constituency of Harrogate and Knaresborough, I have ended up with tireless campaigners coming to me when they face maternity issues at Leeds hospital.

I turn to the amendments tabled in my name. The first is new clause 36, which would require the Government to bring forward a formal transition strategy and to report back to Parliament on what happens when NHS England is abolished. I have tabled the new clause out of concern for families who have lost loved ones at the hands of the Tees, Esk and Wear Valleys mental health trust. They have said time and again that they are concerned about the delayed appointment of a chair to the inquiry. They are really worried about that as we see the largest changes to the health service in a generation, and they do not want the inquiry to be lost. I press the Minister on whether she might be able to push that forward or get her colleagues to do so.

New clause 43 would reduce inequalities in access to clinical research funding and trials. I have been working closely with Yorkshire Cancer Research, based in Hornbeam Park in my constituency. We know that funding for clinical research and trials across Yorkshire is about a quarter of what is received in London. If areas outside London and the south-east are getting less research funding, the logic follows that we will struggle to close inequalities in those areas.

Infants, Parents and Carers Bill

Caroline Nokes Excerpts

2nd reading
Friday 4th September 2026 Commons Chamber

[David Davis]

claimed to move the closure (Standing Order No. 36).

[Madam Deputy Speaker (Caroline Nokes)]

I thank the right hon. Gentleman for his point of order. He will be conscious that there are in the region of 15 more Members wishing to speak in this debate, and we have not yet heard from the Minister, so I am not minded to accept a closure motion at this point.

Sudden Cardiac Death: Young People

Caroline Nokes Excerpts

Tuesday 1st September 2026 Commons Chamber

[Amanda Hack (North West Leicestershire) (Lab)]

rose—

[Madam Deputy Speaker (Caroline Nokes)]

I am conscious that another Member has risen, but we have only 10 minutes left. The hon. Lady might prefer to confine her comments to an intervention on the Minister in the interests of time.

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[Mr Frith]

I thank my hon. Friend for her intervention; I hope I will cover and do justice to those important points.

NHS pathways also give providers call-level CPR data to support local reviews and improve quality, as well as reviewing data and emerging evidence to see where we must do better. They send quarterly reports to the national clinical assurance group, which is made up of senior clinicians drawn from royal colleges, professional bodies and urgent and emergency care services. These professionals can and often do submit constructive feedback on the way that pathways are run.

At present, NHS clinical staff are trained in CPR, but from April 2027, this will be extended to all NHS staff, including those in A&E. The roll-out of this training will take time, but it will hugely increase the number of people in the country with valuable lifesaving knowledge.

Finally, when it comes to recognising cardiac arrest, I can confirm that the Care Quality Commission does assess call handlers’ skill as part of its inspections. We know that no human system is perfect, and I am all too aware that a list or accounts like this can risk sounding defensive, so let me repeat my openness to sitting with the hon. Member for Mid Buckinghamshire, Adam’s parents and other colleagues to see how and where we can do better and go further.

Turning to the hon. Member’s points about genetics, I am hugely optimistic about the potential of genomics and life sciences over the next 10 years. The NHS clinical genetics services deliver a comprehensive clinical genetics and genetic counselling service for individuals with a family history of genetic conditions, including cardiac conditions. They provide a detailed review of family history that can direct the diagnosis, risk assessment and lifelong clinical management of patients of all ages and their families who have, or are at risk of having, a genomic condition.

The current specification for the clinical genetics services was published more than a decade go under the previous Government and is no longer fit for purpose, not least because this is one of the most innovative fields in healthcare. Today, specialist clinical services simply do not have the capacity or infrastructure to contact family members proactively, except where a particularly high risk has already been identified. For me and my work, it is a clear example of why innovation must help connect our public services.

NHS England’s genomics programme, working with the genomics clinical reference group, has done a review of the 17 regional NHS clinical genetics services. This has shone a light on the challenges to be addressed for this service to match the Government’s expectations.

I am unable to confirm a specific date for the hon. Member for Mid Buckinghamshire, but suffice to say, there is much more to be done before expectations are met by service. On his point about the UK National Screening Committee, it is true that the draft recommendations, which have been consulted on, did not find that the current scientific evidence—

[Madam Deputy Speaker (Caroline Nokes)]

Order.

National Maternity and Neonatal Investigation

Caroline Nokes Excerpts

Tuesday 30th June 2026 Commons Chamber

[The Secretary of State for Health and Social Care (James Murray)]

With permission, Madam Deputy Speaker, I shall make a statement on the national maternity and neonatal investigation.

Less than a week ago, I stood at this Dispatch Box to respond to the report by Donna Ockenden that exposed devastating failings over more than a decade in Nottingham. As many right hon. and hon. Members rightly made clear following my statement, the shocking report into what had happened was far from the first: in 2015 we learnt of the failures at Morecambe Bay; in 2022 we were appalled to hear about what had happened at Shrewsbury and Telford; and that same year the Kirkup inquiry exposed failings in East Kent. There were also other reviews and reports over the years on specific issues related to maternity care, and it is deeply upsetting to recognise that Donna Ockenden is preparing to undertake further reviews into failings in Leeds and Sussex. Despite all the warnings, the NHS is still failing women, babies and their families on a scale that shames our society.

Bereaved and harmed families are hearing once again the unbearably painful and distressing consequences of the opportunities that have been missed to put things right. As I stand here, I think of how they must be feeling. I know from meeting some of the Nottingham families that their unwavering determination is accompanied by a sense of exhaustion—a sense that however many times they have told their stories, however hard they have campaigned for justice and accountability, and however strongly they have fought to stop what happened to them from happening to others, hardly anything has changed. That feeling will be shared by mothers and their families up and down the country who have suffered so appallingly too, and there will be deep sadness and distress as they are forced to relive their trauma. The burden they bear must sit with us all.

That is why my right hon. Friend the Member for Ilford North (Wes Streeting) decided last year to announce a national investigation into maternity and neonatal services. That investigation has been carried out by Baroness Amos, whose report is published today. I put on record my thanks to her and her team for the comprehensive and compassionate way they have carried out their work.

The Amos investigation gathered evidence from more than 10,500 people, with Baroness Amos and her team personally meeting more than 450 affected families. They visited 12 NHS trusts and heard from over 9,000 staff through surveys, site visits and one-to-one discussions. Although they found that many women experience good and safe care, the report paints a bleak picture of failings at every stage for too many: from pregnancy, labour and delivery to the first hours, days and weeks after birth. When I read about those systemic failures, I found them not only shocking and upsetting but devastatingly familiar, because they are explicitly repeated in review after review. Baroness Amos found a system that is fragmented, overly complex and far too slow to learn. It needs to be radically overhauled.

Last week I spoke about the need to avoid having review recommendations accepted but then sitting on a shelf gathering dust. Other hon. Members agreed with the need to break that cycle, so that is what we will do. As I told the House last week, the national maternity and neonatal taskforce, which I chair, will create a comprehensive action plan by the end of this year.

Today’s recommendations from Baroness Amos include a proposal for a modern service framework in line with the 10-year health plan to support system change and drive consistent, quality care. Those recommendations, along with the national-level recommendations from Donna Ockenden, will feed into our plan, which will make sure that women and babies receive safe, compassionate care no matter where they live. But I do not want people to have to wait for the plan to be completed for us to start making progress, so I am also taking immediate measures in response to Baroness Amos’s investigation, which I shall now set out for the House.

In considering Baroness Amos’s recommendations, the words of a Nottingham mother I met ring loudly in my ears. She said that “accountability drives action”, so today I can confirm that, in response to these recommendations, the Government will appoint the first ever maternity and neonatal commissioner. The holder of this new statutory role will have responsibility for driving change across all parts of the NHS, including those who provide, regulate and investigate care. They will co-chair the national taskforce, along with me. They will hold the system to account, and their role will be to champion the voices of women, babies and families; to ensure that those voices are heard within Government when decisions are made and implemented.

Last week I announced that the Government would roll out Martha’s rule, so that women and their families can demand a second opinion if they feel their concerns are being ignored. That meets a key and familiar concern that the Amos investigation pointed to: women not being listened to as a common factor in maternity failings. Because those concerns are too often batted away before women even arrive at hospital, I can today confirm that we will this week publish new national standards for maternity triage, so that care is consistent across the NHS and women’s concerns are recognised, valued and acted upon at every turn. I expect every trust to prioritise the implementation of these standards and I have asked NHS England to make sure that this is the case and to report progress directly to me.

Some of the starkest examples of racism, discrimination and inequality happen in maternity and neonatal settings, as the Amos report laid bare. The result is that the risks are notably higher for some women and babies and, as Baroness Amos points out, this is a critical safety issue. Black babies are still more than twice as likely to be stillborn as white babies, and black women are almost three times more likely to die during pregnancy or shortly after birth than white women. While tackling inequalities will be a core component of the national action plan, we will make a start straightaway by rapidly expanding the roll-out of the perinatal equity and antidiscrimination programme to every trust. All teams will be mandated to receive hands-on support, to hear first-hand experience, and to undertake face-to-face learning and development programmes. Every trust will have completed the programme by the end of next year.

Births that are safe for mothers and babies depend on health services having skilled, trained midwives. As Baroness Amos rightly identified, staff shortages can have a dangerous impact, with examples of some services being forced to delay admissions when they get too busy. Since coming to office, we have recruited 2,000 more midwives, and last year our graduate guarantee gave 850 more newly qualified midwives an immediate route into the profession. I can tell the House today that we have now created a further 1,000 temporary roles to help newly qualified midwives join the NHS. These new posts will be accompanied by investment, too, and I can confirm that we are investing an extra £41 million, on top of the £145 million already invested, to upgrade outdated and rundown maternity and neonatal facilities.

Alongside these practical measures comes a far more profound challenge that we must face. It is clear from my conversations with affected families, with Donna Ockenden and with Baroness Amos, and from the findings of all the reports, that culture is where so much of the responsibility lies. That culture is the most deep-rooted cause of the failures we have seen, and the most fundamental thing we must change. We know that when families have been in distress and looking for answers, they were too often ignored, sneered at, disbelieved, blamed and lied to. We know from review after review that wrongdoing is covered up and that bullying towards staff who try to sound the alarm is rife, so we will dismantle toxic dynamics, boost staff morale and support better teamwork between midwives, doctors and other clinicians.

We need not only the right policies, procedures and processes to be in place, but a fundamental reset in the culture of a service that too often puts the desire to protect itself above its duty to protect women and babies. That culture change must come from the top. It is time for trust leaders, executives and senior clinicians to pay attention to what is happening on their watch, to put professional tribalism aside, to lose the bunker mentality when things go wrong and to ensure that the safety of women and babies always comes first.

This has to be a watershed moment. We must break the cycle of recommendations sitting on a shelf gathering dust. We cannot go on having review after review while women and babies, as well as their fathers and other family members, continue needlessly to suffer injury, death and lasting trauma. We should all feel a responsibility to ensure that this opportunity is not squandered. We owe nothing less to every family the NHS has failed in the past, and to every family who will rely on it in the future. I commend this statement to the House.

[Madam Deputy Speaker (Caroline Nokes)]

I call the shadow Secretary of State.

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[Several hon. Members rose—]

[Madam Deputy Speaker (Caroline Nokes)]

Order. Before I call the next Member, I wish to say three things. First, the Secretary of State for Defence will commence his statement at 2.30, so time is limited; Members may help each other if they ask short questions. Until then, the Macmillan Room in Portcullis House and Committee Room 7 are available as reading rooms for the defence investment plan. The plan will be made available from the moment that the Secretary of State for Defence begins his statement at 2.30.

[Wes Streeting (Ilford North) (Lab)]

May I add my thanks to Baroness Amos? I join the Secretary of State in emphasising the importance of culture change, but culture change will not happen without accountability. In all the conversations I had with families who were suffering bereavement, harm to themselves or harm to their children, what shocked me most was the cover-up culture in the NHS, which persists to this day, and was exposed once again by Donna Ockenden in her report last week.

There is a legitimate debate to be had about whether we continue with place-based inquiries or have a national statutory public inquiry, and we must have that debate. But whatever the answer to that question, any report will be worth the paper it is written on only if all those involved in decision making and care are held to account through a duty of candour. Given that, where is the Hillsborough law? The law is important not just for justice for the 97, but for justice for these families and in preventing future harms. Will it at least go through this House before the summer recess? Until it is on the books, people will continue to duck the real questions.

[James Murray]

I thank my right hon. Friend for his comments, and again put on record my thanks and tribute to him for having initiated the investigation that Baroness Amos published today. He has been a committed champion of change in maternity services in this country.

I could not agree with my right hon. Friend more about the importance of accountability in culture change. Without accountability, we will not have culture change across maternity services, and the culture of cover-ups will continue. Senior clinicians will feel that they can continue to get away with any mistakes. They will feel that they can avoid scrutiny when investigations take place, and will continue, in too many cases, to be more concerned with protecting themselves than with protecting women and babies.

On what we can do to change that culture, culture is deep-rooted and requires us to take a number of different actions, but the duty of candour is the single most powerful change we can make clearly, loudly and publicly, because the message it will send to senior clinicians thinking about what to do in the future if they make a mistake, or if they are tempted to cover up things that go wrong, is that one day they will be held to account, and there is no avoiding that. With a duty of candour in place, there will no longer be an opportunity for clinicians, in particular senior clinicians, to refuse to engage in that process, to refuse to be held to account and be part of the justice process. People will face up to two years in prison if they refuse to co-operate, so it is a serious measure. I very much agree with him on the importance of ensuring that the Hillsborough law gets on the statute book so that this duty of candour can apply to future maternity investigations.

[Madam Deputy Speaker]

I call the Liberal Democrat spokesperson.

[Helen Morgan (North Shropshire) (LD)]

May I also add my thanks to the Secretary of State, to Baroness Amos and her team, and to the families that have relived the pain of their experiences to bring about this report? But the Amos report tells us little that we did not already know—indeed, it confirms our worst fears. Maternity services in England are fundamentally broken with the cost of political neglect being paid in trauma, injury and lost lives. Figures revealed by the Liberal Democrats in the last week show that the first quarter of 2026 saw the worst rate ever recorded for maternity injuries. In fact, while the number of reviews into NHS maternity services has steadily ticked up, we have also seen rising maternal mortality rates.

Four years ago, I spoke in this Chamber in response to the findings of the Shrewsbury and Telford review, which were devastating for my community. Last week, I stood here really distressed, actually, as we heard further traumatic reports from the Nottingham review. But anger is not enough. The Government must meet this moment now and implement Baroness Amos’s recommendations in full and without delay, or the families simply will not forgive them. To do this, we need genuine accountability through the NHS and the Department of Health and Social Care, accompanied with the investment needed to make Britain the safest country in the world to have a baby.

I welcome the Government’s commitment to a national maternity commissioner—a long-standing Liberal Democrat campaign—and the other urgent and immediate actions that the Secretary of State has outlined in the last week. They are all urgent and are signs that this is being taken seriously. But we need to recognise that a commissioner alone cannot fix the broken system. I urge the Secretary of State to work with us and look at our maternity rescue package for inspiration for his action plan—it has a great degree of overlap with Baroness Amos’s recommendations. Our package would ensure one-to-one midwifery care for every woman in labour, additional senior midwives, an obstetrician on every ward, and mandatory updated annual training. Will the Government commit here and now to implementing all those recommendations and working with us to deliver the change we need?

[James Murray]

I thank the hon. Lady for her comments, and she puts it well when she talks about Baroness Amos’s investigation confirming our worst fears. I was shocked but not surprised, sadly, to read the investigation report. It was devastatingly familiar to read what it set out as being the failings across the country. The report’s recommendations will now become part of the work of the taskforce, which I chair, to produce the comprehensive action plan by the end of this year. My intention is that the taskforce will take all the national recommendations from Baroness Amos’s report, as well as the national-level recommendations from Donna Ockenden’s report last week and recommendations from any other investigations and reports, and ensure that the action plan it produces comprehensively addresses all the issues raised. I think that we would all agree that there is not—one, two, three—a small number of actions that we need to take; this has to be a comprehensive plan to truly transform the service.

[Madam Deputy Speaker]

I call the Mother of the House.

[Ms Diane Abbott (Hackney North and Stoke Newington) (Ind)]

The Secretary of State will know that many women are never more vulnerable than in childbirth. It is about not just the vulnerability, but the horror of what women and their babies are exposed to in childbirth. We see inquiry after inquiry, and nothing seems to improve. Very many of those who suffer during childbirth are black women and their babies. The Secretary of State said himself that

“Black babies are still more than twice as likely to be stillborn than white babies, and black women are almost three times more likely to die during pregnancy or shortly after birth than white women.”

The whole House wants to see progress, but it is not enough to have another inquiry or another report; what black women want is equity of treatment and fewer black women and their babies dying.

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[James Murray]

My hon. Friend draws out an important point: a key part of developing the national action plan is to ensure we have the right metrics and mechanisms for monitoring its implementation and the right structures in place to make sure it is implemented across all trusts. In working with members of the taskforce, I will ensure that those accountability mechanisms for the delivery of the plan are in place, because I have spoken many times today about the importance of recommendations not sitting on shelves. We need to ensure we have the structures in place such that the actions in the national action plan are implemented, we can see they are being implemented, and we can give people confidence that that is the case.

[Madam Deputy Speaker (Caroline Nokes)]

I call the Chair of the Health and Social Care Committee.

[Layla Moran (Oxford West and Abingdon) (LD)]

I, too, thank Baroness Amos, her team and, most especially, the families who so bravely gave the evidence that has formed this report. Further to the conversation about accountability, the Secretary of State will have noticed that some families are concerned that the commissioner is just one person, and that there is too much for them to do. Can he make clear that the buck stops with him and, indeed, the PM, and that he will not let go of this? The commissioner will report every six months to the Health and Social Care Committee—we welcome that—and once a year to Parliament. Further to that, will he personally commit that the Secretary of State will seek permission from Mr Speaker to make a statement to the House once a year, so that they can be held personally accountable for the progress made too?

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[James Murray]

I will take away the right hon. Gentleman’s suggestion and think on it, because it is critical that we have accountability. As I said in response to earlier questions, I find the decision of senior clinicians not to take part in the Nottingham inquiry utterly unacceptable, and incomprehensible on a personal level. We must ensure that that never happens again.

[Madam Deputy Speaker (Caroline Nokes)]

I call Dr Ben Coleman.

[Ben Coleman (Chelsea and Fulham) (Lab)]

I am not a doctor, but thank you so much, Madam Deputy Speaker. Perhaps I am a doctor from the university of life—who knows?

I pay tribute to Baroness Amos for this excellent report, and to my right hon. Friend the Member for Ilford North (Wes Streeting) for commissioning it. It is a remarkable piece of work. It follows on from Ockenden, and the report on black maternal health done by my Health and Social Care Committee—its Chair, the hon. Member for Oxford West and Abingdon (Layla Moran), sits on the Opposition Benches. We see the same problems again and again: misogyny, racism and a lack of accountability. I am therefore delighted that this plan will be developed in six months, through the taskforce, and that we will have a maternity commissioner. I know that my constituent Louise Thompson, who has been campaigning hard for this position to be created, will be delighted. However, like me, I think she will have a question about timing. Will it be possible for the commissioner, who will be introduced on a statutory basis, to be brought in quickly enough for them to have a full role in shaping and creating the plan that will be before us in six months? If not, why not?

Department of Health and Social Care

Caroline Nokes Excerpts

Tuesday 30th June 2026 Commons Chamber

(3) a further sum, not exceeding £115,924,112,000, be granted to His Majesty to be issued by the Treasury out of the Consolidated Fund and applied for expenditure on the use of resources authorised by Parliament.—(Lilian Greenwood.)

[Madam Deputy Speaker (Caroline Nokes)]

The debate will be opened by the Chair of the Health and Social Care Committee. Before I call her, I wish to alert Members that the same time limit of three minutes will be imposed in this debate, and I am sure the Chair of the Select Committee will be cognisant of that during her opening remarks. I call Layla Moran.

Puberty Blockers

Caroline Nokes Excerpts

Tuesday 23rd June 2026 Commons Chamber

[Madam Deputy Speaker (Caroline Nokes)]

I inform the House that Mr Speaker has not selected the amendment. I call the Opposition spokesperson.

--- Later in debate ---

[James Murray]

The MHRA has introduced additional safeguards. As a result of its dialogue with the trial sponsors, the amended protocol published last week increases the level of safeguards. That means that if the regular monitoring, which will happen at least every three months—it can be more regular during the trial—shows any sign of increased risk of harm, that will lead to increased monitoring, clinical review and, when considered against objective criteria, automatic withdrawal from the trial.

It is a question of monitoring this trial, possibly more closely than any trial before—the level of scrutiny is very great indeed—to ensure that at the first sign of any increased risk of harm, action will be taken. That is the assurance that I have sought in interrogating this matter carefully in recent days, and that is the basis on which I am talking to the right hon. Gentleman and others in the House today.

We must come to a fair and settled conclusion on this matter to move forward as a country, and I believe that we should follow clinical advice and establish the clinical evidence gathered in a highly scrutinised trial with all the safeguards in place that I have described. Only that approach will give us the confidence about where we settle on this matter in the future. On that basis, the Government oppose this motion.

[Madam Deputy Speaker (Caroline Nokes)]

I call the Liberal Democrat spokesperson.

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[Alison Bennett]

I will not.

We must never lose sight of the fact that at the core of the debate is young people’s wellbeing and health. It is not about ideology; it is about what is best for young people. The Government must always prioritise clinical evidence and put the interests of patients at the heart of care.

[Madam Deputy Speaker]

I call the Chair of the Women and Equalities Committee.

Pathways Study: Puberty Suppression

Caroline Nokes Excerpts

Monday 22nd June 2026 Commons Chamber

[Madam Deputy Speaker (Caroline Nokes)]

I call the shadow Minister.

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[James Murray]

As my hon. Friend will know, the recommendations in Dr Hilary Cass’s review set out how to establish better services for young people in the future. The focus of today’s statement, the clinical trial, is just one part of the wider work on how best to support young people who need extra support in this situation. It was welcome that there had been, at least until recently, a cross-party consensus that Dr Cass was finding the right way through this difficult matter.

[Madam Deputy Speaker (Caroline Nokes)]

I call the Liberal Democrat spokesperson.

[Helen Morgan (North Shropshire) (LD)]

I thank the Secretary of State for advance sight of his statement. The Liberal Democrats have long highlighted the need for better access to specialist healthcare for children and young people struggling with gender identity. The closure of the Tavistock clinic and its inadequate rating by the Care Quality Commission demonstrated that urgent change was needed. Young people struggling with gender identity face serious challenges. They have been badly let down for years by low care standards and extremely long waiting lists. On top of that, they have to contend with a toxic public debate, which comes at a huge cost to their wellbeing at a particularly vulnerable stage in their life. The average three-year wait for a young person to see a specialist can be extremely harmful at such a vulnerable age.

We agree that treatment should first be based on talking therapies, so that patients are given the space and support that they need, but it is crucial that young people can start those therapies as a matter of urgency, not after years of delay. Decisions about these young patients’ futures should be made in an informed way, with expert clinicians and based on the best possible evidence, which the NHS must build up safely and effectively. We support prioritising clinical evidence, so that patients’ interests are put at the heart of decision making in all areas of healthcare. Guidance and decisions around puberty blockers must be led by experts and clinical evidence, and not influenced by ideological opinion. That is why we supported the decision of the former Secretary of State, the right hon. Member for Ilford North (Wes Streeting), to pause the Pathways clinical trial while concerns raised by the MHRA were thoroughly addressed. Will the Secretary of State confirm whether the MHRA has confirmed that the concerns that led to the withdrawal of the trial have been substantially addressed, and how many children are expected to take part in the trial now that its parameters have been altered?

--- Later in debate ---

[James Murray]

I absolutely agree with my hon. Friend about the importance of following clinical evidence and taking a clinically led and evidence-based approach to this decision. As I said, I have felt uncomfortable and uneasy about some of the challenges raised by this matter, but for me, the right way to move forward is to follow the clinical advice, and to base future decisions on clinical evidence, given that I have received the most robust assurances about the safeguards that are in place to protect young people involved in this trial from harm.

[Madam Deputy Speaker (Caroline Nokes)]

I call the Chair of the Health and Social Care Committee.

[Layla Moran (Oxford West and Abingdon) (LD)]

I welcome the statement and this approach. I thank the MHRA for engaging with the Committee when we asked it specific questions about this. It told us that the role of the regulator is to ensure that participants in any clinical trial are kept safe and are exposed to medicine only if there is a reasonable expectation of a positive effect, and that is what was foremost in its mind. It also reassured us that if it had not felt 100% assured, it would have not allowed the trial to go forward.

There was a lot of disquiet about the iterative process that the trial has gone through—that it was stopped, paused and then started again. Could the Secretary of State outline for the House how usual or unusual that is? What support can the NHS offer those families who might have hoped to be part of the trail but now find themselves excluded from it?

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[Jonathan Hinder (Pendle and Clitheroe) (Lab)]

The Secretary of State has repeatedly told us that he feels uncomfortable and uneasy. If I am totally honest, I do not think that he believes that this is right at all. I think that in his heart, he knows that this is wrong. Of course it is wrong: stopping an 11-year-old—a primary school child—from going through the natural process that we must all go through to become adults by injecting them with drugs is wrong. We must think about the title of the statement: puberty suppression. People do not need a medical or a science degree to know that the suppression of puberty is wrong. This is a moral question and I am afraid that as it stands the Secretary of State is on the wrong side of it. He says “let them be”—if only they had let Keira Bell be. When she had the treatment, Keira Bell was much older than these children will be when they are given it. She regrets it all and now campaigns to stop this. There is huge public opposition to this—

[Madam Deputy Speaker (Caroline Nokes)]

Order. I assume the hon. Gentleman is getting to a question.

[Jonathan Hinder]

There is huge opposition to this among people who vote Labour, including many of my constituents, so I implore—

[Madam Deputy Speaker]

Order. The hon. Gentleman’s question is far too long. I call the Secretary of State.

[James Murray]

Despite our different conclusions on this matter, I respect my hon. Friend. Part of taking decisions as Health Secretary involves sometimes approaching issues where one might feel uncomfortable on a personal level, but none the less being guided by the right principles in order to take decisions for other groups of people in the country and for the country as a whole. I am not in any way disputing how difficult a matter this is; it is one where I, as Health Secretary—and my predecessors—have had to carefully consider how we ensure that the clinical basis for any future decisions is robust and that we can point to it as a foundation for where this matter settles.

Before Dr Cass did her review, the situation at the Tavistock clinic was totally unacceptable, as the right hon. Member for South Holland and The Deepings (Sir John Hayes) recognised, and we must never go back to a position where the situation is out of control in the way that it was then. In working out how to move forward, I believe that, as uncomfortable as it may make myself and others on an individual basis, focusing on the principle of following clinical evidence, demanding the highest possible safeguards and protections for the children involved, and setting objective criteria for them to be withdrawn or for action to be taken if the risk of harm increases, is the balanced and correct way to proceed.

Health Bill

Caroline Nokes Excerpts

2nd reading
Monday 1st June 2026 Commons Chamber

[Relevant documents: Oral evidence taken before the Health and Social Care Committee on 20 May, on the Work of NHS England, HC 583; Written evidence to the Health and Social Care Committee, on the Health Bill, reported to the House on 20 May, HC 219.]

[Madam Deputy Speaker (Caroline Nokes)]

Mr Speaker has not selected the reasoned amendment.