Health Bill (Seventeenth sitting)

Dave Robertson Excerpts

Committee stage
Thursday 16th July 2026 Public Bill Committees

[Karin Smyth]

Indeed. They wanted to work with resident doctors to talk through a way to make progress without resorting to strike action, because that is a sign of failure in any system.

On new clause 81, we are committed to reforming trade union legislation to bring it into the 21st century. We want to create an industrial relations framework that is fit for a modern economy, and workplaces that work for everyone. That is why the Employment Rights Act 2025 repealed the Strikes (Minimum Service Level) Act 2023. The previous legislation created a hostile environment, which was not conducive to good partnership working with trade unions or to settling disputes.

On new clause 82, although strikes are hugely disruptive, a ban on a doctor’s right to strike is not the answer.

[Dave Robertson (Lichfield) (Lab)]

As I am sure the Minister knows, I have been a trade unionist since I started my teaching career some years ago. I have been involved in a number of industrial actions over that time, as a teacher and member of a trade union and as a trade union staffer. The driving force behind a significant majority of those industrial actions was not pay; it was often the safety of staff, the safety of sites, bullying managers or the inability to deliver an environment in which members felt they could deliver their best. Does the Minister agree that the ability to take industrial action is not always about money-grubbing or about pay? It is often about health and safety and about delivering the very best workplaces for our workers.

[Karin Smyth]

I thank my hon. Friend for bringing his experience to bear on this matter. I absolutely agree. New clause 82 stems from that resident doctors dispute. One of the first things that we did was to agree the 10-point plan with regard to the management in trusts. I have said before how truly shocking the working conditions are in many trusts not just for resident doctors, but for other doctors and professionals. There is no ability to take a break, have a rest or get away. Some of the equipment that they are dealing with is also shocking, as are the levels of the estate. Those are some of the many things that have driven and continue to drive poor industrial relations, along with the fact that there is no one to speak up for them.

Health Bill (Fifteenth sitting)

Dave Robertson Excerpts

Committee stage
Thursday 9th July 2026 Public Bill Committees

[Dr Caroline Johnson (Sleaford and North Hykeham) (Con)]

I rise to speak to new clauses 14, 79 and 80, tabled by the Liberal Democrats. New clause 14 would require the Secretary of State, within six months, to establish a statutory target for healthy life expectancy in England and then to produce a strategy every two years to meet that target. This is not the first time the House has heard about life expectancy targets; as I am sure you will remember, Ms Lewell, the previous Government’s 2022 levelling-up White Paper talked about narrowing the gap in healthy life expectancy between the areas where it is highest and lowest, and aimed for healthy life expectancy to rise.

As the hon. Member for Winchester said, life expectancy has increased quite dramatically over the last century, but that is largely due to improvements in child mortality. That is a good thing, but it is worth looking at how healthy life expectancy is calculated. The Sullivan method starts by looking at mortality rates over a specific timeframe for a specific population, and then takes data from a cross-sectional study where people are asked to rate their own health, multiplies them together and produces a figure for healthy life years. Therefore, the main element that separates healthy life expectancy from unhealthy life expectancy is survey responses; it is not a clinical metric. If somebody on a huge amount of medication and treatment feels healthy, they are healthy. If someone on very minor treatment feels unhealthy, they are unhealthy. It is a self-reported measure.

The Government’s website says that if mortality improves by 2%, healthy life expectancy increases a very small amount; if self-reported feeling healthy goes up 2%, there is a much bigger increase in healthy life expectancy. We want people not just to live longer but to live well, but it is a case of how we measure it and how we ensure that there are no perverse incentives. We should look at it over time in the same individuals. How do people feel when they get up in the winter, when it is cold, dark, raining or icy? They may feel less healthy than when the sun is shining, it is the weekend or England have won the world cup.

The Government’s own figures show that musculoskeletal health is particularly important. Musculoskeletal conditions are prevalent among 17.2% of the population, and people with them are three times more likely to have self-reported ill health. We have asked before if the Government will introduce a modern service framework on musculoskeletal disease, having scrapped our long-term conditions strategy. I would be grateful if the Minister could say whether the Government have given more consideration to that and are now willing to do an MSF on musculoskeletal health.

New clause 79 would require the Government to create a committee across Government, including the Prime Minister, all Cabinet members and one Minister from each Department. The idea behind the new clause—that we need to work together—is important, but I would be grateful for the Minister’s comments on how feasible, practical and effective that would be.

Finally, new clause 80 concerns the duty to promote public health. Of course, it is the Minister’s duty to do his or her job, and part of that is promoting public health. What does the Minister think the practical effects of that new clause would be on bureaucracy in Departments?

[Dave Robertson (Lichfield) (Lab)]

It is always a pleasure to see you in the Chair, Ms Lewell. I will speak briefly on new clauses 79 and 80. I really like the intent of these new clauses, and the idea of Government working better and more together, public health being more of an agenda, and trying to get people working together in that framework. I am pretty sure that every Member in the House would support that. I do, however, have some serious concerns about the wording.

New clause 79 proposes a new committee, whose membership would include at least one Minister from each Department and all Cabinet Ministers—I presume that that is in addition, so it would be all Cabinet members plus one other Minister from each Department, which makes it seem like quite an unwieldy committee. There comes a point when a committee, if it has 70 people in it, ceases to be a committee, particularly when it will also need to be chaired, have clerks and have various people in the room. I have concerns about its size. I also have concerns about the frequency with which it would meet, and the requirement that every single Cabinet Minister must attend a minimum of three times a year, which is the implication of the wording.

[Dr Prinsley]

Public health used to be clearly under the aegis of the national health service. Some years ago, public health officers became employees of the local authorities, and the thing became somewhat separated from the NHS. Does my hon. Friend agree that we must join public health more closely to the activities of the national health service? Public health was at the very foundations of the national health service. I do not know whether other Members have, like me, read A. J. Cronin’s famous book, “The Citadel”, which describes the health service’s origins; in fact, I understand it was the book that the original politicians had all read. It has a marvellous description of a typhus epidemic, caused by an infected drain running down the middle of a street in a little Welsh mining village. The doctors had been completely unable to get any of the authorities to deal with it, so one night—they were ex-military—they put a little dynamite in the drain and blew the whole thing up. That is well described in the book, and it just shows how public health was absolutely integrated into the foundational principles of the national health service.

[Dave Robertson]

My hon. Friend makes an important point about the centrality of public health to the founding of the NHS. Earlier in Committee, I said that the NHS was the greatest gift the Labour party had ever given the country, and I fundamentally believe that. He is absolutely right to mention the centrality of public health in that process. I also thank him for his recommendation of a book to read over recess—that is always a pleasure.

To return to new clause 79, I want to focus on what we are asking when we say that all Cabinet members have to attend this new committee. That would include the Secretary of State for Defence, and although I understand cross-Government working and the need for Departments to work more closely together, I am scratching my head over what actions we expect the Secretary of State for Defence to take to support public health, and especially over the fact that they will be required to attend this committee a minimum of three times a year with, in my reading of the wording, another Defence Minister.

[Dr Chambers]

I pay tribute to the Royal Army Veterinary Corps. It does good work in trying to eradicate rabies in countries with street dogs, as part of hearts-and-minds engagement. We can work public health into pretty much any Department.

[Dave Robertson]

I absolutely join the hon. Member in thanking those service personnel who do so much good around the world, but I wonder whether it is appropriate to ask the Secretary of State for Defence to focus on public health. It is absolutely right that the Defence Department could do things, but does the Secretary of State need to be so centrally involved in this committee that they will have to attend three times a year, in addition to another Minister, who will have to attend a minimum of four times a year? Yes, a variety of Departments would be able to do that.

[Dr Chambers]

Just to blow my own trumpet, my greatest academic achievement was getting correspondence published in Nature on the impact of conflict on antimicrobial resistance. It might interest Members to know that, in Ukraine, 80% of wounds have novel bacteria that are displaying multi-drug resistance, which has become a limiting factor in getting soldiers back on to the frontline. We are trying to reframe issues such as antimicrobial resistance as national security and defence issues, rather than purely public health issues.

[Dave Robertson]

I very much appreciate that intervention, and I congratulate the hon. Gentleman on getting published in a very important journal. I am not in any way saying that the Secretary of State should not have any regard—[Interruption.] Now that he has made a joke, I want to say that I think he looks like a trombonist, rather than a trumpeter.

There is a very important point to draw out here. Although Departments can think about the public health impacts of the work that they undertake—I am sure many Ministers will do so—I am not sure there needs to be such a requirement to focus on public health for the Ministry of Defence, which obviously has a very significant, serious role.

New clause 80 would require all Ministers to have regard to public health. I really appreciate and value that—I think this is a good debate for us to have—but if the Minister for investment has managed to secure an investor to save a large business that is essential to the economy of an area, do I want them to be held up by having to demonstrate that the investment will ensure public health? I am not sure I do. A lot of decisions have to be made very quickly. I am not going to go through a long list of Ministers; we would all be here until next week. I just think the wording of the new clause is too broad, and I am not sure I can support it in its current form because it would place too much of a requirement on too many Departments to focus too much on areas that are not their core responsibilities.

[Joe Robertson (Isle of Wight East) (Con)]

It is a pleasure to serve with you in the Chair, Ms Lewell. I find myself unequal to the level of analysis and detail that the hon. Member for Lichfield brought to public health in the Ministry of Defence.

I will add just a few brief thoughts. The good intention of extending the life expectancy of the people in this country—although my hon. Friend the Member for Sleaford and North Hykeham made the good point that it is about living well, not just for a long time—is not always best served by creating committees, and additional duties, reports and responsibilities in legislation.

The hon. Member for Winchester argued—I paraphrase, but it is a matter of record—that he would like all Departments to have an eye on the health of the nation. That sounds sensible. There are other things that I would hope all Ministers have an eye on in everything they do, such as the wealth of the nation and inequality, but I would not advocate for embedding those things—I hope they would come with good governance, public duty and responsibility—in legislation as a duty, a committee, a set of meetings and a report. Indeed, it is things done with good intentions that lead to growing bureaucracy, which slows down decision making and requires more people to be employed to discharge those duties at a growing cost to the public purse. It is something that western democracies do all too well, and not always for the good. I would not want this well-intended set of new clauses to lead to growing bureaucracy with very little benefit. The benefit that the hon. Gentleman wants to see, which I agree with, can be best delivered in other ways.

--- Later in debate ---

[Karin Smyth]

I am not party to the negotiations. That is above my pay grade, like the conversation yesterday that the hon. Gentleman alluded to. I will get back to him on any outstanding questions, as the Department will to the Select Committee with other details.

[Dave Robertson]

To quote the Precision Health Technologies Accelerator at the University of Birmingham, very close to my Lichfield constituency, its leadership has been supportive of the removal of tariffs from pharmaceuticals, saying that the introduction of the tariffs could lead to

“supply chains collapsing and patients suffering.”

That is an enormous growth opportunity for the West Midlands combined authority, for Birmingham and for the wider region. There have been a lot of discussions, but I wanted to make sure that the views of organisations that will benefit are on the record, because this will be so beneficial for my region.

[Karin Smyth]

My hon. Friend clearly highlights the advantages for his constituents and the importance, particularly for that university and universities across the country, of such outward-facing arrangements, which benefit constituencies in many ways, not only through employment, but through the pharmaceuticals and medical devices, and so on, that help all our constituents.

New clause 76 specifically references the trade arrangement between the United States and the United Kingdom. That landmark partnership with the United States Government on pharmaceuticals pricing and tariffs is in the best interest of UK patients, supporting the NHS and the economy. As a result of the changes to the UK’s medicines pricing, NHS patients will get improved access to lifesaving treatments. New medicines have already been recommended under the updated approach, including a brain cancer drug available to patients as young as 12 and a last-resort treatment for a rare, aggressive stomach cancer—something that I think the entire House and the Committee would support.

Health Bill (Thirteenth sitting)

Dave Robertson Excerpts

Tuesday 7th July 2026 Public Bill Committees

[Dr Chambers]

The hon. Gentleman must have read the next line of my speech. We are concerned that a DHSC employee appearing before that Committee will not clearly and openly state whether DHSC is failing.

New clause 78

“would ensure that Healthwatch England and local Healthwatch organisations are funded to the level estimated by the Department for Health and Social Care”

in 2013-14. We do not just want to protect Healthwatch; we want to strengthen it. As I mentioned, it receives almost £26 million a year, which is spread over 153 organisations. In real terms, that is about 60% less than the £43.5 million that DHSC originally estimated would be needed to fund the network. The Healthwatch network does such amazing work—I will not go through it all again—despite being underfunded compared with those original estimates. Imagine the work it could do if it was adequately funded.

Even more worryingly, there is still no clarity on how Healthwatch’s functions will be funded once they have been transferred to the new system. Given the ongoing constraints and cuts to ICB running costs, there is a real risk that the funding for Healthwatch will simply end up being incorporated into wider ICB budgets, and money for the patient experience infrastructure could end up being cut entirely. The new clause aims to ensure that the Healthwatch network is properly funded, but it also raises the point that, if this change is to go through, funding for patient experience infrastructure must be protected. Otherwise, the Bill risks not just weakening patient experience, but removing it altogether as the funding gets swallowed by wider NHS operational demands.

[Dave Robertson (Lichfield) (Lab)]

It is, as ever, a pleasure to see you in the Chair, Ms Lewell.

Healthwatch was established, at least in part, as a response to the Mid Staffs scandal. Mid Staffs came up three times in our evidence sessions, and the hon. Member for Winchester mentioned it just now. That scandal matters to everyone, but it has a particular resonance for my role in Parliament. Many of my constituents were harmed by the failing at Mid Staffs. I was born in that hospital, and I speak as a Staffordshire MP. None of us should ever forget what happened or allow it to be swept aside without examining it. There were a great many failings at Mid Staffs over a long period. Oversight was just not in the room when decisions were being made.

Staffordshire county council’s health and care overview and scrutiny committee clearly did not do that job. The Francis report stated:

“The arrangements for public and patient involvement, and for local government scrutiny in Stafford, were a conspicuous failure.”

The report recommended some changes to ensure that Healthwatch, which was in the process of being set up at the time, was funded properly. In that light, the framing of this debate is important and timely. Healthwatch has been going for well over a decade. It is right that we now examine its impact, as it is a significant part of patient voice within the NHS.

Despite the very best efforts of a great many hard-working staff and an army of committed volunteers across the country, the quality of local healthwatch organisations is pretty changeable. Over the past few weeks, I have spoken with right hon. and hon. Members from across the House. The feedback that I have received has ranged from, “My local healthwatch team is brilliant— I work with them really closely and they have really helped out with a huge amount; they deliver great things in my constituency” all the way to, “I have some pretty significant concerns about their impact.” In a couple of cases I heard, “What is Healthwatch? I have never heard of it.”

[Helen Morgan (North Shropshire) (LD)]

We heard in evidence that the reason for that variability was a lack of funding. Would the hon. Gentleman support our new clause 78, which tries to deal with the lack of funding and ensure a consistent service from Healthwatch across the country?

[Dave Robertson]

Funding Healthwatch is really important, but to address the issue properly, we must make sure that Healthwatch is in the rooms it needs to be in. Funding needs to be part of the process that ICBs follow. I will touch on that later, so the hon. Member will hear further thoughts on the matter.

Local healthwatch organisations across all our constituencies have an important role. At the local level, they are geographically bound to counties. In constituencies like mine and that of the hon. Member for North Shropshire, those geographical areas are huge. The health disparities within my constituency, with two towns that are 4 miles apart, one with a significant mining—

[Gregory Stafford (Farnham and Bordon) (Con)]

I hesitate to intervene on the hon. Gentleman, because he seems to be straying into the next grouping and I do not want to encourage him down that route, but now that he has raised it, I share his concern. I do not know what it is like in his area, but the ICB areas that local branches of healthwatch will be absorbed into are even larger than counties. In my area, Surrey and Sussex make up three administrative counties. That is an even larger area. The provisions are clearly not the solution to the problem that the hon. Gentleman is outlining.

[Dave Robertson]

In isolation, that criticism would be legitimate, but, alongside other changes being introduced, there are ways to mitigate that problem.

I am concerned that local healthwatch branches are not truly local. The healthwatch in Staffordshire has not held an event in my constituency for a number of years. I think its last three events were just volunteer fairs to get more volunteers involved. That is not to say that there are not significant numbers of people there who work very hard to support people in their engagement with the health service, but geographic changeability is real. On a national scale, Healthwatch England has a huge role to play.

--- Later in debate ---

[Helen Morgan]

Will the hon. Gentleman give way?

[Dave Robertson]

I will make some progress. There are concerns that if we roll some responsibilities into ICBs or councils, the Department needs to make sure that the issue does not get pushed to the side and that the funding does genuinely remain for patient voice. I am reassured that there will be a patient experience directorate within the Department. That will bring decision making and the patient voice into the Department while also keeping an eye on what is happening with those ICBs and ensuring that they have standards to hit.

The Department needs to ensure that it is sharing good practice and keeping oversight of local authority commissioning of social care. The CQC is starting to do that, and there are some positive indicators. There is obviously more work to do, and we need to stay on top of it because, as I said earlier, there are risks whenever there are changes to healthcare. I am reassured that bringing the patient voice into the room with decision makers is the right way to enact change.

[Dr Johnson]

Will the hon. Gentleman give way?

--- Later in debate ---

[Dave Robertson]

I am just about to conclude, so I will allow the hon. Lady to come back when she makes her speech shortly.

The final point I want to make is about local government. I hope the Secretary of State will issue guidance on how local government will commission adult social care services. I also hope we will get annual reporting from ICBs and local councils on how they are using the patient voice. I know that the Secretary of State will have the ability to intervene, and I would expect him to do so should those reports show that the patient voice is not being used, is not finding its way into the room or is not leading to the meaningful change that the Amos report suggests.

[Edward Argar]

I will confine my remarks to group 47, conscious that the next group will give us an opportunity to discuss local arrangements, so I will stick to the national ones.

We are all aware of the significant role that Healthwatch England plays, as well as its popularity and the trust that many people place in it. As a former Minister in the Department, I was on the receiving end, on occasion, of some sharp—or firm—suggestions from Healthwatch England, but that is what it was there for. It was there to be the grit in the oyster. It often made useful suggestions, and its independence meant that it could put reports not only to me but to the public—it published them. It could give them, for example, to my hon. Friends who served on the Health and Social Care Committee and, if it wished, go to the media to make sure that that voice was heard.

That is where, for me, the challenge with what is proposed comes in, because a new directorate in the Department, staffed by civil servants, will simply not be able to do that. We all know that those who work in a Department, however excellent they are, report upwards ultimately to the permanent secretary and to Ministers. They are answerable to the political leadership of the Department. Would they be able to decide that something was coming through regularly from patient feedback and publish it independently, without ministerial approval or that of the permanent secretary, or hand it to the media? Would that director be able to champion the patient voice by going on television, irrespective of any ministerial approval?

The reality is, of course, that they could not. It would all be kept in-house in the Department, part of a closed process that would not alter decision making in reality, because that is already happening in the Department. The Department should already be looking at reports from Healthwatch England as part of decision making by Ministers and senior officials. What this simply does is remove the independence. It weakens that voice by making it something that happens within the Department rather than in the public sphere because, quite rightly, those officials will not be able to have their own independent voice out there, irrespective of the leadership of the NHS or the Minister.

I genuinely worry that what we see here is the continuation of a theme that has run throughout other aspects of this legislation—a theme of centralisation, of removing independent external challenge and bringing it inside the system, be it the Department or the NHS. When that happens, my fear is that the people who will lose out will be the patients, whose voice will no longer carry as loudly.

Health Bill (Eleventh sitting)

Dave Robertson Excerpts

Committee stage
Thursday 2nd July 2026 Public Bill Committees

[Dr Chambers]

I will speak to clause 47 and to new clauses 7 and 8, which were tabled by my hon. Friend the Member for Newton Abbot (Martin Wrigley). The sector has been calling for a single patient record for decades, and it is the single most impactful part of the Bill. It could be transformational for patient experience, care, outcomes, consistency of treatment and reducing errors.

Members have talked about the hassle of people having to tell their story repeatedly or recollect the history, which many people cannot do accurately, so the clause could be hugely impactful. Polling shows that nine out of 10 Britons want better access to medical records. Many assume that a single patient record already exists and are often quite surprised when they go to another hospital and find that it has no record of what has been done in the county next door.

Although the public are rightly concerned about the use of their data, especially outside of direct care and for planning and research purposes, we wholly support the idea of a single patient record. The plan is for people to be able to see their primary, secondary and social care records all in one place, all in the NHS app. It will be transformational, but patients should be in control of their data. They should be able to see who is accessing their records and should be able to opt out of sharing data. It is essential that there is sufficient control and guarantees around the sharing of data, whether for research or other reasons. The Bill does not go far enough to provide reassurances that patients will ultimately be in charge of their own data and how it is used.

Trust among medical staff, patients and the public is essential for this much-needed system to succeed, and we have only to look at the pushback on the federated data platform to see that. Sufficient guardrails are necessary to make sure that secondary uses of health data are allowed only when they deliver a clear public benefit. Rules need to be future-proofed so that they are not vulnerable to change depending on the political or economic situation. There should be meaningful checks, balances and transparency.

We want to make sure this technology is focused on enabling and delivering healthcare. We know that, in the US, Palantir is providing health data to US Immigration and Customs Enforcement, which is then used to support deportations. We would be really concerned if people were too worried to come forward for medical treatment because they thought that their immigration status might be passed on to another Department.

There was a Westminster Hall debate recently on the concerns about Palantir and about the single patient record being abused. From an economic point of view, it seems a lost opportunity to have such a huge infrastructure project farmed out to foreign companies based abroad. First, this is a huge opportunity for companies in the UK to boost our economy, provide employment and drive innovation. Secondly, if we are reliant on foreign companies to deliver this service, we could lose our health sovereignty and their motivations might change depending on the political and economic situation of the country in which they are based.

There have been recent examples of NHS staff inappropriately accessing the private health records of the victims of the Southport and Nottingham terror attacks. The decision by the University Hospitals of Liverpool Group not to inform patients of the breaches understandably raised privacy concerns. The Government must therefore ensure that there are sufficient safeguards and guardrails, and that they are communicated clearly to the public to build trust.

The single patient record needs to happen, but in the right way. The issues with the FDP’s uptake have shown that patient and staff mistrust can significantly undermine a system’s effectiveness. The most important safeguards should not be left entirely to later implementation. They should be laid out in primary legislation at the beginning of the process. The Bill should be more explicit on who is responsible for decisions about access, sharing, liability and redress. That is why we have tabled various amendments, which we will get to later, most notably on our health data charter, setting out the key principles of how health data should be handled and a duty to prioritise domestic suppliers in technology procurement.

We welcome Opposition amendment 49, which we debated earlier—I believe it was echoed by the NHS Alliance—suggesting that a plan should be laid before Parliament for a minimum three-month public information campaign before the system goes live. The discussion on this needs to be constructive, not alarmist, to make sure that the SPR is rolled out in a safe fashion and so that we all get to feel the benefits.

Public involvement should be ongoing, visible and tied to real implementation decisions. Past NHS data reforms show that support depends on people feeling informed, heard and able to challenge decisions. Any red lines should also be clear. For example, there should be consented use for marketing or insurance purposes.

We also need to discuss the role of GP practices in this debate, given that they work within the NHS but are also private businesses. GP records are among the NHS’s richest data assets, and GP practices are to remain independent data controllers. I have spoken to three different practices in Winchester, and the practice managers are quite concerned that GPs will be required to share data much more routinely than they do now, but they will still carry the legal and professional risk and will likely act as the channel to explain to patients how their data will be used. GPs will need to be brought on side for the SPR to work, and that will depend on who decides, what safeguards apply and how burdens on practices are managed. Recent experiences show the sensitivity of the issue. The British Medical Association has stated that it may consider collective action on GP data sharing. The 2022 roll-out of automated prospective GP record access through the NHS app was paused after concerns about safeguarding and the burden on practices.

Will the Minister expand a little on the detail and on how all this will be implemented? What precautions will be taken to ensure that patient data is protected? Will she consider the Lib Dem proposal for a health data charter that sets out principles and responsibilities for handling NHS data?

[Dave Robertson (Lichfield) (Lab)]

As ever, it is a pleasure to see you in the Chair, Ms Lewell. I have listened very carefully to people’s speeches, and it is important to say that we are debating that clause 47 stand part of the Bill. The clause creates the single patient record and, while many Opposition Members have justifiably and understandably asked how we will do this right and what safeguards we will have, it is important that what we are debating is that the clause stand part of the Bill.

The clause creates the single patient record, and it creates the overarching ability for the NHS to use data better than it currently does. I am not a data scientist. I am a physicist by training, and I taught physics and worked in trade unions for a long time. Because of my training and my use of data, every group of people I have ever worked with invariably came up with nicknames for me, which usually boil down to “Data Dave”. There is something so valuable about being able to use aggregated values to tell us something that we do not already know.

One of the most valuable things we may get from this is that, when a clinician talks to a patient and they say or present something that does not match what is on the single patient record, it will raise a red flag that leads the clinician to realise something they would not have realised if they did not have access to notes previously taken elsewhere. I genuinely think that is one of the most valuable things that will come from this.

On a wider stage, the ability to aggregate data and properly track what is going on within the health service, and for people to be able to track what is going on with their care, with a wider view of what is going on, will be so valuable to clinicians and wider afield.

[Dr Johnson]

I am interested in what the hon. Gentleman is saying. Does he agree that, in many ways, the NHS dataset will be one of the most valuable datasets in the world, not only to patients themselves—in terms of the value to them and their privacy—but in the ability to analyse it and perhaps understand parts of medicine that we do not understand at the moment and so improve patient care?

[Dave Robertson]

I am not entirely certain that I want to agree with “one of” the most valuable datasets in the world; I think it could potentially be the most valuable dataset in the world.

We know that the NHS is the largest healthcare provider in the world. We know that the data is potentially very valuable. Creating this will allow our NHS to be at the forefront of managing how it works, in a way that no other health system will be able to, and certainly to a scale that no other health system anywhere in the world will be able to. That obviously comes with risks.

I have been listening carefully, and it is important that we tease out those risks and make sure that we stay as red hot as we can on all the issues that hon. Members have raised. I go back to the salient point of whether this clause should stand part. I fully support that this measure should be part of the Bill and that we should be moving in this direction.

I have spoken about the more global ideas and the reasons why, intellectually, I think this is a good idea, but let me take an example from my home county of Staffordshire up in the west midlands. There are reports that one hospital in Staffordshire uses 450 different electronic systems, which is absolutely bananas.

For so long, we have not had a single patient record. We have not had one unifying system. Over a cup of tea with the Minister a couple of days ago, I got very excited and started talking about primary keys because, although I am not a data scientist, I like the use of data. I do not think we need to get into a situation where there is a single primary key that is instantly recognisable to everybody and where we are necessarily using some machine learning to assess that. That could potentially come later down the line. That is not what the clause is doing, and it would need a much wider discussion than we are currently having.

If we take the example of Staffordshire and its 450 different data systems in one hospital—I do not know that number for certain, although it has been reported to me by two or three colleagues—I cannot imagine the difficulties that the IT team has in trying to get that number of systems to talk to each other. It will be nigh on impossible. All it leads to is delays. All it leads to is people having to reproduce data from one system to another manually. By creating an overarching single patient record, we will force it to happen.

[Joe Robertson]

The hon. Member has hit the nail on the head. A single patient record is not the same thing as mandating that 450 record-keeping systems become one. In fact, the single patient record will work as a theory on paper only if there is interoperability between different databases. That is a massive challenge that is not dealt with here. It cannot be dealt with here, in the real world, and the single patient record will not be realised until it is dealt with, which could take years. Does the hon. Member have a reflection on that point?

[Dave Robertson]

I appreciate the intervention, and it is nice for the hon. Member to get me back after I got him the other week. He is absolutely right. I do not think anybody in this room expects that after we have this discussion and the clause forms part of the Bill, and after the Bill goes through the parliamentary process and hopefully becomes an Act very soon, the next day there will instantly be this magical, ethereal thing called a single patient record and everything will drop into place immediately. I have a bridge to sell to anybody who thinks that.

What the clause does is put the NHS on a path to being able to deal with data appropriately, in a 21st-century way, by adding the ability and requirement for the NHS to use data appropriately. In terms of how that is done technically, I am very far from a computer programmer—I have done a tiny bit in parts of my life, and it always drives me absolutely wild—but there would be a number of architectures that could be used to make this work. I am not an expert and would not profess to be or to give anybody advice on that.

An advantage of the way the Bill is written is that things can be picked up by secondary legislation, which can go into a lot more technical detail. That is a real strength of how this is drafted. If we tried to mandate in primary legislation, in an Act of Parliament, far too granular a level of data science and information technology architecture, we would run a real risk of falling behind. Everybody is very aware of AI, and it is rare that I go a day without hearing people talk about it. Quantum is just behind it, and it is potentially much more disruptive and much more beneficial to huge parts of the economy, especially healthcare.

Trying to do everything through primary legislation is absolute folly. However, making sure we have primary legislation that allows us to drive the NHS into this space and to require and enable the NHS to stay on top of the proper use of data and to modernise its structures and practices can only be a good thing.

I close by saying that I absolutely support clause 47 standing part of the Bill. It has the potential to drive huge improvements in the NHS, both on a local scale and on a more global scale.

[Joe Robertson]

I will pick up where the hon. Member for Lichfield left off.

I make it clear that a single patient record is not a single electronic record-keeping system. Also, the single patient record is a theory, and it will remain a theory long after this legislation has been passed, as I am sure it will be, unless and until the electronic record-keeping databases and software in this country are able to speak to each other.

I have experience of working for a national nursing charity, and my role specifically dealt with the legal and governance issues of trying to embed community nurses in different settings. However, that work was beset by the problem of different databases—different electronic record-keeping systems—that did not speak to each other. Even those systems that were supposed to speak to each other did not do so. As the hon. Member for Lichfield said, sometimes there can be dozens, even hundreds, within even one NHS trust.

That should not be a problem today, but it is, and the Bill will get us no further on the technicalities and the technology problems we have. These systems are already meant to speak to each other, and we do not need legislation to realise that should be happening. Indeed, there are still paper record-keeping systems in many places up and down the country. The theory of a single patient record is a good one, but it will mean nothing in practice until those paper record-keeping systems have become electronic and then all the electronic systems speak to each other.

That makes me wonder whether a single patient record will ever be realised, regardless of legislation on the model that is supposed to exist. Indeed, the Bill does not mandate a single preferred electronic record-keeping system, and nor should it; there is a competitive market out there in which NHS trusts are free to engage and contract with different providers of electronic record-keeping.

I wrote to the local health bosses in my area after being made aware that the provider of one of their main electronic record-keeping systems had offered to extend the system further throughout the trust in order to save money. However, the trust has not yet responded. I am not in a position to say whether that offer is a better one, but on the face of it, it certainly looked like it would save money because it was a record-keeping system that the trust was already using; it just was not being used across all parts of the trust. That letter has gone unanswered for a year. It is not just a technological issue; there is also a cultural issue of the lack of nimble, joined-up decision making.

Some health bosses, not necessarily those in my area, are unable to take advantage of the financial benefits of changing or adapting to using new systems. Until that is resolved, a single patient record will remain ever wanted but never actually delivered.

To use an analogy, different companies provide the services on people’s mobile phones—the internet access, social media; software and even hardware. Most of us end up with a smartphone that does pretty similar things to every other smartphone and, broadly speaking, all the different apps co-operate with each other. Of course, the major global technology companies have faced legal action in the US, Europe, this country and elsewhere to ensure that their systems talk to each other, and primary legislation has been required to make them do that.

[Dave Robertson]

The phone analogy is really valuable. I am not an expert on the various architectures that make up phone operating systems, but I know a little about drivers and a little about computer programming languages. The hon. Gentleman is right that all the different bits of hardware in every single phone speak to themselves in a different language. Lots of them use different computer programming languages, and they all require drivers to translate that into whatever the operating system uses.

There are two or three major providers when it comes to mobile phones in the UK: Google and Android, and iOS. There is effectively a requirement on the phone companies that says, “If you want your app to be on our phones, it’s going to have to be able to use this language.” Depending on the operating system, the language will be slightly different, but the commercial requirement that apps must be able to use a certain language obliges the individual app producers and the individual pieces of hardware to have the driver to translate whatever language they use to talk to themselves into the one that works with the operating system.

Does the hon. Gentleman think there is a parallel in the Bill? Having a piece of legislation that requires a single patient record, whatever that looks like and whatever language it uses, potentially shortcuts some of the problems he is talking about with using a plethora of systems. Rather than having 450 systems, which could potentially use 450 languages, and trying to teach all of them all 450 languages, we create the requirement to use a specific language. We then teach all 450 one additional language and they will all be able to feed in—

[The Chair]

Order. This is a very long intervention. Will the hon. Gentleman please wrap it up?

[Dave Robertson]

Apologies.

[Joe Robertson]

That was a long intervention, but it was helpful. I disagree with the hon. Gentleman, because the legislation is not seeking to require technology companies or the providers of electronic record-keeping systems to be able to talk to each other. It is trying to create the concept of a single patient record, which is good, but it does not mandate a way to achieve that. I do not particularly want to name companies, but a big provider that is already in the health space and that provides electronic record-keeping systems might say, “We can already provide a single patient record. It is for other providers to adapt and feed into our record-keeping system,” and there is nothing in the Bill that says one technology company must adapt to another.

The technological issue is completely unaddressed. I am not even saying that it should be addressed in the Bill, because there are all sorts of issues around competition law and state support for particular companies. It is not a criticism per se of the way in which the Bill drafted, but this is an opportune moment to make the point that absolutely none of the clause will be delivered until a major issue that the Government have not yet addressed is dealt with. That issue is the interoperability of different electronic record-keeping systems provided by the private sector. They are all in competition with each other to get a bigger share of the market; unless and until that is addressed, the Government are not going to realise any of this. I do not want that to be the case. I want the single patient record to be realised, broadly speaking.

[Sojan Joseph]

I wish to speak in support of clause 47. I spoke on Second Reading about my strong support for the introduction of a single patient record. I am not a tech expert like my hon. Friend the Member for Lichfield—

[Dave Robertson]

I don’t know about that!

[Sojan Joseph]

It really surprised me to hear my hon. Friend talk about his experience of 450 systems in the computer system in his local hospital. I was shocked, because as a clinician who previously worked in the NHS, I wanted a system that made patient records readily available so that we could care for patients.

My understanding is that the clause amends the National Health Service Act 2006 to enable the Secretary of State to make regulations to establish a system to make patient information readily available to patients and to those involved in providing health or social care in England. Under the current system, care and treatment across different parts of the NHS are not as co-ordinated as they could and should be. All too often, that means that patients have to repeat their medical history every time they see a different medical professional. The shadow Minister, the hon. Member for Sleaford and North Hykeham, talked about how that can sometimes be useful for getting the diagnosis right, but it can be very traumatising for someone to have to explain the same story again in such a short period of time.

Speaking in the Chamber, I previously gave the example of a mental health patient going to A&E on a Friday. They tell their story to the professionals there and they tell the same story later when a mental health professional comes to see them. When they are admitted into a mental health hospital, they have to explain the same story when going into the ward, and then again to the nurses. Having to repeat their story again and again is traumatising for most patients.

Health Bill (Sixth sitting)

Dave Robertson Excerpts

Committee stage
Thursday 25th June 2026 Public Bill Committees

[Dr Johnson]

In essence, the clause confers the commissioning duties of NHS England on to the Secretary of State, because NHS England is being abolished. In that respect, it is quite straightforward. In the existing National Health Service Act 2006, which is to be amended, section 3 sets out the duties of integrated care boards as to commissioning health services, and section 3A similarly. Section 4 is about NHS England’s responsibility for the provision of high-security psychiatric services. In essence, clause 12 replaces the references to “NHS England” in sections 3 and 3A with “the Secretary of State”. The ICBs now must act consistently with the discharge by the Secretary of State of the section 1 duty to promote a comprehensive health service. That is consistent with the aims of the Bill. I have concerns, which I have expressed previously, about how the Government ensure that the Secretary of State can make those decisions fairly, on the basis of clinical need, rather than because of pressure from a lobby group, a celebrity campaign or such like, but again, that seems consistent.

The clause also replaces entirely section 3B of the 2006 Act. Under the previous section 3B, the Secretary of State could direct NHS England to commission the service nationally; the proposed new section 3B confers a regulation-making power to require the Secretary of State to arrange nationally services for members of the armed forces and their families specifically, as well as such services or facilities as may be prescribed. Perhaps the Minister will comment on what sort of services or facilities might be prescribed under that proposed new section.

In doing that, the Secretary of State must have regard to the number of people needing the service, the cost and the number of possible providers. That reflects a balance. Some services, such as hip replacements, are very common. They occur in all areas of the country, perhaps at different rates, but they are broadly a common service. Accident and emergency is another common service. Some people, however, have the misfortune to have a condition that is rare and requires specialist care, in small numbers. That needs to be commissioned on a more national basis, because of the need for specific expertise among commissioners and health professionals.

In subsection (4), proposed new section 3B(5) modifies section 4 of the 2006 Act so that the duty to arrange high-security psychiatric services transfers from NHS England to the Secretary of State, and the Secretary of State gains a new power to direct the providers of those bodies—but only non-public bodies—if he is satisfied that the provider is already licensed under the Health and Social Care Act 2012 and would be required by its licence to obey the direction.

In one respect, as I said, it is necessary to transfer powers to Secretary of State, now that NHS England is to be abolished, but I have a couple of questions. NHS England published a direct commissioning update on 2 March, which describes a new commissioning structure. At the moment, NHS England commissions regional NHS England bodies and the ICBs at a more local level. The update suggests that we will have the ICBs commissioning services, and the Secretary of State instead of NHS England, but that each of the seven regions will have an office for pan-ICB commissioning, known as an OPIC, to support ICB commissioning services—both standard commissioning and at-scale commissioning in some instances.

How is that more efficient than the old structure? Are we just going to see the people working in the regions of NHS England get made redundant, at a huge cost to the state, only to be re-employed by the OPIC? What is the estimated cost of that? Is that the intention? We are going to either lose the expertise of the regional advisers in NHS England or end up re-employing them having paid them redundancy. Can the Minister explain which she thinks it is?

There is a hugely long list of specialist nationally commissioned services. Can the Minister guarantee that those services will not be moved locally? The ICBs only have so much capacity. It will be a challenge for an ICB to deal with conditions that may affect only one or two people in its area in a given year, particularly given the 50% budget cut; obviously, it will prioritise things that affect more of its population. People who have the rare conditions that are currently commissioned nationally may be worried that they will not get the same level of service that they are getting at the moment.

The direct commissioning update talks about prisoners and the justice system. At the moment, NHS England works directly with the Ministry of Justice to commission healthcare for those in the justice system. That includes adults in the custodial system, children in secure children’s homes, non-custodial care, sexual assault and abuse centres, and abuse referral centres.

There are eight high-security category A prisons in England. Instead of being specially commissioned as one batch, they are going to be commissioned specially by their local ICBs. Where are the ICBs going to get the advice and expertise to do that? Dealing with category A prisoners is about not only managing the prisoner and providing them with healthcare, but keeping the people providing that healthcare safe while they are working. This is a specialist area. I am interested to understand why the Minister thinks it will be managed best locally. If, under her new system, it is to be managed locally and the prisoner’s home address ICB is different from the prison address ICB, where will the funding move from and to? Will the prison’s ICB be reimbursed by the prisoner’s home ICB or will it bear the brunt locally?

What will happen to the sexual abuse referral centres? It is perfectly possible, particularly in some areas of the country, that an individual is sexually assaulted in one ICB area, lives in another and reports a crime in a third. Will local commissioning have an impact on where the individual needs to go for their pretty intimate examination and assessment? Has the Minister considered that? What is her view?

What happens to healthcare for migrants? That is another area that is dealt with partly by the justice system at the moment. Can the Minister update us on that? There are over 100,000 people in asylum accommodation, including 30,000 in hotels, and many members of her party are keen to welcome even more. Who will be responsible for commissioning their care?

The Government are also delegating the child health information services, which are the record of whether children have been vaccinated and such like. Given that they are planning to have a single patient record and the electronic red book, why do they want the services to be commissioned locally rather than nationally? Do they expect commissioning for a uniform service, such as a screening service, to lead to differential outcomes—and if it does not, what is the rationale for it?

A particular example is blood spot screening. The Minister will be aware that there was a Westminster Hall debate earlier in the week on spinal muscular atrophy, in which blood spot screening was mentioned. Metachromatic leukodystrophy is another condition for which people want blood spot screening. If blood spot screening is to be commissioned on a local ICB level, will ICBs be required to do it in line with Government guidelines, or will they be able to vary the service they provide to those patients?

By delegating more to ICBs, Ministers are creating variation. On one hand, they want local differentiation and variation; on the other hand, they have put in a clause that requires the Secretary of State to limit local variation. Again, there is a tension there. Will the Minister talk about that?

Moving to some technical points, I noticed that “hospital premises” is defined in section 4 of the 2006 Act, but I cannot find it defined in the Bill. Under the original section 3B of that Act, the Secretary of State had to obtain appropriate advice before making regulations about commissioning services; when services were commissioned locally or nationally, the Secretary of State had to take expert advice. That seems like a sensible thing that we want the Secretary of State to do. One would hope that if the Secretary of State were doing his job properly, he would do that, but it seems a little odd that that requirement has been taken out, as though there is an intention for the Secretary of State not to do that. I would appreciate the Minister’s comments on that.

Proposed new section 3B provides that a direction can be given to a person other than a public authority regarding high-security psychiatric services. The Minister knows that high-security psychiatric services are currently provided at Broadmoor, Ashworth and Rampton, which are still stand-alone units run by NHS providers. Does she plan to ask a private provider—someone other than a public authority—to run those facilities? If not, what is the purpose of the clause? There is a secure children’s unit in Sleaford in my constituency. What will happen to those children if it is commissioned locally, and where will the money flow from?

We asked in a previous sitting whether the Minister thought that the new Prime Minister will want to continue with this Bill. When it comes to the OPICs, in essence the Government will be firing staff from one job, paying them redundancy, and rehiring them, potentially on different terms and conditions, to do a similar job in the OPICs. Is the Minister aware that the right hon. Member for Makerfield (Andy Burnham) used to speak out against firing and rehiring staff, and abolishing and recreating organisations? That is essentially what is happening, so will she have to abandon these changes?

[Dave Robertson (Lichfield) (Lab)]

We have heard a few times about Conservative fears about redundancy payments and so on. Why did they not add NHS England to the list of organisations covered by the modification order when they had the opportunity to do so? Is the hon. Lady aware of a reason why that did not happen when the Conservatives were in government?

[Dr Johnson]

I am afraid I do not know the answer to that question. The key point is that it is not logical to abolish a three-tier structure and recreate it with taxpayers’ money to do exactly the same thing. If NHS England is replaced by the Secretary of State, the regional NHS England is replaced by the OPICs and the ICBs are at the bottom—the more local tier—what has changed? The middle tier will be doing the same thing.

[Dave Robertson]

The modification order is a piece of legislation that is often used in the public sector. It means that when people from a lot of public sector organisations are made redundant and find alternative employment at another state-funded organisation, they are not entitled to a redundancy payment. During their 14 years in power, it would have been entirely possible for the Conservatives to add NHS England to the list of organisations covered by the modification order. That would have prevented the costs that the hon. Lady has mentioned several times. It just seems like they did not take the opportunity to do that, and now they are saying that they should have done that when they were in government.

[Dr Johnson]

But we were not planning to abolish NHS England, so we had no reason to worry about redundancy. We were not planning a large-scale abolition—the largest that has ever happened in this country.

Amendment 57 would require the Secretary of State to publish and consult on commissioning transition plans before making regulations under proposed new section 3B that alter which services are commissioned nationally. It is a very reasonable amendment that would just mean that people get answers. It would mean that vulnerable people with unusually rare or highly complex conditions requiring regional or even national treatment could understand any changes the Government planned to make. We know that some services are delivered in only three or four centres in the UK. If a patient lives far from a centre, and suddenly that centre is closed, that can have huge travel and service implications, which can create huge distress and worry and make care worse.

Health Bill (Fourth sitting)

Dave Robertson Excerpts

Committee stage
Tuesday 23rd June 2026 Public Bill Committees

For example, on the adoption of electronic record-keeping systems, certain trusts used a number of them that did not speak to each other. There was a cultural barrier—if by culture, we mean work culture—in that some NHS trusts were very good at embedding and adopting an electronic patient record system that was uniform across the trust, or, where more than one system was operating, the systems were interoperable and spoke to each other. In other NHS trusts, there was a cultural issue of wanting to leave teams alone and not disrupt their working practices, even if the imposition of a new system would have delivered efficiency and better patient outcomes.

[Dave Robertson (Lichfield) (Lab)]

I think this is the first time we have had a Robertson on Robertson intervention. It is a pleasure to break that duck.

The hon. Gentleman is making a powerful point about the need to change culture to embed innovation across the NHS. There is an example that we always come back to: fax machines. Fax machines were used in the NHS for far too long. It was mandated in 2018 that the use of all fax machines had to be stopped by the end of March 2020, yet in 2023, the NHS still owned 600. That mandation came up against a cultural barrier and it did not work, because 600 of them survived for three years after that.

In amendment 58, I see more mandation and nothing on culture. The problem with the amendment is that, by trying to mandate innovation too closely, we would miss the cultural point. We could undermine the Secretary of State’s power to say that all parts of the system are fair game for them. Would the hon. Gentleman like to respond to that point?

[Joe Robertson]

I thank my namesake for his intervention. I do not completely understand what he says, because the amendment refers to cultural barriers. He is absolutely right that we have to be careful when we mandate things, but the strength of the amendment is that it has a broad application and does not seek to mandate specific detail. I accept that it has more detail than the Bill, but its strength is that it gives some direction without being overly detailed. I again draw his attention to the fact that it asks the Secretary of State and the Department to identify and remove cultural barriers.

Health Bill (Third sitting)

Dave Robertson Excerpts

Committee stage
Thursday 18th June 2026 Public Bill Committees

[Helen Morgan (North Shropshire) (LD)]

The Liberal Democrats broadly support the abolition of NHS England. As constituency MPs and users of the NHS, we see a huge amount of duplication and unnecessary bureaucracy as our local health organisations try to navigate the processes of securing capital investment, for example. Reducing duplication between the Department and NHS England is clearly welcome if done well, but we have concerns about the way in which that is being undertaken.

We think that this centralising process, under which the Secretary of State takes on more powers, risks political capture. That may not seem like a huge risk considering who the current Secretary of State and shadow Secretary of State are, but given the febrile political atmosphere that we are working in, it seems a poor time to give a Secretary of State sweeping operational powers over the detailed functioning of the NHS, with few checks and balances. I will speak about the most concerning elements and make the argument in greater detail when we debate cause 11.

As the hon. Member for Sleaford and North Hykeham said, the former Health Secretary, the right hon. Member for Ilford North, said that top-down reorganisation of the NHS was the last thing he wanted to do, and yet that is where we find ourselves today. It feels as if the plan has been pulled together very quickly, and that it has been complex to turn into a piece of workable legislation. It has taken a long time even for the Treasury to agree on the funding of the redundancy bill. We have found out that redundancy costs of £800 million will be taken out of the future operating costs of the NHS. I hope that the Minister will describe how that will be delivered to ensure that the costs do not detract from patient care on the frontline.

There is still some uncertainty about the new structures within the DHSC and NHSE reorganisation. We have heard that the previously announced plan for three top-level roles—a permanent secretary, a chief medical officer and an NHS chief executive officer—might be changed, and that there is a proposal to merge the permanent secretary and NHS CEO roles. At this stage, as we start to consider the legislation, it would be helpful to have clarity on who will be in charge of the NHS and how the layers below will be organised. We have also heard that hours of staff time, leadership focus and money have been directed away from frontline services. In the oral evidence session, Sarah Woolnough of the King’s Fund and Jon Restell of the Managers in Partnership union suggested that that has been distracting and that, in any body, a significant reorganisation has an opportunity cost.

In my previous life, I was an accountant at Centrica plc—one of those back-office checkers everybody wants to get rid of, but who turns out to be quite important in providing the information that enables the business to run smoothly. We found reorganisation hugely distracting; it took away from our ability to do our day jobs well. Then, within a couple of years, a lot of the equivalent roles were re-hired and we were back to square one. It is critical that the Government avoid that scenario in this big reorganisation of the NHS. I hope that the Minister can provide reassurance that it has been well thought through and that we will not find ourselves, two or three years down the line, with similar numbers of people replicating the roles that exist currently, following a huge distraction that resulted in no improvement in patient outcome or experience.

My questions are fairly limited. Does the Minister know, at this point, what the impact the reorganisation has had on the system and how much it has cost in secondary impacts? We have had eight Health Secretaries in the past 10 years. After all that swapping and changing, how can the Minister ensure a degree of continuity when the new Secretary of State takes over? One benefit of quangos is continuity over a long time, divorced from the political turmoil of Westminster. We must be clear about how distractions will be avoided in the new structure.

Finally, we heard in evidence on Tuesday that the new structure feels like a centralisation of power in Whitehall, when what is needed is more power devolved down to local level so that local services can be shaped to reflect the demographics that they serve and to address the important point of health inequality. Will the Minister explain why she is confident that measures to ensure local accountability and local shaping of services will be able to go ahead? Tackling health inequalities is the priority of everybody in this Room, and we need to ensure that we have an efficient structure in place to ensure that it happens.

[Dave Robertson (Lichfield) (Lab)]

It is a pleasure to see you in the Chair, Sir Jeremy. One of the most powerful things we can do as Members of this place is bring our constituents’ stories here so that they can form part of our discussions. That is what I will do as we discuss the future of NHS England.

I openly admit that I have never knocked on a door and found that someone’s burning question was about the abolition of NHS England. I have never had that particular discussion, but I do have regular discussions about the NHS. We know how important it is to people. They value the greatest gift that the Labour party has ever given the United Kingdom. As we have those discussions, one thing that comes up time and again is that people will always want more; they will always want better healthcare, and they should be able to expect it.

Across my constituency, the biggest health need is access to primary care. Two towns each make up one third of my constituency, so a third of my constituents live in Burntwood, 4 miles up the road from Lichfield— I believe my constituency is misnamed, but that is a matter for the boundary commissioner, not for me. When I talk to people about healthcare and access to primary care in Burntwood, one thing comes up time and again: the new health centre for Burntwood that was promised but never delivered.

That centre was promised in 2009 when the old one was demolished, but its funding was cut in 2011 following the change of Government, and we are still waiting. A modular building had to be put up in the car park of the leisure centre—“modular building”, by the way, is a grand term for what are portacabins stacked on top of each other. A huge number of people have worked at that site for a long time, delivering the best care they can, but they are being failed by the facilities that they are forced to work in. When I have conversations about primary care with people in Burntwood, they are never unhappy about the care they receive, about their doctors or about others who work in the NHS; they are unhappy about the facility that they are forced to use. I am standing here in 2026 and we still do not even have planning permission for the replacement centre. It has been promised so many times that people are beginning to doubt that it will ever happen. That is so hard to hear.

Health Bill (First sitting)

Dave Robertson Excerpts

Tuesday 16th June 2026 Public Bill Committees

[Helen Morgan]

Q As a former Secretary of State for Health, what are your reflections on the abolition of Healthwatch and the absorption of its functions into the Department of Health, ICBs and local authorities?

Sir Jeremy Hunt: It is not dissimilar to my earlier reflections. It is really important that patients have a voice, but it is even more important that their voice is heard not just through a bureaucratic process that listens to them, and gives them a sense of being listened to, but then nothing happens. The problem with the Healthwatch structure we have is that it is very good at the listening bit, but I do not think people have confidence that things actually change.

[Dave Robertson (Lichfield) (Lab)]

Q It is always a pleasure to see you in the Chair, Sir Roger. Sir Jeremy, I want to turn to NHS England’s accountability, or lack thereof. I know you made the point that you did not want clinically advised decisions to be overly politicised, but I had the reverse in my constituency when a decision was made after the lease on a doctors’ surgery ran out. It could not be extended because of some rule in NHS England, but due to that lack of accountability, there was nothing that we could do. The surgery closed, and one in six of its patients was just redistributed to another surgery, so that accountability clearly failed in that space.

If you are concerned that accountability ends up too close to the Department, where else should it land? I am quite comfortable with a Minister being accountable for that decision, because they are accountable to MPs, who are ultimately accountable to the people that it affects. Can you pare back your answer a little bit and talk about where that accountability should lie, and how we can ensure that it works?

Sir Jeremy Hunt: That is a story I think every single Member of Parliament could repeat, and it is a fundamental flaw in the system. Do you not think it is completely ridiculous that you have to go to the Health Secretary, who is responsible for a budget of £160 billion—the largest healthcare system in the world—to sort out something like a GP surgery lease in your constituency? That is a perfect example of a problem that we should be able to sort out locally, and that is why I think the bureaucracy has got completely out of hand.

[Joe Robertson]

Q The safe space principle is arguably under threat by the merging of HSSIB and the CQC. From the evidence you gave to the Health and Social Care Committee, I understand your argument that if you get rid of the independence of HSSIB, staff members who have witnessed wrongdoing and unsafe practices will not feel there is anywhere they can go, when they feel compelled to disclose things they see, where there is no consequence to them. Can you just comment on that?

Sir Jeremy Hunt: Maybe I should just clarify, because I think Dr Dash referred to those comments. The CQC is incredibly important to hospitals and GP surgeries because it gives them a rating—“outstanding”, “good”, “requires improvement” or “inadequate”—and they really care about that. If a staff member is talking openly to HSSIB about a failure of governance in their organisation, and that is the same organisation that could decide whether they get stripped of their “outstanding” rating and downgraded to “good” or “requires improvement”, my concern is that some people may worry and say, “Maybe I shouldn’t be open, because this could affect my hospital’s rating.” Obviously, I would always want staff members to be completely open with HSSIB, but we have to be really careful that people still have confidence in the safe space function if this merger goes ahead.

General Medical Council

Dave Robertson Excerpts

Thursday 4th June 2026 Commons Chamber

[Dave Robertson (Lichfield) (Lab)]

I begin by thanking the right hon. Member for North East Cambridgeshire (Steve Barclay) for bringing this debate to the House today and for his advocacy on behalf of his constituents. I hope that Jack’s family, at what must be a terrible time for them, gain a small measure of solace from his story being raised in this place.

I have the great privilege to be a co-chair of the all-party parliamentary group for the survivors of Fayed and Harrods. I say that because it gives me the privilege of working with dozens of survivors who bring their stories to us, and members of the APPG can drive forward the agenda of bringing the crimes to light and ensuring that the systems that enabled the abuse for so long are dismantled. That is why I wanted to take the opportunity of this debate to place on the record the serious concerns that survivors of abuse by Mohamed Al Fayed and his associates have about the failings of the General Medical Council in his case and associated ones.

I am sure that the House knows that Fayed has been accused of systematic trafficking for sexual abuse, aided by a network of enablers. So far, almost 500 survivors have come forward to tell their stories, and there are believed to be many more. Fayed has rightly been called the UK’s Epstein. One dimension of the network that enabled his abuse relates to invasive medical examinations that he had doctors perform on female staff at various companies he owned. They were billed as standard company medicals, but they involved invasive gynaecological procedures and testing for sexually transmitted infections. In many cases, survivors say, results were delivered straight to their abuser without their knowledge.

The women have been left with significant trauma, and anyone who has directly heard their stories, as I have, will no doubt be astonished by the serious consequences of that abuse, yet the doctors who carried out these tests have not paid any price. Survivors are still waiting for justice. One of the doctors who has been accused is still practising on Harley Street today. The General Medical Council says it has a zero-tolerance approach to sexual misconduct—as it should, and as I am sure all right hon. and hon. Members would expect—yet survivors tell me that their complaints to the GMC have gone unacknowledged and unaddressed for far too long.

That is simply unacceptable, as I am sure we would all agree. It is appalling. These women have been left with nowhere to turn. Medical staff who should have been prioritising these women’s safety and health, and who should have been a safe port of call for reporting abuse, were instead complicit in it. The GMC should strike off any doctor found to have participated in these disgusting abuses. I welcome the attention that the Government are rightly giving the issue. Yesterday was a difficult day; there was a meeting between the all-party group and the Prime Minister—the first sitting Prime Minister to meet a group of survivors of historical sexual assault and abuse. In that meeting, he made it very clear that the meeting was the first step in ongoing engagement on this. I wonder if the Minister could carve out an opportunity to meet me and the co-chair of the all-party group, the hon. Member for North East Fife (Wendy Chamberlain), to discuss where the GMC’s responsibilities lie on this, and whether there might be an opportunity for us to feed into the consultation that is open, so that we can ensure that the GMC takes action, although it has failed far too many women for far too long.

Health Bill

Dave Robertson Excerpts

2nd reading
Monday 1st June 2026 Commons Chamber

[Dave Robertson (Lichfield) (Lab)]

We are here tonight to talk about a very large piece of legislation, but I would like to focus my remarks on just one part of it, which is the changes the Government want to bring in around planning for the future in the NHS, which are so very needed. There is perhaps no better example of where that planning is going wrong than in Burntwood in my constituency.

Almost 20 years ago, a new doctors surgery was planned for the town. The NHS at that time was very good at knocking things down; however, when the coalition Government rode into town in 2010, all the funding for the replacement was cut. Here we are, almost 20 years later, with no replacement. That has been to the detriment of the town: for well over a decade, people in Burntwood have had to see their doctor in portacabins in the leisure centre car park. In all that time, nobody has stepped up to right that wrong.

We thought there might be light at the end of the tunnel in 2023, when we were promised a replacement by the end of last year. But before that happened, some pen pusher at NHS England decided that the existing surgery in that temporary structure had to close, which meant 5,000 patients distributed to other surgeries in the town. In a town of 30,000 people, that is a significant number. They were told simply to disperse them—“It’ll be fine, don’t worry. We’ll just disperse them.” That dispersal was so traumatic that an existing surgery has had to pick up the same temporary structure and is now operating out of there as well. There was also all the paperwork, legal matters and everything that went with that, because NHS England said that it could not extend for two years. I am very pleased to see the back of that particular quango, which so disadvantaged my constituents.

However, that structure is still being used because the replacement is still not here—it was not delivered by the end of 2025. We do not have the planning application yet. We have once again been promised that it will be here by the end of next month.

I am aware that the Reform-led county council inherited this situation and promise from a Conservative-led county council, but it has not sought to talk to the people in Burntwood. The council has not sought to explain why that promise was not going to be met; it just blew past it. It broke the promise with very little expectation. We now have another one, and that must be met, because so many people across the town have seen so many broken promises and false dawns that they are failing to believe that anything will actually come good.

This entire saga reinforces exactly why the Bill is needed and why these changes are needed. I do not want any other community in any other constituency to be overlooked and forgotten in the way that Burntwood in my constituency has been for so long.