Health Bill

Judith Cummins Excerpts

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

[The Minister for Secondary Care (Karin Smyth)]

I beg to move, That the clause be read a Second time.

[Madam Deputy Speaker (Judith Cummins)]

With this it will be convenient to discuss the following:

Government new clause 95—Disclosure of information relating to medicines.

Government new clause 98—Disclosure of information relating to medical devices.

Government new clause 99—Further and consequential amendments relating to medical devices.

Government new clause 100—Power to amend meaning of “medical device”.

Government new clause 101—Power to restate medical devices law in Northern Ireland.

New clause 9—Powers for coroners and medical examiners to report suspected health system failings—

“(1) The Secretary of State must, by regulations, establish a standard mechanism for coroners and medical examiners to refer cases where they suspect failings in the provision of health care.

(2) A coroner or a medical examiner has a duty to report (a “duty to whistleblow”) using the mechanism established under subsection (1) if, in the course of their duties, they have reasonable grounds to suspect that a death or incident involved systemic failings in a health care setting.

(3) A referral under this section must be directed to any or all of the following bodies, as the coroner or medical examiner considers appropriate, based on the nature of the suspected failing—

(a) the chief officer of police for the relevant police area,

(b) the Care Quality Commission,

(c) the Department of Health and Social Care, and

(d) the Health Services Safety Investigations Body.

(4) Regulations under subsection (1) must specify—

(a) the information to be included in a referral,

(b) the timeframe within which a referral must be made following the formation of a suspicion, and

(c) guidance on the criteria for determining to which of the bodies listed in subsection (3) the referral must be directed.

(5) A disclosure made in fulfilment of the duty under subsection (2) is a protected disclosure for the purposes of Part 4A of the Employment Rights Act 1996 (protection for whistleblowing).

(6) The duties imposed by this section are in addition to, and do not affect, a senior coroner’s duty to make a report under paragraph 7 of Schedule 5 to the Coroners and Justice Act 2009 (reports on action to prevent other deaths).”

This new clause requires the Secretary of State to create a standardised framework for them to formally refer suspected health system failings (including systemic issues) directly to the police, the CQC, the Department of Health and Social Care, and the HSSIB, with a duty on coroners to participate. It provides legal protection for those making such referrals.

New clause 10—Duty of NHS boards to report medical malpractice—

“(1) A member of the board of directors of an NHS trust or an NHS foundation trust in England must report any evidence or reports they have seen of systemic medical malpractice within the trust to—

(a) the Care Quality Commission,

(b) the Department of Health and Social Care, and

(c) the Health Services Safety Investigations Body.

(2) The board of directors of an NHS trust or NHS foundation trust in England has a collective duty to—

(a) refer the trust to the Care Quality Commission, and

(b) alert the Department of Health and Social Care and the Health Services Safety Investigations Body, if staff employed by, or acting on behalf of, the trust raise concerns of systemic medical malpractice.

(3) In this section, “systemic medical malpractice” means an action or omission in the provision of health care that falls below the expected standard of care and indicates a widespread, patterned, or recurring failure within the systems, processes, or governance of the trust.”

This new clause would introduce a mandatory individual duty for members of NHS and Foundation Trust boards to escalate evidence of systemic medical malpractice to the CQC, the Department of Health and Social Care, and the HSSIB. It also imposes a collective duty on the board to formally refer the trust to regulators if staff raise concerns regarding malpractice.

New clause 13—Medical Disinformation—

“(1) The Secretary of State must, within 6 months beginning on the day on which this Act is passed, publish a strategy on anti-vaccine and medical disinformation (“the Strategy”).

(2) The strategy must consider—

(a) support for medical professionals to build trust and engage with persons who are anti-vaccine,

(b) support for medical professionals and NHS leaders to engage with anti-vaccine councillors or officials in local authorities,

(c) investment in public messaging to combat medical disinformation, including engagement with trusted online influencers,

(d) outreach campaigns focused on communities who are sceptical about vaccinations,

(e) introducing criminal liability for those, including online influencers and politicians, who profit from medical disinformation,

(f) a new verification requirement for any social media account claiming to be a medical professional.

(3) The Secretary of State must lay a copy of this strategy before Parliament upon publication.”

This new clause places a duty on the Secretary of State to publish a strategy to combat anti-vaccine and medical disinformation.

New clause 14—Healthwatch funding—

“(1) The Secretary of State, must within 12 months of the passing of this Act, enact a scheme to fund Healthwatch England and local Healthwatch organisations for the 2027/2028 financial year to the level estimated by the Department for Health and Social Care in 2013/14.

(2) The Secretary of State must consider uprating this funding with inflation for 2026/2027.”

This new clause 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.

New clause 20—Cancer Survival Research—

“(1) Within 12 months beginning on the day on which this Act is passed, the Secretary of State must by regulations establish a Cancer Survival Research Programme.

(2) Regulations under this section must—

(a) require government co-ordination and funding for research into cancers with a five-year survival rate below 20%, and

(b) establish a fellowship programme for foreign academics in cancer research.

(3) Any programme established under paragraph 2(b) must make provision to waive visa fees for entry into the UK for participating academics.

(4) Regulations under this section are subject to the affirmative procedure.”

This new clause would require the Secretary of State to introduce regulations requiring the government to coordinate research into cancers with the lowest survival rate.

New clause 24—Strategy for provision of Minor Injuries Units and Urgent Treatment Centres in rural areas—

“(1) Within six months of the passage of this Act, the Secretary of State must prepare and publish a strategy for expanding the provision of Minor Injuries Units and Urgent Treatment Centres in rural areas.

(2) The strategy under subsection (1) must be laid before both Houses of Parliament.

(3) The Secretary of State must lay a report before both Houses of Parliament on the implementation of the strategy every 12 months after the strategy has been published.”

This new clause would require the Secretary of State to prepare a strategy for expanding the provision of Minor Injuries Units and Urgent Treatment Centres in rural areas and report on the implementation of the strategy annually.

New clause 26—Patient safety recommendations: national oversight—

“(1) The Secretary of State must establish a scheme relating to the oversight of patient safety recommendations (“the scheme”).

(2) The scheme must make provision for the monitoring and delivery of patient safety recommendations arising from—

(a) investigations,

(b) inquiries,

(c) reviews, and

(d) other patient safety bodies,

relating to patient safety.

(3) Within one year beginning on the day on which this Act is passed and every subsequent year, the Secretary of State must lay a report before Parliament on the progress of the scheme.”

New clause 27—Duty of candour and enforcement of standards of ethical conduct in DHSC—

“(1) In discharging its expected standards of ethical conduct, the Department of Health and Social Care (DHSC), must, in particular—

(a) set out the steps DHSC will take to ensure that legal services provided to NHS bodies and other relevant health-related organisations are consistent with the statutory duty of candour and the principles of openness, transparency and learning following patient safety incidents,

(b) set out which oversight body is responsible for ensuring the standards set out in DHSC code of ethical conduct are adhered to and enforced,

(c) set out provisions to allow a relevant oversight body to examine, on its own initiative, suspected serious or systemic breaches of DHSC’s code of ethical conduct,

(d) set out a mechanism for ensuring that any breaches of DHSC’s code of ethical conduct are recorded and that proper data is kept and published that records the extent to which complaints have been made regarding its ethical conduct and their outcome.”

New clause 28—Review of NHS neurodiversity policy—

“(1) Within six months of the passage of this Act, the Secretary of State must publish a review on—

(a) standards of NHS care for neurodiverse people,

(b) the effectiveness of current NHS trust policies regarding care for neurodiverse patients,

(c) the quality of training and guidance for frontline NHS staff in supporting neurodiverse patients, and

(d) health outcomes for neurodiverse patients at NHS trusts.

(2) The review under subsection (1) must be laid before both Houses of Parliament.”

New clause 30—Review into acute stroke support services in rural areas—

“(1) Within six months of the passage of this Act, the Secretary of State must publish a review of acute stroke support services in rural areas.

(2) The review under subsection (1) must include an evaluation of—

(a) decision making processes,

(b) evidence used to justify decisions,

(c) public consultation processes,

(d) health outcomes,

(e) travel times for access to services, and

(f) impact on the NHS workforces.”

New clause 41—Remit of the Human Tissue Authority—

“(1) The Secretary of State must, within six months of the passing of this Act, by order under section 14(4) of the Human Tissue Act 2004, amend the remit of the Human Tissue Authority to include the regulation of funeral directors, private mortuaries, direct cremation services and other organisations which transport or hold the bodies of deceased persons for the purposes of ensuring that the carrying out of their functions is consistent with the protection of public health.

(2) The Authority must establish and maintain a register of the bodies subject to its oversight under subsection (1).

(3) The Secretary of State may by regulations make further provision regarding the establishment and operation of the register under subsection (2).

(4) Regulations made under subsection (3) are subject to the affirmative procedure.”

This new clause would require the Secretary of State to extend the remit of the Human Tissue Authority to include regulation of funeral service providers to ensure their activities are consistent with the protection of public health; and to maintain a register of those bodies subject to its regulation.

New clause 42—Oversight of funeral service provider premises and practices connected to the storage, preparation and movement of human remains—

“(1) The Secretary of State may by regulations establish a body corporate, or confer functions on an existing public authority, ("the Regulator") to provide oversight of the premises and practices connected to the storage, preparation and movement of human remains by funeral service providers in England.

(2) The purpose of the Regulator is to ensure that the activities undertaken under subsection (1) are consistent with the protection of public health.

(3) The Regulator shall be independent in the exercise of its functions and shall not be regarded as a servant or agent of the Crown.

(4) Regulations under this section may, in particular, make provision for—

(a) a scheme for the registration of funeral service providers;

(b) the inspection of premises, vehicles and other facilities used by registered providers for the storage, preparation, care or transportation of deceased persons, or from which funeral services are arranged or conducted;

(c) the publication and enforcement of a code of practice for the funeral services sector; and

(d) the imposition of sanctions, including suspension or removal from the register, for breach of that code.

(5) Before making regulations under this section, the Secretary of State must consult—

(a) providers of funeral services;

(b) such persons representing the interests of bereaved people as the Secretary of State considers appropriate; and

(c) such other persons as the Secretary of State considers appropriate.

(6) Regulations under this section are subject to the affirmative procedure.”

New clause 45—Secretary of State directions relating to early access to medicines—

“(1) The Secretary of State may give directions to any of the bodies mentioned in subsection (2) about the implementation of a scheme providing early access to medicines to people with life-threatening or seriously debilitating conditions.

(2) The bodies are—

(a) integrated care board,

(b) NHS Trusts,

(c) NHS Foundation Trusts,

(d) NHS Advanced Foundation Trusts, and

(e) other health and social care bodies.”

This new clause would give the Secretary of State power to direct integrated care boards, NHS Trusts, NHS Foundation Trusts, and NHS Advanced Foundation Trusts to implement a scheme to provide early access to medicines to people with life-threatening or seriously debilitating conditions.

New clause 47—Review of the Early Access to Medicines Scheme—

“(1) The Secretary of State must, within six months of the passing of this Act, commission a review of the regime for early and accelerated access to medicines in England and Wales.

(2) The review conducted under subsection (1) must consider—

(a) the effectiveness of the Early Access to Medicines Scheme (EAMS),

(b) the effectiveness of early access outside of the Early Access to Medicines Scheme (EAMS), and

(c) equality of access across England and Wales, with the aim of reducing geographical inequalities between different NHS trusts.

(3) The Secretary of State must lay a copy of the report and recommendations of the review before both Houses of Parliament.”

This new clause would require the Secretary of State to commission a review of regime for early and accelerated access to medicines.

New clause 49—National Guardian’s Office—

“(1) Within three months beginning on the day on which this Act is passed, the Secretary of State must re-establish the National Guardian's Office.

(2) The Office established under subsection (1) must—

(a) hold any responsibilities held by the National Guardian's Office as of 29 June 2026; and

(b) be operationally independent.”

This new clause will re-establish the National Guardian’s Office.

New clause 52—Cancer treatment: waiting times—

“(1) Within six months beginning on the day on which this Act is passed, the Secretary of State must make provision for every patient to have access to cancer treatment within 62 days following referral.

(2) Provision under subsection (1) must by regulations amend the National Health Service Commissioning Board and Clinical Commissioning Groups (Responsibilities and Standing Rules) Regulations 2012 to place a right in the NHS constitution for England for every patient to have access to cancer treatment within 62 days following referral.

(3) The Secretary of State must establish a scheme to support NHS hospital trusts in meeting the requirement under subsection (1).

(4) As part of the Scheme, the Secretary of State must expand the capacity of the Medicines and Healthcare products Regulatory Agency.

(5) The Secretary of State must make an annual statement to Parliament on progress made in meeting the requirement under subsection (1).

(6) Any statement made under subsection (5) should be made as close as reasonably practicable to 4 February.”

This new clause would give patients a right under the NHS constitution to start cancer treatment within 62 days of referral and requires the Secretary of State to establish a scheme to deliver this. It also requires the Secretary of State to update the House on progress against the target on or around the time of World Cancer Day.

New clause 63—Social Care—

“(1) Within 3 months beginning on the day on which this Act is passed, the Secretary of State must lay before Parliament detailed proposals for reform of the social care sector.

(2) Proposals under subsection (1) must include provision for—

(a) a respite care scheme;

(b) reform of carers allowance;

(c) free personal care; and

(d) a cap on care costs.”

This new clause would require the Secretary of State to lay before Parliament plans to reform the social care sector, including free personal care, a cap on care costs and that delivers for family carers.

New clause 68—Report on dementia care—

“(1) Within 12 months of the passage of this Act and every 12 months thereafter, the Secretary of State must publish and lay before both Houses of Parliament a report on—

(a) the provision of NHS care in relation to dementia.

(b) the provision of social care in relation to dementia.

(2) A report under subsection (1) must have regard to—

(a) any targets or standards set out in a national plan, guidance, or framework relating to dementia services, and

(b) any other information the Secretary of State considers appropriate.

(3) A report under subsection (1) must include—

(a) an assessment of variation in dementia services and outcomes between Integrated Care Board areas,

(b) information on workforce capacity, capability and training standards relevant to dementia care,

(c) information on access to ongoing post-diagnostic support services, including support for unpaid carers of dementia patients,

(d) information on continuity and coordination of care for people living with dementia, including access to a named professional responsible for coordinating support across services,

(e) outcomes and experiences for people living with dementia and unpaid carers, including crisis prevention, carer wellbeing, and experiences of joined-up care,

(f) progress on dementia prevention and risk reduction, and

(g) dementia research activity in the NHS.”

This new clause would require the Secretary of State to publish an annual report on the provision of NHS care and social care in relation to dementia.

New clause 72—Provision of Minor Injuries Units in Rural Areas—

“(1) The Secretary of State must, within 12 months of the passing of this Act, publish and implement a strategy to improve access to minor injuries units in rural communities.

(2) The strategy under subsection (1) must include measures to—

(a) expand, maintain and protect existing minor injuries units serving rural populations;

(b) ensure that integrated care boards assess local demand for urgent treatment services in rural constituencies and make provision accordingly, and

(c) promote the recruitment and retention of healthcare professionals required to staff such facilities.

(3) The Secretary of State must lay before Parliament an annual report on—

(a) the number and geographical distribution of minor injuries units in England;

(b) changes in patient access to urgent care services in rural areas; and

(c) progress made in implementing the strategy required under subsection (1).

(4) In this section, “rural constituency” means a parliamentary constituency designated as predominantly rural by the Office for National Statistics or such successor body as may be prescribed by regulations.”

This new clause would require the Secretary of State to expand and safeguard minor injuries units in rural communities with the aim of improving access to urgent care, reducing pressure on major hospitals, and ensuring equitable healthcare provision regardless of geography.

New clause 81—Family support duty following serious childhood diagnosis—

“(1) Where a child is diagnosed with cancer or another life-threatening condition, the responsible NHS provider must, within 14 days of diagnosis, ensure that the child’s family is offered appropriate information, support and coordination services.

(2) For the purposes of subsection (1), the responsible NHS provider must offer—

(a) access to a named family support coordinator;

(b) information regarding welfare benefits, financial support and relevant public services;

(c) information regarding employment rights and workplace support available to parents and carers;

(d) signposting to appropriate mental health and psychological support services;

(e) information regarding relevant local and national charities, support organisations and peer-support services;

(f) a written family support plan setting out the support available to the family during treatment; and

(g) notification and information sharing in accordance with subsection (3).

(3) The responsible NHS provider must provide the child’s registered general practitioner and where different, the registered general practitioners of the child’s parents or primary carers, with a Family Support Summary.

(4) A Family Support Summary must include—

(a) the child’s diagnosis;

(b) the proposed treatment plan;

(c) the expected duration and intensity of treatment, where known;

(d) information regarding the potential impact of the diagnosis and treatment on parents, carers and siblings; and

(e) any recommendations regarding wellbeing support, monitoring or referral for the family unit.

(5) Following receipt of a Family Support Summary, the relevant general practice shall be encouraged to consider the wellbeing needs of parents, carers and siblings and, where appropriate, provide information, assessment, referral or signposting to suitable support services.

(6) The Secretary of State must publish guidance for NHS providers on the discharge of duties under this section.

(7) In this section—

“child” means a person under the age of 16;

“family” includes parents, guardians, primary carers and siblings; and

“life-threatening condition” means a condition designated as such by the Secretary of State in guidance.”

This new clause places a duty on NHS providers to offer practical information, coordination and support to families within 14 days of a child being diagnosed with cancer or another life-threatening condition.

New clause 82—Parent mental health and bereavement support duty—

“(1) Where a child is diagnosed with a life-threatening condition, the responsible NHS provider must ensure that the psychological wellbeing of parents, guardians, primary carers and siblings is considered as part of the child’s care pathway.

(2) Within 14 days of diagnosis, the responsible NHS provider must offer—

(a) a parental psychological wellbeing assessment;

(b) access to a designated family support practitioner, psychologist, counsellor or other appropriately qualified professional;

(c) information regarding the psychological impact of serious childhood illness, including trauma, anxiety, depression, stress and bereavement;

(d) a written Family Mental Health Support Plan;

(e) notification to the child’s registered general practitioner and, where different, the registered general practitioners of parents or primary carers.

(3) During active treatment, the responsible NHS provider must ensure that parents and primary carers are offered periodic psychological wellbeing reviews.

(4) The responsible NHS provider must offer an additional psychological wellbeing review following any—

(a) significant deterioration in the child’s condition,

(b) relapse,

(c) progression of disease,

(d) transition to palliative care, or

(e) other material change in prognosis.

(5) The responsible NHS provider must ensure that support under this section is offered proactively and must not be dependent upon a parent, guardian, carer or sibling requesting support, identifying their own need, or making a self-referral.

(6) Following the death of a child, the responsible NHS provider must—

(a) offer a bereavement wellbeing assessment to parents or primary carers;

(b) offer access to bereavement counselling, psychological support or equivalent specialist services;

(c) make proactive contact with the family within 14 days of the child’s death;

(d) offer further follow-up support at intervals specified in guidance issued by NHS England; and

(e) ensure that referral pathways are available where significant psychological distress, trauma, anxiety, depression or post-traumatic stress symptoms are identified.

(7) The responsible NHS provider must ensure that information regarding available support services is provided to siblings and that age-appropriate emotional support pathways are available where required.

(8) NHS England must publish guidance regarding—

(a) parental psychological wellbeing assessments;

(b) family mental health support following serious childhood diagnosis;

(c) bereavement support following the death of a child;

(d) support for siblings affected by serious childhood illness;

(e) referral pathways into specialist mental health services; and

(f) minimum standards for proactive family mental health support.

(9) NHS England must publish and lay before Parliament an annual report on compliance with this section.

(10) In this section—

“child” means a person under the age of 16;

“family” includes parents, guardians, primary carers and siblings; and

“life-threatening condition” means a condition designated by the Secretary of State in regulations.

(11) The Secretary of State must, within three years of the commencement of this section, undertake a review of its operation and lay a report before Parliament.”

This new clause would establish a statutory duty on NHS providers to identify and support the psychological wellbeing of parents, carers and siblings following the diagnosis of a life-threatening childhood condition. It would create a proactive, opt-out family mental health pathway from diagnosis through treatment and, where applicable, bereavement.

New clause 83—Review of uncertain imaging findings in high-risk childhood illness—

“(1) Where imaging undertaken in relation to a child with a high-risk cancer or other life-threatening condition identifies findings that are—

(a) inconclusive,

(b) indeterminate, or

(c) suspicious,

the responsible NHS provider must ensure that the findings are reviewed by a consultant clinician responsible for the child's care.

(2) Following such a review, the responsible NHS provider must ensure that the child's parent, guardian or primary carer is informed—

(a) of the nature of the uncertainty identified;

(b) whether disease progression, relapse or recurrence can be confidently excluded;

(c) what further investigations or surveillance are being considered; and

(d) the risks and benefits associated with immediate further imaging, alternative imaging modalities, or continued observation.

(3) Where disease progression or relapse cannot be confidently excluded, the responsible NHS provider must consider whether additional imaging or investigation should be undertaken within 14 days or as soon as clinically practicable, whichever is sooner.

(4) The outcome of any discussion held under subsection (2), including the views expressed by the child's parent, guardian or primary carer, must be recorded in the child's medical records.

(5) NHS England must publish guidance on the operation of this section, including circumstances in which further imaging should be considered following uncertain or indeterminate findings.”

This new clause requires consultant review of uncertain imaging findings in children with designated high-risk conditions. It also aims to ensure that parents are informed of the uncertainty, the available options and the risks and benefits of those options before a decision is made.

New clause 86—Compassionate access to innovative treatments—

“(1) In exercising their functions in relation to the health service, the Secretary of State must by regulations make provision for compassionate access to innovative treatments, involving substances listed in Schedule 1 of the Misuse of Drugs Regulations 2001, for patients with serious or life-threatening conditions in circumstances where conventional treatments have been unsuccessful, unsuitable, or unavailable.

(2) Regulations made under this section must make provision for the authorisation, supply, possession, administration and supervision of such treatments, notwithstanding any restriction imposed by or under the Misuse of Drugs Act 1971 or the Misuse of Drugs Regulations 2001, including provision for—

(a) appropriate clinical and regulatory safeguards;

(b) approval arrangements for participating clinicians, providers and pharmacies; and

(c) case-by-case decision-making having regard to clinical need, patient safety, and available evidence.

(3) For the purposes of this section, a serious or life-threatening condition is defined as a condition involving a substantial risk to life or serious impairment of health or functioning.

(4) Regulations under this section are to be made by statutory instrument subject to the affirmative procedure.”

This new clause would require the Secretary of State to make provision for compassionate access to innovative treatments, involving substances listed in Schedule 1 of the Misuse of Drugs Regulations 2001, for patients with serious or life-threatening conditions in certain circumstances.

New clause 87—Research into innovative treatments involving controlled substances—

“(1) The Secretary of State must by regulations take steps to enable and support the development of research relating to innovative treatments, which use substances listed in Schedule 1 of the Misuse of Drugs Regulations 2001.

(2) Regulations made under this section must make provision, for—

(a) the lawful possession, supply, administration, production and importation of such substances for the purposes of clinical trials or other research activities approved in accordance with regulations made by the Secretary of State, notwithstanding any prohibition or restriction imposed by or under the Misuse of Drugs Act 1971 or the Misuse of Drugs Regulations 2001; and

(b) proportionate and timely arrangements relating to the approval, licensing and oversight of authorised research activities under this section.

(3) Provision under subsection (2) applies to—

(a) approved research bodies,

(b) authorised researchers, and

(c) participating healthcare providers,

and specified substances used for approved research purposes, and does not alter the schedule or classification of a substance.

(4) Regulations under this section are to be made by statutory instrument subject to the affirmative procedure.”

This new clause would require the Secretary of State to take steps to enable and support the development of research relating to innovative treatments, which use substances listed in Schedule 1 of the Misuse of Drugs Regulations 2001.

New clause 88—New Hospital Programme: publication of multi-criteria decision analysis (MCDA) reports—

“(1) Within three months beginning on the date on which this Act is passed, the Secretary of State must publish the MCDA reports used to determine the prioritisation of schemes and their allocation to waves within the New Hospital Programme.

(2) The information published under subsection (1) must include—

(a) the multi-criteria decision support analysis tool used to prioritise schemes;

(b) the input data used in that analysis for each hospital in the New Hospital Programme;

(c) the scoring mechanism used in that analysis;

(d) any assessment of estate condition, including data from the NHS England Estate Return Information Collection;

(e) any assessment of patient safety, service disruption or maintenance backlog;

(f) any assessment of the presence of reinforced autoclaved aerated concrete;

(g) any assessment of the risks associated with delaying individual schemes; and

(h) any review of the appropriateness of the input data or scoring mechanism by NHS England or the Department of Health and Social Care.

(3) The Secretary of State may redact information published under this section where publication would—

(a) prejudice commercial negotiations,

(b) disclose personal data, or

(c) endanger the safety or security of patients, staff or NHS premises.

(4) Where information is redacted under subsection (3), the Secretary of State must publish a statement explaining the reason for the redaction.

(5) The Secretary of State must lay the reports and information published under this section before Parliament.”

This new clause requires the Secretary of State to publish the criteria, input data and scoring mechanism used to determine the prioritisation of schemes and their allocation to waves within the New Hospital Programme. Whilst the input data was obtained from publicly available sources, the MCDA reports are currently not publicly available.

New clause 89—New Hospital Programme: estate failure—

“(1) Within six months beginning on the date on which this Act is passed, the Secretary of State must review whether hospitals experiencing significant estate failure are being appropriately prioritised within the New Hospital Programme.

(2) For the purposes of subsection (1), “significant estate failure” includes the closure, partial closure or restricted use of hospital buildings because of structural, safety or infrastructure failures.

(3) In prioritising schemes within the New Hospital Programme, the Secretary of State must ensure that hospitals experiencing significant estate failure are treated with the same urgency as hospitals affected by reinforced autoclaved aerated concrete.

(4) The Secretary of State must publish the outcome of the review in subsection (1).”

This new clause requires the Secretary of State to review whether hospitals experiencing significant estate failure are being appropriately prioritised within the New Hospital Programme, and to ensure that such hospitals are treated with the same urgency as RAAC-affected hospitals.

New clause 92—Duty to report on the regulation of cosmetic surgery—

“(1) Within three months of the passing of this Act, the Secretary of State must publish a report assessing the effectiveness and safety of current regulation of cosmetic surgery.

(2) The report under subsection (1) must investigate regulatory measures regarding professional checks on the providers of cosmetic surgery, including whether they—

(a) are registered medical practitioners;

(b) have completed recognised specialist surgical training; and

(c) hold Cosmetic Surgery Board Certification, or an equivalent certification, accreditation or qualification.

(3) The report must also consider the safety of current regulations of the premises where cosmetic surgery procedures are undertaken.”

This new clause would require the Secretary of State to prepare a report assessing the regulation of cosmetic surgery.

New clause 102—Report on impact on health of social media addiction—

“(1) The Secretary of State must, within six months of the passage of this Act, commission a report on the impact on health of social media addiction.

(2) The report under subsection (1) must consider and make recommendations concerning—

(a) the mental health effects of social media addiction;

(b) the physical health effects of social media addiction; and

(c) the effects of social media addiction on demand for NHS services.

(3) The Secretary of State must lay a copy of the report with proposed actions to minimise the health harms of social media addiction before both Houses of Parliament.”

This new clause would require the Secretary of State to commission a report considering the impact on health of social media addiction.

New clause 103—Communication with parents of critically ill children—

“(1) The Secretary of State must, within 12 months of the passing of this Act, issue guidance to integrated care boards on communication with parents of critically ill children, with particular reference to major decisions in the child’s treatment and care.

(2) Guidance issued under subsection (1) must—

(a) make provision for ensuring that parents have been fully consulted and are fully informed of decisions concerning the care or treatment of their child and the rationale behind such decisions;

(b) make provision, where potentially life-ending or life-changing decisions are to be made, to facilitate parents in accessing an independent specialist second opinion;

(c) make provision, where there is a disagreement between parents and clinicians on the care or treatment of a child, for the appointment of an independent mediator;

(d) make provision, following the advice of an independent specialist second opinion, for transfer of the child to another hospital, subject to appropriate clinical safeguards;

(e) make provision, prior to the death of a child, for family members to be given access to the child, whether in the hospital, a children’s hospice or the family home.

(3) Guidance issued under subsection (1) must have regard to Article 2 of the European Convention on Human Rights.”

This new clause would require the Secretary of State to issue guidance to integrated care boards concerning their role in communicating with parents of critically ill children, and involving them in decision-making.

New clause 107—Fracture liaison services: implementation framework—

“(1) The Secretary of State must, within six months of the passing of this Act, publish an implementation framework for ensuring universal access to fracture liaison services in England by 2030.

(2) The framework must set out—

(a) the minimum standards expected of fracture liaison services;

(b) the steps to be taken to reduce unwarranted variation in access and quality between integrated care board areas;

(c) the respective responsibilities of integrated care boards and NHS trusts;

(d) the workforce, diagnostic, digital and data requirements necessary to support implementation; and

(e) arrangements for identifying people at risk of further fragility fractures and ensuring that they receive appropriate assessment, treatment and follow-up.

(3) The Secretary of State must make a statement to Parliament each year, until 2030, setting out progress towards universal access to fracture liaison services.”

This new clause would require the Secretary of State to publish an implementation framework for ensuring universal access to fracture liaison services in England by 2030.

New clause 110—Rural access to child and adolescent mental health services—

“(1) Each integrated care board must make arrangements to ensure that children and young people in rural areas have reasonable access to child and adolescent mental health services.

(2) In exercising its functions under subsection (1), an integrated care board must have regard to—

(a) travel distances and travel times;

(b) the availability of public transport;

(c) the availability of locally accessible community facilities; and

(d) the particular needs of children and young people who may face barriers to travelling to a centralised service.

(3) The Secretary of State must provide appropriate support to integrated care boards and local authorities to develop community-based child and adolescent mental health services in rural areas.

(4) An integrated care board and a local authority may make arrangements for the use or repurposing of vacant or underused public buildings for the provision of child and adolescent mental health services.”

This new clause would improve access to CAMHS in rural areas by supporting locally delivered services and enabling vacant or underused public buildings to be repurposed for community mental health provision.

New clause 111—Child and adolescent mental health workforce and service capacity—

“(1) Each integrated care board must assess whether child and adolescent mental health services in its area have sufficient staffing and clinical capacity to meet the needs of children and young people.

(2) Where an assessment under subsection (1) identifies a significant shortfall, the integrated care board must prepare and implement a plan to address that shortfall.

(3) The plan must include measures to support the recruitment and retention of suitably qualified staff and, where clinically appropriate, the provision of specialist services including trauma assessment, dialectical behaviour therapy and art therapy.

(4) In preparing the plan, an integrated care board must have regard to—

(a) the number of children and young people receiving CAMHS services;

(b) waiting times for assessment and treatment;

(c) the number and complexity of cases managed by individual staff members; and

(d) the availability of specialist clinical services.”

This new clause would require integrated care boards to assess and address staffing and service capacity in CAMHS, including access to appropriate specialist services.

New clause 112—Review of child and adolescent mental health services in rural areas—

“(1) The Secretary of State must conduct, or arrange for the conduct of, reviews of the provision of child and adolescent mental health services in rural areas in England.

(2) Any review must consider—

(a) waiting times for assessment and treatment;

(b) access to interim support following referral;

(c) travel distances and access to public transport;

(d) staffing and specialist service capacity;

(e) the availability of community-based provision; and

(f) the use of vacant or underused public buildings for the delivery of services.

(3) A review must identify areas where the provision of child and adolescent mental health services is insufficient to meet local need.

(4) The Secretary of State must publish the findings of any review and an action plan setting out measures to address any significant deficiencies identified.

(5) The first review under this section must be completed within 12 months of the passing of this Act and subsequent reviews must be completed at intervals of not more than five years.”

This new clause would require a national review of CAMHS provision in rural areas, including access, waiting times, workforce capacity and the availability of community-based services.

New clause 113—Radiotherapy services: access and accountability—

(1) The Secretary of State must publish and maintain a national framework for improving access to radiotherapy services in England.

(2) The framework must set out nationally agreed metrics against which integrated care boards must measure and report their delivery of, and investment in, radiotherapy services.

(3) The metrics must include, but are not limited to, metrics relating to—

(a) waiting times for radiotherapy;

(b) access to radiotherapy services, including variation in radiotherapy treatment rates between integrated care board areas;

(c) the age, capability and replacement needs of radiotherapy equipment;

(d) radiotherapy capacity against assessed population need; and

(e) workforce capacity.

(4) Each integrated care board must publish an annual report on its performance against the metrics in the framework.

(5) Before publishing or revising the framework, the Secretary of State must consult persons with clinical, technical, operational and patient expertise in radiotherapy services.

(6) The Secretary of State must lay before Parliament, at least once in each financial year, a report on the implementation of the framework and any steps proposed to address underperformance or unwarranted variation.

(7) In this section, “radiotherapy services” means services involving the use of ionising radiation for the treatment of cancer.”

This new clause would require the Secretary of State to publish a national framework for improving access to radiotherapy services. Integrated Care Boards would be required to report annually against national metrics on waiting times, access, equipment, capacity, workforce, investment and variation.

New clause 114—Radiotherapy services: access and waiting times—

“(1) Within six months of the passing of this Act, the Secretary of State must conduct and publish a review of access to radiotherapy services and waiting times for radiotherapy in England.

(2) The review must include an assessment of—

(a) variation in access to radiotherapy services between integrated care board areas;

(b) waiting times for radiotherapy services, including where radiotherapy is the first, second or subsequent cancer treatment received by a patient; and

(c) the extent to which capacity, equipment, workforce or investment constraints are affecting access to radiotherapy services or waiting times for radiotherapy.

(3) In conducting the review, the Secretary of State must consult persons with clinical, technical, operational and patient expertise in radiotherapy services.

(4) The Secretary of State must lay the review before Parliament and set out any steps proposed to address identified gaps in access to radiotherapy services or waiting times for radiotherapy.

(5) In this section, “radiotherapy services” means services involving the use of ionising radiation for the treatment of cancer.”

This new clause would require the Secretary of State to review access to radiotherapy services and radiotherapy waiting times. The review would examine variation between ICB areas, delays where radiotherapy is a first or subsequent treatment, and the capacity constraints affecting patient access.

New clause 116—Access to medicinal cannabis for children: review and clinical trials—

“(1) The Secretary of State must, within six months beginning on the day on which this Act is passed, publish a review on access to medicinal cannabis for children on the NHS.

(2) The review under subsection (1) must consider—

(a) variation between integrated care boards in the referral and prescribing of medicinal cannabis to children;

(b) the barriers preventing children from accessing medicinal cannabis through the NHS, including the number of patients who access private prescriptions as a result;

(c) the current evidence base for the clinical effectiveness of medicinal cannabis for children; and

(d) options for expanding that evidence base through clinical trials.

(3) The Secretary of State must take reasonable steps to support and facilitate clinical trials into the use of medicinal cannabis for children, with the aim of establishing a clearer evidence base to inform NHS prescribing guidance.

(4) The Secretary of State must lay a copy of the review before both Houses.”

This new clause would require the Secretary of State to review inconsistencies in NHS access to medicinal cannabis for children, including the extent to which patients are forced to rely on private prescriptions, and would place a duty on the Secretary of State to support clinical trials to strengthen the evidence base for prescribing.

New clause 117—Access to speech and language therapy—

“(1) The Secretary of State must, within six months beginning on the day on which this Act is passed, publish a strategy for improving access to NHS speech and language therapy services in England.

(2) The strategy under subsection (1) must include—

(a) an assessment of waiting times for speech and language therapy across integrated care boards;

(b) an assessment of variation in access to speech and language therapy between different areas of England;

(c) an assessment of the speech and language therapy workforce, including current vacancy rates and future workforce need; and

(d) proposals to reduce waiting times and geographical variation in access.

(3) The Secretary of State must lay a copy of the strategy before Parliament.

(4) The Secretary of State must publish a further report reviewing progress against the strategy within eighteen months beginning on the day on which this Act is passed.”

This new clause would require the Secretary of State to publish a strategy to address waiting times and geographical inequality in access to NHS speech and language therapy, and to report on progress against that strategy.

New clause 123—NICE technology appraisal recommendation: accountability scheme—

“(1) The Secretary of State must establish by regulations an accountability scheme relating to the implementation of NICE technology appraisal recommendations (the "scheme").

(2) Under the scheme, Health and Social Care bodies must take all reasonable steps to implement a NICE technology appraisal recommendation within three months of receiving such a recommendation.

(3) Any Health and Social Care body that fails to meet the requirement set out in subsection (2) must—

(a) publish an explanation of the reasons for the failure;

(b) specify any circumstances which have prevented implementation; and

(c) publish a plan setting out the steps it will take to implement the recommendation.

(4) Regulations under this section are subject to the affirmative procedure.”

New clause 131—Activities of religious groups in medical settings—

“(1) The Secretary of State must, within six months of the passage of this Act, make regulations concerning the activities of religious groups in medical settings in England.

(2) Regulations made under subsection (1) must make provision for—

(a) clinical oversight of training provided by representatives of religious groups to healthcare professionals and students on the treatment of patients who hold religious beliefs that may influence their choice of treatment;

(b) ensuring that the contacting of any religious group on behalf of a patient, or for advice on care, is made only at the request of the patient;

(c) requiring opportunities for patients to indicate final treatment preference in the absence of religious representatives, and ensuring religious representatives cannot later verify a patient’s final treatment choice; and

(d) any other matter that the Secretary of State deems appropriate.

(3) Regulations made under this section are subject to the affirmative procedure.”

This new clause would require the Secretary of State to make regulations governing the activities of religious groups in medical settings in England, to prevent medical coercion.

New clause 132—Non-therapeutic male circumcision—

“(1) The Secretary of State must, within six months of the passage of this Act, make regulations relating to non-therapeutic male circumcision (NTMC).

(2) Regulations made under subsection (1) must make provision for—

(a) a requirement that NTMC may only be performed by a suitably qualified healthcare professional and must be inspected by the Care Quality Commission;

(b) the inclusion of NTMC as a regulated activity under the Health and Social Care Act 2008;

(c) the creation of a statutory duty for integrated care boards to produce annual data on prevalence and complications of NTMC;

(d) a requirement that NTMC be included in the Single Patient Record; and

(e) any other matter that the Secretary of State deems appropriate.

(3) Regulations under this section are subject to the affirmative procedure.”

This new clause would require the Secretary of State to introduce regulation of non-therapeutic male circumcision, following several prevention of future death reports issued by coroners as a result of deaths arising from this procedure.

New clause 137—Cancer outcomes—

“(1) The National Health Service Act 2006 is amended as follows.

(2) After section 1GA insert—

“1GB Cancer outcomes

In exercising functions relating to the health service, the Secretary of State must treat objectives relating to cancer outcomes as having priority over any other objectives relating specifically to cancer.””

The Secretary of State is currently required to set cancer outcome objectives for NHS England, with those objectives taking priority over other cancer goals. The Health Bill removes this provision. This new clause would place a new duty on the Secretary of State to prioritise cancer outcomes such as survival by inserting a new section into Part 1 of the National Health Service Act 2006.

New clause 138—Report on occupational health screening for fire and rescue personnel—

(1) The Secretary of State must, within 12 months of the passing of this Act, publish a report on access to occupational health screening, including blood testing for biomarkers of exposure to carcinogens, for members of fire and rescue services in England.

(2) The report under subsection (1) must consider—

(a) the classification by the International Agency for Research on Cancer of occupational exposure as a firefighter as carcinogenic to humans;

(b) the current provision of occupational health screening for fire and rescue personnel by fire and rescue authorities, NHS bodies and integrated care boards;

(c) options for a national baseline entitlement to periodic health screening for fire and rescue personnel, informed by exposure risk;

(d) the resource and workforce implications of any such entitlement; and

(e) the interaction of any such entitlement with existing work by the Fire Brigades Union and the University of Central Lancashire on the UK Firefighters Cancer and Disease Registry.

(3) The Secretary of State must lay a copy of the report before Parliament.”

This new clause would require the Secretary of State to report on occupational health screening, including blood testing, for fire and rescue personnel, in recognition of their elevated risk of cancer arising from occupational exposure to carcinogens.

New clause 139—Duty on integrated care boards to share data with fire and rescue authorities concerning vulnerable persons—

“(1) An integrated care board must take reasonable steps to share, or to facilitate the sharing of, relevant data with a fire and rescue authority for the area, or part of the area, for which the integrated care board has responsibility, for the purpose of enabling the fire and rescue authority to identify and prioritise vulnerable persons in the event of an emergency.

(2) In this section, “relevant data” means data relating to a person’s vulnerability, including but not limited to age, disability or mobility, that is necessary and proportionate for the purpose in subsection (1).

(3) Data may only be shared under this section—

(a) in accordance with the requirements of the UK GDPR and the Data Protection Act 2018;

(b) subject to arrangements agreed between the integrated care board and the fire and rescue authority setting out the purpose, extent and security of the data sharing; and

(c) where a mechanism exists for a person to object to the sharing of their data under this section, save where doing so would be likely to endanger life.

(4) The Secretary of State must, within 12 months of this section coming into force, publish guidance for integrated care boards and fire and rescue authorities on the operation of this section.

(5) In this section, “fire and rescue authority” has the meaning given by section 1 of the Fire and Rescue Services Act 2004.”

This new clause would place a duty on integrated care boards to share relevant data concerning vulnerable residents with fire and rescue authorities, subject to data protection safeguards, to enable fire and rescue services to identify and prioritise vulnerable people in emergencies, including fires and flooding.

New clause 140—Corridor care—

“(1) The Secretary of State must end the practice of corridor care in NHS hospitals within one year of the passage of this Act.

(2) If the requirement under subsection (1) is not met, the Secretary of State must commission an independent inquiry into the Government's handling of corridor care.

(3) The inquiry under subsection (2) must—

(a) investigate the effectiveness of policies, funding and guidance relating to corridor care in the Department of Health and Social Care;

(b) assess the impact on patient safety and staff morale from the continued practice of corridor care; and

(c) recommend steps the Secretary of State should take to end the practice of corridor care.

(4) The inquiry under subsection (2) should be supported by patient safety professionals from the Health Services Safety Investigations Body and the Care Quality Commission.

(5) The inquiry under subsection (2) must be published and laid before Parliament as a final report within 6 months beginning on the day on which the inquiry is established.”

This new clause places a duty on the Secretary of State to end Corridor Care within 12 months, if they fail to do so they must order an independent inquiry into corridor care and the failure to eradicate the practice.

New clause 141—Suspension of Advice and Guidance pending HSSIB report and mitigation plan—

“(1) The Secretary of State must ensure that the operation and further rollout of Advice and Guidance services (including any targets, incentives, pathways or contractual requirements that treat Advice and Guidance as a prerequisite or preferred alternative to direct referral) are suspended until the conditions in subsection (2) are met.

(2) The conditions are that—

(a) the Health Services Safety Investigations Body (or, if its functions have already been transferred under section 63 of this Act, the Care Quality Commission exercising those functions) has laid its final report on Advice and Guidance services before Parliament, and

(b) the Secretary of State has published a written mitigation plan addressing the patient safety risks, harms and recommendations identified in that report (including any linked to patient deaths, near misses, treatment delays, resource and capacity gaps, workforce training, digital systems and incident reporting).”

New clause 142—Puberty blockers—

“(1) Within three months of the passage of this Act the Secretary of State must make regulations which ensure that puberty blockers may not be prescribed, dispensed or supplied to persons under 18 years of age for the purposes of treatment related to gender dysphoria, gender incongruence or a combination of both, in the United Kingdom.

(2) Regulations under this section must ensure that such drugs cannot be given out or used as part of clinical trials for the treatment of gender dysphoria, gender incongruence or a combination of both, unless that trial has specifically been approved by a resolution of both Houses of Parliament.

(3) For the purposes of this section, puberty blockers means—

(a) a “gonadotrophin-releasing hormone (“GnRH”) analogue” which means a medicinal product that consists of or contains buserelin, gonadorelin, goserelin, leuprorelin acetate, nafarelin or triptorelin, and

(b) any other drug which has the effect of suppressing or delaying puberty that the Secretary of State may by regulation appoint.”

This new clause would create a requirement for the Secretary of State to make regulations which prevent puberty blockers from being prescribed to persons under 18 years of age for the purposes of treatment related to gender incongruence, or being given in clinical trials related to gender incongruence unless specifically approved by Parliament.

New clause 143—Single sex facilities—

“(1) The Secretary of State is required to ensure that there are single sex—

(a) changing rooms for NHS staff,

(b) toilets and washing facilities for NHS staff,

(c) wards for NHS patients, and

(d) toilets and washing facilities for NHS patients.

(2) The Secretary of State may make exemptions to the duty in subsection (1)(c) and (1)(d) where necessary for—

(a) children,

(b) intensive care units,

(c) critical care, and

(d) specialist high observation areas such as resuscitation in Accident and Emergency and the initial recovery area in theatres.”

This new clause creates a requirement for the Secretary of State to ensure certain single sex facilities are made available for NHS staff and patients. It provides exemptions in certain circumstances.

New clause 146—Fracture liaison services: delivery plan and annual reporting—

“(1) The Secretary of State must, within 90 days of the day on which this Act is passed, publish and lay before both Houses of Parliament a delivery plan for securing universal provision of fracture liaison services across England by 2030.

(2) The plan under subsection (1) must include—

(a) a baseline assessment of current access to, and quality of, fracture liaison services in each integrated care board area, distinguishing clearly between services established before and after July 2024;

(b) annual milestones for the number of patients identified, assessed and treated through fracture liaison services, sufficient to reach the level required for universal coverage;

(c) the specific steps the Secretary of State will take to support integrated care boards to commission and sustain high-quality fracture liaison services, including any use of directions, guidance, financial incentives, capital funding or other mechanisms;

(d) workforce, diagnostic (including DEXA capacity), digital and data requirements, with associated funding assumptions;

(e) arrangements for independent monitoring and public reporting of progress against the milestones; and

(f) an estimate of the expected reduction in fragility fractures, hip fractures, associated deaths and NHS bed days, drawing on available evidence including that published by the Royal Osteoporosis Society.

(3) The Secretary of State must, within 12 months of publishing the plan under subsection (1) and every 12 months thereafter until 2030, lay before Parliament a report setting out—

(a) progress against each annual milestone;

(b) the number of new fracture liaison services established and the number of patients identified in the preceding year;

(c) any revision to the milestones or timetable, with the reasons for any such revision; and

(d) action being taken to address any shortfall.

(4) In this section “fracture liaison service” means a service for the systematic identification, assessment, treatment and ongoing monitoring of people who have sustained a fragility fracture, for the purpose of reducing their risk of further fractures.”

This new clause would require the Secretary of State to publish a plan to roll out fracture liaison services across England and publish reports of progress.

New clause 147—Plan to manage acquired brain injury—

“(1) The Secretary of State must, within 30 days of the day on which this Act is passed, publish a plan for the management of acquired brain injury across England.

(2) A plan under subsection (1) must include but shall not be limited to—

(a) proposed government actions to prevent acquired brain injuries;

(b) proposed government actions to improve acute treatment for acquired brain injuries;

(c) a statement of priorities regarding the Secretary of State’s approach for rehabilitation and long-term support for persons with acquired brain injuries across public services delivered by—

(i) the Department of Health and Social Care,

(ii) the Department for Education, and

(iii) the Ministry of Justice;

(d) proposals for data sharing between government departments, health care, and rehabilitation providers to improve patient—

(i) identification,

(ii) care, and

(iii) support;

(e) a commitment to providing 95% of people with complex needs with a personalised care plan by 2027;

(f) commitments for research into acquired brain injuries in sport;

(g) any proposed use of directions, guidance, financial assistance, incentives or other mechanisms to secure delivery of the plan’s objectives;

(h) workforce, diagnostic, digital and data requirements for implementation of the plan; and

(i) arrangements for monitoring, publishing and reporting progress against the plan.

(3) The plan under subsection (1) must be laid by the Secretary of State before both Houses of Parliament.

(4) The Secretary of State must, within 12 months of publishing a plan under subsection (1), and every 12 months thereafter until 2030, lay before Parliament a report on progress made against the proposals and commitments in the plan.”

This new clause would require the Government to publish their action plan to manage acquired brain injury within 30 days of the passing of this Act.

New clause 148—Radiotherapy cancer treatment services—

“(1) The Secretary of State must publish and maintain a national framework for improving access to radiotherapy services in England.

(2) The framework must include nationally agreed metrics against which integrated care boards must measure and report their investment in, and delivery of, radiotherapy services.

(3) The metrics must include provisions relating to—

(a) waiting times for radiotherapy, including time to definitive treatment;

(b) patient travel times to radiotherapy services, including defining an appropriate recommended travel time;

(c) the number of cancer patients receiving radiotherapy and the quality of such radiotherapy;

(d) the age, capability and replacement needs of radiotherapy equipment, including the proportion of linear accelerators that are more than 10 years old or otherwise beyond the recommended replacement age;

(e) access to modern radiotherapy techniques and technologies;

(f) radiotherapy capacity against population need and the projected increase in number of cancer patients;

(g) variation in access to radiotherapy services between integrated care board areas;

(h) provision of sustainable, flexible workforce that is equipped to harness advances in radiotherapy for patient benefit; and

(i) investment in radiotherapy services and the extent to which such investment reflects clinical need.

(4) Each integrated care board must publish an annual report on its performance against the metrics in the framework.

(5) Before publishing or revising the framework, the Secretary of State must consult persons with clinical, technical, operational and patient expertise in radiotherapy which the Secretary of State considers appropriate.

(6) The Secretary of State must lay before Parliament, at least once in each financial year, a report on the implementation of the framework.”

This new clause would require the Secretary of State to publish and maintain a national framework for improving access to radiotherapy services in England.

New clause 149—Modern Service Framework for Respiratory Disease – prioritisation and reporting—

“(1) Within 12 months of the day on which this Act is passed, the Secretary of State must—

(a) publish a statement setting out the criteria and process by which the National Quality Board will assess proposals for future Modern Service Frameworks (including respiratory disease), and

(b) lay before both Houses of Parliament a report on the prioritisation of respiratory disease for a Modern Service Framework.

(2) The report under subsection (1)(b) must include—

(a) an assessment of the current burden of respiratory disease in England including—

(i) emergency admissions,

(ii) variation by integrated care board area,

(iii) outcomes;

(b) the evidence of potential for rapid and significant improvements in quality of care and productivity that a respiratory Modern Service Framework could deliver;

(c) the status of existing work on respiratory pathways including for—

(i) pulmonary fibrosis,

(ii) pulmonary rehabilitation,

(iii) diagnostics,

(iv) early detection and lung cancer screening,

(v) supported self-management,

(vi) access to medicines;

(d) the expected timetable for any decision by the National Quality Board on whether to prioritise a respiratory Modern Service Framework; and

(e) interim actions the Secretary of State and NHS England are taking to reduce unwarranted variation and emergency admissions attributable to respiratory disease pending any such decision.

(3) If the National Quality Board decides not to prioritise a respiratory Modern Service Framework within 18 months of the day on which this Act is passed, the Secretary of State must, within three months of that decision, publish and lay before Parliament an alternative national plan for improving respiratory care that addresses the matters set out in subsection (2)(a) to (c) and (e).

(4) The Secretary of State must publish an updated report under subsection (1)(b), or a progress report against any respiratory Modern Service Framework or alternative plan, at intervals of not more than three years.

(5) In preparing any report or plan under this section the Secretary of State must consult clinicians with expertise in respiratory medicine, organisations representing people with respiratory disease, integrated care boards, and NHS providers of respiratory services.”

New clause 150—Modern Service Framework for Musculoskeletal Care – prioritisation and reporting—

“(1) Within 12 months of the day on which this Act is passed, the Secretary of State must—

(a) publish a statement setting out the criteria and process by which the National Quality Board will assess proposals for future Modern Service Frameworks (including musculoskeletal conditions), and

(b) lay before both Houses of Parliament a report on the prioritisation of musculoskeletal care for a Modern Service Framework.

(2) The report under subsection (1)(b) must include—

(a) an assessment of the current burden of musculoskeletal conditions in England including—

(i) waiting times,

(ii) emergency admissions or unplanned care,

(iii) variation by integrated care board area,

(iv) impact on work and economic inactivity,

(v) outcomes,

(b) the evidence of potential for rapid and significant improvements in quality of care and productivity that a musculoskeletal Modern Service Framework could deliver;

(c) the status of existing national programmes including—

(i) the Getting It Right First Time (GIRFT) MSK Community Delivery Programme;

(ii) any related elective recovery or neighbourhood health initiatives,

(d) the expected timetable for any decision by the National Quality Board on whether to prioritise a musculoskeletal Modern Service Framework; and

(e) interim actions the Secretary of State and NHS England are taking to reduce unwarranted variation, waiting times and the impact of musculoskeletal conditions on patients and the wider economy pending any such decision.

(3) If the National Quality Board decides not to prioritise a musculoskeletal Modern Service Framework within 18 months of the day on which this Act is passed, the Secretary of State must, within three months of that decision, publish and lay before Parliament an alternative national plan for improving musculoskeletal care that addresses the matters set out in subsection (2)(a) to (c) and (e).

(4) The Secretary of State must publish an updated report under subsection (1)(b), or a progress report against any musculoskeletal Modern Service Framework or alternative plan, at intervals of not more than three years.

(5) In preparing any report or plan under this section the Secretary of State must consult clinicians with expertise in musculoskeletal medicine and related professions, organisations representing people with musculoskeletal conditions, integrated care boards, and NHS providers of musculoskeletal services.”

New clause 151—Patient safety recommendations: Government response—

“(1) This section applies where the Secretary of State commissions a review or a report into a patient safety issue.

(2) The Secretary of State must—

(a) decide within six months whether they are going to implement each recommendation of the review;

(b) publish a response to each recommendation with a statement indicating whether each recommendation will be implemented; and

(c) publish a timeline for implementation of recommendations which will be implemented.”

This new clause requires the Secretary of State to respond to patient safety recommendations.

New clause 159—Mental health waiting time standards and reporting—

“(1) The National Health Service Act 2006 is amended as follows.

(2) Section 12F (expected mental health spending) is amended as follows—

(a) in subsection (1), after paragraph (a) insert—

“(aa) stating the Secretary of State's expectations for that year regarding performance against the waiting time standards published under section 12FA;”;

(b) in subsection (1), after paragraph (aa) insert—

“(ab) stating the Secretary of State's expectations for that year regarding the relationship between performance against those waiting time standards and expenditure on mental health services, and”;

(c) for subsection (1)(b) substitute—

“(b) explaining the reasons for the expectations stated under paragraphs (a), (aa) and (ab).”.

(3) After section 12F insert—

“12FA Mental health waiting time standards

(1) The Secretary of State must adopt target national waiting time standards covering mental health services, including community and urgent care.

(2) In determining standards under subsection (1) the Secretary of State must have regard to advice from the Chief Medical Officer about the standards necessary to ensure safe and effective mental health care.

(3) The Secretary of State must publish waiting time standards under this section within 12 months beginning on the day on which this Act is passed.

(4) The Secretary of State may make regulations under section 14Z45A to give effect to the waiting time standards published under this section.””

The new clause would require the Secretary of State to adopt and publish waiting time standards for mental services having regard to advice from the Chief Medical Officer. It would expand the Secretary of State’s existing annual reporting duties to parliament to include reporting the NHS performance in meeting the NHS waiting times standards.

New clause 161—Report into the availability and quality of data relating to dementia care—

“(1) The Secretary of State must publish a report on the availability and quality of data relating to dementia care within 12 months of the passing of this Act.

(2) The report must include an action plan to address gaps in dementia data across prevalence, the health and social care interface, the dementia care pathway, experience of care, and workforce.

(3) The action plan must, in particular, address the absence of key performance measures, including but not limited to—

(a) waiting times to assessment and diagnosis;

(b) non-medication related interventions; and

(c) care and treatment outcomes.”

Amendment 82, in clause 62, page 45, line 37, at end insert—

“(8B) Provision under (8A) about the period within which a recommendation is to be complied with must—

(a) only apply to individual recommendations in the case of exceptional circumstances,

(b) follow a process aligned with NICE's health technology evaluation procedures,

(c) be subject to engagement from industry stakeholders.”

Amendment 106, page 45, line 37, at end insert—

“(8B) Regulations under subsection (8) must include provision about the period within which NICE guideline NG206 on myalgic encephalomyelitis (ME) must be complied with.

(8C) The Secretary of State must publish an annual statement on compliance with NICE guideline NG206, including the extent to which integrated care boards and relevant NHS bodies have implemented recommendations relating to ME specialist services and severe or very severe ME.”

This amendment would require that a period must be set within which the NICE guideline NG206 on ME must be complied with by ICBs and other health bodies. Furthermore, the Secretary of State must publish an annual statement on compliance with NICE guideline NG206 across the NHS in England.

Amendment 1, page 45, line 39, leave out clause 63.

Amendment 2, page 46, line 3, leave out clause 64.

Amendment 3, page 46, line 39, leave out clause 65.

Amendment 4, page 47, line 36, leave out clause 66.

Amendment 7, page 48, line 15, leave out clause 68.

This amendment removes the clause abolishing Healthwatch England.

Amendment 5, page 48, line 18, leave out clause 69.

Government amendments 65 and 66.

Amendment 6, page 52, line 34, leave out clause 75.

Government amendments 67 to 69.

Amendment 89, in clause 80, page 54, line 36, at end insert—

“(3A) The Secretary of State may not make regulations under subsection (3) commencing section (1) until the condition in subsection (3B) has been met.

(3B) The condition is that the Secretary of State has published an impact assessment in respect of the abolition of NHS England that complies with subsection (3C) (a "qualifying impact assessment").

(3C) A qualifying impact assessment must include—

(a) a quantified estimate, expressed in monetary terms, of the total transition costs of abolishing NHS England, including in particular—

(i) redundancy costs;

(ii) the costs of integrating data, digital and information technology systems;

(iii) the costs of reorganising and rehousing staff and functions; and

(iv) productivity losses during the transition period;

(b) a quantified estimate, expressed in monetary terms, of the ongoing annual costs of the restructured Department of Health and Social Care following the abolition of NHS England, including any costs falling on integrated care boards as a result of the transfer of functions to them;

(c) a quantified estimate, expressed in monetary terms, of the estimated annual savings arising from the abolition, including savings from the elimination of duplicated corporate functions and reduced administrative costs;

(d) a quantified estimate, expressed in monetary terms, of the net present value of the abolition, being the difference between the total costs under paragraphs (a) and (b) and the total benefits under paragraph (c) over a period of not less than ten years;

(e) a statement of the key assumptions underlying the estimates in paragraphs (a) to (d) and an assessment of the sensitivity of those estimates to changes in those assumptions;

(f) an assessment of the risks to the delivery of the anticipated benefits, including the risk of disruption to NHS functions during the transition period; and

(g) a statement of the methodology used to produce the estimates, including any data sources relied upon.

(3D) Before publishing a qualifying impact assessment, the Secretary of State must submit it for independent scrutiny to the Regulatory Policy Committee (or any successor body) and must publish the Committee's opinion on the assessment alongside it.

(3E) The Secretary of State must lay the qualifying impact assessment and the Committee's opinion before both Houses of Parliament.

(3F) Regulations to commence section (1) are to be made by statutory instrument and may not be made unless a draft of the instrument has been laid before, and approved by a resolution of, each House of Parliament.

(3G) A draft instrument under subsection (3F) may not be laid unless at least 60 sitting days have elapsed since the qualifying impact assessment was laid under subsection (3E).”

This amendment requires the Secretary of State to publish, and submit to independent scrutiny, an impact assessment on the abolition of NHS England, containing quantified cost and benefit figures, before making regulations to abolish the body.

Amendment 90, page 54, line 36, at end insert—

“(3A) The Secretary of State may not make regulations under subsection (3) commencing section (1) until the condition in subsection (3B) is met.

(3B) The Secretary of State must publish a plan setting out how health services provided by or under arrangements made by NHS bodies are to work alongside and be integrated with the social care system in England (the "health and social care integration plan").

(3C) Before preparing the health and social care integration plan, the Secretary of State must have regard to—

(a) the recommendations made by the Independent Commission on Adult Social Care (or any successor body undertaking that Commission's work) in any report published by the Commission; and

(b) the need to reflect any recommendations of the Independent Commission on Adult Social Care in the plan which are relevant to the interface between health services and adult social care.

(3D) The health and social care integration plan must include—

(a) a description of the structural and operational arrangements for joint working between NHS bodies and local authority social care services following the abolition of NHS England;

(b) proposals for how the transfer of NHS England's functions to the Secretary of State will affect the coordination of health and social care commissioning, including commissioning of services for people with complex needs spanning health and social care;

(c) arrangements for reducing delayed discharges from hospital attributable to the absence of suitable social care provision;

(d) proposals for how the funding flows between the NHS and the social care system, including NHS Continuing Healthcare, will be managed following the abolition;

(e) the workforce implications for the health and social care sectors arising from the abolition of NHS England and the steps to be taken to address them; and

(f) a timetable for implementing the arrangements described in the plan.

(3E) The Secretary of State must lay the health and social care integration plan before both Houses of Parliament.

(3F) Regulations to commence section (1) must be subject to the affirmative procedure.

(3G) A draft instrument under subsection (3F) may not be laid before either House of Parliament until at least 60 sitting days after the health and social care integration plan has been laid under subsection (3E).

(3H) In this section—

“NHS body” has the same meaning as in the National Health Service Act 2006;

“social care system” means the system for the provision of care and support under the Care Act 2014 and services provided by local authorities in the exercise of their functions relating to adult social care.”

This amendment requires the Secretary of State to publish and lay before Parliament a plan setting out how health services will work alongside the social care system following the abolition of NHS England before using their powers for its abolition. The plan must address joint commissioning, funding flows (including NHS Continuing Healthcare), delayed hospital discharges, and workforce.

Amendment 25, page 112, line 18, leave out schedule 9.

Amendment 12, in schedule 9, page 130, line 16, at end insert—

“(2A) After paragraph 6(8) insert—

“(9) A committee of the Commission is to be appointed in accordance with regulations.

(10) The purpose of the committee is to oversee the health services safety investigation functions formerly conducted by HSSIB, transferred to the Care Quality Commission under the Health Act 2026.

(11) The committee is to be operationally independent from the Care Quality Commission.

(12) The committee is to consist of a chair appointed by the Secretary of State, and not less than six and not more than twelve other members appointed by the chair.

(13) A majority of the members of the committee must not be members of the Care Quality Commission.

(14) So far as is reasonably practicable, the persons appointed to the committee must include persons with knowledge or experience relevant to the discharge of functions under this paragraph.””

This amendment would ensure that oversight of HSSIB’s functions would remain operationally independent of the Care Quality Commission (CQC) following the transfer of its functions to the CQC.

Amendment 8, page 134, line 20, leave out schedule 10.

This amendment removes the schedule abolishing Healthwatch England.

Amendment 9, page 136, line 1, leave out schedule 11.

This amendment removes the schedule abolishing Local Healthwatch organisations.

Amendment 78, schedule 11, page 137, line 2, at end insert—

“(2A) In making arrangements under subsection (2), an integrated care board must have regard to the need to facilitate participation by persons who may experience barriers to engagement, including persons with long-term, complex or fluctuating health conditions.”

This amendment would require an integrated care board, in making arrangements for gathering patient views, to have regard to the need to facilitate participation by persons who may experience barriers to engagement, including persons with long-term, complex or fluctuating health conditions.

Government amendment 72.

Amendment 100, in schedule 12, page 155, line 5, at end insert—

“(10) An order under this section that establishes, varies the area of, abolishes or merges an integrated care board may not be made unless a draft of the order has been laid before, and approved by a resolution of, each House of Parliament.”

Amendment 33, in schedule 12, page 156, line 28, at end insert—

“(c) must publish any evidence the Secretary of State has received in respect of the impact of the proposal.”

Government amendments 73 to 75.

[Karin Smyth]

I know that many hon. Members want to talk about the provisions in the Bill covering many important issues. I will therefore speak briefly about two Government amendments relating to medical device licensing and information sharing.

I will first address new clause 94 regarding medical devices licensing, and consequential amendments new clauses 99 to 101 regarding medical devices disclosure. These amendments are about ensuring that Great Britain’s medical devices regulatory framework remains fit for the future. As we know, medical technology is evolving rapidly, particularly in areas such as software and artificial intelligence, while our current framework was designed for a very different technological landscape. This set of amendments establishes the statutory foundation for a future medical device licensing regime, applying to Great Britain only. EU medical devices legislation will continue to apply in Northern Ireland.

Such a regime would require medical devices to be licensed and certain persons operating within the supply chain to hold a licence. By placing the detail in the regulations, the amendment allows us to work with patients, healthcare professionals and the medical device sector to create a regulatory framework that protects patients, supports innovation and strengthens the UK’s life sciences sector.

--- Later in debate ---

[Sir Bernard Jenkin (Harwich and North Essex) (Con)]

Will the Minister give way?

[Madam Deputy Speaker (Judith Cummins)]

I think the Minister has finished her remarks.

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

As is now routine, I declare an interest as an NHS consultant paediatrician, a member of the British Medical Association and a member of the Royal College of Paediatrics and Child Health. Yesterday the Government voted not to introduce a backstop to decide on the Hughes report. I submitted a written question that also had a deadline of last night to ask when they were going to respond, and they have not answered that either. Taking their time about something is one thing, but for the Government to completely ignore victims, refusing to give an answer and refusing to provide a backstop or a deadline, is frankly shameful.

Patient safety is really important, and one key element to improving it is striking a good balance between accountability and blame. If we do not hold people accountable for their actions, they may not be as careful, but if they feel that their superiors are looking to find fault, they will be defensive and may cover things up. That makes it hard to get to the root cause and prevent mistakes from happening again. The Health Services Safety Investigations Body, or HSSIB, was set up with this problem in mind. Like the Air Accidents Investigation Branch, it has a safe space. This means that people are not held legally responsible for what they reveal to that team. They can then get to the bottom of why things are going wrong and find system errors. People come forward because they know and trust that HSSIB is independent, but this Labour Government want to change that.

The Health Bill will abolish HSSIB and transfer all its functions to the Care Quality Commission—the body responsible for regulating health and social care. This is the same CQC that, according to Ministers, is not fit for purpose. Why are the Government doing this? Ministers cite a review by Dr Penny Dash that said that the patient safety landscape was “cluttered” and “fragmented”, but too many different organisations are producing too many recommendations. That report was narrow in scope, and the clutter is not caused by HSSIB. In recent years, 30 public inquiries produced 1,400 recommendations, but HSSIB produced just 56.

The Government have suggested that moving HSSIB into the CQC can improve the quality of care and safety, but it is not clear how. People come forward to HSSIB precisely because it is a safe space, and this Government are removing the confidence in that safe space. For the new set-up to work, frontline workers will need to believe that the new unit in the CQC is independent, despite the law making it clear that it is not. The Government’s impact assessment says that the national quality board will provide clear direction to the new investigations unit, but the national quality board is tied to the NHS, so how does that square with the new unit staying independent? The impact assessment also says that the vast majority of investigations are expected to be directed by the Health Secretary. How can we be sure that the new unit will have the power and resources to look at things that might be politically difficult for the Government? How will the people in charge of the CQC balance the responsibility of investigating with the responsibility of maintaining that safe space?

--- Later in debate ---

[Several hon. Members rose—]

[Madam Deputy Speaker (Judith Cummins)]

With the exception of Front-Bench speeches, there will be an immediate three-minute time limit.

[Grahame Morris (Easington) (Lab)]

I am speaking today in support of new clauses 113 and 114, which stand in the name of the hon. Member for Westmorland and Lonsdale (Tim Farron) and to which I have added my name.

I say at the outset that I am in full support of this Government’s ambitions on cancer. I welcome the recent investment in radiotherapy equipment, and I sincerely want the national cancer plan, which was published in February, to succeed. But I speak as someone who worked in the health service, who is a cancer survivor and who has taken a particular interest in this issue, not least as vice chairman of the all-party parliamentary group on radiotherapy. It is in that capacity, and as a supporter of what the Government are trying to achieve, that I respectfully ask Ministers to accept one or both of these new clauses.

By way of brief explanation, new clause 113 requires the Secretary of State to publish and maintain a national framework of agreed metrics for radiotherapy, requires integrated care boards to report annually against those targets and requires a report to this House once a year. New clause 114 asks very straightforwardly for a single review of access to radiotherapy and radiotherapy waiting times to be laid before Parliament within six months.

--- Later in debate ---

[Grahame Morris]

The hon. Gentleman hits the nail on the head—that is perfectly put. I believe there is cross-party consensus that this is the way forward. Over the last 16 years that I have been a Member, along with the hon. Gentleman, I have presented the case to a whole succession of Ministers from various parties, all of whom seemed to be in agreement. We definitely have an opportunity to restore what was once a world-class cancer service and get us back to where the international benchmarks say that we should be.

As I am sure Members are aware, responsibility for commissioning radiotherapies was devolved to the integrated care boards. I can understand the logic of moving commissioning closer to local populations. The hon. Member for Westmorland and Lonsdale, who tabled the new clause, and I do not seek to undo that. However, we wish to stress to the House that radiotherapy is not an ordinary local service, and it should not be considered as one. It is delivered from a very limited number of highly specialised centres dependent on capital equipment with long replacement cycles. It relies on a small, highly skilled workforce of about 6,000 people, all of whom take years to train, all the while relying on physical infrastructure that cannot be commissioned at short notice.

Patients routinely cross integrated care board boundaries to reach these specialist centres. Many boards, entirely understandably, do not have dedicated radiotherapy expertise in house. In August 2023, 70% of integrated care boards had no named person responsible for ensuring sufficient radiotherapy treatment capacity at all. I am willing to work with Ministers to seek a resolution with the solutions that we propose.

[Madam Deputy Speaker (Judith Cummins)]

I call the Liberal Democrat spokesperson.

[Helen Morgan (North Shropshire) (LD)]

Yesterday, I highlighted our concerns about the implications of quick-fix, top-down reorganisation for the sovereignty of the NHS and the interests of patients. In a system that already spends too much time and money reacting to failure, rather than planning for success, patient safety is already under threat. Rather than addressing those failings, this Bill is at risk of making a bonfire of patient safety. Our amendments would reverse the gutting of safety mechanisms from the NHS, all of which have been painstakingly introduced after far too many scandals.

Amendments 8 and 9 would restore Healthwatch England and local Healthwatch organisations, while new clause 14 would restore Healthwatch funding after 10 years of cuts to its service. Given that Healthwatch was originally established as a response to the devastating Mid Staffordshire scandal, its abolition would be a step backwards, showing that lessons have not been learned. An independent patient voice is essential to shape local services and highlight where they are not working well, and folding it into existing NHS structures risks destroying the trust that exists precisely because of its independence.

NHS Corridor Care

Judith Cummins Excerpts

Wednesday 8th July 2026 Commons Chamber

[Dr Allin-Khan]

I thank the hon. Member for his intervention. Although it digresses from the debate about corridor care, I will happily answer his question. I think everybody in the NHS must be able to go to work free of intimidation, bullying and harassment. Wherever that happens, people should feel free to speak out—not to their direct line manager, because very often they are involved, but to a safe third party within the hospital, clinic or public setting where it happens, so that they will not be concerned about finding themselves moved or no longer in the job they love. I thank the hon. Member for raising that point; I have gone off topic, but it is an important point to acknowledge.

[Madam Deputy Speaker (Judith Cummins)]

I am sure the hon. Lady understands how much support there is in the Chamber for this debate, and will be coming to a conclusion shortly.

[Dr Allin-Khan]

Thank you very much for raising that, Madam Deputy Speaker—I am nothing if not a talker. I am sorry that I am taking such a long time, and I will move forward quickly with my speech.

The Royal College of Emergency Care and I, as the chair of the all-party parliamentary group on emergency care, have put together a number of recommendations. First, restore patient flow by reducing delayed discharges; secondly, focus equally on four-hour and 12-hour performance; thirdly, reform funding and incentives; fourthly, spread responsibility for patient flow across the hospital; and lastly, address inequalities in access and outcomes. We cannot have a debate like this without recognising the terrible inequalities that scar our healthcare service—we have to work to reduce the disproportionate burden of long waits on deprived communities, older patients and people with mental health needs. Those measures would make a real difference to hospital systems, patient experience, and the overall effectiveness of the NHS.

The founding principles of the NHS are stretched to breaking point every time someone waits for 10 hours, in terrible pain and sometimes in their own urine, under the harsh strip lights of a corridor, unable to feel that they can ask for help. It is completely undignified. The Minister will be very familiar with the stats we have sent to the Department, which show the disproportionate number of deaths in our country that are due to corridor care. The fact that we in the UK have people dying because they have been treated in a corridor is simply unacceptable to me and other Members of this House, so let us commit today to ending it once and for all, and ending corridor care forever.

[Several hon. Members rose—]

[Madam Deputy Speaker (Judith Cummins)]

We will start with an immediate five-minute time limit.

Nottingham Maternity and Neonatal Services

Judith Cummins Excerpts

Wednesday 24th June 2026 Commons Chamber

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

With permission, Madam Deputy Speaker, I will make a statement on the independent review of maternity services at Nottingham University hospitals NHS trust.

Donna Ockenden’s review is the largest into a maternity service in the history of the NHS. The nature and sheer scale of the failings it exposes are horrific. It uncovers dangerously and tragically deficient care at almost every turn. Its findings and conclusions are chilling.

The report covers 13 years, including accounts from 838 members of staff and, crucially, the experiences of 2,536 affected families. I met a small number of those affected families last week, and I felt numb after hearing the depth of their pain. I felt even more numb when I considered how many families not in the room went through such trauma too, and the forgotten children who survived but live every day with the consequences of maternity care failings.

I felt devastated that so many women and babies, as well as their fathers and other family members, had suffered injury, death and lasting trauma while under the care of the NHS. Now having met the families, and having seen the report, I feel appalled by the neglect, incompetence, racism, discrimination, contempt and harassment that so many suffered. I feel heartbroken to know that, so many times, when they tried to raise the alarm about their care, they were ignored, sneered at, disbelieved, blamed and lied to. How on earth could this have happened? There is no single answer, but Donna Ockenden shines a light on what was going on.

First and foremost, women were not listened to. Donna Ockenden says that the staff shortages and lack of training in Nottingham were among the worst she has ever come across. Bullying by doctors and senior midwives was rife, which meant that staff who tried to speak up were intimidated and ridiculed. There was a culture of cover-up at the highest levels of the trust, and there were ineffective and inadequate responses from regulators.

Perhaps most damning of all, for years the trust ignored evidence of clinical and cultural flaws in both internal and external reviews that it had itself ordered. When I met Donna Ockenden last week, she told me that those inquiries were “diligent” and of “good quality” but that they were effectively swept under the carpet by the board. That refusal to act is unforgivable.

Donna Ockenden and her team deserve huge credit for their forensic and compassionate approach, as does my hon. Friend the Member for Sherwood Forest (Michelle Welsh), herself a harmed mother, as well as Members for neighbouring constituencies who have walked side by side with their constituents through years of anguish and struggle.

However, the driving force behind the review has been the affected families themselves. They have demonstrated more patience, more courage and more tenacity than one might imagine is possible from those dealing with broken hearts that will never mend. Though each of their experiences is unique, one feature is common: at the very moment when they were at their most vulnerable, they placed themselves and the lives of their unborn babies in the hands of the NHS—and the NHS failed them catastrophically.

To all those who have suffered so appallingly, I say today, on behalf of the NHS: I am sorry. I am sorry not just for the failures, or the heartless and undignified treatment, but because your cries of concern went unheard for too long—and so the Government will act. We will act by taking immediate steps, including to expand Martha’s rule to all maternity and neonatal settings so that parents can demand a second opinion if they feel their concerns are being ignored.

I know that some people may want me to accept all the review’s recommendations today, but in the past too many recommendations have been accepted and then have sat on a shelf gathering dust, and we have seen more deaths and more suffering. I do not want to let down the families I met in Nottingham, or bereaved parents anywhere else in the country. I want to use the national maternity and neonatal taskforce, which I chair, to create a comprehensive action plan to be published by the end of this year that will address all the national-level recommendations from this review and others. I am confident that work will be welcomed by all those midwives, obstetricians, paediatricians and other healthcare workers who strive every day to make sure that babies are born safely and that women receive outstanding levels of care.

It is clear that, in case after case, families felt that regulators, including the General Medical Council, the Nursing and Midwifery Council and the Care Quality Commission, were more concerned with protecting clinicians than with providing accountability. That is damning and that is wrong. As one grieving mother told me:

“They put the fox in charge of the hen house.”

Clinicians and trust leaders must know that their behaviour will be properly scrutinised and that their actions will have consequences. We must meet the test of the Nottingham victim who told me last week that “accountability drives action”.

We are making changes to the CQC, one of which is to extend the cut-off period to initiate proceedings from three to five years so there is more time for families to bring cases. I will also call in the chair and chief executive of the GMC to hear directly their account of the failures at NUH. Let me be clear: if their response falls short, things will change at the GMC.

From speaking to families in Nottingham, I know that there is real and understandable anger that some leaders and clinicians at the centre of this review were able to avoid giving evidence. Today, I make a commitment that, when passed, we will use the Hillsborough law’s duty of candour to ensure that witnesses in upcoming reviews of maternity service failures, including those in Leeds and Sussex, can be forced to provide evidence. That change will make sure no one is able to refuse to co-operate in the search for accountability and justice ever again.

There is so much in the stories of the families in Nottingham that is shocking and heartbreaking, but the way the bodies of their loved ones were handled by hospital mortuary services revealed a level of disrespect and a lack of humanity that—I will be honest—left me utterly aghast. The details are disturbing, but they need to be heard to understand the gravity of what families were confronted with: deceased babies referred to as a “specimen” or “sample”; a baby placed into a mortuary space already occupied by an unknown and unrelated adult; a baby disposed of as clinical waste against the express wishes of their parents; and a baby kept in a domestic fridge in a bereavement room. The emotional and psychological effect of those dehumanising failures was to layer the most profound disrespect on the most unbearable distress. There is also evidence that the trust actively decided not to report failings in mortuary care to families.

As hon. Members will know, there is an active police investigation and arrests have been made, which limits what I can say. As a start, however, I have asked NHS England to write to trusts to make sure these appalling experiences are not happening elsewhere in the NHS. I confirm today that the Human Tissue Authority will require all mortuaries to review internal records going back 10 years to ensure all incidents have been logged and reported. I have instructed them to report the findings directly to me by 16 October.

When I met the Nottingham families last week, they also raised with me the issue around what are known as secondary victims. In maternity settings, fathers, partners and others are actively encouraged to be present to support mothers through labour and delivery. However, the law does not allow them to bring their own claims for the psychiatric illness suffered as a direct result of witnessing their partner or baby suffer injury or die. I have therefore asked David Lock KC to work with my officials to consider that important issue as part of his wider work on clinical negligence.

Donna Ockenden acknowledges that NUH has not waited for her findings to be published to start making improvements. I will speak to the chief executive next week to interrogate the trust’s response and make sure there is a proper plan in place for implementing the recommendations speedily and effectively. But there is a long road ahead before NUH fully addresses all the issues and before it can possibly regain the full trust and confidence of the communities it serves.

I close where I began: with the families. Nothing can make up for what they have gone through, but this report is a tribute to their resilience and tenacity. I say to them directly: you had to drive this for so long, but you are no longer driving this alone. We are with you and we will not stop until you have the accountability and the justice you deserve. I commend this statement to the House.

[Madam Deputy Speaker (Judith Cummins)]

I call the shadow Secretary of State.

--- Later in debate ---

[James Murray]

I thank my hon. Friend for her questions. Let me put on record again how much I have appreciated her advocacy, her support, her sharing of her own experience and her standing up for the many hundreds of families in the area she represents. Her contribution is invaluable to this most important work that we are doing as a Government. She talked about families driving this report and making sure that it happened, and she is absolutely right. I met some of those families last week in Nottingham, and as well as feeling numb at the depth and breadth of their pain, the feeling I left with was a sense of their exhaustion at having fought for so long to be listened to and to get this into the open. Our responsibility as a Government and as MPs is to say that, now it is out in the open for us all to see, we all bear a responsibility to help them carry this forward. I take that responsibility with the utmost seriousness.

My hon. Friend asked about a plan to change maternity services in Nottingham and across the country. There will be specific local recommendations in Nottingham, and I am meeting the chief executive of the trust next week to pick that up directly with him, but there are more recommendations in the report that will have national implications, along with the recommendations from the national review that is under way. It is crucial that all those recommendations are formed into a plan of action, and the taskforce that I chair will be crucial in making sure that these recommendations do not just get accepted and then sit on a shelf gathering dust, but form a plan of action that we can stand behind as a Government.

Finally, my hon. Friend mentioned the importance of action, accountability and change. I repeat what I said in my statement: one of the phrases that stuck with me powerfully from my meeting with Nottingham families last week was from the person who said that “accountability drives action”. Without that accountability, we cannot have a guarantee of action. That is why the accountability that the families seek is the change that we as a Government must seek to deliver.

[Madam Deputy Speaker (Judith Cummins)]

I call the Liberal Democrat spokesperson.

[Helen Morgan (North Shropshire) (LD)]

May I start by acknowledging the hon. Member for Sherwood Forest (Michelle Welsh), Donna Ockenden and the Secretary of State for the statement and for their hard work? I thank the Secretary of State for the actions that he has proposed so far, which I think are the first tangible actions we have heard in this place. I must also acknowledge the incredible courage and resilience of the Nottingham families who have been instrumental in bringing about this review. No one can imagine the pain that they have gone through.

I am distressed and angry to be stood here once again speaking about babies who should not have lost their lives, mothers who should not have lost their lives and trauma that families should not have experienced. Review after review has led to 748 recommendations since 2015, but birth injury and mortality rates have continued to rise. These reviews all reveal similar issues: unsafe staffing levels, lessons not learned, issues not escalated, insufficient training, and women’s concerns ignored.

Four years ago, after the Shrewsbury review, we found that over 200 babies had died unnecessarily in Shropshire, yet things have got worse. Donna Ockenden’s Nottingham report reveals new and extremely distressing revelations about serious failures to protect the dignity of the deceased in after-death care, something that must be addressed through proper regulation.

Liberal Democrats have put forward a maternity rescue package that would guarantee one-to-one midwifery care and introduce a national maternity commissioner to oversee vital improvements. It would be nonsensical for the Government not to take a strategy forward. Will the Secretary of State pledge to implement every single one of the Nottingham report’s essential actions, and to work with us to deliver the essential investment we need to make Britain a safe place to have a baby, and end this shocking cycle of failure? Anger is not enough. Mothers, doctors and midwives are sick of seeing review after review and being met with stasis, with the same failures repeated over and over again. This must be the moment we say, “Enough.”

--- Later in debate ---

[James Murray]

I thank my hon. Friend for his comments and questions, and I echo his words about paying tribute to the courage, dignity and determination of the families who have driven the report and driven these shocking failures out into the open, so that we can all see the scale and depth of what has happened. He asks me about embedding the lessons from the review. I assure him that my priority is to ensure that the local lessons around the situation in Nottingham are embedded, and I will meet the chief executive of the trust next week, but also that those recommendations that have implications about national maternity services are taken directly into the taskforce that I chair, along with recommendations from other reports, and that we produce that plan of action by the end of the year. Let me also reassure him that, in that search for change, justice and accountability, I will take nothing off the table.

[Madam Deputy Speaker]

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

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

I, too, pay tribute to those families who came forward with their stories, but also to the thousands, if not tens of thousands, of families across the country who are hearing these stories today and are triggered because it reminds them of their own, including in my area in Oxfordshire.

What struck me most about the report was the section on leadership and culture, and how when midwives and members of staff raised the alarm, they did not have access to the board, and board members were not curious enough to ask the right questions. I am also struck that in the Secretary of State’s answers—he is right to point to the national recommendations that are yet to come; our understanding is they are coming next week—he failed to mention whether there will be any pot of money to ensure that any recommendations that need double-running in order to happen quickly will have the necessary resources. Can he assure the House not only that will his taskforce seek to implement these recommendations, but that he will ensure that the money exists for staffing, training and buildings so that they are implemented as quickly as possible, so that we do not have to sit here crying on these Benches on behalf of our constituents any more?

Health Bill

Judith Cummins Excerpts

2nd reading
Monday 1st June 2026 Commons Chamber

[James Murray]

I am going to make more progress.

Alongside the removal of confusion and duplication at a national level, the Bill also gives those with local expertise the power, resources and flexibility they need to design and deliver health and care services for their area. The Bill will empower them to innovate, drive progress and do what is in the best interests of the patients they serve.

Under the Bill, ICBs will have more direct responsibility for their services than ever before. They will be at the heart of integrating health and social care, and they will include those people responsible for housing, transport and jobs, so that we can tackle the root causes of ill health, which is better both for patients and for the NHS.

The NHS gave me a second chance at life, and so as Health Secretary I will fight for the NHS every day with the strength it has given me back. The Tories ran down the NHS through 14 years of neglect, and the Lib Dems enabled them. Reform wants to abolish the NHS altogether and replace it with an insurance-based system. The Greens seem intent on ignoring clinical advice and have no practical solutions for the health service. Only Labour has a plan to get the NHS back on its feet. Only Labour is determined to both invest in and fundamentally transform the NHS for the future. Only Labour is showing that change is possible.

We promised to cut waiting lists—we delivered the biggest annual fall in 16 years. We promised an extra 1,000 GPs in our first year—we delivered twice that number. We promised 8,500 more mental health staff by 2029—we have delivered them three years early. We promised 700,000 more NHS dentistry appointments—we have delivered an extra 1.8 million already.

We promised to transform the NHS for the future, and that is what this Bill will do. We are already boosting investment in the NHS where it needs more. We have begun stripping out bureaucracy from the NHS where it needs less. And now we will build a truly modern NHS that will be there for generations to come. The Bill is the next crucial step in our mission, and I commend it to the House.

[Madam Deputy Speaker (Judith Cummins)]

I call the shadow Secretary of State.

--- Later in debate ---

[Several hon. Members rose—]

[Madam Deputy Speaker (Judith Cummins)]

Members will have noticed that about 50 Members want to speak in the debate, so with the exception of Front Benchers I will be starting with an immediate six-minute time limit.

[Andy McDonald (Middlesbrough and Thornaby East) (Lab)]

May I begin by welcoming the Secretary of State to his place and wishing him well in the responsibilities that he carries on behalf of patients, NHS staff and communities across the country? I welcome the Bill and its intention to improve patient care through investment, modernisation and better integration across the health service.

It is right to acknowledge the progress made on waiting times and waiting lists since Labour returned to government, with the overall waiting list falling significantly and long waits continuing to come down, but may I add my voice to those of others about the appointment of a chair for the Tees, Esk and Wear Valley inquiry? My right hon. Friend the Member for Ilford North (Wes Streeting) gave that commitment, which we were pleased to hear, but we have yet to see that chair appointed. If that could be given attention, we would be most grateful.

I remain concerned about the continuing impact of historic private finance initiative costs on NHS trust budgets, including the pressures facing South Tees hospitals NHS foundation trust in my patch. Too much money is still being diverted from frontline care. I regret that this issue remains unresolved.

The principal reason I rise today is as chair of the all-party parliamentary group on spinal cord injury. Last summer, the APPG’s inquiry into spinal cord injury services reached a clear conclusion: the evidence points to the need for more national co-ordination, not less. Spinal cord injury is a low-volume but highly complex condition requiring specialist pathways, lifelong rehabilitation and co-ordinated support, yet the inquiry heard repeated evidence of fragmented services, postcode variation, delayed rehabilitation and patients being lost within the system. The APPG therefore called for a national strategy and a modern service framework for spinal cord injury care. As we intend to hold a lived experience roundtable shortly, I invite the Health Secretary to come and meet people with spinal cord injury to hear their concerns about the proposed changes to commissioning.

We welcome the excellent constructive engagement from the Under-Secretary of State for Health and Social Care, my hon. Friend the Member for Washington and Gateshead South (Mrs Hodgson), and NHS England officials, but we remain deeply concerned about proposals to transfer spinal cord injury commissioning from national oversight to integrated care boards. Indeed, NHS England’s own evidence to the inquiry emphasised national standards, national quality metrics and nationally co-ordinated pathways, quality measures and oversight. If national consistency has not yet been achieved under national commissioning, what evidence demonstrates that transferring responsibility to multiple ICBs will improve outcomes or equity?

What is at stake is not abstract. When somebody sustains a spinal cord injury, their life changes overnight. They may require specialist rehabilitation, housing support, benefits advice, mental health support and long-term clinical care. Patients and families should not be left to navigate a fragmented system alone. That is why I welcome the ambition behind the single patient record and Diagnosis Connect.

Connecting newly diagnosed patients directly to specialist support reflects one of the APPG’s recommendations. Organisations such as the Spinal Injuries Association help people rebuild their lives after life-changing injury. I hope that Ministers will consider including spinal cord injury within the early phases of Diagnosis Connect.

The question is not whether structures change on paper; it is whether people living with spinal cord injury will experience safer, more equitable, more co-ordinated care. I hope that the Secretary of State will answer some straightforward questions. If NHS England accepts that national consistency has not yet been achieved, what evidence shows that localised commissioning will improve it? How will national standards, benchmarking and quality oversight remain coherent under a fragmented arrangement? Do the Government accept that spinal cord injury differs fundamentally from standard population health commissioning because of its low volume, high complexity and cross-boundary nature? What safeguards will prevent widening regional inequity, if accountability is dispersed across multiple ICBs?

The APPG’s inquiry concluded that spinal cord injury services require stronger national co-ordination and oversight, not greater fragmentation, and I hope the Government will reflect carefully on that evidence. This country led the world in spinal cord injury provision under the leadership of Professor Ludwig Guttmann after the second world war, with the remarkable work that he achieved. We need to return to those days of being pioneering and world-class. As a lawyer who previously practised in this area, I am afraid that over the past several decades services have deteriorated and gone backwards. We must restore those services and bring trust to people who so desperately want reassurance that there is a national system for them to rely on that will address their needs. We are currently not in that place at all. The Bill is an opportunity to address that, and I trust the Minister will take that on board.

[Madam Deputy Speaker (Judith Cummins)]

I call the Liberal Democrat spokesperson.

--- Later in debate ---

[Wes Streeting (Ilford North) (Lab)]

That was a characteristically thoughtful speech by the hon. Member for Runnymede and Weybridge (Dr Spencer). It is also a particular pleasure to follow my hon. Friend the Member for Glasgow South West (Dr Ahmed), who was an outstanding Minister in the Department of Health and Social Care and has demonstrated again today why his expertise and integrity are highly valued on the Government side of the House.

I strongly supported the speech made by the Secretary of State. He has hit the ground running, and he knows that he has my full-throated and wholehearted support. He does not need a predecessor being a back-seat driver—something that I am sure the Prime Minister feels about one or two of his predecessors after recent days. I also thank the Minister of State for Health, my hon. Friend the Member for Bristol South (Karin Smyth), for her leadership on the Bill, and the brilliant team of officials, who have worked exceptionally hard to prepare the Bill for its introduction.

It will come as no surprise to anyone that I strongly support the Bill. The latest NHS waiting list figures show the biggest cut to NHS waiting lists for 17 years, and as we heard from the Tories today, they cannot stand it. They cannot stand that within less than two years we have done something that they failed to achieve in 14: lowered waiting lists. Waiting lists are shorter than when we came in—lots done, and lots more to do, but the numbers are there. Despite record levels of demand and strike action by the British Medical Association, we delivered record levels of activity and waiting lists are falling. That is the difference that a Labour Government make.

To understand how and why this happened is to understand why the Bill matters. Those who claim that recent improvements in NHS performance are simply the result of more money are making exactly the same mistake that held the NHS back for years under the Conservatives. Investment matters—of course it does—but, as the Secretary of State outlined, we are combining investment with reform. We are embracing technology, cutting bureaucracy, improving productivity and changing how care is delivered—from cutting £1 billion from spend on agency staff to funding GPs to treat more patients in the community, equipping NHS staff with the latest AI tools, and sending crack teams of top clinicians to bust the backlogs in hospitals with the most patients off work sick. Every single change has been opposed by vested interests, but that is why we are seeing more patients treated and better value for taxpayers. That is the difference between managing decline and delivering change.

For all our progress, we know that there is so much more to do. Too many people are still waiting too long. Too many staff are working against systems that make their jobs harder, not easier. Too many patients have to tell their story over and over again. Too much money is trapped in bureaucracy when it should be reaching the frontline. Too often, accountability is blurred between two different headquarters or two different boards, bodies and acronyms that the public do not know and cannot hold to account. This Bill is the NHS modernisation Bill, and it addresses every single one of those challenges, giving expression to the principle that the NHS should be run for the patient, not the other way around.

The Leader of the Opposition recently claimed that we have not kept our promise to abolish NHS England. In fact, we have already started: 7,000 posts removed from ICBs, and 4,500 more posts going from NHS England and the Department of Health and Social Care. I know that those changes are not easy for the people affected, and I never treated them lightly, but abolishing NHS England is about cutting duplication, reducing bureaucracy and putting responsibility for the NHS where it belongs: with elected Ministers who are accountable to the public.

Every pound wasted on administration is a pound that could be spent on patient care. That is why we are stripping out unnecessary layers and directing more resources to the frontline. Hearing the opposition from Conservative Front Benchers, it is no wonder that they presided over such a bloated bureaucracy. This Bill will save money, but they never once asked how much it would cost to pile on layer after layer of bureaucracy, saddling the NHS with top-heavy management, which frustrated patients and really frustrated staff.

Some will say that there is a contradiction: that centralising accountability and giving patients more control over their own data pull in opposite directions. But that is precisely the point. For too long, power in the NHS has sat in a no man’s land—an accountability sink, too distant from patients and citizens to be meaningful and just far enough away from Ministers that there is plausible deniability when things go wrong. The Bill takes back power in order to give it away: accountability for Ministers where it belongs, and power for the patient where it belongs, too.

The Government must face down powerful producer interests on patient data. Our health data is precious. Two things matter above all else: that our data is held securely and that it is used ethically. However, the single patient record is one of the most important reforms of the NHS for decades. It is frankly unsafe, as well as absurd, that patients are still being asked to repeat their medical history every time they access a different service. We also have to take on the producer interest of those who think patient data belongs to them rather than to patients. Our health, our data, our NHS—patients should control who can access their data, and they should control their own data.

By all means let us scrutinise the Bill and suggest improvements, but do not slow it down. The NHS does not have time to waste. The NHS is on the road to recovery, and this Bill puts the foot down on the accelerator.

[Madam Deputy Speaker (Judith Cummins)]

I call the Chair of the Health and Social Care Committee, after whose speech there will be a four-minute time limit.

--- Later in debate ---

[Paulette Hamilton (Birmingham Erdington) (Lab)]

As someone who has worked in the NHS for 25 years as a district nurse and who has been involved in integrated care systems in Birmingham and Solihull since the very beginning, I will focus my contributions on three areas of the Bill: health inequalities, patient voice and integrated care boards.

Let me start by saying that I support the principles of the Bill. My constituents want services that work better. They want care that is easier to access closer to home and properly joined up, and parts of the Bill help to support that ambition. I want a focus on neighbourhood health plans and shifting more care into communities. Some of the best healthcare happens in people’s homes, in clinics and through early intervention before problems become a crisis. That is why the investment in Stockland Green health centre in my constituency in Birmingham matters so much to my residents and to me. It represents the right ambitions: shifting care into the heart of the community, bringing services together locally and making healthcare more accessible for residents in Birmingham Erdington. The principle of that is absolutely right.

My concern is that parts of the Bill risk moving us away from the original purpose of integrated care. Integrated care systems were created because health is shaped by far more than hospitals alone. I am concerned that the Bill risks moving us away from that local collaborative model and towards something far more centralised. As a former cabinet member on Birmingham city council with governance responsibility for health and social care and public health, and as the chair of Birmingham health and wellbeing board, I know how important local government involvement is in these decisions, yet under these proposals, somebody in that position would not automatically have a seat around the table—they would have to compete for it.

I believe the Bill should protect three things in relation to ICBs: genuine local partnership, a combined focus on health inequalities and prevention, and a strong focus on place, reflecting the needs of local communities like mine. One of my biggest concerns about the Bill is the reduction in independent patient representation, including the abolition of Healthwatch structures. If patient voice is weakened at the same time that local representation is reduced, there is a real risk that health inequalities become even less visible within the system, and we cannot allow that to happen.

The ambition to improve joined-up care and strengthen community healthcare is the right direction of travel. I simply ask the Government to keep a close watch on local representation and patient voice as these changes are implemented. Patient voice must not be lost and health inequalities must not increase. ICBs should not be used as a vehicle to reorganise NHS management structures.

[Madam Deputy Speaker (Judith Cummins)]

I will call a Member on the Opposition Benches, and then I will reduce the time limit to three minutes.

--- Later in debate ---

[Gideon Amos (Taunton and Wellington) (LD)]

This Bill contains welcome elements, such as creating a single patient record and enabling integrated care boards to become commissioners across a wider area. However, I cannot support the weakening of patient voices, nor removing local authorities from oversight of health trusts. I pay tribute to Gill Keniston-Goble and her team at Somerset Healthwatch for all the fantastic work they have done.

In moving to a single patient record, we need to prioritise privacy and rethink putting the American firm Palantir in charge of our data, with its founders such as Thiel opposing democracy and denigrating our NHS as part of a “Stockholm syndrome”. My constituent, whose family member was brutally murdered, is rightly horrified that victims’ NHS records were shared unlawfully online with NHS workers—she called it “repugnant voyeurism”, and she was right to do so. I hope the Minister will echo the apology of the trust and condemn that kind of behaviour.

However, none of the reforms in the Bill will have a positive impact on patients or staff in Taunton and Wellington who use the maternity and paediatric department until and unless the promised new unit is brought forward. One of my constituents, Jeff, told me of their grandson Ryan, who was admitted to the ward a couple of weeks ago. The lack of air conditioning meant that temperatures there exceeded 30°C over the past week—no wonder medical staff have fainted in the heat while looking after mothers and children who are baking in single-storey flat-roof buildings—buildings that were put up for the United States army as a temporary measure during the second world war and never replaced.

As Jeff put it,

“Walking down the corridor of the old building is an embarrassment. There are literally sheets of plastic attached to the leaking ceilings running into guttering in the corridor”.

I do not need my architectural training to know that guttering should be on the outside of the building, not the inside. It is therefore unsurprising that the previous Secretary of State, the right hon. Member for Ilford North (Wes Streeting), when challenged on BBC Radio Somerset only a month ago, promised that he would speed up the Musgrove Park hospital project if he could. I hope the new Secretary of State will honour his predecessor’s promise to meet me to discuss that.

The Bill is based, at least in part, on the mission to move from treatment to prevention, which is of course the right ambition. Because of its major teaching hospital status, Taunton has a big medical community who know a thing or two about prevention, and I will highlight two areas in which this Bill should be going further on prevention. On prostate cancer, I hope the Government do not decide to hold back from widespread screening, as a recommendation to do so is before them. As a member of a family in my constituency recently hit by that disease told me,

“I am a recently retired doctor and I do not believe the statistics that have been published, with the emphasis being placed on over-investigating patients and the distress this causes. This pales into insignificance compared to a missed diagnosis.”

Finally, more should be done to reform the dental contract. Unless the Bill leads to more NHS dentists, social care reform and better prevention—

[Madam Deputy Speaker (Judith Cummins)]

Order.

Allied Health Professionals

Judith Cummins Excerpts

Thursday 23rd April 2026 Commons Chamber

[Relevant documents: Oral evidence taken before the Health and Social Care Committee on 26 November 2025, on Delivering the Neighbourhood Health Service: Workforce, HC 1527; and correspondence from the Health and Social Care Committee to the Minister of State for Health, on the NHS 10 Year Workforce Plan and Neighbourhood Health, reported to the House on 7 January.]

[Madam Deputy Speaker (Judith Cummins)]

I call Jen Craft, who will speak for up to 15 minutes.

GP Contract

Judith Cummins Excerpts

Monday 16th March 2026 Commons Chamber

[The Minister for Care (Stephen Kinnock)]

When we came into office, we found GP services in an appalling state—underfunded, understaffed and in crisis. Since July 2024, this Government have been fixing the front door to the NHS, investing more than £100 million to fix up GP surgeries this year, making online booking available to patients across the country and recruiting 2,000 more GPs who are now serving patients on the frontline. Following investment in advice and guidance, we have seen 1.3 million diverted referrals since April 2025. Those are people who would have otherwise been added to the electives waiting list. A lot has been done, but there is a lot more still to do. We are determined to make the system fairer for coastal communities and deprived areas, so we have launched a review into the Carr-Hill formula to close the gap on health disparities and ensure that funding is targeted on the basis of need. We will shortly update the House in the usual way on our Carr-Hill review.

Last year’s GP contract saw the biggest cash increase in more than a decade, and this year we are investing an additional £485 million, taking the total investment made through the contract to more than £13.8 billion this financial year. Investment must always be combined with reform, so the new contract will improve access for patients by requiring that all clinically urgent requests are dealt with on the same day. It will provide a mechanism to hire even more GPs via a new practice-level reimbursement scheme, and it will support the shift from treatment to prevention, as set out in our 10-year plan, through incentives to boost childhood vaccination rates, better care for patients living with obesity and requiring GPs to share data with the lung cancer screening programme.

These ideas were not cooked up by someone sat behind a desk in Whitehall. What is happening is that we are taking the best of the NHS to the rest of the NHS, working with pioneering practices that have been doing these things for a long time. Today we can see that our policies are working, and after years of decline in general practice, we are getting the front door back on its hinges. Patient satisfaction with general practice is finally moving in the right direction. According to the Office for National Statistics, almost 77% of people described contacting their GP as easy in January this year, up from just 60%, where it was languishing in July 2024. I know that when he gets up, the hon. Member for Hinckley and Bosworth (Dr Evans) will hugely welcome, as will his hon. Friends, the progress that we are making.

[Madam Deputy Speaker (Judith Cummins)]

I call the shadow Minister.

[Dr Evans]

The Health Secretary and his team have perfected the sales pitch for NHS reform. The problem is that the detail never seems to arrive. We have seen a 10-year health plan with no delivery chapter, and a plan for the abolition of NHS England with no price tag; the Health Secretary has announced 10 new “straight to test” referral pathways, but could not name a single one; and now we are seeing a new GP contract with more questions than answers.

Calling something modernisation does not make it reform. If the rules and the delivery are unclear, it is simply confusion with branding. “Advice and guidance”, for example, appears in practice to create a single point of access for referrals. GPs will no longer be able to refer patients directly to a consultant, even when they believe that it is clinically appropriate. Will the Government publish the clinical evidence supporting that approach? Who will carry the legal responsibility if, in a GP’s professional judgment, a patient needs to see a consultant but must first go through “advice and guidance”? If advice and guidance becomes mandatory as an extra layer before referral, are the Government not, in essence, managing the waiting list by keeping patients in primary care rather than treating them in secondary care? Waiting lists will look shorter on paper, but patients are simply waiting elsewhere in the system. Can the Minister clarify exactly where those patients will appear in the official waiting list figures? The contract also requires patients whose cases are deemed “clinically urgent” to be dealt with on the same day, but it does not define “urgent” or explain what “dealt with” means, and that really matters.

Let me therefore ask the Minister three clear questions. First, when will the Government publish the clinical definition of “urgent”—a patient’s sick note is urgent for the patient, but not clinically urgent—and what counts as a patient’s being “dealt with” on the same day? Secondly, the Minister has talked about access, but how can practices guarantee same-day responses when demand is uncapped and definitions are not published? Finally, with advice and guidance being required as a mandate beforehand, how will we ensure that patients are protected, and where will they appear on the waiting lists?

--- Later in debate ---

[Stephen Kinnock]

The Carr-Hill review is happening as we speak, and I expect to get a submission from officials on the first round of analysis that is being conducted by the National Institute for Health and Care Research. That will be the first step towards agreeing on how we make the formula work, with a view to implementing the new Carr-Hill formula from 1 April 2027.

[Madam Deputy Speaker]

I call the Liberal Democrat spokesperson.

[Helen Maguire (Epsom and Ewell) (LD)]

I welcome the fact that the Government have adopted our policy of seeing clinically urgent patients on the same day, but patient safety has been put at risk by increasing workloads, according to members of the Royal College of General Practitioners. One in five patients has been forced to wait at least two weeks for an appointment. Although the Government’s funding of 1,600 new GPs is welcome, it is insufficient to deliver the required shift to community care. The Health Foundation says that an additional 6,500 GPs will be needed by 2031, and the Liberal Democrats would provide 8,000. What is the Minister doing to address the shortfall? Residents in Epsom and Ewell, who already struggle to get a GP appointment, are concerned that increased housing will make it even harder. What is the Minister doing to ensure that there is funding for GP buildings, as well as GPs?

I welcome the Government’s focus on the obesity crisis, but it does not fix the root cause. Aside from the junk food ban, what steps are the Government taking to encourage children and young people to create active and healthy habits for life from an early age?

National Cancer Plan

Judith Cummins Excerpts

Thursday 5th February 2026 Commons Chamber

[The Parliamentary Under-Secretary of State for Health and Social Care (Ashley Dalton)]

With permission, I will make a statement on the Government’s national cancer plan for England.

A cancer diagnosis changes you forever. When I was diagnosed with metastatic breast cancer 18 months ago, I did not know whether I would be alive today, never mind standing at this Dispatch Box announcing a national cancer plan, but one year ago almost to the day, the Prime Minister asked me to do just that. Since the Government took office, over 212,000 more people are getting a cancer diagnosis on time, over 36,000 more are starting treatment on time, and rates of early diagnosis are hitting record highs. Despite those vital signs of recovery, though, the NHS is still failing far too many cancer patients and their families. That is why first and foremost, this plan is a break with the failure of the past 15 years.

In 2011, the coalition Government published “Improving Outcomes: A Strategy for Cancer”. That strategy was followed in 2016 by “Achieving world-class cancer outcomes: a strategy for England”. In 2019, the long-term health plan for England made cancer a priority and included a headline ambition to diagnose 75% of cancers at stages 1 and 2. However well-intentioned they were, not one of those strategies has lived up to its promises. Cancer mortality rates in the UK are much higher than in other, comparable countries, while survival rates are much lower. Cancer incidence is around 15% higher than when the 62 day standard was last met, and working-class communities are being failed most of all. The most deprived areas, including rural and coastal communities, often have fewer cancer consultants, leaving patients waiting longer. This all adds up to the chilling fact that someone living in Blackpool is almost twice as likely to die young from cancer than someone living in Harrow. Wherever in our country a person lives, they deserve the same shot at survival and quality of life as everyone else. Wealth should not dictate their health, and neither should their postcode.

Behind these statistics are real people. I have heard from those whose care lacked empathy and dignity, from those whose cancer was missed or whose test results were lost, from those who were passed from pillar to post and kept in the dark about their condition, and from those whose loved ones died before their turn came for surgery because the wait was too long. Those experiences are unacceptable—they are devastating. From day one, I was determined to put their voices front and centre of our plan. Over the past year, we have listened to and learned from cancer charities, clinicians and, most importantly, patients and their families. Every action is a response to someone’s lived experience. Every commitment is a promise to transform someone else’s life. Their stories have become the blueprint to make the biggest improvement in cancer outcomes in a generation.

Three major themes stood out from the 11,000 responses to our call for evidence, some 9,000 of which came from patients and their carers: core performance standards, improved survival, and quality of life after diagnosis. Those are not radical ideas, but unlike previous strategies, this plan is not limited to incremental improvement. Instead, it is an ambitious, bold plan to save 320,000 more lives by 2035, which will be the fastest rate of improvement this century. We will do that by modernising the NHS, harnessing the power of science and technology, putting our patients at the front of the queue for the latest medicines, and helping them to live well after diagnosis, not least for people diagnosed with stage 4, metastatic and incurable cancers—people like me.

How do we get there? We are placing big bets on genomics, data and artificial intelligence, as set out in our 10-year plan for health. We will hardwire the three shifts of our 10-year plan into cancer pathways. First, on moving from analogue to digital, we heard from patients about the importance of clinical trials, so we will make the UK one of the best places in the world to run a trial with a new cancer trials accelerator. We will start people’s care earlier using liquid biopsy tests, which can return results up to two weeks faster than conventional testing. We will harness AI to read scans, plan radiotherapy and identify the right path for each patient. We will harness genomics so that every eligible patient has access to precision medicines. We will harness data to make sure that all metastatic disease is counted properly—starting with breast cancer—so that people with incurable cancer are properly recognised and supported. When people are not counted, they feel like they do not count, but we will end that.

Innovation will also help us fight inequalities and make the shift from sickness to prevention. We will turn the NHS app into a gateway for cancer care. By 2028, it will host a dashboard for cancer prevention, with access to tests and self-referral. By 2035, it will bring together genomic and lifestyle data with the single patient record to advise every patient according to their risk. That will benefit people in rural and coastal communities who can find it difficult to access specialist care simply due to geography.

Finally, we will use the neighbourhood health service to make the shift from hospital to community. That will mean more care, from prehabilitation to recovery support, delivered closer to home. We will help people live well with cancer through tailored support closer to home. People will be given personal cancer plans, named neighbourhood care leads and clear end-of-treatment summaries so that no one feels abandoned after their treatment.

For too long, those with rarer cancers have seen little to no progress for many of their conditions. They told us we need a special focus on these cancers, and our plan sets out how they will benefit from the deployment of genomics, early detection and the development of new treatments. That was asked for by patients and will be delivered by this Government. I pay tribute to my hon. Friend the Member for Mitcham and Morden (Dame Siobhain McDonagh) for her campaigning in memory of her late sister Margaret. We should also remember that the late Tessa Jowell raised this issue in 2018, and her family have campaigned ever since.

Our plan also gives pride of place for children and young people. We will improve their experience of care at every level, from hospital food to youth worker support and play support. I pay tribute to my hon. Friend the Member for Leyton and Wanstead (Mr Bailey) for his campaigning on that point. Our children and young people cancer taskforce asked for support with travel costs, because when someone’s child has cancer, the last thing they should worry about is how they will pay for their train ticket. Today, I can announce that we will fund those travel costs.

Alongside rare and less common cancers, we will make research for children and young people a national priority. I take this moment to thank the children, young people and families who made up our children and young people cancer taskforce. It was a pleasure and a privilege to meet them earlier this week. I thank the many families and loved ones of people lost too soon who continue to fight to make change for others. I am so grateful to them, and I want people to hear their voices as they read the plan, because it is rooted in the voices of patients, families, clinicians and charities. It will turn cancer from one of this country’s biggest killers into a chronic condition that is treatable and manageable for three in four patients. It delivers the ambition of the 10-year health plan, embodies this Government’s three shifts and sets a clear path towards earlier diagnosis, faster treatment and world-leading survival rates by 2035.

This plan does not belong to the NHS, and it does not belong to the Government; it belongs to us all. We all must play a part in making it work. Over the past year, I have met the patients, families, carers, clinicians, researchers, cancer charities and voluntary groups who all contributed to our plan. This Government is on their side. We wrote this with them, and we cannot deliver it without them. Let us do it together. I commend this statement to the House.

[Madam Deputy Speaker (Judith Cummins)]

I call the shadow Secretary of State.

--- Later in debate ---

[Ashley Dalton]

I thank my hon. Friend for his question, for his expertise and for all that he has shared from his experience to help us develop this plan. I note how important specialist nurses are, but we are also doing more to help people navigate the NHS. I know exactly what it is like; I think I have in my Filofax—I am that retro!—about 38 email addresses and phone numbers of the various people I have to contact in order to project manage my treatment. We are going further and ensuring that the NHS app can handle all that information. Cancer patients will have the ability in their hands, or in their pockets, to manage scans, appointments and test results directly through the NHS app.

I am delighted to say that my hon. Friend the Minister for Technology, Innovation and Life Sciences is already looking at the issues that my hon. Friend the Member for Sheffield South East (Mr Betts) raises around blood products and donations, and is working with the Anthony Nolan trust on those. I will be more than happy to work with my hon. Friend further on those issues.

[Madam Deputy Speaker (Judith Cummins)]

I call the Liberal Democrat spokesperson.

[Helen Maguire (Epsom and Ewell) (LD)]

I thank the Minister for advance sight of the statement and for her personal experience that has gone into this plan. After the Conservatives failed to invest in our NHS, it is no surprise that cancer survival in the UK is still around 10 to 15 years behind leading countries, with worse survival rates for some cancers than Romania and Poland. I am therefore pleased that this Government listened to my hon. Friend the Member for Wokingham (Clive Jones) and brought this national cancer plan to life, because cancer touches everyone.

One of my residents, a mum with a young family, discovered a lump in her breast. Despite attending the one stop breast clinic on four separate occasions, it took two horrendous years for her to be diagnosed with breast cancer. When she was finally diagnosed, the cancer was aggressive and required a mastectomy, chemotherapy and radiation therapy. That is why I welcome the Government’s target on meeting all cancer wait time standards by 2029, but the aim to halve the backlog in three years’ time is not ambitious enough. Will the Minister go further and back a Liberal Democrat plan to write into law a guarantee for all cancer patients to start treatment within 62 days from urgent referral?

The focus on ending delays in cancer care is a step forward, but funding 28 new radiotherapy machines is not enough when the treatment is so cost effective and successful. We need to end radiotherapy deserts, so will the Minister extend her ambition to 200 extra radiotherapy machines?

The Minister says that the plan will turn the NHS app into a gateway for cancer care, but how will she support older people and the digitally excluded? The plan promises to drive up productivity, end the postcode lottery, expand NHS diagnostic capacity, introduce personalised cancer plans and more. That is optimistic and will require more investment to increase NHS capacity, but without clear funding and capacity building plans, is it realistic?

Labour was right to put patients at the heart of this plan and incorporate the Liberal Democrat’s calls for a specialist cancer nurse for every patient. We costed for 3,000 extra cancer nurses; how many additional cancer nurses does the Minister believe are needed?

Finally, will the Minister confirm that the plan’s annual summary of progress will be reported in the House for Members to scrutinise?

--- Later in debate ---

[Several hon. Members rose—]

[Madam Deputy Speaker (Judith Cummins)]

Order. Members will know that this statement is on a very important, sensitive and sometimes personal subject, but I remind them that after this we have two debates that are also important, so please keep questions short.

[Martin Vickers (Brigg and Immingham) (Con)]

Further to the exchanges about radiotherapy, I understand that the national figure for access to radiotherapy is 53%, which itself does not seem particularly high. However, the figure for my Brigg and Immingham constituency, which falls in the Yorkshire and the Humber region, is only 35%. Could the Minister give some assurance to my constituents about progress on increasing that figure, and when does she think we can reach the national average?

Medical Training (Prioritisation) Bill

Judith Cummins Excerpts

Committee of the whole House & 3rd reading
Tuesday 27th January 2026 Commons Chamber

[Judith Cummins in the Chair]

[The First Deputy Chairman of Ways and Means (Judith Cummins)]

I remind Members that in Committee they should not address the Chair as “Deputy Speaker”. Please use our names. Madam Chair, Chair or Madam Chairman are also acceptable.

Clause 1

UK Foundation Programme

Question proposed, That the clause stand part of the Bill.

[The First Deputy Chairman]

With this it will be convenient to consider:

Amendment 6, in clause 2, page 1, line 16, at end insert—

“(e) persons within subsection (3),”.

This is a paving amendment for amendment 7.

Amendment 7, page 2, line 6, at end insert—

“(3) A person is within this subsection if they—

(a) were actively employed as a doctor in the NHS or Health and Social Care Northern Ireland on 13 January 2026; and

(b) had submitted a valid application for a UK specialty training programme for a start date in 2026 before the day on which this section comes into force.

(4) For the purposes of subsection (3), “actively employed” includes, but is not limited to, persons on fixed-term Trust Grade, Clinical Fellow or Staff, Associate Specialist and Specialty Doctor contracts.”

This amendment would require applications to specialty medical training in 2026 from those already employed in the NHS to be prioritised.

Clause 2 stand part.

Clause 3 stand part.

Amendment 10, in clause 4, page 3, line 2, at end insert—

“unless that time was spent outside the British Islands as part of a posting with the UK armed forces.”

This amendment would include within the definition of a UK medical graduate anyone who spent all or part of their training on a military posting outside the British Islands.

Amendment 9, page 3, line 3, after “are” insert

“a British citizen or are”.

This amendment would require British citizens to be prioritised for places on UK Foundation programmes and for interviews and places on speciality training programmes from 2027 onwards.

Clause 4 stand part.

Amendment 8, in clause 5, page 3, line 30, at end insert

“,provided that the majority of training for the programme takes place in the United Kingdom.”

This amendment would require a UK Foundation Programme to be a programme for which the majority of training takes place inside the United Kingdom.

Clause 5 stand part.

Clause 6 stand part.

Amendment 2, in clause 7, page 5, line 1, leave out paragraph (a).

This amendment, taken together with amendment 4, would provide that regulations made under Clause 3 are subject to the affirmative procedure.

Amendment 3, page 5, line 24, leave out “section 3 or”.

This amendment is consequential on amendments 2 and 4, which provide that regulations made under Clause 3 are subject to the affirmative procedure.

Amendment 4, page 5, line 40, after “under” insert—

“section 3 (regulations describing persons who may be prioritised for specialty training programmes from 2027 onwards)”.

This amendment, taken together with amendment 2, would provide that regulations made under Clause 3 are subject to the affirmative procedure.

Amendment 5, page 6, line 19, at end insert—

“(6) Before laying before Parliament a draft statutory instrument containing regulations under section 3 the Secretary of State must obtain the consent of—

(a) the Welsh Ministers, if the draft regulations contain provision which would be within the legislative competence of Senedd Cymru if it were contained in an Act of the Senedd;

(b) the Scottish Ministers, if the draft regulations contain provision which would be within the legislative competence of the Scottish Parliament if it were contained in an Act of the Scottish Parliament;

(c) the Department of Health in Northern Ireland, if the draft regulations contain provision which—

(i) would be within the legislative competence of the Northern Ireland Assembly if it were contained in an Act of that Assembly, and

(ii) would not, if it were contained in a Bill for an Act of the Northern Ireland Assembly, result in the Bill requiring the consent of the Secretary of State.”

This amendment would require the Secretary of State to obtain the consent of the relevant devolved government before laying draft regulations under section 3. It is consequential on amendments 2 and 4.

Clause 7 stand part.

Amendment 1, in clause 8, page 6, line 23, leave out from “on” to the end of line 24 and insert

“the day on which it is passed”.

This amendment would bring the Act into force on the day on which it receives Royal Assent.

Clause 8 stand part.

New clause 1—Report on impact—

“(1) The Secretary of State must lay before Parliament an annual report on the impact of the provisions of this Act.

(2) A report under this section must include—

(a) an assessment of the impact of the provisions of this Act on the number of applications for places on—

(i) UK Foundation Programmes, and

(ii) UK speciality training programmes, and

(b) if the assessment under paragraph (a) concludes that there has been a decrease in the total number of applications attributable to the provisions of this Act, an analysis of the potential impact of that decrease on the number of fully qualified doctors working in the NHS and Health and Social Care Northern Ireland, including specific analysis of the impact on the number of general practitioners and on each medical specialism.

(3) The first report under this section must be laid before 31 December 2029.”

New clause 2—Allocation of individual places on merit—

“(1) This section applies to the allocation of individual candidates to specific places on a UK Foundation Programme or a UK specialty training programme, whether that allocation takes place in the course of deciding offers of places or otherwise.

(2) A person who has a function of allocating places on a UK Foundation Programme or a UK specialty training programme must ensure that, once the prioritisation requirements set out in sections 1 to 3 of this Act have been applied, those allocations are based on an assessment of the applicants’ merits.

(3) For the purposes of the assessment of the applicants’ merits, a person may take into account—

(a) the candidates’ educational achievements,

(b) the candidates’ clinical performance,

(c) structured assessments of relevant skills and knowledge,

(d) the candidates’ research, leadership, management, quality improvement, and teaching skills, and

(e) the candidates’ knowledge relating to the place being allocated.”

This new clause would require the allocation of candidates to specific training places to be decided on an assessment of the candidates’ merits, after the prioritisation requirements in clauses 1 to 3 of the Bill have been met.

New clause 3—International students—

“(1) The Secretary of State must report annually to Parliament on the impact of the provisions of this Act on the numbers of international students at UK medical schools.

(2) This report must include an assessment of the financial impact on medical schools.”

This new clause would require the Secretary of State to report to Parliament annually on the impact of the measures in this Act on the numbers of international students studying at UK medical schools.

[The Minister for Secondary Care (Karin Smyth)]

In the interests of time, I will address the amendments at the end of proceedings, when I have heard from them—I think we have the gist of most of those issues. I restate our firm commitment to the Bill and all clauses.

Let me turn to clause 4 and clarify how we are defining “UK medical graduate” and “the priority group” for the purposes of the Bill. “UK medical graduate” in this context excludes those who have spent all or the majority of their time training for their medical qualification outside the British isles. This means that if a person has obtained a primary UK qualification but has studied mainly overseas, they will not be eligible for prioritisation as a UK medical graduate unless they fall into another group that is to be prioritised under the Bill. While internationally educated graduates from overseas remain an important part of the workforce and can continue to be recruited under the Bill, we are committed to growing home-grown talent, who are more likely to work in the NHS for longer, and to be better equipped to deliver healthcare tailored to the UK’s population.

Clause 8 sets out the territorial extent of the Bill and deals with commencement. The Bill extends to England, Wales, Scotland and Northern Ireland, and we have worked closely with the devolved Governments to ensure that it meets all needs and provides consistency. We are grateful to them for their support in bringing these measures forward so quickly. The Bill will engage the legislative consent motion process, and the devolved Governments have committed to commence this process in their Parliaments.

To ensure that the systems, planning and operational capacity required for successful implementation are in place, the Bill will be commenced

“on such day or days as the Secretary of State may by regulations appoint.”

As the Secretary of State outlined on Second Reading, this is an important fail-safe to ensure that we are not in a position in which a law is enacted that we cannot implement effectively at the time. I am happy to expand on that after we have discussed the amendments, but the key issue is the ability of the NHS and training providers to deliver the measure. That is why we have a fail-safe; we first need to be very clear that the NHS is in a position to deliver. Members have talked about the strikes. Those would be one consideration, and there are many others. We are asking the NHS and training providers to do something very difficult very quickly, and in order to ensure that they have the capacity and capability to do it safely, we are reserving the right to commence the Bill at a later date, rather than at the end of this Session. I will come back to the amendments when I close the debate.

[The First Deputy Chairman of Ways and Means (Judith Cummins)]

I call the shadow Minister.

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

I will speak to the amendments tabled by the Opposition. First, amendment 9 would require that from 2027, priority is given to British citizens on UK foundation programmes, and that they are prioritised for interviews and places on specialty training programmes. Clause 4 defines a UK medical graduate as a

“a person who holds a primary United Kingdom qualification within the meaning of the Medical Act 1983 (see section 4(3) of that Act)”.

However, it does not include

“a person who spent all or a majority of their time training for that qualification outside the British Islands.”

The Secretary of State has stated his intention to prioritise UK medical graduates, but he has failed to protect all British citizens in doing so. Our amendment would ensure that British citizens who study on an eligible medical course overseas were still prioritised in the Bill. There are many scenarios in which we may need to ensure that we protect British citizens. Consider, for example, a spouse, partner or child of a serving member of the UK armed forces who completes relevant training overseas while their relative is posted in Cyprus; a student at Queen Mary University of London who has completed the bachelor of medicine and bachelor of surgery course at its Malta campus but received a UK medical degree; a young British citizen who has studied in the US or France, owing to a family relocation; or, given that the largest bottleneck is not in training places but in getting a place in medical school at all in some cases, a British student who has gone to study overseas because of their fervent desire to become a doctor.

Those are all entirely possible and plausible scenarios in which British citizens have completed their relevant training, and wish to bring their skills back and to relocate in their homeland for the rest of their career, but may not be covered by the Government’s prioritisation model. The Government’s prioritisation model is based on where the degree was taken, rather than also considering who did it. The Secretary of State must ensure that we do not overlook our own citizens if we are to fairly address the competitive landscape for training posts. The Opposition therefore urge the Government to accept amendment 9.

Amendment 10 is a probing amendment to explore the effects of the Bill on military personnel. As a Member of Parliament representing an area with a large armed forces community, I know that medical trainees are an integral part of our serving community. The world is becoming an increasingly dangerous place, and junior trainees may be sent abroad earlier in their career than is currently the case. It is clearly wrong to penalise people who are doing brave work caring for our armed forces. They ought to be provided with optimal opportunities, and the Secretary of State has a duty to ensure that they are not overlooked. I would be grateful if the Minister covered that in her response.

New clause 3 would require the Government to make an annual report to Parliament about the Bill’s impact on the number of international students at UK medical schools, and the financial impact on UK medical schools. We talked about the bottleneck, and the balance between UK and international students training at UK medical schools; clearly, becoming a UK graduate will now come with a significant premium. What impact will that have on British children getting to make their choices and become doctors if they want to? What incentives does it provide to universities to increase the number of international students, and what effect will that have overall on UK medical schools?

New clause 2, tabled by my hon. Friend the Member for Runnymede and Weybridge (Dr Spencer), is about places for UK foundation and speciality training programmes, and the importance of allocation on merit, because we all want the very best doctors. When I became a doctor—believe it or not, it was 25 years ago this year, Madam Deputy Speaker—I applied for a job as a junior house officer, as it was called then. I applied for the jobs I wanted, I was interviewed by the consultants who would have been supervising my training, and then I was offered the jobs.

The experience of students today is very different. They are allowed to put in a preference and say which deanery or foundation area they would like to work in, but that is all. After that, the application goes into a computer system, which gives them a single rank that is not based not on anything they have done at university, or on whether they got good results or worked hard, or anything like that. The computer system will do a first pass, and if the first choice is available, it will give the student their first choice. If it is not available because by the time its gets to that student those places have gone, the computer system will miss the student and go on to the next one. When it has completed its full pass of the list, it will start again, and when it comes to that student next time, it will give them the highest preference that is still available.

Once the student has been allocated a foundation deanery, the process starts again within the locality, and I mean “locality” in the loosest possible sense. Take those applying for the Trent rotation; they could be posted in Lincoln, Boston, Nottingham, Derby or Burton. The doctor has no control over where they will go, and very little ability to express a preference. My hon. Friend the Member for Weald of Kent (Katie Lam) spoke about a student in her locality who had not been able to get a place, despite being at the top—third, I think—of their university class. It is clearly not fair to give people no opportunity to control their future. By the way, there is no right of appeal, so having been given their place, the choice for the student is: that place or no place.

The hon. Member for Sunderland Central (Lewis Atkinson) spoke about ordinary children from the north-east. Having once been an ordinary child from the north-east, I agree that it is important that people have opportunity, but it is equality of opportunity, not equality of outcome, that matters. I worry that the system creates equality of outcome. We therefore support new clause 2, tabled by my hon. Friend the Member for Runnymede and Weybridge.

Amendment 1 would require the Bill to take effect on the date of Royal Assent, as opposed to a date at the discretion of the Secretary of State for Health and Social Care. The Bill is deemed necessary emergency Government legislation to prioritise medical graduates in the United Kingdom for places on medical training programmes. When he announced the Bill in an attempt to avert industrial action by resident doctors in December, the Secretary of State told the House that he had been working intensively with his team to

“to see how quickly we could introduce legislation”—[Official Report, 10 December 2025; Vol. 777, c. 430.]

However, the Bill does not commit to a date when these measures will be enacted. Instead, the power lies in the hands of the Secretary of State, giving him a clear bargaining chip for future negotiations. It is clear that the Government intend to pass this legislation urgently, as they have said. However, without a commencement date, there are clear concerns that the Bill is just a negotiating tactic to prevent industrial action by resident doctors, and can be scrapped at a later date. There remains the prospect of further industrial action, despite the legislation being introduced. The Secretary of State should not be asking Parliament to pass a Bill that he has no intention of enacting if the British Medical Association plays ball and holds off on strikes. Either the Secretary of State thinks that this is emergency legislation that we need to get on with and enact, or he does not.

It is vital that the legislation is enacted straight away, because students are due to be given their training programme places now, and they need to decide where they are going to live. They cannot put their life on hold, and measures to prioritise UK doctors cannot be held off, until the Secretary of State has finished dangling a carrot in front of the British Medical Association. The Opposition are clear: while we are supportive of the principles of the Bill, it must be used for offers made this year.

Amendment 8 would clarify that under clause 5, a UK foundation programme is a programme where the majority of training takes place inside the United Kingdom. A foundation programme is defined as

“an acceptable programme for provisionally registered doctors”

in section 10A of the Medical Act 1983. It is vital to clarify that a UK foundation programme is a programme where a majority of training takes place inside the United Kingdom. That is because the General Medical Council can approve foundation programmes overseas. If it is not explicit that a foundation programme needs to be in the United Kingdom, a loophole is created whereby a foundation programme could be approved overseas, creating a back way into the system and circumventing the measures that the Government have tried to put in place. I encourage the Minister to look at that carefully as the Bill progresses.

In summary, we support the Bill, but we have concerns about some of the clauses, so we have tabled amendments that we hope the Government will look at carefully.

[The First Deputy Chairman]

I call the Liberal Democrat spokesperson.

[Helen Morgan (North Shropshire) (LD)]

The amendments in my name raise concerns about the Bill’s impact on fairness, transparency and the smooth functioning of the NHS, notwithstanding the Liberal Democrats’ overall support for the Bill.

Clause 7(1) would allow Ministers to change who is eligible for prioritisation through the negative procedure, meaning that such changes could be made unilaterally, without meaningful scrutiny. In practice, that hands the Secretary of State the power to redraw the boundaries of opportunity, and to decide who gets prioritised for medical training places, without Parliament ever having a say. That is unacceptable for a decision that affects people’s lives and careers, as well as the future capability of our health service. While I do not doubt the intentions of the Secretary of State and the Front Bench team, it opens the door to the risk of political whim or prejudice influencing who gets access to career-defining opportunities in the future. That is why the Liberal Democrats have tabled amendments 2 to 5 to reverse this, and to ensure that any changes must be subject to full parliamentary consent.

On the timing of the Bill’s implementation, the Government intend to apply the new prioritisation rules midway through the 2026 specialty recruitment cycle. Let us reflect on what that means in practice. Doctors already working in the NHS have entered this cycle under one set of rules. They have paid for exams, secured visas, arranged travel, uprooted their families and committed themselves to the NHS. To change the rules halfway through the process would not only be potentially destabilising for services, but very unfair to those individuals, many of whom are plugging urgent staffing gaps right now.

We already face real workforce pressures, so the last thing our NHS needs is a wave of dedicated doctors forced out by uncertainty, or pushed to leave the country because the Government moved the goalposts after applications had already begun. For this reason, we believe that the Bill should come into force from 2027. We must protect frontline services and protect the integrity of the applications process. To address the problem directly, we have tabled amendments 6 and 7 to safeguard those already in the 2026 application cycle, ensuring that they are not deprioritised, because that is a simple matter of fairness.

We have also tabled amendments to improve the transparency and long-term impact of the Bill. Across the NHS, we face severe shortages, not just in general practice but in radiology, oncology, mental health services and many other specialities.

Medical Training (Prioritisation) Bill

Judith Cummins Excerpts

2nd reading
Tuesday 27th January 2026 Commons Chamber

[Madam Deputy Speaker (Judith Cummins)]

I call the shadow Secretary of State.

--- Later in debate ---

[Preet Kaur Gill]

I am not the Chair of the Select Committee, and I think that the Secretary of State set out his position. This is really important. This is about UK taxpayers’ money being invested in training doctors, and we must ensure that UK trainees are able to secure training places once they graduate. That is the issue that we are discussing.

Let me be clear: this is not a criticism of international staff. The NHS would not and could not function without the dedication, skill and compassion of people from around the world, and we should say that plainly and with gratitude. Every day, they hold our system together. However, a mature, confident country can value that contribution while also saying that we cannot replace long-term workforce planning with a permanent reliance on overseas recruitment. That is not fair on British trainees, not fair on source countries, and not fair on the NHS. As we heard from the Secretary of State, the World Health Organisation has estimated that by 2030, there will be an 11 million shortfall in health workers, as every country competes for the same limited workforce. This Government understand that putting British workers first is not something for which we will apologise. It is what the public expect.

The Prime Minister has been clear: a serious Labour Government must align migration, skills and training policy with the national interest. We cannot simply be passive; we must shape our domestic workforce to ensure that the NHS can continue to function. The same principle should apply wherever we are overly dependent on skilled migration because domestic training was neglected for 14 years under the Conservatives. Investing in people in the UK, and expecting that investment to strengthen Britain, is not ideological; it is responsible government.

The powers conferred to the Secretary of State in this Bill are important. The Royal College of Radiologists’ 2024 census found that 83% of cancer centre heads of service in the west midlands were concerned about patient safety as a result of workforce shortfalls. In 2024, only 19% of clinical oncology training places in the west midlands were filled. Will the Secretary of State outline how he intends to use the powers in this Bill and work with the integrated care boards to ensure that access to training matches regional workforce needs and health demands?

Above all, this Bill is about respect—respect for the taxpayer, respect for the NHS workforce, and respect for a health service that must be planned for the long term, not patched up year on year. This is exactly the kind of reform that the public expect from a Labour Government who are serious about work, contribution and the future of our NHS.

[Madam Deputy Speaker (Judith Cummins)]

I call the Liberal Democrat spokesperson.

--- Later in debate ---

[Ms Julie Minns (Carlisle) (Lab)]

I would like to place on record my interest as the mother of an NHS nurse.

It is a privilege to speak in today’s debate and to do so on behalf of my Carlisle constituency, which I am proud to say has recently taken a transformative step with regard to medical training, with the opening of the Pears Cumbria School of Medicine. This new graduate school of medicine is being jointly pioneered by Imperial College London and the University of Cumbria, and I put on record my thanks to Professor Martin Lupton, Professor Mary Morrell and Professor Brian Webster-Henderson, whose vision the medical school is, and to Sir Trevor Pears and the Pears Foundation, whose generosity has made their vision a reality.

As with the Medical Training (Prioritisation) Bill before us today, the Pears Cumbria School of Medicine purposefully prioritises home-grown talent. The school also seeks applications from students from non-traditional backgrounds, encouraging applications from groups that are less well represented in medicine. As part of the school’s commitment to widening access, the four-year graduate programme has no GCSE or A-level requirements. The reason for this approach is simple: it provides the best chance, year in, year out and generation after generation, for Carlisle and Cumbria to produce our own doctors. These doctors will often come from the surrounding communities and, in part because of where they are trained, will be deeply committed to the local area and its people.

In geographically remote areas such as ours, the ability to train and retain our own doctors is critical. It matters enormously. Cumbria faces some of the most entrenched health inequalities in the country. We have struggled for years with recruitment and retention across both primary and secondary care, and our hospital trust relies heavily on locums. We know all too well that the traditional model of medical education, centred on large metropolitan teaching hospitals, simply does not produce or attract the workforce that rural areas such as mine need.

That brings me back to the Bill before us today. The Government are right to prioritise UK graduates for foundation and specialty training places. The Bill represents a significant and welcome step towards restoring confidence in the training pipeline, addressing the growing mismatch between the number of medical graduates and the number of available posts, and ensuring that those who have invested years of training in our NHS are not left without a route on which to progress. It is a sensible, fair-minded reform that will bring much-needed stability to a system that has been under real strain.

For Carlisle and Cumbria, however, the issue is not only who gets priority but where the training posts are located. At present, although foundation training can be delivered locally, it can be delivered only where accredited F1 and F2 posts exist. In Cumbria, the number of those posts is limited. The North Cumbria integrated care trust is able to provide places for some foundation trainees, and others will find F1 and F2 posts in primary and community care settings, but further accredited places will be required at foundation level. I ask the Minister to explain, in her response, not just how the new powers will prioritise UK medical graduates and members of the priority group, but how the powers might be used to widen the availability of accredited F1 and F2 posts in areas such as Cumbria, where there is a shortage of doctors.

Even if we successfully retain Pears medical school doctors in Cumbria for their foundation programme training, the risk of losing them when they come to their specialty training programme is even greater, because doctors will overwhelmingly choose to settle near to where they complete their training, particularly their specialist training, and Cumbria will never be able to provide every specialty training pathway within the county to retain our home-grown talent. We simply do not have the population size or the case mix to deliver all specialisms in our trusts. However, that does not mean that we cannot design a system that keeps trainees connected to Cumbria throughout their training. I therefore urge the Minister to consider how the regulation-making powers granted by the Bill can address that issue.

Pears medical school believes that a new approach to specialist training is the way forward. I recently wrote to the Secretary of State seeking a meeting between him and representatives of the medical school to explore that approach, and I very much hope that he will soon accept that meeting. I also ask Ministers to consider seriously how specialty training can be structured so that trainees who complete F2 in Cumbria are supported to remain based in the region, even if their specialist rotations take them elsewhere for short periods. That could mean funded return-to-base arrangements, rotational models anchored in Cumbria, or formal partnerships between specialist centres in UK cities and community providers in Cumbria. In other words, we need a training pathway that allows people to specialise with Cumbria, not away from it, because if we allow the system to pull trainees out of Carlisle at the very moment they are beginning to put down roots, we will simply recreate and repeat the cycle that has left rural areas like mine short of doctors for too long.

The Pears Cumbria School of Medicine is a once-in-a-generation opportunity to reshape the medical workforce in Cumbria, but it will fully succeed only if training programmes are aligned with its purpose. In welcoming the Bill, I urge Ministers to ensure that its implementation meets the requirements and needs of remote communities. Prioritisation is important, but place matters too.

[Madam Deputy Speaker (Judith Cummins)]

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

Resident Doctors: Industrial Action

Judith Cummins Excerpts

Wednesday 10th December 2025 Commons Chamber

[The Secretary of State for Health and Social Care (Wes Streeting)]

With permission, Madam Speaker Deputy, I shall make a statement on industrial action by resident doctors. I thank you, Mr Speaker, business managers and the official Opposition for facilitating this evening’s statement.

As we head into winter, our hospitals are running hot and the pressures on the NHS are enormous. Flu season has come earlier, with a sharp rise in cases and the peak still to come, and this year’s strain is more likely to affect older people more severely. Already, the number of patients in hospital in England with flu is the highest on record at this point in the year. It is 50% higher than this time last year and 10 times higher than in 2023. Some 95% of hospital beds are occupied, growing numbers of staff are off sick and we are already seeing the pressure in our A&E departments. It is against that backdrop that the British Medical Association is threatening to douse the NHS in petrol, light a match and march its members out on strike. This represents a different magnitude of risk to previous industrial action.

The BMA resident doctors committee is in dispute on two issues: pay and jobs. On pay, resident doctors have already received a 28.9% pay rise—the highest in the public sector. For a first-year resident doctor, that is the equivalent of a £9,400 pay rise. I have been consistent, honest and up front with resident doctors that we cannot go further on pay this year. There is a gap between what the BMA is demanding and what the country can afford. Nor would further movement on pay be fair to other NHS staff, for whom I am also responsible and many of whom will never in their careers earn as much as the lowest-paid doctor. As I have made clear to the BMA and other trade unions, I am open to discussing multi-year pay deals with any trade union if we stand a chance of bridging the gap between affordability and expectations.

On jobs, I have much more sympathy with the BMA’s demands. I have heard the very real fears that resident doctors across the country have about their futures; it is a legitimate grievance that I agree with. My Conservative predecessors created training bottlenecks that threatened to leave huge numbers of resident doctors without a job. In 2019, there were around 12,000 applicants for 9,000 specialty training places. This year, that number has soared to nearly 40,000 applications for 10,000 places.

It used to be the case that UK graduates competed among themselves for specialty roles; now, they are competing against the world’s doctors. That is a direct result of the visa and immigration changes made by the previous Conservative Government post-Brexit, and it is compounded by the Conservatives’ decision to increase the number of medical students without also increasing the number of specialty training places.

Taxpayers spend £4 billion training medics every year—we then treat them poorly, and some leave to work abroad or in the private sector. It is time that we protect our investment and give bright, hard-working UK medical graduates a path to becoming the next generation of NHS doctors. Our 10-year plan for health set out our commitment to provide that path. It pledged to introduce 1,000 extra specialty training places and prioritisation of medical graduates from the UK and Ireland.

Today, in an offer to resident doctors, I can announce that I am able to go further. I want to thank Sir Jim Mackey, the chief executive of the NHS, and his team, who have been going trust by trust to see how many extra places can be funded and are needed. Thanks to their hard work, I am in a position today to be able to offer 4,000 specialty places for resident doctors, starting with an additional 1,000 for those applying this year.

In the Department of Health and Social Care, we have been working intensively on UK graduate prioritisation. The barriers have been legal ones, so I have been working intensively with my team to see how quickly we could introduce legislation. Thanks to their efforts, the co-operation of colleagues across Government, and my counterparts in Wales, Scotland and Northern Ireland, I can notify the House tonight that, subject to the agreement of resident doctors, we intend to introduce urgent primary legislation in the form of a Bill to be presented to Parliament in the new year.

The legislation will prioritise graduates from UK medical schools over applicants from overseas during the current application round and in all subsequent years. The reforms will also prioritise doctors who have worked in the NHS for a significant period for specialty training. This will not exclude international talent, who will still be able to apply to roles and continue to bring new and vital skills to our NHS, but it will return us to the fair terms on which home-grown medics competed before Brexit. The impact of these changes is that instead of four doctors competing for every training post, it will now be fewer than two doctors for every place. That is a good deal for doctors.

Following discussions with the BMA, we are also addressing the specific costs faced by resident doctors that do not apply to other NHS staff. Although I cannot go further on pay this year, I am able to offer today to put money back in resident doctors’ pockets by reimbursing royal college portfolio, membership and exam fees, with the latter backdated to April. The allowance for less-than-full-time resident doctors—many of whom are parents and carers—will be increased by 50% to £1,500, helping to close the gender pay gap.

In recent days, I formally made this offer to the BMA resident doctors committee. The BMA will now survey its members in the coming days on whether to accept this offer and end its dispute with the Government. The BMA told us that it will survey its members quickly and give us less than 48 hours’ notice of whether the strikes are going ahead. That presents serious operational challenges for NHS leaders, who need certainty now as to whether they are cancelling patient appointments and cancelling staff annual leave to cover strikes.

In my determination to prevent the havoc that strikes would cause this Christmas, I therefore made one more offer to the BMA, which I will now share with the House, the country and frontline doctors. So that the BMA could run a genuine ballot of its members and call off next week’s strikes while that ballot ran, I offered to extend its strike mandate. This would have allowed enough time for the BMA to reschedule next week’s strikes for the end of January, were the offer to resident doctors rejected in a ballot. It would have avoided the chaos that looming strike action threatens at the most dangerous time of year by removing the spectre of strikes next week. I knew that extending the BMA’s strike mandate would leave me open to attack from political opponents; that was a risk I was willing to take to stop the Christmas strikes going ahead. Madam Deputy Speaker, I must report to the House that the BMA’s leadership said no.

In the coming days, as the NHS prepares for strike action that may or may not happen, there are patients whose operations will be cancelled. There are NHS staff who will have to tell their families that they will not be home for Christmas because they have to cover for their resident doctor colleagues. This was entirely avoidable—no one should be in any doubt that the BMA has chosen to play politics with people’s lives this Christmas, and to continue holding the spectre of strikes over the NHS. I ask resident doctors to bear that in mind when they cast their votes.

The power to end these strikes now lies in the hands of doctors. Resident doctors face a choice: to continue the damaging industrial action in which everyone loses, or to choose more jobs, better career progression, more money in their pockets and an end to strikes. The deal that is on offer would mean emergency legislation to put our own home-grown talent first; to increase the number of extra specialty training places from 1,000 to 4,000, with a quarter of those places delivered now; to reduce the competition for training places from around four to one to less than two to one; to put more money in doctors’ pockets by funding royal college exam fees, portfolio fees and membership fees, with exam fees backdated to April; and to increase the less-than-full-time allowance by 50% to £1,500. It is a chance for a fresh start, to end this dispute and look ahead to the future with hope and optimism—a chance to rebuild resident doctors’ working conditions and rebuild our NHS. I urge every resident doctor to vote for this deal, and I commend this statement to the House.

[Madam Deputy Speaker (Judith Cummins)]

I call the shadow Health Secretary.

--- Later in debate ---

[Wes Streeting]

I agree entirely with my hon. Friend. She brings considerable frontline experience to this House, having worked in the NHS and dedicated her life to it. I am pretty sure that as well as speaking for her constituents, she speaks for so many other NHS staff. I do not want to see nurse pitted against doctor, or NHS staff pitted against each other. I do not want to see people resenting each other at a time when we should be pulling together to get the NHS back on its feet, and to make sure that it is well down the road to recovery. That is why, even at this late stage, I urge the BMA to think again. There is nothing to stop me extending the strike mandate tomorrow and giving Jim Mackey and NHS leaders the opportunity to stand down planning for strikes next week, even at this late stage. It would be an extraordinary gesture of good will, and it would be a Christmas present for the country. It would benefit doctors, resident or otherwise, and all NHS staff. Most importantly of all, it would benefit patients. I hope that message is heard in good faith by the BMA, even now.

[Madam Deputy Speaker]

I call the Liberal Democrat spokesperson.

[Dr Danny Chambers (Winchester) (LD)]

I thank the Secretary of State for his statement. People will be hugely alarmed at the threat of more industrial action right before Christmas, and we cannot forget how we got here. We know that the previous Government under-resourced the NHS. It was overburdened, people felt underappreciated, and the whole system was being held together by the good will of the staff.

Having said that, the timing is terrible, because we have the worst winter flu outbreak in decades, right before Christmas. We have to urge the BMA to work constructively to resolve this dispute in a way that is fair for both patients and taxpayers. Given that resident doctors received a 29% pay rise last year, I think most of the public feel that pushing for another 28.9% this year is unaffordable and unreasonable.

The Secretary of State touched on resident doctors’ legitimate concerns. The previous Government increased medical school places without increasing the facilities to deliver the necessary specialist training placements, so this was a predictable bottleneck that we are now up against. Waiting lists are long, we need more doctors, and we have doctors who have been trained largely at the taxpayer’s expense struggling to find work. We very much welcome the extra 4,000 placements that were announced today, which are hugely necessary. Can we ensure that they will address the acute shortages in general practice and psychiatry? To put those 4,000 places in context, 10,000 doctors applied for 500 psychiatric training places last year, and the Secretary of State said that about 40,000 doctors have applied for 10,000 places this year. Is there work to try to increase places as quickly as possible in the next few months and years?

At Winchester hospital, one in five beds is taken up by people who do not have any social care packages. That is not good for them, because they are stuck in the hospital, and we want to get them home for Christmas, but it will also affect the flow through the hospital right now, during a winter flu crisis.

We welcome this action and urge the BMA to call off the strikes, but can we address the legitimate grievances that the Secretary of State has mentioned?

--- Later in debate ---

[Wes Streeting]

I wholeheartedly agree with my hon. Friend. I was about to say that it is always a disappointment when Reform and Green Members do not appear in the Chamber, but I would not want to be accused of misleading the House. I am sure they had a better offer, and there is a Christmas party up the road.

In all seriousness, my hon. Friend is absolutely right. The tragedy of the past couple of rounds of industrial action is that each round costs about a quarter of a billion pounds. Each round, despite the best efforts of NHS leaders and frontline staff, does cause disruption, and we all lose when that happens. One of the things that is really hard for staff is that they are also confronted in a very real way with the impact of the state of the NHS on their patients. They are not in it for themselves, but because they believe in public service and want to improve the health of our nation. We are so much better able to achieve our shared goals if we work together, and we can grasp that opportunity if doctors vote for this deal, we draw a line under this dispute, and we try to reset the relationship between me and this Government on one hand, and the BMA’s leadership on the other.

[Madam Deputy Speaker (Judith Cummins)]

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

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

This is just not the time for a strike. As much as we have huge sympathy with many of the grievances of resident doctors, we understand that the next few weeks will be critical for how the next few months will be for the NHS, so I echo calls for the BMA to listen to reason. However, I spare a thought, and I hope the Secretary of State does, for the overseas doctors we rely on so heavily, because there is an acute workforce shortage. How, through this plan and this legislation, will the Secretary of State avoid creating a two-tier system that risks undervaluing the critical work that overseas doctors do to prop up our NHS?

--- Later in debate ---

[Several hon. Members rose—]

[Madam Deputy Speaker (Judith Cummins)]

I do want to finish this statement shortly, so could Members keep their questions and answers short? I call Andrew George.

[Andrew George (St Ives) (LD)]

I welcome the Secretary of State’s statement and the manner in which he has been handling the issue. However, I want to ask him about the way he summarised the position at the end of his statement. He presented it as a choice between striking and having more jobs and the other parts of the offer. I seek clarity on the matter. Is he genuinely saying that he is going to withdraw that? Was that purely for oratorical effect, or is that his negotiating position?