Cross-border Healthcare

Karin Smyth Excerpts

Tuesday 4th November 2025 Westminster Hall

[The Minister for Secondary Care (Karin Smyth)]

It is a pleasure to serve under your chairmanship, Mr Dowd. I am grateful to the hon. Member for Brecon, Radnor and Cwm Tawe (David Chadwick) for securing this important debate. I knew that hon. Members from across the United Kingdom would come here for it, and so it has proved. There are no end of technicalities that devolution has brought us, but we respect devolution and difference while recognising that we are all citizens of the United Kingdom. On the initial point made by the hon. Member, I gently remind him that an extra £1.5 billion has been allocated by the Welsh Government to public services in Wales, to put Wales on a path back to growth, undoing the damage of the last 14 years. That money includes an extra £600 million for health and care, which was voted against by the Welsh Conservatives and by Plaid Cymru. That is the difference made by having a Labour Government at one end of the M4 and a Labour Senedd at the other. Let us hope that arrangement can continue into next year so that we can get on with resolving those issues for the people of Wales.

I am very proud of my Irish heritage, with family on both sides of the Irish border, and I represent a city just across the Severn from Wales, so I am no stranger to the issues that arise from sharing a border. I spent many years in the British-Irish Parliamentary Assembly and on the Public Administration and Constitutional Affairs Committee, looking at constitutional issues across the United Kingdom. As my hon. Friend the Member for North Northumberland (David Smith) said, given the reality of people’s lives across our borders, we need to be better at joining those dots, and—as my hon. Friend the Member for Carlisle (Ms Minns) said—at remembering those people who live at the edge of some people’s maps.

To assure everybody, with my hon. Friend the Member for Aberafan Maesteg (Stephen Kinnock) as the Minister for Care and with my hon. Friend the Member for Glasgow South West (Dr Ahmed) as the Minister for Health Innovation and Safety, on whose behalf I am speaking, we in the Department of Health and Social Care are well served by all voices in the United Kingdom. I reaffirm our commitment to ensuring that all patients on both sides of borders can access timely, high-quality care. Healthcare is devolved but patients cannot be left to navigate a fragmented system or face delays just because of where they live.

I assure hon. Members, in response to points made by the Opposition spokesperson, the hon. Member for East Grinstead and Uckfield (Mims Davies), that officials meet regularly. That co-operation is happening, and they will continue to meet. My colleagues and I also meet members of those Governments. However, I will come on to that at the end when discussing the requests for my colleague, the Minister for Health Innovation and Safety, to meet with hon. Members.

The spiritual home of the NHS is Tredegar. This Government will not leave anyone behind, not least patients in Welsh border communities who rely on services in England—the point of the debate. My hon. Friend the Member for Montgomeryshire and Glyndŵr (Steve Witherden) raised problems with data sharing and patient record transfer, confusing and inconsistent referral pathways and some of the disputes across borders. However, as we have heard, such disputes sometimes happen within countries and over more local borders. As we heard from the hon. Member for Berwickshire, Roxburgh and Selkirk (John Lamont), they happen internally as well, so let us not underestimate how hard it is to resolve such disputes.

Around 30,000 people who live in England have a GP in Wales, and vice versa. That is why the statement of values and principles for cross-border healthcare was published in 2018. That statement remains the foundation for our approach. It sets out clear expectations that patients living in defined border areas, whether they are registered with a GP in England or in Wales, should receive care without delay or administrative burden. Emergency care is available to all patients, regardless of residency or GP registration. We expect both integrated care boards in England and local health boards in Wales to consider the impact of commissioning decisions on cross-border communities.

The hon. Member for Brecon, Radnor and Cwm Tawe raised the issue of waiting times for residents in Powys who seek treatment in England. Waiting times on both sides of the border are falling. Whenever I appear in the media or speak in a debate, I hear people still saying, even to their television, “Well, where’s my appointment?” Nevertheless, it is the case that waiting times are falling, which is helped by the allocation of money from the Welsh Government to reduce waiting lists.

[David Chadwick]

Will the Minister give way?

[Karin Smyth]

I will get through all the points, if I can, because I know there are lots of issues to address.

As I was about to say, too many people are still waiting, but we are committed to working with the Welsh Government to keep the cross-border arrangements fair, transparent and patient-centred.

Patients also face challenges in accessing specialist services. NHS England commissions a number of these services on behalf of the devolved nations and we are willing to explore further contract arrangements with NHS Wales to improve access to them.

As we have heard this afternoon, travel to appointments can be a barrier. In England, patients referred for specialist NHS treatment may be eligible to claim a refund of reasonable travel costs under the healthcare travel costs scheme, and a similar scheme exists in Wales. I join my hon. Friend the Member for Shrewsbury (Julia Buckley) in welcoming the tremendous changes that we are seeing at Shrewsbury and Telford hospital, which are starting to benefit not only her constituents but people travelling from Wales. That is really good to see. It is a long way for people from Wales to travel, but we are still very pleased to see those changes being made.

The hon. Member for Brecon, Radnor and Cwm Tawe also raised the issue of digital interoperability. Again, I wish I could say that that was only a problem for hospitals on the border between England and Wales, but I am afraid that it is an issue for trusts across the country and across each country. It does not help that, after 14 years of under-investment, IT in the NHS lags behind IT in the private sector by at least a decade. That is why this Government are investing £10 billion into improving how patients access services through technology. My hon. Friend the Minister of State for Science, Innovation, Research and Nuclear, Lord Vallance, is currently giving the NHS the biggest digital makeover in its history as part of our 10-year plan.

I can also tell the hon. Member for Brecon, Radnor and Cwm Tawe that NHS England is working with NHS Wales to improve interoperability, especially through the shared care record and technical collaboration on the so-called fast healthcare interoperability resources, or FHIR for short, which allows systems from different manufacturers to exchange messages and data, regardless of the setting that care is delivered in. I commend my hon. Friend the Member for Montgomeryshire and Glyndŵr on meeting leaders in the local cross-border system to understand that issue better. However, I gently say to him that we cannot get very far without the private sector working with us, not only across genomics and future healthcare but in IT and the way that we develop some of these services.

In October, the chief information officers across all four nations agreed to start looking at digital architecture and standards. They are exploring what we can do to improve how we use shared systems, common standards for better communication, which was raised by nearly everyone this afternoon, and the potential of future alignment. This work should lead to some progress in the short term, ahead of our long-term ambition of building a single patient record.

We are also making cross-border billing arrangements easier. Although the NHS payment scheme applies only to services in England, we sat down with the Welsh Government and agreed that Welsh commissioners will pay English tariff prices for Welsh patients who are treated in England. For English patients who are treated in Wales, local agreements are in place and we are open to making those agreements more efficient through the provision of clearer guidance.

As for our constructive co-operation with devolved Governments, the Government were elected on a manifesto to reset our relationship with the devolved Governments, and from day one that is what we have been doing. In that spirit, and without downplaying many of the issues that the hon. Member for Brecon, Radnor and Cwm Tawe and others, including the hon. Member for Ynys Môn (Llinos Medi), have raised today, I will highlight some of the positive examples of collaboration between our healthcare systems.

In many areas along the border, NHS staff in England and Wales are showing the rest of the UK how joined-up care is done. For example, patients in south Wales regularly access paediatric intensive care services in my home city of Bristol, and there are long-standing arrangements for cancer care, renal services and mental health support that cross the border seamlessly. Such partnerships are a testament to the professionalism and dedication of our NHS workforce, but cross-border healthcare is just one part of our partnership.

First, we have seen immense progress through the Interministerial Group for Health and Social Care, which met last September. Such meetings are really important. They bring together all four nations to find common ground on key priorities, such as elective recovery for those on waiting lists, innovation and health reform, and we look forward to continuing these discussions at the next meeting in December.

Secondly, all four nations are working to protect our kids through the Tobacco and Vapes Bill, which is UK-wide in scope but tailored to the specific needs of each nation. If the representative of the Opposition, the hon. Member for East Grinstead and Uckfield, could indeed talk to her colleagues in the House of Lords, who are battling very hard to get some of this legislation through, we could start making this generation the first smoke-free generation and support kids with this public health measure.

Thirdly, the Mental Health Bill that applies to England and Wales has been a masterclass in constructive engagement between compatriots who want to put their differences aside and get stuff done. May I echo the words of the hon. Member for Strangford (Jim Shannon) and add my support to the hon. Member for South Antrim (Robin Swann) in his efforts to ensure progress on that often forgotten part of the Good Friday/Belfast agreement that deals with healthcare? It is not easy. If they can do it over there, it is not beyond the rest of us to do it in Scotland, Wales and England. I was so grateful when my own mother was being cared for at Altnagelvin hospital during the covid crisis in 2021 to see the co-operation across the border and staff just getting on with treating the patients wherever they came from. We have a lot to learn from our colleagues in Northern Ireland.

In conclusion, I want to assure colleagues that the UK Government remain committed to supporting cross-border healthcare arrangements that work for patients. I will not offer hon. Members lots of individual meetings, but what I have heard today is that there is a lot of good work going on among officials. People here have issues to raise, including things from the past. I will take that up and share that more widely. I will also endeavour to write to the hon. Member for Strangford on the issue he raised to do with university students.

We are building bridges with Wales to work through our issues in the national interest, but I am afraid to say that although waiting lists are falling in England and Wales, in Scotland they are rising, which is a great shame. My friend Anas Sarwar, a former NHS dentist, is committed to resolving that. The NHS is in his DNA, given his own professional work. Getting waiting lists down will be his No. 1 priority, should Labour be successful in Scotland next year. It is a shame for Scottish people to see waiting lists rising while we make progress in England and Wales.

The greatest Welshman in history, Nye Bevan, founded our national health service. The hon. Member for Brecon, Radnor and Cwm Tawe might want to dispute that and give the title to Lloyd George—we will politely disagree on that one. But the serious point is that Bevan’s vision was for a health service where no one was left behind, not least in his own country of birth. Working in partnership, we will fix the NHS across the United Kingdom and make it fit for the future.

Early Pandemic PPE Procurement

Karin Smyth Excerpts

Thursday 30th October 2025 Written Statements

[The Minister for Secondary Care (Karin Smyth)]

During the gathering and review of evidence for module five of the covid-19 public inquiry, officials at the Cabinet Office concluded in April 2024 that another supplier, Luxe Lifestyle Ltd, should be on the list of suppliers identified as having been processed through and awarded a contract from the “high priority lane” for personal protective equipment procurement in 2020. This addition takes the total number of companies awarded contracts through this route to 52.

The Department of Health and Social Care agrees with the Cabinet Office’s findings, and notes two other corrections that are to be published. The corrections amend the referral details for another supplier, P1F Ltd, replacing the previously named person with “FCO Donations Team”, and correct a spelling error for another (Inivos Ltd, previously misspelled as Invios).

These changes and the corrected lists will be published on a new gov.uk page, which will supersede the original page published on 17 November 2021 by the previous Government. This new page will carry any subsequent amendments that might arise. Corrected lists can be found at: http://www.parliament.uk/business/publications/written-questions-answers-statements/written-statement/Commons/2025-10-30/HCWS1006/

[HCWS1006]

Obesity and Fatty Liver Disease

Karin Smyth Excerpts

Tuesday 28th October 2025 Westminster Hall

[The Minister for Secondary Care (Karin Smyth)]

It is a pleasure to serve under your chairmanship, Mr Efford. I congratulate my hon. Friend the Member for Worthing West (Dr Cooper) on securing the debate. We have veered quite a long way into the public health arena in the last while, but that demonstrates how important it is. I pay tribute to the expertise that my hon. Friend brings to this House and everything that she is doing to promote public health, including sharing the news about the winter flu vaccine—I will get that in while I am here, Mr Efford, because it is so important.

As has been said by many, including the resident GP on these Benches, my hon. Friend the Member for Stroud (Dr Opher), we have all learned from this debate. Well done to the British Liver Trust for its fantastic campaigning and briefing, which has clearly paid dividends. My hon. Friend the Member for Worthing West has given me the chance to update the House on the Government’s efforts to tackle the obesity crisis. I am here on behalf of the Under-Secretary of State for Health and Social Care, my hon. Friend the Member for West Lancashire (Ashley Dalton), who is responsible for public health, but this issue concerns us all. Many of us have been involved in this area for some time, and it is one of the defining public health challenges of our time.

We heard today some of the facts. Obesity is a major risk factor for both fatty liver disease and cardiovascular disease; there are common risk factors such as high blood pressure, high cholesterol and type 2 diabetes. Non-alcoholic fatty liver disease now affects about one in three adults in the UK. Prevalence has increased with the rise in obesity rates. Currently, almost two thirds of the adult population in England are overweight or obese, and almost 29%—almost 13 million people—are living with obesity. When children in England start school, just over one in five of them are overweight or obese, and that rises to more than one in three by the time they leave primary education. Children living with obesity are five times more likely than other children to live with obesity as adults.

We have heard that there are major inequalities in how obesity is distributed across the United Kingdom. That was highlighted brilliantly by my hon. Friend the Member for Bootle (Peter Dowd), and by my hon. Friend the Member for Blackpool North and Fleetwood (Lorraine Beavers), who talked about the loss of her constituent Stuart. My hon. Friend the Member for St Helens South and Whiston (Ms Rimmer) spoke eloquently for Sara and her stepmother Dorothy on their loss of Stephen, which brought home to all of us the real impact of this disease on people’s lives.

Kids in deprived areas are twice as likely to struggle with obesity as those in the least deprived, so this is an extremely serious matter. We are effectively hobbling the life chances of a little boy or girl before they have had a fair start. The Government cannot and will not look the other way as a generation of kids miss out on the best start in life. The points made by my hon. Friend the Member for Worthing West make sense, given that we both stood on a manifesto that committed to halve the gap in healthy life expectancy between the richest and poorest regions in England, and reverse the legacy left to us by the last Government. We share that goal. The question is: how do we get there?

On my hon. Friend’s calls for a liver strategy and a childhood obesity plan, our 10-year health plan sets out decisive action—we have heard about some of it in this debate—on prevention to tackle the obesity crisis head on and create a fairer, healthier food environment. We are looking at people as a whole: where they live, what services they need and how to prevent illnesses in their communities. That will help us to be better prepared for the changing nature of the disease and allow our services to focus more on the management of chronic long-term conditions. I will talk more about prevention later.

On my hon. Friend’s call to extend the levy model, we are taking steps to ensure that the soft drinks industry levy, which the Lib Dem spokesman, the hon. Member for Winchester (Dr Chambers), discussed eloquently and which colleagues know as a sugar tax, remains fit for purpose. On the request that my hon. Friend the Member for Worthing West made for an ICB pathway, we are working with partners including the British Liver Trust to raise awareness and address the stigma related to hazardous and harmful levels of alcohol use and viral hepatitis, which are key drivers of liver disease. We will continue to work with communities and help those most affected by liver disease through the community liver health checks programme.

[Peter Dowd]

This must be one of the safest places in the Palace, with at least three medics and a vet in the Chamber. My constituency has been designated a pride in place area. One of the aims of that programme is to create safer, healthier environments. Does my hon. Friend agree that there is a great opportunity in those areas, which include an area of her constituency, for funding to be used in a lateral way for local community initiatives such as those that have been highlighted during the debate? There is real opportunity for those initiatives to be tested out, with local people making local decisions.

[Karin Smyth]

My hon. Friend is absolutely right. The pride in place programme does just as it says on the tin, and it is important. The Government’s drive is to make sure that those communities, which know best what they need, are the drivers of how that is done. We will think laterally and bring together all that they know about why there is that level of deprivation in those communities. I know that, with his experience as chair of a primary care trust and as a local councillor, my hon. Friend is well placed to see what needs to happen for us to bring things together and think laterally. In my community, the legacy of the tobacco industry is the source of so much of the long-standing inequality.

The ICBs need to be tied into that community work and support it, and make sure that community health checks proactively identify people suitable for liver cancer surveillance. More widely, as my hon. Friend the Member for Stroud said, our shifts, and particularly the transfer to community and neighbourhood health, absolutely support that agenda. I know that hon. Members will make sure that that agenda is well delivered. This disease lends itself very much to that drive, which we are determined to make happen.

My hon. Friend the Member for Worthing West asked for us to be patient-ready for the next generation of liver disease medications. If my hon. Friend the Minister for Innovation, Lord Vallance, were here now, he would happily chew her ear off about everything that the Government are doing to ensure that the next generation of life sciences discovery is available to NHS patients. I will touch briefly on medicines later.

My hon. Friend also asked about local food partnership funding and action on food affordability. I cannot go into those points in detail here, but we absolutely recognise them, and we are working closely with my right hon. Friend the Secretary of State for Environment, Food and Rural Affairs to develop DEFRA’s cross-Government food strategy to provide healthier and more easily accessible food, particularly in deprived areas. I encourage my hon. Friend to ensure that she is completely aligned with that agenda, as I am sure she is. We want to make that work. On her call to enforce the 9 pm watershed, I will update the House on where we are in delivering our manifesto commitments.

Prevention is clearly an important part of this work, and our manifesto specifically promised to restrict advertising of junk food to children, along with banning the sale of high-caffeine energy drinks to under-16s. We are consulting until 26 November on that ban, and the restrictions on junk-food advertising will take legal effect on 5 January. I thank the advertisers and broadcasters who are doing the sensible thing in getting ahead of the regulations by applying the restrictions already.

We have also restricted volume price promotions such as “buy one, get one free” on less healthy food and drinks, and given local councils stronger powers to block new fast-food outlets near schools. We will go further. Current promotion and advertising restrictions on less healthy food and drinks use an outdated nutrient profile model. That was formulated under the previous Labour Government, almost 20 years ago, because we also took this agenda seriously when we were last in government. We will update the standards that apply to the restrictions, and we will consult on their implementation in the coming year.

In a world first, as per our 10-year plan, by the end of this Parliament all large food businesses will be required to report against standardised metrics on sales of healthier food. That means that the large food companies will have to tell us regularly how healthy the food they are selling is, and whether that is improving. That will set full transparency and accountability around the food that businesses are selling, and it will encourage healthier products. We will also set new targets to increase the healthiness of food sales in all communities. Finally, with regard to liver disease, we are exploring innovative approaches to early detection, such as intelligent liver-function testing, to reach more people at a stage when liver damage can better be reversed.

Our focus is prevention—we have the shining example of the hon. Member for Strangford (Jim Shannon)—but we do need to treat the millions of people who already live with obesity in the UK, so let me say what we are doing for them. First, we are building relationships with the biggest pharmaceutical companies to expand access to weight-loss services and treatments across the NHS.

Secondly, obesity drugs can be game changers in supporting weight loss, and we are entering what could be a golden age for obesity drugs, with many more in the pipeline. Over the summer, the NHS started its roll-out of the weight-loss injection Mounjaro through GPs. About 220,000 people, prioritised by clinical need, are expected to receive Mounjaro on the NHS over the next three years.

Thirdly, our obesity pathway innovation programme, supported by industry, is testing new ways of delivering that care, including through pharmacy-led services in the community and through digital services—again, part of our shifts. We recognise that these drugs are not a replacement for good diet and exercise, as exemplified by the hon. Member for Winchester, and they are not the first thing for patients or the NHS to try. That is why we have committed to doubling the number of people who can access the NHS digital weight-management programme.

On hospital to home, we are providing treatment options for children by shifting care from hospital to community. That comes back to the point made by my hon. Friend the Member for Worthing West about the left shift. Earlier this year, the Government announced that we would support thousands of severely obese children to lose weight and live healthier lifestyles, thanks to the roll-out of specialist NHS clinics and new digital smart technology to deliver expert care at home. That game-changing tool is helping our specialists support and keep track of children’s weight-loss programmes, without those children needing to leave home, while offering regular advice to them and their parents to help build healthier habits.

I have set out how the Government are tackling the obesity crisis head on, especially when it comes to safeguarding our children’s future, but while we are shifting the focus of our NHS to prevention, we are also doing more to help people who are already affected by obesity and fatty liver disease, especially through medicines and new technologies and by shifting care from hospital to home. We remember that we stood on a manifesto that committed to tackle the root causes of ill health and to close the gap between the richest and the most deprived areas. That is exactly what we are focusing on through our 10-year health plan. This Government will not sit by and let ill children become ill adults—not on our watch. I thank my hon. Friend the Member for Worthing West for securing this debate.

Menopause and the NHS Health Check

Karin Smyth Excerpts

Thursday 23rd October 2025 Written Statements

[The Minister for Secondary Care (Karin Smyth)]

My noble friend the Parliamentary Under-Secretary of State for Patient Safety, Women’s Health and Mental Health (Baroness Merron) has made the following written statement:

Today I am pleased to be updating the House on a key step we are taking to support women who are going through the menopause.

Menopause is a major life event affecting all women in a variety of ways, both short and long term. Each year around 400,000 women in the UK enter menopause and around three quarters will experience symptoms, lasting an average of seven years.

While menopause is a natural stage of a woman’s life course, symptoms are common with one in four women experiencing the impact on every area of life, at home and at work with women's employment rates falling as the number of menopausal symptoms they report rises.

That is why we are taking action to ensure women are supported through this journey.

Every five years, people aged between 40 and 74 without pre-existing heart conditions are invited to an NHS health check, aiming to detect people at risk of heart disease, stroke, type 2 diabetes and kidney disease.

Perimenopause symptoms can often start from the age of 40, with most women starting the menopause between the ages of 45 and 55, so NHS health checks provide a key opportunity to reach and support these women.

We have listened to women, organisations like Menopause Mandate and the all-party parliamentary group on menopause who have long campaigned for the menopause to be included in the NHS health checks.

That is why we will ask all local authorities to introduce a new element to NHS health checks in 2026. This new menopause question included in the NHS health check will mean eligible women aged 40 to 55 can access advice about the menopause and perimenopause more easily.

We know that women have faced difficulty with access to NHS services being fragmented and through this change we are delivering on our commitment to women’s health, by personalising services to support individuals to manage their health, as set out in the 10-year health plan.

Together, we will ensure women feel supported and are able to access high quality information on the menopause, including advice on managing symptoms and where to seek support.

[HCWS989]

NHS Workforce Levels: Impact on Cancer Patients

Karin Smyth Excerpts

Thursday 23rd October 2025 Westminster Hall

[The Minister for Secondary Care (Karin Smyth)]

It is a pleasure to serve under your chairship, Mrs Hobhouse. I thank the hon. Member for Wokingham (Clive Jones) for securing the debate, and for getting through it—I hope he is well. I thank other hon. Members for their contributions. As others have noted, I am aware of the work that the hon. Gentleman has done, using his experience for good, on access to primary care, radiotherapy and cancer. He has campaigned on behalf of his constituents in Wokingham and people across the country, as the hon. Member for Strangford (Jim Shannon) said. He has been a keen advocate for the NHS workforce’s importance to delivering the health services we need.

I thank the wife of my hon. Friend the Member for Edinburgh South West (Dr Arthur) for her service and wish her well in her new role at the hospice. It is really good to have a voice from Scotland in these debates. My hon. Friend spoke about the shocking and deeply concerning waiting times that our friends and families in Scotland are experiencing. The Scottish people will have a chance to start reversing the situation next May. I hope they take that opportunity, and I look forward to joining my hon. Friend to try to make that happen.

I have my green jacket on, but I am sorry that I could not join today’s Macmillan coffee morning, which the hon. Member for Strangford mentioned. The Under-Secretary of State for Health and Social Care, my hon. Friend the Member for West Lancashire (Ashley Dalton), is working very closely with Macmillan and many other cancer charities as she develops the cancer plan. She is in good contact with them; they do great work, and we will ensure that we continue to talk through their many asks of the Government as she develops the workforce plan.

As many hon. Members said, half of us will have a cancer diagnosis in our lifetime. The health team has certainly taken our full part in that, as 50% of us have had a cancer diagnosis. Some of us are still undergoing treatment. Although more than three quarters of all people diagnosed with cancer in the UK are 60 and over—as hon. Members said, the population is ageing—I decided to get mine at 59. My hon. Friend the Member for West Lancashire is also younger than 60, and the Secretary of State would not forgive me for not reminding everybody that he is only in his early 40s. We make the point well: as other Members said, that although incidence will increase as a result of our ageing population, cancer can strike anybody at any age.

Diagnosing and treating cancer is a growing part of NHS elective activity, and responding to demand in a way that best suits patients is crucial. That includes the issues that the hon. Members for Wokingham and for Harrogate and Knaresborough (Tom Gordon) raised about the variability we often see even in a small geographical patch, and certainly between different cancers. The hon. Member for Wokingham talked about clinical nurse specialists. Mine were absolutely fantastic, and I did know who they were. The statistics he outlined are deeply concerning, so those points were very well made. Our mission to tackle cancer and the other biggest killers is underpinned by the 10-year health plan published earlier this year, focusing on those three shifts: from hospital to community, from analogue to digital, and from sickness to prevention.

On the workforce plan, we know that we need an effective and sustainable workforce to deliver better outcomes for everyone, including those with cancer. In the 10-year health plan, we set out that, to deliver a workforce fit for the future, we need a new, sustainable approach to workforce planning. Our 10-year workforce plan will be different. It will set out how we will create a workforce ready to deliver a transformed service for patients when and where they need it, with more empowered, flexible and fulfilled staff.

Since we launched our call for evidence on 26 September, we have been struck by the huge enthusiasm of staff, the sector, stakeholders and colleagues in sharing their thoughts and ideas with us. Many have said that they would like more time to have those conversations, to test ideas and to work together to deliver a truly reformed service. I am grateful to them for raising that, and it is why we have made the decision to give more time to that process. We will now publish the plan in the spring of 2026. A spring publication will allow us to have more detailed discussions with partners, hon. Members and other stakeholders, not just to listen but to work in a truly joined-up way to deliver for staff and patients.

The shadow Minister helpfully outlined all the decisions that were made by her Government over the last few years—decisions that essentially led to many of the workforce problems we now have. We are trying to resolve those problems, and we will. She informed the House that the resident doctors committee has now decided to go on strike again, which is, of course, deeply disappointing. It will be damaging for the work we want to do, and we urge it not to go ahead. However, we will continue to commit to ensuring that the workforce is fit for purpose, including to diagnose and treat cancer. We will progress with the work that we have already started.

In July 2025, there were over 5% more staff in the key cancer professions of clinical oncology, gastroenterology, medical oncology, histopathology, clinical radiology and diagnostic and therapeutic radiography than in July 2024. There were also more doctors working in clinical oncology and more radiology doctors, compared with last year.

My hon. Friend the Member for Edinburgh South West asked particularly about haematology. NHS England has invested in expanding specialty training posts in high-demand disciplines, including haematology, and is supporting local systems to retain and develop multidisciplinary teams. That includes increased medical training posts in haematology, and enhancing the scientific workforce supply through other initiatives.

We have also ensured that the cancer-facing workforce are put on a more stable footing to ensure they have the stability they need to continue to provide the care that patients need. In 2025, we provided grant funding to the Royal College of Radiologists to encourage foundation and internal medicine trainees to specialise in clinical oncology. That work is currently under way and involves a series of webinars as well as targeted engagement. In 2024-25, around 8,000 people received training either to enter the cancer and diagnostic workforce or to develop in their roles. As part of that, more than 1,600 people were on apprenticeship courses, with more than 270 additional medical specialty training places funded. More than 1,000 clinical nurse specialist grants were made available to new and aspiring CNS workers, and it is a really valuable service.

[Tom Gordon]

I thank the Minister for giving way. As ever, she is most generous with her time. She has outlined the positive steps that the Government are taking to address the workforce challenge. Could she elaborate on the points I made about the inequalities between the north and the south in the NHS and the cancer workforce?

[Karin Smyth]

I do not have those numbers to hand but, as we outlined in the 10-year health plan, we are particularly committed to people in rural and coastal communities with regard to workforce and access to many other services. If there is anything specific the hon. Gentleman is not aware of, I am happy to furnish him with more information. We are, however, minded to rectify the variability across the country, even within towns and cities, let alone rural and coastal communities, whether that be in the north, south, east or west.

We will ensure that ongoing investment in practice education continues to enhance clinical supervision, education and training across cancer and diagnostic workforces. That will increase placement capacity, support staff retention and contribute to high-quality patient care.

We will not only ensure that the cancer workforce have the numbers to succeed, but also the skillset. Training academies in imaging, endoscopy and genomics are all being delivered across regions to provide intensive skills development and to support new models of care. We will also ensure that staff have the skills to adopt the treatments needed by cancer patients. Adoption of innovative cancer treatments is often clinician-led and self-identified, with doctors seeking out specialist training opportunities themselves. This may include overseas fellowships or short courses, after which skills are cascaded locally through continued professional development, multidisciplinary teams and peer-to-peer learning.

The complex challenge of tackling the cancer and workforce issues we face will not be solved with a single solution, which is why the Department will be publishing a national cancer plan in the new year. The plan will have patients at its heart and will cover the entirety of the cancer pathway from referral and diagnosis to treatment and ongoing care, as well as prevention, research and innovation. The national cancer plan will build on the progress of the 10-year health plan to improve survival rates and reduce the number of lives lost to the biggest killers.

On 4 February, we launched a call for evidence on the national cancer plan, which closed on 29 April. We received over 11,000 responses from individuals, professionals and organisations who shared their views on how we can do more to achieve our ambition. We have worked with crucial industry figures in the development of the national cancer plan, including the Royal College of Radiologists. The submissions are being used to inform our plan to improve cancer care. As I said, the Under-Secretary of State for Health and Social Care, my hon. Friend the Member for West Lancashire, is working hard on that issue.

I thank the hon. Member for North Shropshire (Helen Morgan) for her recognition of the improvements being made at Shrewsbury and Telford and for her contribution, and that of other local MPs, in supporting that trust. Those are very welcome improvements.

On research, the life sciences sector is critical to this Government’s growth mission and we want to make this country the best place to do life sciences. Of course, the Department is working closely with colleagues in the Department for Science, Innovation and Technology, the Department for Business and Trade, and His Majesty’s Treasury to make that happen.

Finally, through this Government’s action on workforce and cancer capacity, we will ensure the NHS has the staff it needs to treat cancer patients safely across the country. I thank the hon. Member for Wokingham for securing this debate.

Oral Answers to Questions

Karin Smyth Excerpts

Tuesday 21st October 2025 Commons Chamber

[Steve Darling (Torbay) (LD)]

5. What progress his Department has made on the implementation of the new hospital programme.

[The Minister for Secondary Care (Karin Smyth)]

The Conservative Government’s promise of 40 new hospitals by 2030 was a fantasy—there was no funding beyond last March. In January, we published a realistic plan that put the programme on a credible and sustainable footing. We are committed to delivering all the schemes in the programme and are moving at pace with funding in place for design work, construction activity and business case development.

[Steve Darling]

The Conservatives still have not apologised for the appalling state that they left our NHS in. Torbay hospital is the third oldest hospital in the United Kingdom. It has a tower block wreathed in scaffolding to stop bits of it falling off rather than it being under repair, and it has sewage leaks throughout. Sadly, it needs significant investment, which has been kicked into the long grass. A senior manager described the situation only this week as “dire”. Will the Minister meet me and hospital representatives to explore how we can achieve the investment to turn this round?

[Karin Smyth]

The hon. Member makes an excellent point; it was echoed by Lord Darzi in his report about the state of our hospitals, and I know many hon. Members have similar problems. I have visited many such hospitals and would be happy to discuss the matter with him further. I remind him that, of course, the Torbay and South Devon NHS foundation trust has been provided with £7.3 million from the estates safety fund for works at the hospital, and we are absolutely committed to ensuring that it will be developed in line with the programme.

[Rebecca Smith (South West Devon) (Con)]

6. What recent progress he has made on reorganising the NHS.

[The Minister for Secondary Care (Karin Smyth)]

We are putting the final nail in the coffin of the hon. Member’s party’s disastrous Lansley 2012 reorganisation—so bad that it made me become an MP. We are abolishing the world’s biggest quango, NHS England, along with 200 other bodies. The question is: why did the Conservatives not do that when they had the chance?

[Rebecca Smith]

Yesterday I met Lila, a sixth-form student at Coombe Dean school, who raised the issue of long waiting lists for mental health services for children and young people across Devon. What action has been taken as a result of the Government’s policy of reorganising the NHS to reduce the unacceptable delays in mental health diagnosis and treatment for children and young people, particularly in constituencies such as South West Devon?

[Karin Smyth]

All of us as constituency MPs are fully aware of the state of mental health services, particularly for young people, which is why my hon. Friend the Minister for Care is working at pace on our manifesto commitments to support young people, particularly through schools. We also understand the difficulties that her ICB in particular has with its financial situation—something we are also targeting as part of our reforms to ensure that ICBs develop services for local people in line with the expectations that we have set them.

[Rachael Maskell (York Central) (Ind)]

Likewise, in York, children and adolescent mental health services are just not working for children, who are left on waiting lists often with no management or treatment. In order really to achieve reorganisation in our NHS, would our Government look at local authorities commissioning mental health services, to deliver such services and to meet the holistic needs of young children’s development and mental health wellbeing?

[Karin Smyth]

Again, I echo comments on the state of mental health services, as the hon. Member has done. As it says in our manifesto, we are committed to those 8,500 extra mental health support workers in local areas such as hers. It is important that commissioners work closely with their local authorities on mental health services, and I know my hon. Friend the Minister for Care is ensuring that that happens as part of the reforms we are undertaking.

[Mr Speaker]

I call the shadow Minister.

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

We have.

[Karin Smyth]

As my right hon. Friend has just said, we have delivered on that commitment. The hon. Member talks about the reorganisation being a distraction. If her party had focused taxpayers’ money on patient services rather than ballooning bureaucracy, with costs increasing both among providers and through ICBs, we would not have inherited the mess that we did, and would be able to roll out programmes more effectively. We have committed to doing that.

[Dr Caroline Johnson]

I thank the hon. Lady for her answer, but I would like her to check and perhaps update the guidance for GPs and the websites that continue to say that it is only available to 80-year-olds who turned 80 after 1 September 2024, which is not all people over the age of 80.

Reorganisation is affecting delivery elsewhere, too. The Secretary of State also promised that the continued roll-out of fracture liaison services would be one of his first priorities. How many new fracture liaison services have opened since the general election?

[Karin Smyth]

On the hon. Lady’s first point, this Government, unlike the previous Government, do believe in experts, and we follow the clinical advice that we are given. On her second point, as she is so keen on reading our manifesto commitments, the commitment was to do that by 2030. It is currently 2025. Our reforms to ICBs and providers, bringing NHS England inside the Department of Health and Social Care to make it more democratically accountable for taxpayers, will reverse the shocking increase in funding that the previous Government put into a leaky bucket. We are fixing the foundations of the NHS. We are targeting resources at people in line with our 10-year plan.

[Natasha Irons (Croydon East) (Lab)]

7. What assessment his Department has made of the potential impact of NHS online on waiting times.

--- Later in debate ---

[Ian Lavery (Blyth and Ashington) (Lab)]

12. What steps he is taking to ensure that frontline NHS services are supported following the potential introduction of new public-private partnership contracts.

[The Minister for Secondary Care (Karin Smyth)]

Let me be clear: this Government will always protect the NHS and have the service free at the point of use for everyone. This Government are determined to shift health out of hospitals and into the community, as set out in the 10-year plan, and neighbourhood health services will be fundamental to delivering this shift, so it is right that we look at a range of options to provide the best care for people across the country. Let me reassure hon. Members that all proposals are subject to robust, value-for-money assessments to ensure taxpayers get the best possible return on investments in our health services.

[Ian Lavery]

May I begin by congratulating the Secretary of State on his actions in trying to repair our cherished NHS following 14 years of Tory destruction? We must learn from past mistakes. The private finance initiative was a huge, expensive mistake—an absolute disaster—with £80 billion repaid for an investment of £13 billion. Will the Minister reassure the House that the lessons of PFI have been well learned, and that they are well and truly in the past and in the dustbin?

[Karin Smyth]

I thank my hon. Friend for his words of encouragement and congratulation. I assure him that lessons have been learned; we will ensure value for taxpayers’ money in all future proposals.

[Pippa Heylings (South Cambridgeshire) (LD)]

I meet regularly with GPs in my constituency, and they have highlighted that they do not yet have clarity or certainty about the role and resources that they will have in the roll-out of services from hospitals to communities and neighbourhood health services. Will the Minister meet me to provide that clarity to our GPs and assure them that they will be at the table during that roll-out?

[Karin Smyth]

It is absolutely the role of the hon. Lady’s local integrated care board to ensure that it involves all partners, particularly primary care, in the exciting roll-out of neighbourhood health services, which I think they welcome. I am happy to discuss that further with her.

[Richard Burgon (Leeds East) (Lab)]

14. What steps his Department is taking to tackle wasteful spending in the health service.

[The Minister for Secondary Care (Karin Smyth)]

As well as the record investment that we put into the NHS, we are ensuring that we get a better bang for the taxpayer’s buck. Under the Conservatives, for example, the NHS was paying £3 billion to recruitment firms for agency shifts. We have cut agency spending by a third and are abolishing it altogether, with the savings reinvested in staff pay and treatment for patients. That is just one example of how our reform agenda is good for patients and for taxpayers.

[Richard Burgon]

Private finance initiative deals did huge damage to NHS budgets. Despite receiving just £13 billion in assets, NHS trusts were saddled with more than £80 billion in PFI debts—most of that is still being paid back. We have even seen some hospitals spending more on PFI debts than on medicines. If they really want to cut out waste and avoid a PFI-style disaster 2.0, will the Government rule out using private finance for the new network of new NHS clinics, as has been floated?

[Karin Smyth]

As I answered in response to my hon. Friend the Member for Blyth and Ashington (Ian Lavery), we will absolutely ensure that we learn the lessons of the last Government’s failure.

[Tim Farron (Westmorland and Lonsdale) (LD)]

Does the Minister agree that it is completely wasteful to make cancer patients who need to go for chemotherapy in Carlisle on a Wednesday but who live in, say, Kirkby Stephen to have to travel to Carlisle on the day or on the day before to get their bloods taken? Why is that? Because the local hospital will no longer fund the local GP surgery in Kirkby Stephen or Appleby to take their bloods there. Is it not wrong that those GP surgeries can no longer provide secondary healthcare blood services in their own settings in people’s own communities?

[Karin Smyth]

As he often does, the hon. Gentleman highlights in his own very rural constituency some of the fundamental problems at the heart of our NHS. That is why we are reforming it, ensuring that we move hospital services from hospitals into the community and developing neighbourhood health services. We are also looking at the financial flows in the system that lead to these sorts of perverse incentives and funding arrangements, which do damage to his constituents, as they do to many others and to rural and coastal communities. That is why we highlighted that in the 10-year plan. We need to see the end of such examples.

[Josh Newbury (Cannock Chase) (Lab)]

15. What steps he is taking to ensure that women have access to menopause treatments on the NHS.

--- Later in debate ---

[Naushabah Khan (Gillingham and Rainham) (Lab)]

T4. A Channel 4 “Dispatches” documentary recently went undercover at an ambulance centre in my constituency of Gillingham and Rainham. It showed exhausted staff working under difficult circumstances—the result of years of Tory neglect and mismanagement of our NHS. Does my right hon. Friend agree that after the chaos under the last Government, this Administration will put staff and patients first? Will the relevant Minister come to my constituency to meet healthcare providers and discuss our local challenges?

[The Minister for Secondary Care (Karin Smyth)]

We know that there have been issues with the urgent emergency care response. We are absolutely committed to supporting ambulance trusts to continually improve the patient experience. The urgent emergency care plan for 2025-26 is backed by nearly £450 million of funding. I am happy to discuss that further with my hon. Friend.

[Mr Speaker]

I call the Liberal Democrat spokesperson.

--- Later in debate ---

[Leigh Ingham (Stafford) (Lab)]

In my constituency of Stafford, Eccleshall and the villages, I recently ran a survey, which had a whopping 99% response rate, in support of an urgent treatment centre in my constituency. Would the Minister agree to meet me to discuss urgent treatment provision in my constituency?

[Karin Smyth]

My hon. Friend does an excellent job in her constituency. I meet her regularly to discuss issues in her constituency, and I am very happy to discuss the provision of urgent care centres with her.

[James Wild (North West Norfolk) (Con)]

Greater transparency about NHS data should be used to drive improvements, so what assessment has the Health Secretary made of the impact on the Queen Elizabeth hospital in King’s Lynn of being forced to make savings of £18 million this year? What impact will that have on the need to reduce waiting times for A&E and cancer treatment, as identified in the league table that he published?

Healthcare: Bolton

Karin Smyth Excerpts

Wednesday 15th October 2025 Westminster Hall

[The Minister for Secondary Care (Karin Smyth)]

It is a pleasure to serve under your chairship this afternoon, Ms Lewell.

It was a valiant effort from the hon. Member for Hinckley and Bosworth (Dr Evans) to raise things such as top-down reorganisation and the state in which the Conservatives left the health service after their 14 years in government. It is as a result of that record that I am delighted to have my hon. Friend the Member for Bolton North East (Kirith Entwistle) here, alongside such strong representation from Labour, following the electorate’s verdict on the last 14 years only 14 months ago. She has been an excellent campaigner since joining Parliament, and securing this important debate is part of that. I am grateful to other hon. Members for taking part.

As a result of the action taken by my hon. Friend the Member for Bolton North East in securing this debate, I met the chief executive, Fiona Noden, and the local ICB to understand, in a more granular fashion, some of the issues I expected my hon. Friend to raise. She was right to thank the staff—both at a leadership level and across the board in Bolton—for their great work. I commend that leadership for meeting regularly, and my hon. Friends the Members for Bolton North East and for Bolton South and Walkden (Yasmin Qureshi) for meeting regularly with those leaders. That happens in my own patch, but it does not happen everywhere. As I often say, it is a really valuable local relationship, because it makes hon. Members more informed and NHS managers better leaders as well.

As we have heard so eloquently, the NHS faces pressures all over the country, including in Bolton and north-west England. Our 10-year health plan is designed to fix that. I thank my hon. Friend the Member for Bolton North East for holding one of those important consultation events. They were very powerful. As a result of the work that she and others have done to bring the patient voice directly to Government and make it a fundamental part of the plan, I think our plan has widespread support. I hope her constituents can hear their voices reflected in the plan that we have developed: it is about access to healthcare for everyone, no matter where they live or how much they earn. We must make sure that our health service is based on that need.

The three shifts—hospital to community, treatment to prevention, and analogue to digital—will ensure that community and neighbourhood health services get the investment they need and that patient communication is more joined up. We are also working with the NHS to make the tough choices that are needed to get it back on its feet.

We will create an NHS where patients have more control, staff have more time to care, bureaucracy is reduced, power is devolved and the health inequalities that we have so sadly heard about again this afternoon are narrowed. That includes creating a new operating model with fewer, larger ICBs, enabling them to harness a shared budget of sufficient size to improve efficiency and reduce running costs. It is a 10-year plan, but of course we are already seeing some improvements and we have set key targets and milestones along that trajectory. As my hon. Friend the Member for Bolton South and Walkden said, we cannot all wait 10 years. We have to see that improvement along the way.

Child health is crucial. We have heard about the inequalities and poverty that many children in Bolton experience. That is why the Government have committed to raising the healthiest generation of children ever, and will soon publish an ambitious strategy to reduce child poverty, tackle the root causes, and give every child the best start in life.

A huge part of realising our ambitions for the NHS is about improving access to dentistry services. The Government understand that, which is why extra urgent dental appointments are being made available across the country, including in Greater Manchester. That is expected to deliver an extra 17,897 urgent dental appointments across 2025-26. Additional dentists have also been recruited in areas that need them most, and we are committed to delivering fundamental contract reform before the end of this Parliament.

All of that will deliver better dental care for everyone in England, including those in Bolton. We also recognise that we need to go further to improve the oral health of children, which is why we are providing funding to local authorities to roll out the targeted, supervised toothbrushing programme for three to five-year-olds. As a result of the programme, Bolton has received over 32,000 donated products to implement supervised toothbrushing alongside an additional £127,000 this financial year.

Hon. Members rightly raised the issue of RAAC at Royal Bolton hospital, which is obviously deeply concerning for staff and patients. Let us be very clear: the safety of patients and staff has to come first. Each trust with RAAC issues has invested significant levels of NHS capital to mitigate safety risks. Locally, the Bolton NHS foundation trust has received over £9.5 million to mitigate the RAAC risk and for eradication works at Royal Bolton hospital. The trust will continue to have access to further necessary funding for RAAC removal, enabling the hospital to complete development and modernisation upgrades.

Hon. Members also raised the important subject of women’s health. As part of our work in this area, we are tackling waiting lists, of which gynaecology is a substantial part. We will see those waiting lists come down and we will soon make emergency hormonal contraception free in pharmacies, but we know that there is much more to do for women. That is why we will look at where we can go further and reflect that in an updated women’s health strategy to better meet the needs of women in Bolton and across the country.

This year the Secretary of State announced a rapid national independent investigation into NHS maternity and neonatal services. He will also chair a maternity and neonatal taskforce to develop the action plan based on the investigation’s recommendations. I am happy to report encouraging local initiatives such as Bolton’s new maternity and women’s health unit, which is set to open in early 2027, as well as a focus on paternal support and investment in strong community-based care and specialist parental mental health support, which we know is so important.

Issues around mental health were raised this afternoon. Mental health support in maternity is made possible only by strong mental health services across the board. That is why we are transforming mental health services. We have heard about Opposition Members serving on the Public Bill Committee and we thank them for their work. We need to build new dedicated mental health emergency departments, improve outreach, and increase overall funding to benefit Bolton and the rest of the country. That includes transforming mental health services in 24/7 neighbourhood mental health centres, building on the existing pilots, and investing up to £120 million to bring the number of mental health emergency departments up to 85.

We also heard about urgent and emergency care this afternoon. We will be publishing an urgent and emergency care plan. The plan will reduce A&E wait times, provide almost £450 million of capital investment for same-day emergency care and mental health crisis assessment centres, and get more ambulances back on the road. The local picture is promising. In Bolton, 12-hour wait times are down compared with a similar time last year, and meaningful infrastructure improvements are being delivered. We are not complacent, however, and we know the situation is not acceptable for people.

A large part of the contributions was about improving general practice and recognising the need for people to feel they have access to it, because that is where most people have contact with the health service. That improvement is a crucial part of our agenda. It is heartbreaking to hear about patients not getting the testing or treatment they need, and of course Leah and her son should not have had to endure that shocking ordeal. I hope that they are getting the support they need, and I am sure that my hon. Friend the Member for Bolton North East will be supporting them.

On access, my hon. Friend will be aware that part of our negotiations with doctors has been about increasing online access, which was rolled out on 1 October. That is helpful to know if that is available in her patch. New funding for the advice and guidance scheme is helping GPs to work more closely with hospital specialists to access expert advice quickly and speed their patients through the system, so they get care in the right place as soon as possible.

[Dr Luke Evans]

Hearing Leah’s story was very concerning and upsetting. When it comes to further online access, one of GPs’ biggest concerns is about what to do with the emergencies that may come in through a computer at 6.20 pm as a result of that access, having to make that assessment when the system is supposed to be closing, and the ability to move GPs to take them away from face-to-face consultations to deal with online access. How will the Government square the circle of access versus patient safety? That is at the crux of the dispute.

[Karin Smyth]

The shadow Minister opens up a discussion that could take some time. Clearly, practices regularly manage emergency situations. The system that we have put in place aims to make sure that patients have access during the day. Different practices will obviously have different opening times—that is a matter for the local system—but I know that if an emergency comes forward, practices all over the country do all they can to make sure that patients are safe. There are also disclaimers on their websites about the times of operation and so on. If there are any individual cases that he wants to raise, we will look at them, but that urgent emergency interface is a matter of negotiation locally and I think most practices understand how to manage it.

I am pleased to report that we are investing more than £1 billion extra in GP services and £82 million in the primary care workforce to ensure that places such as Bolton get the resources and GPs they need. On infrastructure, a new £102 million fund will create additional clinical space across more than 1,000 practices in England. As a result of those efforts, 8 million more appointments have been delivered this year compared with last year. Our shift to a neighbourhood health service is exactly about the joined-up, accessible and locally accountable care that we all want to see, and that my hon. Friend the Member for Bolton North East rightly highlighted. That is also what staff in the system want to see.

On waiting lists, we published our elective reform plan to deliver the change that we promised at the last election. Between July 2024 and June 2025, we delivered more than 5 million additional appointments compared with the previous year. There has also been a reduction in the number of people on the waiting list of over 200,000. I think patients and members of the public are seeing and feeling that progress, and although there is a long way to go, staff are starting to feel it too.

Since June 2024, the number of people on the waiting list at Bolton NHS foundation trust has reduced by more than 7,000, and the number of patients waiting over a year has more than halved. Those are tangible improvements in a very short time, and we thank the staff for their hard work to achieve that. Patients deserve better, but they are seeing progress. We know there is more to be done.

I thank hon. Members for bringing their knowledge and experience of Bolton’s health services to this debate. I know that they and my hon. Friend the Member for Bolton West (Phil Brickell) will continue to advocate strongly on behalf of the people of Bolton, continue to work closely with local leaders, and continue to hold the Government to account for the promises we are making. That conversation between local Members of Parliament about what is actually happening on the ground, which we all hear about in our inboxes, in our surgeries and when we talk to local people, is an important part of what they are doing to raise these issues. I hope that my response shows how much the Government are committed to addressing these issues and working to improve healthcare for the people of Bolton.

Health and Social Care Update

Karin Smyth Excerpts

Monday 13th October 2025 Written Statements

[The Minister for Secondary Care (Karin Smyth)]

I would like to inform the House of several updates from the Department of Health and Social Care over the conference recess.

National Commission on the Regulation of Artificial Intelligence in Healthcare

This Government have established the national commission into the regulation of AI in healthcare. This marks a major step forward in the Government’s mission to make the NHS the most AI-enabled healthcare system in the world.

This is a bold new initiative to lead the UK’s efforts in shaping safe, effective, and trusted AI regulation. The national commission will advise the Medicines and Healthcare products Regulatory Agency, our globally renowned healthcare product regulatory body, on the development of a new regulatory framework for AI and software as medical devices, to be published in 2026. This framework will ensure the UK is the fastest and safest place to bring AI-driven health technologies to market, supporting both NHS transformation and building public trust, while positioning the UK as a global hub for health tech investment and providing valuable insights for our international partners.

The national commission will consist of a diverse panel of experts, including clinicians, patient representatives, international experts, innovators, and regulators. The national commission will be chaired by Professor Alastair Denniston (Head of the UK’s Centre of Excellence in Regulatory Science in AI and Digital Health), with Dr Henrietta Hughes (Patient Safety Commissioner) as deputy chair.

Cloud Based AI tool

The Department of Health and Social Care, through the National Institute for Health and Care Research, is partnering with NHS England to create the AI research screening platform, a single, secure national infrastructure where AI tools can be installed, tested, and integrated with local screening services for research across all NHS trusts.

AI could transform NHS screening by improving early detection, speeding up diagnosis, and easing pressure on staff. Yet progress is limited: many promising tools remain stuck in pilots because there is no reusable, scalable digital infrastructure to evaluate them. Each study currently requires bespoke IT systems that are costly, slow, and unsustainable.

AIR-SP will enable large-scale, rigorous evaluation by comparing AI analysis of screening images with standard clinical pathways. The platform will support multiple NHS, academic, and industry-led research studies, accelerating safe AI deployment.

Building on the NHS digital screening programme, the initial focus will be on mammograms, retinal images, and lung CT scans, with future expansion to other imaging data. As part of the life sciences sector plan, AIR-SP will strengthen the UK’s position as a global leader in health AI, delivering faster diagnoses and better outcomes for patients.

Fair Pay Agreement

The Government intend to introduce the first-ever fair pay agreement for adult social care in 2028, backed by £500 million in funding to improve pay and terms and conditions for adult social care workers. This will complement the wider programme of workforce reforms under way to reform adult social care by improving recruitment and retention and giving staff better recognition for their vital work.

The funding is part of the £4 billion available for adult social care in 2028-29 and will be given to local authorities to support providers in improving pay and terms and conditions.

A public consultation on the design of the fair pay agreement process is now open until 16 January 2026. The consultation will inform the development of regulations, intended to be laid in 2026, establishing the adult social care negotiating body composed of employer and employee representatives. Negotiations are expected to begin in 2027, with implementation of the first FPA expected in 2028.

Over this Parliament, alongside our changes to the minimum wage and new measures in the Employment Rights Bill, care workers will receive one of the biggest upgrades in their pay, rights and conditions in a generation.

NHS Online

On 30 September, the Government announced they will be setting up an “online hospital”, NHS Online—a significant reform to the way healthcare is delivered.

This innovative new model of care will not have a physical site; instead, it will digitally connect patients to expert clinicians anywhere in England. It will give people on certain pathways the choice of getting the specialist care they need at home, having chosen to be referred to NHS Online by their GP. The first patients will be able to use the service from 2027.

NHS Online is part of achieving the Governments ambitions outlined in the 10-year health plan, which holds a radical and sustainable vision for how we think about elective care, with digital being the default and hospital attendances the exception.

NHS Online will help to reduce patient waiting times, delivering the equivalent of up to 8.5 million appointments and assessments in its first three years, four times more than an average trust.

Patient choice remains central to care. In-person care will always be available for those who prefer and for those whose care needs require it. NHS Online will free up capacity for face-to-face appointments.

[HCWS955]

Independent National Maternity and Neonatal Investigation

Karin Smyth Excerpts

Monday 15th September 2025 Written Statements

[The Minister for Secondary Care (Karin Smyth)]

I am announcing today the 14 hospital trusts that will be looked at as part of a rapid, independent, national investigation into maternity and neonatal services. In June, the Secretary of State for Health and Social Care, my right hon. Friend the Member for Ilford North (Wes Streeting), announced this urgent investigation because of concerning patterns in baby deaths and maternal mortality, and because of the extremely harrowing and traumatic stories that bereaved families brought directly to the Secretary of State and the Department.

The Secretary of State asked Baroness Valerie Amos to chair this review—a former diplomat with vast leadership experience and a passion for driving change. Baroness Amos has selected the 14 trusts for local investigations, based on a range of factors. These include data and metrics, such as data from the Care Quality Commission maternity patient survey and MBRRACE-UK perinatal mortality rates, as well as criteria to ensure: a diverse mix of trusts; variation in case mix, trust type, and geographic coverage; and provision of care to individuals from diverse backgrounds, including consideration of social, economic and racial inequalities, family feedback, and where previous investigations have taken place.

From smaller hospital trusts to those operating in our bigger cities, the 14 trusts will help Baroness Amos and her expert advisers to assess maternity and neonatal units of all shapes and sizes. Rest assured that the voices of women and families remain at the heart of this process, as evidence is gathered directly from those with lived experience. I know that for families who are carrying a traumatic burden from what they have gone through, helping us shape this is yet another extremely difficult process to bear. The Secretary of State and I are incredibly grateful to all the families who have taken part and fed into this investigation.

To be clear, this is not about naming and shaming trusts. Expecting parents should not be discouraged from visiting their local hospital, wherever it is, because of this investigation. Hard-working maternity staff should know that this is a sincere and focused effort to support trusts across the country by giving them the tools to provide the best possible care. The Secretary of State has now agreed the final terms of reference with Baroness Amos, and these will be published today.

The 14 hospital trusts are:



Barking, Havering and Redbridge University Hospitals NHS Trust

Blackpool Teaching Hospitals NHS Foundation Trust

Bradford Teaching Hospitals NHS Trust

East Kent Hospitals NHS Trust

Gloucestershire Hospitals NHS Trust

Leeds Teaching Hospitals NHS Trust

Oxford University Hospital

Sandwell and West Birmingham Hospitals NHS Trust

Shrewsbury and Telford Hospital NHS Trust

The Queen Elizabeth Hospital, King’s Lynn

University Hospitals of Leicester NHS Trust

University Hospitals of Morecambe Bay NHS Foundation Trust

University Hospitals Sussex NHS Foundation Trust

Yeovil District Hospital NHS Foundation Trust / Somerset NHS Foundation Trust

The investigation will start detailed work with the 14 trusts straight away, looking closely at the care for women, babies and families. There have already been a raft of reviews and reports, and Baroness Amos and her team will draw on these to create one clear, national set of actions to improve care across the country.

Importantly, the investigation will gather evidence directly from women and families, including fathers and non-birthing partners. This evidence will inform recommendations and result in an initial set of findings and recommendations by December 2025.

Baroness Amos will develop one clear set of recommendations for achieving consistently high-quality, safe maternity and neonatal care. The chair will be supported by a small team of expert advisers and will engage regularly with affected families throughout the investigation process.

This investigation is separate from the National Maternity and Neonatal Taskforce, which the Secretary of State will chair, and will take forward the recommendations of the investigation, forming them into a national action plan to drive improvements across maternity and neonatal care. These recommendations will supersede the multiple existing actions and recommendations already in place.

[HCWS923]

Non-surgical Aesthetic and Cosmetic Treatments

Karin Smyth Excerpts

Thursday 11th September 2025 Westminster Hall

[The Minister for Secondary Care (Karin Smyth)]

It is a pleasure to serve under your chairmanship this afternoon, Sir Desmond. I thank the hon. Member for Bromsgrove (Bradley Thomas) for securing today’s debate on this important issue, and other Members for their contributions. This is an area of significant interest to colleagues, and indeed the public.

I think this may the first time the hon. Member for Bognor Regis and Littlehampton (Alison Griffiths) has spoken formally for the Opposition, so I congratulate her on that, and I wish her colleague, the hon. Member for Sleaford and North Hykeham (Dr Johnson), well. She made the point that we had been slow. Let me make the point gently back to her that this is an issue I inherited and that, as people will know if they have read Lord Darzi’s report—if they have not, I really commend it to them—both the breadth and the depth of the inheritance for me and my colleague, the Secretary of State for Health and Social Care, is sometimes beyond description.

I was therefore determined to make progress on this issue, and was absolutely delighted to be able to announce in August that we will, as a Government, step in to regulate in this space. As colleagues will know, doing a press round on an August morning is often not the highlight of everyone’s day, but I was humbled by the responses from families, journalists and campaigners—those women who have shared their stories over many years. I pay tribute to many of them, particularly lots of young women journalists who have taken those stories and told them so powerfully.

The response to that announcement, and the interaction with journalists, was humbling. Indeed, it was a pleasure to make those announcements in my home city of Bristol, where some surgeons have been campaigning on this issue for 20 years, and for them to see what has happened and that the Government are prepared to move in. We are really aware of this issue, and I thank hon. Members for the cross-party support for us moving in this area. We have all seen those troubling headlines about the devastating consequences of unsafe cosmetic practices, and all our inboxes have been inundated by constituents who rightly expect us to make things safer. I am grateful to those who have shared their stories about what can go wrong and who have pushed for action.

I have particular concern for parents who are worried by what their children see on social media, as we have heard this afternoon: young women and girls who are made to feel unhappy in their own bodies by what they see online and feel the need to go through risky and unregulated procedures to ease their concerns. Also as we have heard this afternoon, people think the industry is regulated and are shocked to find out that it is not

The Government of course back small businesses. We recognise the benefits that the industry brings to people and communities. I am also mindful that the sector is full of female entrepreneurship. It is an industry led by women, largely for women, and is a success story to be celebrated, especially in the face of fierce competition from medical tourism. Getting a cosmetic procedure can be a very positive experience—a point made by my hon. Friend the Member for Calder Valley (Josh Fenton-Glynn) and others. The sector is growing to meet a demand, as more and more people seek to take advantage of the increasing availability and affordability of cosmetic treatments. That is a good thing, but for too long the sector has been left with little in the way of safeguards. We need to balance the priority of public safety without stifling creativity and innovation.

My hon. Friend the Member for North West Leicestershire (Amanda Hack) made some excellent points. She visits salons to talk to women—there might also be an occasional man running one of those salons, and we want to work with them, too. She talks to them so that she is informed. I encourage her and others to keep sharing views from the frontline, because people want to do a good job and we are keen to hear from them.

So what are we doing? First, we will prioritise developing legal restrictions on high-risk cosmetic procedures, as we outlined in last month’s response to the consultation. I urge anyone listening to this debate to look at “The licensing of non-surgical cosmetic procedures in England”. High-risk procedures include the so-called liquid Brazilian butt lift, which tragically led to the death of Alice Webb in September last year. Her Member of Parliament, my hon. Friend the Member for Stroud (Dr Opher), has been talking to me about these issues since he became a Member.

Bringing the restricted high-risk procedures into the Care Quality Commission’s scope of registration will mean procedures being performed only by suitably qualified, regulated healthcare professionals working for providers who are registered with the CQC. We will come down like a ton of bricks on providers who flout the rules, with tough enforcement from the CQC.

Secondly, the hon. Member for Bromsgrove raised a really important point about qualifications. He is right that it is currently far too easy for someone with minimal or no training to set themselves up as a practitioner. We will introduce a local authority licensing scheme in England for lower-risk cosmetic procedures such as botox and lip fillers. This was widely supported by many people who responded to the 2023 consultation started by the last Government on the scope of licensing. That consultation received over 11,800 responses. Licensing will ensure consistency of standards and allow action to be taken against practitioners who fail to comply with the requirements. All practitioners will be required to meet rigorous safety training and insurance standards.

Local authorities will run and enforce the scheme, under which it will be an offence for anyone to carry out specific non-surgical procedures without a licence. I understand the excellent points made by many Members about local authorities. It will be an offence for anyone to carry out procedures without a licence. If the rules are breached, businesses risk fines or financial penalties. Detailed proposals will be set out in the consultation in the new year, which will seek views from local authorities on suitable enforcement powers and costs. Many hon. Members here who are experienced in local authorities know that we need to do that carefully with them. We also understand that that will add to local government’s workload, so we will work with them closely to understand what support, training and resources are required as we try to strike the right balance and ensure that councils have enough time to prepare and implement proposals safely across England and to swiftly protect public safety. That will be an ongoing discussion as we go through the next stage of the process.

Licensing will allow people to be confident that the practitioner they choose to perform their procedure has the skills to do so safely. For those in the sector who do the right thing, as so many do, this will protect their businesses and position them as trusted providers in a regulated market.

The hon. Member for Bromsgrove also warns about so-called lower-risk procedures falling through the gap. I can assure him and other hon. Members present that we will work closely with all our partners on where we should set the bar to make ensure that the measures we introduce to protect the public encompass all necessary procedures, and that all legislative safeguards are proportionate and informed by a careful evaluation of risk. As I said, we will prioritise action against the highest-risk procedures first. We look forward to setting out the changes in a detailed public consultation early next year.

In terms of the impact of regulation, I want to make it clear that this is not about stopping people from getting treatments altogether; it is about preventing the cowboys, the crooks and the chancers from exploiting people. We want to support legitimate and safe businesses to continue to provide treatments while, as the hon. Gentleman mentioned, saving taxpayers from footing the bill when things go wrong.

I began my remarks by talking about societal pressures and the influence of social media. Children and young people can be particularly vulnerable to concerns around body image. The Advertising Standards Authority places a particular emphasis on protecting young and vulnerable people. In 2022, new rules came into effect across all media, including social media, banning ads for cosmetic procedures being directed at under-18s.

To meet the challenges of regulating online, the ASA has rebalanced its regulation away from reactive complaints casework and towards proactive tech-assisted gathering, monitoring and enforcement, using artificial intelligence to proactively search for problematic adds and ensure that children are not being influenced by inappropriate and irresponsible marketing.

Choosing to go through a cosmetic procedure is a serious decision, which requires a level of maturity to undertake an informed consideration of the risks and benefits. That is why many procedures should never be performed on children who are still developing physically and emotionally. In England, it is already illegal to give botox or fillers for cosmetic reasons to under-18s unless it is done by a qualified healthcare professional and approved by a GMC-registered doctor. We want to extend this level of protection, and will be introducing further age restrictions on a range of cosmetic procedures.

This is a UK-wide issue, and it is good to see the hon. Member for Strangford (Jim Shannon) in his place. I thank him for his kind words. I can assure him and others that we are working closely with the devolved Governments to understand and share information on approaches being taken across the country. We are pleased that Scotland is also considering similar information, and I have been really encouraged, in my conversations with officials, to learn about the relationship between our officials and the shared learning that is going on with colleagues in Scotland. This is a really complex area and it is changing all the time, with new things coming on board.

The changes we make will affect livelihoods, and it is essential that we get the balance right, given that we know that people are at risk and the sector is expanding. Government action must be proportionate to protect public safety without restricting the legitimate activities of those businesses. We want to collect data, gather more evidence and give businesses their say through the public consultation. That will take time, but we will leave no stone unturned and work tirelessly with expert partners and people across the sector. The proposals will be taken forward through secondary legislation, and therefore subject to parliamentary process in the usual way before legal restrictions or licensing regulations can be introduced.

My hon. Friend the Member for Putney (Fleur Anderson) raised an issue around implants. She has been a fantastic campaigner for her constituent, Jan Spivey. I know that she has been in touch with my hon. Friend about that, and has played a key role in ensuring that this issue, along with others, received due parliamentary attention in previous Parliaments when women raised the issue. I myself am due to appear before the Women and Equalities Committee, which has an interest in this issue and PIP. We will certainly want to work with them and await the outcome of their review, to see whether any further work is needed in that area.

I thank the hon. Member for Bromsgrove for raising such a vital issue and all hon. Members for their contribution. Due to different things happening in London, many parliamentarians who would have liked to be here this afternoon cannot. The hon. Gentleman did excellently by getting in early after the announcement.

It is our duty in this place to protect people like Alice Webb from unqualified practitioners who cut corners, while backing British businesses that do the right thing. This is something we take seriously. Colleagues will want to hold us to account as we deliver, and I give hon. Members my commitment that we want to work with colleagues as we develop these regulations. We want to get them right, and that will take time. This is complex, as people understand. I look forward to working with colleagues to make this a success.