Health Bill (Tenth sitting)

Liz Twist Excerpts

Committee stage
Thursday 2nd July 2026 Public Bill Committees

[Karin Smyth]

I am grateful to the hon. Member for Winchester for bringing this discussion to the Committee. I will turn to amendments 9 and 10 along with new clause 27, which address similar points. These amendments would require integrated care boards to increase their spending on mental health services at least in line with their growth in their total programme funding. Amendment 10 would enable the Secretary of State to implement financial penalties for non-compliance, and new clause 27 would also place the mental health investment standard, or MHIS, on a statutory footing by requiring the Secretary of State to specify an annual increase in the proportion of mental health expenditure for each integrated care board and require integrated care boards to meet that level of expenditure.

I want to be really clear with the Committee: mental health remains a priority for this Government, and the Government are already making record investments in mental health services. Spending on mental health continues to increase in real terms and is forecast to reach a record £16.1 billion in 2026-27. That represents a real-terms increase of around £140 million, compared with 2025-26 and around £900 million of real-terms growth since 2023-24.

[Liz Twist (Blaydon and Consett) (Lab)]

The Minister has pointed to some improvements. She will know there is real concern about parity of esteem between mental and physical health, including the ways that we measure them. The Government have already done a great deal, but would the Minister say how we can ensure that parity of esteem between mental and physical health is achieved using the powers in clause 43?

[Karin Smyth]

I thank my hon. Friend for that and for her work on this issue. She is absolutely right: parity of esteem is critical, and we are committed to a spending increase to deliver it. I will come on to some of the points that she quite rightly made.

Although I do not think he was speaking on behalf of the Select Committee, the hon. Member for Farnham and Bordon took us through some of the concerns of his Select Committee. The Government have put a formal standard and a financial safeguard in place through the mental health investment standard, and as set out in NHS England’s medium-term planning framework, we expect all integrated care boards to meet the standard over the next three years, and all are currently forecast to do so. For this period—2026-27 to 2028-29—the standard has been set on real funding growth, meaning that funding is expected at least to keep pace with inflation.

Meeting the mental health investment standard remains essential to delivering the Government’s ambitions on mental health, including achieving full national coverage of mental health support teams in schools and colleges by 2029, and expanding access to NHS talking therapies. The Government’s approach is to maintain strong protections for mental health investment, while giving local systems the flexibility to focus on outcomes and deliver services that meet the needs of their communities, which, as we have heard this morning, are very different. However, workforce increases and funding alone will not deliver the improvements the public and patients rightly expect in mental health care and support.

Demand for mental health support has risen rapidly, as we all know from our constituencies, with long waits and too many people unable to access the right support when they need it. We need a new approach that reduces waiting times, improves care quality and promotes early intervention and prevention in mental health. That is why we are developing a new cross-Government mental health strategy for England that will transform mental health care into a system that responds and intervenes earlier, reduces waiting times for support and ultimately supports people to participate fully in education, work and community life.

[Liz Twist]

I wonder whether, as part of that strategy, the Government will look at waiting times for mental health services, as we have heard of the considerable delays. That issue is important to everyone, but especially young people. Will the Government look at that issue and get waiting lists down?

[Karin Smyth]

Again, my hon. Friend makes an important point. Of course, the rising demand and the ways that waiting lists are managed and supported locally will have to be a critical part of any strategy. Also, as we have said in our elective reform plan, giving people information so that they can understand what is happening in their local systems is part of the wider patient experience work that we are going to do.

The Government are committed to prioritising the delivery of mental health services. That is why we have a standard already ensuring that mental health spending keeps pace in real terms, while allowing systems discretion to make additional investment in the way that best meets local needs. The amendments would place an inflexible financial requirement in statute. A more effective and overarching approach will be delivered through our cross-Government strategy. For those reasons, a further statutory duty is unnecessary and I ask the hon. Member for Winchester to withdraw the amendment.

Health Bill (Eleventh sitting)

Liz Twist Excerpts

Committee stage
Thursday 2nd July 2026 Public Bill Committees

[Gregory Stafford]

Precisely. These questions need to be thought about when the Government are creating this system.

As hon. Members have described in their speeches and in their amendments, the system could contain much wider information, including highly sensitive information about disability, safeguarding, care assessments, addiction, pregnancy, military service, caring responsibilities and many other personal matters. This is not simply about a hospital record; it is about bringing together health and social care information. That makes it even more important—indeed, essential—that safeguards be clear and robust.

That leads me on to my fourth issue, which is confidentiality. The Bill says that where information is processed under the regulations, doing so will not breach any duty of confidence. I think that that is a significant legal challenge and change. Confidentiality has been one of the foundations of healthcare. Of course there are already situations in which information can and should be shared, but where Parliament is creating a new legal basis for disclosure, it is reasonable to expect strong safeguards alongside it.

That brings me to my next concern. The Bill says that the Secretary of State must have regard to the need for “adequate safeguards”. That is welcome, of course, but the Bill does not say what those safeguards are. There is nothing in it about role-based access controls, audit logs or whether patients would be able to see who had looked at their records. There is nothing about minimum cyber-security standards, about how inappropriate access will be detected or about independent oversight. Those matters may appear later in regulations or in guidance, but they are not guaranteed in the Bill.

[Liz Twist (Blaydon and Consett) (Lab)]

I thank the hon. Member for his clear summary, at the start of his speech, about what we are discussing, which is the regulations. He and other Members have rightly pointed out many issues that need to be resolved, but does he agree that the proper way to work through this very detailed and very real concern is through the regulations, which will come with expert advice and ensure that we cover all these points properly?

Health Bill (Sixth sitting)

Liz Twist Excerpts

Committee stage
Thursday 25th June 2026 Public Bill Committees

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

It is a pleasure to serve under your chairmanship this morning, Ms Lewell.

It is right that Ministers are ultimately responsible to the House for the performance of the health service and subjected to the scrutiny of Parliament for its execution, but there is an important distinction between accountability and operational control, which I fear the clause risks eroding in some cases. The national health service has over many years developed a structure that seeks to balance political accountability with operational independence, and that balance exists for a reason. Decisions on what services are commissioned, where they are delivered and how resources are allocated are not purely political judgments; they are complex, technical decisions that ought to be guided—primarily, in my view—by clinical evidence, patient need and professional expertise. Transferring commissioning functions directly to the Secretary of State, as the clause will do, risks drawing those operational decisions more directly into the political sphere, even if that would not happen in every case.

The more that Ministers are involved in determining which services are commissioned nationally and which are not, the greater the risk that over time those decisions will be influenced by short-term considerations and short-term pressures rather than long-term patient outcomes. Even when no such influence is intended, the perception that that could occur will be damaging. As I said in discussions on previous clauses, the NHS depends heavily on public trust, and that trust rests in part on the belief that decisions are being made in the best interests of patients and on the basis of evidence, rather than political expediency. We should therefore be cautious about any measure that threatens to blur that line.

Despite the Minister saying that the stated intent in the Bill is to decrease centralisation, the clause appears to move some parts of the system closer towards centralisation, rather than maintain that balance. I do not believe that the Committee should take that step without careful consideration of the potential consequences.

There is also a practical dimension to this issue. Under the clause, the Secretary of State potentially assumes direct responsibility for any and all decisions currently exercised at arm’s length. That raises legitimate questions about capacity and focus. As I said previously, the health service, as we all know, is vast, complex and complicated, and decisions, especially about specialised commissions, are technical and require detailed expertise and understanding. What is not immediately clear from the clause is that such decisions are best taken by the Secretary of State rather than by bodies with dedicated expertise and a degree of operational independence.

Both my hon. Friend the Member for Sleaford and North Hykeham and the Liberal Democrat spokesman, the hon. Member for North Shropshire, spoke about highly specialised services, where essentially there is a capacity issue and a need to be able to look at the demand as a whole. They both raised the danger that, if those commissioning decisions are taken at local level, those at that level may not have the expertise, the finances or indeed the capacity to truly understand those highly complex, low volume specific needs.

I have some sympathy for the Minister, because the danger that we have seen in the NHS is that everything becomes more and more specialised and the ICBs push it away. I understand why the Government are proposing some of these changes, but we must not throw the baby out with the bathwater. We must ensure that services continue to be commissioned by experts at the national level if they need to be; and that if they need to be commissioned by experts at ICB level or even more locally, it is done through the neighbourhood health schemes that the Government are pushing, which I support in principle.

For those reasons, if the Committee is minded to support the shift in responsibility, I suggest that we put in place some robust safeguards to ensure we have transparency, consultation and evidence-based justifications for decisions. Without those safeguards, there is a risk that the centralisation of power on the one hand and the devolution of specialist services on the other will unintentionally make a system that is less transparent and less robust.

That is why I support amendment 57 in the name of my hon. Friend the Member for Sleaford and North Hykeham. The powers in clause 12 need to be bounded by checks and balances, because these are not minor administrative changes, but a significant shift in responsibility. We must ensure that decisions to move service commissioning are made as transparently as possible. In those circumstances, it is entirely right that Parliament should be able to scrutinise those decisions.

The amendment would achieve that. Subsection (4A) would require the Secretary of State, before making regulations, to prepare and publish a commissioning transition plan and to lay that before Parliament. Subsection (4B) would require the plan to set out, in detail, the services being changed and the reasons for the changes. It would also require clarity on which bodies will assume the responsibility and why they are considered capable of doing so. That level of transparency is essential if Parliament is to exercise meaningful oversight. Subsection (4C) would establish a formal consultation requirement, and subsection (4E) would require the Secretary of State to publish a response to that consultation, setting out how concerns have been addressed. That is vital, because there is no point having a consultation if the Government just ignore it. Finally, subsection (4F) would ensure that no regulations can be made until a defined period has elapsed after that response, thereby providing a time for proper parliamentary and public scrutiny.

Those of us who sit on Select Committees, especially the Health and Social Care Committee, often receive responses to our recommendations from the Department that, as my right hon. Friend the Member for Godalming and Ash (Sir Jeremy Hunt) said in evidence, give the veneer of acceptance, but then no meaningful action is taken. The amendment would allow meaningful scrutiny and ensure that the Government actually respond to that request.

Taken together, the provisions would ensure that decisions are not only made, but made openly, transparently and accountably to those who are elected in this place to represent our constituents.

[Liz Twist (Blaydon and Consett) (Lab)]

I wish to speak on clause 12 in the context of specialised commissioning. In my parliamentary work, I deal with a great number of rare disease communities and other specialised groups. Specialised commissioning is important to them to ensure that they get the service they need and deserve. Will the Minister explain how we can ensure that there is patient involvement in a more dispersed system of commissioning, and that there is national oversight and clinical leadership for all these things? How will she ensure that specialised commissioning groups are monitored and that effective services are being provided to those in the communities who need them?

Health Bill (Fourth sitting)

Liz Twist Excerpts

Committee stage
Tuesday 23rd June 2026 Public Bill Committees

[The Chair]

I gently suggest to all Committee members that it would help me tremendously if they could stand at the beginning of the debate on a group if they wish to be called.

[Liz Twist (Blaydon and Consett) (Lab)]

I will speak in support of clause 6 and against amendment 58. I work with a great many rare disease groups as part of my work as a Member of Parliament. Those people have specific health needs, and innovation is key to developing ways of dealing with their needs and to making their lives better, so innovation is at the heart of what we do.

We have many great institutions. In my region of the north-east, I will mention Newcastle University, which is doing a huge amount of research into a range of rare diseases and is working collaboratively with other institutions, particularly in partnership, to address those health needs. The clause allows the Secretary of State the breadth to encourage that innovation and to help to make it into a viable spin-off. We too often lose the benefits of the innovation that we create, and it is adopted in other countries.

Amendment 58 would put this important clause in danger of being too prescriptive, and sometimes, if we prescribe particular things, we lose the ability to do other things. I support the clause, and I do not support amendment 58.

[Joe Robertson]

The clause, and amendment 58, deal with innovation. Although the NHS is responsible for some great healthcare innovations, not only in this country but around the world, unfortunately, it is often an example of a complete failure to innovate, or even to use fairly basic technology that has been around for a long time—I am thinking of using computers for patient records, as paper records have lasted for far too long. Promoting innovation is clearly a good thing—it is essential—so I support the amendment. I will speak about the details in a moment.

Spinal Muscular Atrophy: Newborn Screening Test

Liz Twist Excerpts

Monday 22nd June 2026 Westminster Hall

[Liz Twist (Blaydon and Consett) (Lab)]

It is a pleasure to serve with you in the Chair, Mr Mundell. I thank my hon. Friend the Member for Sunderland Central (Lewis Atkinson) for opening this vital debate on behalf of the nearly 150,000 people who signed the e-petition. I am glad that, with the help and promotion of Jesy Nelson, who brought the petition forward, we are able to highlight the need for preventive action to protect children from the impact of SMA.

In my work with the all-party parliamentary group on genetic, rare and undiagnosed conditions, I closely supported the campaign for newborn screening for spinal muscular atrophy for many years. I praise the work of SMA UK and Muscular Dystrophy UK, which led the “Every Moment Matters” campaign along with Genetic Alliance UK to press for newborn screening for SMA. It is absolutely fabulous that Jesy Nelson has been able to put focus on the issue and to press the former Health Secretary, my right hon. Friend the Member for Ilford North (Wes Streeting), to take real action, although it is very sad that she had to learn about the devastating impact of SMA from her own heartbreaking experience.

With SMA, time is muscle. The condition causes rapid and irreversible neurodegeneration. By six months of age, an untreated baby with SMA type 1 will lose 95% of their lower motor neurons. Transformational treatments are available on the NHS, but we are diagnosing babies too late for them to receive the maximum benefit. I have seen the life-changing difference that early diagnosis made for a family in my constituency.

I want to talk about two brothers, Freddie and Louis. Freddie is a happy, social and determined young man who has hugely benefited from access to the lifelong treatment nusinersen. His family say that it saved his life and independence, but they still face challenges and costs in securing equipment to allow Freddie to have the freedom he needs and deserves, including by fundraising with the community for an all-terrain wheelchair that allows him to take part in as many activities as possible with his peers. Because Freddie was diagnosed with SMA, his younger brother, Louis, was screened for SMA and diagnosed before birth. As a result, Louis became the youngest pre-symptomatic baby in the UK with SMA type 2 to receive Zolgensma, a groundbreaking new gene therapy, at just 18 days old. Since getting that treatment, Louis has done well and is able to live his life free from the disease. That completely transformational treatment was available only to siblings, creating, as we have heard, an unacceptable health inequality where the wider population is denied the same chance of a healthy life.

[Luke Taylor (Sutton and Cheam) (LD)]

I was recently contacted by a constituent whose daughter was diagnosed with SMA type 1 at five months old and, in her own words, five months too late. Her child is now two and needs a wheelchair. She cannot sit or stand unaided. She depends on specialist equipment and multiple weekly visits and appointments. That is no way for a toddler to live. Does the hon. Member agree that families like my constituents urgently need the Government to fast-track the roll-out of a testing programme to all children in all areas to ensure the best possible outcomes for children affected by the condition?

[Liz Twist]

I certainly do agree. The test should be made available to everyone to prevent people from living with the effects of SMA that could have been diagnosed and treated.

As I was saying, it is important that we now have testing, but we must expand it to the whole of the UK very quickly.

[Amanda Martin]

Does my hon. Friend agree that we need to ask the Government why babies born in Portsmouth matter less than babies born in other parts of the country? If we are one of the six areas that will not have testing or screening, the babies born in my city have less chance and are therefore less valued.

[Liz Twist]

I certainly agree with my hon. Friend’s point, which was also made by my hon. Friend the Member for Sunderland Central. All babies should have access to treatment. We know the clinical consensus is absolute.

In February 2025, leading clinicians published a letter in The Lancet contrasting the UK with countries that have screening programmes. In Belgium, babies born with SMA are ambulant. In the UK, babies with the exact same condition are still dying or remaining permanently reliant on ventilatory support and tube feeding. On the wider issue of newborn screening, a range of conditions could be the subject of testing, but we are behind the world on testing. Genetic Alliance UK and the APPG on rare, genetic and undiagnosed conditions are asking for a clear timeline for a systematic review of the NHS newborn screening programme from each of the four Governments across the UK to ensure that we do not miss the opportunity to give more children a better and a healthier life.

Returning to the issue of SMA screening, the UK National Screening Committee’s updated model from August 2025 confirms that introducing screening would prevent three early deaths and stop two babies from requiring permanent ventilation every single year. Crucially, it would also prevent about 30 babies from being confined to sitting and enable 37 babies annually to live largely normal lives.

There is a rigorous financial case for acting now. Treating SMA pre-symptomatically reduces the need for lifelong mechanical ventilation and round-the-clock care. Introducing newborn screening would result in lifetime savings to the public purse of over £62 million and 529 quality-adjusted life years for each annual cohort of newborns diagnosed.

I was relieved by the Government’s announcement last month that the in-service evaluation for SMA screening will finally begin in England this October. However, the Government confirmed on 16 June that the evaluation will cover only part of the country. Specifically, it will launch in only the seven newborn screening laboratories that already have the required equipment. There must be a way of getting around that problem so that all our babies can be tested and receive appropriate treatment if necessary. The Scottish Government began a national screening pilot for all newborns earlier this year, and Ireland announced the introduction of its own screening programme in April.

We cannot accept a health system in which a baby’s chance of typical neuromuscular development depends entirely on the hospital in which they happen to be born. Will the Minister confirm whether the evaluation will be extended immediately to cover all of England, as well as Wales and Northern Ireland, for the sake of those children? We have the treatment, economic case and diagnostic tools; we must stop denying babies the chance of a healthier future.

Mental Health: Parity of Esteem

Liz Twist Excerpts

Wednesday 17th June 2026 Westminster Hall

[Wera Hobhouse (in the Chair)]

I will call Liz Twist to move the motion and then call the Minister to respond. I remind other Members that they may make a speech only with prior permission from the Member in charge of the debate and the Minister. As is the convention in 30-minute debates, there will not be an opportunity for the Member in charge to wind up.

[Liz Twist (Blaydon and Consett) (Lab)]

I beg to move,

That this House has considered parity of esteem between physical and mental health.

It is a pleasure to serve under your chairship, Mrs Hobhouse. In my constituency surgeries I see the devastating consequences of our failure to treat mental illness with the urgency it requires. In my role as chair of the all-party parliamentary group on suicide and self-harm prevention, I hear from young people about their experiences and the impact of waiting for treatment from mental health services. Bad mental health is routinely cited as a reason for economic stagnation, low school attendance rates and an increase in benefit claimants. Long waits for mental health support are directly linked to worsening symptoms and, tragically, to spikes in self-harm and suicide attempts.

[Adam Dance (Yeovil) (LD)]

Tragically, my constituent’s husband, John, took his own life in 2021 after a mental health crisis while in the care of NHS mental health services. Does the hon. Member agree that we need more Government support and funding for access to quality mental health services in rural areas? If we were losing people in this way to physical conditions, it would be a national scandal.

[Liz Twist]

The hon. Member might be reading my mind, because I will come on to that issue. I am sorry to hear of the death of his constituent—it is tragic.

[Jim Shannon (Strangford) (DUP)]

I commend the hon. Lady for securing the debate, and she is absolutely right to address this issue. In Northern Ireland, we have extreme mental health issues; indeed, the figure is 25% higher than it is here on the mainland. The Government have made a commitment to address the nation’s physical health. Does the hon. Lady agree that they must now treat the nation’s mental health equally? In doing so, they will address the emotional issues among the people we represent here.

[Liz Twist]

I do agree, and I will expand more on that theme.

Parity of esteem means tackling mental health with exactly the same respect, funding and clinical focus as physical conditions.

[Danny Beales (Uxbridge and South Ruislip) (Lab)]

I thank my hon. Friend for securing this important debate, and I know that she is a strong advocate for mental health in her role on the APPG. In the NHS, it is vital that funding for mental health keeps pace with funding for physical health care, and the mental health investment standard has been a crucial policy in driving parity of investment. Does she agree that it is vital that the mental health investment standard is retained in the NHS?

--- Later in debate ---

[Liz Twist]

I agree with my hon. Friend on the importance of the mental health investment standard as one of the measures for securing good mental health support and for making mental health equal with physical health.

As I was saying, parity of esteem means tackling mental health with the same respect, funding and clinical focus as physical conditions. We are here today to debate that principle, which has been discussed in this place for over a decade, yet it remains unfulfilled. We have made great strides in mental health: the Mental Health Act 2025, investment in mental health support teams for schools, which were rolled out this week, and additional mental health workers. Now it is time to deliver on our manifesto commitment to

“give mental health the same attention and focus as physical health.”

We need to look at the current waiting lists for mental health support, but before I look at the figures, I remind Members that every patient waiting to access mental health support is in urgent need of support, just as those on physical health waiting lists are. Sadly, and all too often, people see their condition worsen as they wait, which can lead to extreme consequences. Furthermore, physical illnesses frequently cause profound psychological distress, yet our services treat the physical and the mental in isolation. From my experiences of working with people who have rare conditions, I know the impact that that can have.

The most recent figures show that almost 1.87 million adults and over 576,000 children and young people currently hold open referrals for mental health services. If these were patients waiting for hip replacements or cardiac care, that would dominate the national discourse. NHS England has developed waiting list targets for mental health patients after referral—the longest being four weeks after referral for access to community-based services for non-urgent mental health care—but those developed standards have never been adopted. Research shows that 12 times more patients with mental health conditions are waiting longer than 18 months for treatment, compared to those with physical conditions. The Government have rightly instructed the NHS to drive down waiting times for elective physical health care, but so far mental health services have been excluded from that ambition.

The situation for our children and young people is particularly concerning. Barnardo’s says that one in five children now has a probable mental health disorder, which is double the rate in 2017. Demand has increased hugely, yet around 28% of referred children are still waiting for help, with nearly 40,000 facing unthinkable waits of over two years for treatment. We see the human cost of those delays in the lives of people like Amy, a young woman diagnosed with complex post-traumatic stress disorder. She has spent over a decade isolated at home, yet she has seen a psychiatrist only once in those 10 years. We also see it in the harrowing accounts collected by Rethink Mental Illness. One patient told Rethink that their psychosis was full-on and that an attempted suicide was the only thing that got them help. That is an unacceptable threshold for care.

I have heard of more experiences from the suicide prevention charity Body and Soul, with which I have worked. One young person it supported spent almost a year on an NHS waiting list for cognitive behavioural therapy. Just as they neared the top of the list, their health deteriorated into a severe crisis, and they attended A&E, battling suicidal thoughts. Instead of receiving urgent intervention, they were informed that their crisis made them “too severe” for the therapy they had waited so long to access. They were removed from the waiting list entirely and, with nowhere else to turn, they attempted to end their own life. As Body and Soul rightly highlights, no patient with a life-threatening physical condition would be told they are too ill to qualify for treatment, unlike in this case.

Mental health charity Mind is calling for the development of open-access mental health support pathways, ensuring that people can seek help early and directly, without facing unnecessary referral barriers or rigid clinical thresholds. When we fail to provide accessible care, the results can be fatal. People living with severe mental illness face a premature mortality gap of 15 to 20 years, compared to the rest of the population. Closing that gap by treating mental health with the same urgency as physical health must be the baseline of our approach. Rethink Mental Illness recently found that 83% of people said their mental health deteriorated while waiting for support, and nearly a third of those whose health worsened attempted suicide. Families are making impossible choices, with some parents reporting that they are skipping meals to pay for private therapy for their children because they cannot get the help they need.

This crisis in mental health impacts on our Government’s core mission to kick-start economic growth. We are seeing a rise in economic inactivity driven by long-term sickness, and poor mental health is a primary factor. The Mental Health Foundation estimates that the economic and social costs of mental health problems reach £118 billion a year. Those figures have not arisen overnight; the previous Conservative Government have much to answer for in this crisis.

We need to make sure that we maintain the emphasis on mental health. Last year, the Department of Health and Social Care reported that the proportion of NHS funding spent on mental health is expected to decline over the next two years. We need to look at that again.

[Chris Bloore (Redditch) (Lab)]

My hon. Friend was a champion for mental health long before I came to this House, and I congratulate her on securing the debate. She makes a point about spending, and I read this morning that despite 28% of cases in the NHS being related to mental health, it receives only 13% of the funding. That is at the same time that parity of esteem has been a legal requirement for over a decade. If we are serious about parity of esteem between physical and mental health, the spending must follow the rhetoric.

[Liz Twist]

My hon. Friend is quite right to point to those figures and to say that we need much more input into tackling that difference in funding.

As I said, the proportion of NHS funding spent on mental health is expected to decline, and we need to look again at that. That is exactly why the mental health investment standard was introduced, and why we need the planned 10-year mental health strategy, when it is published, to set out the actions we need to take to ensure that mental health has parity of esteem with physical health. It is vital that the MHIS continues to protect mental health spending until a suitable long-term funding measure is firmly in place to ensure that funding matches need.

Three weeks ago, the interim Milburn review highlighted the unique combination of pressures faced by young people entering adulthood today, including a mental health system that cannot respond to the current level and severity of demand, a pandemic that affected their social development and an ongoing loneliness crisis.

[Gordon McKee (Glasgow South) (Lab)]

My hon. Friend is being very generous in giving way. I know that this is a topic she understands deeply and has campaigned on for many years. She is right to highlight the Milburn review. Does she agree that part of the response has to be developing a mental health support system that is preventive, not just reactive? We see that in child and adolescent mental health, particularly in Scotland, where there are enormous waitlists. We have to tackle those, but we also have to have a system—in education, for example—where we prevent people from reaching crisis, whether in childhood or when they become adults.

[Liz Twist]

I absolutely agree with my hon. Friend, which is why I am so pleased that we set up mental health teams in schools.

We need to look at preventive measures so that we do not keep getting into this position. When people are left to languish on waiting lists, their ability to participate in the workforce collapses. We must stop waiting for people to hit rock bottom before we step in: we have to deploy preventive measures. It is simply not good enough that one in three young people must wait more than 18 months for treatment after referral.

I welcome the changes the Government have implemented, the extra investment for mental health support in schools, and the expansion of that support to 100% of schools by 2030, but I have some specific asks of the Minister, supported by mental health charities. First, will she ensure that reducing waiting times for non-urgent community mental health care is included as a specific priority in NHS planning guidance? That would send a clear message to local systems that this must be tackled alongside elective physical care.

Secondly, Mind, the mental health charity, says that reducing mental health care waiting times must be treated as a core test of parity of esteem; Rethink makes the same point. Will the Minister commit to fully rolling out the access and waiting time standards consulted on by NHS England in 2021 to ensure that emergency mental health care is provided within one hour, urgent care within four hours and community care within four weeks?

Thirdly, to help us to meet our shared ambitions for parity of esteem, will the Minister outline how we will work together to reverse the projected decline over the next two years in the proportion of NHS funding spent on mental health? Will the Government also commit to protecting the mental health investment standard until a long-term alternative funding plan is firmly in place?

Finally, the Government have outlined an ambitious shift toward neighbourhood health services. How will the Department ensure that community mental health is a central component of this roll-out, so that patients can access multidisciplinary support before they reach crisis point? We have a historic opportunity to build a national health service that treats the mind and the body with equal respect. I look forward to the Minister’s response on how we will finally deliver true parity of esteem between physical and mental health services.

Health Bill (First sitting)

Liz Twist Excerpts

Tuesday 16th June 2026 Public Bill Committees

[The Minister for Secondary Care (Karin Smyth)]

I am a member of the Managers in Partnership trade union, which is giving evidence this afternoon.

[Liz Twist (Blaydon and Consett) (Lab)]

I am co-chair of the Unison group of MPs, which is linked to Managers in Partnership.

[Peter Prinsley (Bury St Edmunds and Stowmarket) (Lab)]

I am a retired ENT surgeon and a fellow of the Royal College of Surgeons.

--- Later in debate ---

[Gregory Stafford]

Q What happens if the problem is the CQC?

Dr Dash: Well, we then have to deal with that as a problem. That is the same as saying, “What happens if the problem is this organisation or that one?” We have 150 organisations—150. What if the GMC is a problem? What if the Nursing and Midwifery Council is a problem?

[Liz Twist]

Q Dr Dash, you have explained why you believe that the changes to Healthwatch will strengthen patient responses. How do you think that could be strengthened to ensure that the levers really are being pulled for patients? That seemed to be the case.

Dr Dash: There are a few different things. First, we have talked about appointing a director of patient experience. They will report directly to the chief exec of the NHS. That is crucial; it is about emphasising the importance. We are about to do the interviews for that person, so I hope they can be in post very quickly.

Secondly, we are hopefully about to publish the quality strategy. Within that strategy, which has come out of the 10-year plan, we are very clear about the three dimensions of quality. Those are: safety, so ensuring that basic standards are in place; effectiveness, so making sure that patients receive the right care in the right place at the right time and it is delivered to a high standard; and, crucially, patient experience. In the quality strategy, we emphasise that all three of those are crucial. You need to have all three and all three need to be done really well.

We then go on to talk about different mechanisms for improving those dimensions. Crucially, we have a set of 183 metrics, which we will review within the NHS England quality committee while it still exists, and then within the National Quality Board. We also expect every region to review those metrics, as well as others, and every ICB and provider to review the ones that are relevant to them. So the next bit is to have all those different metrics.

Thirdly, we need wider transparency. There are way more than 183 different metrics and we need to have far more on patient experience. They need to be routinely collected in the same way that we do surgical audits or audits of GP work. Those all got in the public domain; that was a big element of the 10-year plan.

Finally, as I said before, we need boards to take full responsibility and accountability for all aspects of quality, which includes patient experience. As I go round and meet individual hospital boards, I ask them about that. I spend quite a lot of time with chairs and new non-executive directors coming into NHS providers, and I continually emphasise, “This is a crucial area for you to focus on as a board.” What are you asking your exec colleagues? Who have you put in place as your director of patient experience within the organisation? How are you routinely collecting information from a whole spectrum of users from the whole of society? How are you doing that in a confidential way for the reasons we spoke about earlier, and then ensuring that people are acting on it? I do not think we are doing anything like enough of that, and we need to get much better and do far more of it.

[The Chair]

For a final brief question—and a brief answer, please—I call Joe Robertson.

--- Later in debate ---

[Sojan Joseph]

Q Mr Lant, I am trying to understand a bit more about the patient experience and improvement in care that Healthwatch brings. My understanding is that when a patient raises a complaint with the local provider, it usually gets investigated by a local service manager or a matron, but when somebody is not confident about raising a complaint with the local provider, they go to Healthwatch, and that complaint usually filters down for the same local service manager or matron to investigate it—we have seen that happening. Patient experience is not being improved without local accountability or local change. Can you explain why you are concerned about abolishing Healthwatch and bringing more accountability to local ICBs or local authorities, which may improve patient experience and patient care?

Jacob Lant: The issue is that the system—the NHS provider, the commissioner or whoever is picking up the individual complaint—will treat that as an individual incident to look into. Healthwatch may support the individual to raise that complaint or that individual piece of feedback, but the collective learning across that is more important, and it is pulling out the themes that are consistent across multiple bits of feedback, both positive and negative, that makes the difference. We see that evidence and insight from Healthwatch making a difference in local and national policy. It might not feel like that to the individual patient, but things like the creation of a single patient record exist in part because of a lot of campaigning by local healthwatch on the issue of people having to repeatedly tell clinicians about their experiences.

It also could be issues to do with not being able to find a dentist, for example; the system will treat that as an individual incident of helping someone who is trying to find a dentist or not, but Healthwatch could use that insight to petition and push for national change around the commissioning of a service like dentistry. A topic like administration of care, which Healthwatch, National Voices and the King’s Fund have all worked on together, is invisible from the way that the system perceives performance at the moment, but because we listen thematically to patient experience, we can push for a much greater focus on things like the basics of communication and keeping patients up to date on what is happening with their care, which really matter. Healthwatch is thematically looking at patient feedback differently from the way that system does, and that is something I fear may be lost.

[Liz Twist]

Q Ms Woolnough, you have talked about the abolition of NHS England, and, as I understand it, you are dealing with what the position is rather than taking a stand. Beyond the legislation, what are the key things that we should be looking at to get the transfer of functions to ICBs and DHSC right?

Sarah Woolnough: We have talked quite a lot about the culture in the NHS and whether these changes enable the sort of shift that lots of people talk about wanting. Let us be really serious about devolving power and earned autonomy, and about the balance between politicians rightly being held accountable for high-level metrics but with enough operational freedom to allow local systems—services close to people and patients—to get on and do the best for them?

We have a slight concern that, even though the Carltona principle should mean that the Secretary of State will enact powers in a way that does not slow things down, because of the broad sweep of powers given back to the Secretary of State, and the quite extensive powers of direction, politicians come under extreme pressure to intervene in certain cases or when there has been a scandal or patient safety issue, and that could lead to things clogging up.

Fundamentally, our worry has been—again, this goes beyond the legislation—how do you genuinely create a system where the culture is not as paternalistic as it has traditionally been, where you are empowering both staff and patients and citizens to have more say in their care, and where system leaders are not constantly looking up for permission, worried they may be held to account for quite a narrow set of metrics? Although managing money and constitutional standards is very important, if we are to deliver the 10-year plan aims and improved patient care, it is more than that. Our worry has been that the abolition of NHS England by the legislation will narrow things. We do not know, because it is broader than legislation, but how do we fundamentally shift the culture? I know that that is the Government’s intention, but it is about more than legislation. Where is the work to make that happen?

[Liz Twist]

And do you think—

Health Bill (Second sitting)

Liz Twist Excerpts

Committee stage
Tuesday 16th June 2026 Public Bill Committees

[Helen Morgan]

Q My second question is similar. In reality and in practice, how do you envisage ICBs will be locally accountable once these legislative changes have taken place?

Sir Ciarán Devane: According to the ICBs we are talking to, which is all of them, they are saying that they believe in local authority engagement. We will be saying, “You may not be told you have to, but we would encourage you to do it.” I am sure that should be coming from the Department as well.

The witness to my right is an example of that; we know that when the NHS has really good local connections, you can get things done in the interests of your patients much more easily. The belief is there, but we need to make sure that the legislation is not seen as a signal that this is unimportant. That is a risk. As a representative organisation, we have to say to people, “We hear you saying that you really believe in this. Therefore, you need to demonstrate, not least to the Secretary of State, that you are following it through.”

I have a small additional point about mayors in unitary authorities being able to appoint somebody who is both the chair of the ICB and the local health commissioner. That should help. Those individuals will have to work out how to serve two masters, but that is okay—other people learn how to do that, too.

James Blythe: I would focus on a slightly different part of the Bill in terms of how this needs to work. There are 25 ICBs; that is quite a large footprint. From my experience of delivering meaningful collaboration and joint working between health and local government, I think it tends to happen at a more local level than that. The neighbourhood health plan in the Bill becomes extremely important. As a system, we should be very ambitious for those neighbourhood health plans. They should go a lot further than just describing what should happen in terms of improving health outcomes at a local level.

We should set an aspiration as a system that there should be a responsibility on health bodies and local government bodies to describe how changes will be made. The role of ICBs is to enable groups of providers and other organisations in local areas—most ICBs will have several places—to come together and not just work out what a local population needs, but actually do it. That will mainly be about relationships on the ground between an acute hospital team, a community services team, a mental health team and a social work team.

The role of ICBs is very much to give the contractual tools and mechanisms to local NHS organisations to work effectively with their local authorities so that there are really good neighbourhood health plans. Most importantly, they should not just write them but actually see them through.

[Liz Twist (Blaydon and Consett) (Lab)]

Q Sir Ciarán, the 10-year health plan, which is behind a lot of this, demands that we are really ambitious in involving patients and communities in shaping the services that they need. How can we best support ICBs, local authorities and other organisations to drive that change?

Sir Ciarán Devane: I go back to our having to convince people. Many people are convinced—that is probably the first thing to say. But we have to convince people of the benefit of doing this. Delivering the ambitious neighbourhood health plans that James describes will happen only if everybody is in the room and doing it.

I do not necessarily think that the legislation can mandate that belief or the way to do that. However, it can set an expectation for the ICB that, in developing its plans, it should be able to demonstrate that it has engaged with the local authorities, patient organisations and the public local to it. The legislation can set an expectation that the ICB is using population evidence to make the right commissioning choices and that, if reconfigurations, which may well be locally contentious, are to happen, engagement happens beforehand. As elected Members, the Committee will know that those conversations should start early and that local populations should not just be bounced into something.

It will be incumbent on the new department to set those expectations with the ICBs about the new way of working. That is the only way we are going to create an NHS that will be able to cope with the number of frail, elderly people with multiple morbidities. Those people are a consequence of the success of the NHS over decades. People are living longer with cancer; the prevalence of cancer—the number of people alive with cancer—has doubled in 20 years. But that means that there are four million people who are not necessarily well. The only way to cope with that is to make a significant and radical change to the neighbourhood health plans and bring the public with us. That will happen only with proper patient and public engagement.

[Liz Twist]

Q Do you think that there are any good examples we can learn from?

Sir Ciarán Devane: Yes, I do. I was in Epping recently, at St Margaret’s. I talked to the lady who runs the patient engagement: she is a volunteer and is a patient herself. They are a very good example, because they have said, “If we want to provide good services and avoid people turning up at the A&E in Harlow, we can do a neighbourhood diagnostic service.” The patient representatives got in very early. They ran some public meetings ahead of it and said, “We are thinking of doing this: what do you think? We’ll feed it back.”

Everything good is happening somewhere. It is the variability that is causing the problem. We need to make sure that good practices are deployed across the sector. That has to be the expectation: if this reform, which is huge, is to deliver value, that is the value that it has to deliver.

--- Later in debate ---

[Edward Argar (Melton and Syston) (Con)]

Q I know that in this conversation some have highlighted that patients have stated that their experience has worsened or not improved, but I would argue that is not a Healthwatch failure; it is actually down to the NHS or ICBs not acting on Healthwatch recommendations. It seems to me perverse to give that voice to the organisations that are actually part of the problem through not acting.

As a Minister, I was on the receiving end of some quite sharp recommendations from Healthwatch, but they were always constructive. Whether right or wrong, my fear is that this measure risks a perception among patients that it will be down to NHS managers and ICBs essentially to make recommendations that reflect their priorities, rather than the priorities and voices of patients. Professor, even if the principles that you have enunciated that might mitigate that risk were applied to the new model, are you really confident that they could mitigate the risk to patients’ confidence that their voice is genuinely and independently heard, loud and clear, however unhelpful it is perceived to be by bits of the NHS?

Professor Croisdale-Appleby: I cannot be confident of that, because we are in the foothills, not up the slope, and the details have not been given. ICBs have received something approaching a 50% cut in their running costs. I will not comment on the appropriateness or otherwise of that, but one has to be realistic and think about how high a really informed patient voice—particularly one that seeks out the views of both communities and individuals where the health inequalities are the greatest—will be on the priority list. I would question that, but I will leave it there.

[Liz Twist]

Q You all represent patient organisations in different ways. I would like to put this in the context of the 10-year plan and the shift to involve patients and communities in shaping services. From your patient perspective, how can we best support ICBs, local authorities and other people to drive that change for patients?

James Cooper: It is key that ICBs are given that support. In the conversations that Together for Short Lives and the services we represent have with ICBs, we certainly get the sense that they want support. They want to know how much they should be funding certain services, and they want to know how to plan. A lot of guidance is already out there, particularly in children’s palliative care, where we have service specifications and NICE guidance and quality standards—there is even a legal duty to ensure that ICBs commission palliative care for children and adults. That accountability and support from the centre, and making sure that resource is there, is key.

[The Chair]

Q Do panel members have any further comments?

Professor Croisdale-Appleby: I just want to reassure colleagues here that Healthwatch England and the Healthwatch network are still fully functional—I think that is important for you to know. Although we are sensibly on a reducing trajectory in line with the Government’s abolishment plans, we will maintain that full functionality and the ability to meet our formal mandate right through until the Bill is enacted, and until the guidance that will probably follow is in place. I just wanted to reassure the Committee of that.

--- Later in debate ---

[Dr Johnson]

Q The question was really about trust, and how people can be trusting of figures. For example, with Healthwatch, if you internalise patient experience into an organisation, do people then trust you when you say that it has got better? They will have only their own experience and the experience of their own family to work on; that will be the lens through which they look at things. We know that the waiting list numbers have come down, and there is not widespread trust in those numbers, for all sorts of reasons. If the numbers for patient experience are governed by the Department of Health, or the ICBs themselves marking their own homework, will the public trust them? Whether they should trust them is one question, but will they trust them?

Karin Smyth: I will come back to the waiting lists, but you are absolutely right about trust. In saying that I expect this to be the board’s job, I think it is its job to get this right, and we need to support it to do that. We heard a bit from Penny Dash about the national quality board and the patient experience directorate inside the Department of Health and Social Care reporting directly to the chief executive and the permanent secretary. That has to be part of the wider architecture, which is of course outside the Bill, so we need to be able to tell that story to the wider public.

We know from all the recommendations, reviews and the support that we give as Members of Parliament to our constituents that trust is really important. Getting that right and bringing people on that journey with us will be really important. Independence helps with that, and that it is why it is good to debate it as we consider the Bill—it is good to be able to air some of it—but I think people accept that things are not working and have not been working.

I think your question about waiting lists is about the data and the information that says where we are at. It is really complex. To follow NHS England’s data, of which there is a lot—I commend the amount of data that is available—you need to be quite clever at spreadsheets, and at finding and articulating data, in order to bring it back to your own constituency and local place. These things are complex. It is complex to record, track and recognise how people move through a waiting list, for example.

It is good that we are transparent about that. One thing that I am keen to push out is data on performance in trusts. Making so-called league tables is controversial, but the more information that we have out there, and the more we have honest debates about how complex and difficult it is—I am happy to take your questions around how that moves in order to for us to explain that—the more that helps to build trust.

[Liz Twist]

Q Minister, we have talked a lot today about ICBs, the local government Healthwatch and the single patient record, and we have heard some interesting comments. Can you summarise why you believe it is important that we look at this legislation now?

Karin Smyth: I will come to the single patient record because I think it is a gamechanger. We have heard today from some fantastic experts about the work they are doing to identify how it might work and how we might bring patients and the public with us. Again— I do not think we should just bank this—we have not heard anybody object to it.

We did have some evidence highlighting how things have gone wrong in the past. I worked at a primary care trust and clinical commissioning group at the time when care.data was brought forward. We can all point to where it has gone wrong, but nobody has said that this is not the right thing to do. That is good, but there is still a lot of detail to go through.

We need to keep highlighting the benefits. We heard from Peter Prinsley about whether patients have more control—we do think this is about empowering patients. That was what we said in the 10-year plan. The 10-year plan is about empowering patients in this very large system, for which they are now paying £200 billion of their taxes.

We heard from the excellent clinical panel. I defer to clinicians about what they need, both if they are dealing with chronic long-term conditions—we heard that it can sometimes take two and a half hours for an assessment—or if they are working in a busy emergency department. The fact that this is needed will be controversial. There will be a lot of questions about it and a lot of concern about privacy, data, cyber and so on. We need to hold on to those benefits, which are huge in clinical terms and for patients.

Another point we heard, which is also true, is that people think this already happens. People do not understand why, when they turn up at an A&E in Whitby, as we heard, or somewhere else, and then go back to central London, the systems cannot talk to each other. For me, that is about people’s trust and belief in what is a public service. It is a really important part of that.

On abolishing NHS England, I do not think anyone has come to one of my constituency surgeries and said, “Please do this,” or talked about it in great detail, but people do understand. My experience in opposition and so far in government is that MPs are perplexed when they try to intervene on behalf of patients, or to get an answer locally as to why on earth chief executives of ICBs or trusts sometimes do not respond even to a Member of Parliament’s requests for meetings. I find that shocking, but it does happen. How on earth is a patient or somebody struggling through the system expected to get a response? Getting it right is not black and white, and it is not easy to get the balance right between the Secretary of State’s democratic oversight and autonomy at a local level, but the Bill starts the process of doing that, and it is fundamentally important.

Regarding the other provisions, I accept that great work has been done by many people in Healthwatch and its predecessor organisations, and by people working in the patient safety landscape, but again it is not working. I think that those bodies have been allowed to abdicate responsibility for the core role of patient experience and patient voice. That is not their homework; it is their actual job. It is not something that should be outside, and that is why I think this Bill is really important.

[Helen Morgan]

Q I think I would agree with you, Minister, that no one thinks that abolishing NHS England is, in itself, a bad idea, given the duplication and cost. People do not think that a single patient record is a bad idea; I think that they assume that it already exists, and it could be transformative. There are therefore some really good points of agreement on the Bill.

It would, however, be helpful to reflect on where there is not agreement: on abolishing Healthwatch and HSSIB. You make the very good point that they have not been successful in their current incarnation, but it is important to consider whether that is because they do not have teeth, or because the organisations that they are trying to change are defensive.

We heard earlier about the culture of fear, and I think that we have probably all had people in our surgeries who can describe being frightened to speak up about their own personal care because they feel that they might be victimised for it. I know of clinicians who are frightened to speak up about their own experience in the organisation in which they work, because they feel that they will be punished for it.

In the light of that defensive culture that we know exists in the NHS, and has been highlighted time and again—Mid Staffs; the Shrewsbury and Telford maternity scandal—is the answer not to put the patient voice in the organisations that have a culture problem, but to give those other organisations the teeth they need, or confer a duty on the ICBs or providers to act on recommendations that are given to them, because I think that might be a more helpful way of dealing with this problem?

Karin Smyth: I think that gets to the crux of some of this. We will discuss it a lot in Committee, and I am obviously very open to keep discussing it.

Thank you for your support on the main provisions. I do not take that for granted because, again, they are still controversial. However, as I think I said earlier, you are right, although it is not true everywhere. I am not blaming individuals, because I think that people have been trying to do a difficult job, particularly in getting us through the pandemic and beyond. But they are defensive. That is why Members of Parliament and others do not get responses to their phone calls or their emails. That is a culture that we have to change, and we need to support people to change.

One of the things that we will do is to bring in regulations—that is a manifesto commitment from the Government—but another commitment that we have made outwith the Bill is to develop a leadership college to support in particular clinical and non-clinical managers, who have a very difficult job, in having the right skills for the new world, which patients and the public rightly expect to be more open and more transparent. We have to change this defensive culture.

However, even since Francis, the adding of bodies and the adding of recommendations, and with the bad experience that you have done so much around, something different has to happen. Again, what we heard from Jeremy Hunt was that we needed to put more prescription into the system and yet more requirements to do something without actually making that someone’s central function and job.

Now, it is a source of disagreement. As I have said, I think that there is a philosophical disagreement about the best way forward. It is not an antagonistic disagreement; there are fundamentally different views about what to do. We will continue to have discussions, because I think that ultimately we all want the same thing: a more open, transparent and supportive culture. By the way, nobody wants to work in a defensive culture, so I think people want that outcome.

It is up to us as politicians to support difficult conversations and trade-offs that happen locally. My view has always been that politicians will support difficult conversations and trade-offs—we heard a little bit about reconfigurations earlier—if the system provides good clinical rationale, good data and good evidence, but those bits of it do not always line up.

That is what I would like to get to. I absolutely understand and hear what you say—we will hear more about it and discuss it more, and I have read all the amendments about the best way forward. I think that we all want to get to the same place, but what is the best way to do that, given that we all know that this is really not working and cannot continue?

Oral Answers to Questions

Liz Twist Excerpts

Tuesday 9th June 2026 Commons Chamber

[James Murray]

The renewed women’s health strategy was a really important achievement under the previous Secretary of State, which updated the approach of this Government and reflected the differences in healthcare that women too often receive. If I might offer a personal reflection, since I have become Secretary of State, one issue that many women have raised with me is that they do not feel the health service adequately listens to them, takes their pain seriously, or gives them the right pathways to get the treatment they need. That must change, and this Government will change it.

[Liz Twist (Blaydon and Consett) (Lab)]

4. What assessment he has made of the adequacy of progress on implementing the suicide prevention strategy for England.

[The Parliamentary Under-Secretary of State for Health and Social Care (Preet Kaur Gill)]

This Government are committed to delivering the five-year, cross-Government suicide prevention strategy, and have published NHS England’s “Staying safe from suicide” guidance. Although progress has been made, we recognise that there is more to do and will continue to drive delivery of the strategy.

[Liz Twist]

The strategy said that it would

“reduce the suicide rate over the next 5 years—with initial reductions observed within half this time or sooner”.

However, we have now passed the halfway point, and sadly, those initial reductions have not been achieved. What is the Government’s plan to ensure that target is achieved by the end of the strategy?

[Preet Kaur Gill]

First, I commend my hon. Friend for her tireless campaigning to improve mental health and prevent suicides—I know this is personal for her. We have made progress on implementing the strategy, including launching the near to real-time suspected suicide surveillance system to detect trends earlier. We have also committed £3.6 million in support for middle-aged men for areas that need it, ensuring that it is co-produced with families and local partners so that it is accessible. We plan to update the strategy, which will consider the evidence, the progress so far, and where there are opportunities to go further, but I would welcome my hon. Friend’s input into this very important work.

Health Bill

Liz Twist Excerpts

2nd reading
Monday 1st June 2026 Commons Chamber

[Liz Twist (Blaydon and Consett) (Lab)]

First of all, I very much welcome the Bill. It has been designed to deliver and work with our 10-year plan in that bigger picture.

I will touch on three issues raised with me by my constituents in Blaydon and Consett. The first is the single patient record. Of course it makes absolute sense for everyone to be able to access up-to-date records when a patient is admitted. I think of the groups I have worked with who have rare conditions, for example, who find that when they are taken into a different hospital, the doctors there are unable to access the records of their specialist treatment. That is the first thing, although there is also a good deal of concern among my constituents and others about how that will be managed and brought about, and how the data will be handled and the contracts awarded.

The second issue I wish to raise is Healthwatch. I understand that the Government’s real intention, through the Bill, is to strengthen the patient voice and the ability to raise issues, but there is real concern that an organisation inside the Department of Health and Social Care will not provide that independence. Will the Minister commit to looking again at how that independence can be built in and linked with the ability to pull the levers that Ministers have talked about, in order to make a real difference for patients? It is about getting that balance right.

Finally, I want to talk about parity of esteem for mental health services. As we move from treatment to prevention services, we need to use this legislation to reinforce parity of esteem for mental health services, including in the ability to access them. We need to build in preventive measures and access to those mental health services. I would just like to comment on the point made by my hon. Friend the Member for Worthing West (Dr Cooper) about building public health issues into the overall health framework. We need to look at re-establishing that public mental health function within DHSC under the new arrangements, and indeed within ICBs. We need also to link this to our mental health strategy, which we are expecting in the very near future. I welcome the Bill greatly and look forward to seeing those issues addressed in Committee.