Thirlwall Inquiry Terms of Reference

Debate between Preet Kaur Gill and Aphra Brandreth

Thursday 16th July 2026 Commons Chamber

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

It is an honour to respond for the Government in the last debate until September. I extend my thanks to you, Madam Deputy Speaker, as well as to the other Deputy Speakers and Mr Speaker, for your stewardship of this House, and to everyone who works here in Parliament and in our constituency offices. I also thank all our NHS staff, who are keeping the service going despite record demand over the summer.

The right hon. Member for Goole and Pocklington (David Davis) has raised an extremely serious matter. I want to start by expressing my heartfelt sympathy to all the families who were affected by the terrible events at the Countess of Chester hospital—as a mother of two daughters, I cannot begin to imagine what they are going through. On top of their grief, they have been subject to a level of press scrutiny that would match anything we have faced as Members of this place. They have been left in limbo, waiting for answers. As someone who advocates for constituents at my own trust, I know that this will take an additional toll on their mental health, and all of us in this Chamber can agree that they deserve closure.

The previous Government established the Thirlwall inquiry in October 2023 to examine the events at the Countess of Chester hospital NHS foundation trust. Its terms of reference are available online. Lady Justice Thirlwall’s recommendations will help us to understand what went so wrong at the Countess of Chester. Her inquiry has now finished hearing evidence, and the final report will be published at the earliest practical date.

Lucy Letby was found guilty by her peers, following two criminal trials. She is currently serving 15 whole-life sentences for murder and attempted murder, and her convictions were upheld by the Court of Appeal. This is an independent judicial process, and it is not for the Government to comment on judicial decisions or appeals.

The right hon. Gentleman has called for the inquiry’s terms of reference to be amended or expanded to reflect the ongoing public debate around the safety of Miss Letby’s convictions, but the point of the inquiry is not to rehearse Lucy Letby’s trial; it is to focus on how people within the trust responded based on what they knew, or should have known, at the time of the events. The inquiry is now in the report-writing stage, and I have every confidence that the chair will consider all the evidence when drawing conclusions and writing her report and recommendations. I do not consider that there is a case to either amend or expand the terms of reference, based on the information currently available.

There is a separate process going through the Criminal Cases Review Commission, which received a full application in relation to Miss Letby’s case in April 2025. The merits of the application are solely for the CCRC to consider and, if appropriate, to refer the case for further consideration to the Court of Appeal. An application to the CCRC does not in itself indicate that the convictions are, or are likely to be, unsafe. Again, the right hon. Gentleman will understand that this is an independent process, and it is not for the Government to comment on, nor intervene in, individual applications.

I am aware that the right hon. Gentleman has also called for the inquiry to be paused or suspended while the CCRC is reviewing Miss Letby’s application. An application was made by legal teams for Miss Letby and former executives at the trust to the inquiry chair to consider exercising her powers to pause the inquiry under section 17 of the Inquiries Act 2005. An application was made in parallel by the same legal teams to the then Secretary of State, my right hon. Friend the Member for Ilford North (Wes Streeting), to suspend the inquiry under section 13 of that Act. The basis for both applications was that the inquiry should be halted until the CCRC had determined Letby’s application.

In March 2025, the chair refused the application and set out her reasons in detail. For transparency, that has been made available online. In her judgment, the chair considered, among other things, the question of fairness, and she was satisfied that the inquiry process had been fair and would not become unfair because there is a possibility that all the convictions were unsafe. My right hon. Friend the Member for Ilford North agreed with that reasoning.

It would not be appropriate for the Government to speculate on the outcome of the CCRC’s determination, and we should take into account that the families have not supported any pause or suspension of the inquiry either. Even if, hypothetically, we did take that unprecedented step, I concur with my right hon. Friend that any suspension would create unnecessary delays and become a barrier to the families receiving the answers they deserve.

There has been no new information that would make us think twice about this decision, nor change the terms of reference, and there is a strong public interest in the inquiry being concluded as soon as possible. That is why this Government shall not suspend the inquiry pending the outcome of Miss Letby’s application to the CCRC to review her convictions.

[Aphra Brandreth (Chester South and Eddisbury) (Con)]

The Countess of Chester hospital is the local hospital for me and for many of my constituents. They will rightly want to know the outcome of the inquiry. On top of these historical matters, last year the CQC rated the Countess of Chester hospital’s urgent and emergency care services inadequate and found that the overall hospital requires improvement. While I recognise the work that the trust is doing to deliver against its improvement plan, and I thank it for its communication with me, there is still vital work to be done. Can the Minister set out what she is doing to ensure that it makes those improvements, so that my constituents can be reassured that they will be getting access to the best possible healthcare, as they deserve?

[Preet Kaur Gill]

The hon. Member makes some important, valid points. Of course, the Countess of Chester hospital will want to know the outcome of the inquiry. As she rightly says, the CQC has been in and has made lots of recommendations, especially because of the inadequate rating.

I have asked for a submission from the CQC to understand what progress has been made. I have been informed that there has been some progress, but equally there are lots of areas in which there has not been progress. I am making sure that I am receiving regular updates, because, as the hon. Lady rightly says, every parent wants to see change. In the end, this is about so many lives. Parents have had to go through such heartbreaking situations just to get to justice, and they do deserve disclosure. I therefore really do thank her for her intervention.

Where the inquiry identifies lessons on safeguarding vulnerable patients or on how management responds to patient safety concerns, the Government will examine them rigorously and take forward all recommendations that are deliverable, justified and in the public interest.

There is a huge amount of interest, inside and outside the Chamber, about the professional regulation of managers in the NHS. We all know that the NHS needs and deserves the best leaders. We are committed to supporting their development and professionalism, and to strengthening accountability where they fall short. Work is already under way to develop an NHS college of leadership and management to support and develop NHS leaders.

In addition, we will legislate in this Parliament to enable the Health and Care Professions Council to begin to operate a statutory barring system for senior managers. The mechanism will enable the Health and Care Professions Council to prevent senior NHS leaders whose conduct is unacceptable from working again in senior roles. The Government have also launched the maternity and neonatal taskforce, personally chaired by my right hon. Friend the Secretary of State, which will translate Baroness Amos’s recommendations into action.

The right hon. Member for Goole and Pocklington has campaigned against Government overreach his entire career; I respect him for that. I know that he will agree with me that our democracy rests on a separation of powers, and I trust our independent judiciary to get on with the job. There are well-established criminal processes and procedures for how expert evidence is used at criminal trials. In our democracy, there are also routes for people to challenge convictions if they protest their innocence—even for Lucy Letby.

It is not for me or the Government to undermine those processes. Our attention should remain on the families and parents impacted by the case and on continuing to work towards providing answers and closure for them. That is what the Government are focused on, and we trust the Thirlwall inquiry to give us those answers.

Question put and agreed to.