Draft Health and Social Care Act 2008 (Regulated Activities) (Amendment) Regulations 2026

Zubir Ahmed Excerpts

Wednesday 15th April 2026 General Committees

[The Parliamentary Under-Secretary of State for Health and Social Care (Dr Zubir Ahmed)]

I beg to move,

That the Committee has considered the draft Health and Social Care Act 2008 (Regulated Activities) (Amendment) Regulations 2026.

It is a pleasure to serve under your chairmanship, Mr Stringer. This statutory instrument makes an important change. It will amend the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 so that the treatment of disease, disorder or injury—TDDI—is brought within the regulatory scope of the Care Quality Commission. The change will be for TDDI provided in sports grounds and gymnasiums or under temporary arrangements at sporting or cultural events where it is delivered for the benefit of those taking part in or attending those activities.

Members will recall the tragic events of 22 May 2017, when the Manchester Arena bombing killed 22 people and injured more than 1,000. The subsequent Manchester Arena inquiry uncovered serious failings, including inadequacies in the provision of healthcare services at the arena. The inquiry noted that those shortcomings may have been present in other venues across the country, in part because of the absence of regulation. A central finding of the inquiry was clear: the Department of Health and Social Care should consider changes to the law to enable the CQC to regulate healthcare delivered at events. The CQC has outlined initial concerns about the quality of care provided at events. It has heard serious allegations where unregulated provision has resulted in harm. The Government are committed to acting on the inquiry’s recommendations and strengthening public safety. I recognise that these changes are overdue, but it was important to consider the impacts carefully, and I am pleased that they have now been laid.

This statutory instrument brings TDDI at events into line with hospitals, clinics, ambulances, GP surgeries, community services and care homes, where it is already regulated. That means that a provider delivering TDDI at an event must register with the CQC and comply with the same robust regulatory standards that apply elsewhere in our healthcare system. Some of these providers will already be registered to provide TDDI in other settings, and the process will be quicker for them.

There has been some confusion about what TDDI actually is. It includes a wide range of treatments from emergency interventions to ongoing care for long-term conditions. I wish to be clear to Members that TDDI does not include first aid. First aid remains outside the scope of CQC regulation.

To support providers to make this transition, they will have significant time to prepare. I can assure everyone involved that there will be a 15-month period in which providers can register and the CQC can process registrations before regulation becomes enforceable. The CQC will consult on guidance and produce supporting materials to help determine whether registration is required. The provision to allow registration will come into force on 7 September 2026. It will not become an offence to provide TDDI as an unregulated provider until 6 December 2027. In developing this policy, the Government have considered a range of options carefully, guided by the Manchester Arena inquiry findings. We concluded that partial removal would risk fragmenting provision, and a threshold based on event size would not reflect risk.

[Mike Kane (Wythenshawe and Sale East) (Lab)]

The Chair and I represent the great city of Manchester, and one of its darkest moments was Salman Abedi’s arena attack in 2017. These provisions are long overdue, and I thank the Minister and the Government for taking this action.

[Dr Ahmed]

My hon. Friend has worked tirelessly, as all hon. Members in and around the Manchester area have, since the unconscionable events of the Manchester Arena bombing. Regulation such as this could not have come into force without their representations in addition to the inquiry’s findings, so I am grateful to him and other colleagues.

That is why we are taking forward a coherent package, developing non-statutory guidance for providers and organisers alongside the change to secondary legislation to remove the two exemptions and bring TDDI at events within CQC regulatory scope. Stakeholders were concerned that smaller events could be targeted by substandard and unregulated providers. Size does not always correlate with risk, and the Government are determined not to leave those smaller events exposed to inadequate care.

I have heard concerns from stakeholders about the impact on those providing TDDI, such as clinicians who often do so voluntarily, and the potential impact that a requirement to pay to register with the CQC could have on them and the wider event sector. The CQC will therefore commence a consultation in May, which will provide opportunities for further consideration of the appropriate implementation of the regulations for sectors such as individual volunteer clinicians and mountain rescue services.

Some stakeholders have asked whether the CQC is the right body to regulate TDDI. Does it have the capability to do so, given the issues identified by Dr Penny Dash in her review? First, the CQC is the statutory independent regulator for health and social care in England, and it already regulates TDDI in a number of other settings. Extending that regulation to the additional settings outlined will bring more consistency for patient safety and quality of provision.

Moreover, this is an essential amendment to the regulations. The Manchester Arena inquiry recommended action to address gaps in the standard of healthcare provision at events, and it pointed specifically to statutory regulation and enforcement by a regulator. The Government have accepted those recommendations, and this policy reflects our intention to implement them.

Secondly, I will address the CQC’s capability to act as a regulator. It is right to acknowledge the findings of Dr Penny Dash in her 2024 review. Those critiques, I am glad to say, have been catalysts for change. The CQC has accepted the high-level recommendations and is taking forward targeted reforms, including stabilising its regulatory platform and improving the registration experience for providers.

The CQC has set out further steps to improve its inspection framework and strengthen transparency on ratings, characteristics and how judgments are made. This addresses the concerns highlighted by Dr Dash’s review and will help ensure timely, risk-based assessments—exactly what event healthcare providers will need as they register.

Extending CQC regulation to event healthcare is the safest and most straightforward route. It leverages an existing regulatory system, answers the inquiry’s call to action, is being implemented alongside reforms strengthening the regulator’s performance, and closes this long-standing gap in public safety.

By making these changes to the 2014 regulations, the Government will make true their commitments, fulfilling the recommendations of the Manchester Arena inquiry and its drive to improve patient and citizen safety. I commend the regulations to the Committee.

--- Later in debate ---

[Dr Ahmed]

Thank you again for chairing the Committee, Mr Stringer. The shadow Minister is very knowledgeable about these matters. Like her, I have been an attending doctor at events, and I am very sensitive to the representations she made, as well those made by other colleagues over the last few weeks and months. Much of what she talked about relates to the definition of “quality”, but defining that is not for the Government but for experts, clinicians and regulatory bodies, which is why it is so important that we give the CQC the power to do this.

I do not want small events and village fêtes to be overregulated; that is not the intention of this legislation. Nor do I want individual doctors, clinicians and other volunteers to be over-burdened with financial registration fees, and we will look into this with the CQC. Given the changes that have been made to the CQC governance architecture, I believe that it is absolutely the right body to do this work, which is basically an extension of what it already does in hospitals, care homes and GP surgeries up and down the land.

The tragic events in Manchester highlighted the care gap, and this Government intend to ensure that it is closed for the benefit of our citizens attending events up and down the county. By amending the CQC’s regulation, event organisers and those attending events can be reassured that the medical cover provided is adequate and of a suitable quality. Regardless of the size and type of event, a basal level of quality must be assured.

[Kerry McCarthy (Bristol East) (Lab)]

The Minister may be about to answer exactly what constitutes first aid, but I have been looking up the definition of TDDI on the CQC site, which seems to cover mental health. Thinking particularly about festivals, where health incidents arising from drug misuse may lead to associated psychotic episodes and suicidal ideation, would the legislation cover volunteer organisations helping people on that side of things?

[Dr Ahmed]

My hon. Friend raises an excellent point; I am very happy for the CQC to take that away and answer her specific question. On the issue of what constitutes first aid or more complex medical care, all of us who have been medical cover at events have sometimes come across the incongruous situation where being a medically qualified doctor is sometimes not enough to provide first aid. Those incongruities have existed for as long as I have been in practice, and I do not think the regulations particularly change that. It is often down to individuals’ interpretation of first aid, as well as their insurance cover, and I am sure that we do not want to overly complicate this matter.

[Dr Johnson]

Will the Minister give way?

[Dr Ahmed]

The hon. Lady knows that I often indulge her interventions, but not today. These regulations are a response to a public inquiry and are designed to ensure that the CQC has the scope and oversight of events and arenas. It is for the CQC over the next 15 months to provide some of these definitions and clarity, and they are absolutely the right people to do it. On that basis, I ask colleagues to support this very necessary measure to protect those the people we were elected to serve.

Question put.