Fuller Inquiry Phase 2 Report: Government Interim Update on Progress
Zubir Ahmed Excerpts(2 days, 4 hours ago)
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The Parliamentary Under-Secretary of State for Health and Social Care (Dr Zubir Ahmed)
I am today updating the House on the Government’s progress in responding to the recommendations of the independent inquiry into the serious issues raised by the appalling actions of David Fuller, including an accompanying interim update published alongside this statement.
The final report of the Fuller inquiry, published on 15 July 2025, set out 75 recommendations to strengthen the security and dignity of people after death across a wide range of settings. The inquiry’s findings were clear: current arrangements for the care of the deceased are partial, piecemeal, and not universally mandated. A dedicated cross-Government programme board was established in July and has met fortnightly since.
At this interim stage solid progress has been made on 54 of the inquiry recommendations.
Eleven are accepted in full and work is already in progress to implement these recommendations—22, 23, 26, 27, 28, 30,31, 32, 33, 34 and 75—covering standards, data and operating procedures in the wider health sector. Implementation highlights include: the publication by the Human Tissue Authority on 1 December of updated guidance to ensure adverse incidents in the anatomy sector are recorded—recommendation 26—with incidents already being reported; agreement by NHS England that data collection on the conveyancing of deceased patients will be rolled out in 2026-27 for the first time—recommendation 31. Further details are included in the interim update publication— https://www.gov.uk/government/publications/fuller-inquiry-government-interim-update-on-phase-2-recommendations.
Forty-three of the inquiry’s recommendations relating to both NHS and local authority mortuaries require further work before they can be implemented. Those include nine recommendations—1 to 9—for the NHS estate, and NHS England continues to assess the recommendations and is working with NHS trusts to develop actions at trust board level. A further 12 of the inquiry’s recommendations —10 to 21—relate to governance, accountability and safeguarding in NHS trusts. Analysis of the logistics and costings of these recommendations is currently being carried out by NHS England. Recommendations 35 to 56 relate to local authority mortuaries, which include 21 HTA licensed mortuaries. MHCLG sought views via the Local Government Association on the state of the estate, and there is an LGA-led roundtable meeting in January. The LGA and HTA are also working together to assess how LA mortuaries’ current practices compare with the inquiry’s recommendations, and existing HTA standards in the post-mortem sector. The HTA has reviewed these recommendations against their own standards and concludes that seven are fully covered by existing HTA standards, and has shared this analysis with the LGA.
There are a further 21 recommendations still under consideration. Seven of these are miscellaneous recommendations—24, 25, 67, 68, 69, 70 and 73—and three are for LAs who contract with third party providers —57, 58 and 59. A roundtable was held in November regarding the role of faith organisations—67 and 68—in the care for the deceased in these settings. Outputs of the roundtable will inform the response to these two recommendations. In addition, the chief coroner has notified all coroners of the inquiry’s conclusions, in response to recommendation 70.
No decisions have been made regarding the 11 recommendations—29, 60, 61, 62, 63, 64, 65, 66, 69, 71, 72—relating to wider regulation in all settings that care for people after death. We are working closely with the NHS, local authorities, the Human Tissue Authority, the Care Quality Commission, and other partners to explore how we can ensure that robust and consistent standards are in place across all settings. This includes reviewing mortuary access controls, oversight arrangements, contractor vetting, and requirements for training and reporting.
The Government are committed to transparency and accountability as this work progresses. This update demonstrates that work is actively under way to consider and respond to the inquiry’s recommendations, with action already being taken towards implementing 54 of 75 recommendations. Full details of the status of all recommendations are contained in the published update. A full response to the inquiry’s recommendations will be published in summer 2026.
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Tackling Sexual Misconduct in the NHS
Zubir Ahmed Excerpts(1 week, 2 days ago)
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The Parliamentary Under-Secretary of State for Health and Social Care (Dr Zubir Ahmed)
Any instance of sexual violence, harassment or abuse in the NHS is unacceptable and will not be tolerated. On 5 December 2025, NHS England set out further actions for all trusts and integrated care boards, so that they can redouble their efforts and take swift and robust action to tackle sexual misconduct in the health service. This builds on action already taken to address sexual violence, harassment or abuse in the NHS.
In September 2023, the sexual safety charter was published by NHS England, and every trust and integrated care board has signed up to the charter now. In October 2024, NHS England produced a sexual misconduct policy framework, which it urged trusts and ICBs to adopt or adapt. E-learning was also introduced to support awareness of sexual safety in the NHS. In August 2025, NHS England set out further actions for all trusts and ICBs to take to identify and act against potential perpetrators of sexual misconduct in the NHS:
Complete an audit on their sexual misconduct policies.
Review policies, such as information sharing and chaperoning policies, to ensure that they are up to date.
Staff to complete training modules on sexual misconduct.
Keep electronic staff records up to date, with ongoing and complete investigations into staff.
The most recent letter went further still, by setting out new actions for trusts and ICBs:
Take part in national training on sexual misconduct investigations.
Ensure a pool of doctors or dentists have received specialist training in sexual misconduct.
Ask all primary care providers to sign up to the sexual safety charter, self-assess themselves, and confirm with their ICB that they have done so.
Principles to be reflected in chaperoning policies to ensure that chaperones are being used correctly and in an auditable way by providers.
Review groups to be adopted for sexual misconduct cases.
Issued a further audit on sexual misconduct policies for all trusts and ICBs to complete.
The Department of Health and Social Care fully endorses the actions taken by NHS England, and expects them to be rigorously implemented. The Department will require ongoing updates from NHS England on implementation on a quarterly basis. You can find further detail of the actions in the NHS England letters.
The August 2025 letter: https://www.england.nhs.uk/long-read/actions-to-tackle-sexual-misconduct-in-the-nhs/
The December 2025 letter: https://www.england.nhs.uk/long-read/an-update-on-actions-to-prevent-sexual-misconduct-in-the-nhs/
The NHS operates a robust approach to sexual misconduct. The Department of Health and Social Care stands with NHS England to take all necessary action to identify sexual perpetrators, and prevent them having access to our NHS. Together, we will continue to monitor and take all necessary action to help ensure the sexual safety of everyone accessing the NHS.
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Terminal Illness: Mental Health Support
Zubir Ahmed Excerpts(2 weeks, 1 day ago)
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The Parliamentary Under-Secretary of State for Health and Social Care (Dr Zubir Ahmed)
It is a pleasure to serve under your chairmanship, Sir Jeremy, and I start by sincerely thanking my hon. Friend the Member for Altrincham and Sale West (Mr Rand) for securing this debate. I also welcome Mike and his family to the Public Gallery, and pay tribute to Mike for all his efforts.
My hon. Friend raises an important issue that can affect so many people—all people perhaps, at some point—about ensuring that when someone is diagnosed with a terminal illness, they can receive the mental and emotional support that they need in the place that they need it. We want to be a society where every person receives high-quality, compassionate and personalised care from diagnosis through to the end of life. The Government are determined to shift more healthcare out of hospitals into the community to ensure that patients receive personalised care in the most appropriate setting.
Palliative care and end-of-life care services, including those provided by hospices, have a big role to play in that shift. Palliative care services are included in the list of services that an integrated care board must commission, promoting a more consistent national approach and supporting commissioners to prioritise palliative care and end-of-life care. To support that process, NHS England has published statutory guidance stating that ICBs must work to ensure that there is sufficient provision of care services to meet the needs of their local population. It also includes references to mental health, wellbeing and support for those with palliative care and end-of-life care needs.
Of course, there are many examples of voluntary initiatives, such as grief or bereavement cafés, or the Good Grief community, which aims to support people at the end of their life and their families through a programme of events and courses, and the provision of resources that often include pre-bereavement advice and support.
I know that my hon. Friend the Member for Altrincham and Sale West feels passionately about mental health support for those with palliative care and end-of-life care needs, and that he has been supporting Mike’s campaign for improved mental health services and support. I offer him my deep appreciation, as well as a meeting with the Minister for Care and end-of-life care officials, so that we can engage him around the palliative care and end-of-life care modern service framework that was recently announced, which we hope to publish in the spring.
The Government are also transforming the current mental health system, ensuring that people get access to the right care at the right time in the right place. That is why we are increasing our investment in mental health support by £688 million in cash terms.
The hon. Member for Hinckley and Bosworth (Dr Evans), who spoke for the official Opposition, talked about impact assessments. I gently say to him, in the context of this convivial and constructive debate, that when we came into office we had an impact assessment by virtue of the Darzi review, which highlighted in stark terms the difficulties that the NHS in its totality is under after 14 years—the difficulties that we inherited. I also point out that our real-terms investment of £26 billion is an increase to the NHS budget that will translate into, among many other things, a new national cancer plan. That will examine not only the process of getting the best treatments to patients, but improving communication, improving pathways, and instilling better and more bespoke mental wellbeing support into some of those pathways.
Dr Evans
The Minister is indeed right to say that there was an injection of cash, but the proportion of funding being spent on mental health was actually cut. The written ministerial statement is very clear that that proportion went from 8.78% to 8.71%, which the royal college said was about £300 million of investment. Can he confirm from the Dispatch Box—if he cannot, he can write to me later—whether the Government are still committed to the mental health investment standard, or is that commitment going to change? Currently, it is unclear whether they are still committed.
Dr Ahmed
The mental health investment standard is something that we expect ICBs to meet. I will gently push back on what the hon. Gentleman is saying because, as we have been so succinctly reminded in this debate, investing in mental wellbeing is about more than just headline figures. For instance, we need psychology in oncology, in children’s health, and in other forms of cancer care. The provision of such services is not always recorded in the way that the hon. Gentleman would wish it to be recorded, but there are still formats and sub-types of mental health support.
The Government are also keen to press ahead with our 10-year plan, and we are setting out ambitious plans to boost mental health support across the country while delivering the shift from hospital to community. As part of that process, we wish to open around 85 mental health emergency departments, reducing pressure on busy A&E services, which are the last places that people with mental health needs should be, and ensuring that people have the right support they need in a calm, compassionate environment.
We will also use new integrated health organisations to break down barriers between services, which I also think is really important in the context of this debate, and to ensure integrated and holistic care, addressing both physical and mental healthcare needs, with more freedom to determine how best to meet the needs of those local populations. That will build on the work that has already begun to bring down waiting lists. As I said, we are investing an extra £688 million this year to transform mental health services. On staffing, I am pleased to say that almost 7,000 extra mental health workers have been recruited since July 2024, against our target of 8,500 by the end of this Parliament.
We are also expanding talking therapies, and we have committed to continuing that expansion over the coming years. More adults already benefit from better access to those therapies, and the aim is for over 900,000 people to complete a course of treatment with improved effectiveness and quality of services by March 2029. Anyone who develops a common mental health condition, such as anxiety or depression, in any context, including terminal illness, can self-refer to talking therapies. [Interruption.]
Sir Jeremy Wright (in the Chair)
Order. I am sorry to interrupt the Minister, but a Division has been called. I am very much in the Minister’s hands at this point, and I am conscious that there may be more he wishes to say. If he has only a minute or two of his speech remaining, I gather there will be several Divisions, so I do not want to force everyone to come back for just that. If he has more to say, there is of course more time for him to take, and the same applies to the hon. Member for Altrincham and Sale West. I am in the Minister’s hands; does he wish to conclude now, or would he rather come back?
Sir Jeremy Wright (in the Chair)
Order. I am afraid that we will now need to suspend as the Division is active. I will suspend the sitting for 15 minutes for the first Division and for 10 minutes for any subsequent Divisions. I gather that there may be several Divisions, so I apologise to the Minister and all other Members who will have to wait.
Dr Ahmed
Thank you, Sir Jeremy. Can I reassure all Members participating in this debate of the Government’s commitment to deliver on the issues that have been raised? We will work constructively with everyone, including patients and their families, as we develop the framework that Members have already outlined. We will also work with other mental health partners, local authorities and charities so that everyone can be assured that the Government are playing their part in delivering a better standard of access to care for not only palliative care but mental health care in that context.
Sir Jeremy Wright (in the Chair)
The hon. Member for Altrincham and Sale West may have a very brief word.
Pandemics: Support for People with Autism
Zubir Ahmed Excerpts(2 weeks, 2 days ago)
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The Parliamentary Under-Secretary of State for Health and Social Care (Dr Zubir Ahmed)
It is a pleasure to serve under your chairmanship, Mr Vickers. I am grateful to my hon. Friend the Member for Ipswich (Jack Abbott) for raising this important topic. Having known him for the last 14 months, I know how passionately he feels about the national health service in his area, particularly the mental health service provision in his area. His constituents can be rightly proud of his doughty advocacy on their behalf. My hon. Friend spoke about his constituent’s campaign to improve support for autistic people following his very difficult experiences during the covid-19 pandemic. I also place on the record my commendation of Ivan for his tireless work to ensure that autistic people will receive the right form of support.
We have heard today of the challenges that autistic people faced during the pandemic. It is important that we learn from those experiences and ensure we do better in future. In 2020, the Department of Health and Social Care commissioned research into the impact of the pandemic on autistic people and their families. The report, published in May ’21, made several key recommendations that chime with the issues my hon. Friend so eloquently raised today. It included findings about access to education for autistic children during lockdown; lack of respite and support for family members and carers; the impact of the pandemic on the mental health of autistic people and the challenges they face accessing healthcare in the round; and, as highlighted in this debate, the need for clear communication and transparency of decision making to help autistic people to follow advice and guidance appropriately.
I want to provide reassurance that the Government remain committed to learning the lessons from the pandemic, to help us to prepare better in future. As my hon. Friend the Member for Ipswich alluded to, the Government have acknowledged the disproportionate impact that the pandemic had on vulnerable groups in the United Kingdom. Module 1 of the UK covid-19 inquiry was published in July last year and focused on the UK’s resilience and preparedness for the pandemic. The Government’s response, published in January this year, sets out the changes we have made to ensure that we reduce the potential unequal impacts of events on particular groups or individuals in any future pandemics. However, as my hon. Friend also highlighted, we recognise that there is a lot of further work to do to ensure that the impact of inequalities and vulnerabilities in pandemic decision making is fully anticipated and planned for.
The inquiry recently published module 2 of its report, focusing on UK decision making and political governance. The report highlights that considerable numbers of people suffered from the social, economic and cultural consequences of steps taken to combat the pandemic, such as lockdown, including the impacts of social isolation, loneliness and declining mental health, and of course the chopping and changing of advice—which was sometimes necessary, but perhaps, on reflection, sometimes unnecessary. Module 10 of the inquiry is focusing on the impact of the pandemic on society in more detail and will carefully consider the findings in due course.
It is clearly critical that the UK is prepared for a future pandemic, and that is rightly a top priority for the Government. The Department’s new strategic approach to pandemic preparedness continues to recognise the disproportionate and unintended impacts that pandemics can have on vulnerable people and groups. The Department is therefore committed to publishing a new pandemic preparedness strategy, which will be published next year and will show how the unequal impacts of pandemics on social health and healthcare are considered in all areas of preparedness and response.
As my hon. Friend also alluded to, we have recently concluded participation in Exercise Pegasus, the largest ever simulation of a pandemic in UK history. Exercise Pegasus gives us an opportunity to examine our preparedness, capabilities and response arrangements, and we will continue to learn as we plan for phase 4 of the exercise in 2026. The Government have committed to communicating the findings and lessons, and a post-exercise report will be delivered in due course.
I recognise the concerns raised about accessible communications during the pandemic, and hear loudly my hon. Friend’s reflections. The UK Health Security Agency was established in 2021 and is responsible for preventing, preparing and responding to infectious diseases and other environmental hazards. The UKHSA collaborates closely with the voluntary and community sector, including organisations working with and representing autistic people. That close collaboration has allowed it to gain rapid feedback from those organisations regarding the efficacy of communication and guidance materials so that they can be adapted as required, in real time, to communicate with all members of our society and not just some.
More broadly, the Government recognise the importance of accessible communications and have published guidance on that for all Government Departments. Within health and social care, all NHS organisations and publicly funded social care providers are expected to meet the accessible information standard, which details the approach to supporting the information and communication needs of people with disability, impairment or sensory loss. NHS England published a revised standard in June this year to ensure that the communication needs of people with a disability, impairment or sensory loss are met within health and care provision. We are also taking steps in the health and care system to improve the accessibility of services for autistic people more broadly. For example, there is work underway in NHS England to make sure that staff in health settings know that they need to make reasonable adjustments for people. That includes the introduction of a reasonable adjustment digital flag, which enables the recording of key information about a citizen or a patient, including that a person is autistic, and the reasonable adjustment needs to ensure support can be tailored appropriately.
Chris Vince
Would that digital flag also flag up something like someone being a young carer or having caring responsibilities?
Dr Ahmed
I will have to go back and check that particular sub-group of flagging and get back to my hon. Friend, but I think the point he makes is that, wherever possible, we should be identifying those groups that have specific communication needs, by virtue of either their own personal health or social needs, or the needs of those they are looking after. He makes a very valid point and I will be delighted to write to him with a more detailed response than I can give at the moment.
More broadly, I have heard concerns about support for autistic people. I reassure my hon. Friend the Member for Ipswich that we are committed to supporting autistic people, who should have the right support in place, tailored to their individual needs. Our 10-year health plan sets out an ambitious reform agenda to transform the NHS and rightly make it fit for the future. That future must at its core include early intervention and support for autistic people and those with specific needs.
We are working with the Department for Education on reforms to the special educational needs and disabilities system, ensuring that joined-up support is available across education and health, including for autistic children and young people. We are also taking steps to improve access to adult social care services for those who need them. To build consensus on plans for a national care service, Baroness Casey is chairing an independent commission to shape the medium and long-term landscape reforms needed, and we have been putting the core foundations in place to facilitate that. That includes strengthening joined-up care between health and social care, so that people experience more integrated, person-centred care, including through the development of neighbourhood health services.
I have also heard about the impact of the pandemic on autistic people’s mental health and wellbeing. We know that autistic people are, sadly, disproportionately impacted by mental ill health and face challenges in accessing services in relation to their mental health. We are taking steps to address that, including raising awareness and understanding of autism within health and social care systems. We have been rolling out the Oliver McGowan mandatory training on learning disability and autism to support Care Quality Commission-registered providers to meet their statutory requirements and ensure that their staff receive specific training on learning disability and autism. NHS England has been rolling out additional training services across its mental health services, and has published guidance for mental health services on meeting the needs of autistic adults and guidance on adaptations of NHS talking therapies specifically designed for autistic people.
I am sure that my hon. Friend is aware that the House of Lords special inquiry Committee on the Autism Act 2009 published its report and recommendations for Government on 23 November. I understand that his constituent Ivan contributed to the inquiry, and I personally thank him and others for sharing their valuable insights and experiences, despite all the trauma that they have been through. The Government are carefully considering the Committee’s recommendations on the next autism strategy and support for autistic people, and we will respond formally in due course.
I end by reiterating my thanks to my hon. Friend and his constituent Ivan. I also thank my hon. Friend the Member for Harlow (Chris Vince) and the hon. Members for Westmorland and Lonsdale (Tim Farron), for Strangford (Jim Shannon), for Upper Bann (Carla Lockhart) and for Birmingham Perry Barr (Ayoub Khan) for their contributions.
Whether through Exercise Pegasus, looking at how we can better co-create guidance with vulnerable groups, using better guidance tailored for specific communities, using digital flags on health records, or indeed better mandatory training, I give my hon. Friend the Member for Ipswich this assurance: no longer will disabled people or people with specific or additional needs be treated as an afterthought. They will be at the forefront of our minds when planning future pandemic training and preparedness—and when executing that preparedness, should we be so unfortunate as to suffer another pandemic. He has my assurance, and I am once again grateful to him for securing this debate.
Question put and agreed to.
Children of Alcoholics
Zubir Ahmed Excerpts(3 weeks, 1 day ago)
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The Parliamentary Under-Secretary of State for Health and Social Care (Dr Zubir Ahmed)
It is a pleasure to serve under your chairmanship, Mrs Harris. I congratulate the hon. Member for Mid Norfolk (George Freeman) on securing this important debate, in particular during what must be an unimaginably difficult week for him. I think I speak for all of us when I say that we send him our love and sympathy. I also thank my hon. Friend the Member for Stoke-on-Trent Central (Gareth Snell) for sharing his powerful personal story, and the hon. Member for Strangford (Jim Shannon) and my hon. Friend the Member for York Central (Rachael Maskell) for their thoughtful contributions. I will be very happy, once the APPG has been convened, to liaise with the hon. Member for Mid Norfolk and the Under-Secretary of State for Health and Social Care, my hon. Friend the Member for West Lancashire (Ashley Dalton), who has responsibility for public health, to see what form of meeting can be arranged.
Alcoholism is a tragedy that blights communities across the United Kingdom, including in my constituency of Glasgow South West and the west of Scotland. Having practised as a medical doctor for more than 20 years, I have seen it, including in some of the transplant patients who have arrived across my operating table. As much as I love my job as a surgeon, I would love nothing more than for those transplants to never be needed again.
I want to reassure colleagues that this brief sits not just with my hon. Friend the Member for West Lancashire, but with all Ministers across Government, who are rightly focused on raising the healthiest generation of children in history. We want to support children whose parents have alcohol problems, but we also want to support their parents to get better.
Although not all children of parents with an alcohol problem will experience harm, they are clearly at far greater risk and, as we have heard, far too many of them will have their childhood scarred by their parents’ drinking. In 2024-25, 14% of child social worker assessments cited parental alcohol use, and in 2023-24 alcohol or drug use was identified in 43% of child safeguarding practice reviews where a child was seriously harmed or, sadly, died.
Children growing up in these environments are more likely to face additional challenges, such as parental mental health problems and sometimes, unfortunately, domestic abuse. The trauma from such experiences can last well into adulthood, which means that the cycle can repeat, with the trauma passed on through multiple generations. We must do everything we can to break that cycle.
As we have heard, alcoholism can affect anyone, but at times it hits hardest in some of our deprived communities. That is why from April next year, the Government will be rolling out Best Start family hubs to every local authority. Those hubs will provide a high-quality service for parents, and will focus on early child development and the digital resources to facilitate that. They will be open to all and based in communities where alcoholism is most prevalent, ensuring that services reach the children and families who are likely to benefit most from them.
The Government have also confirmed that we are giving vulnerable families and children better access to local support services. Our strategy is based, first, on breaking the cycle of late intervention and, secondly, on helping more children and families to stay safely together as a unit. We are doing this through the national roll-out of the family help multi-agency child protection and family group decision-making reforms, which will be delivered through the Families First Partnership programme led by my right hon. Friend the Secretary of State for Education. The programme’s funding amounts to £2.4 billion over the next three years. To help identify vulnerable children and families affected by parental alcohol problems who need a helping hand, my Department will support local authorities with an additional range of resources, including local prevalence and treatment data, and child safeguarding guidance for alcohol and drug treatment services.
We are doing this for children and their families, but we must also target our support to make a sustainable difference to pregnant women with alcohol problems. Timely and effective treatment is key, because drinking in pregnancy leads to long-term harm for babies—for example, foetal alcohol spectrum disorder, which has already been highlighted in this debate. Unfortunately, the more that women drink, the greater the risk. That is why the UK chief medical officer’s guideline is that if a woman is pregnant or thinks she might become pregnant, the safest approach is not to drink at all.
It is a genuine tragedy that pregnant women and mothers with alcohol problems are sometimes the most stigmatised and harshly judged people in our society. That means it is incredibly difficult for those women to speak out about their issues and to let services know that they have children, which prevents women, children and families from getting the help they deserve. We cannot forget that many women who drink during pregnancy come from homes where their own parents were dependent on alcohol and are often at the sharpest end of not only inequality, but complex and multiple other needs. Many of them were victims of trauma and abuse in their own childhood.
That is why the Government are committed to reducing stigma, improving the quality of treatment and making support available to every woman who needs it. First, we are piloting local approaches to reduce stigma among doctors, nurses and other healthcare professionals. Secondly, we will soon publish the UK’s first clinical guidelines for alcohol treatment that include advice for supporting pregnant women and parents to stop or safely slow down their alcohol use. Thirdly, the Department of Health and Social Care and NHS England are finalising the co-occurring mental health and substance use delivery framework, which will outline the commitments that we are making to improve integration of alcohol and drug treatment with mental health services at a national level. Fourthly, we plan to publish guidance on how treatment providers can better support and improve service provision for women. We will work with local commissioners to ensure that they consider in their drug and alcohol treatment commissioning plans the specific needs of pregnant women and parents.
We are also continuing to invest in improvements to local alcohol treatment services, which faced significant cuts followed by a decade of disinvestment. Just last week, the Government announced an investment of £13.4 billion—a 5.6% cash increase—over the next three years in local authorities’ vital public health work through the consolidated public health grant. That includes the overall £1 billion of drug and alcohol treatment and recovery improvement grants over the next three years. But treatment alone is not enough to improve outcomes for children. The evidence suggests that alcohol treatment, combined with support to help parents raise their kids, can increase the likelihood of recovery from alcohol dependency, reduce the risk of child neglect or abuse and, crucially, keep families together.
I am grateful for the opportunity to respond to this debate. It has given me the chance to outline how the Government are laser-focused on improving outcomes for children from all kinds of backgrounds who find themselves in these situations—children who, through no fault of their own, were born to parents who suffer from alcohol problems. I hope I have demonstrated that our approach is based not on stigmatising, but on keeping families together. That is why our strategy is based on Best Start family hubs and the Families First Partnership programme, so that we can make sure that parents in alcohol treatment services also receive vital parenting and family support.
The Department for Education has released statutory guidance called “Working Together to Safeguard Children”, and I want to pick out one line from it:
“Nothing is more important than children’s welfare.”
That could not be more true. Everything we are doing across Government is aimed at improving children’s health and protecting child welfare, so that every child can thrive in a loving, safe and stable home.
Let me end by speaking directly about the hon. Member for Mid Norfolk. Today he has spoken not only in this place, but to the nation. In doing so, he has ensured that more Members and citizens of our nation will now look, acknowledge and see below the line, so that together we can ensure that more children do not continue to suffer in silence.
Question put and agreed to.
Oral Answers to Questions
Zubir Ahmed Excerpts(3 weeks, 2 days ago)
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Liz Twist (Blaydon and Consett) (Lab)
The Parliamentary Under-Secretary of State for Health and Social Care (Dr Zubir Ahmed)
Too many people are waiting too long for mental health support. Since coming into office, the Government have put mental health support services on the road to recovery. We promised 8,500 more mental health staff by the end of the Parliament, and we have already recruited 6,500 of them. We are introducing the first 24/7 mental health crisis support services through NHS 111, and we have rolled out mental health support to schools and colleges across the country, providing help to 5 million children and young people.
Liz Twist
Our mental health system is still suffering from the strain of 14 years of Conservative government. Rethink Mental Illness has reported that 12 times as many people are now waiting for mental health treatment than for physical health treatment. Nearly one third of those surveyed attempted suicide while waiting, and one in five lost their jobs. What are the Government doing to tackle those long waits and offer support to people before they reach crisis point?
Dr Ahmed
I thank my hon. Friend for all her tireless work to improve the lives of people living with mental illness and to prevent suicide. The 10-year health plan will build on the work that has already been done to reduce waiting lists, including through an extra £688 million of real-terms investment this year, the hiring of more staff and the expansion of talking therapies for an extra 380,000 patients. In addition, as she will know, the Mental Health Bill, which is in its final parliamentary stages, will modernise legislation and make a significant impact on the lives of those who live with mental illness.
Wera Hobhouse (Bath) (LD)
My all-party parliamentary group on eating disorders recently published a report on preventing eating disorder-related death. The report highlighted that eating disorders are not accurately recorded on death certificates. I was promised an update from the Minister for Women’s Health and Mental Health over two months ago, but am yet to receive one. How much longer will I have to wait?
Cat Smith (Lancaster and Wyre) (Lab)
The Parliamentary Under-Secretary of State for Health and Social Care (Dr Zubir Ahmed)
We are carefully considering the work undertaken by the Patient Safety Commissioner, which sets out various potential options for redress. I am both a clinician and a Minister who has recently taken on this area, and my hon. Friend will know that this is highly complex work, but it is a complexity that I am willing to step into. It requires input and planning across Government, which takes time. I am certainly committed to taking this issue seriously, and I will return to update my hon. Friend and the House in due course.
Cat Smith
I welcome the new Minister to his post. I have been campaigning on this issue for 10 years, and I have a stack of letters and answers to written parliamentary questions that say things like “in due course” and “the Government are considering”. On behalf of a group of people who have been gaslit by the medical profession, will the Minister step up and be the Minister who ensures that these families, who are victims of the sodium valproate scandal, actually see the redress that they absolutely deserve? Will he make sure that they get a meeting with him at the earliest opportunity?
Dr Ahmed
I thank my hon. Friend for all her tireless work, campaigning and advocacy on this issue for many years, particularly since the Hughes report was published in February 2024. Like me, she will be sensitive to the fact that we are coming up to the two-year anniversary of that report. It is a call to action for me and the Department to answer the questions that she has been asking for so long. I have a meeting with the Patient Safety Commissioner very shortly, and I am very happy to meet her separately when she wishes.
Robin Swann (South Antrim) (UUP)
The Minister will know that the Hughes report focused very much on England, but those affected by the redress scheme will be found across the entire United Kingdom. Will he ensure that he engages with Health Ministers from the devolved authorities?
Dr Ahmed
The hon. Gentleman can certainly be given that assurance from me, as the Minister also responsible for four-nation engagement. The Hughes report examined both the sodium valproate and pelvic mesh issues, and I know that these resonate across the four nations, particularly when it comes to licensing and regulation of medical technology. He has that assurance from me.
Alison Griffiths (Bognor Regis and Littlehampton) (Con)
Tristan Osborne (Chatham and Aylesford) (Lab)
The Parliamentary Under-Secretary of State for Health and Social Care (Dr Zubir Ahmed)
My hon. Friend is absolutely right. As announced in the 10-year health plan, David Lock KC is providing expert policy advice on the rising legal costs of clinical negligence and how we can improve patients’ experience of claims. That review is ongoing, and following initial advice to Ministers and the recent report from the National Audit Office, the results of David Lock’s work will inform future policymaking in this area. I am happy to update my hon. Friend as soon as that happens.
Dr Danny Chambers (Winchester) (LD)
Kenneth Stevenson (Airdrie and Shotts) (Lab)
Dr Ahmed
While the NHS in Scotland has no app and no plans for a national roll-out, the NHS in England has had an app since 2019, with 71 million logins in October 2025. Three in four people now have the app in their pockets and it has more subscribers in England than Netflix. You may ask, Mr Speaker, why NHS Scotland does not have an app? The answer comes in a freedom of information request by the champion journalist Simon Johnson: when asked about some of the drawbacks of applying the NHS England app in Scotland, they said:
“political optics of adopting an English solution”.
It is time for Analogue John to move over and let Anas Sarwar and Jackie Baillie finally drag the Scottish NHS into the 21st—
Mr Speaker
Order. We are on topical questions. The Prime Minister is in the Chamber. If you do not want Members to get in, please tell me; it would be easier.
Peter Swallow (Bracknell) (Lab)
Bracknell is a life sciences superpower, with Eli Lilly, Sandoz and Boehringer Ingelheim all having a footprint in our town. What can we do to speed up clinical trial set-up to help to deliver the next generation of treatments for our NHS?
David Mundell (Dumfriesshire, Clydesdale and Tweeddale) (Con)
The Secretary of State will be aware that since the law change, the number of children who have received NHS prescriptions for medical cannabis for severe epilepsy has been pitifully low. Families and campaigners believe that part of the reason is that the Home Office still has large responsibility for those products. Will the Secretary of State meet me and other interested MPs to discuss whether his Department could take more responsibility?
Dr Ahmed
Although the Government have no plans to change the departmental responsibilities applicable to unlicensed cannabis-based products, we are cognisant of the need for research in this area. We have agreed to more than £8.5 million in funding for two world-first clinical trials to investigate the safety and efficacy of cannabinoid treatments for drug-resistant epilepsy in both adults and children, and I am happy to speak to the right hon. Gentleman about this matter further.
Sonia Kumar (Dudley) (Lab)
I have seen at first hand how severe musculoskeletal conditions such as lower back pain can devastate someone’s ability to work, have relationships and sleep, as well as their overall wellbeing. The education of more than 1 million children is disrupted by MSK conditions due to missed schooling and fragmented, hard-to-navigate services. Will the Minister therefore prioritise MSK conditions in phase 2 of the modern service framework and confirm when that will be published?
NHS Prescription Charges
Zubir Ahmed Excerpts(3 weeks, 3 days ago)
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The Parliamentary Under-Secretary of State for Health and Social Care (Dr Zubir Ahmed)
The Prime Minister has announced that NHS prescription charges in England will be frozen for a second successive year.
This builds on wider Government action as part of the plan for change to tackle the cost of living pressures and will save patients around £12 million in 2026-27.
The single charge for prescriptions in England will remain at £9.90. The cost of prescription prepayment certificates will also remain the same, with three-month PPCs staying at £32.05, 12-month PPCs at £114.50, and the hormone replacement therapy PPC staying at £19.80.
The charges freeze will also apply to NHS wigs and fabric supports. These prices will remain at current levels:
Surgical brassiere—£32.50
Abdominal or spinal support—£49.05
Stock modacrylic wig—£80.15
Partial human hair wig—£212.35
Full bespoke human hair wig—£310.55
Around 89% of prescription items in England are already dispensed free of charge to children, the over-60s, pregnant women, and those with certain medical conditions. This freeze will not impact current exemptions. All working-age adults who would normally pay for their prescriptions, which is estimated to be around 40% of the population, could benefit from the freeze.
In addition to the freeze on charges, the NHS low-income scheme continues to offer help to those on low incomes who otherwise need to pay for prescriptions, while prescriptions are free for eligible people in certain groups such as pensioners, students aged under 19 in qualifying full-time education, and those who receive certain qualifying state benefits or live in care homes.
[HCWS1091]
Draft Health and Care Act 2022 (Consequential Amendments) Regulations 2025
Zubir Ahmed Excerpts(4 weeks, 1 day ago)
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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 Care Act 2022 (Consequential Amendments) Regulations 2025.
It is a pleasure to serve under your chairmanship, Mr Twigg. A copy of the draft regulations was laid before the House on 21 October.
There are estimated to be around 47,000 people in the UK with Down’s syndrome. Despite existing legal duties and frameworks, those people face real challenges in accessing the care and support they need to live the lives they want to in their own communities. This Government are determined to set that right. Through the implementation of the Down Syndrome Act 2022, aligned with the overarching aims of our 10-year health plan for England, we are striving to improve the life outcomes for people with Down’s syndrome by improving their access to services, raising awareness and understanding of their needs, and breaking down the barriers to opportunity that they and other disabled people face. The draft regulations will make a technical but necessary amendment to the Down Syndrome Act to support its effective implementation, and it is right that they should be given full scrutiny in Committee.
I will begin by setting out what the Down Syndrome Act requires. Under the Act, the Secretary of State for Health and Social Care is required to give guidance to relevant authorities in health, social care, education and housing services on what they should be doing to meet the needs of people with Down’s syndrome. Relevant authorities must have due regard to the final statutory guidance, once published. This Government want disabled people’s access to, and experience of, healthcare services to be equitable and effective. The guidance under the Down Syndrome Act supports that aim by raising awareness of, and bringing together in one place, the practical steps that organisations should take to meet the needs of people with Down’s syndrome. It also helps to clarify the support and services that people with Down’s syndrome can expect to receive.
On 5 November, we launched a public consultation on draft guidance under the Down Syndrome Act. Work to develop the draft guidance has involved significant engagement with people with lived experience and, importantly, with the organisations that support them. The consultation presents a further opportunity for people with lived experience and their families to share their views. We expect the guidance to improve support for people with Down’s syndrome and for those with other, similar conditions. In order for the guidance to deliver improvements for those people, it needs to be implemented effectively across the range of communities that it serves.
On 9 May 2023, NHS England published statutory guidance stating that every integrated care board should identify a member of its board to lead on supporting that ICB to perform its functions effectively in the interests of people with Down’s syndrome. The NHS England guidance also states that ICBs should have a lead for learning disability and autism, and a lead for children and young people with special educational needs and disabilities. It will be important for ICB leads to work collaboratively across the integrated care system, with local authority, public health, education and wider partners. The consultation on the draft guidance will help us to understand whether the guidance is clear, informative and useful to relevant authorities in carrying out their legislative requirements in support of people with Down’s syndrome. We will use the feedback received to ensure the guidance is fit for purpose.
I now turn to what the draft regulations will do. Under the Down Syndrome Act, relevant authorities must have due regard to the final statutory guidance when exercising their relevant functions. The Act does not create any functions beyond that duty. The schedule to the Act specifies the relevant authorities that must have due regard to the guidance and the specific functions of those bodies to which the guidance applies. As drafted, the schedule does not include NHS England or ICBs. Rather, it refers to the National Health Service Commissioning Board, which was the former name of NHS England, and to clinical commissioning groups, which were the commissioning bodies in place at the time the Down Syndrome Act was passed.
These draft regulations seek to bring the legislation up to date by replacing references to CCGs with ICBs, and references to the National Health Service Commissioning Board with NHS England. The changes are required because the Health and Social Care Act 2022 made provision for the abolition of CCGs and replaced them with ICBs, and renamed the National Health Service Commissioning Board as NHS England. The purpose of that change is to bring ICBs and NHS England within scope of the Down Syndrome Act duty to have due regard to the guidance.
Final guidance issued under the Down Syndrome Act will not be published until these changes come into force. We intend to publish the guidance before the planned abolition of NHS England comes into effect. We understand that the ongoing reforms across Government affect the timing and content of the final guidance, and its content after publication. We will keep the final guidance under review, and it will be updated to reflect the latest policy and legislative frameworks as and when necessary.
The Down’s syndrome guidance will not be statutory for those not specified in the schedule to the Down Syndrome Act, which means that persons who are not relevant authorities are under no obligation to have due regard to the guidance. It is therefore important that we change the wording in the Down Syndrome Act now to ensure that the guidance will apply to current relevant authorities. The change will also ensure that the legislation is in alignment with NHS England’s statutory guidance on the ICB leads on Down’s syndrome. ICB leads are responsible for the implementation of the guidance under the Down Syndrome Act. It is therefore critical that they are referenced in the legislation itself.
The regulations will come into force on the day after the date on which they are made. The rationale is to ensure that the duty under the Down Syndrome Act to give guidance to relevant authorities applies to the correct authorities. The regulations will have no material effect until the final guidance is published. We therefore do not believe it necessary to engage with or notify the public further on these changes.
By making important updates to the Down Syndrome Act, these regulations will provide vital assurance that the guidance will be implemented effectively, ensuring that it can achieve the aim of improving the life outcomes of those with Down’s syndrome. I commend this statutory instrument to the Committee.
Dr Ahmed
I am grateful to the right hon. Gentleman for showing the consensus on the Down Syndrome Act. It should be placed on record that the Act was a private Member’s Bill sponsored by Sir Liam Fox, then a Conservative Member. I am delighted to carry forward the draft regulations on the basis of that consensus.
The right hon. Gentleman asked what these statutory instruments will look like in relation to future iterations of NHS governance structures. As he said, NHS England will continue to undertake the statutory functions until parliamentary time allows for legislative changes. I am confident that the Down Syndrome Act and Acts like it will be components of the primary legislation that will be required to make those new arrangements, such that we will not require this type of Delegated Legislation Committee process again.
I will take back the question about digital access to the consultation process to my officials. The right hon. Gentleman raises a very important point on exclusion, of which I am also very cognisant. I am happy to write to him with a fuller answer.
Again, I am grateful for the consensus on both sides of the Committee. I commend the draft regulations to the Committee.
Question put and agreed to.
Clive Treacey Safety Checklist
Zubir Ahmed Excerpts(1 month ago)
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The Parliamentary Under-Secretary of State for Health and Social Care (Dr Zubir Ahmed)
I thank my hon. Friend the Member for Lichfield (Dave Robertson) for securing this important debate. I recognise the efforts of Clive’s family, particularly Elaine and Michael who join us today in the Gallery.
As my hon. Friend described in his wonderful speech, Clive Treacey was a caring, gentle and humorous man, who liked to paint and who enjoyed gardening and listening to music. As we have heard, Clive also had a learning disability and epilepsy, and sadly he died in 2017, at the age of just 47, following a seizure. His loss, I am sure, is still felt very deeply by his family and loved ones. I pay tribute to all the work that they have done by channelling the tragedy they have been through, and the work that they continue to do in advocating for change following Clive’s death.
The independent review into Clive’s death highlighted that there were multiple system-wide failures in delivering his care and treatment that together placed him at a higher risk of sudden death. It was found that Clive experienced sub-optimal care and support throughout his life and death, and that he was not always placed in settings that could meet his needs, in terms of both epilepsy care and support for his disability.
I am pleased that since Clive’s death, meaningful changes have been made. Following the publication of the independent review into his death in December 2021, organisations directly involved in Clive’s care developed high-level actions in response to its findings and there was an overwhelming commitment from all organisations involved to address the systemic issues raised in the report. NHS England midlands region set up a group that became known as the Clive Treacey conscience group and last year it published “Clive’s Way: A Conscience Manual”, outlining in detail the progress the midlands region is making in taking forward and implementing the learnings from the independent review.
We know that around 30% of people with epilepsy have a learning disability and that the risk of sudden unexpected death in epilepsy is much higher for those with a learning disability, as my hon. Friend pointed out. The latest annual LeDeR—learning from lives and deaths—report found that epilepsy was one of the most common underlying causes of death for people with a learning disability between 2021 and 2023. That highlights how crucial it is that information and support for patients with epilepsy who have a learning disability are tailored to their individual needs. We welcome the development of the Clive Treacey safety checklist; it is an important part of Clive’s legacy. We encourage commissioners and service providers to use the checklist and its accompanying guidance as a key tool when designing services for their local populations and to ensure that the steps outlined in the checklist are followed whenever a patient experiences a significant change in their care.
Since Clive’s death, a number of NHS regions have reviewed the way that they care for patients living with a learning disability and epilepsy—
Dr Ahmed
It is a very positive development that a number of integrated health boards in the midlands, the north-west, the north-east and Yorkshire have carried out detailed appraisals to identify any weaknesses in their services.
My hon. Friend the Member for Lichfield raises an important point about how we can go further, including how annual health checks can significantly reduce the chance of premature death in people with a learning disability who have epilepsy. NHS England has developed a quality framework to set expectations for annual health checks for people with a learning disability and accompanying health action plans, which are vital to identifying needs early, providing the right support and mitigating the risk of sudden death.
The National Institute for Health and Care Excellence guidance on epilepsies in children, young people and adults recommends that people with a learning disability should have monitoring reviews at least annually. The NICE guidance on epilepsies also includes a number of recommendations on how information should be tailored and adapted for patients with epilepsy who have a learning disability. It sets out that patients with a learning disability should have access to specialist care and should receive co-ordinated care using a multidisciplinary approach. For young people with a learning disability who are transitioning to adult epilepsy services, transition planning should begin early. This Government expect commissioners and service providers to take NICE guidelines fully into account when making decisions about how to best meet the needs of their local communities.
We are rolling out mandatory training on learning disability and autism to health and adult social care staff. Support for people with a learning disability is also a key area of focus for the NHS RightCare epilepsy toolkit. The toolkit includes a number of actions that systems should take to support people with epilepsy who have a learning disability, such as ensuring that specialist epilepsy services are upskilled and make reasonable adjustments to support the needs of people with a learning disability, including working in partnership with staff trained in how to manage learning disability. The toolkit also sets out that services should ensure that community specialist nurses in learning disabilities have the right training in the management of epilepsy.
I recognise the important work of organisations such as Epilepsy Action and SUDEP Action. Epilepsy Action has produced the “Step Together” toolkit, which describes what good-quality integrated services for people with a learning disability and epilepsy should look like. SUDEP Action has developed an epilepsy self-monitoring app, which is a digital tool designed to help patients understand their own personal risk of seizures and to track that risk. SUDEP Action has played a key role in the development of the Clive Treacey safety checklist.
Once again, I thank my hon. Friend the Member for Lichfield for securing this important debate, and I thank the hon. Member for Strangford (Jim Shannon) for his contribution. It goes without saying that Clive’s death must not be in vain and that we must learn the lessons to ensure that this does not happen again. I believe we also need to commit further that no longer in our national health service should a tragedy be the only way to make things better for the patients and citizens we serve and to save their lives.
Finally, the patient voice must be our guiding star when designing services and safety checklists and keeping patients safe in the community and in hospital. I believe that through the actions we have taken in our 10-year health plan and the actions that I have taken as the Minister responsible for patient safety, we can undertake today to Members of this House that that shall be the case going forward in this Government’s approach to patient safety.
Question put and agreed to.
Down Syndrome Act 2022: Draft Statutory Guidance Consultation
Zubir Ahmed Excerpts(1 month, 1 week ago)
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The Parliamentary Under-Secretary of State for Health and Social Care (Dr Zubir Ahmed)
People with Down syndrome have the right to make informed decisions about their future. This Government recognise our duty to support them in achieving their goals and aspirations in life.
There is estimated to be around 47,000 people in the UK with Down syndrome who, despite existing legal duties and frameworks, often face real challenges accessing services and the right support due to a lack of understanding of their needs and how to meet them.
We are determined to set this right. That is why we are breaking down barriers to opportunity for disabled people through our 10-year health plan, and today we are launching a consultation on draft statutory guidance under the Down Syndrome Act 2022.
I strongly encourage everyone with an interest to respond to the consultation and share their views.
The guidance supports the Government’s aims to ensure disabled people’s access to, and experience of, services is fair and effective. It does this by raising awareness and bringing together in one place the practical steps that organisations should take to meet the needs of people with Down syndrome. It also helps to clarify the support and services people with Down syndrome can expect to receive.
During the passage of the Down Syndrome Act, it was clear there were concerns about ensuring that the guidance could have the widest possible benefit for people with other chromosomal conditions, genetic conditions and/or a learning disability who have similar needs, and we have sought to address areas where there are overlaps.
We expect the guidance to improve support for people with Down syndrome and also for those with other conditions and/or a learning disability who have similar needs. An equalities impact assessment has been published alongside the consultation.
In March 2024, the previous Government formally commenced the Down Syndrome Act, bringing into force the duty for the Secretary of State to consult on and publish guidance. On 21 October 2025, we laid amendment regulations to ensure the Act reflects current NHS structures.
I am grateful to Sir Liam Fox for introducing his private Members’ Bill, now the Down Syndrome Act. I fully recognise that quite some time has passed since the Act received Royal Assent in April 2022. Following close engagement with our partners, this Government are now in a position to publish the draft guidance for public consultation, with today’s announcement taking us a step closer to the final guidance being published.
The consultation will run for 12 weeks, and easy read versions of the draft guidance and the consultation questions have been made available, so everyone is able to make their voice heard.
I am proud to say that people with lived experience, and the organisations who support them, have been at the heart of the work to develop this guidance.
I would like to thank all those people with lived experience, their families and carers, and partner organisations who have worked tirelessly to help us produce the draft guidance for consultation, and to all colleagues who supported us to get this over the line.
I look forward to receiving responses to this consultation to help us to develop guidance that has a real and lasting impact on people’s lives.
[HCWS1026]