Local Government Reorganisation: Devon
12. For what reason the local government reorganisation model in Devon was selected.
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Local Government Reorganisation: Devon
I congratulate the Secretary of State on her return to her place in the Ministry of Housing, Communities and Local Government. I welcome her team, too. I thank her for her upcoming statement and the review that she has just started, which address my question and that of my colleague, my hon. Friend the Member for South Devon (Caroline Voaden), about the Devon local government reorganisation, which had been described as bonkers. Next time around, will the Government include the local MPs in the process? Will the local councils be refunded the costs incurred this time around?
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Health Bill
On that very point, does my hon. Friend agree that the recent NHS cost-benefit analysis showing that the Palantir project will cost £1.1 billion and deliver benefits of £800 million—a net loss of £300 million for the NHS—underlines the fact that we need to get rid of it now?
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Health Bill
On interpreting statistics, does the hon. Gentleman agree that when it comes to data, GP confidentiality—in respect of the Palantir federated data platform, for example—is critical, certainly when we come to the single patient record, and that the Bill should not reduce confidentiality or data privacy to achieve the single patient record?
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Health Bill
Does the hon. Member agree that it is a fundamental principle of anything like the SPR that it must have privacy by design at the centre of it, and that therefore a firm such as Palantir—which has a US, slightly cavalier and somewhat casual attitude to how data privacy should be controlled—should not be allowed anywhere near it?
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Health Bill
Does my hon. Friend agree that that element of trust is even more important when we get the single patient record, and critical to enabling GPs and medical professionals everywhere to use it, and patients to trust it?
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Health Bill
Will the Minister give way?
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Hate Crime Law: Misogyny
The hon. Gentleman makes a really important point about certainty of funding. Some of the organisations that I have spoken to in my Chelmsford constituency that deal with victims of domestic abuse point out to me that often the funding is project-based. It is not about what they have tried before, have proven to work and want to continue with; they find that people say, “Oh, yes, but we’re starting this new project now, so we’re only accepting bids for new projects and things that haven’t been done before,” and all the great work that has been done before is forgotten. Does he agree that we are always going to be chasing our tails in that way, and nobody will be well served by it, and that we need certainty of funding for things that are proven to work as well as for trialling new stuff?
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Hate Crime Law: Misogyny
It is a pleasure to serve with you in the Chair, Sir Edward. I thank those across the country who signed this petition to ensure that we had this really important debate. Violence against women and girls is a national emergency. As others have said before me, it is really important that we underline that: it is an emergency. This is affecting a whole generation, and I am terrified of what that means for society if we do not deal with it. Liberal Democrats have long called for misogyny to be made a hate crime so, while we very much welcome the Government’s amendment to extend the list of aggravated offences under hate crime legislation to cover sex or presumed sex, and while I was proud to sponsor the amendment that extended that to LGBT people and disabled people in the last parliamentary Session, my Liberal Democrat colleagues and I agree with the petitioners that Ministers should go further and amend the Sentencing Act to ensure that all crimes motivated by misogyny are classed as hate crimes. I also want to highlight that the extension of aggravated offences to cover sex, disability, sexual orientation and transgender identity has not yet been brought into force, so I hope to hear a timeline from the Minister on when that will be brought forward by the required secondary legislation. Hatred is just as unacceptable no matter its type; that means that there must be zero tolerance for misogyny. As the petitioners noted, misogyny can fuel crimes including sexual violence. The need to make misogyny a hate crime and the importance of tackling it early on is borne out by the data: studies have confirmed what women, from our own experiences and those of our friends, know to be true: that the majority of us have, at some point, encountered some form of abuse in outdoor spaces, and that this is so commonplace that very few ever bother to report such incidents to the police. That is why, in a similarly themed Westminster Hall debate at the start of this year, I pressed the Government to accept and begin implementing all 13 recommendations of part 2 of the Angiolini inquiry, set up after Sarah Everard’s murder. That has not happened, I am sad to say. One recommendation yet to be taken up was to “immediately” improve national data collection and sharing on sexually motivated crimes against women in public spaces. The inquiry found that data is fragmented and inconsistently documented across police forces. Given that making misogyny an aggravated offence under hate crime legislation should allow for greater information gathering, I ask the Minister here today how she anticipates making use of that if data on more serious sexual violence is not being effectively collected right now. The petitioners also called on the Government to act on anti-feminist hate groups and the harassment and online abuse that they perpetrate. I am sure that many of us are aware of the abbreviation IRL, meaning “in real life”, which differentiates between the online space and in-person, so-called real spaces. However, there is increasingly less distinction with what is happening IRL and, instead, a blurring of boundaries between our digital and in-person experiences. Both cross over into the other’s realms with relative ease. That is why it is as important as ever to take decisive action to tackle misogyny wherever it originates, including online, as other Members have said. From cyber-flashing to sharing intimate images without consent, or the more recent development of AI-generated sexual images, it is crucial that the Government do all they can to keep pace with the rapid technological changes that pose particular harm to women and girls. We need legislation that tackles that in advance of it happening. It is important that we are a bit more prescient as to what might come next, rather than constantly playing catch-up, because when we are playing catch-up, the harm has already been done. For example, 98% of deepfake intimate images reported to the revenge porn helpline are of women. As organisations such as Internet Matters have underlined, given that not every case that I have mentioned reaches the hate crime threshold, taking strong measures against them is crucial to ensure that misogynistic attitudes are dealt with early and the tools that misogynists may use against women and girls are disrupted. Research by Internet Matters found that a shocking 14% of children aged between 13 and 16 had experienced some form of intimate image abuse and harassment, such as cyber-flashing or having a non-consensual image of them shared. The organisation states that “these behaviours are becoming normalised”. For those of us who grew up a few decades ago—let us not go into it too much—that was not the norm back then. Things are changing rapidly, and we must recognise that. On that note, when the violence against women and girls strategy was announced to Parliament last December, I pressed the then Minister to tackle harmful, misogynistic online content, highlighting the fact that Ofcom’s official guidance was only voluntary and that waiting until 2027 to strengthen it would be far too late. Tomorrow marks the deadline that the previous Minister set for tech companies to implement on-device safety measures to protect children from taking, receiving or viewing nude images—exactly the kind of harm that Internet Matters found children are increasingly being exposed to. I would therefore be grateful if this Minister confirmed whether the Government will uphold the previous Prime Minister’s deadline to big tech—and if not, whether and by which date they will take action on this matter. Liberal Democrats are clear that the Government’s first duty must be to tackle online harms and misogyny, not to prioritise the profits of big tech. More broadly, I and Members from across the House would very much welcome a recommitment from the Minister to the violence against women and girls strategy published at the end of last year and, in particular, the goal of halving violence against women and girls within a decade. I very much welcome that, and Members from across the House have been welcoming it, too. With data showing that more than four in 10 people arrested during the 2024 riots had previously been reported for domestic abuse, taking on violence against women and girls is not a stand-alone aim; it is inherently linked to facing down the normalisation of extremist, far-right rhetoric and policies. We cannot allow this VAWG strategy to fail where others have failed before. It must be a top priority for this Government. We must not accept a world that tells women and girls to expect violence and abuse. I thank again all those who brought forward and signed this petition. I expect the Government to consider their calls very carefully and, most of all, to recognise and indeed take confidence in the strength of feeling and breadth of public support that exists for tackling violence against women and girls.
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Draft Licensing Act 2003 (Mandatory Licensing Conditions) (Amendment) Order 2026
It is a pleasure to serve under your chairship, Mrs Barker. The Liberal Democrats are supportive of the order. Individuals should be able to have the option to verify their age digitally, but we want to make it clear that doing so must not replace the use of physical ID. The option must always be retained, thereby giving young people the freedom to choose. It is important that the protections are robust and contain adequate safeguards to prevent misuse and ensure that digital identities are genuine. Will the Minister therefore set out whether she is satisfied that sufficient safeguards are in place to ensure that the system will be enforced in the prescribed manner? Furthermore, what discussions has she had with the sector about the implementation of the system? How will the change be communicated to the public? What future measures will the Government consider to ensure that age is verified effectively under the 2003 Act when alcohol sales take place remotely? What steps are they taking to monitor compliance and accountability, and where necessary to take enforcement action against companies certified under the DVS trust framework? I thank the Minister for clarifying that the order is not about going down the route of compulsory digital IDs. I reiterate that the Liberal Democrats are clear that a mandatory digital ID system would cross a red line. It would risk eroding long-held civil liberties. Digital tools should be about giving individuals more control over their personal data, not giving the Government more control over our lives. Our concern remains that a mandatory digital ID system could deepen digital exclusion and disproportionately affect society’s most marginalised: older people, people living in poverty, and disabled people, who often have limited access to digital devices or low digital literacy. I look forward to the Minister’s response.
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Local Government Reorganisation
This sudden U-turn is greatly disappointing for my constituency, after so much work by council officials, residents, councillors and other partners, and after so much money wasted on LGR costs. Given that the two-unitary model in Warwickshire—South Warwickshire and North Warwickshire—was championed by my constituents, the majority of local council leaders and the majority of Warwickshire MPs, will the Secretary of State reassure us all regarding the timescale for this review? Above all, will she reassure us that the decision will respect the democratic input of the people of Warwickshire who contributed to the previous LGR process?
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Local Government Reorganisation
Communities like mine in Eastleigh are being denied funding opportunities because they do not yet have an elected mayor. With the timeline for local government reorganisation and elections now thrown into doubt, will the Secretary of State ensure that funding opportunities are offered to all local authorities, whether or not they have an elected mayor?
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Health Bill
I thank the Minister for accepting our amendment on this issue. We pressed her and her colleagues over and over again—to the extent that we got a letter back that we honestly thought had been generated by AI, because the logic in it had no follow-through at all. I am delighted that she has listened. On what else does she intend to listen to us? In particular, there are amendments on the Health Services Safety Investigations Body, Healthwatch and health inequalities, which we will consider tomorrow, and, most importantly, the special needs amendment, which we are considering today. What else will she listen to us on?
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Health Bill
Let me start by taking up the theme of maternity, which has already been mentioned by a number of Members. I welcome the Government’s commitment to instating a maternity commissioner. I sit on the expert reference group—that is what we are called—that feeds into the maternity and neonatal taskforce, so I see how the Government are trying to pull all these different issues together. The Health and Social Care Committee has heard repeatedly, and across a number of inquiries, how important this issue is, and we need someone who is independent of Government and able to knit it all together. Our Committee’s “Black Maternal Health” report heard how workforce shortages are undermining efforts to improve maternity care, data is lacking, and there is a culture in which women, particularly black women, are not listened to. Investment and training are needed to tackle that. The “First 1000 Days” report found that the UK has some of the worst early years health outcomes in Europe, including in infant mortality, and we have called for proper targets for early years professionals in the long-lost workforce plan. As an aside, where is the workforce plan? I would love to see it. Locally, Oxford University hospitals provide maternity care for my residents, and indeed for my own family—baby took their first steps this weekend, finally! It was a momentous occasion. I also reflect genuinely that there are people in my National Childbirth Trust class who did not have as good an experience as we did. They have been proactively contacted by the hospital to have an apology and an explanation given for their awful, traumatic birth, and they did not even complain. In part, that is a result of the CQC inspections and, more importantly, the inclusion by Baroness Amos of OUH and John Radcliffe hospital in her report. I toured the hospital again this summer and heard specifically from trust leaders and midwives. They are doing everything they can to respond to all the criticisms being levelled at them by families, but they told me that there is only so much that they can do without a new building. Baroness Amos’s report said: “The maternity and neonatal units sit across multiple floors… We saw delivery suites that didn’t have windows, that were cold, small and cramped and had pillars in the middle of them affecting where equipment could be placed”. A large number of the suites did not have en suites. Can you imagine what it must be like to give birth in those rooms? As the Government knit together their action plan, I beg them not to forget investment, particularly capital investment, when they empower the commissioner to do their good work. Let me move on to a few other amendments. I support the work to tackle health inequalities in new clauses 90 and 91. Our Committee hears over and over again that if we want to unlock productivity in the NHS, that is where we need to focus. I also support the campaign of my hon. Friend the Member for Newton Abbot (Martin Wrigley) and his cross-party new clause 34, which echoes the findings of my Committee. The Government really need to think again when it comes to Palantir and instead supercharge the capability of UK-based companies.
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Health Bill
I thank my hon. Friend for his intervention; he has been a doughty campaigner on this issue, as have other members of the Committee, including the hon. Member for Chelsea and Fulham (Ben Coleman). We also know that much of the data is based on the data being taken from Chelsea and Westminster hospital, and not much else across the country. We have a lot of questions about that contract, hence why we came to the same conclusion. However, I primarily urge the Government please to consider new clause 85, in the name of the hon. Member for Thurrock (Jen Craft), which would impose duties on ICBs for delivering education, health and care plans. In my constituency we held a roundtable to provide evidence for our own hearing on this issue—by the way, this was based on a recommendation that came out of the Education Select Committee’s work on EHCPs, so we decided to take up the “H” bit. In that roundtable, I heard movingly from families who kept saying things like, “Everything is a battle.” One child, Stefan, suffers from multiple epiphyseal dysplasia, which affects his hips, and needs support to get around. He is very bright and desperately wants to learn. His mother was at that roundtable, and told me that, exceptionally and against school policy, he is allowed to keep a phone on him. There is no one whom the school can employ to make sure he can be wheeled from class to class, so instead what happens—and mother and school have done everything they possibly can—is that Stefan rings his mum so that she can come from home and deliver him to his next class. Ridiculously, this is the kind of thing that goes to tribunal, and then those tribunals cannot hold the ICBs to the same level of accountability as local authorities. The whole thing is nonsensical.
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Health Bill
I am grateful to the hon. Member for his intervention, and for the work of that Committee. We are doing work together right now on children’s mental health, so I am sure we will continue to pursue this theme. The point is that the impact was not just on that child; it was also on the mother, who could not work, and there was also the distress of having to battle the system. The mental health of both parents was affected. It does not need to be this way, and I genuinely believe that accountability is part of the answer. As such, my plea to the Government is simply to say that it is past time that the “H” part of EHCPs is put on a statutory footing, and I urge the House to support new clause 85.
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Topical Questions
I recently met a homeless man at the homelessness charity the Matthew 25 Mission, who said that he had been “dumped” in temporary accommodation in Eastbourne by Brighton and Hove city council without the support that he needed. The previous Minister promised that she would review the out-of-area placement guidance for local authorities on this matter, so will this Minister meet me to discuss the progress of that review?
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Surrogacy Law and Legal Parenthood
Ian and Stuart, who are constituents of mine in Horsham, welcomed their daughter through surrogacy last October. Although Ian is the biological father, at birth it was the surrogate mother and, remarkably, her partner who were named as the child’s parents, not Ian. As my hon. Friend said, it typically takes up to 12 months to correct the record in such cases. Ian understands why surrogates need legal protection, but there must be a better way to do this. The Law Commission’s 2023 report set out a simple, proportionate fix: a new pathway to recognising that at least one parent, where genetically related to the child, is a legal parent from birth. Does my hon. Friend agree that the Government should now respond to that report?
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Surrogacy Law and Legal Parenthood
It is worth putting on record that the Law Commission report in 2023 suggested that, if everything was decided before the birth, the legal parents could have the rights from day one, but the biological, or surrogate, mother would have a chance to go against that in the first six weeks of the baby’s life. Does the hon. Member agree with the Law Commission report, which still has that fundamental safeguard, but which also recognises that the intended parents are the parents from day one?
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Surrogacy Law and Legal Parenthood
The hon. Member says “many” go on to deeply regret the decision to be a surrogate. What does the data show? How many end up regretting their decision, in terms of a percentage of the surrogates in the UK?
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Surrogacy Law and Legal Parenthood
It is a pleasure to serve under your chairmanship, Mr Pritchard. I pay tribute to the hon. Member for Lichfield (Dave Robertson) for opening the debate and for so thoughtfully laying out both sides, which have been well exercised today. Being able to start a family is one of life’s greatest privileges. However, for those in many families, whether they are struggling with infertility, are in same-sex relationships or have health issues that would prevent them from having a safe pregnancy, surrogacy has become an option that would allow them to start a family. The landscape of surrogacy has changed in the years since the first known surrogate baby was born in 1984. Surrogacy is now being widely recognised as a pathway to parenthood, with 67 parental order applications received by the family courts in 2008, rising to 514 in 2025, although I recognise that many different numbers have been suggested today.
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Surrogacy Law and Legal Parenthood
I do not think any woman enters into any pregnancy lightly, whether it is their own pregnancy or a surrogate pregnancy. I would assume that any surrogate mother is well informed of the risks they are taking in growing a life over nine months, which is no mean feat. Since 2018, there have been 350 parental order applications from couples in a same-sex relationship, according to Brilliant Beginnings. Adam and Jamie, who brought this petition to the House today, chose to go abroad to the US because they would be recognised as Leven’s parents from day one. I am sure it would have come as a shock to them to discover, before Leven was born, that their home—the UK—does not recognise them as Leven’s legal parents under UK law until the parental order is completed, which can take anywhere between six and 12 months.
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Surrogacy Law and Legal Parenthood
My hon. Friend pre-empts what I will go on to say, but he also makes an important point. If I chose to be a surrogate for a friend or a family member, I think my husband would be pretty shocked at being named as the father on a birth certificate, when it was my decision to be a surrogate. Regardless of where we sit in this argument, I think we can all agree that that does not make any sense. I commend Adam and Jamie for their bravery in sharing their journey to parenthood and the additional challenges that they have faced in securing their rights, which they are already recognised as having in the US, as their daughter’s parents. The journey they took is more common today. Around 500 babies are born through surrogacy to UK parents every year, and nearly three quarters are now born through international surrogacy. The most popular destination is the USA, with the other quarter spread over countries including Canada, Colombia, Georgia, Kazakhstan, Mexico, Nigeria and Ukraine. It is legitimate to raise concerns about surrogacy practices in other countries, especially ones where it is not regulated and there is a risk of trafficking and exploitation. That is why the subject needs to be handled with such sensitivity. We must ensure that the rights of the surrogate, the baby and the intended parents are at the heart of everything we do, and that legislation reflects that. The recommendations of the Law Commission’s report into surrogacy law, published in 2023, attempted to address many of those issues. The report, requested by the UK Government of the day, sought to create a new pathway to parenthood for UK surrogacy, with intended parents recorded on their child’s birth certificate provided the surrogate does not change her mind. It also called for regulation of non-profit UK surrogacy organisations to oversee the new pathway, including requirements for a written surrogacy agreement, screening, legal advice and counselling, as well as tighter categorisation of permitted payments to UK surrogates. The hon. Member for Strangford (Jim Shannon) highlighted that there should be no doubt between payments and legitimate expenses, and I agree with him. The Law Commission’s report found a lack of clarity about what payments can be made by the intended parents to the surrogate, which makes the law difficult to apply in practice. We need a law that can be clearly and fairly applied, to ensure that families and surrogates alike understand their rights and responsibilities. However, the report has not had a formal response from Government, even though it was published three years ago, nor has any time been given for the House to debate the wider conversation around surrogacy so that we can reflect the changing environment—a call made by hon. Members from across the House. That is why this needs to be looked at as a matter of urgency. I ask the Minister today to explain what work is being done to improve clarity on the issue and whether we can expect legislation to address it. As the hon. Member for North Warwickshire and Bedworth (Rachel Taylor) said, there is a Bill ready to go. The Liberal Democrats recognise that the current system can create long delays as intended parents apply for a parental order after birth, and we recognise the distress that delays can cause to those involved. It is clear that delays can also cause practical issues for parents who have caring responsibilities but lack legal security, which creates problems around registering.
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Surrogacy Law and Legal Parenthood
I am in no way suggesting that we create a two-tier system. Talking about how long the adoption process can take, especially for those who have had fostering responsibilities and are transitioning into adopting those children, and talking about how arduous that process can be, including when making sure that children have up-to-date health records and so on, would be a separate debate. We are clearly talking about health services as well. If a child is born with a health concern, the intended parents who are providing their day-to-day care should have the facility to act on behalf of that child to make sure they are well looked after. It is also worth pointing out at this stage that, if a heterosexual couple presented in a hospital with a child who is poorly, it is very unlikely that a health professional would ask, “Can you please prove that you are the legal parents?”, but for same-sex couples it is more likely that someone would ask that question. We are creating a two-tier system between heterosexual couples who choose surrogacy and homosexual or same-sex couples who choose surrogacy, and I am not in favour of a two-tier system at all. The Liberal Democrats also believe that, as with all the issues raised in this debate, any decisions regarding the legal parenthood of a new baby must ensure that the rights and wellbeing of all those involved are balanced and respected. I ask the Minister when the Government intend to respond to the report in full and whether they intend to bring forward any legislation on this issue for Parliament to consider—because, although this is Adam and Jamie’s debate, they represent a much wider group of people. I will finish by saying that so few people have touchpoints with our Parliament and our political system, and passing the threshold to have an issue debated in Parliament is no mean feat; but it should not be the end of the story. It would be helpful if the Minister could set out what the next steps are, to ensure that the conversation about this issue continues.
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Local Government Reorganisation
I want to impress upon the Secretary of State the anger that my local councillors, across all parties, are feeling at yet another pause, because pauses create more uncertainty for local authorities, when they should be planning for the future so that our residents get better services in the long term. Does the Secretary of State believe that a single resident in West Sussex is better off because of the reforms that were announced two years ago?
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Local Government Reorganisation
Large numbers of my constituents took part in the Government’s consultation on proposed boundaries for the East Sussex unitary authority in good faith. They were appalled by Brighton and Hove city council’s attempted land grab in our area, and together, we resisted it. Can the Secretary of State be crystal clear for my constituents on whether she intends to reopen the discussion over East Sussex’s local government boundaries as part of this review?
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Economic Growth
The Minister cites our world-class universities and an ambition to double the number of UK unicorns that run frontier technologies such as quantum and AI, but does she recognise that those breakthroughs often come from the curiosity-driven frontier physics research in our universities, and that that research base now faces a £700 million funding gap?
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Health Bill
I have tabled several amendments to the Bill, but I will hopefully keep my remarks focused so there is a good opportunity for other Members to make their speeches. The Bill should be about fixing the front and back doors of the NHS. It offers the opportunity to bring in tangible changes for patients to address pressing problems and introduce desperately needed improvements to patient safety and experience. The primary care and social care crisis, in particular, are millstones around the neck of the NHS. But instead of addressing them, the Bill has focused on a top-down reorganisation, which risks diverting time and money away from those pressing issues, and it gives sweeping powers to the Secretary of State, which is not in itself without risk. The Liberal Democrats would instead have put social care and general practice at the heart of the Bill—a move that would represent real reform of the health service. In particular, new clauses 54 and 56 tabled by my hon. Friend the Member for Mid Sussex (Alison Bennett) would together transform the rights of family carers through guaranteed respite care and reform of the carer’s allowance. They would put free personal care, and an end to catastrophic care costs, at the heart of social care reform. New clause 53, tabled by my hon. Friend the Member for Epsom and Ewell (Helen Maguire), would ensure that everyone can see a GP within seven days, or 24 hours if urgent, and amendment 17 would introduce a primary care investment standard. Although general practice is the core of a patient’s relationship with the NHS, it has seen its funding decline as a share of NHS spending. Less than 10% of the NHS budget is spent on primary care, although that is estimated to constitute 90% of a patient’s direct experience with the NHS. A primary care investment standard would help to reverse that trend. Dentistry is another area of primary care that has been neglected, leading to dental deserts and dangerous DIY dentistry. New clause 18 would introduce a scheme to end dental deserts, and guarantee appointments for children and those most in need.
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Health Bill
I broadly agree with the hon. Gentleman, and I am about to come to mental health. It is right to modernise the NHS and end some of the duplication that we see between NHS England and the Department of Health and Social Care, but the way it has been handled has been chaotic. It has been combined with 50% cuts to ICB budgets, unfunded redundancy payments, and chaos through the system. I was alarmed to read the report in The Times at the weekend about advice to the Secretary of State that the changes envisaged under the Bill are impossible to implement, given that the staff of NHS England are on different pay scales to those in the Department. Given those significant hurdles, I hope that in her closing remarks the Minister can provide some reassurance that abolishing NHS England in the way the Bill envisages is achievable. We are particularly concerned that the functions of the Secretary of State under these reforms open the door to political capture, which is a huge risk given the unstable political climate we live in. Amendment 16 would create a firewall between the Secretary of State and operational decisions. These new powers are particularly worrying in the context of patient safety issues created by the Bill, which we will discuss in more detail tomorrow. Beyond the Department, the Bill is complacent on taking seriously the vulnerability of our NHS to foreign interference and its implications for national security. That is why we tabled new clauses 2 to 5, which recognise and address the role of the NHS as part of our sovereignty, and the sensitivity of patient data. New clause 17 would require scrutiny in the House of the arrangement between the United States of America and the United Kingdom on pharmaceutical pricing. That deal, forced on us by Donald Trump with no say from the British people, will hike medicine prices in the coming years by billions of pounds, and deserves parliamentary scrutiny. All those shortcomings of the Bill attest to the fact that the NHS already spends far too much time and money responding to failure, rather than improving the safety and quality of services in the first place.
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Health Bill
Crumbling estates are a big part of the problem across the whole NHS and in maternity, and my hon. Friend is right to highlight the state of his own local hospital and advocate for its quick remediation. Amendment 10, which I am sure my hon. Friend the Member for Winchester (Dr Chambers) will outline in more detail, would reintroduce the mental health investment standard. That is a crucial investment to avoid failures further down the line if interventions are not made for patients early on. Nowhere is the cost of failure more obvious than in maternity—a devastating scandal which, despite many recent reviews, still deserves far more attention. Our amendments to make our maternity services finally safe for mothers and babies will therefore be the main focus of my remarks today. I thank the Minister for her constructive engagement with me on new clause 1, and the commitment that she made at the Dispatch Box today to table relevant amendments when the Bill reaches the other place, and to put that maternity commissioner in place. I am grateful to her for the discussions we have had, and the constructive approach she has taken both with me and with the many campaigners on the issue beyond this place. In the light of that, I will not be pushing new clause 1 to a vote. I have seen up close the human costs of failures in our maternity system. Four years ago the Ockenden review found that over 200 babies and nine mothers in my community had died needlessly in Shrewsbury and Telford due to failures in maternity care. That has been devastating for my community, and we have heard since then that the situation was not isolated. There have been terrible stories from families around the country, most recently following the review into services in Nottingham. New clause 6 would introduce a scheme to ensure that every maternity unit in the country is rated “good” or “outstanding” by the Care Quality Commission. That new clause is essential if we are to meaningfully address the crisis in our maternity services and show families that lessons have been learned not just locally but nationally. The Liberal Democrat maternity rescue package would require an estimated £600 million a year to bring safety in maternity units up to standard, investing in safe staffing and listening to mothers. The Government already spend £1.3 billion a year—more than double the cost of the package—on maternity negligence payments, so introducing that reset is a no-brainer. Rather than spending a fortune compensating for failure and heartbreak, the NHS should be getting it right in the first place. Recently we have seen the consequences of safety failures, with lack of staffing causing North Devon’s maternity unit to close, forcing women to take a 50 mile trip if they go into labour. My hon. Friend the Member for North Devon (Ian Roome), whose constituency has been hit hard by that news, has tabled new clause 66 to guarantee safe staffing levels and access to a maternity unit within 45 minutes. While on women’s health, I also want to highlight new clauses 11 and 12. Earlier this year I wrote to the Equality and Human Rights Commission to highlight the stark inequality in research and investment in women’s health, with a huge gap in investment, governance and reporting mechanisms between women’s and men’s health strategies. The new clauses would set up an inquiry into women’s health outcomes, and ensure that average waiting times for women’s health conditions do not exceed the average waiting times for wider elective treatments. The crisis in our maternity care is a national shame and reveals a systemic neglect of the safety of women and their babies over many years. However, that is indicative of even wider concerns for patient safety, which I urge the Secretary of State to address in the Bill, and which we will discuss in more detail tomorrow. If the Government are serious about using the Bill to improve our NHS, they must invest time and money in the front and back doors of the NHS rather than structural reorganisations. The safety of staff and patients must be at the centre of those changes, and I urge the Minister to consider the amendments tabled by me and my Liberal Democrat colleagues, which would improve the Bill to achieve just that.
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Draft Building Safety Levy (Amendment) (England) Regulations 2026
It is a pleasure to serve with you in the Chair, Ms Jardine. I congratulate the Minister on her appointment and welcome her to her place. I rise to restate the Liberal Democrat commitment that no leaseholder who has found themselves subject to cladding remediation costs for which they were not responsible should shoulder those costs without access to remediation. We support these amendments to improve the 2025 regulations, but there is a bigger question about other buildings. High-risk buildings need to be addressed first, as the shadow Minister said, but there are none the less residents in buildings under 11 metres tall and in buildings whose standard does not meet PAS 9980:2022, which means that they continue to live in buildings with flammable cladding. Although that cladding would last an hour, so it is safer for them to escape, it is not a standard recognised by insurers, who expect buildings to be built to building regulations. Thousands of leaseholders are potentially in that position, and many of them cannot get insurance—except at very high cost—and cannot sell their properties. I invite the Minister to comment on how the funding towards the building safety regime can be widened beyond the levy, and to confirm that the Government will bring forward proposals in their remediation Bill to tackle the cladding manufacturers, which have been largely responsible for the crisis since it began.
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Draft Building Safety Levy (Amendment) (England) Regulations 2026
On a point of further clarification, I hope that the Minister agrees that one reason for broadening the scope of funding for the safety regime so that it includes cladding manufacturers is that in constituencies such as mine in Somerset, there are no high-rise buildings at all—indeed, most of Somerset has no high-rise buildings—but all the developers in Somerset will none the less pay for remediation in the big cities. None of us begrudges the importance of paying for that remediation, but I hope that that example illustrates the importance of widening the funding of the regime so that cladding manufacturers are required to contribute.
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Health Bill
On safety, does my hon. Friend agree about the gravity of the national maternity review, which found that Musgrove Park hospital was the “most challenging” estate in the country? If it is the most challenging estate in the country, does my hon. Friend agree that that needs to be addressed sooner than 2033, so that mums get better treatment sooner than the 2040s? That is unacceptable if it is the most challenging estate in the country.
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Health Bill
Only half the children in my constituency have seen a dentist in two years. There has been a 20% decrease in NHS dental practices, and some constituents have written to me recently to say that they have been quoted in excess of £7,000 for the most basic of treatments. Amendment 47 would require the Government to establish training hubs in Dorset. It would ensure that dental hubs trained dentists for the future, and would mandate final-year trainees to provide supervised treatment to NHS patients straightaway. Trainees are already providing treatment for free, paid for by the taxpayer, as part of their training. Those appointments should be for the NHS, and not for private patients. Amendment 48 would ensure that the dental funding underspend is redirected towards additional NHS appointments, shorter waiting times, outreach, and home and school-based services. Amendment 49 would require the dental funding formula to account for rurality, an ageing population, disability, transport costs and recruitment difficulties.
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Local Government Reorganisation
You wait a while and two Surrey questions come along at once! One of the potential unintended consequences of today’s announcement is to leave Surrey in the slightly discomfiting position of being in an experimental cohort with a sample size of one—the one county being reorganised under this legislation. We all know why: it is because the Conservative-run Surrey county council begged the Government to put it on this rollercoaster with no known destination and, as it turns out today, with legally slightly shonky rails. Do the legal concerns that the Secretary of State has expressed today also relate to Surrey? If Surrey is affected by those legal concerns, what faith should my residents have that this experiment is not going to come fully off the rails before 1 April 2027?
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Health Bill
I rise to speak in favour of new clauses 133 and 134, which stand in my name. The new clauses would require the Secretary of State to work with Welsh Ministers to update the England and Wales cross-border healthcare statement of values and principles, and to bring forward proposals to place those principles on a formal legal footing. For many people living along the border, cross-border healthcare is simply a fact of life. In Powys, at least 40% of people depend on hospitals across the border in England. Yet the framework governing how our two healthcare systems work together is based on a voluntary statement of values and principles dating back to 2018. We do not need to look far to see why the current arrangements need reform. Since last July, Powys teaching health board has been asking English hospitals treating Powys residents to treat them more slowly than patients from England as part of cost-cutting measures, despite the fact that they had always previously been treated as equals. The impact of that decision has been devastating. Many patients have had their waiting times increased to up to two years—forced to wait longer in pain, all while their conditions deteriorate. It is not just me and the Liberal Democrats who have been sounding the alarm; providers on the English side of the border have resisted the arrangements because of concerns about the impact on patients. However, there seems to be little will to resolve the issue from either the Welsh Government or the health boards responsible. Meanwhile, patients are falling through the cracks. My constituents should not have to navigate the administrative boundaries between the NHS in England and NHS Wales simply to get the arrangements and treatment they need. Eight years after the statement of values and principles was introduced, the limitations of relying on a voluntary statement with no formal legal footing are clear. New clause 134 would require the Secretary of State to work with Welsh Ministers to update that statement, reflecting the problems that cross-border patients face today. Crucially, it would also require the Government to bring forward proposals within two years to place those principles on a statutory footing. The border should never be a barrier to receiving healthcare. It is time to update and strengthen these principles and give cross-border patients the statutory protections they deserve, because I fear that cross-border healthcare will continue to deteriorate over the next couple of years. Over the summer recess, I held a series of public meetings in response to plans by Powys teaching health board to cut the number of community beds, which will just mean that more people end up stuck in community beds on the English side of the border.
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Local Government Reorganisation
I draw Members’ attention to my entry in the Register of Members’ Financial Interests: I am a district councillor on East Cambs district council. The residents of Ely and East Cambridgeshire will be relieved that they are not going to have the wrong unitary imposed on them, but they will be worried about the chaos and uncertainty that we have heard about, and about what happens next and when. What is the remit of the review? How is it going to be run to ensure that local people get their voices heard? And what is the real timetable? “As quickly as possible” and “at pace” are all great, but what is the actual timetable? Also, the Secretary of State appeared to say that May’s elections would be held on the existing district council boundaries unless the unitaries were in place by then. What did she mean by that?
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Health Bill
In my constituency, only 40% of adults have seen a dentist in the past two years, and only 54% of children have seen one in the last year. The impact of that is that 12.5% of children in East Cambridgeshire have tooth decay by the age of five. We are in a dental desert, and it is incredibly difficult to get an NHS dentist appointment. When I talk to the dentists, the most frustrating thing is that it is the contract that prevents them from treating people, not their intentions. The contract is based on units of treatment. For example, dentists tell me that if they do one filling, they just about cover their cost for the unit they get paid for. That unit covers up to three fillings, however, and at three fillings they are making a loss. Even more frustrating is that they get allocated units at the beginning of the year. Once they have used them all, they can get no more; yet they are aware that other local dentists have not used all their units by the end of the year, and they hand them back. Why is there no mechanism whereby those units can be given to dentists who have the capacity to do more work, so that more people can be treated? It is really frustrating to know that my constituents are struggling without a dentist, and that there are dentists in my constituency who are willing to treat them but cannot get funding to do that from the NHS. It is utterly shocking. That is why I support new clause 18 and other amendments that seek to make dentistry more available to people.
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Health Bill
I absolutely agree. The single patient record is so important to make the NHS work efficiently and effectively, and to help it treat patients better. To achieve that, patients have to trust that the data is being well protected, and I am afraid that a lot of the people I talk to, including GPs—who are obviously critical in convincing patients that Palantir is safe—do not trust it. We have to pull out of the contract with Palantir. Will the Minister please consider that, please consider the issues faced by rural areas, and please, please, please get us some NHS dentists in Ely and East Cambridgeshire?
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Economic Growth
I thank the Chancellor and the Minister for their speech and statement. We know that the Conservatives’ Brexit deal has hit national GDP by as much as 8%, costing the country up to £90 billion a year in lost tax revenues. Will the Government now pull the largest zero-cost growth lever available to them by negotiating a growth and defence partnership with the EU, including joining the single market and a new customs union, rather than clinging to the same failed red lines, which are costing businesses billions every year? Being outside the single market and the customs union directly links to the 13% fall in the UK’s export of goods since 2022, which has hit traditional manufacturing regions the worst—the same places that the Government’s reindustrialise-the-north agenda claims to prioritise. I would like to understand whether she acknowledges the reality of that linkage or not. I welcome the Chancellor’s emphasis on the importance of fiscal credibility and, linked to that, meeting the fiscal rules. However, the reality is that those rules have been easily gamed by successive Governments, with our budgetary process being summarised as speculation without scrutiny, short-term headroom chasing and gaming the system, with an approach of jam today, which is spending, and pain tomorrow, which is tax, but tomorrow never arrives. The result is that it has been more than 25 years since we had a balanced Budget, and our national debt is now six times larger than 20 years ago. Will the Chief Secretary demonstrate that she is serious about tackling our debt and agree that a key way to do that is to grow our economy? Will she consider what we can learn from how other countries such as Switzerland, Sweden and New Zealand have addressed and solved their budget process problems?