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12,832 spoken contributions under 12 words (interjections such as “Will the hon. Member give way?”) are hidden. Show them
What would the Secretary of State say to my constituents in Broxbourne, who never asked for this reorganisation and are concerned that it is just a waste of time and money that will leave them with higher council tax bills and less say over local planning decisions?
Churches are important historical buildings and are often at the heart of our local communities. Labour stopped the last Conservative Government’s VAT scheme, which helped to maintain places of worship across the UK, but the new, more restricted places of worship renewal fund applies only to England. Thanks to Coldingham & St Abbs parish church, it has come to light that the Scottish Government are not passing on extra funds to churches and places of worship in Scotland. Will the Leader of the House encourage his ministerial colleagues to contact the Scottish Government to ensure that this money is passed on to places of worship in Scotland?
It is a great pleasure to close the Sir David Amess Adjournment debate on behalf of the Opposition, in which we have heard a great many excellent contributions from across the Chamber. Of course, this is a time to remember Sir David himself, who always made sure that the people of Southend were put firmly on the map during this debate. I will always remember his warmth, conviction and generosity when I was first elected to this House in 2017. He was a tireless advocate for the people he represented and for the causes he championed. I join right hon. and hon. Members in paying tribute to Ann Widdecombe, who was a woman of great conviction and always said what she thought. You might not have completely agreed with her, but you always knew where she stood. The way in which her life was cut short last week in such horrific circumstances is truly heartbreaking, and my thoughts are with her family, her friends and everyone who knew and loved her. I also pay tribute to the members of the staff who are leaving the House of Commons this summer, including Godfrey from the Tea Room; Richard, after 37 years in the Strangers Bar; Francelise and Denis, after 25 years and almost 27 years respectively at the Members’ Restaurant; and many others who have served this House diligently for many years. A number of Members have highlighted some of the great attractions in their respective constituencies today, such as the putting greens in Fife that the hon. Member for North East Fife (Wendy Chamberlain) mentioned, the air show in Sunderland that the hon. Member for Sunderland Central (Lewis Atkinson) mentioned, or the entertainment zone at Braehead that the hon. Member for Paisley and Renfrewshire North (Alison Taylor) mentioned. Lastly, I am looking forward to visiting the green belt mentioned by my right hon. Friend the Member for Aldridge-Brownhills (Wendy Morton). The summer is a wonderful time to visit the Scottish Borders. Members do not need to take my word for it; only a few weeks ago Jeremy Clarkson described the Scottish Borders as Britain’s “most beautiful” region. If Members are looking for a last-minute staycation this summer, they know where to come. One of the highlights of my year remains my annual summer surgery tour, which starts on Saturday, on which I will hold more than 80 advice surgeries in every town and village across my Scottish Borders constituency. This is in addition to my regular monthly surgeries, and gives me an opportunity to visit every town, village and community, particularly those in the more remote and isolated parts of my constituency. I will once again be holding this tour alongside my Scottish Conservative colleague Rachael Hamilton MSP, who was overwhelmingly re-elected to represent the Scottish Borders back in May. There are still appointments available, so I encourage any of my constituents who would like to meet in the coming days or weeks to get in touch. It has been a busy year. I have continued to campaign for better public transport links for the Borders, in particular to extend the Borders railway from Tweedbank to Hawick, Newcastleton and on to Carlisle, and to restore direct LNER services that have been cut from Berwick-upon-Tweed to London, which are so vital for keeping the Borders and north Northumberland connected. My constituency is, of course, a borderlands community. We regularly cross the border to shop, visit friends and family, get to work or enjoy the beautiful Northumberland coastline. However, access to NHS services for cross-border communities remains a significant challenge. My view is simple: my constituents should be able to access healthcare as close to home as possible, even if that hospital or facility happens to be in England. It is only common sense that taxpayers, who fund our NHS, should be able to use the services that best meet their needs. I will continue to campaign alongside local residents to ensure that access to NHS care is quick and easily available to everybody who needs it. We have heard some excellent contributions from Members across the Chamber, and I want to mention some of them. The hon. Member for Stirling and Strathallan (Chris Kane) mentioned the red telephone box in Balfron, which has been used as a food exchange. That is a great example of the redeployment of the red phone box network, and I know of several examples in my constituency. I congratulate the residents in Balfron on securing that. My right hon. Friend the Member for Goole and Pocklington (David Davis) highlighted some of the big questions regarding the Peter Murrell scandal and the problems circulating around the SNP just now. He rightly asked those questions, because many people in Scotland are asking them and calling for a full inquiry into who knew what and when—particularly former First Minister Ms Sturgeon. The hon. Member for Warrington South (Sarah Hall) and my hon. Friend the Member for Runnymede and Weybridge (Dr Spencer) both raised very difficult and tragic cases. My thoughts are with the family of Lucy. I am grateful to the hon. Member for Warrington South for raising that challenging and difficult case. My hon. Friend the Member for Runnymede and Weybridge raised an important point about fraudulent paternity testing. I hope that the relevant Minister will take that forward. My hon. Friend the Member for Stockton West (Matt Vickers) raised the important issue of off-road bikes in Stockton. I know that it is an issue for many communities. The hon. Member for Carlisle (Ms Minns) raised a similar issue in respect of e-bikes. My right hon. Friend the Member for North East Cambridgeshire (Steve Barclay) raised concerns about the ongoing, increasing costs associated with the restoration and renewal project. I know that many Members share those concerns. It is imperative that the new Government make time for a debate on it so that the relatively newly elected Members from the 2024 election have an opportunity to have their say. Ultimately, we are dealing with huge amounts of taxpayers money, and we need to have an open and frank discussion about it. The hon. Member for North Warwickshire and Bedworth (Rachel Taylor), who is not in her place, raised the importance of sport, with which I wholly agree. She also highlighted the risk of taking part in parliamentary sports activities, given that sharp elbows seem to have given her a broken rib—a lesson for us all, perhaps. The hon. Member for Cannock Chase (Josh Newbury) gave a very moving tribute to one of his late council colleagues. I am grateful to him for highlighting that serious condition and what people suffering from brain tumours have to deal with. I have not been able to mention everybody, but I am grateful to all right hon. and hon. Members who have taken time to raise the issues affecting their constituencies. However, we should have had this debate next week, once the right hon. Member for Makerfield (Andy Burnham) had assumed the office of Prime Minister, so that he could come to the House to explain what he plans to do with the country. As things stand, we have little idea what he intends to do. The right hon. Member did not publish a manifesto during the Labour leadership election. He has not yet been tested. For many years, he has made countless promises without having to deliver them, but soon he will have to do so. The right hon. Member for Makerfield said that WASPI women should receive compensation, but we hear now that he has changed his mind. What are his plans for taxation? Which taxes does he plan to increase? He has said that he will “take his responsibilities fully” to fund the defence investment plan after the Prime Minister and Chancellor left a £4.7 billion black hole. How does he intend to pay for it? What is his plan to tackle the out-of-control welfare spending? All of our constituents deserve answers to those questions. The new Prime Minister should have come to this House early next week to answer those basic questions. Instead, he has bottled it. Yesterday, the Opposition planned to move a motion to delay the parliamentary recess until Monday so that the incoming Government could face proper scrutiny and to allow the nation to hear from the new Prime Minister about his plans. Instead, the Leader of the House—presumably acting as proxy for the incoming Prime Minister—came to the House and blocked the motion. I sincerely hope that the Leader of the House believes that his actions were worth it—or perhaps he will be rewarded with a plum job in the reshuffle. I, for one, hope that he will continue in his current job because I think that he has been an exceptional Leader of the House. As I close, may I thank my amazing constituency team, who have worked hard for me since my election to this place in 2017, and some who have suffered even longer, since 2007, when I first became a Member of the Scottish Parliament? I thank you, Madam Deputy Speaker, Mr Speaker and his office and the other Deputy Speakers. I also thank everyone who supports the Speaker’s Office throughout the parliamentary year. The Doorkeepers, Clerks, caterers, security staff, cleaners and Members’ parliamentary and constituency staff all work tirelessly to keep this place running every single day, and I am sure that Members across the House will join me in expressing our sincere gratitude for everything they do. I wish colleagues from across the Chamber a restful and enjoyable summer recess. I know that for many of us, it will be time spent working in our constituencies. I look forward to seeing everybody in September.
I beg to move, That the clause be read a Second time.
It is a pleasure to serve with you in the Chair, Ms Lewell. These two new clauses, the latter of which is in my name, deal with the publication of an annual report detailing NHS and social care provision for dementia care and how the Government are performing against targets, standards and outcome measures set out in national guidance and frameworks relating to dementia services. I would like to thank three important charities working in this area: the Alzheimer’s Society, Alzheimer’s Research UK and Dementia UK. All three back the two new clauses. The data requested is imperative to ensuring that the Government can measure and monitor progress against relevant national targets, standards and guidance, including the new modern service framework on dementia, the forthcoming Care Quality Commission statutory guidance and outcome measures that may be set in future NHS operational planning guidance. That is crucial to improving transparency and accountability, allowing systems to see the full picture of dementia provision in England and highlighting challenge areas or inequalities. The Bill makes provision for the establishment of information systems to collect, analyse and publish health and care data that is in the interest of the health service in England. The clause fits into that and would require the collection of data on the provision of dementia services in health and social care. I do not propose to speak too long, but I do want to make a couple of remarks on the current situation, which sets these new clauses in context. Dementia data is not currently comprehensively or consistently collected, analysed and published. That means that we cannot fully understand the provision of NHS care or social care for dementia, which is the biggest cause of death in the UK; how national targets, guidance or frameworks are being met; and where inequalities and challenges lie. As well as being the leading cause of death, dementia is a disease that around 1 million people live with. That number is expected to rise to 1.4 million by 2040. That will, of course, impact many more friends, families and carers who support those living with dementia. More than a third of people living with dementia in England do not have a formal diagnosis. Those who do receive a diagnosis live with the condition for an average of three and a half years before that diagnosis. Post-diagnostic care and support is often fragmented, leaving people affected by dementia without a clear point of contact, co-ordinated care, or access to specialist support for those with complex needs. Recent findings show that only 14% of people with dementia have an advanced care plan in place. That is not good enough for a disease that affects so many people and is the leading cause of death in England. Dementia puts immense pressure on our healthcare system: one in six hospital beds is occupied by someone living with the condition. Lord Darzi’s investigation into NHS performance highlighted how “there is an important challenge to improve both the quality and quantity of care for people with dementia.” The new clauses would go some way to addressing that, and I urge the Government to support them.
I beg to ask leave to withdraw the clause. Clause, by leave, withdrawn. New Clause 97 Publication of annual dementia care report “(1) The Secretary of State must publish annually and lay before Parliament a report on— (a) the provision of NHS care in relation to dementia, and (b) provision of social care in relation to dementia. (2) In preparation of the report under subsection (1), the Secretary of State must have regard to targets, standards and outcome measures set out in national plans, guidance and frameworks relating to dementia services. (3) In preparation of the report under subsection (1), the Secretary of State may have regard to any such measures or information that they consider appropriate, including— (a) an assessment of any variation in dementia services and outcomes between integrated care board areas, (b) information on workforce capacity, capability and training standards relevant to dementia care, (c) information on access to ongoing post-diagnostic support services, including support for unpaid carers, (d) information on continuity and coordination of care for people living with dementia, including access to a named professional responsible for coordinating support across services, (e) outcomes and experiences for people living with dementia and unpaid carers, including crisis prevention, carer wellbeing, and experiences of joined-up care, (f) progress on dementia prevention and risk reduction, and (g) dementia research activity in the NHS. (4) The Secretary of State must publish the first such report under subsection (1) within 12 months of the passage of this Act.”—(Joe Robertson.) This new clause would require the Secretary of State to produce an annual report on the delivery of dementia care by the NHS and social care sectors against relevant national targets, standards and outcome measures. Brought up, and read the First time. Question put, That the clause be read a Second time.
I thank the Minister for pausing the MCA’s brutal decision about coastguard rescue officers, and for convening meetings on cross-Solent ferry transport to the Isle of Wight, which will start next month. It is of some concern, however, that I have received a letter—not from him—telling me certain things that I was not allowed to discuss, including evidence of ticketing and reliability going back more than 10 years. I am sure he understands that the world did not start in 2016, and I will not be told by anyone how to best represent my constituents, or what I can or cannot say.
I thank the Leader of the House for the business. This seems a moment for the words of Philip Larkin: “What will survive of us is love.” It is a day of sadness and departings. I know that the whole House will want to join me in saluting the England football team. I simply say this to them: you went out to a foreign field, you fought like true lions, and you did us proud. Thank you. Let us also pay tribute to Ann Widdecombe for her bravery, spirit and independence of mind. There is a book of condolence in the Members’ Library, which I know many Members will wish to sign. Ann’s politics were not especially my politics, Mr Speaker, but let me tell you a story that illustrates my personal experience of her a little. We were at a dinner of the Holborn and St Pancras Conservatives—a vibrant local organisation—in the time of the late Frank Dobson, where Ann was the guest speaker. At the end of the evening, a bottle signed by her was thrust into my hands and I was asked to invite her to auction it. You will recall, Mr Speaker, that she had just had a bit of a dust-up with the noble Lord Howard on the subject of which she had said that he had “something of the night” about him. Quick as a flash, holding this bottle of whisky, she said, “Ladies and gentlemen, what will you give me for something of the nightcap?” I thought that pretty game, under the circumstances. This week has featured a certain amount of rancour, as the late Roy Jenkins might have put it. The Government found themselves changing the business twice and cancelling an Opposition day debate they themselves had scheduled and reaffirmed only the previous day on the entirely bogus excuse that they wanted an urgent debate on Iran. That debate was so urgent and important that it was opened by the most junior Minister in Government, finished two hours early and featured precisely three—count them: three—speeches from Labour Back Benchers. I think we can all agree that it will be a tragedy if we lose the Leader of the House from business questions, but if he is not promoted after the embarrassing heroics he has performed this week on behalf of the new Prime Minister, it will be a huge injustice. But we are not going to cast nasturtiums, in the words of a friend of mine, on any of this nonsense—not even on Baroness Lloyd and the hopeless Building Digital UK, who have entirely failed to address the issue of fibre broadband in neglected parts of my constituency and simply repeated the same language of incompetence and failure to me for more than a year now. I hope that the Leader of the House will pick that up. No, we will cast no nasturtiums. There will be no rancour from this side of the House. I come to praise the outgoing Prime Minister, not to bury him. He is a transparently decent and honourable man who is dedicated to public service. He rescued the Labour party, and he worked with great diligence to lead this country. No one who has not been close to leadership of that kind can have any idea of how hard it is. We all owe him a great debt of gratitude. As for the incoming Prime Minister, my advice is simply this: be careful what you wish for. He has had a coronation and an election hustings with just one candidate—a single name on the ballot paper—but on Monday afternoon, he will start to learn the true difficulty of the decisions that face him. There will be hard trade-offs that cannot be abolished by tinkering with the fiscal rules or still more tax and spend. Vibes will not be a solution to these problems. Eyelashes will not suffice. He will have to stand up and say, or perhaps decide, what it is he believes in. We can only hope that he will bring energy, frugality, a long-term focus, and a talented team adequate to the tasks ahead. We wish him very well. I wish you, Mr Speaker, the Leader of the House and all the staff and Members of the House a summer break full of rest and happiness.
I am very aware that this may be the last time I face these Ministers across the Dispatch Box, so I just want to say that from my perspective, they are a good bunch. I have really enjoyed it, and I wish each and every one of them the best of luck on Monday or Tuesday. Turning to the question at hand, I welcome the Minister’s statement that he is going to stop the ill-judged decision on CROs, but that does not let the MCA off the hook. At a meeting of MPs recently, the chief executive of the MCA claimed that 93% of coastguard rescue officers supported plans to make them unpaid volunteers. We know from a leaked internal survey that the MCA misrepresented the views of CROs both to Ministers and to Parliament. Up to half of them said that they would quit or reduce their hours if the Government forced through the plans to remove their pay. Given that the Minister has reversed the decision and that he has signally failed to express his support for the chief executive, can he now confirm whether or not he still has confidence in the chief executive of the MCA?
Passengers on the Fen line from King’s Lynn are suffering repeated cancellations and an unacceptably poor level of service. Now that the Government control both the track and the trains, will the Transport Secretary intervene and demand a robust action plan to sort out this poor performance?
The Minister failed to respond to any of the questions asked by the shadow Minister, my hon. Friend the Member for Reigate (Rebecca Paul), so I will try again: some companies have expressed an interest in the business, so what discussions is the Minister, or his colleagues, having with potential buyers?
It is a pleasure to serve under your chairmanship, Dr Huq. I welcome the Minister back from her son’s graduation —I hope it went well. I rise to state my support for new clause 47, which would require the Secretary of State to publish a clear roll-out plan for fracture liaison services across England and report annually to Parliament on progress towards universal coverage by 2030. It is not about creating a new target, because the target already exists: both this Government and the previous Government committed to achieving 100% fracture liaison service coverage by 2030. The question before us, as proposed by the shadow Minister, is simple: how will that promise be delivered, and how will Parliament know whether meaningful progress is being made? Fracture liaison services are one of the most evidence-based interventions in osteoporosis care. They systematically identify people aged over 50 who suffer a fragility fracture; assess their bone health; initiate treatment where appropriate; and monitor patients to reduce the risk of subsequent fractures. Given that around half of patients who sustain a hip fracture have previously broken another bone, those services represent a vital opportunity to intervene before a life-changing injury occurs. The human cost is considerable. Osteoporosis affects millions of people, particularly older women, and fragility fractures can result in a loss of independence, reduced mobility, social isolation and significant pressure on health and social care services. The National Institute for Health and Care Excellence estimates that around 180,000 fractures each year in England and Wales are attributable to osteoporosis. There is also a compelling economic case: the Royal Osteoporosis Society estimates that investing around £30 million in fracture liaison services could prevent approximately 74,000 fractures over five years, including 31,000 hip fractures, saving the NHS around £665 million and freeing up some 750,000 bed days. Few preventive interventions offer that combination of better patient outcomes and substantial savings for the NHS. The Government frequently point to their commitment to universal coverage by 2030, but as the shadow Minister pointed out, progress has been achingly slow. When the Secretary of State appeared before the Health and Social Care Committee last week, I questioned him on that issue directly. While he confirmed that the Department remains committed to meeting that 2030 target, which was first established by the previous Conservative Government, no plan—or indication of when a plan would come—was given. A commitment alone is not a delivery plan. There are also growing concerns that the Government have overstated the progress that has already been made. The Royal Osteoporosis Society has confirmed that more than 97% of the fracture liaison services counted by the current Government were already in place before the change of Government. So, rather than that representing any significant expansion in national coverage, this Government have gone slow. I think it is therefore very reasonable—to answer the question from the hon. Member for Bury St Edmunds and Stowmarket—for Parliament to be entitled to ask what additional progress has actually been made since the commitment was reaffirmed. New clause 47 would also require the Secretary of State to publish an assessment of access in every integrated care board area. It would also require annual milestones, because, at present, there is no publicly available timetable showing where the services will be established, or which areas will be prioritised or progressed between now and 2030. Crucially, the new clause would require the Government to set out how integrated care boards will actually be supported. Ministers rightly point out that fracture liaison services are commissioned locally by integrated care boards, but if the responsibility for delivery rests locally while responsibility for national targets rests with central Government, there clearly needs to be a well-thought-through national framework explaining how those boards will be supported through funding, guidance, workforce planning and accountability. This is, therefore, a straightforward request for transparency, accountability and, most importantly, delivery. If Ministers are committed to achieving this by 2030, they should have absolutely no objection to publishing a plan that shows how they intend to get there. For those reasons, I support the new clause.
It is a pleasure to serve under your chairmanship, Ms Lewell. I had written a 25-page speech for this debate, but to the disappointment of my researcher—and probably the delight of this Committee—I do not intend to read out all 25 pages. [Interruption.] There are cries of “Shame!” from my own side, but I accept that there are a number of amendments and new clauses to get through. My stated objection to the puberty blocker trial is also well known and on the record, so I do not wish to detain the Committee for too long. I want to pick out five areas where I think there are problems. They are why I support new clause 66, tabled by my hon. Friend the Member for Sleaford and North Hykeham. My first point can be summarised as: “Don’t repeat a mistake to find out whether it was a mistake.” Thousands of children have already received puberty blockers through the former Tavistock pathway, and my view is that, before exposing a whole new cohort, the Government should complete the long-promised data linkage study to establish what happened to those children. That is probably the core argument. Secondly, if the Government rightly say that the drugs present an unacceptable safety risk, how can it be ethical to give them to children in a trial? It must still be an unacceptable safety risk, whether it is for the general population of those who wish for it or for the people in the trial. The Government banned routine prescribing because of the safety concerns, yet propose administering the same medicines in a research setting. That is a complete contradiction of the ban. Thirdly, clinical equipoise does not exist in the evidence if the evidence already points to significant risk and uncertain benefit. The Cass review concluded that the evidence base for puberty blockers is weak and that concerns remain over bone health, fertility and neurodevelopment. A trial should not proceed unless there is genuine uncertainty that justifies exposing children to those risks. Fourthly, children should not bear the burden of answering questions that the NHS should have answered itself. The failure to collect the robust, long-term evidence from previous patients, including through the data linkage trial, should not be remedied by recruiting another generation of vulnerable children. Ethical research requires exhausting the existing evidence first. Finally, even the medicines regulator—the MHRA—had sufficient concerns to halt the trial. The MHRA intervened to pause the pathways trial over safety and wellbeing concerns, reinforcing the idea that the scientific and ethical questions remain unresolved. A pause should lead to a complete reassessment, not simply restarting as soon as possible.
It did. If memory serves, that question was raised—although I cannot say more because it was in private. I do have concerns that the professor who was in charge and raised those concerns at the MHRA was recused. I cannot discuss the details of that, but it could show that there was a bias in the selection of the people who were pushing the trial forward. I am not saying that there was bias, but I think that, on an issue of such importance, the perception of bias is almost as bad. We need to be very careful about that. Either way, I think the trial is wrong for the five reasons I have outlined. The key reason is the moral and ethical issue, and my hon. Friend the Member for Isle of Wight East raised it in both the Health and Social Care Committee and the Chamber: it is clearly morally wrong to experiment on children just for the sake of experimenting. The fact that there is no evidence does not mean that we should put children through a trial to see whether the evidence exists.
Unlike that of the hon. Member for Guildford, my constituency covers both Surrey and East Hampshire, so I welcome the focus that new clause 72 places on our local area. Constituents regularly raise with me their concerns about seeing an NHS dentist. As I have announced a number of times in this Committee—although I have not checked today, so may not be true any more—there is not a single dentist in my constituency taking on adult or child NHS patients at the moment. For many people, the challenge is not simply one of convenience; it is about being able to access timely care when they need it. Good oral health is an essential part of overall health, and we cannot allow dentistry to become an afterthought in our healthcare system. The ability see a dentist for routine check-ups, preventive care and urgent treatment helps to reduce pressure elsewhere in the NHS by dealing with problems before they become more serious. The new clause rightly highlights the need both for urgent appointments and for improved access to routine NHS dental care. Prevention is at the heart of a sustainable healthcare system, and regular access to dental services plays an important role in achieving that. I welcome the accountability that the new clause seeks to introduce. In places where there are persistent challenges in accessing services—so-called dental deserts—local communities deserve transparency about what action is being taken and why improvements have not yet been delivered. As I have mentioned before, the spanking new dental surgery in Haslemere hospital has sat entirely unused since it was built, and, as far as I am aware, there are no plans to use it. That seems like a shocking waste of money and, more importantly, a shocking waste of a dental surgery that could be treating patients in Haslemere and the wider area. The hon. Member for North Shropshire always wants to place the blame with the Conservatives, and does not seem to feel the need to challenge the Government, but I gently remind her that there was a Liberal Democrat Minister in the Department of Health and Social Care for five years, and apparently they did absolutely nothing to raise this issue. Although this issue is particularly important for Surrey and East Hampshire, it reflects a wider challenge facing communities across the country. Residents should not have to struggle to find an NHS dentist, and ensuring that provision is adequate must remain a priority. I hope the Government take that on board.
My hon. Friend has just sat down. I was not sure whether she had finished her speech or was willing to take an intervention.
Hopefully, this is a pleasure postponed. I rise to support new clauses 81 and 82, tabled by my hon. Friend the Member for Sleaford and North Hykeham. As legislators, we have a moral duty to ensure that patients are protected during times of disruption in the NHS. Nobody disputes the fact that NHS staff work incredibly hard. They absolutely do. The dedication shown by doctors, nurses, paramedics, midwives and all those who keep our health service running deserves enormous respect. Having worked in healthcare for pretty much all my career, including for professional organisations such as the Royal College of Occupational Therapists, I know at first hand how hard they work. Equally, we need to recognise that the NHS is not an ordinary service. Working for it is not like being a shop assistant, a bin collector or a tax inspector; in its importance to the health and safety of this nation, it is more akin to being a police officer or a member of our armed forces. It is an essential public service. When people are at their most vulnerable, whether that is because they are waiting for an operation, procedure or intervention or because they are in the process of having those interventions, they must have confidence that the care they rely on will still be there. The right to strike has to come with responsibilities. In the NHS, the consequences of industrial action are real: cancelled operations, delayed treatments, missed appointments and increased pressure on emergency services. When I raised some of these issues with Sir Jim Mackey when he appeared before the Health and Social Care Committee, he could not tell me, hand on heart, that people have not died because of these strikes. I suspect that they probably have. For patients awaiting cancer treatment, for someone requiring urgent surgery or for families relying on maternity services, the impact can be deeply serious and potentially even deadly. There is a moral obligation, both on NHS doctors and on us as legislators, to ensure that we have a universal, 24-hour, seven-day-a-week service that is free at the point of use that patients can and should expect to rely on. I therefore support new clause 81’s minimum service requirements and new clause 2’s the removal of clinicians’ ability to strike. We must ensure that our NHS staff are supported, protected, paid appropriately and given the resources they need to do their job, but the corollary is that they should remain on the job to serve our constituents.
I declare that I am a member of the all-party parliamentary group on patient safety. Patient safety cannot be something that is discussed only after a tragedy has occurred. It requires a culture of accountability, transparency, and most importantly, action. That is why the new clause is such a sensible and important amendment to the Bill. It would not dictate the outcome of every review or every recommendation, but it would require the Government to respond properly. The new clause would create a straightforward expectation that when experts have identified changes that could improve patient safety, Ministers cannot simply leave those recommendations unanswered. The new clause pushes that forward, as recommended by my right hon. Friend the Member for Godalming and Ash. There must be a clear process and a clear timeline. Such a process and principle are closely connected with new clause 98 and the Government response to the Hughes report on those harmed by sodium valproate and pelvic mesh. Those are deeply serious issues involving people who have suffered life-changing consequences and have spent years seeking recognition and redress. Last week, I think, at the Health and Social Care Committee, I questioned the current Secretary of State on this matter, and his answer was equivocating, dissembling and, I am afraid to say, frankly unacceptable to those patients who have suffered from both those. He could not even tell me whether the response would be published by the end of the recess—we probably have two hours until recess, so unless the Minister is going to tell me otherwise, I suspect it is not coming before the recess. It seems shocking—perhaps even a slap in the face to those victims—that the Secretary of State could not even give an answer on that issue. However, they received some positive news on Tuesday evening, when the right hon. Member for Makerfield (Andy Burnham)—presumably the incoming Prime Minister—raised this issue in the House during the debate on the remaining stages of the Public Office (Accountability) Bill. I hope the Minister has had the chance to speak to the right hon. Member—unlike the rest of us—so that she understands his priorities and when redress is coming. If her new boss has given his stamp of approval, Labour MPs on the Committee should have no problem supporting these Opposition new clauses.
I heard the Liberal Democrat spokesperson say that she will not press the amendment, but I would be sorely tempted to vote for it if she did so. This important amendment sums up a number of our concerns about the Bill, and the commencement amendments to follow are also appropriate. As the hon. Member will not press her amendment, however, I will not speak for long, save to say that I have enjoyed the past few weeks on this Committee. I hope that the Minister is still in place when we return in September. If she is not, I wish her very well and thank her for all her hard work, not just in this Committee, but in her role over the past two years.
What a weekend, Mr Speaker! Ministers will be hovering by the phone on Monday or Tuesday. What a visual display of success or failure there will be, as the number of holidaymakers heading to the continent ramps up for the summer season. The Government have had two years on this. Multiple Select Committees in the previous Parliament warned that the technology would not be ready, and that the introduction of the system would be a disaster. How on earth have we got to a situation where the Secretary of State is making last-minute dashes to the European Commission and the French Government to try to get a few extra kiosks—for which the technology does not even work—as holidaymakers face chaos this weekend?
I have always enjoyed my exchanges with the Minister. As the nation learned devastatingly last night, trying to defend a single position for a prolonged period does not always have a happy ending. If we get the chaos that is predicted for holidaymakers and freight operators this weekend, will the Government go to the European Union and the French Government and demand that the system be shut down and paused until the technology can be got right?
I appreciate the point that the Minister made about the taxpayer having only owned British Steel for a matter of hours, and how the board is still being appointed. It is, however, imperative that the Government are clear, once the board is appointed, what the strategic priorities are for the board—as opposed to British Steel at large. Top of those priorities must be a timescale to get to profitability. Can the Minister—or his successor—commit to ensuring that the red lines set for the board are made clear to this House as soon as it returns in September, when the board will have been functional for five or six weeks?
Notwithstanding the article 2 sovereignty clause, this treaty demands that Gibraltar aligns with a number of EU laws, standards and tariffs. If the European Court of Justice is at odds with a Gibraltar court on the application of those, no matter of arbitration will ever shift the European Union from being absolutely wedded to the supremacy, in their eyes, of the European Court of Justice. How can that sovereignty test ever be met?
It is a pleasure to serve under your chairmanship, Sir Desmond, and to take part in this debate about the impact of changes to the national planning policy framework. At the outset, I thank the hon. Member for Wells and Mendip Hills (Tessa Munt) for securing this important debate. She made a strong speech, particularly focused on the danger of building in areas prone to flooding. I also thank the 10 hon. and right hon. Members who have made speeches—and the three who have made interventions—so far in this debate. The NPPF is the rulebook by which our planning system is guided. It is an extensive and comprehensive statement of the Government of the day’s policy direction, and perhaps the clearest signal to developers, local authorities and local people about how a Government will approach changes to their surrounding built environment. It covers everything from roads to housing, local communities to land use, and provides the overarching checks, balances and direction in the planning system. We are not in blanket opposition to everything that the Government are seeking to do with the NPPF. However, we do have significant concerns about some aspects of it, and I will focus on those in my remarks today. Since coming to power two years ago, this Government have twice proposed revisions to the NPPF, both times with severe consequences for our green spaces, rural towns and villages, and local democratic voices. In their first revisions, made just before Christmas 2024, the Government’s policy direction was clear. Unfortunately, what was on offer was an unwelcome gift of urban sprawl. That was because the Government made it easier for local authorities to release green-belt land for development in more ways than one. The first, and most obvious, was the announcement that new golden rules would need to be met to expand on to the green belt. That effectively invited developers to test the waters by highlighting that the NPPF stated that, where a development complied with the golden rules, local authorities should give “significant weight in favour” of approving the scheme. The second release came from the Government’s spurious grey belt designation. Concocted in the bowels of Marsham Street, “grey belt” is a disingenuous label. The Prime Minister has told us that it means low-quality land made up of “disused car parks”, but that is far from the truth, because, for too many sites, grey belt is simply a façade for releasing green-belt sites for urban sprawl and overdevelopment. That is backed by research in December 2025 by the Campaign to Protect Rural England, which showed that, a year after the first NPPF reforms, of the 13 developments of 10 or more homes approved by Government planning inspectors on so-called grey-belt land, 88% of those 1,250 homes “will be built on previously undeveloped countryside”— not disused petrol stations, low-quality land or any other trumped-up example taken straight from a Ministry of Housing, Communities and Local Government press release, just our countryside. Worse, those developments make up more than 90% of homes granted planning permission on grey-belt sites by inspectors; a further 21 smaller schemes, totalling no more than 91 homes, comprised the remainder. That is not the only attack on our green spaces. The 2024 NPPF revisions also reintroduced mandatory top-down housing targets across England by removing the word “advisory” from the relevant paragraph concerning housing targets, alongside references to exceptional circumstances for alternative approaches to determining local housing targets. As other Members have said, that came alongside a new standard method for housing targets. The hon. Members for Horsham (John Milne) and for Wells and Mendip Hills highlighted some of the bizarre assumptions underpinning the housing targets generated by the new standard method, alongside some of its counterproductive outcomes. When examined together, those disproportionately redistributed top-down housing targets on to rural areas from urban areas. For example, under the Government’s targets, housing numbers were cut by 11% in London, 38% in Birmingham and 55% in Coventry, while increasing by 106% in the New Forest, 199% in North Yorkshire and 487% in Westmorland and Furness. That is particularly concerning given that major cities—and not least here in central London—have the infrastructure needed to support development. However, even in Greater London, although the collective target has been reduced by 11%, that has been achieved by sharp drops in urban inner London, whereas in the more rural outer-London areas, huge increases have been imposed. For example, in my London borough of Bromley, which is the largest borough in Greater London and is mostly rural, the target has been increased by 400%. The conclusion is inescapable. The NPPF changes show very clearly that this Government are determined to build all over the green belt. What has been the result of these reforms? It certainly has not been large amounts of extra housing. As I pointed out in this place yesterday, the Government’s own figures show that the number of net new additional dwellings in England was just 208,600 in Labour’s first year in power—a 6% drop from 2023-24 under the last Conservative Government’s final year in office. Indeed, the Government admitted that they will not hit the target through their own net additional dwelling forecasts, predicting that by 2029 they will have fallen well short. It does not have to be this way. The Opposition recognise the need to build more homes, and we made it clear from the start of this Parliament that we are broadly supportive of the ambition to build many more homes. However, the Government’s actions, through some of their revisions to the NPPF, are the wrong way to go about it. A future Conservative Government will employ a genuine brownfield-first approach rather than releasing swathes of green belt or relabelling it under the murky and disingenuous designation of “grey belt”. We will not just pay lip service to brownfield development, but prioritise it and make it easier. That can and will be done. The CPRE reported that a large proportion of England’s housing could be swiftly met using brownfield land that already has planning permission, without encroaching on undeveloped greenfield or green belt land. It estimates that there is enough brownfield land to build 1.41 million homes in England, based on the most up-to-date data from local planning authorities’ brownfield land registers up to 2024. That amounts to 93% of the Government’s parliamentary target. Furthermore, it has shown that England’s brownfield sites are increasing in number, land area and minimum net dwellings—up 54%, 6% and 34% respectively between 2018 and 2024. That is why, not for the first time, I press the Minister to go further and faster in helping local authorities and developers to access brownfield sites rather than freeing up our green belt and steamrollering over local democracy, local voices and local communities. Recent history shows that this approach can work. If the Government want to see urban regeneration or densification done right, they can follow Conservative examples and pursue brownfield-first and not greenfield-first. We will not only abandon the Government’s offensive on our green spaces, but harmonise supply and demand-side policies. I will finish with a small note on that point. As the Government continue to tweak the NPPF, they are doing nothing to back first-time buyers, families and downsizers by axing demand-side schemes and cutting stamp duty relief. There is no point in delivering supply-side reforms if the demand is not there to make it worth while. To conclude, it is evident from the speeches here today and the evidence before us that the impact of recent reforms to the national planning policy framework has failed to deliver more homes, failed to protect our green belt, failed to support the housing market, failed to make brownfield sites viable and failed to deliver for voters. Regardless of the outcome of that, the Minister is a man I have a great deal of respect for. I agree with my right hon. Friend the Member for East Hampshire (Damian Hinds) that he is a decent and thoughtful man, and I sincerely wish him well in the pending reshuffle. Regardless of its outcome, he has the chance to raise this with whomever his new boss will be after next week’s coronation. I hope that he grasps the opportunity with alacrity and delivers the right homes in the right places and with the right infrastructure—just as the country deserves.
I live in my patch and I know that there will be genuine local fury at the contempt this Government have shown for my constituents in approving a Leicester city land grab, which has cross-party opposition locally. I have been clear throughout, as have my local councillors and my residents, in our opposition to a Leicester city land grab that will take county communities such as Syston, Thurmaston, Queniborough, Barkby and Beeby into the city and see local residents paying more tax for almost certainly less in the way of services. I continue to oppose what the Secretary of State has announced today, so I have a simple question for him: what makes him think that the views of the Labour Leicester city mayor are worth more than the views of thousands of my constituents?
I beg to move, That the clause be read a Second time. This is a very straightforward new clause. The Secretary of State would be required to ensure that there are single-sex changing rooms, toilets and washing facilities for NHS staff and single-sex wards, toilets and washing facilities for NHS patients. The UK Supreme Court unanimously ruled that a woman is defined by biological sex in 2025, and the Minister herself said: “We are completely committed to single-sex spaces.” However, it appears that the Minister for Women and Equalities did not get that memo. Despite having apparently been sat on her desk since September, the new draft code from the Equality and Human Rights Commission was not laid before Parliament until 21 May. One week before that guidance was published, a female NHS England employee in Leeds won her claims of indirect sex discrimination and harassment over a policy allowing transgender colleagues to use toilets and changing rooms that correspond to their gender identity rather than their biological sex. On 28 June, after the draft code was laid, it was reported that West London NHS trust had told patients that they could use single-sex facilities based on gender identity. It has taken the current Health Secretary some time, but I understand that he has changed his mind on the issue and come to the same conclusion as others: that a woman is, in fact, a woman and that toilets and changing facilities must be protected. Will the Minister follow his lead and protect single-sex spaces in NHS trusts? The Supreme Court has ruled that a woman is defined by her biological sex. My party knows that. The Minister claims her party knows that too. It is time for her to show it by pulling the levers that only she can to ensure that patients and staff are protected right across our health service.
I beg to move, That the clause be read a Second time. New clause 40 would require the Secretary of State to publish a report detailing the business case for the use of public-private partnerships for neighbourhood health centres. This goes back to the use of the private finance initiative in the past, particularly during the last Labour Government when Ministers were attracted by the prospect of off-balance sheet financing. Although the idea looked good on paper, it proved a disaster in practice. Before the 2008 financial crisis, private finance initiative interest rates were 2.5% to 4.4% higher than public sector borrowing rates. After the crisis, PFI projects increased their rates by 20% to 30%. In the interests of time, I will not rehash the story I told earlier in Committee about the problems with simple things such as putting a whiteboard up, but PFI did create operational problems, too. The previous Government rightly called time on PFI and announced in the 2018 Budget that it would not be used for future projects, which is why this Government’s plans are so peculiar. Labour Ministers have taken a trip to the graveyard of bad ideas, resurrected PFI and adorned it in new clothes: it is now PPP. The Government have tried to reassure the public that it is not a rehash of PFI, but the facts suggest otherwise. The funding of neighbourhood health centres is to be 80% through PPP. The Minister told the BBC we will be working with the private sector, particularly around construction and maintenance of many of the new centres. How is PPP different from PFI? The Minister has previously told this House that the new scheme will draw on lessons learnt in the past, so could she please say what those lessons are? If they have been learnt, why did 53 academics write a letter urging the Government to abandon the proposal? Why did dozens of Labour MPs sign an early-day motion expressing grave concerns? And why have the Treasury Committee, the Public Accounts Committee, the National Audit Office, the Institute for Public Policy Research and the Institute of Economic Affairs all cast doubt over the value of money for such schemes? No matter how Ministers dress things up, I am concerned. The Government need to publish a business case for the proposal to show how it will work in practice and demonstrate they have learnt lessons from the past. If they have, Members have no good reason to object to the amendment. It only asks Ministers to show their workings-out in full view of the House openly and transparently.
For the record, I am a member of the Royal College of Paediatrics and Child Health and work as a consultant paediatrician at North West Anglia NHS foundation trust, which will have a new hospital. I would like to press the new clause to a vote. Question put, That the clause be read a Second time.
I beg to move, That the clause be read a Second time. This new clause asks the Government to use private providers to help get waiting lists down. We are told that waiting lists are falling, but the Government’s own figures show that waiting lists are higher than they were last month, and if we look at the group of people who are waiting for admission for a procedure or operation, they are higher than they were last month, last year or indeed at the general election in 2024. There were 76,250 women waiting for gynaecological treatment at the end of July ’24, when this Labour Government took office; that rose by more than 6,000 patients to 82,623 as of May 2026. Private providers have capacity that may be able to help with that. The deployment of private providers is about using all the resources and capacity on offer across the country to get waiting lists down. The NHS uses private providers to perform some surgeries and scans, mental health support, GPs and dentistry, but it is a sensible measure to ensure that all hands are on deck when it comes to treating patients. I look forward to hearing how the Minister can use private providers to get more patients seen more quickly as opposed to wiping them from waiting lists at record rates.
The previous use of private providers was to remove debt from the Government’s balance sheet. That is not the same as providing guidance and regulations on how to increase capacity and use the spare capacity of private providers to reduce waiting lists, which are currently rising. In response to the point made by the hon. Member for Bury St Edmunds and Stowmarket, the workforce plan is important. Despite that plan being “imminent” for several weeks now, it has not been published. I will press the new clause to a vote. Question put, That the clause be read a Second time.
I beg to move, That the clause be read a Second time.
New clause 46 would require the Secretary of State to publish the number of staff in the Department of Health and Social Care and the number of people made redundant following the abolition of NHS England. New clause 75 would require the Secretary of State to prepare and lay before Parliament a formal transition strategy. Amendment 37 would prevent the abolition of NHS England before the production of an operating model. Amendment 38 would require the Secretary of State to publish and submit to independent scrutiny an impact assessment on the abolition of NHS England containing quantified cost and benefit figures before making regulations to abolish it. Amendment 39 would require the Secretary of State to publish and lay before Parliament a plan setting out how health services will work alongside the social care system following the abolition of NHS England before using the powers in the Bill for abolition. The plan must address joint commissioning, funding flows, delayed hospital discharges and the workforce. The problem is essentially that Ministers marched off into a battle without a plan and continue to fight without one. In this Committee, we have heard consistently about the number of times that things have not been thoroughly planned out and properly considered, particularly in relation to social care. I know that Members on all sides of the House are concerned about how social care will interact with the health service under the proposed new regime. In March 2025, Ministers and officials were going to work to determine what was needed, and in March 2026, they were still progressing to develop the design—12 months later, there was a change in tense but still no proper plan. When putting the Bill before the House, the Government published an impact assessment, but where there should be numbers quantifying how much this is all going to cost us, there is simply “N/A”. How is that any way to conduct a reorganisation? That is why I tabled amendments 37, 38 and 39. They would apply the brakes until the operating model had been established by requiring the full publication of a proper impact assessment, a detailed plan of how the health service will work alongside social care, and the publication of redundancy figures. They would ensure that the Government have worked out what they are going to do before they get on and start doing it.
I listened carefully to what the Minister said, but I do not know where the Government have transparently published all these numbers and calculations. A lot of parliamentary questions have been asked on the detail of this transition, so I think it is important that the detail is published so we can see it, and that the detail is planned, before the abolition process takes place. I therefore want to press the new clause to a vote. Question put, That the clause be read a Second time.
I beg to move, That the clause be read a Second time. The new clause would require the Secretary of State to publish a plan for securing the provision of universal fracture liaison services across England. As we get older, our bone density naturally decreases, increasing the risk of bone fractures and possibly osteoporosis, which affects 3.5 million people across the UK. Fracture liaison services identify people aged 50 or over who have broken a bone, and they provide treatment to reduce the risk of further debilitating fractures. Of those over 50, one in two women and one in five men will break a bone because of osteoporosis. Heartbreakingly, 2,000 people die each year from preventable fractures. When the former Secretary of State, the right hon. Member for Ilford North (Wes Streeting), claimed that delivering universal fracture liaison services would be one of his first priorities if elected to Government, many people hoped to see this happen, but it has not. The previous Conservative Government began rolling out fracture liaison services, and it is an indicator of just how little progress the current Government have made that 97% of today’s fracture liaison services were delivered by the Conservatives. What have the Labour Government been doing? What is more, one in two NHS trusts, following freedom of information requests, tell me that they have no fracture liaison service at all, which is quite literally an accident waiting to happen. I am very grateful to the Royal Osteoporosis Society for its campaigning on this issue. By its calculations, at the current rate of delivery, it will take 38 years for the Government to deliver universal fracture liaison services, which is obviously far too slow. We have tabled the new clause because the Government need a plan. The former puppeteer of this Government, Morgan McSweeney, made it clear that Labour did not have a plan for government. The new clause would require the Secretary of State to deliver a plan within 90 days, not just to secure the provision of universal fracture liaison services but to deliver on his predecessor’s very clear and very deliberate promise to do so. The Minister in the other place was asked whether an implementation plan for fracture liaison services was needed. The answer was, effectively, no. What is the view of the Minister before us in Committee? There are so many critical questions in this area that have no answers and that a plan would and should address. What are the Minister’s annual milestones for achieving universal access to fracture liaison services by 2030? How will the Minister’s plans to cut ICB budgets by 50% impact that key promise? An important question on the promise is whether the Minister’s plans to merge ICBs mean that fewer services will now be delivered. How will that impact patients? What extra workforce, diagnostic and NHS estates capacity is required to deliver it? Yet again, as so often with this Government, we are left with a headline-grabbing promise with no plan behind it. The consequence is that more than 40,000 people are predicted to die from hip fractures that could have been prevented through timely national implementation.
Not necessarily, no, but this one does, because the Government clearly made a promise before the election. The former Secretary of State was clear that it would be one of his first acts—that is what he said—and it has not happened, so in this case we need to hold the Government to account. It is our job to hold them to account on their promises, and I am afraid that they are failing on this one. To sum up, the Government need to get their act together, because otherwise more and more vulnerable people will come to unnecessary and potentially fatal harm. I look forward to hearing the Minister’s plans to accelerate the delivery of the Government’s promise—and fast.
Can the Minister be clear on the point about ICBs? There is a concern that, where there are perhaps three ICBs, one of which has a service and two of which do not, and they merge together, the Government then say, “Aha! This ICB area now has coverage,” but that is for part of it, not all of it. What is important for a universal service is that it is available to all.
I am afraid I am not reassured at all. The Minister seems to be saying that the ICBs will do it—the same ICBs where she is cutting their budgets, making them change the board and making them merge with each other all at the same time. The target is behind schedule and it is important that we hold the Government to account on it. Therefore, I will press new clause 47 to a vote. Question put, That the clause be read a Second time.
I beg to move, That the clause be read a Second time.
New clause 48 would require the Secretary of State to “publish and maintain a national framework for improving access to radiotherapy services in England.” One in four people can expect to need radiotherapy in their lives. That is a lot of people who will need consultation, assessment, pre-treatment planning and treatment delivery. Data published a few years ago showed that Scotland, Wales and Northern Ireland have more linear accelerator machines per million people than in England. Can the Minister confirm whether that is still the case? Last year, Radiotherapy UK had research indicating that more than 60,000 cancer patients are not getting the radiotherapy they need and I know particular areas of the country are struggling. Can the Minister provide an update on the roll-out of the new LINAC machines at 28 hospitals, which she spoke about in May 2025? We were also told that by March 2027, up to 27,500 additional treatments will be delivered. Can the Minister share some information on how that will be achieved? The Labour Government have now been in power for two years. They have raised taxes by more than £60 billion and they do not have much to show for it. They have not produced a workforce plan. They have said that one will be imminent; can the Minister confirm whether it will be published today before we break for the recess? Is the intention to publish it during the recess or will we have to wait until the autumn? There is a 31% shortfall in clinical radiologists. New clause 48 essentially requires the publication and maintenance of “a national framework for improving access to radiotherapy services”. This Government have essentially shown that if a requirement is not in legislation, plans just get delayed, diminished and disowned, but patients cannot afford to wait any longer.
If I heard the Minister correctly, she said that the ICBs would provide NICE-approved treatment, which they have to do within 90 days at the moment. At an earlier sitting, we debated an amendment tabled by the Minister that would enable the Secretary of State to delay the provision of NICE-approved treatment, which was agreed to. I am not quite sure how that is congruous, but in either case we would like to press new clause 48 to a vote. Question put, That the clause be read a Second time.