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Latest entry 4 Nov 2026
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Showing every spoken contribution, including 12,832 under 12 words. Hide short remarks
The Transport Secretary and I have held regular discussions about preparations for the EU entry-exit system, and its potential impacts on passenger flows. The Secretary of State has engaged directly with counterparts in France and the European Union, stressing the need for appropriate border staffing levels to support smooth journeys for British travellers on their well-earned holidays this summer.
I thank the hon. Member for raising the important issue of passenger flows relating to EES through the juxtaposed controls. I confirm that the Secretary of State has met her French counterpart and the relevant commissioner at the European Union to discuss a range of issues relating to EES. As part of that, we continually discuss what easements or adjustments are necessary to ensure that flows are appropriately managed.
I would be glad to meet my hon. Friend and representatives from the freight sector. It is crucial that the sector is empowered to carry out its vital work, especially in the short straits, through which approximately 60% of UK-EU trade passes. She is an advocate for the freight sector in her constituency and across the United Kingdom. We want to ensure that we get this right, so I would be glad to meet her to discuss this subject.
That is a very theatrical question from the shadow Minister on the scale of the challenge that we face. I can confirm that the meetings that we are having on EES, both in Government and with our counterparts, are to ensure that we get this right, ahead of the peak period. We have supported the port of Dover and Eurotunnel with £3.5 million each in preparation for EES, and earlier this week, we announced £20 million in funding, subject to the completion of relevant checks, to further support border infrastructure at the port of Dover. We are taking a sober, sensible and non-theatrical approach to getting this right.
I thank the shadow Minister for his question. I can confirm that I have been clear with Ministers in Government, and that Ministers have been clear with French and EU counterparts, that they should do all they can to avoid disruption, including using the existing flexibilities in EES regulations. We are not being complacent and asking for things retrospectively; we are taking the right steps now to ensure that our juxtaposed controls are prepared. There is £3.5 million to prepare for EES operations, both for the port of Dover, and for Eurotunnel and St Pancras.
I thank the Lib Dem spokesperson for his question. I can confirm that we have discussed the flow of passengers through member state airports with our relevant partners in the European Commission, and with member states. That is certainly something I have been doing over the past 10 months. We know that there are outstanding issues with particular airports, which we continue to raise, both through our in-country posts and at ministerial level, to ensure that European partners are fully aware of just how seriously we take British passengers being able to travel with ease to their summer holiday.
The Government are committed to supporting the aviation sector. We are unlocking growth by progressing planning decisions and consulting on the framework for future decisions on Heathrow’s third runway. We are modernising our airspace through the new UK airspace design service and support fund, and are driving decarbonisation, backing sustainable aviation fuel and providing funding for new low and zero emission technologies. We will publish an updated jet zero strategy in early 2027.
My hon. Friend is right that the barriers to a career in aviation are too high, and this Government are committed to supporting recruitment from as diverse a range of backgrounds as possible. Our Generation Aviation programme promotes aviation careers through outreach and apprenticeships to help build a future-ready workforce, and has reached over 1 million young people since it began.
I am glad that the Lib Dem spokesperson shares our concern about consumer rights. Disruption and cancellations—but also disruptive passengers, unfortunately—can ruin the holidays of British holiday- makers who save so much to facilitate those experiences. The new Civil Aviation (Consumer Protection and Regulatory Reform) Bill, which has just come out of the other place, will hopefully re-emerge in the House of Commons on the other side of the summer. It includes a suite of measures to strengthen consumer rights, and I look forward to working with the hon. Gentleman on exactly the sort of issues that he raises as the Bill makes its way through this House.
My hon. Friend raises an important issue. This Government are committed to enabling aviation employers to recruit and train pilots from a broader and more diverse talent pool in Doncaster East and across the United Kingdom, supporting growth by removing regulatory barriers and promoting aviation opportunities.
With enormous respect to the right hon. Gentleman, we are taking proactive action to prepare for any potential EES disruption. We have spoken with our French and European counterparts about using the full range of easements, but most importantly, we have provided funding to the juxtaposed controls so that they can prepare for any disruption before it occurs.
The hon. Gentleman is a dogged campaigner for providing that rail link and I will report back to him about the quality of my journey. I am excited for the steel signing ceremony ahead of the opening of the new eastern roll-on roll-off terminal at the port of Immingham, which I understand the hon. Gentleman has been a passionate champion of.
Fuel security and the Scottish jobs that it underpins are of incredible importance to this Government. We remain in regular contact with both the Scottish Government and other devolved Governments to ensure that we are ready to respond in a co-ordinated manner should any disruption to our fuel and refining capabilities arise.
My hon. Friend is right to point to the fact that the EV industry depends on not only automotive manufacturers but the billions of pounds in the charge point sector and the workers who underpin it. Throughout our consideration of the ZEV mandate, we will ensure that our environmental obligations are met alongside making good business sense for all relevant partners in the sector.
Let me thank the hon. Gentleman for his question. Air quality in relation to both pilot and passenger safety is of real concern to the Department for Transport. We undertake work constantly to monitor the impact of cabin air quality on those affected groups, and I would be glad to have a further conversation with him to take that work further.
It is a pleasure to serve under your chairship, Dr Huq. The hon. Member for Winchester raises an important point. Cardiac issues are serious, and people too often lose their lives as a result of unidentified cardiac conditions. As we know, ECGs are used significantly across the whole of healthcare, from accident and emergency to new community diagnostic centres and beyond. They are important for investigating palpitations or unexpected syncope and for evaluating pacemaker function, and are an extremely useful diagnostic tool. However, as my hon. Friend the Member for Bury St Edmunds and Stowmarket suggested, there is no clear evidence that non-symptomatic population screening using standard ECGs would yield any useful health data or improve population outcomes. Clearly, the loss of life—particularly a young life, as in the case of the constituent the hon. Member for Winchester mentioned, although we have all seen or, sadly, experienced such cases—is an awful tragedy for those concerned, but we need to rely on evidence. The UK National Screening Committee, which is an independent scientific advisory body, advises all four nations and is considering the issue. The committee launched a three-month public consultation on 8 June to look at the evidence on screening for sudden cardiac death. Its draft recommendation is against screening, because ECGs, as well as other tests, are an unreliable tool for identifying significant cardiac issues in asymptomatic individuals. ECGs are useful tools in the diagnosis of symptomatic patients, and the UK National Screening Committee is in the process of reviewing ECG use for asymptomatic individuals. For those reasons, I ask the hon. Member to withdraw the new clause.
I commend the hon. Member for outlining this important issue before the Committee and for his work on the APPG. AMR is recognised as a chronic risk in the Government’s national risk register. In 2022, it was estimated that 7,500 deaths per year can be directly attributed to AMR in the UK, with a further 35,000 deaths per year associated with AMR. It is a significant and growing issue that the Government take very seriously—I want to assure the hon. Member and the Committee of that. Through the delivery of the 2024 to 2029 UK AMR national action plan, the Government are already taking comprehensive action to tackle this threat and ultimately reduce the burden it places on individuals, families and the healthcare system. That is where that work is located. I am not convinced that a review of the number of deaths at this point, while important, would add significantly to our understanding of the impact and burden of AMR or to the action being taken to address it, which we do take seriously. The Government will continue to work with APPGs and with information around this issue through the action plan. For that reason, I ask the hon. Member to withdraw the new clause.
I thank the hon. Member for North Shropshire, who raises issues of patient safety diligently on behalf of her constituents and the wider system. I will take the time to answer some of the points about where the Government are. Obviously, we support prioritising patient safety, which along with service quality and experience is of the utmost importance. On new clause 36, trusts are already subject to regulatory and contractual requirements to report medical malpractice, which is why we do not think the new clause is necessary. For example, CQC regulations on safe care and treatment and on good governance are central to trust accountability for systemic malpractice. They require trusts to have effective systems to identify patterns of harm, manage risks and deliver system-wide improvements. Trusts are required to identify and report incidents leading to significant harm through the Learn from Patient Safety Events service, ensuring that the CQC is informed and enabling NHS England to identify trends and support learning and improvement. This information can be shared with and accessed by HSSIB and could in the future be shared with and accessed by the investigations arm of the CQC. The CQC regulation on duty of candour reinforces transparency through truthful accounts of what has happened when something goes wrong, including where harm reflects systemic issues. Under the patient safety incident response framework, trusts must undertake patient safety learning investigations into certain incidents to support learning and improvement. In parallel, the NHS provider licence requires NHS trust boards to maintain clear accountability for quality of care and reporting of safety information through effective governance systems. Where failures of governance occur, NHS England has the powers to intervene. Those powers will transfer to the Secretary of State as part of the Bill. The new clause would clearly duplicate current processes. Together, the existing mechanisms already help trusts to identify and address systemic issues locally, while enabling national aggregation to support system-wide learning. New clause 37 seeks to require the creation of a standardised framework for coroners and medical examiners to report health system failings. I take the opportunity to reassure the hon. Member for North Shropshire that regulations already require medical examiners to report serious concerns identified in respect of clinical governance, patient safety or public health surveillance, in accordance with local reporting arrangements. Existing regulations also require coroners, in the context of an investigation, to issue a report to a person, organisation, local authority, or Government Department or agency where the coroner believes they may have power to take relevant action to prevent future deaths. In September 2024, the Department of Health and Social Care introduced death certification reforms, putting in place regulations to provide greater safeguards for the public by ensuring independent scrutiny by medical examiners of all deaths not investigated by a coroner. These reforms, as set out in the Medical Certificate of Cause of Death Regulations 2024, which require an independent review to be carried out for all deaths in England, introduce a system whereby all deaths are subject to either a medical examiner’s independent scrutiny or a coroner’s investigation. Should the medical examiner detect concerns about care, they will refer such cases to established clinical governance review processes and bodies and notify the coroner or, if necessary, the police. The Notification of Deaths Regulations 2019 require all doctors, including medical examiners, to refer a death to a coroner if they believe that deficiency of care while undergoing treatment contributed to the death, making the death unnatural. Under the Coroners and Justice Act 2009, a coroner has a statutory duty to report issues to the appropriate bodies where they believe that action can be taken to mitigate or prevent the risk of future deaths, and both the report and responses to it are published by the chief coroner. When incidents and errors occur resulting in death or serious injury, it is important that we learn any lessons. The Government are committed to ensuring that the prevention of future deaths reports are taken seriously and lead to meaningful action. The Department is working across Government and with the chief coroner to identify ways to strengthen oversight and ensure that the right organisations are consistently notified of concerns, respond to them in a timely manner and drive appropriate action. Under the Medical Act 1983, the General Medical Council ensures that all doctors, including medical examiners, report suspected health system failings by speaking up. That is a mandatory professional obligation linked to a doctor’s licence to practise, embedding this whistleblowing requirement into the GMC’s core regulatory and fitness to practise frameworks. The GMC also enforces a professional duty of candour requiring all doctors to be open and honest with patients and official bodies when things go wrong and actively report adverse incidents so that systematic lessons can be learned. In summary, both new clauses duplicate requirements that already exist. Regulations, systems and processes are already in place to report suspected health system failings to the appropriate bodies. For that reason, I ask the hon. Member for North Shropshire to withdraw the new clause.
I am grateful to the hon. Member for bringing this discussion before the Committee. She is right that, following the For Women Scotland case at the Supreme Court in April 2025 and the recent laying of the Equality and Human Rights Commission’s updated code of practice on 21 May, ensuring the provision of single-sex facilities for patients and staff is a prominent issue. The Government welcomed the clarity provided by the Supreme Court judgment. The EHRC code of practice sets out how service providers may lawfully apply sex-based distinctions following the Supreme Court judgment. That guidance is applicable to services, public functions and associations and includes, but is not limited to, the services provided in the NHS. Following that, NHS England drafted the revised guidance, “Privacy, dignity and safety in hospital accommodation”, which will align with the legal position and the EHRC code of practice and replace existing guidance. I know that many colleagues are impatient to see the existing guidance replaced following the Supreme Court ruling. It was important to wait for the EHRC code of practice to be published so that it could be considered in any guidance. The code of practice was published on 21 May. Following the publication, NHS England reviewed the guidance to ensure that it was in line with the code. The code was subject to a 40-day laying period before Parliament, which ended on 9 July. The Government expect the code to come into force in early August. Guidance for the NHS will be published shortly afterwards. NHS England is also developing guidance on staff facilities, including changing rooms, toilets and washing facilities that should be used by trusts and ICBs. The provision of physical single-sex facilities for NHS staff is for NHS organisations to individually manage in line with their legal obligations. There is already legislation covering this issue, particularly the Workplace (Health, Safety and Welfare) Regulations 1992. Organisations should already be conducting assessments of their own estates and the needs of their workforce to decide what changes they need to make to comply with all legislative requirements. On mixed-sex accommodation and breaches, there is a long-standing policy of same-sex accommodation. Individuals should not have to share sleeping accommodation with patients of the opposite sex unless appropriate. In practice, the proposed amendment does not allow scope for mixed-sex accommodation where clinically appropriate—for example, intensive care unit facilities or where it is necessary for patient safety. For those reasons, I ask the hon. Member for Sleaford and North Hykeham to withdraw the new clause. Question put, That the clause be read a Second time.
Well, what was a disaster was the Tories’ management of the capital estate pre-1997 and post-2010, if the hon. Member for Sleaford and North Hykeham wants to talk about disasters on capital planning. I could talk about this for a very long time, but I know the Committee is keen to move forward, and I addressed some of these issues in debate on a previous amendment. I am very proud of, for example, Southmead hospital in Bristol, which is one of the finest examples of a hospital in the country and was built under a PFI scheme. I received treatment there a couple of years ago, in facilities that are good for staff to work and patients to be treated in. It replaced a hospital that was falling down and in shocking condition, despite the best efforts of staff. We can see similar examples across the country. Under the Tories’ management, and for some of the early PFI schemes under the last Labour Government, contracts were poorly negotiated. They had issues with, for example, management of inflation. We have learned lessons from that. The hon. Member for Sleaford and North Hykeham talked about some contracts, including one where, I think, her whiteboard was not working. We know what the lessons are to be learned from that, and we are doing exactly what a good Government do when they take charge—change it. In the 14 years that the Conservatives were in power, they could have started negotiating these contracts differently at any point, but they chose not to. They chose to let the estate atrophy and fall down. That is bad for patients and the public. That is why I was proud last week to launch the Government’s capital plan, building for the future, looking forward and giving nine years of certainty for estates across all our constituencies.
I thank my hon. Friend for that. Across the east of England, where we now have so many Labour MPs, everyone has been trying to rectify the mismanagement that local people have seen, particularly of the capital estate. I will not detain the Committee on the capital estate—one of my favourite subjects—for very long. The hon. Member for Sleaford and North Hykeham is aware that the decision on neighbourhood health centres was announced in the autumn. The decision-making process was supported by a business case to examine the feasibility of developing a new model, learning the lessons of the past on public-private partnerships specifically to build neighbourhood health centres as part of our 10-year plan. That informed the decision to proceed. The business case was a strategic outline case, the purpose of which was to scope and identify the preferred way forward for a new potential model, in line with the Treasury’s five case model. We are now working with the National Infrastructure and Service Transformation Authority to develop this further, and we expect a further round of market engagement in the autumn. I recognise the interest in making the business case available to both Houses, but that must be balanced with the need to develop an effective policy. Publication while policy development is ongoing would limit full, candid and proper deliberation. Civil servants and subject experts need to be able to engage in frank discussion of policy options to expose their merits, demerits and possible implications. Their candour in doing so would be affected by their assessment of whether the content of such discussions would be disclosed. We are committed to building neighbourhood health centres across the country. That is what patients and the public deserve. We will obviously be mindful of public money and subject to the usual processes of the House, including the Public Accounts Committee. We will learn those lessons. We are in full discussion with NISTA. For those reasons, we are committed to developing good estate across our country. That is what our constituents deserve. I therefore ask the hon. Member for Sleaford and North Hykeham to withdraw her new clause.
Again, I am grateful to the hon. Member for Sleaford and North Hykeham for bringing this discussion before the Committee. This new clause would require the Secretary of State to make regulations about how the NHS uses private provision to support access to treatment and reduce lists. I understand the point that she is making, but I assure her that this is an unnecessary new clause. ICBs already can and do use private healthcare providers to offer patients treatment in their area and boost capacity to reduce lists. Our approach is pragmatic, not ideological: in the 10-year health plan, the Government committed to continuing to use private sector capacity where it is available; that is not because we favour the private sector but because we are committed to using capacity wherever it is available. Our priority is treating patients in a timely manner, not favouring one form of provider over another. Under existing legislation, patients must be offered a choice of provider for their first outpatient appointment, where the duty of choice applies. If a person’s needs are not met by local services or waiting times are high, they can use that choice to see an appropriately qualified provider. However, we must resist the temptation to apply a one-size-fits-all approach here. ICBs are responsible for the financial sustainability, planning and strategic commissioning of services for their local populations, so they are best placed to decide how private premises should be used to meet a population’s needs. For example, high waiting times, which we obviously inherited from the Conservatives, for a particular specialty may result not from a lack of capacity but from increased demand from GP referrals. The ICB must have the flexibility to improve how advice and guidance—referral support, for instance—is working for GPs, rather than being required to wastefully spend NHS funds on increasing capacity with the private sector.
I am slightly confused, as I suspect other Committee members are, by the Opposition’s approach to the private sector, having had a discussion in relation to the previous new clause about not using the private sector and boosting work and employment opportunities in our country. They do have a slightly odd view with regard to this. As I said, our view is very pragmatic: it is to support the treatment of patients to get waiting lists down. That is what our constituents deserve. Where capacity can be used, we want to make sure that that choice is available.
That is why I was clear in outlining that ICBs have a duty to make sure that they are financially sustainable and that their planning and strategic commissioning meets the needs of their local population. They need to balance those requirements. Under the new clause, there is a risk that the Secretary of State, by setting blanket requirements, would contravene the level playing field provisions in clause 10 of the Bill. For those reasons, I ask the hon. Member for Sleaford and North Hykeham to withdraw the new clause.
The Government of course recognise the importance of clarity and assurance as we undertake this significant transformation, including on how functions, governance and the workforce will operate in the future. That is essential for ensuring that our staff and other stakeholders understand the new role of the Department. On new clause 46, we recognise the importance of transparency around departmental workforce numbers and the impact of abolishing NHS England. The Government remain committed to significantly reducing headcount across NHS England and the Department of Health and Social Care, but I put on record my thanks to all the staff and talented professionals working in both organisations; this is a difficult time for them. However, this new clause is not necessary. Workforce information is already published both monthly and through the Department’s annual report and accounts, alongside wider Government transparency publications. Placing a further reporting requirement in legislation would risk duplicating existing transparency data, so it is unnecessary to include it in the Bill. On amendment 37, I reassure the Committee that we will consult on the proposed structure for the new Department of Health and Social Care, and that is also required under existing employment law. The structure will clearly explain what every part of the new Department will do and set out every post we think we need. The target operating model is an internal document that sets out the proposed purpose, role, governance and organisational structure of the future Department. It will be shared internally, following engagement with staff and stakeholders, including trade unions. The chair of NHS England, Dr Penny Dash, has committed to sharing it with the Health and Social Care Committee once it is finalised. The target operating model will be used to guide detailed organisational design and will iterate over time. The proposed design of the new organisation will be subject to consultation. The target operating model does not implement changes that remain subject to parliamentary approval through this Bill. On workforce transition, we will follow TUPE-like principles whether TUPE or any other transfer mechanism applies, in line with the Cabinet Office statement of practice on staff transfers in the public sector. That means that recognised trade unions will be formally consulted and engaged with on measures related to the transfer. No changes to contractual terms and conditions will be made without proper consultation and engagement. We are committed to maintaining an ongoing dialogue with trade unions and staff throughout this period of change, and we are updating them as often as possible. Where appropriate, we are also committed to working with staff networks on the changes, particularly on how we can best support staff. Given those commitments, I hope that the hon. Member for Sleaford and North Hykeham agrees that placing further requirements in the Bill would be disproportionate. On amendment 38, we agree that it is important to be transparent about the costs and benefits of this programme. The Department has been open about the initial estimate of around £1 billion of savings per year, and we published an impact assessment alongside the Bill. The detailed timing and scale of costs and savings from the programme depend on factors such as the take-up of voluntary exit and redundancy schemes, which are under way. We will continue to refine our assessment of costs and savings as the programme progresses and as we move towards the abolition of NHS England. We will continue to be open about those figures. The savings will support continued investment in frontline services. The timescales set out in the amendment would risk delaying the abolition of NHS England and, as a result, would delay the transfer of savings to frontline services and the stability and certainty we need for our staff. On amendment 39, the Government are committed to supporting the integration of health and social care so that people experience more joined-up, person-centred care. Key planning frameworks, including for the better care fund and for neighbourhood health, already stress the critical importance of strong join-up and integration. We expect those frameworks to continue to guide the health and care system following the abolition of NHS England. Most importantly of all, we are committed to developing neighbourhood health approaches as an essential part of reforming the health and care system. That approach will deliver more integrated services across health, local government and wider partners, including the voluntary and community sector. The Bill simplifies existing complex legal frameworks to make collaboration easier and emphasises the role of health and wellbeing boards as a focal point for that collaboration. However, partnership and collaboration take many forms depending on local circumstances, and they cannot simply be prescribed through a centrally developed plan. Instead, we should encourage areas to develop effective, productive relationships in the interests of the people they serve. We have discussed that in this Committee, and hon. Members from all parties have a key role to play there. Turning to new clause 75, we absolutely recognise the need to ensure that critical functions, expertise and organisational capability are identified, retained and effectively transferred during this period of change. That is essential to maintaining continuity of services and supporting the delivery of key health programmes, including vital services such as cancer care. I reassure the Committee that that work is already well under way. We are carefully mapping all areas of current activity across NHS England, assessing what capabilities we need to deliver them in future and putting processes in place to support the retention and transfer of expertise. This includes the phased approach we are taking to workforce changes, alongside a robust and consistently applied process for voluntary redundancies and voluntary exits, to minimise disruption and protect critical skills. We are also committed to ongoing monitoring and oversight through the transition, and as part of our programme of governance, there is ongoing consideration of skill retention, knowledge transfer and organisational capability, and we will take action where gaps are identified. As drafted, the new clause would introduce a new statutory requirement to produce and lay before Parliament a formal transition strategy before the abolition of NHS England and the implementation of transfer schemes, alongside new ongoing reporting obligations. While well-intentioned, it would add another unnecessary step into what is already a complex and carefully sequenced programme. It would reduce the flexibility needed to adapt workforce organisational decisions as the transformation progresses. For those reasons, the Government believe that the objectives of the new clause are already being delivered through existing programme arrangements, without the need to place further requirements in the Bill.
I will partly agree with the Opposition to start off with: they are absolutely right that osteoporosis is a really important issue, particularly for older women. The hon. Member for Farnham and Bordon outlined some of the economic case, but crucially, it is a strong health issue. I worked and campaigned on this issue in opposition myself, because it predominantly affects older women. It also very much fits into our 10-year health plan regarding prevention. That is why we have also, for example, increased access to DEXA—dual-energy X-ray absorptiometry—scanners. It is rather disappointing, though, for a subject on which there is obviously so much agreement to be used as a political back-and-forth here today. Let me be clear. I think some of the comments show why some of this has got a bit confused, including for people who genuinely care about this rather than just wanting to make it a political issue. Again, it is entirely the Opposition’s job to oppose the Government, and I do not have any problem with that, but there is a serious issue here about how this is monitored. We are absolutely committed to having coverage across the country by 2030, as the Secretary of State has recently said. That is why we are rolling out more DEXA scanners and so on, but with the clustering of ICBs, 92% of the country is now covered across those clusters.
That is why it is important that we look at what is actually happening on the ground and how we are moving forward. We are committed to supporting this cohort, and particularly those patients for whom this condition is largely preventable. Care closer to home, based around our 10-year plan, is absolutely the right way to go about that.
I was going to outline the points, but I am happy to give way if the hon. Lady wants.
Again, the hon. Lady has intervened, but that is exactly my point. There is a danger here of the Conservative party focusing on a target or number and totally missing the point, which is to have good, locally available services accessible to this predominantly female and predominantly older population through our 10-year health plan. If one counts the new clustered ICBs in that target, 92% of areas are covered. We want to get to the heart of this issue. Integrated care boards are the commissioners of local health services and remain best placed to make decisions according to local need. Commissioning these services at a local rather than national level—which is the entire thrust of our 10-year health plan, and indeed this Bill—means that ICBs are best placed to commission holistic, integrated care that wraps around the patient’s need, where the patient is. We have been very clear in our 10-year health plan, and indeed in this Bill, that we are not expecting patients to fit in with models of care that have been devised over a period of time and in hospitals that are largely located far from their homes. We are looking at a close-to-home service and building models of care around peoples’ needs. A legislative requirement for a national implementation plan would cut across that responsibility, undermining local ability to tailor services to patient needs and causing confusion for delivery. That is why we do not think the new clause is necessary. The renewed women’s health strategy sets an expectation that ICBs prioritise community-based models when commissioning new fracture prevention services. The Department will continue to work closely with NHS England and ICBs to explore a range of options that provide better quality, and better access to, important preventive services. I therefore ask the shadow Minister to withdraw the motion.
This is an important debate, as many of them are today. I understand that waiting for a cancer diagnosis, as I have had to do myself, is very stressful. The national cancer plan sets out how the Government will change that experience for patients and their families. Crucially, the plan is driven by evidence and shaped by the voices of more than 11,000 patients, charities and professionals who responded to our call for evidence. The plan covers the entirety of the pathway, from referral and diagnosis to treatment and ongoing care, as well as prevention and research and innovation, and tackles the key issues raised in the new clauses. Delivery of the plan will be monitored by the national cancer board, with an independent co-chair reporting to the Department. On new clauses 48 and 65, let me be clear that improving access to high-quality radiotherapy services is a priority for the Government, and one that we are already delivering. In May last year we announced the roll-out of new linear accelerator machines, we have committed to meeting all cancer waiting time targets by the end of this Parliament, and timely access to radiotherapy is central to the 31-day and 62-day treatment standards. We will go further by reviewing the targets, once they have been met, to consider whether they should be strengthened. That will include considering what data is needed to support improved performance. A separate statutory framework would duplicate the established performance regime. We are well aware that radiotherapy performance is below that of other treatment types, as the hon. Member for North Shropshire outlined. We are also aware of the serious variation between different parts of the country. We have at our disposal the Getting It Right First Time programme and national interventions to address those issues at a local level. The national cancer plan also tackles unwarranted variation through robust national data and oversight from the national cancer board, while ensuring that service configuration remains clinically led. We have committed to improving the productivity of radiotherapy services, including by using artificial intelligence to streamline treatment. We will make a £70 million investment in state-of-the-art radiotherapy machines by 2027 through a managed national replacement programme. Imposing fixed legislative limits on the age profile of equipment would reduce the flexibility required to manage that programme effectively. Additionally, the NHS is already under a clear statutory duty to fund NICE-recommended interventions, supported by national commissioning guidance. Additional minimum standards would duplicate those safeguards without improving outcomes. New clause 48 also suggests metrics to track radiotherapy performance. I assure the hon. Member for North Shropshire that high-quality and detailed data already helps us to understand emerging issues and to monitor performance. The National Disease Registration Service in NHS England collects diagnosis, treatment and outcome data on cancer patients in England. It routinely reports incidence, prevalence, survival, routes to diagnosis and treatment data on all cancers. NHS England also publishes monthly radiotherapy performance data. On workforce capacity, we are already seeing increases in key roles, including clinical oncology doctors and radiologists, and the Getting It Right First Time review of radiotherapy services will report later this year. The new clauses risk duplicating efforts already in train to improve the oversight of radiotherapy services, workforce, data quality and coverage, and would create additional bureaucracy and divert resources away from patient care. I turn to new clause 53. Improving performance against cancer waiting standards is a priority for this Government. We have made year-on-year progress with cancer waiting times, but we know that there is some way to go. Cancer incidence is about 15% higher than when the 62-day standard was last met, in late 2015. There are more than 200 distinct cancer types, and each is complex. The cancer waiting time targets, including the 62-day referral-to-treatment target, are not set at 100% for several reasons, including patient choice, clinical guidelines and the complexity of diagnosis and treatment planning. That means that not every patient can or should be treated within the waiting time standard. We therefore do not think the new clause is appropriate. Change, including improvements to the cancer pathway and to tackle variation in performance, cannot be delivered overnight. The national cancer plan sets out the concrete actions that we are taking to get there. We have already demonstrated our commitment to transforming diagnostic services by investing £2.3 billion in diagnostic capacity. That will support us in achieving the 62-day standard through faster diagnosis. We recognise that the provision of cancer services, including treatment, varies across the country. The national cancer plan addresses how to tackle that variation. To accelerate breakthroughs in cancer treatments, we will explore innovative procurement methods. That will aim to stimulate the development of new diagnostic tests, targeted therapies and more effective treatment for rare cancers, ensuring that the NHS remains at the forefront of medical innovation. We believe that new clause 54, in the name of the hon. Member for North Shropshire, is unnecessary because the Department already has the National Institute for Health and Care Research and the national cancer plan underpinning its cancer research strategy. The Department invests about £1.8 billion each year on research through the NIHR. Cancer is a major area of its spending, at £141.6 million in 2024-25, reflecting the fact that it is a high priority. The NIHR does not usually ringfence funds for research in specific conditions; it welcomes funding applications for research into any aspect of human health and care, including cancer. Research is funded through open and fair competition and peer review to ensure that the highest-quality proposals most likely to deliver real impact for patients are funded without imposing financial targets or limits. The national cancer plan is the first plan to have a dedicated chapter on rare cancers, which is important to many hon. Members across the House, including my hon. Friend the Member for Blaydon and Consett, who has done great work. The plan includes a commitment to make progress on rare cancers as one of six key research priorities to tackle stubbornly low survival rates. Our aim is to be in the top quartile across 28 countries for survival of 14 rare and less common cancers. Through the NIHR, the Department is the largest funder of clinical academic training. The NIHR plays a key role in attracting training and supporting the best clinical academic researchers, providing comprehensive research career pathways for clinicians across all career stages, from undergraduate level through to professional appointments. New clause 100 would require the Department to publish a report on the feasibility of using data in patient records to flag symptoms. I understand the concerns behind it. We fully support using the single patient record and other data to improve cancer care and diagnosis, but we have largely covered the issues raised by the new clause in the cancer plan. We understand that there are concerns in some areas. The Government have introduced Jess’s rule, which instructs GPs to rethink a diagnosis if a patient presents with the same symptoms. That followed a campaign on behalf of the family of Jessica Brady, who tragically died after symptoms of her cancer were not recognised. The single patient record will give clinicians timely access to a single trusted record, which is why it is such an important part of the Bill. We envisage that the Bill, together with the cancer plan, will enable more personalised insight into cancer risk, for example, through the NHS app. For those reasons, we do not think the new clause is necessary.
I am grateful to the hon. Member for bringing another important disease to the attention of the Committee. I agree that modern service frameworks are important tools for improving patient care. They sit at the heart of our 10-year health plan, enabling a step change in both service quality and delivery. That is why we are prioritising making rapid progress on them. The first two MSFs, on sepsis and cardiovascular disease, will be published shortly, and a further four are in development. Given the momentum, it is clear that primary legislation is not needed to drive the development of MSFs; instead, we have established a robust, expert-led process.
Like my hon. Friend’s constituency, my constituency of Bristol South has a large tobacco industry legacy, and it is crucial to address respiratory disease in a way that looks at the whole person.
My hon. Friend tempts me to go down the path that we went down in another Committee. I recognise that the Tobacco and Vapes Bill took a long time to come through Parliament, despite having been started by the Conservatives under the right hon. Member for Richmond and Northallerton (Rishi Sunak). It faced a lot of opposition, but we are absolutely clear that that is the single most beneficial piece of work. The hon. Member for Sleaford and North Hykeham asked me about the future, in terms of vape shops and so on, and I have corresponded back to her on that issue. Instead of what is proposed in new clause 49, we have established a robust, expert-led process. The national quality board will assess all proposals for new MSFs against a clear set of criteria, ensuring that we prioritise those areas where an MSF will deliver the greatest impact for patients. Alongside developing the first wave of MSFs, we are further strengthening the process, including by setting out a clear and consistent approach for assessing future proposals. Embedding an MSF in respiratory health in primary legislation would risk limiting that flexibility, rather than strengthening our ability to improve care, as my hon. Friends the Members for Blaydon and Consett and for Bury St Edmunds and Stowmarket have outlined, by taking the action that is so necessary to help and support people with respiratory disease.
It is a lot faster than the 14 years in which it was not done under the Conservatives.
It is a pleasure to serve under your chairship, Ms Lewell. As the shadow Minister, the hon. Member for Sleaford and North Hykeham, said before the break, technology is a game changer. It is a key enabler of our 10-year health plan and a modern NHS. This new clause follows the plan’s five big bets, the transformative technologies key to NHS improvement: data to deliver impact; AI to drive patient power and productivity; genomics and predictive analytics for pre-emptive personalised care; wearables to make care real-time; and robotics to support precision. To require those diverse areas to be subject to a cohort of plans to be laid before Parliament, and to make them subject to perpetual monitoring by Parliament, would be to legislate for micromanagement. One of the priorities of tech delivery is that it needs to be agile. The new clause would inhibit that. Parliament does not usually have a role in overseeing delivery plans for specific elements of NHS technology. Adding in new reporting structures is unnecessary bureaucracy that would slow down delivery of the technologies and their impact on patients. In some areas, we already have arrangements in place to underpin delivery, via legislation approved by Parliament. The Health and Care Act 2022, the Data (Use and Access) Act 2025 and related legislation have established a framework for mandatory information standards, which can set the technical and data requirements to ensure interoperability. Along with our 10-year plan, our ambition to be the most artificial intelligence-enabled healthcare system in the world by 2035 and our commitment to an AI road map, that means that the new clause is unnecessary. I therefore ask the hon. Member to withdraw the motion. Question put, That the clause be read a Second time.
May I put on record my thanks to all the excellent managers in the NHS? I am not sure whether I raised the bar, as the hon. Lady said, but it was a great career and one that I enjoyed very much. It is a difficult job, and we want to support managers in future. We cannot deliver our 10-year health plan without them. That is one of the reasons why we have already established a leadership college to support their development, as we committed to doing.
I thank my hon. Friend and the shadow Minister for their comments about NHS managers. I agree that they often get a bad press, and often from politicians as well. We cannot run the health service without both clinically and non-clinically trained managers, so we need to ensure that they have the right support to do their difficult job. My experience is that when the partnership with clinicians works well, it is really powerful. I have certainly learned a lot from working with some fantastic clinicians in my career. We are absolutely committed to introducing a statutory barring system. We will do that by introducing secondary legislation within this Parliament to enable the Health and Care Professions Council to operate that barring system. We intend to do so as part of the planned secondary legislation to modernise the framework that governs the Health and Care Professions Council. Changes to this legislation are subject to a statutory three-month consultation period, in addition to which this legislation will be novel and complex. It will require extensive stakeholder engagement to ensure that we develop a barring system that is proportionate and operates efficiently alongside existing frameworks, codes of practice and other regulation governing the work of NHS senior leaders. For those reasons, a 12-month timeline to bring forward the section 60 order is unfeasible. The new clause also sets out prescriptive duties on the content of the section 60 order; we would not wish to pre-empt the outcome of detailed policy development and consultation. I welcome the support of the hon. Member for Sleaford and North Hykeham for the broad programme of initiatives to professionalise and increase the accountability of managers and leaders in the NHS. Although we do not agree that it would be proportionate to set a requirement in primary legislation to lay before Parliament a timetable to which those measures will be delivered, officials in the Department of Health and Social Care and in NHS England are already working in partnership with organisations across the health sector and will set out more on the individual timelines in due course. For those reasons, I ask the hon. Member to withdraw her new clause.
Hon. Members have brought to the Committee a really important discussion about women’s health. I am very happy to have that discussion, because the Government are committed to prioritising women’s health. That is why I am so proud that we published a renewed women’s health strategy earlier this year. I say in response to the Liberal Democrat spokeswoman, the hon. Member for North Shropshire, that we renewed the strategy partly because—to be absolutely fair to the Conservative party—we agreed with much of what it put in place under its women’s health strategy. We did not see the need to start it from scratch, so to speak. There had not been a men’s health strategy, so they are very different propositions. Much of the direction had been covered, but the implementation had not. On the point made by the hon. Member for Sleaford and North Hykeham, we wanted to go further and faster and acknowledge some things, as the former Secretary of State did, about medical misogyny, as well as the need to renew that strategy. I fully agree with new clause 57 that women should get equal access to high-quality elective care. We are committed to tackling the long waits for services primarily affecting women; I am acutely aware that women can wait disproportionately longer for a wide range of treatments, although none solely impacts women more than gynaecology services. The Government recognise that injustice. That is why we have implemented measures to improve gynaecology services and women’s access to care, including piloting gynaecology pathways in community diagnostic centres for patients with post-menopausal bleeding, increasing the relative funding available to incentivise providers to take on more gynaecology procedures, and using surgical hubs to help endometriosis patients to get quicker treatment. Those measures have helped to improve 18-week referral-to-treatment times for gynaecology by 5.1 percentage points over the past year. We will go further over the course of this Parliament, including by launching NHS Online clinical services from 2027. That will initially prioritise nine conditions, including women’s health conditions such as severe menopause symptoms and menstrual problems that may be a sign of endometriosis or fibroids. Patients will have the choice of getting the specialist care they need from home, and we will provide additional appointments to reduce waiting times. More broadly, we have committed to returning to the NHS constitutional standard by March 2029 so that 92% of patients wait no longer than 18 weeks from referral to consultant-led treatment across all patient groups and specialties. Delivering against this standard would also require the waiting times for a diagnostic test to improve significantly. We recognise that, which is why in the medium-term planning framework, the NHS target is to ensure that by March 2029 no more than 1% of patients are waiting more than six weeks for a diagnostic test. On new clause 58, we acknowledge that women’s health has been neglected and that women deserve better. We acknowledge that there have been longstanding failings in women’s health outcomes, experiences and access to care. That is why we published the renewed women’s health strategy, making it clear that women’s voices and choices are central in healthcare. We will transform NHS performance in the services that matter most to women, support all women to live healthy, prosperous lives, and create an approach to research and development that works for and empowers women. Reducing inequalities is hardwired throughout the strategy. Actions are targeted by deprivation, ethnicity and unmet need, with a focus on marginalised women, community-based services, neighbourhood health models, and transparent data. The renewed women’s health strategy marks a decisive shift from identifying problems to delivering change. By listening to women’s voices, improving performance where it matters most, and tackling the drivers of poor health and inequality, we will ensure that women and girls receive the care, respect and outcomes they deserve. As a result, we do not think that conducting an independent inquiry into women’s health provisions and outcomes in England at this time would add value. Instead, now is the time to deliver the change that we all know and agree is absolutely needed. I recognise the intention behind new clause 104, but I do not believe that it is necessary to publish an implementation plan. The action summary tables in the renewed women’s health strategy clearly highlight the responsible delivery organisation and the planned timeframe for all 117 actions. Some actions are already under way or funded for this year; others will be delivered over the next two to five years, and more fundamental reforms will be phased in over the next decade, aligned with the 10-year health plan. Progress in the renewed strategy will be judged against three overarching outcomes: reversing the decline in healthy life expectancy since the 2010s, raising healthy life expectancy in the poorest regions to at least 61 years, and reducing the time women spend in poor health, particularly where inequalities are greatest—something I see very starkly in my Bristol South constituency. We will also be transparent on progress through a new women’s health data dashboard, publishing neighbourhood-level data on performance, access, outcomes and experience. This Government have already undertaken extensive engagement to inform the development of the strategy. We had nearly 100,000 responses to the 2022 women’s health strategy call for evidence, more than 400 submissions from individuals and organisations with expertise in women’s health, and analysis from the Change NHS engagement exercise, where roundtables brought together women with lived experience, clinicians, academics and expert organisations. I was part of some of those roundtables and it was very instructive. I thank them for the work they did to get us to this point. We will continue to engage and to listen to women through the new women’s voices partnership and through patient-reported experience and outcome measures, which will help to shape and improve services. Creating a new statutory duty to publish an implementation plan risks diverting attention and resources away from delivering the actions in the renewed strategy, which should now be our priority. It is for those reasons that I ask hon. Members not to press their new clauses.
Usually, I say that I am grateful that a discussion has been brought before the Committee and that I am happy to have it, but it is unusual to have a discussion on a clinical trial in a political environment. I stand to be corrected, but I do not think that there has ever been a clinical trial subject to a parliamentary vote. There has been an Opposition day debate about this, in which many issues were rightly aired, so we will not spend much time discussing it this afternoon. The safety and wellbeing of children and young people is paramount. Children’s healthcare must always be led by evidence and expert scientific and clinical advice. We all know that that was not the case in some of the instances at the Tavistock over time, in the late 2010s. We pay tribute, as we have done several times, to the then right hon. Member for Bromsgrove when he was Secretary of State for Health—in 2022, he finally took action on that particular service and what went on there, commissioning Dr Hilary Cass’s review, which we supported on a cross-party basis, for the health, safety and wellbeing of children. Hilary Cass’s interim review in 2022—which bears reading, for those who have not read it recently—found the evidence for the service model and the clinical base to be woefully lacking. In the 2010s, that was allowed to continue for a long time, but fortunately started to be stopped in 2022. Ever since, we have had cross-party agreement in support of Dr Cass’s review. She found that the evidence on the use of puberty-supressing hormones for children and young people for treatment of gender incongruence is “remarkably weak”. Based on the available evidence, NHS England introduced a new clinical policy in March 2024 that means that puberty-suppressing hormones are no longer available routinely in the NHS for children and young people with gender incongruence. In December 2024, for non-NHS prescriptions, the Government introduced an indefinite ban on the sale and supply of puberty-suppressing hormones to children and young people for the purpose of gender dysphoria or incongruence. That followed independent advice from the Commission on Human Medicines. Clinical practice should be based on evidence. When evidence is lacking, clinical research takes place to improve the evidence base. That is why, to properly understand the impact of puberty-suppressing hormones to treat gender incongruence, the Cass review recommended a clinical trial. In line with the Cass review’s recommendation, a trial has been developed and has now secured updated study approvals from the MHRA and the Health Research Authority. This country has a well-deserved international reputation for academic and scientific excellence, with robust independent regulatory processes in place to properly scrutinise and assure the scientific rigour and ethics of publicly funded clinical trials. That helps to ensure that individuals receive evidence-based care, based on the highest quality research, regardless of their clinical diagnosis. I therefore disagree with the view of the hon. Member for Sleaford and North Hykeham that, uniquely, clinical trials for those types of medicines must be subject to the scrutiny and approval of both Houses.
I think that was yet another addition to the hon. Lady’s speech. Initially, she asked whether I recognised the cancel culture in this area. I have already alluded to, absolutely, recognising that what occurred in the 2010s at the Tavistock and around was not acceptable. Under the stewardship of the Conservative party of the NHS and so on, it took until 2022 to start rectifying that situation in order to give good treatment to children and young people. She is herself a clinician, so I am somewhat surprised at her. Noting what I set out, I am surprised that she does not recognise that a clinical trial has never—I stand to be corrected—been subject to a vote in Parliament, whereby politicians who are not experts have a say; but we can come back to that.