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1. 2 Jul 2026·Parliament·Conservative·Dr Caroline Johnson

   Health Bill (Tenth sitting)

   Clause 43 is particularly long: it runs to almost two pages of text. Essentially, clause 43 transfers the responsibility for funding ICBs, and deciding how they use the resources, from NHS England to the Secretary of State. In many cases, that is consistent with the Government’s plan to abolish NHS England, take decisions and responsibility in-house, and get some more control. One thing that does not make sense to me is that the Government are talking about devolving control and decision making, yet this clause gives the Secretary of State powers to control spending, direct how ICBs spend money in different areas, and penalise them if they do not do what they are told. The Minister has also talked in this Committee about a vision for the future in which ICBs are consistent with mayoral authority areas, and mayors sitting on ICBs to provide some sort of democratic accountability. But how can mayors be held democratically accountable if they are, or might be, overruled by the Secretary of State? How does the Minister see that working? Also, greater financial intervention powers for the Secretary of State, if used, could expose ICB budgets to short-term political pressure, such as funding for a specific health area that has received celebrity or media attention. How would the Minister guard against that? If the Secretary of State is able to contest financial decisions taken by ICBs, will that slow down decision making and make things more “sticky”? Essentially, the changes seem to go against the Government’s stated aim of a more devolved and autonomous operating model for the health service. I would be grateful for the Minister’s comments on that. Clause 44 is a little shorter. It essentially makes changes to the joint duties of ICBs and providers. Some of those changes are again necessitated by the abolition of NHS England; keeping some of the sections would result in overlapping systems, so those make more sense. But the duties requiring ICBs and their partner trusts to achieve overall system balance are repealed. That goes against the collaborative principle behind the creation of integrated care systems, and makes it more difficult to manage financial pressures across a geographical footprint. If, in a particular year, there is financial pressure in one area of an ICB but less so in another, it is not able to transfer things so easily between those areas. How does the Minister expect that to work? Clause 44 also allows the Secretary of State to set objectives for “one or more” partners. Is that discretionary or are there criteria for it? If it is discretionary, what would prevent the Secretary of State from selectively choosing which trusts are bound by joint objectives and which are not? How will that decision be made? How will trusts know whether it is likely to be made, or in what circumstances it could be made? This could undermine consistency of treatment across different ICBs and trusts. I will be interested in the Minister’s comments on those points.

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2. 2 Jul 2026·Parliament·Conservative·Dr Caroline Johnson

   Health Bill (Tenth sitting)

   My hon. Friend is talking about uncertainty. Essentially, those powers could not be used at all to direct or they could be used to micromanage. It is not clear what the intent is.

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3. 2 Jul 2026·Parliament·Conservative·Dr Caroline Johnson

   Health Bill (Tenth sitting)

   I note that proposed new section 223GA to the 2006 Act, inserted by clause 43, includes the duty to “publish any directions” but there is no timing for that. Does my hon. Friend agree that it is important to understand how soon after the direction is made we should expect the Minister to publish it?

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4. 2 Jul 2026·Parliament·Conservative·Dr Caroline Johnson

   Health Bill (Tenth sitting)

   Clause 45 makes technical changes to the licence conditions, allowing the Secretary of State to use those conditions as a tool to ensure compliance with legal requirements beyond those in the Health and Social Care Act 2012. That power is somewhat open-ended, which reduces certainty for providers, particularly independent ones, as they will not be able to easily anticipate what additional legal duties might be folded into the licence. The Minister said that there would be a consultation, but does she have any more details on how long the consultation process will be, or on how much notice of changes providers can expect? Like other clauses in the Bill, despite the Government’s discussion of devolution, the clause introduces another centralising power. Clause 46 is about the specifics of to whom legal documents can be served and through what mechanism. I understand the Minister’s argument on the need for modernisation, but everyone will have had emails that were bounced by spam filters or the like. How will she ensure that the emails are not just sent but received, so that there is a fair playing field for everyone?

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5. 2 Jul 2026·Parliament·Conservative·Dr Caroline Johnson

   Health Bill (Tenth sitting)

   I rise to talk about amendment 8. I essentially understand what the hon. Member for Winchester is trying to do—to make sure that carers are provided with the information that they need to provide the best possible care—and I think we would all agree with that ambition. However, I have a couple of questions for him. The Bill, as drafted, discusses “making” information “available to people other than a patient on the patient’s behalf”. I am not quite clear why would that not encompass a nominated carer. My hon. Friend the Member for Farnham and Bordon made an important point about privacy. The single patient record will encompass a patient’s entire medical history, medical notes and medical information, but every person who provides that patient with medical or social care does not need to see all of that, and in some cases, the patient may not want them to. My hon. Friend gave a good example of that; another example would be an elderly lady who does not want her carer to see that she had a termination at 23. There are lots of things that are private to people that they do not want others to see. I am interested in the Minister’s comments on this issue. Access to the record is seen as a binary choice, but in some respects, it needs to be a much more nuanced affair than that, while still allowing someone access to the areas of the record that are required for them to complete their duties.

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6. 2 Jul 2026·Parliament·Conservative·Dr Caroline Johnson

   Health Bill (Tenth sitting)

   I understand the hon. Member’s point, but we need to start with the patient at the centre and ask what is best for patient care. It is about what the patient wants to share with their carers. The patient may make an informed decision not to share information that is potentially useful, but if they have capacity, they are free to do that. It is about starting with the patient. I have huge sympathy with the principle of what the hon. Gentleman is trying to achieve, but I am not sure that that is not already included in proposed new section 250E(2)(c)(i) of the NHS Act 2006, which mentions “making” information “available to people other than a patient on the patient’s behalf”. The important thing is that patients make the decision if they have the capacity to do so, or that someone acting with power of attorney has done so on their behalf. Amendment 65, which is also in this group, talks about support needs. I have some sympathy with that as well. When I see a patient in clinic—I am a paediatrician, so they are all children—I look at the notes, which say they have a particular issue, and I go out into the waiting room and call the child’s name. There is nothing on the record, necessarily, to tell me that the patient and the mum are deaf, or that the other parent is deaf and may not be able to hear me calling them in the waiting room. So I have sympathy with the idea that the record would flag up reasonable adjustment needs; I think there is a place for that. There is something called the reasonable adjustment flag on the NHS Spine, and perhaps the answer is to use that rather better than is happening at the moment. With carers, as the hon. Member for Winchester said, or with parents or legal guardians looking after children, we should consider whether reasonable adjustments also need to be made for the parent, guardian or carer who is likely to bring the patient to be seen.

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7. 2 Jul 2026·Parliament·Conservative·Dr Caroline Johnson

   Health Bill (Tenth sitting)

   I understand what my hon. Friend is saying; he is making a very good speech. I wonder whether he agrees that one of the challenges for us as legislators, in looking at all the amendments on the single patient record, and indeed at the single patient record itself, is that while the principle of a single patient record might be a good, it is all about the devil in the detail and the delivery. We do not have a delivery plan or a vision of more of the detail relating to how it will look, so it is difficult to make judgments on many of the clauses.

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8. 2 Jul 2026·Parliament·Conservative·Dr Caroline Johnson

   Health Bill (Tenth sitting)

   Will the Minister confirm whether the intention of the Government is to separate parts of the record out so that people can give consent for part of the record to be shared, but not the complete record, where they have reasons to want extra privacy?

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9. 2 Jul 2026·Parliament·Conservative·Dr Caroline Johnson

   Health Bill (Eleventh sitting)

   I have a couple of questions about amendment 71 for the hon. Member for Winchester. First, can he comment on why the amendment refers to firearms, which have stricter licensing conditions than shotguns? Also, the GP should be aware, because all relevant medical information should filter back to them, that the person has a firearms licence, which, as I say, has stricter criteria. It is essentially harder to get a firearms licence than a shotgun licence. I am interested to hear the hon. Gentleman’s thoughts on that. On amendment 72, I have a large veteran population in my constituency, and I am very grateful to all those who have put their lives on the line to keep us safe, both today and in the past. I can see that there may be benefits to the amendment in respect of the delivery of the armed forces covenant and aspects of veterans’ care, but I am curious about how it is written. Proposed new subsection (3A) of proposed new section 250E of the National Health Service Act 2006 says that “regulations must make provision for prior membership…to be visible to all relevant healthcare workers under the establishment of a single patient record”, but proposed new subsection (3B) requires a report on the potential merits of doing that. It seems slightly counterintuitive to do it and then decide whether it is a good idea, rather than decide whether it is a good idea, consider the pros and cons, and then do it afterwards. I am interested to understand why the hon. Gentleman thinks the amendment is drafted in that way.

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10. 2 Jul 2026·Parliament·Conservative·Dr Caroline Johnson

    Health Bill (Eleventh sitting)

    Before my hon. Friend moves on, may I ask him about security? It might also be possible for someone who looked at the records to identify where guns are kept. That information is currently is more protected than that.

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11. 2 Jul 2026·Parliament·Conservative·Dr Caroline Johnson

    Health Bill (Eleventh sitting)

    Is it not also the case that anyone who is aware that an employee or relative has a licence and is concerned about their mental health can make such a report?

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12. 2 Jul 2026·Parliament·Conservative·Dr Caroline Johnson

    Health Bill (Eleventh sitting)

    Amendment 70, as the hon. Member for North Shropshire said, would require the Secretary of State to publish a risk assessment on the potential for digital exclusion in the single patient record. That is important because, as our lives become more electronic and online, there are people who are getting left behind. That could be because they have a disability that prevents or makes it more difficult for them to access online facilities, because they do not have the resources, because they live an area of the country that is less well served by digital or broadband provision, or because they are elderly and have decided that they will not get involved in the digital world. In fact, according to the Good Things Foundation, 7.9 million people in the UK lack basic digital skills and 1.6 million adults do not have a smartphone, tablet or laptop. Of those with no basic digital skills, 77% are over 65. People need more healthcare as they get older, yet those individuals have fewer digital skills, so this issue needs to be addressed. The NHS Alliance published a report on digital inclusion in March 2026, which found that rural and coastal areas typically have higher levels of digital exclusion than urban areas. Lincolnshire ICB, which covers the area that I represent, estimates that 21.3% of Lincolnshire’s population live in the most digitally deprived areas. The ICB has a digital inclusion strategy for 2025 to 2028, which includes efforts to try to reduce digital exclusion; I am interested in the Minister’s thoughts on how she might expand that sort of initiative across the country. The Government’s equality impact assessment for the single patient record recognises that digital exclusion is a significant challenge in several groups with particular protected characteristics and other characteristics. I am interested in learning more from the Minister about how she intends to mitigate that challenge. In many ways, digital availability is a good thing, and it makes things much easier for many people—I am not knocking it in any way—but we need to ensure that people do not get left behind. I understand that NHS England is supporting public libraries to signpost users to the NHS website and help them navigate it. What will happen to that support as NHS England gets abolished? Does the Minister intend the Department of Health and Social Care to provide something similar? Amendment 49, tabled in my name, is basically about public awareness. Although we get immersed in what we are doing here, the public are not necessarily following every word that is said in Committee or in this House—or even necessarily every word that appears in the press—so when the single patient record is launched, it is important that they are aware of it, and in particular, aware of their rights. We have talked about whether a person might want to let a carer see the single patient record or whether they might want to let someone see part but not all of the record. If the record goes live before people are aware of their rights and abilities in relation to it, they might find that things are available to people, or can be viewed by people, who they would not have wished to see them, which could lead to a number of problems. The amendment would allow people to be more aware of the single patient record for a period of time before it is brought in to try to make sure that that sort of problem is mitigated, and I am interested to understand the Minister’s view on it.

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13. 2 Jul 2026·Parliament·Conservative·Dr Caroline Johnson

    Health Bill (Eleventh sitting)

    I am advised to declare that, although I am not a licence holder of a shotgun or a rifle, my husband has both a shotgun and a firearms licence.

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14. 2 Jul 2026·Parliament·Conservative·Dr Caroline Johnson

    Health Bill (Eleventh sitting)

    I beg to move amendment 48, in clause 47, page 36, line 1, at end insert— “(4A) Regulations may not be laid under this section unless the Secretary of State has published a plan setting out the measures to be taken to prevent clinicians and other persons involved in the provision of health care or social care from accessing patient information made available through the system otherwise than for the purposes of the care of the patient concerned (an ‘inappropriate access prevention plan’). (4B) The inappropriate access prevention plan must include— (a) a description of the technical controls to be applied to restrict access to patient information to those with a legitimate care relationship with the patient; (b) the system of audit logging to be applied to record each instance of access to patient information, including the identity of the person accessing the information and the time and circumstances of access; (c) the sanctions applicable to persons who access patient information without lawful authority or without a legitimate care relationship with the patient; (d) the arrangements for detecting and investigating suspected cases of inappropriate access; and (e) the role of the Care Quality Commission, the Information Commissioner and any other regulatory body in enforcing compliance with access controls. (4C) The Secretary of State must lay the inappropriate access prevention plan before both Houses of Parliament.” This amendment prevents the Secretary of State from making regulations to establish the single patient record unless a plan to prevent inappropriate access by clinicians and other care workers has first been published and laid before Parliament. Amendment 48 would prevent the Secretary of State from “making regulations to establish the single patient record unless a plan to prevent inappropriate access by clinicians and other care workers has first been published and laid before Parliament.” This is about trust. It is about people being able to trust that the records that will now be more widely available will remain confidential and be looked at only by those who need to look at them. We have seen that people can be uniquely nosey when it comes to accessing medical records. For example, 48 staff members at the University Hospitals of Liverpool Group were found to have looked at the records of those involved in the Southport attack without any medical basis to do so. Almost a dozen staff members were sacked from the Nottingham University Hospitals trust because they had looked at the records of the victims in Nottingham. It is important that we address this, because it is happening already and needs to be tackled. Paul Arnold, the chief executive of the Information Commissioner’s Office, said that trust is being “jeopardised”. The amendment seeks to ensure that proper thought goes into making sure that people cannot access records they should not be able to look at—for example, those of the Prime Minister or members of the Royal family—before the single patient record is live and can be used. We have Public Department 1 for HMRC; is there an intention to have something similar to close off records to reduce their accessibility where the public may be particularly nosey, either because of the person’s job or because of an event such as a terrorist attack, where we have seen people look at records when they should not have? There were reports that staff at The London Clinic, a private clinic, had been trying to sell records of the Princess of Wales online, so there are examples where this has happened before. In addition, it is important that people know what the penalties are for deliberately misusing these records. My final question for the Minister is this. If a record has been viewed and there is a data log of it having been viewed, how long will that data log last for? Will it last for six months or a year, or will I be able to look back in 10 years’ time and see who accessed my records today? It is a case of understanding the Minister’s intentions and pushing the Government to ensure that these records are truly private to those who need to see them, not accessible to anyone who just happens to be curious.

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15. 2 Jul 2026·Parliament·Conservative·Dr Caroline Johnson

    Health Bill (Eleventh sitting)

    I understand what the hon. Gentleman is saying, which is that there are processes in place already and that the fact that someone got sacked for looking at the records is a sign that the systems work to an extent. However, does the fact that they could look at them at all suggest that the systems are not working well enough? Because it is a computerised system, there are methods for identifying whether someone is likely to need to look at that record. By knowing the profession of the person looking at it, and the department they are in, the computer can help to limit the number of people who look at those records when they should not.

    Hansard source
16. 2 Jul 2026·Parliament·Conservative·Dr Caroline Johnson

    Health Bill (Eleventh sitting)

    If we use the example of Southport, the people who could access those records worked in the Liverpool trust, because that is where the records were stored. With the single patient record, as planned, people would be able to access those records from across the country, if they had a clinical reason to do so. However, someone behaving badly could also potentially do so, even if they did not have a reason.

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17. 2 Jul 2026·Parliament·Conservative·Dr Caroline Johnson

    Health Bill (Eleventh sitting)

    My hon. Friend is making a very important point. Does he also think that it is possible for the system to have some designs built into it that identify that someone from another area of the country, or from another department or different profession is unexpectedly looking at results? Perhaps AI could help with this.

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18. 2 Jul 2026·Parliament·Conservative·Dr Caroline Johnson

    Health Bill (Eleventh sitting)

    We think this is an important issue, so we would like to divide the Committee. Question put, That the amendment be made.

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19. 2 Jul 2026·Parliament·Conservative·Dr Caroline Johnson

    Health Bill (Eleventh sitting)

    Clause 47 amends the existing legislation to facilitate the single patient record. We have heard about the many benefits that it may bring, for example for patients who find themselves telling the same story again and again and having to repeat themselves because caregivers cannot see the records that they need to see. That can be frustrating and sometimes very distressing for patients. I caution the Minister against saying that the single patient record will completely fix that issue, because from a clinical perspective, particularly in certain presentations, hearing the story again from the individual can be helpful for a diagnosis, but the principle is a good one, and it will make things easier for clinicians, particularly if the patient is in an area away from home. Records may be kept in a particular geographical location or hospital, and if someone is away on holiday and they come in, we may not have access to their records. In paediatrics, we often give the parents of children with complex problems letters to carry that have the necessary information in them. That would not be necessary if the record were more accessible, so there are benefits to the single patient record. There are, however, a lot of questions about it. One problem is that the single patient record has not really been designed yet, so we are being asked to approve something that is a hazy vision in the distance. On 1 June, the Minister said that “although the Bill establishes the legal framework for the SPR, much of the detail will be in secondary legislation.”—[Official Report, 1 June 2026; Vol. 786, c. 957.] I appreciate that it will be subject to the affirmative procedure, but we are being asked to make a decision now on something that is unfortunately very woolly. Will the Minister reassure us that she will address the following questions in the secondary legislation? Who will have permission to edit the information in the single patient record? When will they have access to it? Will it tell us who has edited it—will there be a record of who, when and where? If the record is not accurate when it is edited, how will that be addressed? How will people know that it is inaccurate, and how will it be improved? In 2025, Healthwatch reported that 23% of adults who had seen their medical records reported inaccuracies or missing details, 12% said they had been refused treatment because of inaccurate information, and 10% said they had received inappropriate medication as a result. This is important. In recent years, there have been several incidents of patients dying after doctors used incorrect medical histories and prescribed medication that they should not have. This information needs to be available, but also accurate. I am interested in what the Minister has to say about that. The other question is: what is going to happen to the records people have now? I am 48. I am sure the Minister is much younger than that, but we have records: our vaccination records, our childhood records, and records of any admissions or treatment we have had. Will those be added to the single patient record, or will the SPR start from day zero and go forwards? If it does, how will people access their historical records? If it goes backwards, what provision has been made to ensure that the data that is input is accurate, and for the cost and personnel required to do it? Is the intention that the SPR will be one-size-fits-all? The Secretary of State talked about people not being asked to have a one-size-fits-all but being able to access the various systems around the country, but there are so many different systems. In my own practice, if I want to look at the notes of somebody I am caring for, I go to Evolve, where the notes are scanned in and I can look at the pages one at a time. If I want to look at blood results, I go to ICE, which is a different system where I can see the test results. If I want to look at the films of an X-ray, they are on a different computer system again. If I want to follow the patient’s pathway through the hospital, see when their next appointment is with me or see who is next in my clinic, I go on to e-Track. There is a different system for maternity, and there is Symphony in A&E. Each hospital trust has a lot of different computer systems and information, and they do not all use the same systems, as I know having rotated through a number of hospitals during my training. How will the single patient record work with that? Will people be able to access all those different systems, and will they need to be trained to use them, or will there be a homogeneous system—and if so, what does the Minister envisage that looking like? The Government say the single patient record will be more efficient, reduce the number of A&E attendances and hospital admissions, and make £20 million in annual savings to the NHS. Those are quite small margins compared with the scale of the project. Is the Minister satisfied that the savings will not be obliterated by the cost of the project running away? The other thing is the public view of this. Polling published in January 2025 by the Tony Blair Institute found that 69% of people are willing for their anonymised data to be used to help plan NHS delivery, 71% are willing for it to be used for research into drugs and new treatments, and 75% are willing for it to be used for speeding up and making better diagnoses. There is an amendment—amendment 11—that make data available only for patient care, but patient audit and research can be quite important. Does the Minister have any comments on how audits and patient research might be used in a clinical context to improve care using anonymised or non-anonymised data? Proposed new section 250E(3) of the National Health Service Act 2006 says: “The regulations may provide that the processing of information in accordance with the regulations does not breach any obligation of confidence owed by the person processing the information.” As one of my hon. Friends said earlier this afternoon, if the Government put a clause into a Bill, they normally have a reason for wanting to use it. Can the Minister expand on the circumstances in which they might want, in essence, to bypass patient confidentiality in pursuit of that provision? In addition, the regulations may make information “available to people involved in the provision to patients of health care or social care anywhere in the British Islands,” which means it will not all be provided in England, and it will not necessarily all be provided within the United Kingdom. Will there be reciprocal arrangements with the self-governing territories? If not, how will the Government ensure that the data is properly protected once it has been shared? I also want to mention cyber-security. On 30 June—just earlier this week—it was reported that the UK healthcare sector experienced a tenfold increase in attacks during January to May 2026 compared with the whole of 2025, recording 264,000 individual events compared with just 27,000 in 2025. In June 2026, Bedfordshire hospitals NHS foundation trust revealed that data relating to 33,000 hospital patients was stolen and shared online two years ago. Mid and South Essex NHS foundation trust reported the theft of 2,380 records in the same attack. The Secretary of State said earlier in June that “the situation with the single patient record is…different from that of the federated data platform, because it is likely that we will let a series of contracts to de-risk the delivery of the single patient record.”—[Official Report, 1 June 2026; Vol. 786, c. 891.] That suggests that the Government are aware of the problem but have not yet nailed down the detail of how to contract the delivery of the single patient record or worked out how they are going to keep data safe once they have. How can patients have confidence when their health data—their most personal data—is on the line and the Government have not yet made the key decisions for protecting it? Does the Minister have any comments on that? What will happen to private providers? The Government are increasingly using private healthcare providers to try to improve the waiting lists, but will they have access to the single patient record? If they will, will they have to contribute to it financially or get it for free? How will the data be protected if it is not in NHS hands and not necessarily under the same regulation? What plans do the Government have to monetise the data? In December 2025, the then Under-Secretary of State for Health, Innovation and Safety, the hon. Member for Glasgow South West (Dr Ahmed), was reported in the Financial Times as having said that the UK should make money from patient data for the “benefit of the Treasury coffers”. Can the Minister expand on her Department’s plans to monetise patient data? Can she guarantee that personal data will not be exposed or leaked? Can the Minister give assurances that the tendering process for contracts to set up and run the single patient record will be fair and transparent? It has been said that companies that donated to Labour before the general election were awarded contracts worth almost £138 million during this Government’s first year. It has also been reported that Peter Mandelson had links to Palantir, which secured a £240 million deal with the Ministry of Defence. It is important that people have confidence in the contracts. Does the first person to get a contract get locked in? Once the system is set up with one provider, will it be prohibitively difficult to change provider? Will the contracts become more and more expensive as time goes on because of the difficulties in redesigning a system? Who will own the intellectual property of the system that is designed? Will it be the Government or the private company? If it is the private company, how will that work going forwards? The other question is: can we trust this Labour Government to deliver this? In 2005, the previous Labour Government launched a digitisation project called the NHS national programme for IT. In 2007, the Public Accounts Committee found that the Government had not sought to keep a detailed record of expenditure and there was no evidence that officials had carried out an examination to see whether the benefits exceeded the cost. The Father of the House, my right hon. Friend the Member for Gainsborough (Sir Edward Leigh), described the project as “one of the biggest IT disasters of all time”. Costs ballooned to more than £9 billion, leading a member of the PAC to say in 2013 that it was one of the “worst and most expensive contracting fiascos” in the history of the public sector. How will the Minister convince the House and the public that the contract is being provided fairly, that it will be useful, that it will deliver what it said it would at the prices it said it would, that the data will be held securely once it is delivered, and that provisions will be in place to record access, decide who gets access and limit access? Who gets access to sexual health records is particularly important. At the moment, sexual health records are kept separate. If someone attends a sexual health clinic specifically for sexual health screening, those records do not appear in their general medical record, in order not to disincentivise people from attending those sorts of appointments. If everything will be in one single patient care record, will sexual health records appear within that record? That is an important issue; indeed, it was raised during the Committee’s evidence sessions, when it seemed that the Government had not yet made a decision.

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20. 2 Jul 2026·Parliament·Conservative·Dr Caroline Johnson

    Health Bill (Eleventh sitting)

    I am interested in what the hon. Gentleman is saying. Does he agree that, in many ways, the NHS dataset will be one of the most valuable datasets in the world, not only to patients themselves—in terms of the value to them and their privacy—but in the ability to analyse it and perhaps understand parts of medicine that we do not understand at the moment and so improve patient care?

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21. 2 Jul 2026·Parliament·Conservative·Dr Caroline Johnson

    Health Bill (Eleventh sitting)

    My point was that this can sometimes be beneficial. If a clinician sees a young lady who has collapsed at school, she might have fainted or had a fit. There are a lot of different potential causes, such as cardiac syncope, and lots of different potential diagnoses. A lot of the detail in making the diagnosis is in the history. The patient will probably already have been asked their story when they arrived at A&E, but it is still important for a senior clinician to ask for it again. My caution was against presuming that we can, in all cases, prevent repeated asking of questions. There would clearly be a benefit when there are particularly sensitive pieces of information, about which we need not ask two, three or four times, but we cannot stop all cases in which a patient is asked for the same story.

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22. 2 Jul 2026·Parliament·Conservative·Dr Caroline Johnson

    Health Bill (Eleventh sitting)

    There is no detail in the Bill. As my hon. Friend the Member for Isle of Wight East said, there is nothing in the legislation requiring the computers in his local area to talk to the computers in my local area.

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23. 2 Jul 2026·Parliament·Conservative·Dr Caroline Johnson

    Health Bill (Eleventh sitting)

    In the event that someone from Scotland comes into the hon. Gentleman’s hospital near Dover and a doctor wants to look at their healthcare record, does the hon. Gentleman envisage that the doctor will log on to their local system and see the records from Scotland, or that they will have access to the Scottish system to look at the records directly there?

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24. 2 Jul 2026·Parliament·Conservative·Dr Caroline Johnson

    Health Bill (Eleventh sitting)

    If it is to include both, who will translate it into the simplest form and how much will that cost?

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25. 2 Jul 2026·Parliament·Conservative·Dr Caroline Johnson

    Health Bill (Eleventh sitting)

    The clause says that information could be made available “to people involved in the provision to patients of health care or social care anywhere in the British Islands”. That implies that the English system will be used to share information with people outside England—in the Isle of Man, the Channel Islands, Scotland, Wales or Northern Ireland—but it does not imply that those areas will necessarily have the same systems to share information with us.

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26. 2 Jul 2026·Parliament·Conservative·Dr Caroline Johnson

    Health Bill (Eleventh sitting)

    I have a couple of questions. In lots of ways the provisions derive from clause 1 and the abolition of NHS England. Schedule 7 refers to operating a system in the interests of the health service, which is not the same as operating it in the interests of the patients. Does the Minister have any comments on that? The Nuffield Trust has pointed out that schedule 7 would not pass over to the Secretary of State NHSE’s duty to report to Parliament. Is that because the Minister thinks that duty is duplicated elsewhere and is therefore not necessary? Under the previous legislation, the Care Quality Commission was slightly stronger and could make a mandatory request that NHS England establish a system, and NHS England had to comply with that unless it related to an existing exception. Now if the CQC makes a request, it goes to the Secretary of State, and whether it is agreed to is then somewhat more optional. Will the Minister say why she needs to change that power?

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27. 2 Jul 2026·Parliament·Conservative·Douglas Lumsden

    Topical Questions

    In Aberdeen South, there is a jobs emergency, with 1,000 jobs a month being lost from the oil and gas sector. So will the Government ditch their damaging policies that are destroying the oil and gas industry and destroying jobs in Aberdeen South?

    Hansard source
28. 2 Jul 2026·Parliament·Conservative·Douglas Lumsden

    Business of the House

    EnQuest has just announced that jobs will be lost at the Sullom Voe oil terminal, in the latest blow to the oil and gas sector. Will the Leader of the House allocate Government time for a full debate on the future of the oil and gas sector before it is too late?

    Hansard source
29. 2 Jul 2026·Parliament·Conservative·Douglas Lumsden

    Historical Forced Adoption

    I thank the Prime Minister for his statement today. I was a Member of the Scottish Parliament when it issued its own apology, and I know how important that was to those families. How will the Government work with devolved Governments to provide ongoing support, access to records and potential redress schemes to those affected?

    Hansard source
30. 2 Jul 2026·Parliament·Conservative·Dame Harriett Baldwin

    Topical Questions

    There is a bit of an end-of-term feel in the House at the moment. I heard the Secretary of State set out his answer to his essay question, but I point out that UK business confidence is at a four-year low, unemployment is up, millionaires are fleeing, and the Department’s own figures show inward investment falling by 26% this year to the lowest level in over a decade. I would say that is a failing mark. What does the Secretary of State plan to do differently when the new headteacher arrives?

    Hansard source
31. 2 Jul 2026·Parliament·Conservative·Dame Harriett Baldwin

    Topical Questions

    I do not know about you, Mr Speaker, but I did not hear a plan for improvement in that answer. I am afraid the mark is “must do better”. Let us turn to another bit of the Secretary of State’s coursework in this failing end-of-term report. Will he agree today to compensate all the Horizon victims, and to get Fujitsu to pay towards it, by the end of the year?

    Hansard source
32. 2 Jul 2026·Parliament·Conservative·Caroline Nokes

    Commonhold and Leasehold Reform: Managing Agents

    Order. There is a very strict time limit.

    Hansard source
33. 2 Jul 2026·Parliament·Conservative·Caroline Nokes

    Commonhold and Leasehold Reform: Managing Agents

    Order.

    Hansard source
34. 2 Jul 2026·Parliament·Conservative·Caroline Nokes

    Commonhold and Leasehold Reform: Managing Agents

    Order. Because of a fire evacuation of the Palace, the Serjeant on duty is requesting a suspension of the sitting. I have been advised by the Serjeant at Arms that the Chamber and Gallery should be evacuated, using the nearest available exits. Please proceed in an orderly manner and follow the directions of Doorkeepers or security staff.

    Hansard source
35. 2 Jul 2026·Parliament·Conservative·Caroline Nokes

    Commonhold and Leasehold Reform: Managing Agents

    Before I call Jonathan Brash to conclude his speech, the remaining Members will have a time limit of three minutes. I call Jonathan Brash.

    Hansard source
36. 2 Jul 2026·Parliament·Conservative·Caroline Nokes

    Commonhold and Leasehold Reform: Managing Agents

    Order. The hon. Gentleman might heed the fact that Members are on a very tight time limit, and he has not been present for any of the debate until this point.

    Hansard source
37. 2 Jul 2026·Parliament·Conservative·Caroline Nokes

    Commonhold and Leasehold Reform: Managing Agents

    That brings us to the Front Benchers. I call the Liberal Democrat spokesperson.

    Hansard source
38. 2 Jul 2026·Parliament·Conservative·Bradley Thomas

    Business of the House

    The House will be delighted to learn that 17-year-old Leo, whom I have mentioned previously in the Chamber, is now cancer-free after being matched with a stem cell donor. This is excellent news. In addition, Leo is up for an award—the BBC Make a Difference young hero of the year. Will the whole House join me in wishing Leo the best of luck, and perhaps the Leader of the House will root for Leo to go on to win?

    Hansard source
39. 2 Jul 2026·Parliament·Conservative·Bradley Thomas

    Historical Forced Adoption

    This is long overdue, and so I congratulate the Prime Minister on bringing this forward and for the tone in which he has delivered it. I would like to raise the case of Jenny and Scott, two constituents who I have been supporting in recent months. They have been fostering a child called Alfie for six years. They have provided a loving and nurturing home to Alfie, but have persistently come up against blocks from the state as they seek to adopt him. With Walsall council in particular, they found it very difficult to gain support so that they could make progress on adopting Alfie and, regretfully, they have now had to instruct the local authority to look at a new fostering placement for him. Does the Prime Minister agree that while a pragmatic balance has to be struck between safeguarding and enabling a loving home to be found, the state must remove any bureaucratic obstructions along the way? Will the Prime Minister support me in trying to secure a meeting with the relevant Minister, so that Jenny and Scott can elaborate on this more comprehensively?

    Hansard source
40. 2 Jul 2026·Parliament·Conservative·Bradley Thomas

    Access to Further Education

    I congratulate the hon. Member for Runcorn and Helsby (Sarah Pochin) on securing this debate. Whatever our political differences, I welcome the opportunity to discuss an issue that should unite Members across this House: ensuring that every young person, wherever they live, has the opportunity to develop the skills they need to succeed. After the previous Labour Government badly neglected apprenticeships, the Conservative party prioritised them, delivering around 5.8 million apprenticeships between 2010 and 2024 and creating apprenticeship routes into 70% of occupations. The Conservatives are clear that further education is a great driver of social mobility. That is why I am proud that the previous Conservative Government introduced T-levels, degree-level apprenticeships and the apprenticeship levy, and put English and maths at the heart of all vocational qualifications, helping people to climb up the ladder of opportunity and fortify their careers with the in-demand skills that businesses need. Access to apprenticeships is not simply about education policy; it is about opportunity, social mobility and ensuring that the next generation can harness their unique talents to build rewarding careers, support their families and contribute to the prosperity of our country. Apprenticeships should enjoy parity of esteem with academic routes. University is the right choice for many, but it is not the only route to success. We know that higher-level apprenticeships are now out-earning the average degree, according to the Centre for Social Justice. The right qualification at the right time can alter the trajectory of an entire family for generations, but we must also be honest that warm words alone will not create a single apprenticeship place, and with level 2 apprenticeship starts hitting their lowest level in four years last year, the time for action is now. Ministers wax lyrical about growth, skills and opportunity, yet employers continue to raise concerns about complexity, uncertainty and a system that is still failing too many young people. Young people cannot build careers on announcements alone. This week, the right hon. Member for Makerfield (Andy Burnham) spoke passionately about placing technical education at the heart of economic renewal. That aspiration is welcome, but aspiration without delivery does little for young people looking for an apprenticeship today or for the small business struggling to recruit for today and tomorrow. His Majesty’s most loyal Opposition has put forward a clear alternative through our new deal for young people, which places apprenticeships and technical education at the heart of economic opportunity. It would expand high-quality apprenticeships, remove barriers that prevent employers from taking on young people and ensure that skills funding follows the needs of local economies rather than the priorities of Whitehall. We believe that employers should find it easier, not harder, to invest in the next generation. We believe that colleges should have the flexibility to respond to local labour market demand. Above all, we believe that every young person deserves a pathway into skilled employment, whether through university, an apprenticeship or another technical route. If the Government genuinely believe that apprenticeships are central to growth, they—and the party of the hon. Member for Runcorn and Helsby, which needs to see what properly considered policy looks like—should accept our fully funded new deal for young people. It would: scrap real interest rates on plan 2 student loans so that balances can no longer rise faster than inflation, saving graduates tens of thousands of pounds over the course of their careers; create 100,000 more apprenticeships for 18 to 21-year-olds by lifting funding caps and supporting employers with up to £5,000 for every British apprentice they hire; and introduce a £5,000 first job bonus allowing young people to keep the first £5,000 of national insurance they would have paid by placing it into a savings account for a first home or future security. The proposal for an apprenticeship hub in the hon. Member’s constituency deserves to be examined on its merits. If it can demonstrate value for money, genuine local demand and strong employer engagement, I hope that Ministers will engage constructively. But the debate, as we have heard in contributions from across the House, is about more than one constituency; it is about whether a young person leaving school believes that hard work and determination will be rewarded, whether employers have confidence that Britain is developing the skilled workforce that it needs and whether the Government will match their words with action.

    Hansard source