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1. 30 Jun 2026·Parliament·Labour·Karin Smyth

   Health Bill (Eighth sitting)

   I thank hon. Members for their comments. I accept those made by the hon. Members for Winchester and for North Shropshire. I offer the Liberal Democrats the assurance that the Government fully appreciate the important role that primary care plays in informing ICB decisions, which is why we have retained the requirement that ICBs engage with their system partners, including primary care services, in the exercise of their planning and commissioning activities. It is universally recognised that full engagement with providers, including primary care, is fundamental to good commissioning, and this is reflected in the strategic commissioning framework. The neighbourhood health framework sets out how neighbourhood health plans should be developed through health and wellbeing boards and with the involvement of system partners. We expect primary care to be fully involved in the process. In addition, ICBs will continue to engage local representative primary care committees, such as the local medical committees. ICBs must comply with their duty to obtain appropriate advice from persons who have broad professional expertise in prevention, diagnosis or treatment of illness and the protection or improvement of public health. Primary care practitioners will remain key sources of such advice. Although I agree that experience of general practice is fundamental—as a commissioner, I worked very closely with general practitioners, who deal with 90% of patient contacts—I do not believe that placing an additional requirement on ICBs to engage specifically with primary care providers is necessary. I will take this opportunity to clarify matters. We are moving between the roles of ICBs and local authority health and wellbeing boards. I know this is a subject of great interest and will continue to be debated in relation to those bodies’ commissioning and providing functions. The planning structure will be improved under clause 24, reflecting our commitment to neighbourhood health and making it a reality. Planning begins with a joint strategic needs assessment developed by health and wellbeing boards; that assessment informs the new neighbourhood health plan, replacing the joint local health and wellbeing strategy. Meanwhile, ICBs will produce population health improvement plans, aligning multiple joint strategic needs assessments, neighbourhood health plans and local priorities. Patient and local voices must, of course, be embedded in ICB decision making and in the planning process. ICBs are being supported to do that. The strategic commissioning framework published on 4 November 2025 clearly set out that user involvement is key to strategic commissioning. Having proper plans that address the needs of neighbourhoods will help the NHS to deliver for every community in our country. That is where the patient focus is and where people experience healthcare the most, and it is why we have made these commitments in neighbourhood health plans. I commend clause 24 to the Committee as the means to make that a reality. Question put and agreed to. Clause 24 accordingly ordered to stand part of the Bill. Clause 25 NHS trust accounts Question proposed, That the clause stand part of the Bill.

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2. 30 Jun 2026·Parliament·Labour·Karin Smyth

   Health Bill (Eighth sitting)

   Clause 25 makes focused but important changes to the accounting and audit arrangements for NHS trusts by amending schedule 4 to the National Health Service Act 2006. It does not put additional burdens on NHS trusts; instead, the aim of the clause is to align the requirements for trusts with the updated accounting arrangements for foundation trusts made elsewhere in the Bill. The changes are needed as a consequence of the abolition of NHS England and the removal of the requirement for foundation trusts to have councils of governors and members. The amendments the clause makes replicate trusts’ existing duties to keep proper accounts and records about those accounts, and to prepare annual accounts for each financial year. The clause also replicates the Secretary of State’s current power to direct an NHS trust regarding the form of its annual accounts, but extends that power of direction so the Secretary of State may also direct a trust to prepare accounts for a specified period—for example, when part-period accounts are needed. That will help to ensure a consistent approach to financial reporting while retaining the flexibility to keep requirements up to date. The clause also sets out and strengthens how the audit arrangements for NHS trusts should operate, mirroring the approach for foundation trusts and integrated care boards. It provides that NHS trust annual accounts are audited under the Local Audit and Accountability Act 2014, as is the case currently, but it also provides that part-period accounts may be audited in accordance with that Act where the Secretary of State so directs. The clause also enables the Comptroller and Auditor General to examine the accounts and related auditor reports, as is currently the case. To reflect the fact that the Secretary of State will have oversight of providers once NHS England is abolished, it requires the accounts and audit reports to be sent to the Secretary of State. Taken together, these measures support transparency, consistency and robust financial assurance. They will help to reduce unnecessary divergence in accounting requirements across different types of NHS provider, while maintaining clear oversight of public funds. That is consistent with the Bill’s broader intent to support effective governance and clear accountability for providers. Clause 26 makes minor technical amendments to ensure that the statute book remains clear and coherent as the Bill aligns the approach to audit and accounts across NHS trusts and foundation trusts. It sits alongside the provisions in the Bill that update the arrangements for the audit of foundation trusts following the abolition of NHS England and the removal of the requirement for NHS foundation trusts to have councils of governors and members. The clause does that by amending or removing outdated transitory provisions relating to the audit of NHS trust accounts in two places: the NHS Act 2006 and the Local Audit and Accountability Act 2014. Clause 26 therefore supports the effective implementation of the wider measures in this part of the Bill by ensuring that the legislation is up to date, accurate and internally consistent. I commend clauses 25 and 26 to the Committee.

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3. 30 Jun 2026·Parliament·Labour·Karin Smyth

   Health Bill (Eighth sitting)

   If there are specific examples that are helpful, I will write to the hon. Lady—I am not entirely sure I got the point about charities, but we will pick that up in Hansard. As I outlined in my opening remarks, these clauses are about standardising the key requirements across the NHS provider landscape in relation to annual and other accounts and records in relation to those, and audit and reporting requirements, including keeping those up to date and having a consistent approach across all NHS provider types. Of course, we worked closely with NHS England colleagues and directors of finance in seeking to bring forward those provisions. Question put and agreed to. Clause 25 accordingly ordered to stand part of the Bill. Clause 26 ordered to stand part of the Bill. Clause 27 Special Health Authorities: establishment and exercise of functions

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4. 30 Jun 2026·Parliament·Labour·Karin Smyth

   Health Bill (Eighth sitting)

   Clauses 27 and 28 make amendments to the legal framework around special health authorities to give the Secretary of State the flexibility to best manage the reliable delivery of healthcare for patients and the public. As the Committee knows, special health authorities are independent bodies established by the Secretary of State, by order, to perform specific functions. They play a key national role in the health system, carrying out specific functions on behalf of the Secretary of State. Clause 27 does two key things to the special health authority legal framework. First, it amends section 28 of the NHS Act 2006 to increase the scope of functions that a special health authority could be established to deliver. Currently, the Secretary of State can create a special health authority only for the purpose of exercising functions under the 2006 Act. The clause allows a special health authority to be established to exercise functions under any other Act as well. Secondly, the clause amends section 29 of the 2006 Act, which currently enables regulations to provide for the functions of a special health authority to be carried out flexibly, by another special health authority or jointly with one or more other special health authorities. That applies only to functions that the Secretary of State has directed the special health authority to exercise under section 7 of the 2006 Act. The clause removes that limitation, so that those arrangements can be made for any functions of the special health authority, not just those that it is directed to carry out under section 7. These changes are needed because the health and care system is underpinned by a range of statutory functions that do not sit exclusively within the 2006 Act. The Secretary of State needs to be able to establish special health authorities to carry out those wider functions, and to give those functions to existing special health authorities. The clause ensures that the Secretary of State has the modern, adaptable tools required to place specialist functions in the right national body, with the appropriate governance and accountability. Equally, special health authorities need to be able to work with other special health authorities across all their functions in a way that best serves the needs of the wider health and care system. On occasion, it is necessary for Ministers to merge, alter or abolish special health authorities, either because of changing circumstances or to ensure the smooth and effective running of the system. Clause 28 provides the flexibility to transfer and redeploy staff. It allows regulations to be made to enable staff to be transferred to an integrated care board or another special health authority. These changes ensure that staff can be transferred where they may be needed most, allowing for flexibility to direct resources in the health system. The clause also allows for arrangements to be made for a special health authority’s staff to be made available to another special health authority, a local authority, the Secretary of State or an integrated care board. That may be necessary during an emergency or to provide specialist support to help an organisation achieve a particular outcome. The clause also allows the Secretary of State to give directions to a special health authority to make staff available to another special health authority or integrated care board or the Secretary of State. Clause 28 also amends the existing power to make regulations about the sharing of information with other bodies, to allow information to be shared with integrated care boards in addition to the Secretary of State and other special health authorities. That allows for information to be shared across the system so that national and local functions can be successfully fulfilled and supports a more joined-up health system. Clauses 27 and 28 provide for future-facing updates that will support effective administration and ensure the more reliable delivery of healthcare for patients and the public. I commend them to the Committee.

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5. 30 Jun 2026·Parliament·Labour·Karin Smyth

   Health Bill (Eighth sitting)

   To be clear, in response to the comments of the Opposition spokesperson, the hon. Member for Sleaford and North Hykeham, it is not currently our intention to set up any new special authorities to deliver any specific functions. We are taking this opportunity to update the legislative framework and ensure that in future the functions that a special health authority could carry out are less limited. The current legislative framework limits the remit of such authorities to their functions under the NHS Act 2006, which is outdated and does not reflect changes since that time. There are functions of the Secretary of State under the Health and Social Care Act 2012 that we may want special authorities to carry out in future. I agree with the Opposition spokesperson that the situation is complex. We have had a lot of changes over many years, as both she and the hon. Member for Farnham and Bordon said. I agree that we need flexibility for future provision, and that is what the clauses provide. We have no immediate intention to delegate specific functions of the Secretary of State. However, following the abolition of NHS England, a range of functions may need to be established, as the hon. Member for Farnham and Bordon outlined. Those functions could, as an example, include the data and information functions in part 9 of the Health and Social Care Act 2012, which currently sit with the Secretary of State. I assure the Committee that the clauses do not change the existing processes or scrutiny that exist around setting up a special health authority. They are, as I think the Opposition spokesperson said, about future-proofing. I commend the clauses to the Committee. Question put and agreed to. Clause 27 accordingly ordered to stand part of the Bill. Clause 28 ordered to stand part of the Bill. Clause 29 Constitution of NHS foundation trusts

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6. 30 Jun 2026·Parliament·Labour·Karin Smyth

   Health Bill (Eighth sitting)

   Amendment 19 reinstates in primary legislation the requirement in schedule 7 to the National Health Service Act 2006 for an NHS foundation trust board to include one executive director who is a medical or dental practitioner, and another who is a registered nurse or midwife. I want to be clear to the Committee from the outset that there was never any intention to change the policy on the clinical membership of NHS foundation trust boards. Foundation trusts would still have been expected to have appropriate clinical leadership on their boards, but we had heard from ambulance foundation trusts that the current framing of the requirement for clinicians is not always helpful, and greater flexibility was therefore required. However, we also heard from important stakeholders, including the Royal College of Nursing, that removing the requirement from primary legislation has been perceived as deprioritising clinicians, which is absolutely not the case. We have therefore tabled amendment 19 to remove any doubt. These roles provide valuable clinical oversight of board governance in decision making in foundation trusts, and are essential to ensuring the safety and quality of patient-facing services in the NHS. At the same time, some providers may need different clinical expertise at board level. For example, in ambulance trusts, an experienced paramedic may be better placed to provide the relevant clinical guidance and oversight. The amendment therefore gives the Secretary of State a regulation-making power to create exceptions to the requirement following engagement with relevant stakeholders. That preserves the current position in primary legislation while allowing for targeted flexibility for ambulance or patient transport-focused foundation trusts where appropriate. I commend amendment 19 to the Committee. Clause 29 introduces schedule 3, which makes changes to the governance and constitution of NHS foundation trusts. It removes the various statutory roles of foundation trust members and councils of governors, and repeals the requirement for FTs to have them. Amendment 73 to 75 look to oppose that, but I do not think that we are discussing those.

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7. 30 Jun 2026·Parliament·Labour·Karin Smyth

   Health Bill (Eighth sitting)

   Thank you for the clarification, Sir Jeremy. I will come to amendment 75 at the end of the debate. The Bill’s removal of councils of governors from NHS foundation trusts is part of delivering the 10-year health plan goal of hospitals putting patient experiences and outcomes at the heart of their decision making. That is not because we want to rid the system of local voices in democratic accountability—far from it. Although governors have provided helpful advice and oversight for some foundation trusts, we expect the next generation of NHS foundation trusts to put in place more responsive and flexible arrangements for drawing on patient, staff and stakeholder insight. Rather than a one-size-fits-all model, providers should develop engagement arrangements that reflect their local populations, geographies and healthcare needs. Foundation trusts will have the option to retain aspects of their engagement model where it is working well, but can take a different approach if needed. Following Royal Assent, foundation trusts will be expected to have those arrangements in place and will be assessed as part of the non-statutory advanced foundation trust process. Schedule 3 makes related changes to governance and decision making, in line with the Government’s policy to streamline oversight of providers and reduce duplication in the system. For example, the legal powers to appoint chairs and non-executive directors of foundation trusts and NHS trusts will, in future, both sit with the Secretary of State while supporting the effective use of talent across the NHS. Other functions of the council of governors, such as reviewing plans and major transactions, currently duplicate existing NHS England responsibilities, which will transfer to the Secretary of State through this Bill. Removing those requirements will therefore reduce duplication in the system. Schedule 3 will also give the Secretary of State responsibility for approving changes to foundation trust constitutions and material changes to private patient income, and deciding chair and non-executive remuneration. The Secretary of State will take on the oversight role currently exercised by NHS England, and previously Monitor, including monitoring foundation trust performance, use of resources and governance. That will support system alignment and ensure that appropriate accountability arrangements are in place. Can I seek clarification, Sir Jeremy, that I can speak to clause 30 at this point?

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8. 30 Jun 2026·Parliament·Labour·Karin Smyth

   Health Bill (Eighth sitting)

   Thank you, Sir Jeremy. Clause 30 clarifies how NHS foundation trust status will be applied for and granted following the abolition of NHS England and the removal of the council of governors model. The Government are committed to reinvigorating the foundation trust sector by granting high-performing providers greater freedoms and autonomy. The power to authorise foundation trusts originally sat with Monitor and passed to NHS England in 2022. The clause, alongside schedules 3 and 11, sets out how that power will operate when it transfers to the Secretary of State. It also makes consequential amendments to the authorisation process, including removing requirements linked to recruiting members and electing governors. The Secretary of State will also set the criteria for becoming a foundation trust. I commend the clauses and the schedule to the Committee.

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9. 30 Jun 2026·Parliament·Labour·Karin Smyth

   Health Bill (Eighth sitting)

   I think I am almost going to agree with the hon. Gentleman on his final point. It is important that local people have confidence in how their local systems are run and managed and, clearly, in the outcomes. I will come first to the issue of governors and boards and then move to the amendments. I think we have all had emails, as is quite right, from local board members. Let me say, as I did earlier, that that is with good intent; they are very good people, who have given public service to be part of their local health system. As I said, this provision is no judgment on them; it is, as we heard, about effectively making the really important patient voice and patient experience central to the functions of the organisations delivering our healthcare. As I said in previous sittings, a debate will continue to be had about where we most effectively have that, but our intention throughout the 10-year health plan and this Bill is about devolution to providers and to ICBs and about making boards, as I also said in a previous sitting, responsible and accountable for the outcomes. Let me outline broadly, because I think this is of interest to people, the impact on governance and the role that governors had. Just to be clear, since the creation of foundation trusts in 2004, NHS England—and, before it, NHS Improvement and Monitor—has had a statutory role to oversee the governance of NHS foundation trusts, including holding the whole board to account and taking steps where it identifies weaknesses in how foundation trusts are being run. The regulatory function is underpinned by the NHS provider licence, which will continue when NHS England’s functions pass to the Secretary of State. That is why we do not consider that the removal of the council of governors will have a negative impact on the governance of FTs, as some hon. Members have suggested.

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10. 30 Jun 2026·Parliament·Labour·Karin Smyth

    Health Bill (Eighth sitting)

    I will move on, if I may. I think my response will the cover the issues raised in the debate. On amendment 36 and new clause 59, I note the concern that the Secretary of State could act inappropriately when making appointments to the boards of ICBs and NHS trusts and foundation trusts. We discussed democratic accountability in a previous sitting, and at the end of the day it is up to the British public whom they elect to Parliament and as the governing party. Transparency and democratic accountability are at the heart of our reforms. It would not be right for the civil service to be given sole legislative responsibility for appointments to NHS trusts, foundation trusts or integrated care boards. Ministers are democratically accountable to Parliament, and civil servants act on their behalf under the Carltona principle. Civil servants serve and advise the Government, and act on behalf of Ministers, but it is for Ministers to take decisions and to be held accountable to Parliament for the performance of the NHS. The civil service will run fair, open and equitable campaigns to fulfil these roles and will recommend appropriate candidates to Ministers. Ministers are under a duty to comply with public law principles and to act reasonably, and will adhere to the Nolan principles, including objectivity, transparency and integrity, in discharging this function. The practical arrangements for appointments are being developed as part of the transition planning for the integration of NHS England’s functions into the Department, and will be based on these principles. It would therefore be inappropriate to exclude Ministers entirely from the appointments process. I urge hon. Members not to push the amendments to a vote.

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11. 30 Jun 2026·Parliament·Labour·Karin Smyth

    Health Bill (Eighth sitting)

    I will address clauses 31 to 34 and schedule 4 together. Clause 31 ensures that NHS foundation trusts are subject to the same robust, transparent audit regimes as other NHS bodies. Together with schedule 4, clause 31 makes provision about the audit of NHS foundation trust accounts, which is needed as a consequence of the abolition of NHS England and the removal of the requirement for NHS foundation trusts to have councils of governors and members. Schedule 4 does that by removing the current bespoke provisions related to the auditing arrangements for the accounts of foundation trusts and amends the Local Audit and Accountability Act 2014 so that foundation trusts are subject to the auditing regime under that Act. This means that foundation trusts will in future be subject to the same auditing requirements as trusts and integrated care boards, ensuring a clear, consistent and transparent framework for local audit across NHS provider organisations. Taken together, these measures strengthen consistency in financial reporting and audit assurance across the NHS provider sector, while preserving the independence of the local audit process. Clause 32 repeals provisions of the NHS Act 2006, requiring NHS England to maintain a register of NHS foundation trusts and a power to charge fees related to maintaining the register. The register formed a repository of documents that related to how foundation trusts were governed and regulated. However, removing the requirements does not mean there will be no transparency. NHS foundation trusts are already required to publish the information provided on this register, and where a foundation trust is placed into special administration the administrator is required to publish its report. As a result, the additional requirement to maintain a register is unnecessary, burdensome and duplicative, providing the public with no new information. For those reasons we are removing that bureaucratic duty in the Bill. On clause 33 stand part, the Department of Health and Social Care, like all Departments of State, has a responsibility to diligently and responsibly steward taxpayer’s money in delivering services to the public. Clause 33 updates and strengthens existing legislation to make sure we have the statutory tools we need in order to effectively manage and oversee the finances of the NHS. It does that by updating sections 42B and 42C of the NHS Act 2006 so that the existing last-resort statutory capital spending limit for foundation trusts can also apply to revenue expenditure for a given year. Foundation trusts account for a substantial proportion of NHS revenue spending, at around 40%, and continue to benefit from significant operational autonomy, including the freedom to retain and reinvest surpluses. We remain committed to seeing those freedoms expanded further through our advanced foundation trust programme. However, this strengthened power ensures we have a financial framework that makes it easier to consider additional freedoms. The Department must therefore ensure it has in place robust tools to oversee the finances of the health service, to reassure taxpayers and Parliament that public money is being managed effectively and to ensure that the Department can meet its financial obligations. The power will remain subject to strong safeguards, including a mandatory consultation period with the foundation trust before any order is made, the requirement for any order made to be published, and detailed statutory guidance setting out the circumstances in which the power would be used and how limits would be determined. Crucially, this is a last-resort measure. This power would be used only in exceptional circumstances—for example, when the Secretary State thinks there is a risk of breaching a departmental delegated expenditure limit. I should note that the existing capital backstop on which it builds has never been used. The purpose here is not routine financial management, but assurance. By ensuring that foundation trust freedoms operate within a viable and sustainable framework, the clause helps protect those freedoms rather than undermine them. Finally, clause 34 makes straightforward but important provision about financial accountability when NHS organisations change legal form. It requires an NHS foundation trust that has been newly authorised, or that has recently acquired an NHS trust or another NHS foundation trust, to prepare the final accounts for its predecessor organisation. As the Committee will appreciate, organisational change, whether through authorisation to foundation trust status or through acquisition, can bring real benefits for local services, but it can also create a practical issue at financial year end. The predecessor body will have ceased to exist in its previous form and so will not be in a position to complete and sign off its final set of accounts. Clause 34 addresses that gap by making clear where responsibility sits—

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12. 30 Jun 2026·Parliament·Labour·Karin Smyth

    Health Bill (Ninth sitting)

    I will start where I left off. Clause 34 addresses the gap by making it clear where responsibility sits, so that there is no doubt about who must produce the final accounts and ensure that they are completed properly, and about how those accounts should be audited. We think this is a proportionate provision to ensure continuity and clarity on how NHS money has been managed during organisational transition. I commend the clauses to the Committee.

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13. 30 Jun 2026·Parliament·Labour·Karin Smyth

    Health Bill (Ninth sitting)

    I thank the shadow Minister for in general, I think, agreeing that the alignment of many of these processes is quite sensible. The shadow Minister talked in general terms about financial controls. The Government take financial controls and our responsibility for taxpayers’ money very seriously. As I said last week, from very early on, we were very keen to ensure that there is a grip on NHS finances in order to properly deliver the sort of healthcare that all our constituents deserve. We take that very seriously. There has not been that sort of grip at board level and through the system in recent years. As a result of the measures that we have taken, I think this is the first year in six or more years that the NHS has not gone back to the Department for additional funds to get through the year. The Committee can be assured that financial control is important. The shadow Minister referred to limits. Of course they are overall limits; the Secretary of State does not go line by line through what a trust spends. I understand the point that people are trying to make to conflate some situations, but of course it is an overall limit. The safeguards in these provisions are designed to protect foundation trusts’ freedoms and not constrain them, but a foundation trust can enjoy such freedoms only if it is in a well-overseen and stable NHS financial system. By including a backstop for use in exceptional circumstances, clause 33 helps to safeguard public funds and will help the Department to meet its financial obligations, which I think hon. Members understand. It is a usual process for the Department to go through, as anyone who has sat on the Public Accounts Committee will know. Adherence to the departmental expenditure limit creates and maintains the necessary environment for the foundation trust to exist. Question put and agreed to. Clause 31 accordingly ordered to stand part of the Bill. Schedule 4 agreed to. Clauses 32 to 34 ordered to stand part of the Bill. Clause 35 Conversion of failing NHS foundation trust into NHS trust Question proposed, That the clause stand part of the Bill.

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14. 30 Jun 2026·Parliament·Labour·Karin Smyth

    Health Bill (Ninth sitting)

    During the process of producing our 10-year plan, we were clear that, as much as we will reward the best performing providers with new freedoms to innovate, we will not hesitate to act on poor performance, and this group of measures deal with just that: action in the event of a failing provider. Clause 35 and schedule 5 insert new provisions into the NHS Act 2006 to enable the Secretary of State to, by order, convert a failing foundation trust to an NHS trust. This is intended to take place only in the most critical circumstances, and where it is in the public’s best interest for the Secretary of State to be able to direct the trust about how it should exercise its functions, to address safety or other issues at the trust. Foundation trust status should be a mark of good performance, and there must be a mechanism to remove it when performance is seriously deficient. This deauthorisation power will help to maintain the integrity of the reinvigorated foundation trust status and provide an additional incentive for challenged foundation trusts to improve. The power to make a conversion order can be used where the foundation trust has failed to comply with a condition of its provider licence or with another legislative requirement. In deciding whether to make a conversion order, the Secretary of State must consider various factors, including the seriousness of the failure, the health and safety of patients, the quality of the provision by the trust of goods and services, the financial position of the trust, and the way the trust is being run. The conversion power is also subject to two additional requirements. First, the Secretary of State must publish guidance about the matters they will consider in deciding whether to exercise the conversion power, including the factors I just outlined. They must consult on any such guidance before its publication. Secondly, where the Secretary of State proposes to use the power, they must first consult the foundation trust in question, any integrated care boards in the areas in which the trust operates, and any other person to whom the trust provides goods and services, and whom the Secretary of State considers it appropriate to consult. Clause 35, together with schedule 5, also inserts new schedule 9A into the NHS Act 2006, which sets out the immediate consequences of a conversion order. Deauthorising a foundation trust has no impact on the property it holds, the contracts it has with commissioners and other groups, or the terms of employment of employees. These powers set clear organisational consequences for significant underperformance and allow the Secretary of State the freedom to take action to protect patients in extreme circumstances. Clause 36 contains another critical power to allow action in the case of a failing foundation trust. It allows the Secretary of State to add conditions to an NHS foundation trust’s provider licence where they consider that the trust will breach its licence conditions due to issues with its governance. The clause is a consequence of abolishing NHS England and makes changes to the powers currently held by NHS England under section 111 of the Health and Social Care Act 2012, to confer them on the Secretary of State, with additional consequential changes reflecting the abolition of councils of governors. The clause sets clear expectations for a foundation trust through the licence conditions and provides the Secretary of State with a transparent mechanism to take more urgent, targeted enforcement action to address failures of governance. Should the foundation trust breach any conditions imposed via section 111, the Secretary of State may require it to make changes to the executive directors of its board as necessary, including removing or suspending executive directors, replacing executive directors with interims, and preventing the trust from appointing specific individuals. If the foundation trust fails to take those actions, the Secretary of State may implement the changes. To reassure the Committee, there are clear safeguards underpinning the clause, which can be used only where there is evidence that failures of governance in the foundation trust will cause it to breach the conditions of its licence. Further, acting under section 111 does not preclude the Secretary of State from using their other regulatory powers, including to require the foundation trust to take steps to address a breach of any condition of the licence, or to accept undertakings from the trust to address the breach. Finally, the section 111 power was originally granted to Monitor in 2012 under transitional arrangements, as it was anticipated that the power could be withdrawn once governors had transitioned into their roles and could hold boards to account without outside intervention. Over 13 years on, that has proven not to be the case. With the abolition of the foundation trust councils of governors, it makes sense to repeal the provisions under sections 112 to 114 of the same Act that made it transitional. Clause 37 makes changes to the special administration framework to ensure that it continues to function coherently after the abolition of NHS England. The clause makes focused, technical amendments to the Health and Social Care Act 2012 to amend the framework for establishing a mechanism for financial assistance in cases where a provider is subject to a health special administration order under chapter 5 of that Act. It also amends the Act to remove the duty to establish a mechanism for financial assistance to foundation trusts to which a trust special administrator has been appointed. The duty no longer needs to apply to foundation trusts, because the Secretary of State already has the power under provisions in the NHS Act 2006 to provide financial assistance to NHS foundation trusts if needed. With the abolition of NHS England, the duty to establish a mechanism for financial assistance for independent providers will be retained and conferred on the Secretary of State. It is worth noting that the provisions related to financial assistance in special administration cases, and chapter 5 of the Health and Social Care Act 2012, which sets out the powers and processes for the making of health special administration orders, have not yet been commenced. However, the amendments made by the clause ensure that the special administration regime can operate smoothly if it is ever needed. The clause does not create new financial support mechanisms, but ensures that existing ones can be used appropriately in the reformed system. In short, clause 37 ensures that the legal framework reflects the new institutional landscape while retaining the ability to act swiftly to safeguard continuity of services during special administration. Clause 38 makes changes to the trust special administration framework to ensure that it continues to function coherently after the abolition of NHS England. This clause, together with schedule 6, make targeted changes to the trust special administration process set out in the NHS Act 2006 for NHS trusts and NHS foundation trusts as a consequence of the abolition of NHS England. It also aligns more closely the processes between NHS trusts and foundation trusts. Trust special administration is, and will remain, a last resort mechanism used only in cases of serious failure. It is used to protect patients, stabilise services and put the organisation back on a sustainable footing. Where deemed necessary, a trust special administrator would be appointed to manage the trust and work with relevant key stakeholders to develop recommendations regarding the organisation and its services. The amendments made by schedule 6 remove functions that currently sit with NHS England and confer the key decision-making functions on the Secretary of State, who will provide clearer lines of accountability and faster decision making when rapid intervention is required. The amendments also simplify the steps involved in the TSA process, with the aim of improving the speed of intervention and providing transparency. They align more closely the processes for trusts and foundation trusts, and set out a simpler process in relation to the administrator’s draft report, consultation and final report. They also require, as is the case now, that key documents and decisions are published and laid before Parliament. That will help ensure proper and meaningful scrutiny of the TSA process and outcomes. It also helps ensure that affected patients, staff and local partners have the opportunity to engage during the process, while maintaining the balance with the need to deliver timely intervention and secure continuity of safe services. In addition, the amendments in schedule 6 make changes to the role of the Care Quality Commission in trust special administration. The CQC will be able to recommend that a trust special administrator should be appointed. The Secretary of State is also required to consult the CQC before making an order, ensuring that independent expertise on quality and safety informs decisions and that intelligence on service performance is co-ordinated. The provisions in the Bill ensure that the process remains fit for purpose, proportionate, and aligned across NHS trusts and foundation trusts. They support faster, more coherent decision making in the most serious cases, with the aim of protecting patients and securing sustainable, high-quality services for the future. Taken together, the clauses provide the necessary tools for the Secretary of State to take proportionate, swift and decisive action in the event of provider failure. I therefore commend these clauses to the Committee.

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15. 30 Jun 2026·Parliament·Labour·Karin Smyth

    Health Bill (Ninth sitting)

    As people who have been listening will know, this is a chunky set of clauses on some technical details. Let me broadly pick up some of the key points. I want to be very clear about deauthorisation and our seeking to establish, essentially, a more dynamic model. As I said, the coalition Government repealed the legislation on deauthorisation in the 2012 Act. Although other regulatory levers exist to manage poor performance, we are using two core arguments. First, converting foundation trusts into NHS trusts will enable the Secretary of State, if needed, to intervene further through their power of direction over NHS trusts. The Secretary of State will therefore be able to focus on the patient and public interest over preservation of providers’ statutory freedoms in cases of serious failure. I hope that that addresses some of the points that have been raised. Secondly, having a more dynamic environment with the potential for deauthorisation in such cases, and the consequent loss of statutory autonomy, may act as an incentive for challenged foundation trusts to improve, and it would show that there are consequences. As I think the hon. Member for Sleaford and North Hykeham knows, the usual processes exist for managing performance across various aspects of the provider. They will continue. This is for exceptional circumstances. As I said, this is about maintaining a more dynamic model than the one we have. The purpose behind her questions about continuous service—the purpose of having a range of failure powers—is to ensure continuity of care for patients and the public. The analogy with general practice does not hold; this is a very different set of circumstances. But, obviously, she raises an important point about public concern relating to the service’s provision, and I assure her on that. We need to make sure that we diagnose the situation, provide the trust with support and assess which toolbox is most applicable. The CQC can recommend that a trust special administrator should be appointed where it is satisfied that there is a serious failure to provide services of a sufficient quality, and it must provide a report on the safety and quality of services following the appointment of an administrator. The Secretary of State must also consult the CQC before making an order to appoint a trust special administrator. Question put and agreed to. Clause 35 accordingly ordered to stand part of the Bill. Schedule 5 agreed to. Clauses 36 to 38 ordered to stand part of the Bill. Schedule 6 agreed to. Clause 39 Joint working and delegation arrangements

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16. 30 Jun 2026·Parliament·Labour·Karin Smyth

    Health Bill (Ninth sitting)

    Government new clause 20 and clause 39 both look to strengthen joint working arrangements across the health system. Clause 39 is part of the architecture of the Bill that allows the delegation of functions from the Secretary of State to NHS bodies, local authorities or other relevant organisations. The clause builds on the existing delegation powers in section 65Z5 of the National Health Service Act 2006, which already allow NHS bodies to delegate functions and pool resources with one another and with local authorities or other relevant bodies on a voluntary basis. It is a well-used voluntary power that enables systems to develop joint working and ensure that health functions are carried out by the most appropriate body or groups of bodies. The result is stronger integration, with better joint working between NHS and local government, and services better tailored to meet local needs. With the abolition of NHS England and the new functions of the Secretary of State, it is right that the Secretary of State should have the flexibility to delegate their health functions appropriately and efficiently under a voluntary arrangement, as and when necessary. We would not want to exclude the Secretary of State from joint working arrangements, if joint working would bring benefits to patients and the public. The power is therefore purposefully broad to allow that, including allowing the Secretary of State to delegate to a range of public bodies, establish joint committees and pool funds. It also allows the Secretary of State to issue guidance to relevant bodies about the use of their powers under sections 65Z5 and 65Z6. This proposal is not, however, a means to avoid accountability. Accountability for any function delegated through this power remains with the person delegating it whereas liability rests with the person to whom the function is delegated. Accountability, as opposed to liability, means that the body delegating a function must provide oversight for how their functions are carried out and ensure that any issues are dealt with. Ultimately, the Secretary of State will continue to be accountable to Parliament for the health service in England, including any delegated powers. I am sure that Parliament will relish holding all Ministers to account. Building on our ambition to support greater local partnership working, as set out in our 10-year plan, we have tabled Government new clause 20 to strengthen section 75 of the NHS Act 2006 by providing much greater scope for combined authorities, combined county authorities and the Greater London Authority to use these arrangements. Section 75 currently supports flexible voluntary partnership arrangements, including the pooling of budgets between NHS bodies and local authorities. These arrangements are a critical tool in supporting local collaboration and ensuring more joined-up working within systems. The new clause looks to strengthen the section 75 guidance-making power. At present, that power only covers consultation and applications for consent on section 75 arrangements. The Government’s new clause will extend the guidance power so that it can cover all aspects of section 75, helping us to support the wider and more effective use of partnership arrangements. For those reasons, I commend new clause 20 and clause 39 to the Committee.

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17. 30 Jun 2026·Parliament·Labour·Karin Smyth

    Health Bill (Ninth sitting)

    I got a little confused at the end, but I think the Opposition generally accept the power in this clause. The hon. Member for Farnham and Bordon contended that this Bill and previous amendments to it will drive local authorities and the NHS further apart; just to have it on the record, I do not accept that that is true at all. Section 75 of the National Health Service Act 2006 and the work that we are doing on this further highlights the effect of some of the things that we are trying to do. The hon. Member for Winchester raised new clause 26. I have sympathy for the intention behind the new clause. We all want health and care services to work closer together, as I have said repeatedly, and we agree that the partnership framework under section 75 of the National Health Service Act 2006 is a useful tool for doing so. While I understand the new clause, it is not necessary. The Department can review the section 75 framework without needing legislation, and indeed it has already done so. The Department carried out a review of section 75 in 2023, as has been said. Since then, we have continued to consider how these partnership arrangements can best support health and care integration. The new clause would risk duplicating ongoing work. Furthermore, that work is not a one-off exercise but an ongoing process of learning and improvement across the country, and we want something that is responsive and flexible enough to respond to changes in health and care services and to the changing needs of people who use them. For that reason, I do not consider requiring a single statutory review to be the most effective approach. Hon. Members raised important issues about clarity of accountability and responsibility. To reiterate, the legislation is clear: the legal responsibility or liability for a function being carried out properly rests with the receiving party; however, the delegating party is accountable for that function being carried out, and they must know how it is being carried out and make sure that any issues are addressed. The hon. Member for Sleaford and North Hykeham rightly alluded to one of the examples that we are exploring around section 75, which is how it might support key priorities in delivering neighbourhood health, to make absolutely clear and sure that we bring services closer together. Both spokespeople outlined a quote from Melanie Williams of ADASS. Although I do not know the whole context of the quote, I understand the frustration of colleagues in social services and this whole area as it is one that I worked in myself. I understand the issue, but it is slightly different because it concerns the what, rather than the how, of what is being discussed. Section 75 is part of the how. We want to make this easier for people who are trying to do the right thing, and these provisions, which I commend to the Committee, do just that. Question put and agreed to. Clause 39 accordingly ordered to stand part of the Bill. Clause 40 Consolidated accounts Question proposed, That the clause stand part of the Bill.

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18. 30 Jun 2026·Parliament·Labour·Karin Smyth

    Health Bill (Ninth sitting)

    We know that robust finances are an essential part of the health service. The financial accounts related to the NHS are of keen interest to His Majesty’s Treasury and indeed to Parliament. The Government are especially mindful of the keen interest of the Public Accounts Committee in this area. Under current arrangements, NHS England prepares a set of financial accounts for all NHS trusts and foundation trusts, and that is audited by the National Audit Office. That is the point at which the National Audit Office conducts its oversight of NHS providers, with that feeding into the National Audit Office’s assurance over the Department of Health and Social Care group. The financial accounts for integrated care boards are currently included in the NHS England group accounts, which are presented separately and audited by the National Audit Office. With the abolition of NHS England, the Government intend to reduce central administration costs, so financial reporting needs to be proportionate while balancing stakeholders’ keen interest in financial information related specifically to the NHS. Clause 40 therefore replaces the current consolidated accounts of NHS providers with a single set of consolidated accounts for the NHS covering its trusts, foundation trusts and integrated care boards. That consolidated account will continue to be audited by the National Audit Office. We believe that bringing the accounts together in this way will assist the public, Parliament and the National Audit Office in scrutinising NHS expenditure. Although it is not covered by the clause, it is important for the Committee to be aware that there will be no change to the current requirement for the Department to publish a Department of Health and Social Care group annual report and accounts that will consolidate the NHS accounts with the core Department and other group bodies—for example, its arm’s length bodies. However, the Government recognise that only reporting figures for the NHS in the overall Department group would reduce transparency compared with the current structure of NHS financial accounts. The clause therefore seeks to prioritise high quality audited financial accounts information being made available while balancing against administrative costs, both of which are important to the Government. Clause 41 amends the Secretary of State’s existing power to create a scheme allowing NHS bodies to pool funds to cover property losses and legal claims arising from their healthcare activities. They ensure that when liabilities arise, whether from damage to property, negligence or other claims, there is a clear and consistent mechanism through which those liabilities can be managed and resolved. In doing so, they protect the financial stability of the NHS. The clause updates the legislation for the new landscape by removing NHS England from the arrangements and ensuring that responsibility for administrating the schemes rests appropriately with the Secretary of State. Although the clause is targeted and technical, its effect is essential in that it ensures continuity and legal clarity and continued effective operation of arrangements that underpin confidence and functionality across the health service. Clause 42 is a necessary technical and structural change that supports the new statutory framework following the abolition of NHS England. It removes provisions in the NHS Act 2006 and the Health and Care Act 2022 that relate specifically to NHS England’s funding and financial responsibilities, which will no longer be required once NHS England ceases to exist. The clause avoids duplication and confusion and ensures that financial accountability is clearly defined in the post NHS England system. Under the reformed framework, the Department is responsible for the overall funding of the NHS and for national financial assurance, while integrated care boards and providers continue to operate within defined statutory financial duties and controls. Clause 42 plays an important housekeeping role, providing legal clarity and underpinning a more transparent and coherent financial framework that is fit for the NHS future operating model. I therefore commend the clause to the Committee.

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19. 30 Jun 2026·Parliament·Labour·Karin Smyth

    Health Bill (Ninth sitting)

    I am pleased that, in an outbreak of cross-party agreement at 3.20 pm on a Tuesday, I completely agree with the comments made by the hon. Member for Farnham and Bordon and the right hon. Member for Melton and Syston. It is a point that I made myself: the ability of Members of Parliament and the public to understand the granularity relating to their local providers and ICBs is very important for transparency and accountability. I hope Committee members recognise that I have tried to drive much more transparency in that system. They are absolutely right that that is separate from this clause, and we will continue to expect providers and ICBs to do that; I hope that addresses that point. To add further clarity on the wider point the clause deals with, the consolidated accounts we prepare include some analysis by different types of body. That will mean separate information about NHS providers being included in the document, such as a summary of income and expenditure. Separately, providers and ICBs will continue to publish accounts so that people can look at those. The Government will listen to any feedback from users to adapt the nature of this content in future years after the initial publication, recognising that this is a new development following the abolition of NHS England. We are also mindful that too many separate publications add to administrative costs and risk losing focus. The intention is to have transparency at the local level, building that up to do something more sensible and cost-effective that is also transparent at national level. I commend the clauses to the Committee. Question put and agreed to. Clause 40 accordingly ordered to stand part of the Bill. Clauses 41 and 42 accordingly ordered to stand part of the Bill. Ordered, That further consideration be now adjourned. —(Emma Foody.)

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20. 30 Jun 2026·Parliament·Labour·Julia Buckley

    High Streets

    The hon. Gentleman is being generous in giving way. Does he join me in congratulating Barnsley market, a local market that is leading the way by bringing health services into the town centre, which is driving up footfall and has led to a thriving community? We will be leading a delegation from the all-party parliamentary group on local markets next week, so we can all learn from that example and hopefully feed into the high street strategy.

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21. 30 Jun 2026·Parliament·Labour·Josh Newbury

    Draft Town and Country Planning (Discharge of Local Planning Authority Functions) (England) Regulations 2026

    Like the hon. Gentleman, I have previously been a local councillor, so I understand the importance of planning committees and of local democracy around planning decisions, but I find the idea that local councillors will have no ability to have any say or influence over officers’ delegated decisions a bit ludicrous. If a councillor is doing their job properly, they are constantly going to the planning department to speak to officers about various issues that are raised with them. It will be more than possible for councillors to speak to planning officers, knowing that they are to make a decision on something like this, to give them whatever local context they feel they would need to come to an informed decision. Does the hon. Gentleman not agree with that?

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22. 30 Jun 2026·Parliament·Labour·Josh MacAlister

    Antisemitism: University Campuses

    It is a pleasure to serve under your chairmanship, Sir John. I start by congratulating my hon. Friend the Member for Leeds South West and Morley (Mark Sewards) on securing this important and timely debate. I will turn to a few of the remarks made by Members in this debate, starting with my constituency neighbour, the hon. Member for Westmorland and Lonsdale (Tim Farron). He is right to highlight the number of former student sabbatical officers in this place, present company included, and the important history of the Windermere children. I am keen to do what I can to support the case he is making to find ways to both rebuild the school and bring greater Holocaust education to the north of England, and I share many of his aspirations in that respect. I thank my hon. Friend the Member for Northampton South (Mike Reader) for praising the leadership of UJS, of which many representatives are here today, and for highlighting the leadership of Michael Necus. In setting out the historical context, the hon. Member for Beaconsfield (Joy Morrissey) reminded me of Baron Finkelstein’s excellent foreword to the UJS “Time for Change” report, highlighting that antisemitism can be taken as a warning sign of moral collapse. The hon. Member for Dewsbury and Batley (Iqbal Mohamed) rightly stated that we must not conflate the action of the Government of Israel with the Jewish community, and I thank him for making that point so clearly. The hon. Member for Strangford (Jim Shannon) powerfully brought to life the harrowing experiences of Jewish students, and I thank him for taking the time in his speech to make sure that their voices have been heard here. Universities are places where ideas are tested, challenged and, where necessary, shown to be wanting, through evidence, scrutiny and debate. Exposure to different viewpoints, including those with which we strongly disagree, is an essential part of higher education. Students should leave university having had their assumptions challenged and their perspectives broadened. Freedom of speech and academic freedom are therefore central to the university experience. At the same time, universities have a duty to ensure that all students can participate fully in university life without fear of intimidation, harassment or discrimination. That is particularly important in the light of the significant rise of antisemitism. Too many Jewish students have been subject to abuse, exclusion and hostility because of their Jewish identity. Although robust debate, including on controversial political issues, is a vital part of academic life, freedom of expression is not a cover for antisemitic harassment, discrimination or abuse. Universities must therefore both uphold the freedom of speech and take effective action to ensure that Jewish students can study, participate and thrive, free from antisemitism. Our task is not to choose between those principles, but to uphold both. In a liberal democracy, we do not resolve disagreement by shutting down debate, nor do we accept intimidation as the price of free expression. Instead, we create the conditions in which robust debate can flourish and everyone can participate with confidence. That must be our ambition for higher education. The rise in antisemitism reported by Jewish students is not simply a challenge for one community; it is a test of whether our universities can remain places of inclusion, academic freedom and respect for all. When Jewish students feel unable to speak openly, participate fully or express their identity without fear, something fundamental is at stake. The scale of the problem is clear, and has been set out by many hon. Members in this debate. In 2025, CST recorded 3,700 antisemitic incidents in the UK—the second highest annual total on record. Antisemitism is not an historical issue; it remains a present and persistent threat, and we must challenge the ideas and narratives that give rise to these incidents. Too often, antisemitism is expressed through familiar tropes and conspiracy theories: allegations of secret influence, dual loyalty, collective responsibility or hidden power. Those claims can sometimes appear superficially innocuous, but they draw on centuries-old racist myths used to marginalise, persecute and dehumanise Jewish people. We should be clear that those ideas are antisemitic and we should have the confidence to speak out against them, and the Government must provide leadership on that. It is never acceptable to hold Jewish people or Jewish communities responsible for the actions of a foreign state. Criticism of the Government of Israel, like criticism of any Government, is legitimate; holding British Jews collectively responsible is not. Tackling antisemitism cannot be left to Jewish communities alone. It requires a whole-society response and education is among our most powerful tools in doing so. That is why we are investing £7 million to tackle antisemitism across education and helping schools, colleges and universities prevent incidents, respond effectively when they occur, and foster environments where Jewish students feel safe, welcome and valued.

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23. 30 Jun 2026·Parliament·Labour·Josh MacAlister

    Antisemitism: University Campuses

    The hon. Member is absolutely right to make that point. To pick up one thread of today’s debate, a number of hon. Members have raised the power of algorithms, which feed off people’s fury and anger and the differences that exist between them. Many of the themes highlighted in this debate could equally apply to other groups in society where our attention is also needed. Government-funded training is already supporting university staff and leaders to recognise antisemitism, support Jewish students and respond appropriately when concerns arise. Last week, we agreed to fund projects through our innovation fund to help students navigate misinformation, engage constructively with difficult issues and develop a deeper understanding of different faiths and communities. We are also developing a new community cohesion framework with students in partnership with the University of Salford and the National Union of Students. Alongside that work, we continue to support University Jewish Chaplaincy to provide pastoral wellbeing and practical support to Jewish students across the country. In his opening speech, my hon. Friend the Member for Leeds South West and Morley asked about the statutory framework. Given the time remaining, I will give the brief update that the Office of the Independent Adjudicator is due to update its good practice framework for higher education providers in handling reports of harassment later this year. In addition, we are working with the sector to improve transparency and accountability for tackling antisemitic abuse. We are also working with Universities UK to undertake a rapid assessment of institutional disciplinary and incident reporting processes and we will develop recommendations and priority actions in autumn this year.

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24. 30 Jun 2026·Parliament·Labour·Josh MacAlister

    Antisemitism: University Campuses

    The hon. Member is right to highlight the essential aspect of accountability. The Office for Students has been given additional powers in recent years. It is also true that the scale of the challenge that we see with antisemitism on university campuses, and the challenge that many universities are facing in meeting their obligations to uphold the freedom of speech while also creating the climate and culture necessary for freedom from intimidation, may lead a Select Committee to hold an inquiry on that. It would, of course, be a matter for Parliament and a Select Committee to do so, but if that were to happen, the Department for Education would be very interested in its findings. We know that many of the conspiracy theories and hateful tropes that underpin antisemitism are also features of extremist ideologies. Left unchallenged, they can create an environment in which radicalisation becomes more likely. At their most serious, they can form part of a pathway towards terrorism. Prevent data shows that in the year to March 2025, there were 8,778 referrals, 21% of which were linked to extreme right-wing concerns and 10% to Islamist extremism. Although Prevent does not record antisemitism as a stand-alone category, those figures illustrate how antisemitic narratives can, and often do, form part of extremist worldviews that carry a risk of terrorism or serious harm. Most antisemitic incidents fall well below the threshold for Prevent intervention. Nevertheless, the data demonstrates that, in the most serious cases, ideas rooted in historical antisemitic prejudice can become part of a trajectory towards terrorism. That is why, through our wider Protecting What Matters programme, we are taking action to challenge antisemitism and extremism wherever they arise. We are strengthening oversight of universities’ Prevent duties; updating guidance on external speakers and events, which is due to come out very soon; improving our ability to identify emerging extremist activity; enhancing whistleblowing protections; and increasing transparency around incidents of antisemitism.

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25. 30 Jun 2026·Parliament·Labour·Josh MacAlister

    Antisemitism: University Campuses

    I reviewed a draft of that guidance a matter of days ago, and it is due to be published very shortly. The issue is probably more that there is a queue of things to be published, rather than it not being ready to go. We must remain alert to the actions of hostile state actors who seek to exploit social tensions, spread disinformation and undermine community cohesion. The Government are therefore strengthening their response to state threats through tougher powers to identify and disrupt hostile activity, greater transparency around foreign influence, and stronger measures against those acting on behalf of foreign states. Where there is evidence of unacceptable activity linked to foreign actors, including Iran, we will not hesitate to act. Our message is simple and unequivocal: there is no place for antisemitism, extremism or hostile state interference in our universities or our society. We will defend lawful free speech, protect students from intimidation and ensure that campuses remain places where learning, debate and mutual respect can thrive.

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26. 30 Jun 2026·Parliament·Labour·Josh Fenton-Glynn

    Family Justice System

    Will the Minister reassure me that we remain committed to repealing in this Parliament the presumption of contact in family courts, to bring full justice to the 67 children murdered at the hands of abusive ex-partners with whom contact should never have been granted?

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27. 30 Jun 2026·Parliament·Labour·Josh Fenton-Glynn

    National Maternity and Neonatal Investigation

    I echo what was said by my colleague from the Health and Social Care Committee, the hon. Member for Oxford West and Abingdon (Layla Moran). Baroness Amos pointed to workforce challenges and their impact on care and safety, and she noted that 67% of midwives reported burnout. Meanwhile, a General Medical Council survey found that 63% of obstetrics and gynaecology trainees had a high or very high workload. That is higher than the 42% average. The workforce plan has to address those problems—but will it?

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28. 30 Jun 2026·Parliament·Labour·Josh Dean

    Financial Inclusion: Young People

    I beg to move, That this House has considered financial inclusion for young people. It is a pleasure to see you in the Chair, Sir John. Today, young people are one of the groups most at risk of financial exclusion. Analysis by Fair4All Finance has identified 2 million unsteady starters in financially vulnerable circumstances across the UK. That includes 11% of financially vulnerable adults in Hertford and Stortford. Predominantly under 35, those young people are facing a combination of pressures: low financial resilience, higher housing costs, insecure work, rising insurance costs and a growing exposure to online financial risks. They experience poorer financial wellbeing as a result, closely linked to poor mental health, creating a vicious cycle that can undermine their educational attainment, employment prospects and economic participation. Financial inclusion is about more than access to banking; it is about access to affordable credit, insurance, savings, trusted financial guidance and opportunities to build a financial track record. I am pleased that the Government have recognised the importance of tackling financial exclusion in the financial inclusion strategy. If we can break down the barriers to financial inclusion, we can improve the lives of millions of people and unlock growth across the country. In this afternoon’s debate, I want to examine the barriers to financial inclusion that young adults face, and consider where Ministers could build on the financial inclusion strategy to prioritise practical interventions to support young people. Although a young person may pay rent regularly, meet mobile phone payments or have built responsible financial habits, they often lack sufficient credit history to access mainstream financial products on fair terms. We know that young adults are over-represented in the gig economy, temporary employment roles, part-time work and on zero-hours contracts. The insecure and variable income they receive is compounded by the high cost of living. It is harder for them to budget effectively or qualify for mainstream financial products, and they are more reliant on costly forms of borrowing as a result. As the cost of living crisis continues to eat into disposable incomes, young people struggle to build emergency or long-term savings. They typically have fewer savings than older adults, which leaves them acutely vulnerable to financial shocks: losing a job, an unexpected bill, increased rent or transport costs. In those circumstances, without emergency savings to draw on, many face a poverty premium, paying more in the long term through instalments because they cannot afford the cost of an up-front payment.

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29. 30 Jun 2026·Parliament·Labour·Josh Dean

    Financial Inclusion: Young People

    I could not agree more about the importance of financial education for young people, which I will come to in my speech. We can already see how those overlapping pressures exacerbate a young person’s financial insecurity. Insurance is another area where they are left facing vulnerability to financial shocks that they are already ill-equipped to absorb. I was shocked to learn that 18 to 24-year-olds are significantly less likely to hold contents insurance, even though they are more likely to experience flood damage, escape of water, fire damage, burglary and theft. That is especially true when they live in rented accommodation, which many young adults do. I want to draw particular attention to the cost of motor insurance. Young people often make significant personal investments in driving lessons, to make it easier to get to work or education, only to find they cannot access affordable insurance when they pass their test. That directly impacts their ability to access work, training and other opportunities, especially in semi-rural communities such as the one that I represent, and it highlights how young people can face financial exclusion even when they are doing everything right. Too often, young people are entering adulthood without the tools, confidence or support networks that they need to navigate increasingly complex financial decisions.

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30. 30 Jun 2026·Parliament·Labour·Josh Dean

    Financial Inclusion: Young People

    I could not agree more about the importance of regulating access to financial information across social media and AI, which is an emerging challenge. Embedding financial education in school is so important, particularly ahead of the social media ban, which my hon. Friend mentions. Research has shown that young people have the lowest confidence in managing their money. The latest MoneyView survey from the Money and Pensions Service found that although 41% of adults lack confidence managing money, the figure rises to 63% for 18 to 24-year-olds. That is the highest for any age group. I welcome measures in the financial inclusion strategy to embed financial education in the primary school curriculum, helping children to develop healthy attitudes towards money at the earliest stage, but there is a need to go further. A report in 2025 by the London Foundation for Banking & Finance highlighted a significant gap in financial education provision. Financial capability programmes are concentrated in primary schools, the early years of secondary school and workplaces. There is comparatively little structured support for young people aged 16 to 24 as they transition to financial independence. That is one of the most financially vulnerable periods in a young person’s life. They have to navigate leaving school, entering work or going to university, and living independently for the first time. Particularly as students, young people are vulnerable to developing bad financial habits, experiencing a financial crisis or falling into debt. They are often having to balance their education with work. If a financial crisis hits, they face the prospect of sacrificing more of their education to pay down debt, with a potential impact on their future life chances. These significant moments in a young person’s life are when small mistakes and unexpected costs can quickly escalate. Early support in this transition period is critical to prevent longer-term financial problems. All this takes place in a rapidly evolving digital landscape. Young adults are adopting AI tools faster than older generations, which is providing them with opportunities for more accessible guidance, but leaving them at risk of exposure to inaccurate information, scams and poor or misleading financial recommendations. MoneySuperMarket’s latest Money Talks research with the Campaign Against Living Miserably found that 44% of 18 to 34-year-olds are turning to generative AI as a private space to express their money worries. That is almost half of young people who are being exposed to unregulated financial advice. Financial exclusion does not only increase economic inequality between those who have savings, access to financial education and good support networks, and those who do not; it also has a significant impact on young people’s mental health. Financial anxiety is no longer associated just with moments of crisis. For many, it has become a daily occurrence. Research from MoneySuperMarket, CALM and UM showed that one in two young adults is in debt, one in four young people has used a food bank in the past year and, more than social media, body image or relationships, money is the topic causing young people the most worry right now. Young adults are 77% more likely to have experienced suicidal thoughts because of issues with money or money worries than the wider adult population. One in 10 young adults with debt will have had suicidal thoughts in the past 12 months because of worries about making repayments. There is a profound link between financial difficulties and poor mental health. It is often cyclical, with financial stress leading to more mental health challenges, and poorer mental health making financial management harder. We must recognise that relationship and how financial insecurity and exclusion are leaving young people lacking agency in our society and without hope. Beyond arguments about economic growth and inactivity, this alone should spur us on to do better. What might solutions to the barriers I have set out look like, and where might we be able to go further? First, on credit visibility, small sum lending can support young people with thin or non-existent credit files to establish their financial identity, and therefore access affordable financial products. For example, Fair4All Finance is piloting small sum lending in partnership with Monzo, and I would be keen to hear the Minister’s reflections on the role of small sum lending in that area. What further action can the Government can take alongside regulators to support young people to establish a financial track record? Secondly, on insurance affordability the interim findings of the recent Milburn review highlighted the stark challenge of 1 million young people who are not in education, employment or training. I know the Government are committed to tackling the high number of NEETs, but I would be grateful if the Minister would set out what work is being undertaken with regulators and industry to improve access to affordable motor insurance for young drivers, and to tackle the prohibitive costs restricting their access to work and education, leaving them financially excluded. Modelling from WPI Economics has found that improvement in that area could increase the UK’s GDP by £369 million annually through increased employment and participation in the labour market—there is an economic opportunity here. Thirdly, will the Minister reflect on how the Government can expand financial education and support in that critical period of transition for 16 to 24-year-olds, and share what consideration she has given to the growing influence of AI on financial decision making? Finally, on financial wellbeing and mental health, will the Minister commit to working across Departments to ensure that financial resilience forms part of the Government’s wider approach to supporting young people’s mental health and wellbeing? If we want to grow the economy, tackle the NEET challenge and improve young people’s mental health and wellbeing, we must ensure that they are not excluded from the financial system that underpins modern life. Real financial inclusion must mean that every young person can build a secure and sustainable financial future. A young adult who can save, build a credit history, access affordable insurance and make informed decisions about their finances is more likely to succeed in work, education and life. They will feel that they have agency in our society, and they will have hope for the future.

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31. 30 Jun 2026·Parliament·Labour·Josh Dean

    Financial Inclusion: Young People

    I will keep it brief, Sir John. To add to the trend, I will just share the fact that my first job was in a local coffee shop. It has been great to hear about rurality, the importance of car insurance, social media, fraud and student loans; I will not share just how high my student loan bill is, having checked recently. The importance of financial inclusion has really been brought to life, as have the challenges that young people face. I thank all Members who have contributed to this important debate, and I thank the Minister for her response. Every young person deserves to build a secure and sustainable financial future. I hope that the Treasury will continue to think ambitiously about how we can support them in doing so. Question put and agreed to. Resolved, That this House has considered financial inclusion for young people.

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32. 30 Jun 2026·Parliament·Labour·Jonathan Davies

    Defence Investment Plan

    I welcome this record investment in defence, and I appreciate that it may lead to us making cuts elsewhere in public expenditure. One casualty may be the expansion of the A38 in Derby, which has been on and off under successive Governments for the past 40 years. Some local people would welcome the scheme’s not going ahead, particularly on environmental grounds, but others would see a cancellation as a brake on economic growth, and we need economic growth to fund our defence. Will the Secretary of State work with me to convince the Treasury and the Department for Transport that we need more investment in Derby, so that our economy can thrive, and we can contribute to defence through public expenditure in the future?

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33. 30 Jun 2026·Parliament·Labour·John McDonnell

    Department of Health and Social Care

    The debate we have had so far highlights the issue at hand. This is an immense change to the way in which we will determine the delivery of drugs to the NHS, and one of my fears is that it will begin to weaken the existing controls. I think it politicises the process, because what will happen now is that Ministers will be able to determine the thresholds. In addition, I am concerned that decision making in the negotiations with the pharmaceutical companies has been transferred from NHS England to the Department itself. There will be real concerns that when we look for objective advice from NICE, the system that we have will now be politicised. I say to my hon. Friend on the Front Bench that it behoves the Government to ensure that we have a proper debate on this issue. I welcome the comments that have just been made by my hon. Friend the Member for North Somerset (Sadik Al-Hassan), because I find them interesting, just as I have found the contributions from Members across the House. The costs have been set out today, and there is a vast range of figures. This could be resolved if the Government just published the impact study that we have all been asking for. Members have emphasised that when No. 10 said very clearly that any additional costs would have to come from the NHS, we wanted to have a debate so that we could ask, “Where from? What areas of service will be reduced?”

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34. 30 Jun 2026·Parliament·Labour·John McDonnell

    Department of Health and Social Care

    That is an incredibly relevant point in this debate. Many of us have examples of that, which is why we need to have a wider debate about the supply of drugs, their effectiveness and how they are evaluated. I thought we had a relatively objective system, but the deal throws that objectivity into question. Figures on the scale of deaths have been bandied about. I want to hear the Government’s view and their proper analysis of that, because we have to engage with the reports from Karl Claxton, Andrew Hill and so forth, as others have mentioned. The justification for the Trump deal was that it would increase UK exports to the US and increase overall investment in drugs in this country. I have yet to see any published evidence of that; in fact, the Government have not brought forward any evidence. I also say to my hon. Friend the Minister, and this is political, that I remember the commitment given by the Prime Minister and the former Health Secretary that the NHS would not be on the table in any Trump deals. This deal does put it on the table, because it has consequences not just for the supply of drugs, but for investment in the NHS and decision making about what our constituents can access. It relates not only to what level of drugs they can access, but—if there are reductions in other expenditure—to whether they will get access to a GP or A&E, or get the care services for which we have been advocating for quite a while. I thank the people who have been providing us with briefings on this issue, such as Global Justice Now and Just Treatment, which I have worked with over the years. They want to engage in the debate with the Government and to bring their expertise to the table, so I would welcome a commitment from the Minister to bring in those organisations before we move forward with implementation. This is my worry and that of those I have worked with: Kamran Abbasi, the editor of The British Medical Journal, has said that the deal “will end up harming vulnerable people to boost the profits of already obscenely profitable drug companies.” I do not want to support a deal that does that.

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35. 30 Jun 2026·Parliament·Labour·John Healey

    Defence Investment Plan

    We all want this defence investment plan to be a success, and I personally thank the MOD officials who have worked so hard for many months to get us to this point. I welcome the extra money the Treasury may have ceded in the last couple of weeks, which builds on the record increase in defence investment that we as a Labour Government have made since the election. However, threats are still growing, demands on defence are still rising in this dangerous world and today’s step means that, as a nation, we will be spending 2.7% of GDP on defence in 2030, the date when NATO warns we could face a Russian attack. With European security at stake, does my right hon. Friend agree that more needs to be done in the months ahead, beyond the DIP, to develop a clear, credible funding plan that will hit 3% and meet our NATO commitment to 3.5% by 2035?

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36. 30 Jun 2026·Parliament·Labour·Jo White

    Topical Questions

    Ranby Prison in my constituency is undergoing a £70 million expansion. The main prison car park is across the very busy A620 road. On 1 December last year, prison officer Phillip Tetley was knocked down and killed as he crossed the road to get to work. He leaves behind his wife Eve and seven children. Eve Tetley is campaigning for a crossing to prevent such an awful accident happening again. Will the Minister meet me and Eve to discuss this further?

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37. 30 Jun 2026·Parliament·Labour·Jessica Toale

    Defence Investment Plan

    Dorset has a proud armed forces tradition and can play a critical role in delivering our defence ambitions. We have a strong ecosystem of cutting-edge drone technology companies at the Dorset Innovation Park and a pipeline of skills and talent coming out of Bournemouth University and Bournemouth and Poole College. Will the Secretary of State confirm that the DIP will back the businesses and institutions in my region to drive forward innovation and deliver the skills that our defence industries need?

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38. 30 Jun 2026·Parliament·Labour·Jenny Riddell-Carpenter

    Nationally Significant Energy Infrastructure Projects

    I beg to move, That this House has considered the contribution of nationally significant energy infrastructure projects to communities. It is a privilege to serve under your chairmanship, Ms Vaz. I am grateful for having secured the debate, and I welcome colleagues across the House who will want to contribute. With this debate I seek to ask two simple questions. First, what contribution should nationally significant energy infrastructure projects make to the communities that host them? Secondly, how should communities be supported when they face disruption from significant energy projects? As the MP for Suffolk Coastal, a constituency that shoulders more of the burden than perhaps any other part of the country, I am well placed to ask those questions on behalf of my constituents. It is often said that up to 30% of Britain’s future energy will be generated in or transmitted through Suffolk Coastal, if planning permission is approved. We will host multiple significant infrastructure projects within a 10-mile radius, including LionLink at Walberswick; Sea Link near Aldeburgh; Sizewell C, which is Europe’s largest energy project, in Leiston; and converter stations at Friston and Saxmundham. All those projects sit in or cut through nationally important landscapes: sites of special scientific interest, the Suffolk heritage coast and Royal Society for the Protection of Birds reserves, all served by B roads and country lanes and all arriving at once, without any co-ordination, and some projects without any serious community benefit. I have raised this issue many times in the House, and the Minister has heard about it in much detail, both in this Chamber and one to one. He will be glad to know that I am here not to repeat many of those points but to set out new challenges and alternatives. I remind him, though, that my constituents are not opposed to clean energy—many are proud that Suffolk will be leading the charge against climate change in our drive towards green energy and away from fossil fuels—but they are taking on enormous disruption. Suffolk Coastal’s dashboard is now flashing red, and we are asking for more help. Businesses, people, community and nature are all asking for more help. The community investment programme should be the main opportunity to provide it, but we need better leadership. I ask Government to do what the previous Government failed to do: to provide leadership, which will sometimes mean challenging developers and telling them that my community and this country deserve better. I want to set out what the Government have done, and I do not want my case to be mistaken for opposition to their policy. In March 2025, the Government published the “Community funds for transmission infrastructure” guidance, which included £200,000 per kilometre of overhead line, £530,000 per substation or converter station, and bill discounts of up to £250 a year for 10 years for nearby households.

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39. 30 Jun 2026·Parliament·Labour·Jenny Riddell-Carpenter

    Nationally Significant Energy Infrastructure Projects

    I agree with a lot of what the hon. Gentleman says. The projects that we are discussing should deliver that as part of their long-term investment, and many of those things do not need to sit within the community investment programme itself. The guidance also included an obligation for the transmission owners, National Grid and ScottishPower Renewables, to run grant programmes, ranging from £10,000 grassroots grants up to £500,000 strategic grants. Importantly, the guidance rests on five key principles, including lasting legacy and transparent outcomes. If the developers depart from the guidance, they must explain why. It is a serious framework and the Government deserve credit for it. But the rates are recommended rates, not diktats. They should be the minimum, not the maximum. In Suffolk Coastal, we are seeing the minimum rather than the maximum far too often.

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40. 30 Jun 2026·Parliament·Labour·Jenny Riddell-Carpenter

    Nationally Significant Energy Infrastructure Projects

    I could not agree more. We need to make sure that we compensate for the impact, especially when projects are built out. I will come to that later in my speech. The National Grid’s Sea Link energy transmission project, a 138-kilometre interconnector between Pegwell bay in Kent and Suffolk Coastal, has a proposed community fund of £2.1 million, split between Kent and Suffolk. Let me break that down: that is roughly 0.1% of Sea Link’s total project budget. For a project that cuts through some of the most important nature sites in our country, in a county proud of nature-based tourism, 0.1% is not an investment strategy; it is a rounding error. It might meet the letter of the guidance, but it falls far short on delivering for our communities. The guidance is explicit that funds should deliver lasting benefits. I want a community-owned energy fund that is locally owned, locally governed and delivers permanent accountable benefit.

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