Draft Pensions (Abolition of Lifetime Allowance Charge etc) Regulations 2026
I have nothing further to add. Question put and agreed to.
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Draft Digital Waste Tracking (England) Regulations 2026
In my constituency, we have already paid dearly the price of waste crime and seen its impacts on our city and the surrounding area, so I really welcome this measure. I think most people would expect that we use digital tools these days to track, trace and gather data on the movements of value streams like this one. As we move forward into a more circular economy and see higher energy waste streams being handled, that becomes all the more important. As an officer in the all-party parliamentary group on critical infrastructure and heritage crime, it is good to see measures coming into place to tackle those areas of crime as well. I note that the regulation introduces a fee and I am interested in the future value for money of that fee. In particular, I note that the Secretary of State has responsibility for the operation of the digital waste tracking system, but it is not clear how that will be administered in practice or to whom the fee will be paid. Can the Minister explain the Secretary of State’s intention on the day-to-day administration of the waste tracking system? Will that be done by the Environment Agency, some other public body, or will it be contracted out to a private entity? Will the Minister also comment on the development of the software? I note from the accompanying papers that it is currently in a private beta test stage, but the optimism bias being used is 400%. Does that indicate a problem or some very high uncertainty on the final areas of development of that software? Apart from those small details, I strongly welcome the regulations and all the Department’s work.
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Health Bill (First sitting)
Q On that point, Dr Dash, what would you say to concerns that have been raised with me by Healthwatch Wolverhampton that patients and service users will be reluctant to raise concerns from within the system? How will your recommendations help with that? Dr Dash: I think that we do need to recognise that. I hear that as well and experience it myself; lots of people are often reluctant to come forward, and they think, “If this is my GP, how is this information going to be treated?” That is why we need to really raise the calibre of our directors of patient experience. There are ways in which you can manage that and treat that data confidentially—in fact, you have to treat all data confidentially. There are ways in which you can support people and give them the confidence that their information will be taken seriously and treated confidentially. You can do that often through focus groups, one-to-one conversations and anonymous surveys. We are hoping to be able to do a lot more of that through the app, to link it directly to people’s care, and to give people prompts as soon as they have had an interaction: “Please feed back.” I think there are ways in which we can overcome that. Bringing this much closer to people’s care, linking it in much more to day-to-day practice and making sure that feedback goes straight back to our frontline clinicians in an anonymised way to encourage and support them to improve brings a significant benefit, and we can find a way around the concerns about confidentiality.
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Health Bill (First sitting)
Q My question is to Dr Dickson and is about education and training policy, responsibility for which will be transferred from NHS England to the Secretary of State. I know that you have a lot of interest in medical training and education, so what do you feel would be the impact? Dr Dickson: I think the impact could be really positive. At the moment, we train nationally to high standards, so that the product of medical education can be deployed anywhere in the UK, and we are also all trained to develop, innovate, change the service and move forward. What we miss at the moment is parity of esteem for education as a productivity function of the NHS. There is the productivity function of elective care, waiting times, cancer treatment and all those things, but education must sit at that level of esteem for productivity for all professions in order for the service to continue—not to innovate, change and develop, but just to continue. Moving things to the Secretary of State gives us a chance to ensure that that pure parity is seen. The danger is that if you move the function in, it gets lost in the service productivity sphere. There is a huge opportunity to firmly embed the education and strategic development of different roles as a true productivity function of the NHS, which it needs to be.
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Health Bill (First sitting)
Q I feel that my question may have just been answered, but you may wish to add something, Dr Benneyworth. Will patient safety accountability be improved when a patient’s care spans different organisations within an ICB? Dr Benneyworth: One of the things that we see regularly in our investigations is that people fall down the gaps between organisations. We have the ability to look right across the system and understand a person’s journey. As a recent example, we looked at medication errors on discharge from hospital. There are a lot of medication errors, and we looked at the process of how information was being shared and what was happening. Those are the type of things where we see a lot of concerns about patient safety. There needs to be much more clarity about accountability for patient safety. No one is accountable for the discharge of a patient. There is not one person—no single individual—who is accountable when someone is discharged from hospital to social care. You go through multiple layers of accountability. We are keen to learn from other industries that have effective safety management systems. Part of those safety management systems is having much more clarity about accountability, which is lacking across the NHS. I very much hope that, with the changes to ICBs, they really do think about accountability for patient safety.
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Health Bill (Second sitting)
Q I would like clarity on a few views that we have heard, not just in this session but in previous ones. There is one mindset that says that by bringing patient voice into ICBs, they are going to be marking their own homework. Equally, I think about places like Wolverhampton, where we have such baked-in inequalities and we simply have not shifted the dial for far too long, as can be seen in the differences in life expectancy. I have also heard that if you want to bring real change, it is best to bring that change from within the system. I will open that up to you, Sarah. Sarah Tilsed: I disagree with that. It is fine for ICBs to be involved, but it is all about local partnership working—bringing in the voluntary sector and really going into the community, and doing it in partnership. That is the only way of doing it. If you are bringing it into the ICB, consider how much funding there was when Healthwatch was doing it and—I do not want to repeat this point, but I will—the fact that it will be marking its own homework. For me, it is about partnership working going from the community—not within the system and not within the NHS, but going out to the community and feeding inwards.
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Health Bill (Second sitting)
Q Constituents have raised issues with me about when elderly patients or patients with dementia, in particular, come to discharge and the transfer of care, because of the lack of effective data and information sharing. To what extent do the provisions in the Bill on the single patient record allow data to be shared with social care providers? I will ask Councillor Wright to start off. Councillor Wright: At the LGA, we are arguing for a single person record, so that we have a single patient record that brings in social care providers, or at least the local authorities’ social care statutory provision, too. Someone discharged into the community would therefore still have access to records and know what was going on, while others would know what has happened to that person and what they need. Yes, we agree: we hope that a single patient record would make things as smooth as possible from hospital discharge to home and would help when someone comes into hospital, so that the clinicians have a better idea of what the patient’s quality of life was like, what treatments they were on, and so on. We are definitely in support of the single patient record for that, and we would like it to become a single person record. Sally Burlington: We are supportive as well. The Bill itself is unlikely to solve all the problems in this space. A huge number of practical cultural system problems exist in data sharing, so the regulations that follow the Bill will be important to enable that to work for social care providers and commissioners. It is worth noting that there are thousands of social care providers, so the implementation of the Bill and subsequent regulations will be important. We are keen to ensure that any approaches are co-produced with the social care sector, as well as the NHS. It will be a lot of thinking, a lot of planning and a lot of hard work to get it right, and social care providers will need lots of notice to upgrade their systems in the right, consistent way to enable them to speak to each other, if we are to see the vision of the single person record delivered. I guess it would also be helpful to think about the role of carers as we move into that space, because we know from covid that data sharing among carers was one of the issues that came up.
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Road Maintenance Funding: Nottinghamshire
I beg to move, That this House has considered funding for road maintenance in Nottinghamshire. It is a pleasure to serve under your chairmanship, Sir Jeremy. The issue of the condition of roads across my constituency is raised with me more than almost any other. Since becoming an MP, I have been contacted by hundreds of residents about potholes, crumbling surfaces and roads that have been left to deteriorate for far too long. Time and again the message from my constituents is the same: our roads are simply not good enough. In Mansfield, potholes are no longer just a nuisance; they are becoming local landmarks. Some residents tell me that they no longer bother trying to avoid them. They simply recognise them, almost like old friends on the school run or the commute. That may raise a smile, but behind that humour is a much more serious reality, because potholes are not just harmless inconveniences—they are hazards that damage vehicles. They also increase costs for families, sometimes by hundreds and even thousands of pounds. In some cases, they put human safety at risk—and not just of injury but sometimes death, and there are examples of that in my constituency. I have also heard from constituents about significant damage to tyres, which leaves people stranded late at night. In an email typical of the many that I have received, one resident described being left alone in Mansfield in the early hours after a punctured tyre, waiting until 5 am for recovery and assistance, and feeling vulnerable and unsafe. Another constituent wrote to me about her local estate, where a single pothole on her street is almost impossible to avoid. It has caused serious vehicle damage. She explained that she no longer reports issues to Nottinghamshire county council, the highway authority, because she has no confidence that it will lead to meaningful change. Instead, she sees the same pattern repeated: small temporary patches of tarmac that break down again after a very short period, or potholes simply marked with spray paint and left for weeks. The sense of resignation is perhaps the most frustrating part of all, and is something that I have heard many times. Roads are patched rather than properly repaired, problems are identified but not resolved, and residents feel that they are paying more and more in council tax only to receive less in return. Let us be clear that this is not just about inconvenience. Roads are essential infrastructure that people rely on to take their children to school, access healthcare and get to work. When they are in such a condition, there is a direct impact on daily life and our local economy. It is not acceptable that residents should be left facing repair bills, avoidable damage and safety risks because our roads have not been maintained properly. How did we get into this situation? The basic issue is quite simple: roads do not last indefinitely without planned maintenance. They require resurfacing at regular intervals, yet that cycle has been allowed to slip far beyond what is sustainable. The Asphalt Industry Alliance reports that roads in England are now resurfaced on average every 39 years for principal roads, 60 years for B and C roads, and sometimes over 100 years for unclassified roads—far beyond the recommended 10 to 20 years. The gap is not just a technical detail; it is a structural failure. It means roads are being allowed to deteriorate until they break down completely, leading to expensive and reactive repairs. Once that happens, the cost spiral is immediate. Patching potholes becomes more expensive than prevention, and each intervention lasts less time. We are, therefore, spending more for worse outcomes. Across the country, including in Nottinghamshire, that has created a repeating cycle of deterioration followed by temporary patching, further breakdown and repeat intervention: a managed decline that never resolves the underlying issues. Nationally, that has built up a substantial backlog, with independent estimates placing the cost of restoring local roads to proper condition at many billions of pounds, and large parts of the network close to the end of their structural life. In plain terms, we are dealing with not just potholes but the accumulated consequence of years of deferred maintenance and under-investment—not the result of a single bad winter or short-term disruption. Under the Conservative Government from 2010, central Government funding for local authorities was significantly reduced, particularly during the Cameron and Osborne years of 2010 to 2015. We all saw the impact of that on our local councils across various services. Capital expenditure on local road maintenance in Nottinghamshire fell from £16.6 million in 2011 to just £12 million by the time Boris Johnson became Prime Minister in 2019. Revenue expenditure on local highway maintenance, funded through council tax receipts and business rates, remained below 2010 levels in every subsequent year, and in some years reduced by more than 50%. In the final five years of Conservative Government, some additional and welcome funding was provided but, after taking inflation into account, the real-terms cumulative loss in funding in Nottinghamshire alone over those 14 years amounted to tens of millions. Furthermore, because highways maintenance is not ringfenced, rising pressures from other areas forced local authorities to divert their limited resources to meet their obligations elsewhere, further weakening any capacity for preventive maintenance. A double pressure emerged: increasing demand on council budgets and a road network requiring more investment just as preventive maintenance was squeezed. The result, after years of Conservative under-investment, is a road network in Nottinghamshire that is increasingly worn out, more expensive to repair and reliant on temporary fixes instead of lasting solutions. That responsibility does not stop at the national level. My residents and others across Nottinghamshire will remember when our county council was led by the Conservatives under my predecessor, Ben Bradley, who was simultaneously leader of Nottinghamshire county council and Conservative MP for Mansfield. As council leader, he failed to reverse the deterioration of local roads or secure the additional funding needed, despite being in a prime position to do so. It is against that backdrop that the Labour Government have had to decide what happens next: whether we continue to manage decline or we finally move to a system where repair and maintenance of roads are done properly. Therefore, I am pleased that the Government have chosen the path of investment in our roads in Nottinghamshire, instead of the path of further deterioration and decline. I welcome the fact that the Labour Government recently set out a record £7.3 billion national multi-year settlement for local road maintenance across the country over the next four years. That is not just a headline figure; it is long-term and guaranteed funding that gives councils such as mine in Nottinghamshire the ability to plan properly, move away from crisis management and invest in proper preventive maintenance. That is on top of the Government’s investment of £1.6 billion for this financial year, which is a £500 million increase compared with the last financial year. This is real year-on-year growth, rather than managed decline. Under the previous system, funding for 2024-25 in Nottinghamshire stood at just £18.6 million. I repeat that figure for emphasis—£18.6 million. However, under this Labour Government, who have worked with the East Midlands combined county authority and Mayor Claire Ward, that figure has risen to £44.7 million in 2025-26, including £15.2 million of additional mayoral investment. It will rise again to £46.9 million in 2026-27, including £17.4 million from the mayor. That is tens of millions of pounds of additional funding in Nottinghamshire to help fix our roads. The contrast with what came before could not be clearer: investment under Labour, and decline under the Conservatives. I therefore place on record my thanks to Mayor Claire Ward and the Minister for the leadership they have shown. Partnership between central Government and regional leadership is exactly how to fix long-standing problems properly, because for years our councils were asked to do more for less. As mentioned earlier, preventive maintenance was completely squeezed, long-term planning was undermined and, as a 2019 Transport Committee report made clear, the system was “fragmented”, “reactive” and failed to deliver the certainty needed to maintain roads properly. Recommendations that were made clearly at the time were not acted on by the previous Government. Labour investment means that Nottinghamshire county council has both the resources and the responsibility to deliver, and what matters now to my constituents in Mansfield and to people across Nottinghamshire is delivery. I accept that there is a major backlog of repairs and that not every road will be fixed overnight. However, with these record funding settlements, Nottinghamshire county council cannot claim that it is not able to get this done due to a lack of funds. The money is coming in, I am glad to say; the question now is whether it can be used effectively at local level. We are investing more than ever before, we are changing a system that has failed for too long, and we are giving councils the tools they need to succeed. However, I also make it clear that this funding must translate into visible improvements on the ground, because residents in Mansfield do not measure success in budget lines or policy papers. They measure it by whether they can drive to work without damaging their car, whether parents can safely take their children to school and whether their roads are finally fit for purpose. That is the standard that I believe the Labour Government are now setting, and I will continue to hold the council to account for making sure it is met.
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Access to Dental Services: West Sussex
It is a real pleasure to serve under your chairmanship, Sir Desmond. I thank the hon. Member for Chichester (Jess Brown-Fuller) for securing this important debate and I am delighted to wish her a happy Sussex Day. We may come from different political traditions, but she occupies Gillian Keegan’s former parliamentary seat, and I occupy Gillian’s former office in the Department of Health and Social Care, so we at least have that in common. This is the second debate that I have responded to on dentistry in as many days—I was in the Chamber yesterday, and I am here in Westminster Hall today. That shows what a critical matter this is to our constituents, which is why this Government are taking clear action. On access to NHS dentistry, I point to 1.8 million extra treatments in the first seven months of the last financial year. In fact, taking the last full year into consideration, we are on track to deliver more than 2.5 million more dental treatments than in the year leading up to the general election.
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Access to Dental Services: West Sussex
I am so delighted that the hon. Lady intervened, as I was about to come to that. We have reduced the underspend—one of the many utterly shocking things I found across my portfolio when we came into office in July 2024 was a £392 million underspend on NHS dentistry. We had an absurd situation where demand for NHS dentistry was going through the roof, but because of utter incompetence, the previous Government were underspending by £392 million. We were hands-on on that. We have the ICBs commissioning; we have micromanaged this. I am delighted to say that we have got the underspend down to just £36 million in 2024-25. That is how we have managed to massively boost the number of treatments. According to the most recent data available, the Sussex integrated care board, which serves the constituency of the hon. Member for Chichester, has delivered over 67,200 more NHS dental treatments. That is 11% more treatments between April and October last year compared with the same period before the general election. I hope that answered the question from the hon. Member for Bognor Regis and Littlehampton (Alison Griffiths). While we have made significant progress, I do not downplay for a second the issues faced by the constituents of the hon. Member for Chichester. Whenever I reel off these statistics in a debate or on the morning media round, I can hear people saying, “Okay, you say that, but where is my dentist appointment?” I understand that there are pockets of progress and areas where we are not at all where we need to be. But it is important to be realistic: 14 years of neglect cannot be put right overnight. The result of that neglect has been people doing DIY dentistry, and the No. 1 reason why children aged five to nine are going to hospital is tooth decay. It is a shocking and Dickensian state of affairs, frankly, and the Government take it very seriously. As I said in the main Chamber yesterday, the solution is not to bring out sticking plasters and press releases, and to tinker around the edges. The sector needs long-term reform, and the Government have laid the groundwork for a recovery that is based on solid foundations, not the sort of gimmicks that we saw under the previous Government. For example, the patient premium cost £126 million and we did not see any increase in new patients. We had to scrap that because it was a waste of time and money. The most important thing we can do to end dental deserts is train the next generation of dentists in the relevant areas. We are taking steps to increase the supply of dentists across the country. Earlier this month, I announced the first sustained expansion of dental school places since 2007. Let that sink in for a minute. It is 20 years since we had any increase at all in dental school places, apart from a one-off increase after covid. Backed by £11 million, a total of 50 dental school places per year have been allocated equally to the University of Portsmouth and the University of East Anglia.
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Access to Dental Services: West Sussex
We will be publishing the data on the golden hellos in August, along with all the other data. There is a time lag from the end of the financial year to when we have collated all the data—it takes a few months—so there will be data in August on a number of issues we have discussed today. The challenge of golden hellos is that we run into problems around the contract, incentivising people to do NHS dentistry, and getting people to live and work in certain parts of the country when they might be more attracted to a big city. We are aware of the challenges for coastal areas. On the Portsmouth announcement, I have never driven from Portsmouth to Chichester, but I understand it is about a 20-minute drive, depending on the traffic—
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Access to Dental Services: West Sussex
Yes, but before the hon. Lady intervenes, I will say that I am fully aware that Portsmouth is in Hampshire, so I ask her not to give me a deluge of letters from her constituents.
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Access to Dental Services: West Sussex
We clearly need to check our GPS on that one. I understand that there are challenges, but the point is that, for the first time in decades, Chichester has a school in its vicinity that is training dentists who will be within striking distance. Who knows where all the dentists will end up living when they have done the training? But our data suggests a strong correlation and causation between where somebody goes to dental school and where they end up putting down roots and working, living and settling. That is very much our hope for the 25 places that are, for the first time in 20 years, going to the University of Portsmouth, which I was pleased to visit just a few weeks ago.
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Access to Dental Services: West Sussex
I strongly echo the hon. Lady’s congratulations to Chichester college. Of course, technicians, nurses and therapists play a crucial role; dentists’ practices function not just because of the dentist but because of the whole team. It was, frankly, a travesty that the hon. Lady’s local area did not have a dental school, and it was a problem that Governments ignored for far too long. I am delighted that we have put that right, and hope she will recognise what a game changer it is. Whereas before, people had to train elsewhere and make an active decision to move to Chichester to practice dentistry, we hope that local people can now train up in the area and stay there if they wish to. That is a real incentive for people in Chichester to choose a career in dentistry, and to stay and serve in Sussex among the people they grew up with. It will also attract young people from across the country, who may choose to continue their careers, make their homes and put down roots in the area. Similarly, the most important thing we can do for the long-term dental health of the hon. Lady’s constituents is to make the shift from treatment to prevention. In 2024, more than one in 10 children aged five years old in Sussex ICB had experience of tooth decay, despite it being largely preventable. We are backing supervised toothbrushing through a national programme that will reach up to 600,000 children in the most deprived areas of England, backed by £21.5 million. Over £290,000 has been invested across West Sussex, East Sussex and Brighton and Hove, and over 45,000 free toothbrushes and toothpastes have been delivered through our innovative partnership with Colgate-Palmolive. We are beefing up the soft drinks industry levy to remove more sugar from children’s diets and updating standards so that there is healthier food and drink in schools. This year, we are undertaking vital reforms in dentistry. Two months ago, we embedded urgent dental care into NHS practices, making it easier for patients to get support where they need it most. The problem we heard time and again from the sector was that dentists were not incentivised to undertake NHS work, so we brought forward a package of reforms, from which I will highlight two measures. First, dentists are set to receive higher payments for treating patients who need urgent care, taking the payment for a unit of dental activity from approximately £42 to approximately £75. Dentists now have the extra incentive to provide urgent care for issues such as severe pain, infections or dental trauma on the NHS. Secondly, from this month, those receiving complex care, such as treatments for severe gum disease or decay in multiple teeth, will be able to schedule a single planned package of treatment and pay one patient charge for it, rather than having several courses of treatment and paying a patient charge for each. That could save people more than £200 per year—money going straight back into the pockets of working people. We are also paying dentists more fairly for this work, to incentivise them. The appointments also mean that we are easing some of the pressures on St Richard’s hospital in the hon. Lady’s constituency, because we are preventing more painful conditions from spiralling into avoidable hospital admissions. In a nutshell, our 2026 reforms are putting patients first and supporting those with the greatest need while backing our NHS dentists, making the contract more attractive and effective, and giving them the resources to deliver more. The Government remain committed to rebuilding NHS dentistry after years of neglect. We have made a start with reforms to the dental contract that prioritise patients with the greatest need, support better access to urgent care and deliver a better deal for dentists. Alongside that, we are taking targeted steps to support areas where access is most challenging, including through workforce incentives, new school places and reforms to the exams process for overseas-qualified dentists, which will deliver an additional 2,000 dentists per year by 2028. And we are just getting started: as I have said previously at the Dispatch Box, I remain firmly committed to delivering fundamental reform of the dental contract before the end of this Parliament. However, meaningful reform requires careful consideration. The challenges facing NHS dentistry are complex, and there is no single universally agreed solution or perfect payment model. That is why it is important that we take the time necessary to develop reforms that are effective and sustainable, and that work for patients and the profession. I will continue to engage closely with dentists, representative bodies and patients to ensure that the reforms we bring forward address long-standing concerns and support the long-term future of NHS dentistry.
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Russian Oil Sales
As you will know, Mr Speaker, Jo Cox was a good friend of mine long before we came into this place, as well as a colleague of mine at Oxfam, and I have to say that coming in today on this anniversary is particularly sad. I also know that Jo would have told me to stop getting so emotional and to get on with the job in her inimitable way, as she often did—so I will do just that. We are committed to increasing the economic pressure on Russia by disrupting the revenue the Kremlin generates from Russia’s energy trade, including oil, which remains its primary means of financing the illegal war in Ukraine. The Prime Minister has today announced further sanctions, designating and specifying 70 individuals, entities and ships under the UK’s sanctions regulations, including 20 shadow fleet vessels.
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Russian Oil Sales
The hon. Gentleman will understand that I am not going to comment on future operational matters. What I can say is that we have also assisted in the interdictions of other vessels, including by working with the French and the United States in relation to the Bella 1. We keep Russia’s activities under very close review and designate hundreds of vessels under the shadow fleet measures, and we will look at all opportunities to ensure that they cannot evade sanctions.
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Russian Oil Sales
With respect, the hon. Gentleman may not have caught up with developments on that front. First, it was never an indefinite waiver; we said that we were keeping it under two-weekly review—my colleagues in the Department for Business and Trade made that very clear. Yesterday in the House, and indeed in announcements over the weekend, we set clear end dates for those temporary licences, which are to phase in these measures. Of course, these are new measures—we were never watering down previous sanctions; these are toughening the sanctions on Russia, but with sensible provisions in place to phase them in.
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Russian Oil Sales
My hon. Friend raises an important issue. I would be happy to discuss it further with him, as, I am sure, would colleagues from the Department for Business and Trade.
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Russian Oil Sales
The shadow Minister asks an important question. I made it clear in yesterday’s Delegated Legislation Committee that that is the end date, but we are keeping it under review every two weeks and the licence could end before then, with the appropriate notice in place for industry. I am clear that our sanctions are having a categorical impact on the Russian economy. Russia has slashed its economic growth forecasts, and collectively our sanctions have denied Russia access to $450 billion, which could have fuelled the war for many more years. Our sanctions are having an impact, but we will continue to toughen them.
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Social Media Disinformation
As the Foreign Secretary said in her Locarno speech in December, and as the Chief of the Secret Intelligence Service reinforced a week later, an industrial-scale attack is being waged every day through social media, designed to undermine our democracies and divide our societies. We know that networks attributed to Russia, including Doppelgänger, are flooding social media in countries across the world—not just the UK—with counterfeit documents and deepfake material in an attempt to weaken global support for Ukraine. We are taking tough action on this front with our international partners.
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Social Media Disinformation
I completely agree with my hon. Friend. That is exactly why we have taken the action that we have: since October 2024, we have exposed and sanctioned 96 actors and entities involved in this type of activity, and in May we imposed sanctions on another 56 individuals and entities that are particularly involved in activity to undermine Ukraine. That included employees of Social Design Agency and ANO Dialog. We are constantly looking at what measures we can take, and taking action. The Kremlin is spending billions of dollars on information warfare. We will expose this activity and take it down.
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Social Media Disinformation
I am sure that my ministerial colleagues with responsibility for Myanmar would like to follow up with the right hon. Gentleman on that issue. The challenge of misinformation and disinformation relates not only to Russia but to a whole series of contexts—and not just states. We also see it in non-state actors, including Daesh and other organisations. We are working very closely with partners to identify and tackle those networks.
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Social Media Disinformation
Well, Jo certainly was funny. I remember standing in King Charles Street with her once just before going to see officials in the Foreign Office—she had lots of climbing ropes in her bag as she had just got back from a hiking expedition. There were many fun moments with her over the years. My right hon. Friend raises a crucial point. I really welcome the work that she and her Committee have done on this issue. We have taken their recommendations seriously and I will continue the conversation with her. I cannot make the promise that she is asking for at the moment, but we are certainly looking closely at the suggestion.
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Social Media Disinformation
I assure the hon. Member that we are very much having discussions with counterparts across Government. I am sure that in the next few days I will be meeting the new Security Minister and the new Minister for the Armed Forces. I also recently met a Minister at the Department for Science, Innovation and Technology to discuss these very issues. I assure him that we are working closely together across Government on this issue.
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Topical Questions
I congratulate my hon. Friend on her damehood, which is well deserved, and on her consistent advocacy in relation to Armenia. I can assure her that we are monitoring the concerning situation regarding Russian economic pressure on Armenia. We are developing our strategic partnership further. In fact, I was discussing Armenia with both US and EU counterparts in recent days, and we will work closely with international partners to ensure Armenia is robust and able to pursue its own future.
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Topical Questions
The illicit finance summit will convene a broad coalition to tackle dirty money globally and focus on financial transparency, property, crypto and illicit gold. The Crown dependencies and overseas territories with financial centres have committed to upholding international tax standards, but we work closely with them on upholding those international standards and on wider transparency, including in relation to beneficial ownership.
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Topical Questions
We wish Scotland very well and congratulate the team on their success against Haiti. The hon. Lady raises an important point. I have raised these issues with the US Government, as has our embassy in Washington. Obviously I cannot comment on specific cases, but I urge all constituents who are travelling to the United States for the world cup to follow the US guidance online. If they encounter any challenges, I urge them to speak to the US embassy.
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Topical Questions
I thank the hon. Gentleman for his consistent advocacy on Gibraltar. We are committed to finalising this treaty imminently. The draft treaty text is undergoing its final legal checks, and as he will know, a draft was previously deposited in the House with a summary on 26 February. We look forward to signature imminently, and the provisional application is expected on 15 July.
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Health Bill (First sitting)
I used to work in a mental health trust for many years, and I am still its employee—I am on an extended career break from the trust.
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Health Bill (First sitting)
Q Mr Lant, I am trying to understand a bit more about the patient experience and improvement in care that Healthwatch brings. My understanding is that when a patient raises a complaint with the local provider, it usually gets investigated by a local service manager or a matron, but when somebody is not confident about raising a complaint with the local provider, they go to Healthwatch, and that complaint usually filters down for the same local service manager or matron to investigate it—we have seen that happening. Patient experience is not being improved without local accountability or local change. Can you explain why you are concerned about abolishing Healthwatch and bringing more accountability to local ICBs or local authorities, which may improve patient experience and patient care? Jacob Lant: The issue is that the system—the NHS provider, the commissioner or whoever is picking up the individual complaint—will treat that as an individual incident to look into. Healthwatch may support the individual to raise that complaint or that individual piece of feedback, but the collective learning across that is more important, and it is pulling out the themes that are consistent across multiple bits of feedback, both positive and negative, that makes the difference. We see that evidence and insight from Healthwatch making a difference in local and national policy. It might not feel like that to the individual patient, but things like the creation of a single patient record exist in part because of a lot of campaigning by local healthwatch on the issue of people having to repeatedly tell clinicians about their experiences. It also could be issues to do with not being able to find a dentist, for example; the system will treat that as an individual incident of helping someone who is trying to find a dentist or not, but Healthwatch could use that insight to petition and push for national change around the commissioning of a service like dentistry. A topic like administration of care, which Healthwatch, National Voices and the King’s Fund have all worked on together, is invisible from the way that the system perceives performance at the moment, but because we listen thematically to patient experience, we can push for a much greater focus on things like the basics of communication and keeping patients up to date on what is happening with their care, which really matter. Healthwatch is thematically looking at patient feedback differently from the way that system does, and that is something I fear may be lost.
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Health Bill (First sitting)
Q I want to touch on the single patient record. I declare that I used to work in mental health services. In my experience, mental health patients often navigate between A&E, GPs and mental health services during weekends. Often the clinicians do not know what medication they are on, or what kind of contact patients had on the Friday or Saturday. Also, during the discharge process, getting medication from the GP can be delayed until the discharge notification gets to the GP. Yes, there are concerns about who will own this data, but do you not think that the single patient record will bring a huge benefit for patient safety and continuity of care? Kay Keane: In the example you gave, the hospital should be giving seven days-worth of medication to the patient. That is clearly its responsibility. Within those seven days, the GP practice should get a discharge letter that says what has happened; if appropriate, we then take over the prescribing. If the information comes and is good quality—if the data is good and timely—the things you mentioned do not happen; they happen when neither of those things are the case. In my experience, information that comes out of A&E is often difficult to understand. A&E might make a diagnosis that it works with, but by the time that gets to the ward it can be different, so the A&E information we act on could be very different from what the patient is discharged with. Timely and good-quality information is therefore really important, and that GP record then becomes the centre of the patient’s care. Dr Dickson: You are talking about transfer of care between services and about a weekend being an important flashpoint, but I think that that transfer of care does not happen appropriately even during the week. It is getting better, with electronic systems, but it is still not necessarily working for the full benefit of patients, especially if they access multiple services. The value of the single patient record is to make that safe, but the question is, will it do that? Can it do that? Is it safe to do that? Will the patient’s data be protected? That is what we are we are worried about. I think that is what patients worry about. They perceive that we do that already, and when they come up against the healthcare service, they realise that it does not happen; they do not realise that it is not a personal thing to them, but a systemic problem. It is about getting patients to understand the systemic nature of the lack of data sharing at the moment.
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Health Bill (Second sitting)
Q Sarah, you mentioned that the patient should be the centre of all this. I do not think that anybody disagrees—including any politicians—that making these changes is in the best interest of the patients. However, many changes have happened over the decades, but data for the last 10 years shows that patient safety incidents and complaints are steadily going up, so those changes have not made any impact on patient care, safety or experience. We need to do something here. After each incident, there is a recommendation or an action plan, but clinical staff or patients do not have much involvement with those and do not see any difference. Healthwatch helpfully finds the issues, but it may not actually go back and see what changes are made following its recommendations. The CQC physically goes into clinical areas to see the difference, and has the power to take action against those responsible, so is it not a good change that more accountability will sit with the providers, and the CQC—or local authorities and ICBs—can take action against them? Professor Croisdale-Appleby: Forgive me; you asked several questions. Which would you like me to start with?
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Health Bill (Second sitting)
I asked whether it is not a good change to streamline these bodies so that fewer of them have powers to take action like the CQC? Professor Croisdale-Appleby: There is always a danger, if I may say so, in the use of the word “streamline”. We have to think what is lost in the streamlining process. I do not want to repeat what I have said and waste your time, but one thing that is important is whether there is a golden thread running through seeking out and listening to patients’ views, putting those together in a coherent form, making recommendations for improvement—that is what we do all the time at Healthwatch—and then holding people accountable for that. I remember Penny Dash saying that one of the points of the Bill is to bring this closer to those who commission and those who deliver. I am not sure that it necessarily takes it closer to that simply by embedding it—as a colleague asked earlier—within the formal structure. There is a danger in that that the patient voice is often a spiky voice. As a former chair of hospitals and so on, I know that patients do not always say things that are convenient. That point about independence is vital. If I may, sir, I take slight issue with your term “streamlining” and would try to take that apart into the different components that might comprise it. Sarah Tilsed: I cannot comment too much on the CQC, but on the point about a rise in complaints but nothing seems to be happening, we are finding that patients do not want to complain any more because they are finding that they are getting a worse service of care. That might be a slightly separate issue, but considering that there are so many complaints and that patients are not wanting to complain because they are scared, I do not think that streamlining is the right way. We need an independent voice that will focus solely on the patient voice, which I think we are completely losing at the moment.
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Health Bill (Second sitting)
Q I was listening to Dr Byrne’s concerns about confidentiality and trust. I want to declare that I have worked in the NHS in the mental health sector for many years. I worked in one of the biggest mental health trusts, Kent and Medway mental health NHS trust. We use an electronic patient record called Rio. As Dr Cocker said, before anyone is given access to the record, they have to have training on information governance and data protection, and access is given based on their role. That system creates an audit trail, so patients can request to see how many people have accessed their information in the last month or two—there are facilities on the system to check that. Is staff training and raising awareness among patients important for creating trust and confidentiality? Dr Byrne: Those things are very important, yes. There are some technical solutions. Again, the SPR is an opportunity to look at that across the system, because systems vary greatly in the sophistication of their audit function, for example. Even when there is an audit function, if someone has legitimate access through their role as a doctor or a nurse, it can be difficult to know whether their access in any particular case is legitimate. These are not common occurrences, but it is extremely distressing for patients if their confidentiality is breached for any reason. It is not simply a matter of technical controls. We need to look at how we build stronger, more effective deterrents across the system by having effective sanctions when incidents do occur. I am keen to look at that and delighted that the Department of Health and Social Care and NHS England are, I think, very interested in having that conversation with me. At the moment, it certainly seems that there is a variable response across the system to inappropriate access. Looking ahead to the SPR, we need to look at that make improvements, so that the public can have faith that, given the harm that it can cause them, it will be taken very seriously if anyone does access their records inappropriately. There are technical, cultural and system aspects to think about here. The SPR is definitely an opportunity to do that, and I am very keen to work with other stakeholders on that.
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Road Maintenance Funding: Nottinghamshire
It is a pleasure to serve under your chairmanship, Sir Jeremy. I am grateful to my hon. Friend the Member for Mansfield (Steve Yemm) for securing this important debate. He spoke with real passion about the state of roads in Nottinghamshire, and rightly so, because this is not an abstract issue. It is about the roads that people rely on every day to get to work, to take their children to school, to support local businesses and, above all, to travel safely. For too long for people across Nottinghamshire, those everyday journeys have been made harder by roads that simply have not been good enough or safe enough. My hon. Friend highlighted that this has not happened by accident. It is the product of years—indeed, over a decade—of under-investment in our local road network: potholes left unrepaired, surfaces deteriorating, preventive maintenance deferred again and again. We are now dealing with the consequences of those decisions. This Government are determined to turn that around. That is why we are providing a record £7.3 billion for highway maintenance over the next four years, giving councils the long-term certainty that they need to plan properly to resurface our roads and tackle the pothole plague once and for all. Crucially, we are also backing the east midlands by providing £2 billion in transport for city regions funding through to 2031-32. Delivered through the East Midlands combined county authority under the leadership of Mayor Claire Ward, this substantial investment, devolved to the region, will enable transformational investment in local transport infrastructure, including roads, and empower local leaders to make decisions that reflect real local priorities, because we know that better decisions are made closer to the communities they serve. However, funding alone is not enough. It must be matched by delivery. That is why we have introduced a strengthened system of accountability, built on transparency, clear performance ratings and incentives for local highway authorities. First, transparency. Councils now have to publish clear annual reports showing the condition of their roads, what they are doing to maintain them and how public money is being spent. That includes not just how many potholes they have fixed, but how they fixed them, whether repairs are built to last and whether they are investing in prevention, such as maintaining drainage and using surface treatments to stop potholes forming in the first place. My hon. Friend mentioned his constituent who had simply given up reporting a pothole on her street. It may be useful to point out that councils will now have to publish how residents can report road defects, how that information is used to prioritise repairs and whether people are kept informed once a problem has been raised. Transparency really matters. It gives residents a clear view of how their roads are managed, makes councils accountable for their choices and helps to ensure that funding is used to deliver long-term improvements, not just short-term fixes. Secondly, ratings bring that information together into a clear, accessible judgment of performance so that residents can easily see how well their council is maintaining the roads they rely on. In the most recent assessment, Nottinghamshire was rated green for highways maintenance spend, but amber for the condition of its roads and adherence to best practice, resulting in an overall amber rating. That tells us two things: funding is reaching the right places because the council is spending the money allocated to it, but there is still work to do on improving road conditions and embedding best practice. Thirdly, incentives. A share of the funding is now linked to clear performance requirements that every authority is expected to meet. That includes spending all the Government’s highways funding on maintenance rather than devoting it elsewhere. It also requires authorities to maintain up-to-date asset management plans, which ensure that maintenance decisions are based on evidence and long-term outcomes rather than simply react to potholes once they appear. Alongside that, we are supporting authorities to improve through highways innovation programmes such as Live Labs 2, targeted support for red-rated authorities and updating the code of practice for well-maintained highways. We are helping councils to adopt new approaches, build capacity and deliver better outcomes for residents. Earlier this year, we published the first national road safety strategy in over a decade, setting out how we will cut road deaths and serious injuries on Britain’s roads by 65% by 2035. Let me be clear that this Government are stepping up. We are providing the funding, we are putting in place the performance framework, and we are backing regions such as the east midlands to succeed. On a national scale, we are already beginning to see the impact of that approach. In 2025, after nearly a decade-long decline, the percentage of roads receiving maintenance treatment went up again, but it is for local highway authorities, in this case Nottinghamshire county council, to get on and deliver. That means more than just filling potholes when they appear; it means investing in long-term preventive maintenance, making smarter use of materials and technology, and building a road network that is safer, smoother and more reliable for the future. Recent figures show that, while overall road fatalities have declined, far too many people are still killed or seriously injured on our roads each year. Every pothole that is left unrepaired and every surface that is allowed to deteriorate is a risk that we must take seriously. I finish by returning to the central point made by my hon. Friend the Member for Mansfield: the people of Nottinghamshire deserve roads that are properly maintained. This Government are delivering the investment needed to make that happen, and we are putting in place clear expectations and accountability to ensure results. It is now for Nottinghamshire county council to turn that investment into results on the ground. I thank my hon. Friend for securing this debate, and I look forward to continuing to work across the House, and with Mayor Claire Ward and local partners, to ensure that the people of Nottinghamshire see the improvements that they have every right to expect. Question put and agreed to.
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Tibetan Plateau: Environmental Change
Mr Speaker, I echo your words about Jo Cox, our friend and colleague, who we remember in our hearts. Had she not been so brutally murdered, she would have been in this House and, I am almost certain, would have been present for Foreign Office questions today. Rivers originating from the Tibetan plateau are thought to sustain 1.8 billion people directly, providing drinking water, irrigation and power generation. Through the Himalayan resilience action programme, the UK has supported research into climate and environment risks around the Tibetan plateau and supported efforts to strengthen climate resilience in the region. The resilience action programme has promoted science-based policy and dialogue across the Hindu Kush Himalaya.
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Tibetan Plateau: Environmental Change
The UK continues to engage with China on climate and environmental issues. During the recent UK-China environment dialogue, the Secretary of State for Environment, Food and Rural Affairs secured agreement for greater collaboration with China on ecosystem resilience, biodiversity, conservation and multilateral environmental processes. Our Himalayan resilience action plan is building regional resilience through nature-based solutions, tackling water insecurity, air quality management and promoting dialogue through the International Centre for Integrated Mountain Development. As countries come together in pursuit of these solutions, it is important that affected communities are consulted.
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Tibetan Plateau: Environmental Change
The hon. Lady raises an important concern. We are concerned by reporting from the UN special rapporteurs that large-scale environmental projects in Tibet risk the forced displacement of Tibetans from their ancestral villages. It is important that we keep these issues on our radar.
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Topical Questions
We recognise the strength of feeling among diaspora communities and continue to press the Sri Lankan Government bilaterally and at the United Nations Human Rights Council for meaningful progress to improve the human rights situation. That includes securing truth, justice and accountability for past abuses affecting all communities, including Tamils. We have consistently raised concerns about the Prevention of Terrorism Act and its ongoing use, and we will continue to urge its repeal and replacement, in line with international law.
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Topical Questions
Anthropic’s Fable 5 and Mythos 5 models have been withdrawn worldwide, including in the US. We respect that this is a decision for the US Government and are in direct contact with US Government officials as this develops. It reinforces the importance of Britain having greater sovereign control over critical technology and maintaining our national capabilities for us and our allies. The AI Security Institute is one of the best resourced teams of its kind anywhere in the world. Protecting our national security is central to this Government’s approach to AI.