Health Bill (Fifth sitting)
I beg to move amendment 47, in clause 11, page 8, leave out lines 15 to 30. This amendment prevents the Secretary of State from removing the Chief Executive of an integrated care board.
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Health Bill (Fifth sitting)
Clause 11 is particularly interesting. In August 2025, Alan Milburn was asked about the abolition of NHS England on the Health Foundation podcast. He said that the Government wanted to see a model that was “more delegated…more devolved” and “more diverse”, which necessitated the centre being smaller. Considering that he is a former Labour Health Secretary and a non-executive director at the Department of Health and Social Care, I do not doubt his understanding of what the Government wanted to achieve. When the former Health Secretary, the right hon. Member for Ilford North (Wes Streeting), announced the 10-year plan to the House, he also talked about dissolving power. He spoke of a “brave new world of devolution of power, resources and control”.—[Official Report, 3 July 2025; Vol. 770, c. 469.] That was repeated in the Government publications that accompanied the Bill: “Empowering ICBs as strategic commissioners will support putting patients at the centre of care by devolving decisions to a local level where different services can better integrate… Reforms to the NHS FT model will give providers more flexibility to design and deliver healthcare around local needs.” Between the announcement of the abolition of NHS England and the publication of the Bill, Ministers articulated a vision for a more decentralised system. There is expert consensus that decentralisation boosts performance, reduces health disparities and fosters innovation. After listening to remarks this morning, I have no doubt that Members are clued up on the importance of innovation to the health service, but a problem—a philosophical contradiction—at the heart of the Government’s reform programme and the Bill is that Ministers talk about decentralisation while these provisions constitute a recentralisation of power.
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Puberty Blockers
I beg to move, That this House calls on the Government to take steps to prevent the PATHWAYS clinical trial into the effect of puberty suppressing hormones on children with gender incongruence. Before I start, I declare an interest as an NHS consultant paediatrician, a member of the Royal College of Paediatrics and Child Health, and a member of the British Medical Association. It is also important for us to recognise at the beginning of this debate that we are talking about the protection of children—vulnerable children who are troubled, and who need our care and compassion and the very best quality of healthcare. The healthcare of children distressed about their gender is an area in which attempts have been made to shut down debate with threats and accusations of transphobia; we saw the way that the hon. Member for Canterbury (Rosie Duffield) was treated when she raised concerns. As adults and as elected Members of this House, we have a duty to safeguard children in our country. That means protecting them from adults who—with whatever motivation, good or bad—could do them harm. As a children’s doctor, I have recruited patients for trials, and I have cared for children and babies participating in clinical trials. I recognise the value of a well-designed clinical trial in improving clinical care, but today the House is not being asked to consider the principle of performing clinical trials in general, or on children in particular—I hope we can all agree that a well-designed trial can improve care. Rather, we are being asked to consider the Pathways trial: whether it meets ethical tests, what it does, the cohort, the protocol and the consent. I will go through each of those points in turn. The Pathways trial is part of a group of studies run by King’s College London and funded by the Government. So what does it do and why are we so concerned? The trial will take 226 children who are physically healthy—who are developing normally—and inject them with powerful drugs to delay that normal development in a way that may weaken their bones, affect their ability to think, damage their sexual function, and leave them unable to have children of their own. We are told that the purpose of this is to treat a diagnosis of gender incongruence. So what is gender incongruence? The International Classification of Diseases states that it is “characterised by a marked and persistent incongruence between an individual’s experienced gender and the assigned sex, which often leads to a desire to ‘transition’”. We know that gender incongruence is a condition that is subjective. It is based on how someone tells us they feel. There are no blood tests and no lab markers that can be used to diagnose it. As a paediatrician myself, I understand that how patients feel, particularly in relation to their mental health, is very important. We know from the Cass review that the vast majority of children with gender incongruence will get better on their own. Again, as a paediatrician, I am used to providing supportive treatment for conditions such as respiratory viruses and gastroenteritis, which generally get better on their own, but I am not used to giving powerful drugs to children that can cause permanent long-term damage for subjective, self-resolving difficulties during adolescence.
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Puberty Blockers
This is not a form of gene therapy. It is a medication that is a GnRH analogue, and what it essentially does is delay puberty. It was designed as a drug to treat children who go into puberty much earlier than they would be expected to, and to delay it until, as it were, the right time. The effects of the use of puberty blockers in older children and for a much longer period, at an age when they ought to have started puberty, are not fully understood.
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Puberty Blockers
My hon. Friend raises a very good point, and I will come to the data linkage study shortly. What we do know from the Cass review is that the vast majority of children who went on to puberty blockers in adolescence went on to receive cross-sex hormones, which are known to have permanent effects. One fact that is crucially important is that it is not possible for clinicians to confidently determine which children with gender incongruence will persist with the trans identity into adulthood, and which will not. How can the clinicians possibly know that they are not injecting potentially dangerous drugs into children whose incongruence will resolve itself? The answer is that they cannot. Will the Secretary of State tell us whether he is aware of new evidence allowing clinicians to work out confidently which children will persist with the trans identity at 11 and which will not? We need to think about the risk involved in the treatment, and whether it is worth the benefits that they will purportedly receive. The trial researchers suggest that they will take a wide approach to looking at potential benefits, that they will look at quality of life and body satisfaction, and that there must be a reasonable prospect of benefit; but how can they know whether there is a reasonable prospect of benefit when they do not know whether or not the condition will persist? Some have suggested that giving puberty blockers will help the few adults who retain their trans identity into adulthood to pass as the opposite sex. Does the Secretary of State think that the long-term damage to many is worth it for the cosmetic benefit of a few? The Medicines for Human Use (Clinical Trials) Regulations 2004 specify that “anticipated benefits” must justify the risk. This is an ethical rather than a medical question. Does the Secretary of State think that the benefits justify the risk? I regret that we have ended up discussing the details of a clinical trial in the Chamber—the reality is that things should be done impartially by scientists in most cases—but with this topic we have seen the quashing of open debate, which is why we have ended up where we are. I will move on to the point made by my hon. Friend the Member for Farnham and Bordon (Gregory Stafford). Even if the Secretary of State thinks the principle of the trial is right, he must surely agree that it is unnecessary and unethically broad. For example, if someone was designing a trial to treat children with a specific form of cancer, the children who would be entered into the trial would have that specific form of cancer. We would not include children with any disease, because that would make the results unreliable in terms of benefit to the target group and children would be unnecessarily put at risk of receiving experimental drugs that they did not need. The same applies to this trial. The Cass report tells us that many of the children in the proposed trial will get better on their own. The Secretary of State said yesterday that “we are talking about a very small subset of a very small group.”—[Official Report, 22 June 2026; Vol. 788, c. 56.]
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Puberty Blockers
Well, one of the things with doctors is that if you ask two doctors, you might get two different opinions. I completely respect Baroness Cass. She has been president of the Royal College of Paediatrics and Child Health, of which I am a member, and she has done great work on the report that we commissioned in the last Parliament. I know she is concerned that people may obtain these drugs illegally if they are not provided, but I do not share that concern. Personally, I think the important thing is whether the people obtaining such drugs legally are using them in a way that is safe, and I am not convinced that that is the case.
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Puberty Blockers
I am sorry, but I just do not support that. We would not give children cocaine on the basis that they wanted it and would get it illegally otherwise. These are not sweeties; they are powerful drugs and need to be treated with respect. Even if we accept the premise that a very small number of people might benefit from treatment, how could clinicians decide which children to treat? On what ethical or moral code would we want to inject powerful drugs into children who are likely to have a self-limiting illness and therefore do not need it? That is what the Government have chosen to do, and it is not necessary. Following on from the point made by my hon. Friend the Member for Farnham and Bordon, they have this data already. The Tavistock was a travesty, but it means that the Government could analyse the data from the outcomes of those children. They could establish the outcomes as children went into adulthood, and Baroness Cass tried to do this using the data linkage study. Shockingly, six out of seven adult gender clinics refused to provide the Government with the data. Even when a specific piece of legislation was passed by the previous Government to clarify that it was legal to provide the information to this trial, the gender clinics still did not provide it. I understand that NHS England is working on the data linkage study, but I ask the Secretary of State why it is taking so long. Is the abolition of NHS England causing delay? Why is he letting this trial, which he has expressed reservations about, go ahead in the knowledge that it is unnecessarily broad and in advance of the data linkage study?
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Puberty Blockers
The hon. Gentleman is exactly right, and he expresses my point succinctly. Why is the Secretary of State going ahead with a trial—experimenting on more children unnecessarily—when he has the data to analyse already? Why has he chosen to fund this trial? Is he worried about the children who will be put on a medical pathway that may lead to cross-sex hormones and a lifetime of medicalisation when they would have got better by themselves anyway? I want to talk about the age of these young people. The Medicines and Healthcare products Regulatory Agency warned in February that the youngest patients are at the greatest risk, and may end up on puberty blockers for a much longer period. They have a higher risk to fertility because sperm and eggs have not yet fully developed at Tanner stage 2, but this Government have chosen to include children of 11 or 12. Some will wonder why it is 11 for girls and 12 for boys—indeed, I was asked that question yesterday—but as a paediatrician I am aware that puberty starts earlier in girls than in boys. It is somewhat ironic that a trial based on the premise that girls could be boys recognises this biology, but I am glad that in this respect it does. However, that means some of the participants will be primary school-aged children with the merest form of puberty. How can they possibly meet the eligibility criteria, which includes “sufficient understanding of the treatment advantages and disadvantages, including discussion of fertility preservation”? How can a child of 11 understand what it means to lose sexual function, to be unable to have children when they are older, to have difficulties in thinking and to have weak bones? Remember that this Government think that 14-year-olds are not old enough to watch social media, but they think 11-year-olds are capable of understanding this.
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Puberty Blockers
I thank the hon. Gentleman for his intervention on devolution, and I am sure the Secretary of State was listening and considering what he has said. To go back to the age of the young people, I am reminded of the judgment in Bell v. Tavistock, which says: “We do not think that the answer to this case is simply to give the child more, and more detailed, information. The issue in our view is that in many cases, however much information the child is given as to long-term consequences, s/he will not be able to weigh up the implications of the treatment to a sufficient degree.” I draw right hon. and hon. Members’ attention to the next part of the quote: “There is no age appropriate way to explain to many of these children what losing their fertility or full sexual function may mean to them in later years.” Yet, as Secretary of State confirmed yesterday, the children must consent or assent to being in this trial. Another question that he did not answer yesterday is why the Government did not heed the MHRA recommendation for a minimum of 14 years. Having established that the Government are going to put a group of physically healthy children with a self-resolving condition at a risk they may not fully understand, the remaining question is why they would they want to do this. The trial itself has an interesting design. We are told that it is a randomised controlled trial—as a doctor, I am familiar with that term—but in this case it is a bit of a fudge. Yes, this Government-sponsored trial will randomise which children get the drugs now and which get them in a year’s time, but the comparison group that does not receive puberty blockers—300 children from the Horizon Intensive trial, with whom the trial will seek to compare—may not be considered a reliable comparison, because the group is a different group with different eligibility criteria. When the results of this trial are published, this fact is bound to be used by people who dispute or disagree with the findings. The Secretary of State said this trial will resolve the dispute over the issue, but that is one of the reasons why I think it will not. I want to discuss sexual function, because yesterday the Secretary of State said that the trial would involve the completion of a number of questionnaires, and one of my hon. Friends raised the question about what happens to children’s sexual function in the long term. What is sexual function? It is desire, arousal and orgasm. The trial organisers are clearly concerned about this, because they put into the trial the ALSPAC—Avon longitudinal study of parents and children—romantic relationships questionnaire. I read the questionnaire on the Health Research Authority website, and children from the age of 12 and over will be asked these questions, one of which is: “In the last year have you had oral sex with another person? (This is when they put their mouth or tongue on your penis/vagina or you put your mouth or tongue on their penis/vagina)”. Let us be clear: if that is happening to a 12-year-old, that is sexual abuse and the police should be called. Is the Secretary of State content for the Government to be asking these questions of such young children? Can he believe that they will be paid £20 for completing their questionnaires, alongside £30 for completing the assessment of cognitive ability and £15 for completing physical and height assessments, in addition to travel expenses? There will be lots of talk this week about the Prime Minister’s legacy. Putting children as young as 11 on puberty blockers, with irreversible life-changing consequences, would be the most disturbing final chapter in what has been a troubled book of leadership. Today, right hon. and hon. Members will be asked to vote to consider their approval or disapproval of the trial. I urge them to look at their conscience, read the trial protocol—it is online—and remember that these are vulnerable children who deserve the best care. One day, the children caught in the middle of this debate will be adults. It is our responsibility to ensure that when they look back on their one childhood, their one adolescence and their one chance to enjoy growing up, they must know that every decision was made with the utmost care, caution and respect for their future. The power to make that happen is in our hands today. I urge hon. Members to protect children’s futures.
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Defence Spending and Readiness
Does my hon. Friend agree that Ankara is going to be extremely interesting this year, especially at a time when characters like Foreign Minister Sikorski are pointing out that Poland will be spending 4.8% of its GDP on defence while we spend £4.5 billion on cycle tracks? Mr Sikorski has pointed out that that is indicative of the priorities of this Government, and, as a committed Anglophile, fears that it is indicative of this country retreating into the shadows. It is difficult to avoid that conclusion, isn’t it?
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Defence Spending and Readiness
I am fascinated by the Minister’s remarks about the withdrawal of troops after the cold war, many of them to Salisbury plain in and around my constituency where they continued to train for current operations. Is she seriously saying that she would recreate the British Army of the Rhine? Is that Government policy—for this Government, or for the Government to come? If so, how is she going to fund it?
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Defence Spending and Readiness
The hon. Gentleman is being very generous with his time. The Liberal Democrats are famously known for their love of bicycling. Does he agree that it would be a good idea for the Government to drop their plan to spend £4.5 billion over five years on creating cycleways and rededicate that money to defence?
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Defence Spending and Readiness
I thank the Minister for giving way. If everything is so great, why has Lord Robertson described the Government’s situation as one of “corrosive complacency”?
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Puberty Blockers
I am grateful to the Secretary of State for giving way. He mentioned parental consent—what would happen in a situation where the child was in the care of the state? Would they be included or excluded from this trial?
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Defence Spending and Readiness
As the hon. Gentleman well knows, it is at the Minister’s discretion whether he chooses to give way or not.
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Puberty Blockers
I inform the House that Mr Speaker has not selected the amendment. I call the Opposition spokesperson.
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Youth Unemployment
8. What assessment she has made with Cabinet colleagues of the potential impact of her Department’s policies on levels of youth unemployment.
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Youth Unemployment
Some 42% of employers have cut back on graduate recruitment, and across Bromsgrove and the villages there has been a 25% increase in youth unemployment over the last two years. With unemployment undoubtedly weighing heavily on the Chancellor’s mind, does she regret the choices she has made and the impact that they are having on young people’s futures?
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Defence Spending and Readiness
I would point out that under the last Government we were the third highest spenders on defence in NATO. The rest of Europe was also not taking defence as seriously. We had all enjoyed the peace dividend and nobody was spending money on defence like they should have. We continued to maintain our presence in NATO though, yet now we are the 12th biggest spenders in NATO. To that extent, is it not the hon. Member’s Government who are not matching their own rhetoric?
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Defence Spending and Readiness
Corona muralis—I wager that few people in this Chamber, if any, have heard that term. Perhaps the odd classicist will have heard it. It was one of ancient Rome’s most coveted military decorations. According to Aulus Gellius, it was a golden crown, shaped like a city wall, awarded for bravery, much like the Victoria Cross. It was awarded to Roman soldiers for being the first up the ladder and on to the enemy castle walls during a siege. Whoever received it found fame, and the accolade could be leveraged as a political stepping stone. Survival might be unlikely, but the prospect of personal and political glory could motivate men to embark on a suicide mission, convinced that they would fare better against impossible odds than those who had tried and failed before them. In “The History of Rome”, Livy wrote: “The men dashed on in the face of wounds and missiles, and neither walls nor armed men standing on them can restrain them from vying with one another in the attempt to climb”. With that, I welcome the Defence Ministers to their new roles, and wish them luck in the forthcoming reshuffle. The new Defence Secretary tells us that he is working around the clock. That is another idiom to add to a lexicon that includes “flat out”, “at pace” and “laser-focused”—the perennial favourite. This Government’s failure to invest in defence, particularly given the high horse that they rode in on, while waxing lyrical about “hollowing out”, is farcical, given that we have already seen two experienced Defence Ministers quit. We now see two more take up the colours—both decorated former officers with an MBE, and each with an MBE for their service. Coronae murales all round. The defence investment plan has entered the zeitgeist, but our duty in this House is to hold the Government to account. We can talk about top-level budgets and use exciting buzzwords, but unless we are actually talking about what is in the plan, that capability is largely irrelevant. The defence investment plan is not funded properly; it is not even close to being funded properly. An additional £10 billion, plus £3.5 billion of loose change that the Government found down the back of the sofa, will not touch the sides. The new Defence Secretary will need to make damaging and difficult cuts. Much of that will not be truly realised until the publication of the ’26-27 Ministry of Defence accounts at the end of next year—by which point he may be long gone. There are projects that sit under the major projects portfolio, specifically Dreadnoughts and GCAP. The defence nuclear enterprise takes up 18% of the entire defence budget. To put that in context, it means that we are last in NATO for our spending on conventional forces. We spend less, proportionally, than North Macedonia and Luxembourg. We need to be mindful of the spiralling cost of Dreadnought. If we couple that with the cost of upgrading the Astraea warhead, and of the AUKUS commitment, we see that we are locked into a huge proportion of the available budget being spent on submarines alone. Last week, the Royal United Services Institute wrote that it anticipates the DNE may hit 25% of the budget within the period covered by this defence investment plan. Meanwhile, its aerial contemporary, GCAP, continues to be a costly endeavour—so costly, in fact, that despite the Minister for Defence Readiness and Industry informing me last week that a new funding deal for Edgewing had been agreed, my sources at the MOD tell me that the deal is not the multi-year settlement that is needed. I would be grateful if the Minister confirmed the duration of the new funding deal. With the demise of the future combat air system, GCAP and F-47 are the only NATO sixth-generation programmes left in town, yet the RAF is struggling to find the money for the platform, has apparently rowed back on committing to pillar 2, and is in danger of being superseded by events. The new uncrewed fighters currently in development are a fraction of the cost, and will be many iterations developed by the time we see the first Tempest. It will take something special to ensure GCAP is not a relic before it even leaves the drawing board. Last year, the previous Chief of the Air Staff—now Chief of the Defence Staff—made clear that there were “no major equipment programmes planned for the next 15 years. We have what we have for the near and medium term”, despite the combat air strategy being about to undergo a refresh. What the RAF has planned now is what we will have through to 2040. We have taken delivery of 48 F-35B jets thus far, and the programme of record states that we are committed to 138. Does anyone genuinely believe that the defence investment plan will lay out the pathway to buying another 90, if we have only bought half that number since 2012 in order to fulfil a purpose—being carrier deployable—that now makes little strategic sense? For reference, the US has budgeted for 85 this year alone, at a cost of $21.4 billion. Analysis by the US Government Accountability Office has shown that the full mission-capable rate of the F-35 is a lamentable 25%. Our own Public Accounts Committee reported in March that “The UK F-35 fleet achieved approximately one third of the MoD’s target” for the time it was able to fly all its required missions in 2024, and achieved only two fifths of the level of availability of the global F-35B fleet.
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Defence Spending and Readiness
I wholeheartedly agree with my hon. and gallant Friend. The UK military flying training system is on its uppers. I do not necessarily hold this Government responsible for that—there are longer-term issues with the flying training system. I believe the average length of time it takes pilots to qualify is somewhere in the region of six years; most of the pilots who are now hitting the frontline have spent as long in training as I spent in my entire military career, by which point I had done numerous operational tours. Significant work needs to be done in that area, and there are questions to be asked of the company that we have outsourced flying training to, as well as about the Hawk jets—which I will not cover in this debate. The Minister knows that that topic is a hobby horse of mine; I will not speak about it today, but he realises that there is a sense of urgency there.
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Defence Spending and Readiness
I do—we need to get more pilots through the door, and I have asked numerous questions about our ratio of pilots to aircraft. I appreciate that the Minister does not want to divulge that information, but I would suggest that currently, it is not as good as it could be. The joint programme office that should fix the F-35 is undergoing a global support solution reset that will cost an additional $13.7 billion. I would be interested to hear from the Minister whether any of that figure will be paid for by us in the UK. As a result, there is no timeline for completing technology refresh 3, which 72% of our F-35Bs still require, and no timeline for the completion of the block 4 upgrade. Talk of the 12 F-35As for the NATO nuclear mission—which the hon. Member for North Durham (Luke Akehurst) mentioned—has gone suspiciously quiet, with rumours that they will be cut, and that is before we talk about the four-year lead times for low rate initial production material required to build them. Crucially, though, there is currently no more money allocated to the F-35 Lightning programme. The departmental budget laid out in the integrated review defence Command Paper back in 2021 only included the procurement of the 48 we now have; all new funding for the F-35 will need to be outlined in the defence investment plan. That brings us on to drones. We know that the RAF is committed to having the Tempest as a manned platform, but by the time it comes into service, the US will be a decade deep into its collaborative combat aircraft programme. It has just awarded General Atomics and Anduril sizeable contracts for the FQ-42A Dark Merlin and FQ-44A Fury uncrewed fighter jets. The Secretary of the Air Force has stated that the US plans to “procure over 150 combat capable CCA by the end of the decade.” The US has budgeted $1 billion for CCA procurement, $822 million for modifications, and another $1.4 billion for research and development. How much of the £10 billion of additional funds available for our entire defence budget do we think we are planning to spend? When the defence investment plan is published, we will need to look closely at investment in those projects that should deliver drones. How does this all tie together? I have spoken briefly about Project ASGARD before—the Chief of the General Staff, speaking at the RUSI land warfare conference earlier, talked about the need to be able to strike Russia within 30 minutes—but whether or not this is properly resourced in the DIP will be instrumental to our fortunes. We need to move past our current squeamishness and invest properly in both Project ASGARD and its RAF cousin, Project BOYD. I was fortunate enough to visit a demonstration of ASGARD during Exercise Arrcade Strike last month, which gave a glimpse of how the next war might be fought. My takeaway, however, was how desperately it will need to be invested in. We risk being a day late and a dollar short when it comes to an integrated anti-access/area denial and integrated air and missile defence solution. The reluctance of our senior leaders to move from an in-the-loop and on-the-loop approach to the kill chain to an on-the-loop and out-of-the-loop posture concerns me—it is better to have the capability and not need it than need it and not have it. The Minister for Defence Readiness and Industry confirmed to me last week that the MOD is looking at machine vision for lock-on in the terminal phase of one-way effectors, but we must move further and faster. For all the talk of defence investment in exquisite capabilities, nobody is suggesting that we increase the mass of the Army significantly. That is before we consider that every single vehicle platform the Army operates, except for Foxhound, is due to go out of service by 2030. Our ability to field an armoured division is at best optimistic; in reality, it is laughable. My own background is in armoured infantry, as is that of my hon. Friend the Member for Spelthorne (Lincoln Jopp), and were we to try and field an armoured battlegroup—let alone a division—I would be interested to see what form it would take. At the front of any armoured push is formation reconnaissance. That role should by now be delivered by Ajax. My views on Ajax are well documented, as I delivered a debate on the topic in Westminster Hall earlier this year, but what progress has been made since then? In the wake of Exercise Titan Storm, the Government commissioned an independent expert panel review. The results of that review have been submitted via a final report, but the Minister appears hesitant to publish the outcome. I would be grateful if he published those findings for scrutiny in the House now that the review has concluded. In his summing up, could the Minister outline when the House will receive an update on that review’s findings? We know that the first phase of bringing Ajax up to speed will require the restarting of trials with the current version of Ajax, but the Minister has also informed me that the current platform requires a number of upgrades outside the scope of work in upgrading from capability drop 3 to capability drop 4, including improvements to the electrical power generation system, the crew compartment heating and the air filtration system. Although those sound like gremlins that need to be worked through on any new platform, can he tell me which of those modifications, if any, will mitigate the injuries sustained by service personnel on Exercise Titan Storm? Ajax must be a success—we cannot afford to be stuck with a platform that no other country is willing to buy. The reputational damage to the platform is in danger of being baked in if the Government do not get the fix right first time. All 589 hulls have been built, and the factory will have no further work once those vehicles are assembled and rolled out. What work will the General Dynamics facility in Merthyr Tydfil then have to do? When I raised that question with the Government, they stated that it is an issue for General Dynamics. There is a reason the Government did not include that facility within the scope of the defence growth deal for Wales. Put simply, the Government cannot afford for Ajax to fail, neither from a defence exports perspective—and there are currently no pending orders—nor from a capability perspective. The Government know this, having made no assessment of any potential replacement platforms such as the Combat Vehicle 90, so when will we finally see Ajax realise its potential? Sadly, though, that is not the only issue. Behind Ajax should be Challenger 3, but Challenger 3 remains in the demonstration phase and, based on reports in The Telegraph last week, is now beset by problems. The turret power traverse gearbox is potentially proving to be a problem that may push back delivery of the tank by years—to put that in layman’s terms, that is the part that makes the turret rotate. The Government have now said that this is not the case, but it is concerning that they are yet to declare the planning assumption for service entry for the new tank, despite all 148 remaining Challenger 2 tanks being in scope for upgrade and conversion. The Government have also previously told me that they are continuing to explore export opportunities for Challenger 3. What export opportunities? We have 148 main battle tanks; how many are we planning to sell, and who would buy them? We have no plans to replace them. I would be interested to understand the full scope of the Army’s heavy armour automotive improvement programme. In January, the Minister for Defence Procurement and Industry told me: “Manufacturing will begin once the tank’s performance is proven, rather than being tied to a specific deadline.” By when does he anticipate the tank’s performance will be assessed to have made the grade? Meanwhile, our allies look elsewhere to rearm. With both the Franco-German main ground combat system to replace the Leclerc and Leopard 2 respectively and other fledgling initiatives, what is the future of armour? “Behind the tanks” Warrior is due to go out of service next year, currently with no realistic replacement. Warrior is due to be replaced by a mixture of Boxer and the Ajax-derived Ares, but neither looks set to be ready in time. More concerningly, the Government’s position appears to have shifted once again, with the Minister telling me last week: “Under current plans, Boxer is initially being fielded as a supporting capability to Armoured Units within 3rd (UK) Division, before being fielded to Mechanised Infantry Units between 2030-2035.” Warrior goes out of service next year, so what is filling this capability gap? We have not yet seen an order for the Patria 6x6 as part of the common armoured vehicle system. The Government told me recently that they were continuing to monitor the market for potential future platforms, but the defence investment plan is supposedly to be published next week, so why have these decisions not already been made? From a Royal Navy perspective, it is no secret that the hybrid Navy concept is the direction in which they are sailing. The commitment of the Royal Marines to the High North and potential investment in a joint commando craft or littoral strike craft would illustrate a longer-term commitment to that force posture, but the hybrid Navy concept means that the Type 83 is dead in the water. The decision to gift Type 26 build slots to the Royal Norwegian Navy kicks the can down the road when it comes to the sticky issue of when we need to pay for the new ships, with just eight to be built for us and a further five for the Norwegians. Given our significant commitment to global operations in comparison with the commitment of the Norwegians, do we really think that just three more ships will cover our global commitments? This has been a whistlestop tour through just some of the myriad capabilities that will need to be detailed in the defence investment plan within the next week or so. [Laughter.] I left a lot out! Members are chuckling, but I could have gone on for another hour. We need to spend more on defence. We need to resource our military to meet the threats that we face, not the ones that we would like to. If this Prime Minister, this Chancellor and this Defence Secretary will not find the funding required by cutting the welfare budget or changing the fiscal rules, they should make way for someone who will—but perhaps that will happen sooner rather than later.
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Draft Employment Tribunal (Extension of Time Limits) (Miscellaneous Amendments and Transitional Provisions) Regulations 2026 Draft Employment Tribunals Extension of Jurisdiction (England and Wales) (Amendment) Order 2026
It is a pleasure to serve under your chairmanship, Sir Alec. It is also always a pleasure to follow the hon. Member for Halifax. She is the second Minister in her role in this Government, and I sincerely hope that we are not due a third. I wish her well over the coming weeks. There was a time—[Interruption.]
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Draft Employment Tribunal (Extension of Time Limits) (Miscellaneous Amendments and Transitional Provisions) Regulations 2026 Draft Employment Tribunals Extension of Jurisdiction (England and Wales) (Amendment) Order 2026
There was a time not so long ago when we had a Government who said that they were obsessed with growth—that it was their core, underlying mission. Casting my mind back to that moment makes me feel old, but my goodness, what a long way we have travelled over the last almost two years. I say that because no Government who were obsessed with growth, no Government who were genuine about creating the economic conditions for prosperity that provide our public services with the resource they need, and no Government who were sincere about giving the young people of this nation the opportunity to find work and climb the ladder of opportunity would, in all seriousness, have introduced these measures. It belies their lack of knowledge of working in business, for they do not understand the stifling impact of piling regulation upon regulation and doubling the period of jeopardy for an employer at a time when, as the Minister acknowledged, our employment tribunals are drowning, deluged and failing. I suspect that hon. Members on both sides of the Committee have some appreciation, although maybe not the full horror, of what is going on right now in our employment tribunals. I would certainly like to hear more from the Minister and her officials about their plans to remedy a situation that we all should recognise as a crisis. To be fair, this did not all happen on the current Government’s watch. It dates back too many years, but it is getting worse by the week. The open caseload of single claims stands at a record 64,157 in the last available figures, which is a 55% increase in a single year. One does not need Carol Vorderman’s maths ability to understand that the backlog has grown by more than half in the last 12 months alone, firmly on this Government’s watch. It is not too late for the Government to recant, to see the light and the wisdom, on this statutory instrument, and perhaps ingratiate themselves with the next Prime Minister and Chancellor, who are more firmly committed to the growth that has eluded the incumbents. New single claim receipts rose by 39% last year to 50,000. That is the addition to the stack of claims, while—please write this down—disposals fell by just 12%. As we sit in this non-air-conditioned Committee Room this afternoon, more claims are being added to the pile. The backlog is growing. The prospect of claimants and employers receiving settlement of those claims now dates back more than two years in many parts of the United Kingdom. Again, I urge the Minister to correct me if any of these statistics, based on the figures of the Office for National Statistics on gov.uk, are somehow erroneous, or if I am portraying a false narrative of the situation as it exists today. In these Committee Rooms, we are supposed to engage our minds and properly look at the evidence, not just vote the way we are told. Wouldn’t that be a good idea: evidence-based policymaking, rather than simply yielding to whatever the Government ask and whatever officials put in front of us? The Government’s overall economic analysis of the Employment Rights Act, of which these regulations are a small measure, implies that the volume of cases in the failing, unreformed employment tribunal system is expected to increase by about 17%—this is the economic analysis of the Department for Business and Trade from January 2026. That is 17% more cases on a backlog of 64,000, which is growing by the day and resulting in delays to claims of more than two years in many parts of the United Kingdom. I will not detain the Committee with every single measure in the 330-page unemployment Act that the Opposition oppose—that is largely behind us—but there is no reason, when we are in a hole, to keep digging and make the situation worse. The independent Institute for Fiscal Studies estimates that about 80% of the costs that the system imposes on employers are passed on through lower wages, so it is the workers we seek to represent, our constituents, who ultimately bear the cost. Business has continually warned that increasing the already 13-week time limit would potentially significantly increase the jeopardy and therefore the risk. And who ultimately pays the price? This may be a fact that Government Members do not wish to fully contemplate, assimilate and understand, but the people who pay the price are the young people who are denied those opportunities. I would be delighted if any Government Member wanted to intervene to tell me the rate of unemployment among 16 to 24-year-olds today, and how much that has increased in the last 24 months under this Government as a result of both the swingeing increases in tax and the crushing amount of red tape. In the absence of anyone intervening, and to move us forward quickly, I can reveal that the figure is 16.2%. That means that one in six of our young people between the ages of 16 and 24 who are actively looking for work—who are dispiritedly firing off application after application—are simply unable to find the work that they seek. That is 735,000 young people, almost three quarters of a million. I believe in the good of Members, so I do not really believe that anybody on the Government Benches came here to put young people out of work, but the law that we pass most often is the law of unintended consequences. I urge Government Members to look at their consciences and decide whether putting more of our young people out of work is really what they came here to do. I will conclude with a few points to the Minister, if she would be so kind as to respond. First, she talked about the idea that six months is somehow fairer than three months. If that is the case, and if it is the Government’s position, will she make representations to the Chancellor to similarly apply that 13-week increase to 26 weeks when it comes to HMRC? The ordinary taxpayer does not have that same luxury of time. If it is the Government’s new principle that the only fair period is 26 weeks, there will be plenty of opportunities to extend that across to other parts of Government in a symmetrical way. Can the Minister share any specific assessment her Department has made of how many additional claims these two instruments alone will generate? We have heard about the 17% overall increase in tribunal claims, but can we have an understanding of the additional claims that relate just to these measures, so that Members can make an informed decision when they cast their vote? That is unless the Minister is kind enough to withdraw the measures today. Given the 64,000-case backlog, what resources does the Minister plan to give the employment tribunal to remove the constraining factors by having additional judges, hearing rooms and sitting days and longer hours? Perhaps she has a comprehensive plan that can reassure hon. Members that 64,000 cases is just a transient backlog, and that it will not grow. Finally, if the Minister is confident—as I am sure she is—about the Government’s reforms, which she mentioned in passing, will she commit today to publishing a clear timetable that identifies the day on which the backlog will be reduced to the pre-2024 level she inherited?
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Venture Capital Trust Income Tax Relief
9. What assessment she has made of the potential impact of reducing up-front venture capital trust income tax relief on VCT fundraising.
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Venture Capital Trust Income Tax Relief
A recent industry survey revealed that 62% of VCT founders are scaling back growth plans, 45% are cutting headcounts, and 25% are leaving the country. Will the Government reverse the Chancellor’s plans to cut this relief, or will her legacy for Britain’s tech sector be lower growth, fewer jobs and lasting damage?
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Spinal Muscular Atrophy: Newborn Screening Test
It is a pleasure to serve under your chairmanship, Mr Mundell. I thank the hon. Member for Sunderland Central (Lewis Atkinson) for opening this important debate on behalf of the Petitions Committee. The debate is an example of Parliament at its very best. I also acknowledge Jesy Nelson and her tireless efforts to raise awareness of spinal muscular atrophy following her twin daughters’ diagnosis with the condition. Little Mix have long used their platform to support a wide range of charitable causes, and I express my sincere thanks for their continuing to do so. However, to open up about something so deeply personal goes a step further. I also pay tribute to all the other families who have opened up to so many Members of Parliament. I have often spoken about my time working in children’s hospices, and it was always the families’ stories that made compelling cases for the extra support that was needed. I acknowledge the work of Spinal Muscular Atrophy UK, whose dedication to supporting individuals and families affected by SMA continues to make a meaningful difference in countless lives. In this country we are lucky to have so many wonderful charities that help families through difficult times. As we have heard, SMA is a progressive condition that causes muscle wasting and weakness. It is a most awful condition that is not reversible with treatment and, as we have heard, there are several types. SMA type 1, which my right hon. Friend the Member for Melton and Syston (Edward Argar) talked about Harvey having, is a severe form that develops between birth and six months of age. Without intervention, life expectancy is often less than two years. Type 2 develops between six and 18 months of age; children usually cannot walk unaided and may suffer respiratory complications into adolescence. Type 3 develops after 18 months of age; individuals can usually walk independently, although that may become progressively more difficult over time. Before 2019, there were no effective drugs available on the NHS to treat the condition. However, over the last seven years, three transformative treatments that can stop SMA in its tracks have become available on the NHS: one is administered by a lumbar puncture every few months; the second is gene editing infusion; and the third is a treatment that patients must take orally for the whole of their lives. There is encouraging evidence that those treatments really are helping. We have heard that SMA cannot be reversed, but NHS data from 2023 shows that children with SMA 1—the most severe form of the condition—are now surviving for longer. For families affected by an SMA diagnosis, time is everything, so that is an important start. When I worked in children’s hospices, I saw so many families go through incredibly difficult times. As the hon. Member for Portsmouth North (Amanda Martin) mentioned, it is not just about caring for a child; there is the impact on relationships, family finances and even sleep. I remember one father saying to me that if he got up eight times in the night, he considered that a good night’s sleep. We had a saying in the children’s hospices: while we cannot add days to their lives, we can add life to their days. However, in this case we can literally add days to their lives, and we really should do so. I agree with my right hon. Friend the Member for Melton and Syston that the Minister is very diligent and clearly cares, but will she tell us how many babies and children are currently receiving the drugs I mentioned from the NHS? Will data continue to be collected to give us fresh insights into the effectiveness of those drugs over time? While the damage inflicted by SMA is irreversible, if treatment is given before symptoms begin, that damage can be prevented. Screening can therefore be an absolute lifeline for babies and families if SMA is caught early. That is why we welcome the UK National Screening Committee’s recommendation to introduce in-service evaluation, which will see newborn screening for SMA trialled in the UK, and the role that the former Secretary of State, the right hon. Member for Ilford North (Wes Streeting), played in all that. It is a positive step forward. I want to add my voice to those of other Members today, and put some questions and points of clarification to the Minister. The ISE, recommended by the National Screening Committee, will evaluate newborn screening for SMA for some newborns in England, commencing in October 2026. However, as we have heard, reports suggest that about one third of newborns will initially not be included. Will the Minister explain the logic behind the choices that have been made? As I understand it, the seven NHS newborn screening laboratories in England that will undertake screening are in Birmingham, Great Ormond Street, Manchester, Newcastle, Sheffield, south-east Thames and south-west Thames. Government statistics do not suggest that babies born in those regions are more likely to have SMA, and there appears to be no correlation at all between instances of SMA and the location of the centres chosen to screen newborns for the condition. I could also find no correlation with the efficiency of delivery for the screening programme. That begs the question: what is the rationale for choosing just those centres, and why have others not been chosen? A baby born today who is screened and treated straight away is likely to walk at three years old. One born in a non-screened area, who is treated only when they become symptomatic, is very unlikely to walk and may not even be with us for very long. NHS England is responsible for organising the screening, but we know that the Government are going through with its abolition, along with the reorganisation of integrated care boards, so what assessment has the Minister made of the impact the restructuring may have on the capacity to deliver screening? That is an important point to bear in mind. There are other conditions that are excluded from newborn screening, such as metachromatic leukodystrophy. I met a mother who has been campaigning hard on that, along with other campaigners. Will that condition and others also be included in newborn screening in the UK? Surely we should help if we can, because, as I say, the impact is really difficult for those children and their families. I am a huge fan of early intervention, so if we can do something about it early on we should—I cannot remember which hon. Member said this, but even if we just look at it through the hard lens of finances and public money, we would save a huge amount of money over the years. It is desperately sad to see babies and their families affected by SMA. I hope that the Minister can provide some reassurance to those families that the forthcoming screening that they have long been fighting for will be fair, effective and accessible to all newborns in the UK. As I mentioned, the families I used to work with in children’s hospices would often say that, when their child was born or diagnosed with whatever condition it may be, their hopes and dreams for their child changed. When the baby was first born, they thought about the first day at nursery, primary school or secondary school, and then doing exams, going on to get married and have children and so on, and suddenly those dreams had to change because their life would be different. If we do this screening, some of those families, can keep their original dreams and we can add days to the lives of those children.
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Armed Forces Bill
I am struggling to see where the JEF, NATO and another alliance, even with our own sovereign capability, come into play. Those frameworks are already in place to enable us to stand up on the stage. It is about our funding of our capability. To the earlier point about strategy that Members were getting confused about, a grand strategy will be set out by the leader of the country, and the strategic defence review is a strategy of defence within that grand strategy.
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Armed Forces Bill
The hon. Member is right to mention defence being underfunded—I called it out under the last Government and I call it out under this Government. The previous Defence Secretary talked about 30 years of defence underfunding. We talk about the DIP going line by line and getting this right, but if it does not come out with correct funding and it is anywhere near the numbers quoted by the previous Defence Secretary, the right hon. Member for Rawmarsh and Conisbrough (John Healey), that will probably be felt most in the hon. Member’s constituency with its shipbuilding and, as she mentioned, submarine capability.
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Armed Forces Bill
I am very conscious of the words that we are saying to veterans. In the Minister’s response to a written parliamentary question on 28 May, she said that UK veterans faced a six-month wait when applying for war pensions in 2024-25. It is now 18 months at a minimum. I know that because I am going through the process, after a minor amputation of my foot. That period has more than tripled on her watch. Was she aware of that? Is that acceptable? It is a bare minimum of 18 months before there is even a response.
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G7 Summit
Does the Deputy Prime Minister share my concern, and that of many of my constituents, about elements of the Iran deal, in particular that the early sanctions relief, access to frozen Iranian assets and $300 billion of economic reconstruction development aid could find its way back to the Islamic Revolutionary Guard Corps, further strengthening an organisation that has done so much damage to regional stability and global stability, both directly and through its proxies? While I am at it, will the Deputy Prime Minister sit down with the police and find some way of stopping the ridiculous heckling and disruption of Prime Ministers on the steps of Downing Street when they are trying to make statements, which further adds to our considerable international embarrassment right now?
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Pathways Study: Puberty Suppression
I first raised the horrors of the Tavistock clinic in this House in 2019, having been provoked to do so by staff who said that they were often under pressure to refer for life-altering treatment children and young people who had experienced mental health difficulties, abuse and family trauma. Indeed, the Secretary of State will know that the Cass review found that childhood trauma, neglect and abuse featured heavily in the cohort of patients seeking gender changes. As many as two thirds of those referred had suffered neglect or abuse, with high levels of parental mental illness, substance abuse and exposure to domestic violence. So will the Secretary of State, even at this late juncture, abandon this trial? I have no reason to believe that he is anything other than a good man who wants to do the right thing. He has made it clear that he knows that this matter often sorts itself out through puberty and adulthood. I implore him to do so, for I fear that because he is a good man, he will regret this cruel experiment on harmless children.
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British Coal Staff Superannuation Scheme
It is a delight to hear a Nottinghamshire voice; as the hon. Gentleman knows, I was an adopted son of Nottinghamshire for a long time. He is making a case for the nobility of labour, and that case is too rarely made in this place. Working men deserve the same respect as anybody who learned at a university, as I and many people here did. That nobility of labour is personified by the hard-working miners whom he describes, many of whom holidayed in Lincolnshire—and retired there, too, as he well knows.
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Teacher Recruitment and Retention
The Secretary of State knows that the figure she has quoted to the House excludes primary schools. The Labour party manifesto promised to increase the number of teachers by 6,500, funded by the party’s education tax, yet this morning the DFE website says that there are now 1,900 fewer teachers than in 2024. Daniel Kebede, the general secretary of the National Education Union, says that the overall fall in teacher numbers makes a mockery of this Government’s promise to increase teacher numbers. He is right, isn’t he?
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UK Politics: Pro-Israel Influence
On a point of order, Mrs Harris. This is no criticism of my hon. Friend the Member for Berwickshire, Roxburgh and Selkirk (John Lamont), who introduces the debate on behalf of the Petitions Committee, but am I alone in feeling distinctly uneasy about this debate? Why is Israel singled out in this way? Why not Gulf countries, Iran, eastern Europe or the USA? The petition is being discussed at a time when the Jewish community are clearly under threat and are suffering numerous hideous attacks. I am not sure I trust the motivation of the petition organisers. I fear the whole thing smacks of an antisemitic conspiracy theory.
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G7 Summit
I really am quite impressed that the Deputy Prime Minister knows more about defence spending than the former Secretary of State for Defence. He was able to stand in for the Prime Minister at questions and also know what was going on in the G7. And apparently the Prime Minister did such an amazing job that the way forward is to sack him. May I ask the Deputy Prime Minister this question? If the demands to go into closer trading relationships with Europe by those who are pushing that in his party—including the right hon. Member for Makerfield (Andy Burnham), according to what he has said recently—are to be met, do those five trade deals that the Deputy Prime Minister has boasted about stand up?
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SEND: Improvement
Just a few months ago, the TES reported that the Government had frozen the high needs funding block, which special schools rely on. Headteachers are warning that the Government’s decision means that children will not get the support they need due to a lack of funding. The Minister may well point to the Experts at Hand service, but it is not the same and does not come close to meeting what each school will have lost. How can she justify freezing the high needs funding block when the demand for special schools is rising, the demand for education, health and care plans is rising, and the Government’s reforms are years away?
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PE and Sport Premium: Primary Schools
I say to the Minister that the Government cannot do more if they are making a 22% cut to funding. The whole nation is watching the world cup and millions of children have recently competed in their annual sports days, yet the Government snuck out this massive cut to PE and sport funding during the recent May half-term. The Secretary of State said that this is a misunderstanding, but it is not; it is a 22% cut that will have serious consequences for millions of children and it will hit the disadvantaged the hardest. Senior headteachers describe it as “a funding cut dressed up as an initiative to boost PE and sport in schools”. It is hastily rolled out and will hurt the poorest children, so why are the Government doing it?
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Spinal Muscular Atrophy: Newborn Screening Test
It is a pleasure to serve under your chairmanship, Mr Mundell. I thank the hon. Member for Sunderland Central (Lewis Atkinson) for opening this important debate on behalf of the Petitions Committee, of which I am proud to be a member. I am grateful to everyone who signed this petition and I pay tribute to the lead petitioner, Jesy Nelson. She has used her personal experience and public platform to raise awareness of spinal muscular atrophy. We know that it is a rare neuromuscular genetic condition that causes muscle weakness, movement problems, and difficulties with breathing and swallowing, as well as tremors, and bone and joint problems. Although those symptoms are most often noticed in babies and toddlers, they can also start in teenagers and adults. This extremely cruel disease has touched many people across the country and beyond. That is evident, given the simple fact that the petition has nearly 150,000 signatures, including that of my constituent Nasser Iqbal. Nasser’s daughter was diagnosed with SMA type 1, the most severe form, three months after birth. She is unable to walk or eat due to nerve damage caused by her condition being left undiagnosed and therefore untreated in the first few months of her life. We know that every year in the UK, 48 babies are born with spinal muscular atrophy, with 60% having SMA type 1. Once symptoms begin, damage to motor neurones cannot be undone. However, there is clear evidence that babies diagnosed before symptoms appear have significantly better health outcomes, with many able to reach developmental milestones that would otherwise not be possible. Earlier intervention would have made a huge difference to Nasser’s daughter. I am proud to speak in this debate on her behalf, because she and many other young people are impacted by the absence of early screening. That is why the petition calls on the Government “to fund and help fast-track the process to add SMA to the NHS newborn heel-prick test” so that every baby is “screened at birth to allow early diagnosis and access to life-changing treatment.” Although screening for SMA in newborn babies is currently not recommended by the UK National Screening Committee, it has confirmed that an in-service evaluation of newborn screening for SMA will start in October 2026. However, the plans will include only seven of the 13 regions, which, as many Members have said, leaves approximately 163,000 babies without screening until as late as 2030 or 2031. I am disappointed that one of the areas not included in the ISE of newborn screening for SMA is West Yorkshire, and I am extremely concerned that it will leave my constituents across Keighley and Ilkley without access to this potentially lifesaving screening, despite the ever-growing need for it. Yorkshire has 1.5 times as many patients with SMA compared with national figures; in the last three years alone, the regional neuromuscular service in Leeds has diagnosed 10 infants with the most severe form of SMA. Two tragically died within their first year of life and two have survived, but are living with significant and lifelong disability. Neither child can stand or walk independently. They require night-time respiratory support and are unable to feed themselves without assistance. In comparison, the children diagnosed and treated pre-symptomatically have achieved their expected motor milestones, and they are sitting and walking as expected for their age. I pay tribute to the Leeds teaching hospital for reaching out to me before this debate. In particular, I thank Dr Anne-Marie Childs and her team of paediatric neurologists, who asked me to tell the Minister that we cannot be in a scenario where not every new-born baby in the UK has access to early diagnosis and life-changing treatment. I therefore call on the Minister to make sure that West Yorkshire and my constituents across Keighley and Ilkley are included as part of the early screening process.
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Spinal Muscular Atrophy: Newborn Screening Test
I absolutely agree with the hon. Member. The reality is that, when dealing with such rare diseases, we are better casting the net far and wide to get as much data as possible. That was one of the points made to me by the Leeds teaching hospital. Dr Anne-Marie Childs is advocating for West Yorkshire to be included as part of the early screening process because, at the moment, it is a postcode lottery. Whether someone has access to early screening depends on wherever they happen to be born. The data collection would feed into national reassurance that the Government should be focusing on this issue. It pains me to say that right now a child born in my constituency of Keighley and Ilkley in West Yorkshire does not have access to early screening. SMA is a debilitating condition and, although it cannot be prevented, the outcomes are significantly better for babies who are diagnosed early. Looking at the progress made in Scotland, which began screening new-born babies for SMA in March based on in-service evaluations, I urge the Government to ensure that no child is left behind and that we roll out screening for every child, no matter where in this country they are born.