5,731 spoken contributions under 12 words (interjections such as “Will the hon. Member give way?”) are hidden. Show them

1. 16 Jun 2026·Parliament·Gregory Stafford

   Health Bill (First sitting)

   Q I should declare that I am a member of the all-party parliamentary group on patient safety. Apologies, Dr Dash, I have questioned you on this many times, but I am going to continue to do so. When the King’s Fund, the Nuffield Trust and the Health Foundation were in front of the Health and Social Care Committee and they talked about bringing HSSIB into the CQC, all three of them said very clearly: “Don’t do it.”. In fact, I can find almost nobody apart from you and the Department who thinks that moving HSSIB into the CQC is a good idea. Does that give you any pause for thought about whether you are recommending the right thing? More specifically, if, as you said to the Health and Social Care Committee, the safe space element would be retained and HSSIB would operate as an independent organisation, how can you square the fact that it would remain independent and yet be part of the CQC? If it does remain independent, what is the need to bring it into the CQC? Dr Dash: The point of bringing it into the CQC, as I said before, is that we are trying to simplify this landscape. There are so many different organisations continually commenting and doing reviews—often replicating the same reviews that other people have done. The concern is that it is distracting rather than enabling. The hope that I had when I made the recommendation, and still have now, is that by bringing HSSIB into the CQC, you can align the work of the two. For example, if the CQC is going round the country and spotting a particular problem with the way in which anaesthesia is being given or with managing patients post-surgery, the CQC could then say to HSSIB—that team of people with specific expertise—“Can you go in and take a look at this? Can you do a detailed focus review of this particular area of care that we are spotting through our visits and which seems to be a particular challenge?” It is that bit about enabling the CQC to identify a problem and then asking HSSIB to review it in detail, and HSSIB bringing its expertise in investigations into the CQC to enable the CQC to go deeper and then come back to the NHS with particular areas, but also to supplement the work of the NHS. I would like to point out that since HSSIB was established, the NHS has established its own much more rigorous, much more robust investigatory teams and processes. Of course, I am not saying that they are perfect—we can all see that—but I encourage all colleagues here today to look at the work they are doing, the specific areas they are reviewing, the outputs of those reviews and the ways in which those are leading to improving care. That feels to me to be a much more systematic way of addressing the concerns of patients, families and staff in the place where those concerns happen, having mechanisms to escalate those through the NHS so you can bring them to regions—some investigations get done at the NHS England level—and having the CQC as an independent body that can separately review and spot if there are problems but also ensure that those investigations within the NHS are happening well.

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2. 16 Jun 2026·Parliament·Gregory Stafford

   Health Bill (First sitting)

   Q What happens if the problem is the CQC? Dr Dash: Well, we then have to deal with that as a problem. That is the same as saying, “What happens if the problem is this organisation or that one?” We have 150 organisations—150. What if the GMC is a problem? What if the Nursing and Midwifery Council is a problem?

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3. 16 Jun 2026·Parliament·Gregory Stafford

   Health Bill (First sitting)

   Q Sarah, when we were at the Health and Social Care Committee, you and your fellow panellists seemed to suggest that the Government could achieve what they needed to in the 10-year plan without this reorganisation. Could you delve into that a bit more and tell us why you think that is the case? Sarah Woolnough: The Government have an incredibly ambitious agenda, which is partly articulated in the 10-year plan. Our ongoing concern has been that some of the biggest-ticket items that the Government rightly want to achieve to fundamentally shift power to patients—delivering a shift towards prevention, moving care closer to home and allowing more digital enablement—do not require this kind of legislation or a reorganisation. I go back to my first answer: what is honestly the opportunity cost of doing some of this at the expense of more focus and attention on, for example, delivering care closer to home? There is a lot of energy and activity in that area, but the Government want to make really good progress over the next few years. To take that example, if you are really serious, you need to understand what the barriers are to delivering more care in the community, closer to people and patients, and wrapping services around patients. It requires you to flow money differently and to have a different incentive scheme, but that is nowhere near this piece of legislation. Our worry has been about what is not in the Bill, and what is the rightly and fantastically ambitious agenda to improve health for people and patients, versus the opportunity cost of a largely technical piece of legislation that reorganises some central functions.

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4. 16 Jun 2026·Parliament·Gregory Stafford

   Health Bill (First sitting)

   Q Would you agree with that, Mr Lant? Jacob Lant: Yes. I kind of think, as the debate goes on, that—with the changes to Healthwatch in particular—you could achieve so much without legislation. You could beef up the internal functions for listening to a patient and engaging with them without legislation—there is no requirement for that. You could invest more resource in that, and you could do the same with Healthwatch. You could think about the resourcing of the structures and the support they receive, so you could make that whole system better without legislating to get rid of it. As Sarah said, the NHS changes are a distraction at a time when we should be moving on with focusing on patient care.

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5. 16 Jun 2026·Parliament·Gregory Stafford

   Health Bill (First sitting)

   Q I reiterate that I am a member of the all-party parliamentary group on patient safety. Dr Benneyworth and I have had many conversations about this issue. I have two questions. The first is about the safe space. We have seen written evidence, and we have heard when others have attended the Health and Social Care Committee, about the fact that if HSSIB is placed inside the CQC, you could have the farcical situation of one set of CQC lawyers, who are representing HSSIB, suing or attempting to sue another set of CQC lawyers, who are looking out for the CQC situation, because they are trying to get information out of part of their own system. Is that parody or is it a possibility and real problem? Dr Benneyworth: It is a problem and something that potentially could happen. I hope that we would work effectively to try to avoid that. Essentially, and just to reassure the Committee, if we see something of a criminal nature, if there are significant regulatory concerns, we have protocols in place to be able to escalate that. But there is a real risk that potentially, if we held information that the CQC needed in part of its regulatory function, in its enforcement function, we would not be able to share that, because of our legislation, and we would not want to share it, because we want to maintain the trust in the system. It would need to go to the High Court to be able to get hold of it.

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6. 16 Jun 2026·Parliament·Gregory Stafford

   Health Bill (First sitting)

   Q Just so that I am clear, you have internal protocols that would raise stuff if you saw something criminal, and if you were investigating something and potentially could not share the information, that would not prevent any of the multitude of other regulators that we have out there from investigating on their own something similar. Your investigation would not preclude them from being able to investigate as well. Dr Benneyworth: No.

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7. 16 Jun 2026·Parliament·Gregory Stafford

   Health Bill (First sitting)

   Q Dr Dash, in her evidence, said that—I am slightly paraphrasing, so I hope I have not got this wrong—NHS England has a number of investigatory bodies that it has established recently, and that although they were not perfect, they were much better, and they could be doing this job. What is your response to that? Dr Benneyworth: NHS England has an investigations unit that commissions regional and national investigations, sometimes from private organisations. We work very closely with the NHS England patient safety team. As I said, we have supported their work in rolling out local investigations around the patient safety incident response framework. We have been instrumental in supporting the training and education around that. We are the only safety investigator with protected disclosure. There is no other body that is like us and can do the same type of investigations in this country, and we are internationally looked at. In fact, I am doing a podcast with Canada tomorrow. Numerous countries are looking at us and saying, “We want the same thing.” There is a handful of investigators like us in Finland and Norway, and they have excellent safety outcomes for their patients, but the rest of the world is looking at us and trying to learn from us, and I am frequently asked to speak internationally about this.

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8. 16 Jun 2026·Parliament·Gregory Stafford

   Health Bill (First sitting)

   Q You are saying that you are a world leader. Dr Benneyworth: We are—

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9. 16 Jun 2026·Parliament·Gregory Stafford

   Health Bill (Second sitting)

   Q This question is to the Royal Berkshire. In response to my colleague, you talked about the benefits of your council of governors. As a foundation trust, you have significant autonomy. The Bill will allow the Government to cap your day-to-day spend, strip away your FT status and make governance changes. What impact will that have on how your boards can carry out their duties? James Blythe: With a lot of foundation trusts, as the NHS has moved into a period of increasingly tight financial control and as we have needed to recover from the covid pandemic, far closer working has been required between all NHS providers and the centre, to manage both the financial implications and the pandemic’s implications for patient access and patient quality. Having recently moved from a senior leadership, board-level role in an NHS trust to two roles as chief executive in a foundation trust, I do not feel that in the day-to-day relationship with the centre and with our local and regional representatives there is an enormous difference in how we balance quality, finance and performance now. Those foundation trust freedoms were most relevant when we were in a system in which expenditure on health could grow and we were not trying to recover from the challenges that we have had recently. Day to day, the relationship between NHS trusts and foundation trusts feels quite consistent now, so I am not sure that the changes proposed in the Bill will necessarily make a huge difference. As I said in response to an earlier question, it depends entirely on whether the provisions of the Bill are used to set a small number of priorities and let NHS organisations get on with delivering them, or whether they are used more regularly to intervene more directly in our day-to-day operations. A lot comes down to how the regime is operated.

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10. 16 Jun 2026·Parliament·Gregory Stafford

    Health Bill (Second sitting)

    Q On the streamlining point, you have articulated very clearly why you think it is inappropriate, as have members of this Committee, and most of the evidence we have received suggests that it is not appropriate. What do you think is the reasoning behind the Government’s real push for this, when the evidence against it is so clearly strong? Is it simply that they want to save money, in your opinion, or is there an alternative motive? Professor Croisdale-Appleby: If we talk about money— I will be quantitative here—Healthwatch England currently costs £3 million per year and the network receives £25 million per year. To people like me, £3 million and £25 million is a lot of money, but in the greater scheme of things it is not a significant amount, particularly when you think what is being produced for it. I cannot speak appropriately, in my role as chair of Healthwatch, about Government policy. It is not my job to do that; it is the Government’s job. If you want to ask me a question on a purely personal basis so I can step outside of that role, I will be happy to answer, but I always have to draw a very distinct line on anything that I say. Everything so far has been said in my formal position as chair of Healthwatch as opposed to any personal views, because I certainly do not want to comment on Government policy.

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11. 16 Jun 2026·Parliament·Gregory Stafford

    Health Bill (Second sitting)

    Q Ms Higson, given that you are a director of transformation, and that this is, in a wider sense, a transformation of the NHS, if you had the money, resources and political capital that the current Government have, would you do this or would you do something else? Maria Higson: Any time we go through an NHS reorganisation, it is distracting—that is the reality of such situations. It is unfortunate that, over the past 15 months, this has been a large distraction for people who are genuinely trying to deliver the three shifts—prevention, digital and neighbourhoods. It is true that it has been a distraction. I am not sure that this Committee is the right space to go into these, as I am aware that we are here to discuss the Bill, but there are probably opportunities to go further on some elements, which may help us in future.

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12. 16 Jun 2026·Parliament·Gregory Stafford

    Health Bill (Second sitting)

    Q Can you give a couple of examples? Maria Higson: To take one example, I would love to see an NHS where we step away from short-term activity metrics, and towards outcomes—that is mentioned in the Bill. The constant firefight on activities is quite challenging, so how can we move that dialogue to ensure genuine transformation? That is an example of where we could potentially go further than the Bill suggests, but I am conscious that I am supposed to comment on the Bill, not give my own random thoughts.

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13. 16 Jun 2026·Parliament·Gregory Stafford

    Access to Dental Services: West Sussex

    It is a pleasure to serve under your chairmanship, Sir Desmond. I thank the hon. Member for Chichester (Jess Brown-Fuller) for securing this important debate, and for outlining the issues that her constituents—and, indeed, many constituents across the country—are facing. It is something of an irony that I find myself speaking on NHS dentistry for the second time in as many days, having co-sponsored yesterday’s Backbench Business debate on precisely this issue, but if anything, that underlines the scale of the issue we are dealing with. The hon. Member for Chichester will know that West Sussex borders my constituency, which spans Surrey and Hampshire. Many of my constituents in Haslemere and the surrounding villages routinely access services across that boundary, and would regard West Sussex as part of their natural health economy. I am sure the same is true vice versa, because dentistry does not respect administrative lines, and access to care either exists or it does not. Let us be clear about the scale of the problem. Oral health is not a luxury issue; as my hon. Friend the Member for Bognor Regis and Littlehampton (Alison Griffiths) set out so clearly and passionately, it is fundamental to dignity, confidence, employability and overall health, yet access to NHS dentistry has become a postcode lottery. Nearly 14 million people are struggling to access care, and in many areas more than 70% of practices are not accepting new NHS patients, including children. As far as I can tell, not a single dentist in my constituency of Farnham and Bordon is accepting new NHS patients. It is often suggested that we simply have a workforce shortage, but the issue is not that we do not have enough dentists; it is that, understandably, too few are willing to work within a contract that no longer makes sense. The 2006 NHS dental contract, introduced under the last Labour Government, is based on units of dental activity. It pays the same whether a dentist carries out one filling or six, rewards volume rather than complexity, and actively discourages preventive care. That contract is central to why the system is struggling. The Government came into office promising a dental rescue plan, including urgent appointments, contract reform, workforce expansion and a greater focus on prevention. Those commitments were clear and repeated, yet delivery has not matched the rhetoric. In practice, the additional appointments that have been rolled out amount in many cases to only a small increase in urgent capacity. According to the British Dental Association, they are equivalent to a couple of extra slots per dentist per month. At the same time, the long-promised NHS workforce plan has still not been published and, without it, there is no credible road map for how capacity will be met. Warm words about recruitment are no substitute for a clear and funded strategy that tells practices and patients what the future looks like. We also need to recognise inefficiencies within the current system. In some practices, around one in seven NHS appointments is missed, costing individual surgeries tens of thousands of pounds a year. That is not just a frustration for clinicians—it is lost capacity in a system that is already under extreme pressure. However, rather than addressing the structural incentives that contribute to this, the Government’s response has been piecemeal. The consequences of all this are not evenly distributed; rural and coastal communities are particularly badly affected, with some having as few as 10 NHS dental practices per 100,000 people. These so-called dental deserts are not accidental, but the predictable outcome of a system that does not align funding, workforce planning and local need. There is a striking example of underused capacity in my local area. In Haslemere, the hospital contains a fully equipped dental suite that remains unused despite clear local demand. That facility could serve patients across the West Sussex border, given the natural geography of where people access care. Instead, it sits idle. I think everyone in this Chamber agrees with prevention in principle, and with the need to move away from a purely treatment-based model. The challenge is delivery. Likewise, workforce expansion is essential, but announcements without a credible plan do not translate into appointments. Ultimately, what is required is straightforward in principle, but urgent in practice: a properly funded and credible workforce plan, contract reform that rewards prevention and complexity rather than volume, and a serious strategy to address dental deserts that reflects real geography and need. We should also acknowledge the previous efforts of the Conservative Government, including the dental recovery plan, which did attempt to address these issues through recruitment incentives, training expansion and support of overseas qualified dentists. I accept that some measures had limited uptake, but they were at least an attempt to respond to a growing crisis. The question now is whether this Government build on what works or continue to drift without clear direction. Patients do not care which Government designed which contract or which plan; they care about seeing a dentist when they need one. I end with three straightforward questions that I asked the Minister in yesterday’s debate, but to which I did not get an answer. When will we see a fully funded and credible NHS dental workforce plan? How many additional dentists, hygienists and therapists are required to meet demand? What is the plan to ensure that dental deserts do not become a permanent feature of our healthcare system? Patients deserve these answers not in the future, but today.

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14. 16 Jun 2026·Parliament·Gregory Stafford

    Russian Oil Sales

    4. What diplomatic steps she is taking with international partners to help prevent the sale of Russian oil to companies in China, Turkey and India.

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15. 16 Jun 2026·Parliament·Gregory Stafford

    Russian Oil Sales

    While diplomatic pressure on China, India and Turkey is essential, we must also do more militarily to disrupt the shadow fleet carrying Putin’s oil. I pay tribute to our armed forces who, this weekend, boarded a Russia-linked tanker in UK waters under new Government powers. Since those powers were announced in March, 184 sanctioned shadow fleet vessels have made 238 journeys through UK waters, including 94 journeys into territorial waters, without a single interdiction until now. What is the Department doing with the Ministry of Defence and international partners to ensure that this is a sustained approach, rather than a one-off?

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16. 16 Jun 2026·Parliament·Greg Smith

    Topical Questions

    My right hon. Friend the shadow Foreign Secretary rightly challenged the Government on the use of Chinese slave labour in the manufacture of solar panels. Chinese companies also dominate the mining companies using slave labour to extract cobalt in the Democratic Republic of the Congo, so how much more needs to happen for the Government to challenge this evil use of slave labour, particularly by the Chinese state?

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17. 16 Jun 2026·Parliament·Greg Smith

    Thames Water

    I have a huge list of complaints about Thames Water across Mid Buckinghamshire, and I am sure it is identical to that of the Secretary of State next door in Wycombe, so I add my voice to my hon. Friends’ calls for real detail about the plan, rather than just ambition. In the meantime, there is something that is causing Thames Water and every other water company to chase their tails: their inability to have a proper voice in the planning system. When a village such as Ickford in my constituency, which already has its sewage pumped away by road in tankers because the system just cannot cope, is told that it has to connect another 90, 100 or 150 properties, it is never going to work. Given the huge demand for house building and data centres in Buckinghamshire, what action will the Secretary of State take to ensure that the water companies can have their say and say no when they cannot connect areas?

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18. 16 Jun 2026·Parliament·Gareth Bacon

    Topical Questions

    I refer the House to my entry in the Register of Members’ Financial Interests. The Government have previously stated that Hamas must voluntarily disarm in accordance with the 20-point peace plan, but that is clearly not happening. What is the Government’s practical strategy to ensure that Hamas is compelled to give up its weapons, cannot rebuild its military capabilities, and does not divert humanitarian aid?

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19. 16 Jun 2026·Parliament·Edward Argar

    Health Bill (First sitting)

    Q In her evidence earlier, Dr Dash said that one of the reasons for her recommendations in her second review of changes to the regulatory and investigatory landscape is that it is a problem for the provider landscape that there are so many different organisations making so many recommendations. You have just said that HSSIB makes very few recommendations. Will the merging or folding—however you wish to characterise it—of HSSIB into the CQC lead to any meaningful reduction in the number of recommendations that organisations have to cope with? Dr Benneyworth: No, we do not make recommendations to provider organisations at all. All our recommendations go to national organisations. I completely agree with Dr Dash that there are too many recommendations. In fact, HSSIB raised that concern through our work two years ago and flagged it to Dr Dash. We wrote a report called “Recommendations but no action”. We are very concerned about the plethora of recommendations going to providers, which create a huge amount of noise but, distressingly for the families involved, do not lead to the changes needed. I completely agree that there are far too many recommendations. I am leading some work to address that—we are setting up a recommendations hub with the Department of Health and Social Care—but we are not that problem. We have made 39 recommendations since investigations launched and HSSIB started three years ago, and they are all to national bodies. We might reduce the burden on national bodies by taking that away, but it will not have any impact on providers.

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20. 16 Jun 2026·Parliament·Edward Argar

    Health Bill (Second sitting)

    Q I know that in this conversation some have highlighted that patients have stated that their experience has worsened or not improved, but I would argue that is not a Healthwatch failure; it is actually down to the NHS or ICBs not acting on Healthwatch recommendations. It seems to me perverse to give that voice to the organisations that are actually part of the problem through not acting. As a Minister, I was on the receiving end of some quite sharp recommendations from Healthwatch, but they were always constructive. Whether right or wrong, my fear is that this measure risks a perception among patients that it will be down to NHS managers and ICBs essentially to make recommendations that reflect their priorities, rather than the priorities and voices of patients. Professor, even if the principles that you have enunciated that might mitigate that risk were applied to the new model, are you really confident that they could mitigate the risk to patients’ confidence that their voice is genuinely and independently heard, loud and clear, however unhelpful it is perceived to be by bits of the NHS? Professor Croisdale-Appleby: I cannot be confident of that, because we are in the foothills, not up the slope, and the details have not been given. ICBs have received something approaching a 50% cut in their running costs. I will not comment on the appropriateness or otherwise of that, but one has to be realistic and think about how high a really informed patient voice—particularly one that seeks out the views of both communities and individuals where the health inequalities are the greatest—will be on the priority list. I would question that, but I will leave it there.

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21. 16 Jun 2026·Parliament·Edward Argar

    Health Bill (Second sitting)

    Q Having been both a local councillor and a Health Minister, I am very conscious that the real test of any joint working arrangements between different bodies comes when budgets start getting a little tighter. We see that tension growing a little bit with the cuts made to ICBs’ budgets. I was the Minister who created ICBs, and I sat on that Bill Committee with the current Minister for Secondary Care. I am getting a sense of déjà vu—we are on different sides of the Chamber now, but we sat through the Committee stage of the Health and Care Act 2022 together. I deliberately created ICBs to match the geography of upper-tier authorities because health and social care is essentially one system. If one bit does not work, the other bit does not work. Since then, we have seen significant mergers and larger areas, further removing them from that direct relationship and read-across. Although the good ones do, I fear that a lot of NHS ICBs do not fully reflect the intention behind their creation, which was to see them as a genuinely collaborative exercise with equal voices in the room. My question is: if we see ever-larger areas or fragmented areas, whether through neighbourhood health plans or mergers and acquisitions among ICBs, how do we maintain genuine local accountability and the relationships that underpin any structure written in law, on a piece of paper or in guidelines? Notwithstanding what is being done about the health and wellbeing boards’ increasing involvement, do they actually have the teeth they need? In my experience, however good the collaboration, it is within the ICB boardroom that the decisions are actually made. However well things have been discussed beforehand, the ICBs will make their own decisions based on their own priorities. Does the removal of that voice from the ICB strengthen or weaken the ability to see this as one local system and to deliver a genuinely holistic local solution? Councillor Wright: It will probably weaken it, unless we are given more say in our local health and wellbeing board. Our Thames Valley ICB has one director of public health. Thames Valley ICB I think has nine local authorities, and one chief executive and one director of public health sit on the board, so already the voice on it is quite small. If we lose that voice, where would we have those conversations? That brings me back to the whole thing about health and wellbeing boards needing to be stronger, definitely. Sally Burlington: We would agree with that. If you take away the voice that is able to speak on behalf of social care, public health and wider public services, it will be harder and an additional job to bring in that consideration. It will be even harder to expect there to be notional teeth in that relationship, so we have concerns about that. Maria Higson: It is also worth recognising that the delivery of any strategy or plan will require partnership working with local authorities, so whether or not they are in the room, they will be needed for delivery, and the proof is always in the pudding. For me, the partnership is somewhat non-negotiable in order to achieve delivery.

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22. 16 Jun 2026·Parliament·Dr Neil Hudson

    Draft Digital Waste Tracking (England) Regulations 2026

    It is a great pleasure to serve under your chairmanship today, Mr Vickers. I thank the Minister for introducing the draft regulations to the Committee. It is good to see the Government building on the progress made by the previous Conservative Government, who laid the foundation for digital waste tracking to be introduced by passing the landmark Environment Act 2021. Additional measures introduced by the Conservatives that sought to tackle waste crime include increasing the upper limit for fixed penalties to ensure proportionate and effective enforcement action. The previous Government also provided 30 local authorities with grants to enhance resources to tackle fly-tipping. The grants supported a range of projects such as CCTV, anti-climb fencing and better waste infrastructure.

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23. 16 Jun 2026·Parliament·Dr Neil Hudson

    Draft Digital Waste Tracking (England) Regulations 2026

    I am very proud of the previous Conservative Government passing the landmark Environment Act. We consulted and brought forward measures to tackle waste crime, and I am very pleased that the Labour Government have taken the baton forward and are enacting some of the measures that we started. Sadly, my constituents have also been faced with the blight of fly-tipping in our communities, with many serious cases caused by shameless criminals who should face the full extent of the law. It not only harms communities and the environment, but threatens the precious wildlife and biodiversity that the forest of Epping Forest is so privileged to enjoy. I must pay tribute to the litter-picking groups across Epping Forest, including the Waltham Abbey community group and Theydon Bois parish council, who regularly roll up their sleeves to fight the scourge of waste carelessly dumped. I have had the pleasure of joining that fantastic community in action on many occasions. When I have joined community groups on litter picks, it has been particularly concerning to see an abundance of discarded large nitrous oxide canisters. They are used illegally for drug misuse and then discarded on the side of roads to be cleared up by those who do the right thing. Any activity to clear up waste, such as the measure we are discussing, needs to address this issue as a priority for urban, rural and semi-rural communities alike. Can the Minister outline what steps the Government are taking to tackle the illegal use of nitrous oxide and the damaging discarding of those dangerous canisters in our environment? I welcome the cross-party support for tackling waste crime. Not only does it cost the English economy about £1 billion a year, but it has become interlinked with criminal gangs who profit from breaking the law. We should all be deeply concerned that an estimated 20% of all waste is illegally managed. Importantly, the regulations have the full co-operation of the devolved Administrations, which is vital to ensure that we have an effective regime that works for waste operators. As the Minister will be aware, the Secondary Legislation Scrutiny Committee noted that the Government need to clarify exactly how the digital waste tracking regime will interact with the new extended producer responsibility —she made some comments on that point. Under the packaging scheme, producers will have to pay the costs of dealing with household packaging waste and provide information about its disposal. I hope she can provide further clear and practical information on that, particularly as many businesses have expressed strong concerns about the timing of the implementation of the EPR regime, which will add costs to businesses when the Chancellor is already taxing them hugely and making their lives very difficult. The Minister might be aware that His Majesty’s most loyal Opposition hosted a food and farming emergency summit last year to which key stakeholders, including food producers, were invited. A key demand from that summit was a call for the Government to conduct a rapid review of EPR for the food, drink and hospitality sectors. The shadow Secretary of State for Environment, Food and Rural Affairs, my right hon. Friend the Member for Louth and Horncastle (Victoria Atkins), wrote to the Government to ask them to act on that. It was disappointing that the Government did not consider the merit of such a request from the businesses directly affected by the policy. Ministers are always keen to emphasise their desire to transition to a circular economy in which we keep resources in use for as long as possible, extract maximum value from them, minimise waste and promote resource efficiency. That goal is shared by all. However, aside from introducing individual measures here and there, the Government have yet to publish their clear circular economy strategy. As I understand it, the circular economy taskforce was established for the very purpose of creating a strategy. Will the Minister clarify when she anticipates further details will be published?

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24. 16 Jun 2026·Parliament·Dr Luke Evans

    Community Hospitals

    It is a pleasure to serve under your chairmanship, Sir Jeremy. I congratulate the hon. Member for South Cotswolds (Dr Savage) on securing the debate. It is fantastic to have the chance to champion community hospitals and what they stand for and provide. I put on record my thanks to the Hinckley and Bosworth Community Hospital, which does fantastic work in my area, in Hinckley. Also, only last week, I was lucky enough to go to the one-year anniversary celebration for my community diagnostics centre—a £24 million investment, set up by the last Government, that we have now carried through. To date, it has served more than 59,000 patients, and it is expanding the delivery of services that it can provide, meaning that services that are provided within the community and people do not have to travel to the likes of Nuneaton or into Leicester. That is exactly what the leftward shift is all about: bringing those services to the community. It may come as no surprise that I have a personal connection to community hospitals—you might expect me to talk about my job, Sir Jeremy, but it actually began much before that. My father was a GP down in Dorset; on Christmas days, before we were allowed to open our presents, we used to visit the community hospital and do the ward round with all the patients. As a child I really looked forward to that—first, because I got to meet Father Christmas, but secondly, because of the family feel of that community hospital had. That is the essence of what these places provide: that ability to be within our communities, to give the support and the family feel that we want to keep hold of and treasure because it is so important. Especially when dealing with healthcare, we often forget about wellbeing, and that is what these community hubs can provide. Looking at the Government’s direction of travel, it very much sets out how neighbourhood health centres should look, but it is not quite so clear about how that dovetails with community hospitals. How do integrated health hubs fit in with community hospitals? It is not clear in the 10-year plan, and it is certainly not clear in the documentation coming out. Given that the Government are expecting ICBs to commission those hubs, and given some of the stories that we have heard—for example from my hon. Friend the Member for Bognor Regis and Littlehampton (Alison Griffiths), who is championing and fighting for the services in her area—the worry is that the Government are not explicit on what ICBs should be doing on community hospitals. We have this intention and general belief, but the actual direction of how this will work is clouded. I therefore pose a question to the Government: are they considering a national strategy for community hospitals—or even a definition? That is one of the biggest problems when we look up community hospitals. What is the definition of a community hospital? Are community diagnostic centres included in that, or not? What about intermediate care? What about step-down care? What about clinics that provide endoscopy? I must admit that, when I look at community hospitals, I am never quite sure what the definition is; looking into the detail, I struggle to find any definition that the Government have come up with. Those are key questions about the leftward shift. I think we all agree that that would be welcome, but it is about the delivery plan. Of course, the 10-year plan has no delivery chapter, which again leads us back to the questions for the Minister today. I appreciate that this is not her portfolio, but these questions will keep coming time and again: how do we actually deliver, and what does this look like in the guise of neighbourhood health centres? On that point, when it comes to delivery, I would like to pose something to the Minister: it was reported in the news over the weekend that NHS capital spend could be under threat to fund the defence investment plan. I hope she will be able to stand at this Dispatch Box and say that that is categorically not true—but that is going to be important. That leads me on to another question that I would like to pose to the Minister. The response to a written question about the abolition of NHS England and its impact on services stated: “The abolition of NHS England is causing no disruption to the development of new services.” Will the Minister state that from the Dispatch Box? Certainly, from what we are hearing on the ground, the ICB changes—losing 50% through redundancies—are having a significant impact on the way in which services are planned and delivered. I am therefore keen to understand the rationale behind that statement. To finish where I started, community hospitals really are the healthcare that feels human. They are local, they are close to home and they are something that we across this House should aspire to. That family approach is where we all want to be; it is how we get there that is the question for the Government.

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25. 16 Jun 2026·Parliament·Dr Luke Evans

    Community Hospitals

    The Government have set out a great ambition, but the Minister is talking about neighbourhood health centres and we are talking about community hospitals. Where do they dovetail and how do they fit? What definition is she using to put this together?

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26. 16 Jun 2026·Parliament·Dr Luke Evans

    Community Hospitals

    I am sorry to hammer this home, but every single point that the Minister has made has been about community services. She is spot on, but the question is where community hospitals fit in. Are they the correct vehicle that the Government want to use to help deliver some of those services, or are the Government moving away from the community hospital model and into further hubs? Both would be reasonable approaches and could be defended or pulled apart. The question is what the Government are choosing, because it is not clear from the Minister’s answers which it is.

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27. 16 Jun 2026·Parliament·Dr Caroline Johnson

    Health Bill (First sitting)

    I am a member of the Royal College of Paediatrics and Child Health, a member of the British Medical Association and an NHS consultant paediatrician.

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28. 16 Jun 2026·Parliament·Dr Caroline Johnson

    Health Bill (First sitting)

    Q Good morning, Dr Dash. What effect is the abolition of NHS England having on its current day-to-day functioning? What sort of number of people are working solely or mostly on the transfer, and is that affecting your ability to deliver on your core business? Dr Dash: I do not believe it is affecting our ability to deliver. Much of the work to date has been led by a joint team of people from across NHS England and the Department of Health and Social Care, who are working together, have put together a process and have been going through all the things you would expect of any integration process. That has been a fairly confined team. As they are starting to look at what needs to happen in each of the different functional areas—the different directorates—that we have set out, they are working with the directors general or the executive directors leading each of those to understand what different functions we need to enact within each of those directorates, and what their teams could look like. They are putting time into that, which is good—that is what we want them to do, not least because they are also looking at ways of working, not just at numbers of people—but I would not say that it is a distraction. In fact, in some ways, I would say it is really helpful, because it is helping to define the core priorities and the key things that we need to focus on, and how we can continue on the journey of seeking to improve health and healthcare services. That is across those executive directors and directors general. The team who are putting a lot of time into this, not surprisingly, are the people working in the HR functions. That team are spending a lot of time going through the mechanics, and they have been managing things like the voluntary redundancy programme. I would hope, and I believe, that there is no negative impact on our focusing on what we need to focus on.

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29. 16 Jun 2026·Parliament·Dr Caroline Johnson

    Health Bill (First sitting)

    Q You wrote a report about the CQC that was not hugely flattering, and you have also written a report about the patient safety landscape. First, why did you choose to roll HSSIB into the CQC, given what you said about the CQC and the clear and obvious conflicts of interest that it creates? Secondly, you identified in your findings that a large number of clinical nursing staff were being moved into more managerial roles, with an effect on clinical capacity. Which of your recommendations would have dealt with that, or what would you recommend now? Dr Dash: On the first question, as you say, my first review looked at the CQC, and that there are a number of considerable challenges there. I would have hoped that, by now, many of those challenges had been addressed. Some of them have been, but some of them have struggled. It has already gone from the previous chief exec to a new chief exec, and it is now out looking for another chief exec, and the chair has changed too. That has definitely impeded progress. As I said, it has made considerable progress in some key areas, in particular the use of technology, but it still has a way to go, and we all need to acknowledge that. I note that the ministerial team in the Department of Health and Social care has suggested that the integration of HSSIB into the CQC should happen only when the CQC is in a more stable position, which sounds sensible and pragmatic to me. On the second review that I did, I was asked to look at the regulatory and quasi-regulatory landscape. I was referred to a report that had been done by Professor Carl Macrae and others that talked about 126 organisations. When I looked, I found more than 150, and I listed all of those in my report. I spoke to many people—well over 200 people who joined various roundtables and so on—and the very consistent theme was that this is so busy and confusing, and keeps leading to all sorts of different recommendations from different organisations, but also to people having continually to respond to all these different bodies asking for people to fill out a form, asking questions and doing reviews. As a result, our clinical staff—not just our nurses, but all our clinical staff—are having to spend considerable time filling out those forms and going through tick-box exercises. You will hear people talk about that a lot. The concern is that this very busy landscape is distracting from what it is there to do, which is to improve quality of care. I was asked by the Department of Health and Social Care to look at that landscape. I was asked to focus on six organisations, which are listed in my report, of which HSSIB was one. Across the six—of course, six is a small number out of that 150—I was asked to look at where there were opportunities for rationalisation and simplification. The observation was that colleagues in HSSIB have some great skills and capabilities in carrying out investigations into healthcare, highly complementary to the work of the CQC, which is equally there to understand how well different organisations are performing, to give the public confidence, to give ratings and to identify problems, and therefore putting those two organisations together would create significant synergies and opportunities for them both to work well.

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30. 16 Jun 2026·Parliament·Dr Caroline Johnson

    Health Bill (First sitting)

    Q What about the risks of that—the conflict? Dr Dash: I do not see a conflict. I think they are complementary and this is all about improving the regulatory landscape in the healthcare system.

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31. 16 Jun 2026·Parliament·Dr Caroline Johnson

    Health Bill (First sitting)

    Q Sarah, the King’s Fund report said that the potential cost savings of abolishing NHS England “would be minimal in the context of the entire NHS budget”. Many MPs across the House have struggled to get numbers and costings in questions both oral and written, particularly in relation to staff redundancies. We have not received information on the full arrangements of where NHS England’s functions are going to go yet. How can we be sure that its abolition will save any money at all? Sarah Woolnough: I think, on the basis of the question, we do not know. Our worry has been about the opportunity cost. The Government, when in opposition, said that they would not launch wholescale reorganisation, because they understood the potential opportunity cost on time and other resources. As this has played out, taking longer than anticipated, we have had multiple examples of teams left in limbo about where they will end up in the target operating model. Our ongoing concern has been, “Is the benefit worth the cost?”

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32. 16 Jun 2026·Parliament·Dr Caroline Johnson

    Health Bill (First sitting)

    Q Yes, although yesterday we received an answer to a written parliamentary question saying that the abolition of NHS England is causing no disruption to the development of new services. That is the Government’s view. Sarah Woolnough: It is inevitable that, in any large-scale change in an organisation, there will be opportunity cost. These arguments were very well rehearsed by the previous Secretary of State. He undertook personally that he would not follow this course of action, exactly because these things take longer and cost more, and because the benefit realisation case is not always clear. It is also quite hard to tell—we have grappled with this as a think-tank—whether there is good evidence of what you are delivering at the end, and whether the benefits will be realised as you stated they would be up front. It is harder to get the granular evidence and costings to prove the case, but our ongoing concern has been whether you need to wholescale reorganise to drive the sorts of benefits that the Government have said they want to deliver. We absolutely understand and agree with those who say, “Let’s reduce duplication. Let’s streamline. Let’s make sure that we’re getting value for money and spending taxpayers’ money wisely.” Do you need to launch a large reorganisation—a mass rearranging of the deck chairs of this nature? Our view has been, “You shouldn’t and you don’t.”

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33. 16 Jun 2026·Parliament·Dr Caroline Johnson

    Health Bill (First sitting)

    Q Thank you, Sarah. That was also the view of the Darzi report. He said that it was “neither desirable nor necessary”. Jacob, what effect will the abolition of Healthwatch have on people’s confidence in the independence and reliability of views of patient experiences? Jacob Lant: First, it is important to note that we know that there are people who are reluctant to come forward and share their poor experiences of care with the NHS directly. They fear retribution if they complain or speak up. Research by Healthwatch has shown that about one in five people experience poor care, so a significant proportion of people are unwilling to come forward and speak to statutory agencies. That will be concentrated in communities who are particularly marginalised—those who already lack trust in institutions. There is a clear case already that there will be a group for whom the lack of independence will be a real concern. The second point is about the unsolicited feedback that is gathered by the Healthwatch network. Dr Dash and others have talked about how the system does lots of engagement itself, and how it could therefore surely take over those functions. But the system engages on its terms: it is about service reconfiguration that it wants to do, or about trying to gather experiences on a particular topic in which it is interested. Healthwatch allows an opportunity for continual listening and engagement with communities, where they can speak up about anything that is affecting them, from dentistry to patient transport and administration of care. Those issues are not necessarily on the system’s agenda. As I see it, under the changes that will disappear.

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34. 16 Jun 2026·Parliament·Dr Caroline Johnson

    Health Bill (First sitting)

    Q The Bill requires that Healthwatch be abolished, to an extent, and that local authorities do their own inpatient engagement instead, but they do not seem to be mandated to do so in quite the same way. Local authorities are under financial pressure. Do you believe that such engagement will happen at all, or to the same extent that it does now? Jacob Lant: There are a few points on that. The narrative around the Bill is that Healthwatch is being abolished and its functions lifted and shifted across to local authorities and ICBs. That is not the case. We lose a number of important functions. For example, the signposting support that Healthwatch provides will disappear so patients and care users will not have that to help them to understand how to navigate local services. I mentioned the unsolicited feedback that is gathered; that function will disappear. The outreach into communities, particularly marginalised communities, will disappear. The voice for patients and communities on health and wellbeing boards disappears, so there is no feed into those local decision-making bodies. There are several places where there is not a direct lift and shift across. That is a concern, and the Committee should probe it further. On the resourcing point, at least local authorities will get part of the existing funding for Healthwatch to support their functions in that space. Under the Department’s impact assessment, ICBs will not get any funding from the current pot. That represents a 50% cut in the resourcing for listening to patients and communities, which is a concern.

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35. 16 Jun 2026·Parliament·Dr Caroline Johnson

    Health Bill (First sitting)

    Q I should perhaps reiterate that I am a member of the Royal College of Paediatrics and Child Health. Dr Dickson, NHS England has responsibility for workforce and workforce planning. How will the Bill affect that, and what effect is the delayed and delayed and delayed workforce plan having on the ability to plan the workforce now and for the future? Dr Dickson: I would go back to some of the comments that have been made before. It is the opportunity cost at the moment. We know that the workforce plan is being worked on in the background, but when you are unsure what the operating and delivery model will formally look like, there is a difficulty in seeing what the workforce for that will be. We are also talking about massive changes in the way we think about care delivery—movement into the community and a different way of working—so we need a different workforce. Therefore, we need to put in some work to look at how curricula drive a different type of workforce, how we train people to work in a different way and how we empower them to see the opportunities to work in that way, when they do not have actual role models. We need a culture shift anyway, whatever is happening, but the abolition of NHS England is in many ways increasing the time. Things need to move, and they are moving, but they are not necessarily moving as fast as they should.

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36. 16 Jun 2026·Parliament·Dr Caroline Johnson

    Health Bill (First sitting)

    Q So, in essence, the fact that NHS England is being abolished, whether that is the right or wrong thing to do, will have an effect on the delivery of new services? Dr Dickson: We are delivering services as normal, but that head space and the innovation to see what the future should be and to work towards that future actively are limited by not knowing what that future looks like. Kay Keane: We do not know what the left shift that we keep hearing about looks like; we do not know what that is for practices. In general practice, we are very practical—we get on with what is in front of us—so the big organisational changes do not have a huge effect on the day-to-day seeing of patients and organising that, but understanding what is around us does.

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37. 16 Jun 2026·Parliament·Dr Caroline Johnson

    Health Bill (First sitting)

    Q I want to move on to the single patient record. Do you feel that general practice has had enough information about its role in terms of who is responsible, who is accountable, who will be editing and who will be responsible for checking that the editors are right on this single patient record? Dr Dickson: The legislation is very much an enabler for a single patient record. The devil in the detail there is not entirely true. In my experience, if you ask most patients if they would like a single patient record, they feel that it is already there. They do not understand that we do not have the ability to share their data in a way that works for them. Therefore, the idea of a single patient record is very much a lodestone for medical practitioners and most patients. When you talk them through the detail of how you achieve that and who owns the data, it is a much trickier issue for many, including the professionals, but also the public. Kay Keane: I agree. The detail is not there at all. At the moment, we look after the data that is in the GP summary care record. That creates lots of questions for our patients. They will see information in there that they are not sure about or that they want help with. They will perhaps be able to read some of their hospital letters within that record. However, lots of patients have a variety of health inequalities that might mean they cannot access that data. In general practice, our non-clinical staff often help them to navigate their way around all that information. We also have patients who will read something in their record on which they want clarity—maybe something that happened a long time ago that they cannot remember and want explaining to them. All those things take time. Where will the responsibility for that go? It takes an awful lot of resources in general practice to educate and support patients and to help them navigate their appointments and the letters coming through. Where will that responsibility sit? At the moment, it is of course with the GPs, but practically it is practice managers, up and down the country, who take on the day-to-day responsibility.

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38. 16 Jun 2026·Parliament·Dr Caroline Johnson

    Health Bill (First sitting)

    Q I have one small question. Dr Dickson, even in paediatrics I have looked after patients who have ring binder after ring binder of notes. Clearly, when seeing a patient for 20 or 30 minutes in clinic, there is not time to read ring binders and ring binders of notes. To what extent will the single patient record oblige clinicians to have read and understood everything for every appointment? Is that really practical? Dr Dickson: You need to believe that you have found out enough about a patient to deliver their healthcare. I would turn it around and say it is very difficult to deliver appropriate care to somebody on whom you do not have full information.

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39. 16 Jun 2026·Parliament·Dr Caroline Johnson

    Health Bill (First sitting)

    The question is, how do you find it within the way it is structured?

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40. 16 Jun 2026·Parliament·Dr Caroline Johnson

    Health Bill (First sitting)

    Q Good morning, Dr Benneyworth. There seems to have been a bit of a muddle in how some of this has been expressed this morning. For clarity, could you explain how a regulator is different from an investigatory body, please? Dr Benneyworth: We are a safety investigator. We have been modelled on other industries that have very successful safety records, and we have learned from those other industries. We investigate patient safety concerns of national significance, and we make recommendations into national bodies about what needs to be improved. We make very few recommendations—only small numbers—into those national bodies, but they are about what needs to change from a systemic point of view to make patient care better. That is underpinned by learning from other industries—the safety science, the human factors and the real knowledge about how you improve safety—and we are trying to embed that in the NHS. Regulation is very different. That looks at individual providers. I used to the work for the CQC and regulate primary care. It looks at how individual providers are functioning. It makes recommendations to individual providers about what needs to change, and it judges an individual’s performance against a set of regulations. The two functions are completely different. The other important thing for us is that we do not attribute any blame or liability in our investigations. That is vital, because we learn from what we see. We learn from those investigations, and we are trying to embed a continuous learning environment and culture within the system.

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