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The Minister failed to respond to any of the questions asked by the shadow Minister, my hon. Friend the Member for Reigate (Rebecca Paul), so I will try again: some companies have expressed an interest in the business, so what discussions is the Minister, or his colleagues, having with potential buyers?
It is a pleasure to serve under your chairmanship, Dr Huq. I welcome the Minister back from her son’s graduation —I hope it went well. I rise to state my support for new clause 47, which would require the Secretary of State to publish a clear roll-out plan for fracture liaison services across England and report annually to Parliament on progress towards universal coverage by 2030. It is not about creating a new target, because the target already exists: both this Government and the previous Government committed to achieving 100% fracture liaison service coverage by 2030. The question before us, as proposed by the shadow Minister, is simple: how will that promise be delivered, and how will Parliament know whether meaningful progress is being made? Fracture liaison services are one of the most evidence-based interventions in osteoporosis care. They systematically identify people aged over 50 who suffer a fragility fracture; assess their bone health; initiate treatment where appropriate; and monitor patients to reduce the risk of subsequent fractures. Given that around half of patients who sustain a hip fracture have previously broken another bone, those services represent a vital opportunity to intervene before a life-changing injury occurs. The human cost is considerable. Osteoporosis affects millions of people, particularly older women, and fragility fractures can result in a loss of independence, reduced mobility, social isolation and significant pressure on health and social care services. The National Institute for Health and Care Excellence estimates that around 180,000 fractures each year in England and Wales are attributable to osteoporosis. There is also a compelling economic case: the Royal Osteoporosis Society estimates that investing around £30 million in fracture liaison services could prevent approximately 74,000 fractures over five years, including 31,000 hip fractures, saving the NHS around £665 million and freeing up some 750,000 bed days. Few preventive interventions offer that combination of better patient outcomes and substantial savings for the NHS. The Government frequently point to their commitment to universal coverage by 2030, but as the shadow Minister pointed out, progress has been achingly slow. When the Secretary of State appeared before the Health and Social Care Committee last week, I questioned him on that issue directly. While he confirmed that the Department remains committed to meeting that 2030 target, which was first established by the previous Conservative Government, no plan—or indication of when a plan would come—was given. A commitment alone is not a delivery plan. There are also growing concerns that the Government have overstated the progress that has already been made. The Royal Osteoporosis Society has confirmed that more than 97% of the fracture liaison services counted by the current Government were already in place before the change of Government. So, rather than that representing any significant expansion in national coverage, this Government have gone slow. I think it is therefore very reasonable—to answer the question from the hon. Member for Bury St Edmunds and Stowmarket—for Parliament to be entitled to ask what additional progress has actually been made since the commitment was reaffirmed. New clause 47 would also require the Secretary of State to publish an assessment of access in every integrated care board area. It would also require annual milestones, because, at present, there is no publicly available timetable showing where the services will be established, or which areas will be prioritised or progressed between now and 2030. Crucially, the new clause would require the Government to set out how integrated care boards will actually be supported. Ministers rightly point out that fracture liaison services are commissioned locally by integrated care boards, but if the responsibility for delivery rests locally while responsibility for national targets rests with central Government, there clearly needs to be a well-thought-through national framework explaining how those boards will be supported through funding, guidance, workforce planning and accountability. This is, therefore, a straightforward request for transparency, accountability and, most importantly, delivery. If Ministers are committed to achieving this by 2030, they should have absolutely no objection to publishing a plan that shows how they intend to get there. For those reasons, I support the new clause.
It is a pleasure to serve under your chairmanship, Ms Lewell. I had written a 25-page speech for this debate, but to the disappointment of my researcher—and probably the delight of this Committee—I do not intend to read out all 25 pages. [Interruption.] There are cries of “Shame!” from my own side, but I accept that there are a number of amendments and new clauses to get through. My stated objection to the puberty blocker trial is also well known and on the record, so I do not wish to detain the Committee for too long. I want to pick out five areas where I think there are problems. They are why I support new clause 66, tabled by my hon. Friend the Member for Sleaford and North Hykeham. My first point can be summarised as: “Don’t repeat a mistake to find out whether it was a mistake.” Thousands of children have already received puberty blockers through the former Tavistock pathway, and my view is that, before exposing a whole new cohort, the Government should complete the long-promised data linkage study to establish what happened to those children. That is probably the core argument. Secondly, if the Government rightly say that the drugs present an unacceptable safety risk, how can it be ethical to give them to children in a trial? It must still be an unacceptable safety risk, whether it is for the general population of those who wish for it or for the people in the trial. The Government banned routine prescribing because of the safety concerns, yet propose administering the same medicines in a research setting. That is a complete contradiction of the ban. Thirdly, clinical equipoise does not exist in the evidence if the evidence already points to significant risk and uncertain benefit. The Cass review concluded that the evidence base for puberty blockers is weak and that concerns remain over bone health, fertility and neurodevelopment. A trial should not proceed unless there is genuine uncertainty that justifies exposing children to those risks. Fourthly, children should not bear the burden of answering questions that the NHS should have answered itself. The failure to collect the robust, long-term evidence from previous patients, including through the data linkage trial, should not be remedied by recruiting another generation of vulnerable children. Ethical research requires exhausting the existing evidence first. Finally, even the medicines regulator—the MHRA—had sufficient concerns to halt the trial. The MHRA intervened to pause the pathways trial over safety and wellbeing concerns, reinforcing the idea that the scientific and ethical questions remain unresolved. A pause should lead to a complete reassessment, not simply restarting as soon as possible.
It did. If memory serves, that question was raised—although I cannot say more because it was in private. I do have concerns that the professor who was in charge and raised those concerns at the MHRA was recused. I cannot discuss the details of that, but it could show that there was a bias in the selection of the people who were pushing the trial forward. I am not saying that there was bias, but I think that, on an issue of such importance, the perception of bias is almost as bad. We need to be very careful about that. Either way, I think the trial is wrong for the five reasons I have outlined. The key reason is the moral and ethical issue, and my hon. Friend the Member for Isle of Wight East raised it in both the Health and Social Care Committee and the Chamber: it is clearly morally wrong to experiment on children just for the sake of experimenting. The fact that there is no evidence does not mean that we should put children through a trial to see whether the evidence exists.
Unlike that of the hon. Member for Guildford, my constituency covers both Surrey and East Hampshire, so I welcome the focus that new clause 72 places on our local area. Constituents regularly raise with me their concerns about seeing an NHS dentist. As I have announced a number of times in this Committee—although I have not checked today, so may not be true any more—there is not a single dentist in my constituency taking on adult or child NHS patients at the moment. For many people, the challenge is not simply one of convenience; it is about being able to access timely care when they need it. Good oral health is an essential part of overall health, and we cannot allow dentistry to become an afterthought in our healthcare system. The ability see a dentist for routine check-ups, preventive care and urgent treatment helps to reduce pressure elsewhere in the NHS by dealing with problems before they become more serious. The new clause rightly highlights the need both for urgent appointments and for improved access to routine NHS dental care. Prevention is at the heart of a sustainable healthcare system, and regular access to dental services plays an important role in achieving that. I welcome the accountability that the new clause seeks to introduce. In places where there are persistent challenges in accessing services—so-called dental deserts—local communities deserve transparency about what action is being taken and why improvements have not yet been delivered. As I have mentioned before, the spanking new dental surgery in Haslemere hospital has sat entirely unused since it was built, and, as far as I am aware, there are no plans to use it. That seems like a shocking waste of money and, more importantly, a shocking waste of a dental surgery that could be treating patients in Haslemere and the wider area. The hon. Member for North Shropshire always wants to place the blame with the Conservatives, and does not seem to feel the need to challenge the Government, but I gently remind her that there was a Liberal Democrat Minister in the Department of Health and Social Care for five years, and apparently they did absolutely nothing to raise this issue. Although this issue is particularly important for Surrey and East Hampshire, it reflects a wider challenge facing communities across the country. Residents should not have to struggle to find an NHS dentist, and ensuring that provision is adequate must remain a priority. I hope the Government take that on board.
My hon. Friend has just sat down. I was not sure whether she had finished her speech or was willing to take an intervention.
Hopefully, this is a pleasure postponed. I rise to support new clauses 81 and 82, tabled by my hon. Friend the Member for Sleaford and North Hykeham. As legislators, we have a moral duty to ensure that patients are protected during times of disruption in the NHS. Nobody disputes the fact that NHS staff work incredibly hard. They absolutely do. The dedication shown by doctors, nurses, paramedics, midwives and all those who keep our health service running deserves enormous respect. Having worked in healthcare for pretty much all my career, including for professional organisations such as the Royal College of Occupational Therapists, I know at first hand how hard they work. Equally, we need to recognise that the NHS is not an ordinary service. Working for it is not like being a shop assistant, a bin collector or a tax inspector; in its importance to the health and safety of this nation, it is more akin to being a police officer or a member of our armed forces. It is an essential public service. When people are at their most vulnerable, whether that is because they are waiting for an operation, procedure or intervention or because they are in the process of having those interventions, they must have confidence that the care they rely on will still be there. The right to strike has to come with responsibilities. In the NHS, the consequences of industrial action are real: cancelled operations, delayed treatments, missed appointments and increased pressure on emergency services. When I raised some of these issues with Sir Jim Mackey when he appeared before the Health and Social Care Committee, he could not tell me, hand on heart, that people have not died because of these strikes. I suspect that they probably have. For patients awaiting cancer treatment, for someone requiring urgent surgery or for families relying on maternity services, the impact can be deeply serious and potentially even deadly. There is a moral obligation, both on NHS doctors and on us as legislators, to ensure that we have a universal, 24-hour, seven-day-a-week service that is free at the point of use that patients can and should expect to rely on. I therefore support new clause 81’s minimum service requirements and new clause 2’s the removal of clinicians’ ability to strike. We must ensure that our NHS staff are supported, protected, paid appropriately and given the resources they need to do their job, but the corollary is that they should remain on the job to serve our constituents.
I declare that I am a member of the all-party parliamentary group on patient safety. Patient safety cannot be something that is discussed only after a tragedy has occurred. It requires a culture of accountability, transparency, and most importantly, action. That is why the new clause is such a sensible and important amendment to the Bill. It would not dictate the outcome of every review or every recommendation, but it would require the Government to respond properly. The new clause would create a straightforward expectation that when experts have identified changes that could improve patient safety, Ministers cannot simply leave those recommendations unanswered. The new clause pushes that forward, as recommended by my right hon. Friend the Member for Godalming and Ash. There must be a clear process and a clear timeline. Such a process and principle are closely connected with new clause 98 and the Government response to the Hughes report on those harmed by sodium valproate and pelvic mesh. Those are deeply serious issues involving people who have suffered life-changing consequences and have spent years seeking recognition and redress. Last week, I think, at the Health and Social Care Committee, I questioned the current Secretary of State on this matter, and his answer was equivocating, dissembling and, I am afraid to say, frankly unacceptable to those patients who have suffered from both those. He could not even tell me whether the response would be published by the end of the recess—we probably have two hours until recess, so unless the Minister is going to tell me otherwise, I suspect it is not coming before the recess. It seems shocking—perhaps even a slap in the face to those victims—that the Secretary of State could not even give an answer on that issue. However, they received some positive news on Tuesday evening, when the right hon. Member for Makerfield (Andy Burnham)—presumably the incoming Prime Minister—raised this issue in the House during the debate on the remaining stages of the Public Office (Accountability) Bill. I hope the Minister has had the chance to speak to the right hon. Member—unlike the rest of us—so that she understands his priorities and when redress is coming. If her new boss has given his stamp of approval, Labour MPs on the Committee should have no problem supporting these Opposition new clauses.
I heard the Liberal Democrat spokesperson say that she will not press the amendment, but I would be sorely tempted to vote for it if she did so. This important amendment sums up a number of our concerns about the Bill, and the commencement amendments to follow are also appropriate. As the hon. Member will not press her amendment, however, I will not speak for long, save to say that I have enjoyed the past few weeks on this Committee. I hope that the Minister is still in place when we return in September. If she is not, I wish her very well and thank her for all her hard work, not just in this Committee, but in her role over the past two years.
What a weekend, Mr Speaker! Ministers will be hovering by the phone on Monday or Tuesday. What a visual display of success or failure there will be, as the number of holidaymakers heading to the continent ramps up for the summer season. The Government have had two years on this. Multiple Select Committees in the previous Parliament warned that the technology would not be ready, and that the introduction of the system would be a disaster. How on earth have we got to a situation where the Secretary of State is making last-minute dashes to the European Commission and the French Government to try to get a few extra kiosks—for which the technology does not even work—as holidaymakers face chaos this weekend?
I have always enjoyed my exchanges with the Minister. As the nation learned devastatingly last night, trying to defend a single position for a prolonged period does not always have a happy ending. If we get the chaos that is predicted for holidaymakers and freight operators this weekend, will the Government go to the European Union and the French Government and demand that the system be shut down and paused until the technology can be got right?
I appreciate the point that the Minister made about the taxpayer having only owned British Steel for a matter of hours, and how the board is still being appointed. It is, however, imperative that the Government are clear, once the board is appointed, what the strategic priorities are for the board—as opposed to British Steel at large. Top of those priorities must be a timescale to get to profitability. Can the Minister—or his successor—commit to ensuring that the red lines set for the board are made clear to this House as soon as it returns in September, when the board will have been functional for five or six weeks?
Notwithstanding the article 2 sovereignty clause, this treaty demands that Gibraltar aligns with a number of EU laws, standards and tariffs. If the European Court of Justice is at odds with a Gibraltar court on the application of those, no matter of arbitration will ever shift the European Union from being absolutely wedded to the supremacy, in their eyes, of the European Court of Justice. How can that sovereignty test ever be met?
It is a pleasure to serve under your chairmanship, Sir Desmond, and to take part in this debate about the impact of changes to the national planning policy framework. At the outset, I thank the hon. Member for Wells and Mendip Hills (Tessa Munt) for securing this important debate. She made a strong speech, particularly focused on the danger of building in areas prone to flooding. I also thank the 10 hon. and right hon. Members who have made speeches—and the three who have made interventions—so far in this debate. The NPPF is the rulebook by which our planning system is guided. It is an extensive and comprehensive statement of the Government of the day’s policy direction, and perhaps the clearest signal to developers, local authorities and local people about how a Government will approach changes to their surrounding built environment. It covers everything from roads to housing, local communities to land use, and provides the overarching checks, balances and direction in the planning system. We are not in blanket opposition to everything that the Government are seeking to do with the NPPF. However, we do have significant concerns about some aspects of it, and I will focus on those in my remarks today. Since coming to power two years ago, this Government have twice proposed revisions to the NPPF, both times with severe consequences for our green spaces, rural towns and villages, and local democratic voices. In their first revisions, made just before Christmas 2024, the Government’s policy direction was clear. Unfortunately, what was on offer was an unwelcome gift of urban sprawl. That was because the Government made it easier for local authorities to release green-belt land for development in more ways than one. The first, and most obvious, was the announcement that new golden rules would need to be met to expand on to the green belt. That effectively invited developers to test the waters by highlighting that the NPPF stated that, where a development complied with the golden rules, local authorities should give “significant weight in favour” of approving the scheme. The second release came from the Government’s spurious grey belt designation. Concocted in the bowels of Marsham Street, “grey belt” is a disingenuous label. The Prime Minister has told us that it means low-quality land made up of “disused car parks”, but that is far from the truth, because, for too many sites, grey belt is simply a façade for releasing green-belt sites for urban sprawl and overdevelopment. That is backed by research in December 2025 by the Campaign to Protect Rural England, which showed that, a year after the first NPPF reforms, of the 13 developments of 10 or more homes approved by Government planning inspectors on so-called grey-belt land, 88% of those 1,250 homes “will be built on previously undeveloped countryside”— not disused petrol stations, low-quality land or any other trumped-up example taken straight from a Ministry of Housing, Communities and Local Government press release, just our countryside. Worse, those developments make up more than 90% of homes granted planning permission on grey-belt sites by inspectors; a further 21 smaller schemes, totalling no more than 91 homes, comprised the remainder. That is not the only attack on our green spaces. The 2024 NPPF revisions also reintroduced mandatory top-down housing targets across England by removing the word “advisory” from the relevant paragraph concerning housing targets, alongside references to exceptional circumstances for alternative approaches to determining local housing targets. As other Members have said, that came alongside a new standard method for housing targets. The hon. Members for Horsham (John Milne) and for Wells and Mendip Hills highlighted some of the bizarre assumptions underpinning the housing targets generated by the new standard method, alongside some of its counterproductive outcomes. When examined together, those disproportionately redistributed top-down housing targets on to rural areas from urban areas. For example, under the Government’s targets, housing numbers were cut by 11% in London, 38% in Birmingham and 55% in Coventry, while increasing by 106% in the New Forest, 199% in North Yorkshire and 487% in Westmorland and Furness. That is particularly concerning given that major cities—and not least here in central London—have the infrastructure needed to support development. However, even in Greater London, although the collective target has been reduced by 11%, that has been achieved by sharp drops in urban inner London, whereas in the more rural outer-London areas, huge increases have been imposed. For example, in my London borough of Bromley, which is the largest borough in Greater London and is mostly rural, the target has been increased by 400%. The conclusion is inescapable. The NPPF changes show very clearly that this Government are determined to build all over the green belt. What has been the result of these reforms? It certainly has not been large amounts of extra housing. As I pointed out in this place yesterday, the Government’s own figures show that the number of net new additional dwellings in England was just 208,600 in Labour’s first year in power—a 6% drop from 2023-24 under the last Conservative Government’s final year in office. Indeed, the Government admitted that they will not hit the target through their own net additional dwelling forecasts, predicting that by 2029 they will have fallen well short. It does not have to be this way. The Opposition recognise the need to build more homes, and we made it clear from the start of this Parliament that we are broadly supportive of the ambition to build many more homes. However, the Government’s actions, through some of their revisions to the NPPF, are the wrong way to go about it. A future Conservative Government will employ a genuine brownfield-first approach rather than releasing swathes of green belt or relabelling it under the murky and disingenuous designation of “grey belt”. We will not just pay lip service to brownfield development, but prioritise it and make it easier. That can and will be done. The CPRE reported that a large proportion of England’s housing could be swiftly met using brownfield land that already has planning permission, without encroaching on undeveloped greenfield or green belt land. It estimates that there is enough brownfield land to build 1.41 million homes in England, based on the most up-to-date data from local planning authorities’ brownfield land registers up to 2024. That amounts to 93% of the Government’s parliamentary target. Furthermore, it has shown that England’s brownfield sites are increasing in number, land area and minimum net dwellings—up 54%, 6% and 34% respectively between 2018 and 2024. That is why, not for the first time, I press the Minister to go further and faster in helping local authorities and developers to access brownfield sites rather than freeing up our green belt and steamrollering over local democracy, local voices and local communities. Recent history shows that this approach can work. If the Government want to see urban regeneration or densification done right, they can follow Conservative examples and pursue brownfield-first and not greenfield-first. We will not only abandon the Government’s offensive on our green spaces, but harmonise supply and demand-side policies. I will finish with a small note on that point. As the Government continue to tweak the NPPF, they are doing nothing to back first-time buyers, families and downsizers by axing demand-side schemes and cutting stamp duty relief. There is no point in delivering supply-side reforms if the demand is not there to make it worth while. To conclude, it is evident from the speeches here today and the evidence before us that the impact of recent reforms to the national planning policy framework has failed to deliver more homes, failed to protect our green belt, failed to support the housing market, failed to make brownfield sites viable and failed to deliver for voters. Regardless of the outcome of that, the Minister is a man I have a great deal of respect for. I agree with my right hon. Friend the Member for East Hampshire (Damian Hinds) that he is a decent and thoughtful man, and I sincerely wish him well in the pending reshuffle. Regardless of its outcome, he has the chance to raise this with whomever his new boss will be after next week’s coronation. I hope that he grasps the opportunity with alacrity and delivers the right homes in the right places and with the right infrastructure—just as the country deserves.
I live in my patch and I know that there will be genuine local fury at the contempt this Government have shown for my constituents in approving a Leicester city land grab, which has cross-party opposition locally. I have been clear throughout, as have my local councillors and my residents, in our opposition to a Leicester city land grab that will take county communities such as Syston, Thurmaston, Queniborough, Barkby and Beeby into the city and see local residents paying more tax for almost certainly less in the way of services. I continue to oppose what the Secretary of State has announced today, so I have a simple question for him: what makes him think that the views of the Labour Leicester city mayor are worth more than the views of thousands of my constituents?
I beg to move, That the clause be read a Second time. This is a very straightforward new clause. The Secretary of State would be required to ensure that there are single-sex changing rooms, toilets and washing facilities for NHS staff and single-sex wards, toilets and washing facilities for NHS patients. The UK Supreme Court unanimously ruled that a woman is defined by biological sex in 2025, and the Minister herself said: “We are completely committed to single-sex spaces.” However, it appears that the Minister for Women and Equalities did not get that memo. Despite having apparently been sat on her desk since September, the new draft code from the Equality and Human Rights Commission was not laid before Parliament until 21 May. One week before that guidance was published, a female NHS England employee in Leeds won her claims of indirect sex discrimination and harassment over a policy allowing transgender colleagues to use toilets and changing rooms that correspond to their gender identity rather than their biological sex. On 28 June, after the draft code was laid, it was reported that West London NHS trust had told patients that they could use single-sex facilities based on gender identity. It has taken the current Health Secretary some time, but I understand that he has changed his mind on the issue and come to the same conclusion as others: that a woman is, in fact, a woman and that toilets and changing facilities must be protected. Will the Minister follow his lead and protect single-sex spaces in NHS trusts? The Supreme Court has ruled that a woman is defined by her biological sex. My party knows that. The Minister claims her party knows that too. It is time for her to show it by pulling the levers that only she can to ensure that patients and staff are protected right across our health service.
I beg to move, That the clause be read a Second time. New clause 40 would require the Secretary of State to publish a report detailing the business case for the use of public-private partnerships for neighbourhood health centres. This goes back to the use of the private finance initiative in the past, particularly during the last Labour Government when Ministers were attracted by the prospect of off-balance sheet financing. Although the idea looked good on paper, it proved a disaster in practice. Before the 2008 financial crisis, private finance initiative interest rates were 2.5% to 4.4% higher than public sector borrowing rates. After the crisis, PFI projects increased their rates by 20% to 30%. In the interests of time, I will not rehash the story I told earlier in Committee about the problems with simple things such as putting a whiteboard up, but PFI did create operational problems, too. The previous Government rightly called time on PFI and announced in the 2018 Budget that it would not be used for future projects, which is why this Government’s plans are so peculiar. Labour Ministers have taken a trip to the graveyard of bad ideas, resurrected PFI and adorned it in new clothes: it is now PPP. The Government have tried to reassure the public that it is not a rehash of PFI, but the facts suggest otherwise. The funding of neighbourhood health centres is to be 80% through PPP. The Minister told the BBC we will be working with the private sector, particularly around construction and maintenance of many of the new centres. How is PPP different from PFI? The Minister has previously told this House that the new scheme will draw on lessons learnt in the past, so could she please say what those lessons are? If they have been learnt, why did 53 academics write a letter urging the Government to abandon the proposal? Why did dozens of Labour MPs sign an early-day motion expressing grave concerns? And why have the Treasury Committee, the Public Accounts Committee, the National Audit Office, the Institute for Public Policy Research and the Institute of Economic Affairs all cast doubt over the value of money for such schemes? No matter how Ministers dress things up, I am concerned. The Government need to publish a business case for the proposal to show how it will work in practice and demonstrate they have learnt lessons from the past. If they have, Members have no good reason to object to the amendment. It only asks Ministers to show their workings-out in full view of the House openly and transparently.
For the record, I am a member of the Royal College of Paediatrics and Child Health and work as a consultant paediatrician at North West Anglia NHS foundation trust, which will have a new hospital. I would like to press the new clause to a vote. Question put, That the clause be read a Second time.
I beg to move, That the clause be read a Second time. This new clause asks the Government to use private providers to help get waiting lists down. We are told that waiting lists are falling, but the Government’s own figures show that waiting lists are higher than they were last month, and if we look at the group of people who are waiting for admission for a procedure or operation, they are higher than they were last month, last year or indeed at the general election in 2024. There were 76,250 women waiting for gynaecological treatment at the end of July ’24, when this Labour Government took office; that rose by more than 6,000 patients to 82,623 as of May 2026. Private providers have capacity that may be able to help with that. The deployment of private providers is about using all the resources and capacity on offer across the country to get waiting lists down. The NHS uses private providers to perform some surgeries and scans, mental health support, GPs and dentistry, but it is a sensible measure to ensure that all hands are on deck when it comes to treating patients. I look forward to hearing how the Minister can use private providers to get more patients seen more quickly as opposed to wiping them from waiting lists at record rates.
The previous use of private providers was to remove debt from the Government’s balance sheet. That is not the same as providing guidance and regulations on how to increase capacity and use the spare capacity of private providers to reduce waiting lists, which are currently rising. In response to the point made by the hon. Member for Bury St Edmunds and Stowmarket, the workforce plan is important. Despite that plan being “imminent” for several weeks now, it has not been published. I will press the new clause to a vote. Question put, That the clause be read a Second time.
I beg to move, That the clause be read a Second time.
New clause 46 would require the Secretary of State to publish the number of staff in the Department of Health and Social Care and the number of people made redundant following the abolition of NHS England. New clause 75 would require the Secretary of State to prepare and lay before Parliament a formal transition strategy. Amendment 37 would prevent the abolition of NHS England before the production of an operating model. Amendment 38 would require the Secretary of State to publish and submit to independent scrutiny an impact assessment on the abolition of NHS England containing quantified cost and benefit figures before making regulations to abolish it. Amendment 39 would require the Secretary of State to publish and lay before Parliament a plan setting out how health services will work alongside the social care system following the abolition of NHS England before using the powers in the Bill for abolition. The plan must address joint commissioning, funding flows, delayed hospital discharges and the workforce. The problem is essentially that Ministers marched off into a battle without a plan and continue to fight without one. In this Committee, we have heard consistently about the number of times that things have not been thoroughly planned out and properly considered, particularly in relation to social care. I know that Members on all sides of the House are concerned about how social care will interact with the health service under the proposed new regime. In March 2025, Ministers and officials were going to work to determine what was needed, and in March 2026, they were still progressing to develop the design—12 months later, there was a change in tense but still no proper plan. When putting the Bill before the House, the Government published an impact assessment, but where there should be numbers quantifying how much this is all going to cost us, there is simply “N/A”. How is that any way to conduct a reorganisation? That is why I tabled amendments 37, 38 and 39. They would apply the brakes until the operating model had been established by requiring the full publication of a proper impact assessment, a detailed plan of how the health service will work alongside social care, and the publication of redundancy figures. They would ensure that the Government have worked out what they are going to do before they get on and start doing it.
I listened carefully to what the Minister said, but I do not know where the Government have transparently published all these numbers and calculations. A lot of parliamentary questions have been asked on the detail of this transition, so I think it is important that the detail is published so we can see it, and that the detail is planned, before the abolition process takes place. I therefore want to press the new clause to a vote. Question put, That the clause be read a Second time.
I beg to move, That the clause be read a Second time. The new clause would require the Secretary of State to publish a plan for securing the provision of universal fracture liaison services across England. As we get older, our bone density naturally decreases, increasing the risk of bone fractures and possibly osteoporosis, which affects 3.5 million people across the UK. Fracture liaison services identify people aged 50 or over who have broken a bone, and they provide treatment to reduce the risk of further debilitating fractures. Of those over 50, one in two women and one in five men will break a bone because of osteoporosis. Heartbreakingly, 2,000 people die each year from preventable fractures. When the former Secretary of State, the right hon. Member for Ilford North (Wes Streeting), claimed that delivering universal fracture liaison services would be one of his first priorities if elected to Government, many people hoped to see this happen, but it has not. The previous Conservative Government began rolling out fracture liaison services, and it is an indicator of just how little progress the current Government have made that 97% of today’s fracture liaison services were delivered by the Conservatives. What have the Labour Government been doing? What is more, one in two NHS trusts, following freedom of information requests, tell me that they have no fracture liaison service at all, which is quite literally an accident waiting to happen. I am very grateful to the Royal Osteoporosis Society for its campaigning on this issue. By its calculations, at the current rate of delivery, it will take 38 years for the Government to deliver universal fracture liaison services, which is obviously far too slow. We have tabled the new clause because the Government need a plan. The former puppeteer of this Government, Morgan McSweeney, made it clear that Labour did not have a plan for government. The new clause would require the Secretary of State to deliver a plan within 90 days, not just to secure the provision of universal fracture liaison services but to deliver on his predecessor’s very clear and very deliberate promise to do so. The Minister in the other place was asked whether an implementation plan for fracture liaison services was needed. The answer was, effectively, no. What is the view of the Minister before us in Committee? There are so many critical questions in this area that have no answers and that a plan would and should address. What are the Minister’s annual milestones for achieving universal access to fracture liaison services by 2030? How will the Minister’s plans to cut ICB budgets by 50% impact that key promise? An important question on the promise is whether the Minister’s plans to merge ICBs mean that fewer services will now be delivered. How will that impact patients? What extra workforce, diagnostic and NHS estates capacity is required to deliver it? Yet again, as so often with this Government, we are left with a headline-grabbing promise with no plan behind it. The consequence is that more than 40,000 people are predicted to die from hip fractures that could have been prevented through timely national implementation.
Not necessarily, no, but this one does, because the Government clearly made a promise before the election. The former Secretary of State was clear that it would be one of his first acts—that is what he said—and it has not happened, so in this case we need to hold the Government to account. It is our job to hold them to account on their promises, and I am afraid that they are failing on this one. To sum up, the Government need to get their act together, because otherwise more and more vulnerable people will come to unnecessary and potentially fatal harm. I look forward to hearing the Minister’s plans to accelerate the delivery of the Government’s promise—and fast.
Can the Minister be clear on the point about ICBs? There is a concern that, where there are perhaps three ICBs, one of which has a service and two of which do not, and they merge together, the Government then say, “Aha! This ICB area now has coverage,” but that is for part of it, not all of it. What is important for a universal service is that it is available to all.
I am afraid I am not reassured at all. The Minister seems to be saying that the ICBs will do it—the same ICBs where she is cutting their budgets, making them change the board and making them merge with each other all at the same time. The target is behind schedule and it is important that we hold the Government to account on it. Therefore, I will press new clause 47 to a vote. Question put, That the clause be read a Second time.
I beg to move, That the clause be read a Second time.
New clause 48 would require the Secretary of State to “publish and maintain a national framework for improving access to radiotherapy services in England.” One in four people can expect to need radiotherapy in their lives. That is a lot of people who will need consultation, assessment, pre-treatment planning and treatment delivery. Data published a few years ago showed that Scotland, Wales and Northern Ireland have more linear accelerator machines per million people than in England. Can the Minister confirm whether that is still the case? Last year, Radiotherapy UK had research indicating that more than 60,000 cancer patients are not getting the radiotherapy they need and I know particular areas of the country are struggling. Can the Minister provide an update on the roll-out of the new LINAC machines at 28 hospitals, which she spoke about in May 2025? We were also told that by March 2027, up to 27,500 additional treatments will be delivered. Can the Minister share some information on how that will be achieved? The Labour Government have now been in power for two years. They have raised taxes by more than £60 billion and they do not have much to show for it. They have not produced a workforce plan. They have said that one will be imminent; can the Minister confirm whether it will be published today before we break for the recess? Is the intention to publish it during the recess or will we have to wait until the autumn? There is a 31% shortfall in clinical radiologists. New clause 48 essentially requires the publication and maintenance of “a national framework for improving access to radiotherapy services”. This Government have essentially shown that if a requirement is not in legislation, plans just get delayed, diminished and disowned, but patients cannot afford to wait any longer.
If I heard the Minister correctly, she said that the ICBs would provide NICE-approved treatment, which they have to do within 90 days at the moment. At an earlier sitting, we debated an amendment tabled by the Minister that would enable the Secretary of State to delay the provision of NICE-approved treatment, which was agreed to. I am not quite sure how that is congruous, but in either case we would like to press new clause 48 to a vote. Question put, That the clause be read a Second time.
I beg to move, That the clause be read a Second time. I will be brief, because we have a lot to get through. The new clause would require the Government to produce a modern service framework for respiratory disease within 18 months and, in essence, to make a plan for providing and improving treatment for those with respiratory disease. The previous Government had a major conditions strategy, which looked at the six major causes of ill health, one of which was respiratory disease. This Government paused that when they came into office to consider their own plans, but have not responded with a plan for respiratory disease in any detail. The new clause would require them to do so.
The Minister talks about momentum, but as I understand it, there is a severe mental illness MSF, for which timelines are to be published in due course; a sepsis MSF that was expected in the spring but is now anticipated in the summer; a frailty and dementia MSF expected sometime this year; a palliative care MSF that was published in June as an interim update, but will not be complete until the autumn; and a cardiovascular MSF. I do not see very much momentum there, given that the Government have been in office for two years.
Actually, there were plans, changes and improvements in respiratory care. One of the more obvious ones for lung cancer was the start of the lung cancer screening programme. I do not think the Government have the momentum and vigour that is required. Of course, they have also paused the long-term conditions strategy, which was already written and would have delivered. This is important, and we will press new clause 49 to a vote. Question put, That the clause be read a Second time.
I beg to move, That the clause be read a Second time. The new clause would require the Secretary of State to produce a delivery plan for the transformative technology commitments in the 10-year plan. The 10-year plan took a lot of people a year to write, and there is plenty of ambition in it, but so far the delivery is rather suspect. The Government are right to say that technology can be game-changing, but it is one thing to ask civil servants and special advisers to draw up a grand plan and a nice brochure, and another to actually deliver on those ambitions. The Labour party came into government without a plan, and we are about to have a new Prime Minister but we do not know what his plan is, or even if he has one, either. We have seen IT outages take down health systems, hospitals fail to communicate critical information after patients are discharged, and warm weather take down MRI scanners and radiotherapy machines. The new clause would require the Secretary of State to produce a delivery plan for the transformative technology commitments in the 10-year health plan, and would provide a clear road map for data quality and interoperability, artificial intelligence, genomics and predictive analytics, wearables, and robotics. Let us be clear: the Opposition support introducing new technology to make the NHS more efficient and improve patient care, but we need clarity from the Government on how they will do that. Ordered, That the debate be now adjourned.—(Emma Foody.)
I beg to move, That the clause be read a Second time. The new clause is a probing amendment. The aim is to press the Government to explain why the Bill does not include provisions to implement statutory regulation of NHS management, as they had said they would, and to commit to a timetable for bringing the regulations they promised into force. I am an NHS consultant paediatrician and am regulated as such by the General Medical Council. The GMC regulates doctors, the Nursing and Midwifery Council regulates nurses and midwives, and different bodies represent other professionals in the health service—but not managers. The Government said that there would be such a register. I know that there are many excellent managers—the Minister was one—but as in every profession, bad apples need to be identified and managed appropriately. The Times has reported that senior bosses at Leeds teaching hospital NHS trust asked consultants and nurses to work in ways that lie outside the national service recommendations. We have also heard from Donna Ockenden that of the 66 former senior staff members in Nottingham she approached, only 35 agreed to be interviewed. The former Secretary of State for Health and Social Care, the right hon. Member for Ilford North (Wes Streeting), has said that he finds it “unconscionable that people who worked for the NHS would deny them”— the families— “an honest account of what went wrong”. Establishing a register would be the first step in ensuring that bad apples can be held to account. Those who bully staff, cover up problems, endanger patients or misappropriate funds should not be allowed to fail upwards. The NHS benefits from having outside experience, including from the private sector and the armed forces, so I am looking not for full occupational licensing, but simply for a register of those who are not suitable to be appointed. We should not see managers going from one trust to another and another after they fail at the first. I should finish by declaring that I worked at Nottingham University hospitals NHS trust during late 2012 and early 2013.
I beg to ask leave to withdraw the motion. Clause, by leave, withdrawn. New Clause 52 Access to dental provision: Dental deserts “(1) Within six months beginning on the day on which this Act is passed, the Secretary of State must establish a scheme to improve access to dental provision (‘the Scheme’). (2) The purpose of the scheme is to end dental deserts. (3) A dental desert is defined as any local authority area with fewer than ten active dental practices per 100,000 people. (4) The scheme must make provision to support integrated care boards to— (a) guarantee emergency access to an NHS dentist, (b) provide free dental checks up for— (i) children, (ii) mothers within one year of having given birth, (iii) pregnant women, and (iv) low-income households, and (c) guarantee dental appointments for persons commencing— (i) surgery, (ii) chemotherapy, or (iii) transplant procedures. (5) The Secretary of State must, before publishing the scheme, issue a reformed dental contract. (6) The Secretary of State must, within six months of the establishment of the scheme, publish a dental workforce plan to support delivery of the scheme.”—(Helen Morgan.) This new clause would establish a scheme to support integrated care boards to end dental deserts. Brought up, and read the First time. Question put, That the clause be read a Second time.
I rise to discuss new clause 104, which stands in my name. The Labour Government’s general election manifesto made a bold pledge: “Never again will women’s health be neglected.” The Government have been in power for two years, and I am not convinced that they are doing all they can for women’s health. The latest NHS statistics show that waiting lists are rising under this Government. The trend is particularly acute for gynaecology services. More women are awaiting admission to hospital for gynaecology treatment or procedures than in July 2024. How does that square with the Government’s ambition to improve and prioritise women’s health? We talked this morning about fracture liaison services, which is another treatment that would predominantly have benefited women if the Government had kept their promise and rolled it out as they said they would. The previous Conservative Government commissioned the Hughes report. The Labour Government have repeatedly pledged to address the issue at the earliest opportunity, but when will the Minister respond to the women who have been waiting so long? The Government published their renewed women’s health strategy in April, but where are the timelines, steps and milestones to deliver and implement improvements to women’s health? Where is the plan to reduce gynaecology waiting lists? Where is the timetable for delivering on long-acting reversible contraceptives, for example? I have no doubt that the Minister has a desire to improve outcomes for women and improve their care, but I am concerned about the actual delivery, which has been a theme throughout the day. I tabled new clause 104 because this Labour Government have made promises to women that they need to keep, and that they need a plan for how they will keep them. My new clause would ensure that they have a plan to deliver, rather than just making promises in glossy brochures.
I beg to move, That the clause be read a Second time. New clause 66 relates to the prescription of puberty blocker drugs, also known as GnRH agonists. A first rule of medicine is “Primum non nocere”—first do no harm. That is what this clause seeks: to make sure that harm does not come unnecessarily to children. It is required because the Government are sponsoring a £10.6 million trial to put 226 physically healthy children on puberty-blocking drugs. That is being done despite the fact that the Health Secretary claims he feels “uncomfortable and uneasy” at the prospect. There are lots of questions that need to be answered. The minimum age for this trial is 11 years old for girls and 12 years old for boys, despite the Medicines and Healthcare products Regulatory Agency having recommended a much older group. When my hon. Friend the Member for Fylde (Mr Snowden) asked why in a written question, the Minister gave a holding answer. Is that because the Government do not know or because they do not want to say? I am not convinced that the trial will produce the answers the Government want. Apparently, they are asking the question of whether puberty blockers benefit children who have questions over their gender and who will later go on to have a trans identity in adulthood. The challenge is that we do not know which of the children who have challenges with their gender during puberty will go on to have such an identity in adulthood, so we are essentially doing a trial on a large number of children to see whether puberty blockers are beneficial for a small group, or, as it was described by the Secretary of State, “a very small subset of a very small group”.—[Official Report, 22 June 2026; Vol. 788, c. 56.] The Government have data that they could use in a data linkage study to try to narrow that field down, but for some reason they are choosing to do this trial before that. I do not understand why; perhaps the Minister can explain. I do not want to detain the Committee too long on this issue—I could talk for some time—because we have had Opposition day debates in the House on it, but we have seen unease from both sides of the House. The Minister will be aware that there was a vote on the trial at the end of the recent Opposition day debate, and there were a large number of abstentions, as well as three votes against, from her party, as well as many votes against from ours. Puberty blockers carry risks that may or may not be reversible: there are concerns about bone density, cognitive damage and fertility loss, all for children who should be enjoying their childhood. The new clause would prevent a trial from taking place without votes in the Houses of Parliament. I appreciate that we would not normally seek to have votes in the Houses of Parliament on a clinical trial, because it would slow clinical trials down, but I think this topic in particular has unfortunately become so polarised that it is very difficult to see how it can be processed properly. Ultimately, the Government have responsibility for what goes on in this country. If the Government want to pay for the trial, then it is the Government’s trial, and the Government should bring it before the House for us to decide as parliamentarians whether it is the right thing to do. I think it is absolutely not. I think we are putting children at risk of permanent harm. We do not know that these children are going to benefit. We do not even know if they are in the pool of children who would, in the long term, have a trans identity, and the Government are not even waiting to see whether they can find out using the data linkage study. It is wrong, and we need to do what we can to try to prevent it.
Does it concern my hon. Friend that the person who raised the concerns about the trial then recused himself from further involvement in it?
A couple of points. Does the Minister recognise that the cancel culture associated with much of the work in this area, and in looking after those vulnerable groups of children, means that the tendency among those who get involved is to have a particular view? How has she worked to ensure no bias among those on the committee involved in producing the trial? Does she recognise that by choosing a cohort of children—226 of them—to do this experiment on, she is selecting a group of children of whom most will have a gender incongruence that will get better by itself? There are two effects of that. First, these children will have unnecessary treatment. Secondly, even if there were in theory a benefit to the small group of children who would have persisted in a trans identity, that would affect the reliability of the results; therefore, whatever the results, people would think them unreliable.