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

1. 7 Jul 2026·Parliament·Gareth Davies

   Summer Jobs

   Let me make some progress for the moment. It is clear that something is not working, as we have all been saying, so we have to try to understand and explain why that is the case. We should not need to point this out, but higher taxes and more regulation are simply not conducive to economic growth or higher employment. If we consider what a business must now weigh up before looking to hire somebody, first, of course, there is the jobs tax—a tax that targets not profit or success, but the very basic act of employing another human being.

   Hansard source
2. 7 Jul 2026·Parliament·Gareth Davies

   Summer Jobs

   Time and again, we in the Opposition try to make the point that it is not the result of any one particular policy; it is the overall environment. We do not, as a state or as a Government, create jobs; it is businesses that create jobs, and they need to know that the Government are behind them. They need to know that there is an environment in which they can invest in people. Right now, for a combination of reasons, that is not the case.

   Hansard source
3. 7 Jul 2026·Parliament·Gareth Davies

   Summer Jobs

   I am very grateful to the hon. Member for making that point. As I was saying, it is not one particular policy that impacts this issue. As he points out, it is a combination of factors, particularly to do with geography in rural areas such as his but also in Lincolnshire, and I agree that transport connectivity is a critical part of that. The way in which we pay for more public infrastructure, by the way, is to boost tax receipts through work, employment, enterprise and risk taking, but that point has been lost right now, because Labour’s £25 billion jobs tax has forced businesses to cut back hiring at every level, especially young people. Thousands of people have now been let go because of the Chancellor’s choices. Secondly, there are the permits, restrictions and forms—all the red tape that is wrapped around those looking to employ young people who simply want to work during the summer. That is a fact that we are trying to highlight through our motion today, and I encourage everybody to look at the detail of it, because it is not often talked about in this place, but out there, among young people, it is.

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4. 7 Jul 2026·Parliament·Gareth Davies

   Summer Jobs

   Completely. There is even now a tax on the great British holiday, which impacts my hon. Friend’s constituency, Mr Speaker’s and many others. The overnight visitor levy, known as the holiday tax, threatens my hon. Friend’s area, just as it threatens Whitby, Scarborough, Blackpool, Bournemouth, the Norfolk coast and even my county in the Lincolnshire Wolds. The Government call it “modest”, but the seaside landlady who is struggling to fill her rooms calls it the difference between a season that works and one that does not. UKHospitality has warned that this tax means that consumers visiting destinations in England are charged double the tax of visiting Paris and 70% more than in Barcelona or Rome. In effect, the Government’s half a billion-pound holiday tax represents little more than a self-inflicted trade tariff on domestic breaks, driving holidaymakers overseas.

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5. 7 Jul 2026·Parliament·Gareth Davies

   Summer Jobs

   The facts are there for all to see. As I was saying, it is vital that we support the business community, and that includes small businesses. So often the narrative is about large multinationals, but it is SMEs and small business owners who drive our country forward and employ people across the country, especially young people. Another thing that businesses in this country are facing is the now infamous Employment Rights Act 2025, which has created so much red tape that the corner café has to focus on hiring a lawyer before it hires a waiter. The Government have laid down so many requirements for employers who need to move underperforming employees on. Indeed, their own law says that after six months, employees are protected from unfair dismissal, but I have to ask, where were these protections for the poor old Prime Minister, with whom they dispatched over a single weekend on WhatsApp? He got less probation than a probationary barista. It is one rule for the shop floor and another rule for the Labour Front Bench.

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6. 7 Jul 2026·Parliament·Gareth Davies

   Summer Jobs

   The whole point here is that businesses, the country and people need flexibility. The whole country runs on choice and flexibility, and if there are unnecessary restrictions that harm economic activity and prevent young people from entering the workforce when they want to, that is clearly not a good thing for our country. I thank my hon. Friend for his intervention, because he makes a very good point about the Employment Rights Act, which we have made it very clear we disagree with. This is not just about the dismissal elements of the Employment Rights Act. The Act also makes British businesses have a fair and open recruitment process. Businesses must find the right candidate, on merit, from a proper field of candidates, and yet here we are today with the Government filling the highest office of the land from a shortlist of one! They will regulate the Saturday job to within an inch of its life but run their own leadership contest with all the rigour of a one-ticket raffle. They will hold a whole by-election to find work for one man, while imposing a permit form on every under-16 in the country, a Sunday working ban and a levy on the town in which they live. It is the same old Labour time and again: “Rules for thee, but not for me.” It is two years since the last election, and Labour’s policies are starting to bite. Job vacancies are down by almost 150,000. Thousands of job opportunities have gone, and the youth unemployment rate is up by 2.5%—that is 735,000 young people now out of work. Borrowing costs have hit record highs. Labour is spending more on welfare than defence, education and prisons combined. Our economy is shrinking. It does not have to be this way. We have a plan that respects young people and the fact that they want to work hard and succeed. We have a plan to back young people already in work and support those who want to find work and gain experience, especially through a summer job. Where Labour’s red tape harms employment, we will work with businesses to scrap it. That includes red tape on the employment of under-16s, such as the two-hour Sunday working limit. In sectors where Labour’s taxes threaten the largest impact, we will choose a different course: we will abolish business rates entirely for thousands of retail, hospitality and leisure businesses on our high streets, with a 100% relief benefiting one quarter of a million firms. We have ruled out the Government’s disastrous holiday tax on working families and treasured domestic tourist destinations. Unlike the Government, we understand that to back businesses and employers is to back their customers and the people they employ too. We cannot lose the aspiration of a generation because of the barrier raised by the failed choices of this Government. Young people want to work. They want to do their bit; they want to build their own futures. It is our job not to stand in their way but to support them. Our plan does just that. The Labour party has spent all summer worrying about one man’s job. We say worry about all the others, back British businesses, back our high streets and back the young people of this country, who ask for nothing more than the chance to work.

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7. 7 Jul 2026·Parliament·Esther McVey

   Future of British Horseracing

   It is a real pleasure to serve under your chairmanship, Mrs Harris. It is a pleasure to see leading trainer Nicky Henderson here today. That should indicate how important this debate is to the racing industry. I congratulate my hon. and gallant Friend the Member for Spelthorne (Lincoln Jopp) on securing this debate. I should make clear at the outset that my husband is a board member of the Racecourse Association and chairman of the National Horseracing College. Previous speakers have set out the importance of the horseracing industry to the economy, tax receipts and jobs, not to mention its importance to local communities and to sporting excellence in the UK. This sport is genuinely world-leading, and we should all be immensely proud of it. I do not actually think the Government need persuading of the case; they already understand it. That can be seen from last year’s Budget, when the Chancellor exempted horseracing from her increases in gambling taxes, something that was welcomed by the horseracing industry following its “Axe the Racing Tax” campaign. I do not fear this Government deliberately seeking to destroy or undermine horseracing in the UK, but I very much fear them doing so inadvertently through ignorance. I am not asking them to do something to support horseracing. Instead, I am urging them not to do two things in particular that would decimate horseracing in the UK if they went ahead. My first request is that the Government direct the completely hopeless Gambling Commission to abandon any form of financial risk assessment or affordability checks in relation to the betting industry. The previous Government rightly said that any checks should be entirely frictionless, but the pilot that has been carried out has been a complete failure. Rather than flogging a dead horse, the Government and the Gambling Commission must abandon this policy. Despite the claim that financial checks are not being carried out—merely showing the incompetence of the Gambling Commission, which is made up of people who know nothing about gambling and do not even understand their own policies—those checks are already driving punters in their droves to the black market. Roughly 10% of gambling in the UK is now carried out on the black market, and that is growing rapidly, all due to the Government’s tax policies and the Gambling Commission’s regulatory policies, which mean that the regulated sector cannot compete with the black market. That is, of course, bad for player protection, and it is also devastating for the horseracing industry, which relies on the betting industry and punters for much of its income.

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8. 7 Jul 2026·Parliament·Esther McVey

   Future of British Horseracing

   Better support is needed from everywhere—that is what I am talking about—but those are key issues that are undermining the industry. That is why I will press on with the key matters today that are threatening the racing industry. Will the Minister assure the House that those affordability checks will be abandoned, despite today’s senseless announcement by the Gambling Commission? My second request is that the Government ignore the siren voices of the Social Market Foundation and its recent policy suggestion to double the tax on category B gaming machines from 20% to 40%. The SMF tried to portray itself last year as a friend of horseracing, and unfortunately some in the industry, who should have known better, were taken in. That proposal proves beyond doubt that the SMF is not a friend but an enemy of the horseracing industry. Such a swingeing increase in the tax rate—which would also destroy casinos and bingo halls—would virtually collapse the remaining betting shops in the UK, whose numbers have already reduced rapidly in recent years. Regulus Partners has calculated that this policy would close 70% of the remaining betting shops, reducing their number from 5,500 to just 1,500. Each and every betting shop contributes a significant amount of money to horseracing through levy payments and, especially, media rights payments. Will the Minister set out how much money horseracing gets from betting shops and take this opportunity to rule out the Government carrying out the SMF policy proposal? Will she also explain how many betting shops she believes will close if the SMF tax proposal on machines is implemented? The simple fact is that, if the Minister will not stop the affordability checks and does not get a grip on the reins of the out-of-control Gambling Commission, and if the Government will not rule out vastly increasing the tax on category B machines, any promise today to support horseracing will be completely worthless, and will undermine the Chancellor’s policy in the last Budget. I await the Minister’s speech with great interest, as will the entire horseracing industry.

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9. 7 Jul 2026·Parliament·Esther McVey

   Future of British Horseracing

   I appreciate that the Minister might not be able to answer some of the very specific questions I raised, so could she make sure that the Gambling Minister writes to me with the answers?

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10. 7 Jul 2026·Parliament·Esther McVey

    Climate Change: International Discussions

    Has the Minister discussed the Peak Cluster project with her international counterparts? What have they made of the lack of cost-benefit analysis by the British Government? Will carbon dioxide be imported from abroad into the UK if this ludicrous and unpopular proposal goes ahead?

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11. 7 Jul 2026·Parliament·Esther McVey

    Point of Order

    On a point of order, Mr Speaker. In response to my question about the Peak Cluster project, the Minister for Climate implied that her Department was open to providing answers on that matter. I have sent numerous questions to the Department that have gone unanswered. They have been the most basic questions, such as “What is the cost? How much will fall on the taxpayer? What is the cost-benefit analysis? Will the UK be importing carbon dioxide from international sources?” I have also had to resort to freedom of information requests; again, they have all gone unanswered. What does a Member of Parliament have to do to get questions on this matter answered by this Government?

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12. 7 Jul 2026·Parliament·Esther McVey

    Early Release of Prisoners

    I took part in the independent rape gang inquiry, meeting victims who had waited such a long time for justice and to see their abusers put behind bars. What does the Minister have to say to those victims who received a letter to say that their perpetrators are back on the streets? Is that a mistake and it will not happen? Ministers had said that those who have committed the most serious and heinous of crimes would not be on the streets. Can he take this opportunity to say that those letters were a mistake?

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13. 7 Jul 2026·Parliament·Edward Argar

    Health Bill (Twelfth sitting)

    I am particularly keen to speak on clauses 59 to 63, because HSSIB was a key part of the Health and Care Act 2022, which I took through as a Minister. At that time, I was grateful for not only the fearless and tough questioning from the now Minister, who was on the Opposition Benches, but for her support. She said: “HSSIB is a really important new body”––[Official Report, Health and Care Public Bill Committee, 19 October 2021; c. 564.] She also said that it is a “new and important body, which we are all desperate to ensure works well.”––[Official Report, Health and Care Public Bill Committee, 19 October 2021; c. 566.] It is fair to say that it does work well, as my hon. Friend the Member for Farnham and Bordon set out clearly in his detailed remarks. The thread running through his remarks, which is particularly important in this context, was trust. People who have had something go wrong and have reported a problem need to trust that it will be looked at independently and dispassionately. I fear that what is proposed here results from a deeply misguided decision, which has at the heart of its logic a fundamental flaw. As the hon. Member for North Shropshire set out, the decision fails to recognise that HSSIB’s role is fundamentally different from the role of CQC. It is an independent investigator; it is not a regulator or an enforcer, yet that somehow seems to be conflated in what the Government are trying to do here. They have simply failed to make a logical case for the change. The hon. Member for Bury St Edmunds and Stowmarket, who I always listen to with great interest on these matters, highlighted that patient safety should be at the heart of this legislation. That is absolutely right, but patient safety goes hand in hand with the confidence of those working in the system to speak out and put forward evidence that will improve patient safety. It is not an either/or; one is complementary to the other. It is important that this safe space remains, because that provides the conditions in which patient safety can be improved. In her evidence during the first session of this Committee, Dr Dash stated that she found more than 150 organisations operating in this space when she undertook her review. However, in Hansard, she went on to say: “I was asked by the Department of Health and Social Care to look at that landscape. I was asked to focus on six organisations”.––[Official Report, Health Public Bill Committee, 16 June 2026; c. 5, Q2.] Only six out of 150? That does not ring true. That is not a tidying-up of the landscape but a very narrow focus. When the Minister comes to her concluding remarks, can she answer who specifically determined those six organisations for Dr Dash and told her to look only at those, ignoring the other 144-plus organisations? We all know that what a review comes up with is, to a large degree, determined by the scope set for it. By picking a mere six out of 150-plus organisations, I fear there is a risk that the scope has effectively, to a degree, stacked the outcome of what would be looked at and what would be concluded. Before addressing specific concerns about the approach being adopted with the abolition of HSSIB, I want to highlight a real challenge with—even if one accepted the premise, which I do not—where it is proposed the functions are transferred to, as my hon. Friend the Member for Farnham and Bordon set out. Dr Dash said in her evidence that the CQC “still has a way to go, and we all need to acknowledge that.” She went on to say: “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.”––[Official Report, Health Public Bill Committee, 16 June 2026; c. 4, Q2.] We are talking about moving an effective organisation into another organisation which, quite apart from whether the merger is appropriate given their different remits, is—by the review author’s own admission in evidence—basically not in a fit state to receive those new functions. I think that has been tacitly acknowledged by the Minister in saying it will only be done at an appropriate time, when the CQC is ready. Therefore, why make those changes at all? At the moment, it does not look like the CQC will be ready, at least in the near future, based on the evidence we have heard.

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14. 7 Jul 2026·Parliament·Edward Argar

    Health Bill (Twelfth sitting)

    My hon. Friend the shadow Minister is right to highlight, for want of a better way of putting it, the cumulative challenges that will potentially be piled on the CQC, on top of the pre-existing challenges with how that organisation is functioning. I read with great care the Adjournment debate that took place last night in the Chamber, which has been referred to by a number of hon. Members, in the name of my hon. Friend the Member for Harwich and North Essex, and I pay tribute to him for his work in this space. I worked closely with him in the context of the passage of the Health and Care Act 2022, and I know that the issue of patient safety is fundamental to what he seeks to improve and achieve in this House. I agree with him: I fear the Dash review simply fails to make the case for those changes. Also, as hon. Members have set out, it sadly appears to contain a number of errors and assumptions that are inaccurate, which I will turn to in a moment. The fundamental challenge is to establish a way for people to feel confident and trusting in challenging a culture of denial and blame. We have seen this most recently in the context of maternity failings and scandals. The need for that safe space, and for an organisation able to challenge the institutions, is very clear, and I fear that this change actually weakens the ability to do that. Dr Dash’s review, I fear, fails to fully recognise just how important the safe space concept is—not just in how it is drafted and framed legally but, as my hon. Friend the Member for Farnham and Bordon said, in how it is perceived by those who need to use it. The CQC, of course, has a legal duty to act on information it receives, but that risks being conflated here. I saw this illustrated last night, for example, in the Adjournment debate, in a comment made by the Minister’s colleague, the Under-Secretary of State for Health and Social Care, the hon. Member for Birmingham Edgbaston (Preet Kaur Gill), when she was responding to my hon. Friend the Member for Harwich and North Essex. She was talking about the criteria for disclosing protected information outside the investigative function. She said: “Those criteria set a high bar for any disclosure—as high as it is currently with HSSIB—and the CQC will publish further guidance setting out much more detail.” This is the key point. She went on to say: “As the Bill sets out, the CQC will appoint a responsible person who will decide whether the case matches the criteria and whether it warrants information sharing outside the safe space.” And this is the crux of it: “That person is likely to be the CQC’s chief executive officer.”—[Official Report, 6 July 2026; Vol. 789, c. 147.] That is an inherent conflict. If the person who is the head of the regulatory body is making the decision on whether information should be disclosed by HSSIB in its folded-in form, that will do nothing to inspire confidence in disclosure and the safe space provisions. I fear that drives a coach and horses through some of the arguments being made that there are sufficient safeguards within this merger to ensure HSSIB can continue as it has done thus far. The crux of some of Dr Dash’s arguments appears to be that there are, as the Minister also alluded to, too many recommendations being made and that it is a complex landscape. Yet HSSIB, as my hon. Friend the Member for Harwich and North Essex set out yesterday, has made 56. He went on to say that the 30 or so public inquiries and other investigations have delivered 1,400, so it simply does not follow that HSSIB is the problem in that complex landscape. What was made very clear by, again, my hon. Friend the Member for Farnham and Bordon is that, of course, the concern is not the recommendations. It is not the organisation making the recommendations that is responsible for the fact that they are not implemented. It is the NHS itself, its inertia, its unwillingness and the Department’s unwillingness to take them forward in a coherent fashion—to drive the recommendations through and monitor whether they have been delivered on by the NHS.

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15. 7 Jul 2026·Parliament·Edward Argar

    Health Bill (Twelfth sitting)

    I do think that the scope of the review, who determined the six organisations and how that was looked at is important, and I am sure that the Minister will be able to clarify that when she makes her concluding remarks. However, there are a couple of other issues that concern me in terms of some of what was in the review, which seems to be the basis on which this is being done. Finding 6 suggests that HSSIB has expanded its “scope of work beyond the original remit.” It goes on to say: “HSSIB was originally established, along the lines of safety investigatory bodies in other industries, to look at specific cases or incidents of severe harm, but it has since broadened its work into making more systemic recommendations.” I have to say, as the Minister who took the Health and Care Act 2022 through, that is simply not the case. That Act does not limit HSSIB investigations to individual incidents. If I recall correctly, in some of the debates on the HSSIB clauses in the Bill, we alluded as a Committee to the need for it to be able to look beyond individual incidents and try to draw out common themes. What has been said simply does not accord with my recollection of the purposes of the legislation. Again, my hon. Friend the Member for Farnham and Bordon highlighted this. Recommendation 3 states: “Most investigations into safety incidents should continue to be managed within provider organisations”. That is the real challenge here. HSSIB’s independence is what allows it to range across the piece—to have issues raised with it and look at individual organisations. The challenge so often is that the provider organisations are marking their own homework and are simply not getting to the truth, or being as candid with those who have made the complaint as they have a right to expect.

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16. 7 Jul 2026·Parliament·Edward Argar

    Health Bill (Twelfth sitting)

    The hon. Lady makes her point extremely clearly, and I do agree with exactly the point she makes, because in any organisation it is a big step for an individual employed by or working in the organisation to make a complaint about their organisation or to whistleblow on something that has gone on or that they feel has not been got right. Key to getting people to do that is that they feel safe and empowered to do it in the public interest, and that is exactly what is at the heart of the air accidents investigation branch and the rail accident investigation branch model, so that the information is brought forward and learnings can be driven by it to improve safety for everyone. As the hon. Member for Bury St Edmunds and Stowmarket said, that safety is patient safety and that has to remain the golden thread that runs through everything we are debating. Whatever difference of perspective we have on this set of clauses, that must remain at the heart of what we are looking for.

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17. 7 Jul 2026·Parliament·Edward Argar

    Health Bill (Twelfth sitting)

    My hon. Friend is rightly highlighting the importance of independence, and trust in the independence, of the organisations investigating failures and making recommendations. Does he agree that that is only half of it? Those organisations are not at fault when recommendations are not implemented, so the other half of this is that the NHS and the system need to act on those recommendations when they are made.

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18. 7 Jul 2026·Parliament·Edward Argar

    Health Bill (Thirteenth sitting)

    I will confine my remarks to group 47, conscious that the next group will give us an opportunity to discuss local arrangements, so I will stick to the national ones. We are all aware of the significant role that Healthwatch England plays, as well as its popularity and the trust that many people place in it. As a former Minister in the Department, I was on the receiving end, on occasion, of some sharp—or firm—suggestions from Healthwatch England, but that is what it was there for. It was there to be the grit in the oyster. It often made useful suggestions, and its independence meant that it could put reports not only to me but to the public—it published them. It could give them, for example, to my hon. Friends who served on the Health and Social Care Committee and, if it wished, go to the media to make sure that that voice was heard. That is where, for me, the challenge with what is proposed comes in, because a new directorate in the Department, staffed by civil servants, will simply not be able to do that. We all know that those who work in a Department, however excellent they are, report upwards ultimately to the permanent secretary and to Ministers. They are answerable to the political leadership of the Department. Would they be able to decide that something was coming through regularly from patient feedback and publish it independently, without ministerial approval or that of the permanent secretary, or hand it to the media? Would that director be able to champion the patient voice by going on television, irrespective of any ministerial approval? The reality is, of course, that they could not. It would all be kept in-house in the Department, part of a closed process that would not alter decision making in reality, because that is already happening in the Department. The Department should already be looking at reports from Healthwatch England as part of decision making by Ministers and senior officials. What this simply does is remove the independence. It weakens that voice by making it something that happens within the Department rather than in the public sphere because, quite rightly, those officials will not be able to have their own independent voice out there, irrespective of the leadership of the NHS or the Minister. I genuinely worry that what we see here is the continuation of a theme that has run throughout other aspects of this legislation—a theme of centralisation, of removing independent external challenge and bringing it inside the system, be it the Department or the NHS. When that happens, my fear is that the people who will lose out will be the patients, whose voice will no longer carry as loudly.

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19. 7 Jul 2026·Parliament·Edward Argar

    Health Bill (Thirteenth sitting)

    Clause 65 and schedule 10 focus on local healthwatch arrangements. As I said when speaking to the previous group of amendments, Healthwatch is respected and trusted at a national level, and that is even more the case at a local level. I fear that the Government seek to remove something that works, that is effective and that ensures a strong patient voice in the system. It simply does not work to have integrated care boards take on those responsibilities, as they will be marking their own homework rather than being the independent patient voice. It is a little like the discussion the Committee had during the previous grouping on HSSIB, in which it turned out that the CQC will be able to investigate itself, but the chief executive of the CQC would decide whether any protected disclosures could be published during that investigation. That measure brings things entirely within the system and removes the independent voice, which is exactly what this clause also does. The ICB is the voice of the NHS system, not the voice of the patient. We need the grit in the oyster that is provided by an independent voice talking to the ICB. Being in the room with an ICB will not mean that the patient voice is heard more loudly or clearly, or that it will be acted on—it is probably more likely to mean that it is not. As an example from my constituency, the ICB did conduct a consultation exercise on the proposed closure of St Mary’s birth centre in Melton Mowbray, the response to which was overwhelming: the patient voice said that they did not want that to happen. That response was fed into the ICB, but the ICB did what I fear it planned to do all along and closed the centre. Given that that voice in the room came from a consultation exercise led by the ICB, it seemingly did not make a jot of difference to the outcome or decision, or to whether the patient was heard. On the impact of local authority scrutiny panels, the NHS ICB in Melton previously recognised the need for increased GP provision in the town due to the increasing size of the town and the long waiting times, but just recently decided to reverse that position and say that it did not see the need for that. Members of the scrutiny committee, across all parties, were absolutely clear that they disagreed with that decision, but did that get listened to or make a jot of difference to the ICB? No—the ICB did what it was going to do anyway and changed its mind. My concern is that we will see less grit in the oyster and patient voice, and more managerialism in the NHS ICB system. We heard from the hon. Member for North Shropshire and the shadow Minister about the challenges there would be, even were that patient voice to happen. Given the Government’s 50% cuts to ICB budgets, which are already impacting frontline services, ICBs will not be able to take on additional responsibilities without the funding that they need. That is quite apart from the principle that they should not be marking their own homework. I fear that “system knows best” will become the default. We have also heard about the geographical challenges. Given that mergers and acquisitions are getting even bigger, ICBs are moving further and further away from what was conceived: for them to have the same geographical footprint as the upper-tier local authority providing social care, to ensure that the two organisations spoke to each other and were better integrated. Removing the representative from the local authority that provides that healthcare from the board, even if they are replaced with a mayor, does not bring about the reconnection with social care provision that is so central. Removing the voice of general practice or primary care from the ICBs again moves that independent challenge away from the system. I fear that this is a fragmentation of those links at a local level and the weakening, if not silencing, of a patient voice that can challenge publicly and ensure that what patients need to have said is genuinely said. Being in the room does not mean that that voice is heard or acted on, as shown from the examples I have spoken about: there is a consultation exercise, the view is reflected on, and the ICB does what it was going to do anyway and does not change its position. I have genuine concerns about the loss of an independent patient voice in a local context. The Minister will correct me if I am wrong, but I think she made the point in her opening remarks that we have lacked not recommendations and suggestions for changes but action to fix the issue. But it is not for Healthwatch to take action to fix the issue; it is for the ICBs and the NHS to act on those recommendations. We are proposing to give the bits of the system that have failed to take action and fix the issue not just the responsibility that they already have but the responsibility for reflecting patient voice. The one bit that is working—where patients’ voices are heard—is the bit that we are getting rid of. We are not seeking to fix the bits that have real pressure and genuine levers to compel an ICB to act on those recommendations when they are made independently, rather than simply marking its own homework. As with my reflections on clause 64, I genuinely fear that in this weakening of patient voice, particularly at a local level, the patient will be the loser because the system will continue to do what it wishes to do. It will do its consultations, and it may have a director of patient experience at an ICB level, but they will be working for the ICB; they will not be there as an independent voice to challenge the ICB—including publicly—on what it is doing. I hope that the Minister reflects further on the real diminution, if not the neutering, of patient voice that comes with some of these arrangements. As always, I look forward to her reflections when she winds up.

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20. 7 Jul 2026·Parliament·Edward Argar

    Health Bill (Thirteenth sitting)

    My questions will be very brief. I am conscious that, given that these are mostly Liberal Democrat new clauses, for once I will be asking the hon. Member for Winchester for a response, not the Minister. New clause 4 would require that contracts be laid before Parliament. I would be grateful if the hon. Gentleman can tell the Committee how many such contracts he thinks would end up being laid before the House in any given year, based on historical data, and therefore how much parliamentary time that would take up. Does he envisage that being handled by an affirmative or negative statutory instrument? What will the process be? I can see what the hon. Gentleman is trying to do, but I have a certain wariness, along the lines of that expressed by the hon. Member for Bury St Edmunds and Stowmarket. Although it is important that we have appropriate protections and scrutiny, when we are procuring services and technology for the NHS we should be looking for the most effective and best tools that have those safeguards but can do the job that eminent surgeons and clinicians need them to do in order to do their work for patients.

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21. 7 Jul 2026·Parliament·Dr Neil Hudson

    Early Release of Prisoners

    I thank my hon. Friend for yet another powerful contribution on this issue. He is an incredibly powerful advocate for the victims of these heinous crimes. I pay tribute to the victims and survivors and thank him for his work. As he is rightly saying, and as our right hon. Friend the Member for Herne Bay and Sandwich (Sir Roger Gale) has also said, there is time now to do something. There is consensus across the House today for something to be done to stop these people being released early and to save the survivors and victims from the impacts on their physical and mental health, and on their safety, that my hon. Friend has articulated. Does he agree that the Government should listen to the voice of the House and to the voices of survivors and act now?

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22. 7 Jul 2026·Parliament·Dr Kieran Mullan

    Early Release of Prisoners

    We will be in a bizarre situation: the House will come together and express an unopposed view on what we should do about this issue, but before we have even done that, the Minister has indicated at the Dispatch Box that that view is immaterial and will not make a difference.

    Hansard source
23. 7 Jul 2026·Parliament·Dr Kieran Mullan

    Early Release of Prisoners

    It is a pleasure to close this crucial Opposition day debate, and I thank all Members who have taken part for their thoughtful contributions. Before I say anything else, I want to acknowledge the people I met earlier today, along with other MPs on a cross-party basis, and who were in the Public Gallery: Jade, Charlotte, Jessica, Sarah, Erin, Carly and Angela. I also want to mention someone who has not been mentioned today: Isabelle, whose daughter took her own life when she saw the perpetrator of her crimes released early under the ordinary early release schemes. I particularly want to thank my hon. Friend the Member for Keighley and Ilkley (Robbie Moore) for reading out all the victims’ words, and letting everybody hear exactly what they have said. That was really powerful. I also thank him for acknowledging the many people watching at home, who are not here. They include Fiona Goddard, who was one of the first people to speak out after receiving her letter. Those people are often referred to as victims, and they are victims, but they are not just victims. Being a victim does not define them. They are people with voices that they want us to hear. They came to this debate because, at the very least, they want answers from the Government, and they want MPs to support them by taking different decisions that will put them, their experiences and their welfare first. I want to say to them directly: we hear you, and I hope that by the end of this debate, the Government will have followed suit and heard you too. When the Minister responds, I hope we will finally get answers to some of our basic questions. This Government have had eight months to answer these questions. When are people being let out, and what offences have they committed? Those are basic things that we still do not know. Instead, the Government have had to write to thousands of victims, not with answers and information, but with just enough to make each of them worry deeply about what might happen, and about whether their perpetrator will be released early; they did not know whether, or when, that would happen. That has made things much, much worse. Victim Support, which supports thousands of victims every year, has a number of questions that it thinks it is important for the Minister to respond to, and I would like to ask them now. It wants to know how people who are not eligible for the victim contact scheme, or who have chosen not to sign up to it, will be able to access information. Those people will hear these stories and read these things in the press, and will see them discussed in the Commons. Who can they approach to find out the answers to their questions? Do the Government know what proportion of victims have been reached and informed about possible changes to their case? Are the victim contact schemes set up to be contacted? How many people are raising this issue with them? What questions are the schemes being asked? What themes are emerging? What extra support are the Government offering victims, to help them back into support services to which they lost entitlement because of the length of time that has elapsed since the offences? The Government have not been honest with the public about this policy from the very beginning, or with MPs—not just once, on a minor point of detail, but on the three promises that mattered most to every victim who received one of these letters. The first promise was on what the Government described, and still describe, as an “earned progression model”. That framing was designed to reassure. If release must be earned through demonstrated rehabilitation, surely the truly dangerous cannot simply walk out. That is what the public were told, but that is not what the Sentencing Act ensures. Members do not need to take my word for it; the Library briefing note on the Bill said in black and white that release under these provisions is automatic, unless the prisoner actively disqualifies themselves through serious misbehaviour in custody. That is not earned release in any way, shape or form. It is automatic release, which is a fundamentally different proposition. Ministers knew that, and they knew the difference when they chose that language. I said that in Committee on the Floor of the House and on consideration of Lords amendments in January. The Government had every opportunity to correct that, and they have chosen not to. The second promise was that the most serious offenders would not be included in the scheme. The Lord Chancellor said that, and the Under-Secretary of State for Justice, the hon. Member for Rother Valley (Jake Richards), repeated it throughout the passage of the Act. I asked him directly, in Committee, whether Labour MPs voting against our amendment to exclude certain offenders would be able to say to the survivors of child sex abuse that they had supported a Government who wanted to classify thousands of child sex offences as being not among the most serious offences. There was no satisfactory answer from the Minister. The Minister has failed repeatedly, during the urgent question and during the debate today, to explain how it is possible for a Government to say that their release scheme excludes the most serious offenders, while including in it people guilty of offences such as rape, the rape of children and child grooming. That is for them to justify. To make matters worse, the Government have now changed the wording they use, months after passing the Act. They now say that only “the most dangerous offenders” are out of the scheme. That is hardly any more of a justification. Do we really think that these offenders are not also dangerous? It is another example of this Government’s manipulation on this issue. That wording relates to the true exclusions—of those on extended determinate sentences, which are for perpetrators whom the judge feels are particularly dangerous. I told the Government during the Act’s passage that that did not exclude serious offenders, and they did not listen. Now they are using the right wording, so they are technically closer to being correct, but they are still deeply wrong in every way that matters. The third promise, or the third way in which the Government rammed these changes through the House, was to pretend that the measures were a short-term fix to a short-term prison capacity crisis. They are not. There is no sunset clause in the Sentencing Act. This is not emergency legislation; it is a permanent change to the law. When the Act was passed, it did not set an end date. It does not state, “Once 14,000 new prison places are built, these provisions will lapse.” It is a permanent and profound change to our sentencing laws that will be in place regardless of how many prison places are available. Victims, MPs and the public deserve to know that. The Government made three promises—three fundamental misrepresentations of what they were doing and the implications of the Act. Those are three questions that the Government did not have an answer for when the Act passed, and still do not have answers for now. We are just weeks away from the start of the releases in September, and we still do not know how many criminals are being released and what offences they have committed. I have been asking the Government about this for months. My freedom of information requests in March and April 2026 were refused, and my oral questions in March and May were deflected. I tabled a named-day question after the commencement order was laid in June. The deadline was missed; it was only with the intervention of Mr Speaker that we got a response, but it was not an answer. It did not give us the figures.

    Hansard source
24. 7 Jul 2026·Parliament·Dr Kieran Mullan

    Early Release of Prisoners

    Mr Speaker could not have been clearer about the reasonable expectations of Members of this House in relation to the early release of serious sexual offenders and others into their constituencies. What did the Minister, the hon. Member for Rother Valley, say during the UQ? He said that the numbers were in the impact assessment. He repeated that twice, and he was absolutely wrong. I have read the impact assessment. Every Member who has read it will confirm that it does not contain the breakdown of offenders and their crimes that we asked for. What it contains is a description of a qualitative process of internal discussion between departmental officials to arrive at a broad estimate of the effect on the overall prison population. There is no table showing how many rapists or child groomers are going to be released. We know that is not just an omission because the Prisons Minister himself, Lord Timpson, said on “Channel 4 News” last week: “It is impossible for us to say who will be released, where and when.” “Impossible”—his word, not ours. He was asked again and again, but could not answer. The Minister at the Dispatch Box told Parliament that the numbers were available to us all. The Prisons Minister told Channel 4 that it was not possible to provide the numbers. Only one of them is right. What is the truth? I think that they actually do not know. I think the Ministry of Justice did not model the eligible cohort by offence type before passing the legislation. It pulled a lever of this magnitude, affecting potentially thousands of the most serious offenders in our prisons and their victims, and it did not even know what sort of vile criminals it would be letting out of prison early. That is a disgrace.

    Hansard source
25. 7 Jul 2026·Parliament·Dr Kieran Mullan

    Early Release of Prisoners

    I can tell my hon. Friend that it is not just a risk; it is a reality. A number of the victims we met earlier said that they were speaking to people who wanted to come forward, and to speak and contribute to the inquiry, but they saw what was happening to those who had spoken up and who had an offender sent to prison, and who now see that the offender will be released even earlier. They ask, “Why would I risk these people being let out even earlier than they otherwise would have been?”

    Hansard source
26. 7 Jul 2026·Parliament·Dr Kieran Mullan

    Early Release of Prisoners

    The only comfort I can give is that there are some exclusions to the early release scheme. If someone is on a life sentence as a minimum term, or on an extended determinate sentence, release does not happen earlier; but we know that more than 90% of the offenders sent to prison every year for child grooming are on a standard determinate sentence and will be eligible for early release. The Government have quite rightly highlighted the challenges around conviction rates, and I accept the criticisms that the Government have made about the reduction in conviction rates—it is an incredibly important issue—but people do not go to court for the sake of it. It is not done just for the hell of it. They go to court and want a conviction so that a sentence is passed that is an appropriate punishment. The Government take away people’s motivation to speak up when they undermine the outcome. Let me be specific about what an assurance that serious offenders would be excluded from the scheme would actually mean in practice to a victim. We talked earlier about Fiona Goddard, a survivor of rape, sexual assault and child grooming, whose abusers were sentenced to between 16 and 20 years in 2019. I again pay tribute to her courage. Fiona received a letter from His Majesty’s Prison and Probation Service, telling her that people who abused her may be released early. She talked to the press and went to the media, and a journalist raised her case with the Ministry of Justice. The Ministry of Justice said officially, in a quote that was read out on “Good Morning Britain” when Fiona appeared on it, that the most serious offenders would be excluded. It said that to a journalist, in writing, and it was broadcast to the nation, with this victim listening in. It was saying that Fiona’s abusers had not committed offences serious enough to allow her to be protected, and would not be excluded from the scheme. Survivors were in the Gallery today because letters landed through their doors telling them exactly the same thing. When the Minister says that serious offenders are excluded, they are saying, to every single victim who receives one of those letters, “Those are not serious offences. They are not heinous crimes. They are included in the scheme.” That is absolutely appalling, and thousands of people have received those letters. I say to every Labour Member that this is not a partisan observation. During the urgent question, the hon. Member for Birmingham Yardley (Jess Phillips) said there should be more exemptions and that Members should work together on this, and the hon. Members for Liverpool Wavertree (Paula Barker) and for Alloa and Grangemouth (Brian Leishman) have contributed to this debate. Let us be clear: there are hundreds of Labour MPs, and not a single one of them has come to the Chamber today to defend the Government’s policy and position. That is absolutely extraordinary and tells us what we need to know. It seems that the Government just want to keep their fingers in their ears and pretend this is not happening. I want to be clear about what has actually happened under this Government. At the same time as this Labour Government have released over 60,000 criminals early, prison capacity has fallen on their watch, so we have roughly 500 fewer prison places under a Government who seek continually to attack our record on prison building. I accept the criticism—we should have built more prison places—but in their time in office, the figure has gone down. As with so many issues, from police numbers to teacher numbers, things have got worse under this Government. We have more than 10,000 foreign national offenders in our prisons right now, representing around 12% of the prison population and costing hundreds of millions of pounds a year. The Government could have moved faster on deportation and freed up those places. As I said, I am clear about our failings in government, and I am happy to say it again: we did build more than 14,000 prison places, but we closed too many prisons that were not fit for purpose, and that has created challenges in the system. However, as my right hon. Friend the Member for South Holland and The Deepings (Sir John Hayes) and I have said, and as Members on both sides of the House have said for a long time, the failings in the prioritisation of our justice system go back many decades, over many political parties. I say this not to make a political point but to demonstrate that these are long-term issues. When Labour was last in office, it introduced the existing automatic halfway release for all offenders. Despite that, prison capacity was so tight that Labour released 80,000 prisoners early. When Labour was last in office, it made use of early release schemes because it failed to build enough prison places to keep people in prison.

    Hansard source
27. 7 Jul 2026·Parliament·Dr Kieran Mullan

    Early Release of Prisoners

    As I said, we inherited the existing system of automatic release. During our time in office, we sought to raise the time served before automatic release to two thirds for some of the more serious offences. I recognise that there are challenges in the prison population, and I am raising Labour’s record to make it clear that these have been challenges for multiple decades over multiple parties, including the Lib Dems when we were in coalition. That is why we have gone as far as we can with our motion to enable the Government to achieve the absolute minimum that we could ask. I do not want any serious offenders let out of prison before they have served their time. Again and again in the meeting with victims earlier, they told us how appalling it is to hear a sentence in the court, knowing that in the vast majority of cases, prisoners will never, ever serve it. I wish that people could serve even longer sentences than the ones we currently give out, but we all know we are not in a position to make those promises. Our amendment to the Sentencing Bill was broad and sought to ensure that any serious or violent criminals—for example, people who kill by dangerous driving, people who commit manslaughter or people who commit child neglect and cruelty—were excluded from these early release schemes. The Government insisted that that is not possible, and Labour and Liberal Democrat MPs defeated us on that amendment. We are not even asking for that today. Our motion purely calls on the Government to exempt those convicted of sexual offences against an adult or a child—that is all we are asking for today. The challenge for the Government is this. They say it is absolutely necessary to keep particular people in prison, but they do not even know how many of these people they will be letting out. For example, if they do not know that 500 rapists are going to be released, they cannot tell us, “Sorry, but we really need those 500 extra places—we don’t have the capacity” because they did not know that when they passed the legislation. The incoming Prime Minister, the right hon. Member for Makerfield (Andy Burnham), is reportedly exploring how to tighten the scheme for child sex offenders, and we welcome that, but I want the House to understand the timeline, because it is closing. The commencement order was laid on 8 June without a ministerial statement, a “Dear Colleague” letter or a response to any of the questions raised by the shadow Justice team. We do not know the details, but we understand from reporting that the first 700 offenders will be released on 2 September, and then a similar number will be released each month for the following nine months. We understand that the total number could be between 5,000 and 7,000 offenders, but we do not know because the Government will not tell us. The House rises for the summer recess at the end of next week and any new Prime Minister will be in Downing Street shortly after that. When Parliament reassembles in September, the first criminals will be about to be released. In fact, the first Prime Minister’s questions that the right hon. Member for Makerfield (Andy Burnham) will take will be on the day those offenders start getting out of prison. The Government, the Lord Chancellor and Ministers have had every opportunity to act differently. They could have excluded serious offenders, made a statement when the commencement order was laid and answered our questions and our freedom of information requests, but at every turn they chose not to do so. I say with all sincerity that we know that Members on all sides of the House agree that a single sex offender released earlier than their sentence demands is one too many. There are Labour Members in the Chamber who we know agree with that. Indeed, 40 of them abstained when we originally divided on the legislation—they did not go into the Lobby and say that they believed that it was right to let rapists and child sex offenders out early. They all had doubts and some of them have spoken in today’s debate because of those doubts. We have now descended into farce. We have been told that the Government will not oppose today’s motion and we expect it to go through, but the Minister made it clear that as far as he is concerned, that does not matter one jot and things will carry on as normal. Parliament is expressing its will today and there is an expectation that the Government should respond to Parliament’s will, but the Minister has already made clear his intention not to give a monkey’s. A vote in favour of today’s motion is to say that Parliament believes that rapists and child sex offenders should not be released early, and that victims deserve better after eight months of evasion and a commencement order laid without a word of notice to Parliament. A vote in favour of the motion would send a clear message that this House has come together to support victims. To finish, I return to the victims I met earlier. It was a privilege to meet them. They asked us, MPs from different parties, whether what they are doing—coming here today, giving up their privacy, reliving their trauma and fighting for a conviction in the first place—was worth it? I told them that it was worth it and that it made a difference because the Government will not oppose the motion, so they have won and they have got the motion over the line. We are going to ensure that that is the case, whatever the failings of my party or the Labour party on the issues of justice, going back over many decades. When I was frustrated earlier by the Minister’s failure and inability to answer basic questions yet again, the Minister told me to calm down. Well, I will not calm down. Whatever our failings and the Labour party’s failings during its previous time in office, victims of rape and child sexual abuse do not deserve to pay the price of political failure over many decades. We will carry on ensuring that this Government are held to account and MPs do not let down and betray the victims of some of the worst possible offences in our justice system because of misleading efforts by the Government to pull the wool over their eyes. The wool has not been pulled over the eyes of MPs from all sides of the House. It is time that the Government came clean about what they are doing and listened to the House, because this House says, “No, we do not want those people released”. The House will vote and tell the Government that, and it is incumbent on the Government and the incoming Prime Minister to listen.

    Hansard source
28. 7 Jul 2026·Parliament·Dr Kieran Mullan

    Early Release of Prisoners

    I have a really easy question. The Minister is talking about grooming gang perpetrators and the like. How many of them will be released as a result of this policy? How many spaces are they taking up that you need to free up?

    Hansard source
29. 7 Jul 2026·Parliament·Dr Kieran Mullan

    Early Release of Prisoners

    I have tried to have a fair hand with the victims who attended Parliament today. I invited every Member to meet them, and I facilitated meetings with Labour and Liberal Democrat Members. So what I say now is universal. One of the aspects of last week’s urgent question that infuriated those victims was the Minister talking about our record. They said to us at the meeting that they had voted Labour in the past—that, indeed, they had voted for various different parties in the past—and they recognised that a lot of issues were involved, but they did not want to see again and again, having come to Parliament to ask about what would happen to them, a Minister getting up and attacking us. So I say to this Minister, “Do not fall into the same trap.”

    Hansard source
30. 7 Jul 2026·Parliament·Dr Caroline Johnson

    Health Bill (Twelfth sitting)

    I have sympathy with the principle behind amendment 58, in the name of the hon. Member for Wells and Mendip Hills. The hon. Member for North Shropshire is right to say that individuals with ME have not always received the best quality care. In many cases, ME is a debilitating and incredibly frustrating condition, and around 10% to 25% of sufferers have severe ME, meaning that they are housebound or bedbound. We know that some patients are sadly not believed by medical professionals. In 2021, NICE said that most medical students have little or no training on the condition. The Government have previously committed to increasing the uptake of ME modules among NHS professionals. What progress has been made on that in the last couple of years? The Government also committed in the ME/CFS action plan to develop and run a public awareness initiative, with implementation expected by May this year. Has the Department developed that initiative yet? If not, what is responsible for the delay? It is not marked as complete on the Government website. The amendment would put guidance for medical professionals into legislation, though, and my concerns about that are twofold. First, it may slow down improvements in the future. If individuals have to legally follow that guidance, how can they innovate and improve treatment without having to come back to Parliament for more primary legislation? That will take time and may mean that people with ME get worse rather than better care in the short term. The requirement would also limit clinical judgment. A patient may have a particular set of symptoms or conditions or be on a particular set of medications that mean that the doctor or clinician looking after them needs to vary from the guidance. NICE intends the guidance to be just that, guidance, not law, but if guidance becomes law, the doctor or clinician will not be able to vary from it. My concern is that the amendment would be overly restrictive. Although it is well-intentioned, and it is a good idea to ensure that guidance is followed where possible, it would be too rigid. I therefore do not support the amendment, while continuing to support the aim of better treatment. Clause 58 amends the Health and Social Care Act 2012 by inserting a new section 237(8A), which states: “Provision made under subsection (8)(b) may include provision about the period within which a recommendation is to be complied with (including provision for the period to be determined by NICE or the Secretary of State).” At the moment, NICE technology appraisals check the value of a product, whether a drug or a technology, then NICE makes a recommendation. It is then supposed to be the case that within 90 days or three months, ICBs ensure that those technologies are available, but we know that in the real world it can take longer—sometimes 12 to 24 months—for some things to become available. That could be because technology needs to be bought or training needs to take place. I understand why there could be variation and why the Government may want to consider varying the period, but it is not clear why they need to do so in legislation, because it is possible now to vary the period on an individual basis. For example, the Government imposed a five-year limit rather than a 90-day limit for the introduction of hybrid closed loop systems for diabetes, because that is a technology that requires proper training and they were never going to be rolled out in such a short period. The other product that notably has a longer time is tirzepatide, which is more commonly known as Mounjaro. I suspect that that is down to cost, but I am not certain. Why do the Government want to change the 90 days? The patient’s right to treatment with a NICE-approved product within 90 days will become a right to getting the product when the Secretary of State says so. That is not really a right at all, because it does not give patients any comfort and may mean that products are received later. The Government have put this power into the Bill, so they clearly intend to use it. Given that they have the power to vary on an individual basis, why do they need the power to vary on a blanket basis? Do they intend to extend the 90-day limit across the board? If so, by how much? There is no ceiling. The Committee received written evidence from Henry Burkitt from Oxygen Strategy, who made the point that there is no ceiling, no maximum time, no duty to consult and no necessity for the Secretary of State or NICE to give reasons why a delay has occurred. The life sciences industry talks about how it wants products to be rolled out. When it is investing and doing research in this country, it wants to see new products rolled out as quickly as possible once they have been approved, and the clause is a sign that roll-out might be delayed. I understand that the Government might want to be able to vary on certain products, but they already can; why do they want to vary on a more general basis? It is presumably to slow down roll-outs, but by how much?

    Hansard source
31. 7 Jul 2026·Parliament·Dr Caroline Johnson

    Health Bill (Twelfth sitting)

    These clauses are about patient safety. As has been pointed out this morning, patient safety is the absolute key here: that is well recognised across the House, among the public and across the national health service. Before going any further, I declare an interest as a patient of the NHS, a member of the British Medical Association, a member of the Royal College of Paediatrics and Child Health and a consultant paediatrician. When I was interviewed in 2012 for my current consultant role, I was asked to deliver a presentation about how I could demonstrate to the trust board that the paediatric services in the hospital were safe. The first question I posed—Members will be pleased to know that I will not go through the whole presentation—was: “What is safe?” Are football stadiums safe? Is the London underground safe? Are aeroplanes safe? Broadly, yes, I think we would say they are safe, but they have not been without incident or safety issues. Healthcare is similar. It involves millions of people, clinical judgment, human decision making and huge variability in the way that patients can present with different symptoms for different problems at different times. Is healthcare safe? Yes, it is safe. Again, however, we know from the many reports we have read that there is a long way to go to make it better and we need to prepare for that. We need to make sure that we design out room for error—that we design processes that limit the opportunities for error—use technology to limit the risk of error, and train people in a way that reduces the risk of error. One of the key factors in that work is accepting that where there is human decision making, mistakes can happen, and that we need to identify and learn from those mistakes. One of the main ways of doing that is striking a balance between accountability and blame. If there is insufficient accountability, there can be an unclear escalation process, such that people do not know who to go to when they identify a problem. There can be a careless culture, which can develop in places where there is not enough accountability. However, if there is too much focus on fault and determining whose fault something is, we can get a blame culture. That can lead to a failure for people to come forward and therefore to a failure to learn from mistakes. It can lead to a culture of cover-up, whereby people try to avoid getting either themselves or their colleagues into trouble. That is where HSSIB comes in because, like the air accidents investigation branch and the similar bodies for rail and shipping, it provides a safe space. That safe space is important in ensuring that people can speak up freely without fear, and know that we can get to the bottom of a problem and understand why and how something went wrong, because that is how we fix it. At the time that HSSIB was established, there was consensus about it. The General Medical Council said: “We support the creation of a ‘safe space’ approach to investigation. This is consistent with our guidance to doctors about their responsibilities to learn from mistakes and reflect on their practice, and their duty to take part in systems of quality assurance and quality improvement to promote patient safety.” The British Medical Association told Parliament: “We welcome the establishment of the HSSIB…Doctors must feel able to report errors and reflect on their own mistakes openly, without the fear of these reflections being used against them at a later stage. Only then can true improvements to patient safety be made.” Similarly, NHS Providers told Parliament: “NHS Providers welcomes the creation of the HSSIB as an opportunity to develop a just culture in the NHS and a focus on learning…For the HSSIB to succeed in contributing to improved patient safety, any investigations associated with it must be carried out independently and without conflict of interest, and be perceived as such.” Indeed, the Minister for Secondary Care herself is on the record as having said: “HSSIB is a really important new body…It must absolutely be built on the highest standards of trust when it comes to the wider system and the general public.”––[Official Report, Health and Care Public Bill Committee, 19 October 2021; c. 564-565.] I think that I have demonstrated that the creation of HSSIB was a matter of consensus and it was confirmed that it was the right thing to do. In order to work, HSSIB needed to be independent and without conflict of interest. NHS staff backed it, the providers backed it, the patients backed it and even the Minister backed it. That is what makes the Government’s plans for HSSIB so perplexing. I am not aware of a single royal college or union that supports folding it into the CQC. Essentially, Ministers have said that this is being done because of the Dash review. “The Dash review says so,” they argue, “so that’s what we’re going to do.” I have huge respect for people who say, “I’ve asked for some experts’ advice, and they have given it, and therefore I should follow it.” However, Ministers also commissioned the report by Lord Darzi, which said that “a top-down reorganisation of NHS England and integrated care boards is neither necessary nor desirable”, and yet here we are, doing exactly that. It is perfectly possible for Ministers to take one report as gospel and another as guidance. I would be grateful if the Minister could explain that. The other reason given for this measure is that it will declutter the landscape, yet few people outside Government seem to think that HSSIB is responsible for cluttering the landscape. For example, the Health Foundation wrote in its submission that “the government needs to do more to explain how the abolition of HSSIB and transfer of its functions to CQC will meet its aim of reducing complexity and, most importantly, maintain the essential focus on improving patient safety.”

    Hansard source
32. 7 Jul 2026·Parliament·Dr Caroline Johnson

    Health Bill (Twelfth sitting)

    The hon. Gentleman is right. When someone comes forward, they need to have trust in the system. If they think that coming forward will harm their job or career, or perhaps their colleagues’, they may be more reluctant to do so. There is a difference between a mistake and a reckless act. If people behave recklessly and badly, that needs to be dealt with for the sake of accountability, but if an individual is aware of a mistake, or aware of a loophole through which a mistake could have been made if only something else had not happened at that moment, they need to come forward and say so. It would be much more difficult for them to do so if there was a culture of fear. Dr Benneyworth made it clear to the Committee that “we are still working in a culture of fear”––[Official Report, Health Public Bill Committee, 16 June 2026; c. 24, Q40.] and that makes it difficult for people to come forward. People come forward now because they know that HSSIB is independent, but they will be less likely to come forward when HSSIB is an office in the CQC that is independent in name only. The Chair of the Health and Social Care Committee, the hon. Member for Oxford West and Abingdon (Layla Moran), said that “people cannot sit at desks near other people who are making decisions and at the same time be perceived as entirely independent. The perception of independence cannot be legislated for—the perception is everything”.—[Official Report, 1 June 2026; Vol. 786, c. 915.]

    Hansard source
33. 7 Jul 2026·Parliament·Dr Caroline Johnson

    Health Bill (Twelfth sitting)

    My hon. Friend is absolutely right. That answer was quite shocking, really. The pause before it and the reaction was remarkable. The purpose of HSSIB is to investigate without fear or favour, and to enable people to come forward in a safe way, but if it was folded into the CQC, as the regulator, and the problem was the regulator, how would it investigate itself? How would it make recommendations to itself? What if it thinks the board that it works for is incompetent? Is it going to tell its boss that it is incompetent? How does that work? No one seemed to know the answer. It also seems that Ministers have not thought about how the HSSIB unit will be vulnerable to political pressure. Under the Bill as drafted, the Government are planning to direct the “vast majority”—according to the impact assessment—of the investigations, and the quality board is going to have some influence over the recommendations, again under the direction of the Secretary of State. The Liberal Democrats have tabled amendment 5, which would require the appointment of a committee. That idea is well intentioned, and we recognise the same problems and the same flaws in the Government’s approach, but I do not think it is enough to solve the problem. Even if the law says that the oversight of the investigative units will remain operationally independent, I just do not see how that is possible. I can see that the hon. Member for North Shropshire is trying to help by creating something better than what the Government have produced, but I do not think it is enough. We have also tabled some amendments, including new clause 42, which would ensure that there is some operational independence in the choice of investigation by requiring the Secretary of State to adequately fund and resource patient safety investigations, including some of those initiated by this unit within the CQC. Amendment 55 is a probing amendment. We noticed that much of the legislation has been lifted and shifted from the previous Act, but some things are missing, including national security grounds. We want to understand why that ground has not been included in the Bill. Very occasionally, health events have national security connotations—the Salisbury chemical weapons attack, for example. In such circumstances, restrictions on investigatory capabilities could be necessary. I do not know—I was just interested in why the Government have chosen deliberately to remove that particular clause. Amendment 56 would allow “the Commission to recoup charges in excess of the costs incurred in providing assistance.” The HSSIB programme is world-leading. People look at it from across the globe, and some have asked for training or information on it, for which we have been able not just to recoup costs but actually charge. I do not understand why the Government have removed that provision, because it is an opportunity for them to get extra money without taking it off people in taxes. Do the Government want HSSIB to lose its international standing, or do they want British taxpayers to subsidise training for foreign health services? It is not clear. I would be grateful if the Minister explained that. We need to come back to what the hon. Member for Bury St Edmunds and Stowmarket said at the beginning: what is the purpose? The purpose is patient safety.

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34. 7 Jul 2026·Parliament·Dr Caroline Johnson

    Health Bill (Twelfth sitting)

    I thank the hon. Gentleman for that intervention, but I think this comes to part of the problem. When producing a list of faults—of things that are wrong with the service—and saying, “We need to improve the culture; it needs to be better”, we need to ask, “Okay, but how? What will be the deliverable, measurable way of doing that? How will we go about improving things?” For example, let us say that there is a problem with patients with aortic dissection, so how will we prevent that? The benefit of HSSIB is that it produces a plan, the plan is implemented and patients are safer. Part of this is about the delivery plan. As for the other part, the hon. Member talked about monitoring progress, but that is not the job of HSSIB. If a mistake or an event happens, it is investigated by HSSIB—HSSIB produces a set of investigations based on understanding how and why it happened, because of the safe space—and then those recommendations are put forward to the Government. The Government then, ideally, implement those changes. The Minister is there to ensure that those are implemented. It will be her job to ensure, having decided which recommendations are to be implemented, that that is done fully and properly. It is a separate function. The CQC is a regulator, HSSIB is an investigator, and the Minister is there to ensure that things are delivered properly. Going back to patient safety, at the end of my interview, I essentially told the panel, “I cannot tell you that anything is 100% safe”. The assurances that can be provided are that the staff and equipment are available, that training is available for people to do the job, and that processes are in place to identify shortcomings and learn from them, so that they are not repeated. That is key: to find the learning and spread it more widely. As the hon. Gentleman said, implementation is a challenge. It is possible to implement this on an individual basis or to implement a lesson in a unit that has had an error or mistake. Spreading it more widely, so that this is heard in every unit across the country, is more challenging. Fundamentally, I do not think I have heard anything from any of the Ministers, and I do not think it is in the Dash report either, to explain why the Government believe that rolling HSSIB into the CQC with all the problems that it might cause—the risk of it suing itself over whether the safe space is available or not—makes patients any safer.

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35. 7 Jul 2026·Parliament·Dr Caroline Johnson

    Health Bill (Twelfth sitting)

    My right hon. Friend will be aware that it is not the only thing that the CQC is being asked to take on. It is also being asked to take on the regulation of event healthcare, which is another new function for the CQC, all at a time when, as he says, it has its own difficulties to manage.

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36. 7 Jul 2026·Parliament·Dr Caroline Johnson

    Health Bill (Twelfth sitting)

    On pages 8 and 9 of the Dash review, Dr Dash talks about this. She states: “Recommendations are…focused on inputs, rather than outputs or outcomes, and fail to…balance…risks within organisations and across systems…the existence of so many recommendations causes considerable confusion for staff. They result in more clinical staff moving into supervisory roles to check that other…staff are adhering to the recommendations. The overwhelming majority of recommendations lack data as to the cost of implementation or the expected impact.” She recognised, did she not, that there was a problem with people being asked to check up on one another’s work and check up on their work? But the recommendations do not deal with that, perhaps because the scope, as my right hon. Friend has described, is so narrow.

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37. 7 Jul 2026·Parliament·Dr Caroline Johnson

    Health Bill (Twelfth sitting)

    My hon. Friend is making a very important case about the importance of the perception of independence and the safe space actually being safe. There is a risk that people feel that they will be hounded or—

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38. 7 Jul 2026·Parliament·Dr Caroline Johnson

    Health Bill (Thirteenth sitting)

    My hon. Friend the Member for Isle of Wight East was talking about the importance of the perception of the safe space, in relation to people being able to come forward, and the fears of whistleblowers. Does he agree with me that it is not just this perception that causes potential whistleblowers to worry? If they read the newspapers on a regular basis, or are on social media, they will see examples of people who have suffered mistreatment as the result of having been whistleblowers.

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39. 7 Jul 2026·Parliament·Dr Caroline Johnson

    Health Bill (Thirteenth sitting)

    My understanding is that, in the past, HSSIB has provided services to not only British health services but overseas health services, which were, in some cases, charged for that service, as it is a world-leading organisation. Why would the Minister not want that to continue?

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40. 7 Jul 2026·Parliament·Dr Caroline Johnson

    Health Bill (Thirteenth sitting)

    The Minister seems to be saying that her reasoning for moving HSSIB into the CQC is to ensure that actions take place in response to the recommendations. But if HSSIB outwith the CQC makes recommendations that are delivered by the provider organisations, commissioned by the ICBs and overseen by Ministers, and then the CQC checks that as part of the regulation, why does HSSIB need to be within the CQC for that to happen?

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