The Minister for Public Health and Patient Safety (Dame Diana Johnson)

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I am grateful for the opportunity to speak on behalf of the Government in support of the Bill. I congratulate the right hon. Member for New Forest West (Sir Desmond Swayne) on securing first place in the private Member’s Bill ballot, and on bringing this important Bill before the House. In the 21 years that I have been in this place, I have never even got close to getting a private Member’s Bill, but I heard from the right hon. Gentleman that he had had to wait 30 years to get his, so there is hope for us all. It has certainly been worth the wait. The Bill reflects both careful thought, and a determination to ensure that babies, parents and carers receive the sustained attention that they deserve.

I also recognise the valuable work of the 1001 Critical Days Foundation, and in particular Dame Andrea Leadsom’s long-standing commitment to that agenda. I served in Parliament with Dame Andrea, and I know that over many years she has helped to build understanding across Parliament, and beyond, of why pregnancy and the first two years of life matter so profoundly. Her leadership has kept babies and their families at the heart of the national conversation. I also commend the work of the CEO of the foundation, Will Quince, who previously served in this House and was a Health Minister, and of course I thank my distinguished colleague, the right hon. Lord Blunkett for all his work in this area. I want to refer to the late Baroness Tessa Jowell, who has been mentioned many times during this debate, and her pioneering work around Sure Start, which I will say a little more about later in my speech. I also thank Graham Allen, the former MP for Nottingham North, for all his work in this area. I am grateful to all the organisations, professionals, parents and carers whose advocacy and experience have shaped this debate.

I acknowledge the many excellent contributions we have heard today, but I will start with the outstanding speech made by my hon. Friend the Member for Washington and Gateshead South (Mrs Hodgson), who until this summer was an excellent Minister in the Department of Health and Social Care. In the 21 years that she has been a Member of Parliament, she has fought long and hard for the rights of babies and children, be that by promoting school food or free school meals or special educational needs, or in this case through all the work she has done to ensure Government support for the Bill. As she said, “Back our babies, back the Bill.” She has been campaigning on these issues for so long—indeed, as the right hon. Member for New Forest West said, “since God was a boy”. In my view it is “since God was a girl”, but I thank my hon. Friend for all the work she has done.

We have had important and wide-ranging contributions from Members across the House covering many issues, and I will highlight a few. My hon. Friend the Member for Dulwich and West Norwood (Helen Hayes), the Chair of the Education Committee, gave us the excellent phrase that is outside Sheringham nursery and children’s centre: “Building brains here”. I think that is very powerful. We heard from my hon. Friend the Member for Ribble Valley (Maya Ellis) that raising children is a public good and we all have an interest in it. The hon. Member for Twickenham (Munira Wilson) spoke about the important role of charities and the voluntary sector, of Home Start, and of the Extra Mile charity in her constituency. The hon. Member for North East Hampshire (Alex Brewer) talked about medical misogyny and domestic abuse, which are really important issues, and my hon. Friend the Member for Sherwood Forest (Michelle Welsh) talked passionately about her frontline experience of early intervention at Sure Start and, absolutely, the power of sitting down with a cup of tea and having someone to talk to. I also pay tribute to her role as the Government’s national maternity adviser, and her wise counsel in that role.

Dame Diana Johnson

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I will carry on, because I want to say something about other hon. Members. My hon. Friend the Member for Glasgow East (John Grady) spoke as a recovering lawyer and talked about safeguarding issues. I found his scrutiny of the Bill’s clauses interesting and important, and we will obviously reflect on that. I wish the hon. Member for Carshalton and Wallington (Bobby Dean) well as a new parent—I think he is the newest parent in the House, so all the very best with that. He talked about maximising the potential of every child.

My hon. Friend the Member for Edinburgh North and Leith (Tracy Gilbert) talked about surrogacy and made passionate comments about the surrogacy laws, particularly in respect of international surrogacy. My hon. Friend the Member for Croydon East (Natasha Irons) gave her personal reflections and talked about her community. The hon. Member for Chichester (Jess Brown-Fuller) talked with great skill and knowledge drawn from experience in her role on the APPG, and talked about the importance of support for mums. I add my best wishes to those of my hon. Friend the Member for Aylesbury (Laura Kyrke-Smith) to Hallie on her first birthday.

We heard about health inequalities. My hon. Friend the Member for Altrincham and Sale West (Mr Rand) talked about how investing in babies will provide the fairer, stronger and more prosperous country that we all want to see. My hon. Friend the Member for Mansfield (Steve Yemm) talked from the perspective of being a grandfather. My hon. Friend the Member for Tipton and Wednesbury (Antonia Bance) talked about temporary accommodation. My hon. Friend the Member for Lowestoft (Jess Asato) quoted one of my favourite Larkin poems—Philip Larkin was the librarian at the University of Hull for many years, and as a Hull MP, I know that poem very well—and talked about the importance of getting safeguarding right.

My hon. Friend the Member for Stoke-on-Trent South (Dr Gardner) spoke passionately on behalf of her constituent, Ashley, and baby Chloe. I am very happy to meet my hon. Friend and Ashley, and I am pleased to hear about the improvements that have been made at the Royal Stoke hospital. My hon. Friend the Member for Newport West and Islwyn (Ruth Jones) brought her experience and knowledge as an NHS professional to the debate.

Dame Diana Johnson

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I know that my hon. Friend has a great deal of experience in this area. My door is always open to Members of Parliament to discuss issues within my portfolio, so yes, of course I would be happy to meet those Members.

I want to say a little bit about the importance of the first 1,001 days. The Government have set out an ambition to raise the healthiest generation of children ever, and to give every child the best start in life. If we are to achieve that, we must begin at the very beginning. The 1,001 days from pregnancy to a child’s second birthday are a unique window of opportunity. During that short period, babies’ brains, bodies and relationships develop at extraordinary speed. The experiences they have and the care and support around them help to lay foundations for physical health, emotional wellbeing, communication and learning. I have seen that myself in recent weeks with the birth of my great-niece, Isabelle Diane.

A baby does not develop in isolation: their world is shaped by the adults who care for them. Supporting a baby therefore means supporting the whole family, helping parents and carers to build confidence, protecting their mental health, strengthening the parent-infant relationship and providing practical help with feeding and child development.

Dame Diana Johnson

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I will carry on.

That support must be accessible and compassionate. Parenthood can be joyful, but it can also be exhausting and isolating. Some families face the additional pressure of poverty, insecure housing, poor mental health or limited support networks. Early help cannot remove every challenge, but it can prevent difficulties from escalating and reduce inequalities before they become entrenched. That is why the child poverty strategy is also so important, alongside all that this Government are doing. Early intervention is not only the right thing to do for babies and families now; it is an investment in the future. When parents and carers receive the right help at the right time, children have a strong platform from which to grow, learn and thrive, and there is less need for costly crisis intervention later on.

I want to say a few things about Sure Start. We all know that well-designed support can make a lasting difference. Sure Start, launched in 1998 under the previous Labour Government, brought health, early learning, childcare, parenting and wider family support together for families with children under five. At its best, it offered a trusted local front door, with professionals working around the needs of the child and the family, rather than expecting families to navigate a maze of separate services.

The long-term evidence of the success of Sure Start is compelling. Research by the Institute for Fiscal Studies found that children with greater access to it experienced fewer hospital admissions later in childhood and adolescence, better educational outcomes, improved mental health and lower levels of school absence. That was felt even more profoundly by children growing up in disadvantaged communities. Very importantly, there is also a strong economic case. The central estimate is that Sure Start’s long-term financial benefits were about twice its up-front cost. That matters, because it shows that early support is not simply a desirable addition to public services, but can improve lives, reduce pressure on health and education services, and provide value for the taxpayer.

The lesson is not that every aspect of the past should be reproduced unchanged. It is that trusted local provision, early help, joined-up services and a clear focus on families can make a measurable difference. Those principles run through the Government’s approach today. Through the Best Start family hubs and the healthy babies programme, we are building a more joined-up, prevention-focused system of support. As part of the wider best start in life agenda, Best Start family hubs are designed to give families a clear route to the help and support that they need, making it easier for them to find information, advice and practical help, from pregnancy through to childhood. They bring together health, early education and wider family services, and connect parents and carers with support with parenting, relationships, child development, special educational needs and disabilities and financial wellbeing, and with community support. Since April 2026, all 153 upper-tier local authorities in England have been delivering the programme.

The healthy babies programme sits at the heart of the Best Start family hubs, providing focused help from conception to the age of two, particularly with infant feeding, perinatal mental health and parent-infant relationships. Those services support parents and carers to nurture their babies and promote healthy physical, social and emotional development. The Government are investing £200 million in healthy babies over three years as part of our wider £900 million package for Best Start family hubs and healthy babies. The healthy babies funding is helping 75 local authorities with high levels of deprivation to strengthen those services. The support is practical and preventive, and includes one-to-one and peer support with infant feeding, help with mild to moderate perinatal mental health difficulties, and evidence-based work to strengthen the relationship between parent and baby. The support also helps local areas to publish clear information and involve parents and carers directly in designing and improving services. Importantly, this is not a one-size-fits-all model. Local areas are responding to the needs of their own communities.

Effective support is about not simply making services available, but ensuring that parents, carers and expectant families feel confident seeking help and can access it when they need it. It means building on the strengths already present in communities, creating opportunities for families to support one another, and developing trusting relationships so that no family feel that they must face challenges on their own. Through the 10-year health plan, we are committed to expanding healthy babies nationally over the coming decade. We want to create a visible local offer, rooted in neighbourhoods and designed around families.

So why is the Bill needed? The Government are taking action to support babies and their families, but history shows us that effective early years support can be vulnerable when it depends mainly on time-limited programmes, non-statutory guidance or broad general duties. Priorities and funding arrangements change, and services that families value can lose visibility or become fragmented. As one of those who was around during the time when we had to fight to try to keep Sure Start in place, and who heard the warnings about how short-sighted it was to cut and dismantle the service, I know that the battle is really hard, so the Bill is very welcome.

The Bill provides a focused and proportionate response. Its central purpose is to ensure that the needs of babies, parents and carers are systematically understood, reflected in relevant decisions and made visible to Parliament. Pregnancy and the first two years should not be treated as a passing policy priority; they should receive sustained attention over time. The Bill does not create a new individual entitlement to a fixed list of services, and it does not prescribe a single model of what these services should look like. Instead, it creates a durable national framework, so that decisions on infant support services are informed by evidence, assessed need and the lived experience of families.

As we have heard, the Bill establishes five linked duties. First, the Secretary of State must make regulations specifying the publicly funded infant support services and relevant functions to which the framework applies. Secondly, the Secretary of State must assess the expected level of need for those specified services. Thirdly, in preparing that assessment, the Secretary of State must take reasonable steps to seek the views of parents, carers and those expecting to become parents or carers and must take those views into account. Fourthly, the Secretary of State must exercise the specified functions with a view to ensuring appropriate provision. Finally, the Secretary of State must report annually to Parliament on the level of provision and the contribution that those services make to positive outcomes.

The Government support the Bill because it aligns with our priorities. It advances our ambition to raise the healthiest generation of children ever and reinforces the work that is under way through the healthy babies programme and Best Start family hubs. For those reasons, the Government are supporting the Bill this afternoon.

The Minister for Public Health and Patient Safety (Dame Diana Johnson)

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It is a pleasure to serve under your chairwomanship this morning, Dame Siobhain. We have had a very thoughtful and well-informed debate on the Bill. I am grateful to all hon. Members who have contributed, but I pay particular tribute to the right hon. Member for New Forest West for introducing the Bill and for the care, determination and constructive spirit with which he has championed it. I will follow his lead and deal with both groupings in my remarks.

We can all agree that every baby should get the best possible start in life, and I am delighted that last month the Secretary of State for Health and Social Care announced the expansion of Healthy Babies to every local authority in England. Like Sure Start before it, Healthy Babies will make enhanced health support available in every part of England, giving all families access to trusted, practical help throughout the critical 1,001 days from conception to age two. The Bill will complement the Healthy Babies expansion by creating a clear and enduring framework for support from conception to age two, providing long-term visibility and accountability.

A number of important points have been raised in the debate today. First, the hon. Member for Chichester asked whether those undergoing IVF would be included as prospective parents. The Bill focuses on support from conception to age two, as we have heard, therefore parents who conceive through IVF will be covered from the point at which a pregnancy is established, in the same way as any other prospective parent.

The hon. Member for Chichester also asked about breastfeeding, and there were a number of contributions on that very important issue. She asked whether there would be support for it in the secondary legislation that would come forward. Our starting point for the secondary legislation will be the Healthy Babies offer, which includes maternity, health visiting, infant feeding support, perinatal mental health support and parent-infant relationship support, while remaining open to considering other services that evidence might show babies and families actually need—so the answer to that is absolutely yes.

We also heard from my hon. Friend the Member for Washington and Gateshead South. I pay tribute to her for all the work she did in her previous role to make sure that the Bill could come before us today and will move through its stages in the House. She made a thoughtful and well-informed contribution—as ever—in support of amendment 1. My hon. Friend the Member for Stoke-on-Trent South also supports amendment 1, and spoke so movingly about the very sad case of her constituent Chloe Wilshaw. I am glad that Ministers will be meeting my hon. Friend shortly.

My hon. Friend the Member for Newport West and Islwyn talked about her experience as a paediatric physiotherapist, and how important the support that families and mothers get from conception onwards is to ensuring that babies get the best start in life. My hon. Friend the Member for York Central made, as ever, a considered speech. She raised a number of points, including whether environmental issues would be considered. I was interested to hear the exchange between her and the right hon. Member for New Forest West on that point, and his belief that it is implicit in the Bill’s drafting that environmental issues would be considered, among others. The sharing of data among health and local authorities in respect of children at risk is absolutely a key issue that we need to work at.

The hon. Member for Sleaford and North Hykeham raised the workforce plan. I am told that we will not have to wait too much longer and that a workforce plan will be published shortly, but I take the point made by my hon. Friend the Member for York Central about the need for integrated workforce planning in respect of babies and children. I also recognise the need to include the voice and agency of families, mothers, fathers and carers in this whole issue.

Finally, pre-conception health is of course very important, but the Bill is deliberately focused on the clearly defined period from conception to age two, when support can be directly linked to pregnancy, childbirth and infant development. Extending the Bill further would significantly broaden its scope and duplicate wider public health policy.

Let me turn to the clauses. Clause 1 establishes the scope of the framework set out in the Bill. It requires the Secretary of State to make regulations specifying the publicly funded infant support services to which the Act will apply, together with the functions connected with their provision. Those services must support pregnancy or childbirth, an infant’s health and development, or the relationship between an infant and their parent or carer. Crucially, the clause allows services and functions to be updated as needs and provisions evolve, thereby helping support to remain relevant to babies and families. Any change will be made through regulations subject to parliamentary oversight. That approach allows the framework to evolve as evidence, services and families’ needs change. The regulations will be subject to the affirmative procedure, so both Houses will have an opportunity to scrutinise and approve them.

Clause 2 puts the needs and experience of infants, parents and carers at the heart of national decision making. It helps to ensure that babies, whose voices are too often unheard, are not overlooked. We all know that the period from conception to age two is a golden opportunity to shape life, health, learning and happiness. The clause therefore requires the Secretary of State to assess the expected level of need for infant support services specified in the Bill. This is a practical, evidence-informed approach. So that it can respond to the needs of babies and families as they change, the clause deliberately does not prescribe every detail of the assessment. It does, however, establish a clear expectation that need will be understood and kept under review, thereby helping to inform decisions about services and resources.

Dame Diana Johnson

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I am grateful to the hon. Gentleman for raising that point. We all understand how important health visitors are, and I acknowledge the reduction in numbers over previous years; this Government are determined to do something about that. I take his point. Given my responsibility for children’s health, I am very conscious that in health visitors we have a service with great potential. I am thinking particularly about improving vaccination rates; work is going on with health visitors on that. I will write to the hon. Gentleman with more specific details, but I absolutely take his point.

I return to clause 2. The Secretary of State must “take reasonable steps” to include the views of parents and carers as well as prospective parents and carers when carrying out the assessment. Just as we encourage local areas to shape services for and with families, national decisions should begin with the experience of babies and those who care for them; that goes to the point raised by my hon. Friend the Member for York Central. Some babies and families, of course, face additional challenges due to issues such as poor mental health, isolation, financial pressure or housing insecurity, and a regular assessment will help bring those pressures into view and inform decisions about the appropriate levels of provision.

It might help at this point if I turn to the amendment tabled by my hon. Friend the Member for Lowestoft. She has long championed the rights of children and the need to address inequalities, and she made her points in this debate with her usual eloquence and passion. I understand and welcome the challenge that she has made. She is right to press the Government to ensure that the assessment looks beyond expressed demand, considering both wellbeing and inequalities, and pays particular attention to those experiencing the greatest disadvantage. The Government share that objective.

It was always intended that the clause 2 assessments would consider health inequalities, drawing on evidence of unmet need and differences between groups and places. We intended—and I think the right hon. Member for New Forest West did, too—that that would be implicit in the drafting of the Bill. We have heard reference to section 149 of the Equality Act 2010 and section 1C of the NHS Act 2006, the public sector equality duty and the duty to reduce inequalities in access to and outcomes from health services. Together, they require particular attention to those experiencing the greatest disadvantage.

However, I absolutely understand the importance of ensuring that the assessment considers wellbeing and inequalities. Families do not experience need equally, and the assessment must pay particular attention to those facing health inequalities so that unmet need is identified and services can respond fairly and effectively. I would therefore welcome the opportunity to work with my hon. Friend the Member for Lowestoft and the right hon. Member for New Forest West to further consider the amendment ahead of Report. On that basis, I ask my hon. Friend whether she would consider not pushing her amendment to a vote at this stage and returning to it on Report.

Clause 3 concerns action. It builds on the assessment required by clause 2 and ensures that evidence of the needs of babies and families informs the exercise of the Secretary of State’s functions. The clause requires the Secretary of State, when exercising functions specified in the Bill, to act with a view to ensuring appropriate levels of service provision for infants, parents and carers, and prospective parents and carers. In doing so, the Secretary of State must have regard to the most recent assessment of need carried out under clause 2. That creates a clear link between understanding need and considering appropriate levels of provision.

The Bill deliberately does not impose a rigid or uniform national requirement. Needs, existing services and local circumstances differ, and an equal distribution of resources will not always deliver an equitable response. Instead, clause 3 allows the Secretary of State to take account of assessed need, differences between areas and the services already available. The level and type of provision may therefore vary, while the needs of babies and families remain central to decision making. This approach strengthens visibility and accountability, while retaining the flexibility needed to respond to circumstances changing. The needs of babies and families can change rapidly, and an agile response is required. Those 1,001 days cannot wait.

Clause 4 provides the accountability mechanism at the heart of the Bill. It requires the Secretary of State to prepare a report for each reporting period, and to lay that report before both Houses of Parliament. The report must assess the level of provision of the specified infant support services during the period, which will give Parliament regular and transparent information about the support available in England to infants, parents, carers, and prospective parents and carers.

Importantly, the report must consider not only what provision exists but the contribution that those services have made to positive outcomes in relation to pregnancy and childbirth, infant health and development, and the relationship between parents or carers and the infant. That includes examining those outcomes in the light of the needs assessed under clause 2. Clause 4 therefore completes the link between understanding need, considering the appropriate level of provision and reporting openly on the contributions that services are making to positive outcomes. By making provision and outcomes more visible, the clause will support sustained focus on babies and their families, and it will provide a clear basis for parliamentary scrutiny.

Clause 5 defines the Bill’s key terms. It defines an infant as

“a child under two years of age”,

which reflects the Bill’s focus on the earliest period of life, when the foundations for health, wellbeing and development are laid. It defines a parent broadly, including anyone with parental responsibility for a child or an infant. It also recognises carers who look after an infant without having parental responsibility. That inclusive approach reflects the range of family circumstances in which infants are cared for, ensuring that the Bill is not limited to one particular family structure or legal relationship.

Clause 5 also covers prospective parents and carers, meaning that the Bill can take account of people preparing to become responsible for an infant, whether through a current pregnancy or in relation to a child who has already been born. Those definitions do not create any separate duties or entitlement to services; they provide the clarity needed for the duties in the Bill to be understood and applied consistently.

Clause 6 contains standard provisions needed to bring the Bill into effect. It deals with territorial extent, commencement, transitional or saving arrangements and the short title of the Act. The Bill extends to England and Wales, but its substantive provisions apply to England. Clause 6 will take effect on Royal Assent, with the remaining provisions commenced by regulation, which allows time to prepare for implementation. As I have said, regulations specifying or changing the services and functions within scope will be subject to the affirmative procedure, giving both Houses the opportunity to scrutinise and approve them.

This is a really important Bill. It will help ensure that babies and families remain visible in national decision making, and that support during the critical period from conception to age two is informed by need, focused on outcomes and accountable to Parliament. I thank all Members again for their thoughtful and constructive contributions today. I pay tribute to the right hon. Member for New Forest West for introducing the Bill, and for his continued commitment to giving every baby the best possible start in life. The Government are pleased to support the Bill, and I commend it to the Committee.