Grand Committee
Arrangement of Business
The Deputy Chairman of Committees (Baroness Healy of Primrose Hill) (Lab)
My Lords, if there is a Division in the Chamber while we are sitting, this Committee will adjourn as soon as the Division Bells are rung and resume after 10 minutes.
Curriculum and Assessment Review
Lord Freyberg
To ask His Majesty’s Government what assessment they have made of the implications of the final report of the Curriculum and Assessment Review, published on 5 November 2025, for education in England.
Lord Freyberg (CB)
My Lords, I am delighted to be opening this debate and grateful for the number of noble Lords who have put their names down to speak. I confess I wish we had been granted more time, given the breadth and importance of this subject. I look forward to hearing all contributions, whatever the topic, and to the Minister’s response to what I am certain will be a well-informed and searching debate. I am grateful too for the many briefings I have received in preparation from a wide range of organisations, among them the Campaign for the Arts.
I intend to focus on arts education, though I will say a brief word towards the end about modern languages, where some difficult questions remain. The Curriculum and Assessment Review, published on 5 November last year, was an independent report led by Professor Becky Francis, and its findings carry considerable weight. The Government’s response deserves to be treated seriously. It acknowledges, clearly and without equivocation, that arts education in England has suffered a prolonged and serious decline—and that acknowledgement alone represents a change of tone that many in the sector had long been waiting for.
The scale of what has happened is worth stating plainly. Since 2011, the number of hours of arts teaching in schools has fallen by 23%. Since 2010, the share of GCSE entries in arts subjects has shrunk by nearly half and A-level entries have fallen by nearly a third. For nearly half of all young people aged 11 to 15—and for a majority when it comes to drama—school is their only contact with the arts. They do not participate in arts activities outside the school gate. When provision in schools declines, those young people do not lose some of their access to the arts, they lose all of it, and the burden falls hardest on those who can least afford it. Children in the most deprived areas are less likely to study arts subjects and less likely to access extracurricular cultural opportunities, creating what the Cultural Learning Alliance has called an entitlement gap. This is not a peripheral concern: it goes to the heart of what we believe education to be and what kind of society we wish to be.
Against that backdrop, the review contains much that deserves recognition. The proposal to abolish the EBacc has been widely welcomed by arts educators and their representative bodies. For 15 years, that performance measure squeezed arts subjects out of timetables, budgets and the thinking of school leaders who had little choice but to prioritise the subjects it rewarded. The reform of Progress 8, although still subject to consultation, signals a more inclusive conception of achievement. The Government’s second pledge in the executive summary, to
“revitalise arts education as part of the reformed national curriculum”,
is not a minor commitment. The arts are described, rightly, as an entitlement for every pupil rather than an optional extra. I welcome these commitments unreservedly.
The challenge, however, lies in the gap between aspiration and implementation, and it is a considerable one. The Government are pursuing an ambitious range of activity simultaneously: a reformed curriculum, an enrichment strategy, the National Youth Strategy, the schools White Paper, the National Centre for Arts and Music Education and the Hodge review of Arts Council England. These initiatives serve different purposes, and not all are primarily concerned with education, but those that are must be properly joined up if they are to deliver on the Government’s commitments. There is, for example, an apparent tension between the national centre’s reliance on leveraged philanthropy to fund activities that would previously have been covered by statutory schools funding, and the Hodge review’s parallel recommendation for an entirely separate philanthropic fund. I ask the Minister directly: is it either viable or desirable to place this much weight on philanthropy to fill gaps that statutory funding ought to cover?
Compounding this, the new National Centre for Arts and Music Education is reported to be operating on a smaller budget than the bridge organisations it replaces, only some of which will continue to receive support from DCMS. But even a well-resourced national centre could not on its own solve what is, in the end, the most pressing problem of all: there are simply not enough specialist teachers to deliver the arts subjects the Government have promised.
The Government have reduced initial teacher training bursaries for creative subjects at precisely the moment when the review calls for their expansion. The consequences are already visible. Drama is recruiting less than half its target number of trainee teachers; music is only just above half. The Campaign for the Arts has noted the obvious tension: the Government have pledged to put creativity at the heart of the curriculum, while simultaneously restricting the financial incentives that draw people into teaching those very subjects. I ask the Minister directly: how do the Government intend to build a revitalised arts education on a diminishing supply of specialist teachers, and will they reconsider the bursary position?
I will add a broader question about how the arts subjects are valued, not merely in policy documents but in public discourse. For too long, arts and humanities subjects have been set in opposition to STEM, as though the two were competing rather than complementary. That false hierarchy has been entrenched by the marketisation of higher education. When universities become dependent on student fees, students become customers, and subjects begin to be valued, or devalued, according to their perceived market worth. The arts and humanities have suffered on both counts: devalued in the league tables that drive student choice and devalued culturally in a discourse that has come to equate worth with starting salary. This is the context in which the review’s commitment to parity of esteem between subjects must be understood. It is why that commitment, if it is to mean anything, will require more than warm words in a curriculum document.
Finally, I will say a brief word about language—not the language of the review, but modern languages as a subject. The abolition of the EBacc is, on balance, good for arts education, but it carries a real cost for languages, which derived much of their school-level protection from that same performance measure. There are already reports of head teachers reducing GCSE languages provision in direct response to the removal of the EBacc. University departments have been contracting for years. Since January alone, closures or reductions have been announced at Leicester, Nottingham, Heriot-Watt and Essex. In 2024, fewer than 3% of A-levels were in languages; PE attracted more entries than French and German combined. Can the Minister say what steps the Government are taking to ensure that the gains for arts education do not come at the further expense of languages? The case for an advanced language premium, along the lines of the advanced maths premium, has to be considered.
The Government have made a public commitment to every child having access to high-quality arts education, regardless of background or postcode. The ongoing consultation on Progress 8 and the new curriculum expected in 2027 represent a genuine opportunity to get this right. I look forward to hearing how the Government intend to take it.
Lord Watson of Invergowrie (Lab)
My Lords, I congratulate the noble Lord, Lord Freyberg, on securing this important if brief debate. There was much to welcome in both the Curriculum and Assessment Review and the Government’s response to it. Like the noble Lord, I welcome the end of the damaging EBacc obsession from the now noble Lord, Lord Gove, which will pave the way to a broader curriculum with stronger access to music, art, sport, drama and vocational subjects. I was not aware of the point that the noble Lord raised about the threat to language learning; I note that and will take it up in future. It was also pleasing to see the report’s emphasis on oracy and, even more, the Government’s recognition of oracy as a foundational skill alongside reading, writing and maths.
The review said that it is important to ensure that assessments test what pupils should be learning, not just what is easy to measure. It then went on to say:
“We consider that the Key Stage 2 assessments are generally performing well”.
That view is not widely shared by educators at primary level, and I and others regret that the Government did not counter it in their response. Many primary school teachers, school leaders and parents had hoped that the Government would take account of the evidence on the harmful effects of the statutory primary assessment system, including year 6 SATs, year 1 phonics checks and year 4 times tables checks. A system that places data collection and whole-school accountability ahead of prioritising the love of learning and children’s well-being has inevitable consequences. Teaching to the test and a narrow curriculum mean that, for many children, year 6 is spent cramming for the end-of-year exams, focusing on maths, English and little else. Research from the UCL Institute of Education indicates that this is particularly common in areas of high disadvantage.
Research has shown that three-quarters of parents think that SATs harm their children’s mental health, as the stress and anxiety of GCSE-style exams at the age of 10 or 11 take their toll. The review claimed that it would emphasise inclusion, belonging and a curriculum that values every child for who they are. Instead, the review recommended that more children spend more time preparing for government tests, including children with SEND. Some 76% of children with SEND do not reach the expected standard in SATs, while 91% of children with EHCPs do not reach that expected standard. For many of these children, preparing for SATs is the start of school avoidance, which often carries over to secondary school.
The call for meaningful reform of primary assessment from school leaders, teachers, parents and children will not go away, because the problems with SATs persist. Head teachers will continue to struggle to recruit and retain year 6 teachers, and too many parents will continue to see damage to the mental health of their 10 and 11 year-olds. There is still time for the Government to listen to those who know children and their education best, and I hope that discussions to that effect can take place in the near future.
Baroness Sater (Con)
My Lords, I thank the noble Lord, Lord Freyberg, for securing this important debate. I will focus briefly on two areas: financial education and physical education.
On financial education, I welcome the review’s recognition of financial literacy, budgeting and wider life skills in the curriculum. With reforms expected by 2028, we now have a critical window to get this right. The proposals to strengthen financial education in secondary schools and to extend it into primary schools are absolutely a move in the right direction. We know that, if young people start early, they develop good money habits and build confidence in managing their finances.
Financial education has been statutory in secondary schools for over a decade, yet, as the Money and Pensions Service has reported, only around half of children receive a meaningful financial education. As the charity Young Enterprise has said, curriculum reform on its own is not enough: teachers need proper support, including training, clear guidance and high-quality resources.
The APPG on Financial Education for Young People, of which I am an officer, has also made it clear that financial education is not being adequately measured in our schools. Until it is inspected—for example, through Ofsted—it will not be prioritised, and, unless we focus on delivery, we risk repeating the same mistake we have seen in our secondary schools. So I do hope the Government will ensure that this is properly resourced, inspected and given protected curriculum time, because it is a life skill that every child deserves.
I turn now to physical education. We know that children are not getting enough physical activity. With huge concerns around high childhood obesity, mental health and well-being, schools are one of the few places where we can reach every child at scale. Once they leave, we lose one of the best opportunities to shape their lifelong healthy habits. There is already an expectation of around two hours of PE each week. However, as the review highlights, this is not delivered consistently—particularly in secondary schools, where the curriculum pressure is greatest. All too often, PE is squeezed out rather than protected.
The review rightly recognises that improving PE is about strengthening delivery, consistency and the conditions that schools need to make it happen. However, I also believe that we should be more ambitious. The Chief Medical Officer recommends around 60 minutes of physical activity a day for children; that should be our direction of travel, properly embedded into the school day. As Ali Oliver of the Youth Sport Trust said:
“By increasing physical activity levels in schools, we can develop children who are happy, healthy and ready to learn”.
I recognise that we cannot endlessly add to the curriculum, but, equally, we cannot continue to treat health and well-being as a secondary consideration. That is why physical education matters.
Finally, I urge the Government to go further by ensuring that financial education is properly resourced and given the priority it deserves, and by placing physical education at the heart of school life. If we want financially capable and physically healthy adults, we must start in our schools.
Baroness Garden of Frognal (LD)
My Lords, we broadly welcome this report as it shows more commitment to the arts and creative subjects, and sees the end of the EBacc, which focused so heavily on academic learning. As the noble Lord, Lord Freyberg, said, it has been sad indeed to see music disappear from many schools, along with drama, dance and art, particularly as the creative industries are sources of pride and economic well-being in the country.
Students will welcome the greater choice offered. There will be challenges in ensuring that the depleted teaching workforce for these subjects is re-energised, with more teachers being recruited. Can the Minister say how teacher recruitment is going for the creative sector? We also need reform of GCSE English and maths—neither currently encourages young people to pursue these subjects—and we continue to face an acute shortage of science teachers, particularly physics teachers. Do the Government have a plan to remedy that?
We are concerned by the new V-level proposals. T-levels have not caught on as the previous Government hoped. BTECs are understood and accepted by employers, colleges and universities. It takes a while for a new qualification, particularly a vocational one, to become known and accepted. I was working for City & Guilds when NVQs, or national vocational qualifications, were introduced—remember them? It was said that they would simplify the vocational offerings and be the lasting solution to the academic/vocational divide, but where are they now?
The Deputy Chairman of Committees (Baroness Healy of Primrose Hill) (Lab)
My Lords, there is a Division in the House. The Committee will adjourn for 10 minutes, but these votes may be back to back, so we may adjourn for 30 minutes; we will have to see what happens with the voting.
Baroness Garden of Frognal (LD)
My Lords, as I was saying before I was so rudely interrupted by the votes, national qualifications were supposed to be the lasting solution—and where are they now? I remember the concerns people had that the qualifications which had shaped so many careers were to disappear. We tried to reassure them that they would be City & Guilds NVQs, which calmed some of the storms, but with City & Guilds currently in the doldrums that will not be so easy this time round.
The current creative qualifications are broadly understood and respected. Why create something new, rather than refurbish the existing? We also note that overly prescribed content will not support those SEND learners who currently thrive under a flexible, adaptable and practical-based curriculum. Will the Minister slow down the pace of reforms and retain funding for the successful creative qualifications, at least until T-levels or V-levels have proved their worth, because they certainly have not yet? It is vital to consult further education colleges and tutors, universities, schools and awarding bodies which know at first hand the value of the qualifications they deliver. The awarding bodies were not fully consulted in the development of T-levels, which meant that mistakes were made.
I associate myself most warmly with the very real concerns about modern languages. If I had more time, I would develop my arguments on those, but I must stick to the time here: just rest assured that modern languages are pretty essential to our future, too.
The futures of our young people—the future creative professionals and international ambassadors who could contribute much to the quality of our lives and to the economy—are at stake. However, I congratulate the Government on rowing back from the exclusively academic programmes of their predecessors.
Baroness Caine of Kentish Town (Lab)
My Lords, developing a cutting-edge curriculum to equip children and young people with the essential knowledge and skills which will enable them to adapt and thrive in the world and workplace of the future was a key purpose of this review. Media literacy and digital literacy were two of the top five issues raised by young people and stakeholders in the review process. The definition of media literacy used in this review was
“understanding and engaging critically with the message conveyed through different media channels, including AI”.
However, Ofcom, the body charged with the responsibility for monitoring and overseeing the delivery of media literacy in the UK, uses this definition in its three-year strategy on it:
“the ability to use, understand and create media and communications”
in a variety of contexts. The difference is apparent.
Using and studying creative media content was absent from the consideration of the curriculum review. Why was it missed out? Is it part of the arts? Yes, and the review did deep dives into other arts subjects, but not these. Was it not seen as important to the future of the economy and the future of work, while film, TV and computer games are priorities for support in the creative industries strategy, and createch is growing apace? Was it not seen as societally relevant?
Most culture that people and young people consume is screen-based, and most creative work they make and exchange is on TikTok and will only grow with AI. Unlike other arts subjects, it was not part of the existing national curriculum, and following the philosophy used to approach the review—evolution not revolution—it had no formal foundations in the curriculum to evolve from. Whatever the reason for not addressing it, the result is that questions need to be asked and answered.
GCSEs and A-levels are currently available in media, film and TV studies. Though the take-up is relatively small, with 26,500 at the moment, it is one of the arts subject areas that is seeing an uptick in applications. Are these subject areas recognised as ones that will stand alongside others that have been identified and be given equal status, alongside performance measures and the reformed Progress 8? Do they need to be looked at, revitalised and updated? Are they rigorous enough? Will they be included in the National Centre for Arts and Music? There is one T-level for broadcast and media. Do there need to be VQs, and how will they align with existing qualifications?
To summate, I believe that this was an omission in the curriculum review. There is a good reason for that omission to be remedied as a matter of priority, so that we can be reassured that the appropriate focus and scrutiny, with attendant recommendations, have been done to inform content and planning for the very welcome and much needed new national curriculum. I look forward to the Minister’s reply.
Baroness Burt of Solihull (LD)
My Lords, I congratulate the noble Lord, Lord Freyberg, on securing this debate. It is much needed. I agree with a lot of the comments that have been made so far. I want to go a little off-piste and talk about teaching about religion and belief in state schools, which, according to the courts, must be conveyed in a way that is objective, critical and pluralistic. That principle reflects the wider human rights framework governing education and has been reiterated over a number of years in domestic and European case law. In England, the High Court in Fox v Secretary of State for Education drew attention to the importance of ensuring that pupils receive a balanced understanding of the diversity of beliefs present in modern society, including non-religious world views such as humanism. The judgment highlighted concerns that such perspectives should not be treated as marginal or incidental but rather form a meaningful part of pupils’ education about religion and belief. More recently, the Supreme Court in Northern Ireland, in case JR87, reaffirmed that same principle, upholding the finding that elements of the religious education curriculum there were not sufficiently objective, critical and pluralistic because they effectively privileged particular religious perspectives. Importantly, the court also made it clear that the existence of a parental right of withdrawal cannot compensate for a curriculum that does not meet the required standard.
In the light of that developing case law, and given that the Curriculum and Assessment Review suggested that religious education may in due course be brought within the national curriculum, can the Minister say what assessment the Government have made of the implication of these judgments for religious education in England? What steps will they take to ensure that RE across the English school system is strengthened so that it reflects the full diversity of both religious and non-religious beliefs in contemporary England?
Lord Hampton (CB)
My Lords, I thank my noble friend Lord Freyberg for getting this important debate and declare, as ever, that I am a secondary school teacher. Several people have asked me recently why I always declare myself as a teacher, and I always answer, because I have to, but I would anyway. I am very proud of being a teacher. People tend to be interested when you say you are a teacher. I think this goes back to the Blair years, when the status of teachers rose dramatically. I am optimistic that with the CAR, the response and the White Papers we have the opportunity of a similar renaissance.
On Wednesday, I chaired a meeting of the APPG for Art, Craft and Design in Education. The subject was continuing professional development. We heard about pedagogy, assessment objectives, autonomy, skill control and even multimodal ephemeral text. I asked the question, “What about fun?” They brightened and said, “Oh yes, we forgot to mention it was really good fun”. We have forgotten the fun. According to the National Literacy Trust, only one in three 8 to 18 year-olds enjoys reading. School refusal is at an all-time high. My answer, which is in the CAR, is to teach less content—not dumbing down but giving more space for context and criticism. Obviously, I have read enough cognitive science to know that the fundamental core of knowledge needs to be taught and drilled. I shall give the Committee an example. If I have time, I teach a lesson to my year 10 product designers on tampons, condoms and anti-personnel mines. All are designed with the human body in mind. They are designed to interact with the human body. The mine is designed to maim rather than kill. They are all designed by product designers. That lesson reinforces the concepts of anthropometrics, ergonomics, ethics and sustainability—all of which are core curriculum topics—but in a memorable way.
As the noble Baroness, Lady Burt, has touched on, we also need to get rid of compulsory religious studies and replace it with a compulsory citizenship GCSE, which would mix issues such as religion versus humanism, financial and media literacy, and politics—perhaps with trusted partners such as BBC Verify and Bitesize Other Side of the Story. We need more time for CPD for teachers to remind them why they became teachers. If teachers are having fun, they are the best ambassadors for a profession that is still struggling to recruit; and if children are having fun, they turn up to school and they fulfil their potential.
Baroness Ramsey of Wall Heath (Lab)
My Lords, last night I went to see my 17 year-old daughter perform in her final show at the BRIT School in Croydon. There were tears aplenty as a hugely talented bunch of students took their final curtain call. The good news for them is that the world of entertainment is a major employer: the Government estimate that over half a million work in those industries. It is undoubtedly very competitive too, but if you go to the right school and study the right qualification, you have a head start.
The Guardian newspaper put it better than I could just last month:
“As the Grammy winners took to the stage in Los Angeles on Sunday night, one common thread emerged: many had once walked the halls of a comprehensive school in Croydon, south London”—
the BRIT School. Just in case any noble Lords do not have Olivia Dean, Lola Young or Raye on their Spotify playlists, all of whom won Grammys last month from the platform of a BRIT education, then I also mention Adele, Amy Winehouse and Tom Holland. Why am I talking about where Spider-Man went to school, I hear noble Lords ask. It is simply because there seems a serious risk that the education he benefited from is under real threat. It is of course not just his, but the education of all these other stars too and so many other performers, less famous to be sure, but none the less all making an important contribution to the UK economy as well as giving pleasure to audiences home and abroad.
What is this risk? It is simply that the BRIT and all other post-16 education producers will be prevented from offering the extended diploma assured by the University of the Arts London in future—or indeed anything like it—for the extraordinary reason, it seems, that the extended diploma is too large. Apparently, the right thing for all 16 and 17 year-olds interested in the vocational path is to take three small qualifications, because that is what A-level students do, even though T-level students do not—I hope noble Lords are keeping up.
Where on earth has all this come from? It seems that someone, possibly in Whitehall, has taken a perfectly understandable recommendation from the Francis review and turned it, for some inexplicable reason, into a very unhelpful one. The Francis review drew attention to the variation in quality of some level 3 vocational qualifications and recommended investment in
“aspirational, coherent, recognised and respected vocational and applied qualifications, to sit alongside A Levels and T Levels”,
called V-levels. It went on to say that the majority should be the size of A-levels but, crucially, that there should be large ones, including for creative subjects, as for T-levels.
Thus far, the Government’s response—drafted, I suspect, by civil servants who did A-levels and do not have a single vocational qualification between them—stated that having large V-levels alongside T-levels would “create confusion”. This is plain silly. More than this, it is pointlessly destructive of world-beating creative vocational education, which is why it is not what Professor Francis and her expert team review recommended, and why it is not what fabulous schools such as the BRIT teach their students. Does my noble friend the Minister, who I am absolutely certain had nothing to do with this silliness, agree that it is not too late to think again, do the right thing and back the wonderful provision that already exists?
Lord Clement-Jones (LD)
My Lords, I thank the noble Lord, Lord Freyberg, for securing this debate and so brilliantly illustrating the “arts dividend” in education—the phrase used by Darren Henley, CEO of the Arts Council England. The Francis review contains important proposals, but the response to it falls short on the issue that will hugely determine our economic and democratic future: AI literacy. Media and digital literacy is, in Internet Matters’ own words, “a postcode lottery”.
I have three specific concerns. The first is institutional agility. I welcome the media literacy action plan published just 10 days ago, in particular the £24 million TechFirst youth programme and the continued investment in the National Centre for Computing Education. But the plan confirms what we feared: curriculum consultation will not begin until later this year. The revised programmes of study will not be published until spring 2027 and they will not be taught until September 2028. The Government’s own foreword acknowledges that one in seven adults avoids the internet altogether due to safety concerns. They cannot simultaneously diagnose that level of digital anxiety and offer a curriculum solution that is nearly three years away. We need to establish an AI in education advisory board, as suggested by Policy Connect in its report, Skills in the Age of AI, to provide real-time expert guidance, ensuring that the curriculum becomes a living document and is not a decade behind the technology.
My second concern is curriculum philosophy. AI literacy must be a mandatory cross-curriculum competence from age seven to 18, prioritising ethical use, critical thinking and the human-centred skills that AI cannot replace. All this is, of course, to be found in the arts and humanities. There is a democratic dimension that the Government cannot ignore. They intend to extend the franchise to 16 and 17 year-olds. Research by Internet Matters, confirmed by the Electoral Commission, shows that digital literacy is directly linked to young people’s capacity to engage meaningfully in democracy. If the Government extend the franchise, they need to equip young people with the literacy to navigate the information environment.
My third concern is the teaching workforce. Teachers are the primary multiplier for these skills, yet 30% cite a lack of relevant training as a barrier and 21% cite a lack of up-to-date resources. AI literacy must be embedded in initial teacher training, the early career framework and national professional qualifications. The action plan’s commitments on teacher support are welcome but conspicuously vague.
I ask the Minister three questions. What provision will be made for children in school now, before 2028? Will the Government establish an AI in education advisory board? When will a funded plan to integrate AI competences into statutory teacher training be published? We cannot build an AI-ready economy on a digitally illiterate workforce. Education must come first, not last.
Viscount Hanworth (Lab)
My Lords, there are four key stages that have mandatory elements in the maths curriculum. The fourth stage concerns pupils aged 14 to 16. Here there is an abundant list of topics that the student should be taught and which they might presume to know by the age of 16. The list is both complete and unexceptional. My primary interest is with stage 5, which corresponds to ages 16 to 18 and is the stage at which students prepare for their A-level examinations. Nothing at all is specified in the national curriculum for this stage. Nevertheless, at this level, the topics and methods of teaching and the texts of mathematics have hardly changed over the course of half a century or more.
The fact that there has been so little innovation has a simple explanation. Little has changed in the exam papers set by the various boards of examiners, which tend to concur on what is appropriate. The boards are predominantly owned by large publishers that have made considerable investments in producing A-level texts, which they are understandably unwilling to revise. Typically, these texts are lavishly produced with a liberal use of colours, but they are turgid and uninspiring, and unattractive to many students.
The number of students pursuing mathematics at this level is by common consent far lower than is needed to service the demands of the nation. There are too few graduates to satisfy the competing demands of education on the one hand, and of industry and commerce on the other. Teachers who are maths graduates are not liable to remain long in the teaching profession: they are lured away by the higher salaries on offer elsewhere. Therefore, a large proportion of those who teach mathematics in schools have derived their knowledge in pursuit of other subjects such as economics, accountancy, the physical sciences, life sciences and even geography. Many do an excellent job, but many teach with a degree of diffidence that is often perceived by the students.
Why is the diet so turgid and indigestible? I contend that it is a legacy from the mathematicians working at the end of the 19th century, when the dominant programme was to secure the axiomatic basis of mathematics. This led to an abstract and brutal style that found its way into the textbooks at the higher levels. It gave rise to a didactic style that filtered down to the lower levels. The diet can be rendered palatable by taking care to associate the elements of a mathematics course with the social, historical and scientific context from which they have emerged.
The Earl of Clancarty (CB)
My Lords, I congratulate the noble Lord, Lord Freyberg, on a brilliant opening speech. I believe in two things with regard to school education. First, education is a good in itself. Secondly, a well-balanced education allows students to try out different things and see where their real interests lie. I am particularly grateful for the briefing from the Independent Society of Musicians. I want to make three points: one on accountability measures, the second on teachers and the third on higher education, on the basis that, in the context of this debate, what happens in higher education has a feedback effect on education in schools.
The EBacc shut out art subjects, so its demise is not mourned. Progress 8 is still with us, although the Government, backed up by their vocal support for art subjects, have pledged to reform Progress 8 further. But there is concern that in the new model, with two guaranteed slots in the science bucket, it is still too heavily weighted in favour of the sciences, while humanities, languages and creative subjects slug it out for slots five and six, so that creative subjects can still be ignored, as can languages. The idea of bringing in an extra science subject into the so-called breadth bucket would reinforce this bias even further. There is therefore the question whether some schools may not need to make any changes to the arts curriculum, as they should.
My questions to the Government are: first, what monitoring will be carried out to ensure that the changes that they would like to see in the arts offering in schools will come about? Secondly, will they address the severe shortage of arts teachers, because the arts curriculum that the Government would like to see will not be effective without the specialist teachers required? If the 6,500 more teachers are not subject-specific, how will this be achieved?
Finally, it is important to call out the truly unhelpful remarks made last month by the shadow Education Secretary, Laura Trott, on the programme “Sunday with Laura Kuenssberg”, when she described creative arts courses as “dead-end university courses”. She would like to see more apprenticeships, as many of us would, but she completely misunderstands two things. One is the nature of creative arts courses, which, whether we are talking about the visual arts, film or the performing arts, have always, by their nature, been college-framed courses. They cannot be turned into apprenticeships. Secondly, these are vocations, not dead ends. It is the vocation, not the salary, that is the purpose. If you remove these courses—and they are already vulnerable in the current higher education system—you effectively remove irreplaceable opportunities for a vast number of young people.
I should add that I agree with everything that the noble Baroness, Lady Ramsey, said about the existing qualifications for the Brit School, which should not be changed0.
Baroness Keeley (Lab)
My Lords, I, too, congratulate the noble Lord, Lord Freyberg, on securing this short debate and introducing it so well. I thank the ISM—the Independent Society of Musicians—Dr Anthony Anderson and Professor Adam Whittaker of Birmingham City University, and Dr Robert Gardiner of the RNCM, for their analysis and briefings on the implications of the Curriculum and Assessment Review for music.
The review found that inequalities in music education are substantial, with music showing the widest disadvantage attainment gap of any subject, driven by unequal access to instrumental tuition and wider inequities in school and community resources. I have also raised with Ministers the fact that music teacher supply is a related problem. Since 2010, we have seen persistently high vacancy rates for music teachers. In fact, in 2023-24, that vacancy rate was among the highest of all subjects, and the Department for Education has missed its music teacher recruitment target in 12 of the past 13 years. There was a small increase in recruitment during 2024-25, after the brief return of the £10,000 bursary, but recruitment still reached only around 40% of target.
The conclusion is clear. The music teacher bursary must be restored. The Government’s opportunity mission makes it clear that we want high-quality music and arts education for every child in all state-funded schools. The curriculum review has recentred music and arts as core to a rounded education, not as optional extras, and it has challenged the narrowing of the curriculum that has squeezed music out of timetables, particularly in disadvantaged areas.
But these are only starting points. Organisations such as ISM are clear that curriculum changes alone will not close the participation gap for pupils from low-income backgrounds, who remain much less likely to take GCSE music and, when they do take it, achieve lower grades because cost is still a major obstacle. For too many families, paid lessons and instruments are out of reach, so school provision is the only option. But, as we have heard, shortages of specialist teachers—particularly specialist music teachers, especially in primary schools and in some regions of the country—limit what can be offered.
The Francis review and the Government’s response to it mark a welcome change of direction, but I ask my noble friend the Minister whether the Government will consider two steps that could genuinely close that participation gap. The first is the return of the music teacher bursary, which makes a career as a music teacher possible for those who would otherwise be unable to afford the cost of tuition. The second is the implementation of the Hodge review’s recommendation that the DfE, DCMS and Arts Council England work with philanthropists, trusts and foundations to create a joint fund to improve the cultural offer in schools, including the cost of training and paying for specialist teachers, now that we have the very good news that the Government have accepted all the recommendations of the Hodge review. If we are serious about opportunity for every child, those are the levers that we need.
Lord Addington (LD)
My Lords, looking at this debate, what strikes me as the most unloved thing in the Room is the EBacc. The fact that we have an overemphasis on academic standards has squeezed out the fun bits. If I had longer, I would go over many of the speeches, but the noble Lord, Lord Hampton, bringing the condom and the landmine into the same sentence, along with the tampon, is something that I will try, but will probably fail, to drive out of my brain. The main thing to say is that something that makes school entertaining and keeps you engaged has often driven up attainment in academic subjects. PE is established here, and arts and other creative activities also have a similar record. How do you bring this in? I suggest that the Government look again at something that they have done in PE, which has had a degree of success—the school sports partnership.
This is not about an elite-level pathway; this is about participation. It is about somebody taking on something and getting something back from it. There may not be national bodies for things such as the arts, am-dram and music, but people are doing this out there. I would hope that the Government have some interaction with the voluntary sector, where people do something that is fun and adds to their life. I have known dyslexics who will read a document about something that they are interested in and try several times to get it. They put far more effort in than they will do into some random piece of literature, no matter how highly it is esteemed by certain academics. They will engage with it, and people who have something to engage with positively in the school experience will do better. I hope that the Minister, when she comes to answer, will at least say that the Government are looking positively at this, because there is a whole group of people who can feed into the system.
Music would be a real benefit. Somebody once described to me that if you give a violin or a piano to a child to learn the basics on, it is a choice between being shot or hanged for many parents. Why do we not expand this to a guitar or a set of drums? This is possibly a different form of death, but you get the idea—these are things in which people can engage. Look to what talks to you in your own language, or language that is accessible to you, and you have a chance of expanding people’s horizons and upping their academic attainment.
Baroness Barran (Con)
My Lords, I, too, would like to thank the noble Lord, Lord Freyberg, for his excellent introduction and for securing this short debate. As we have heard, the Curriculum and Assessment Review built on the work of the previous Government and is described as “evolution not revolution”. I briefly acknowledge the work that the last Government did in important areas: strengthening the evidence base around early reading, expanding the use of phonics and other structured programmes, investing in tutoring to help children to catch up after the pandemic and setting a much clearer expectation for a knowledge-rich curriculum.
We on these Benches welcome the chance to strengthen the curriculum, while in no way wishing to sacrifice the emphasis that has been placed on reading, writing, maths, sciences and modern languages, and ensuring that children can access the breadth of education, which noble Lords have expressed so eloquently today. We definitely share with the noble Lord, Lord Freyberg, the concerns about the impact of losing the EBacc on the uptake of modern foreign languages. We also have concerns about some of the proposed changes to the Progress 8 measure, which is out for consultation; the ill-famed soft bigotry of low expectations risks sneaking back into our schools.
We have seen a dramatic improvement in the global rankings for our children in reading, maths and sciences, yet I think all of us who have spoken in this debate want to see more enrichment opportunities for our children. Therefore, can the Minister say, first, what consideration the Government have given to the community budget that was available to schools to allow them to open their facilities to their wider community, such as swimming pools, sports facilities or drama facilities? My understanding is that the grant is gone, but surely that would be a way to use those facilities more. Secondly, what consideration has been given to building on the work of multi-academy trusts that are offering a longer school day? Some trusts add an hour a day—that is a year of extra time for a child’s education to include a bit of fun.
Baroness in Waiting/Government Whip (Baroness Blake of Leeds) (Lab)
My Lords, I am very conscious of the richness of this debate, and I thank the noble Lord, Lord Freyberg, for instigating it and everyone who has participated. I acknowledge that I have 10 minutes to comment on the incredible breadth that has come from the Room. I will touch on as much as I can, but of course it comes with the caveat that, if I cannot specifically answer some of the points raised, I will endeavour to follow up in the usual ways.
A good-quality curriculum should support educational success, ignite curiosity, introduce fresh perspectives, and lay the foundations for a rich and fulfilling life and career. I note the comments from the noble Lord, Lord Freyberg, on disadvantage, impact and entitlement, as well as those from the noble Lord, Lord Hampton, on fun—that is always missed out. I like the way he included teachers in that; that broadens it out a bit, but he is absolutely right that we need enjoyment and engagement.
We know that too many young people are leaving education without the essential knowledge and skills they need to thrive and adapt in a rapidly changing world, as noble Lords have mentioned. That is why we commissioned the Francis review, and we recognise the need to have join-up. I absolutely challenge from the start any suggestion that we are allowing low expectations to creep back in—that is the furthest from our intentions behind the work we are doing. We realise that too many young people have been let down, and we must make sure that we reverse that.
We will refresh our national curriculum and publish it in spring 2027, so that it can be taught from September 2028. Therefore, there is still time to engage in the process. The new national curriculum and GCSEs will have improved coherence, clarity and sequencing, so that every child leaves school having mastered the subjects they have been taught. As we have heard, it will need to be strong in skills, thereby preparing young people for life and careers in a changing world. It will deliver high standards for all and rock-solid foundations in oracy, reading, writing and maths, as well as providing an engaging and stretching key stage 3.
I could not agree more with the comments from the noble Baroness, Lady Sater, on financial literacy. It is clearly missing. It is so important—particularly for the most vulnerable children, such as our looked-after population, who desperately need this. I really welcome the focus on this but, of course, there is much more to do.
To drive the standards we are determined to deliver, we must support an appropriate transition from key stage 2 to key stage 3 for all pupils, as well as for the teachers who teach them. I thank my noble friend Lord Watson for his intervention on the primary assessment system. SATs play an essential role in our education system. The review panel was clear that, from its perspective, the system of primary assessment is broadly working well, but we have to make sure that such systems are subject to robust development processes, including reviews, to ensure that they are tailored to and reference children with special needs in particular; that point has been made well. Also, where appropriate, there is a range of access arrangements. Children should not be fearful of these experiences of being tested; that, I think, is the concern.
On arts education, which has obviously been the key thrust of today’s debate, we must make sure that a revitalised process for all is at the forefront of our reforms. The arts help young people develop their creativity and their confidence, benefiting their mental health, well-being and attitudes to learning. Our reformed curriculum will ensure that art and design, music, drama and dance spark creativity, with clear progression for all pupils so that their developing practice and knowledge build towards a set of meaningful outcomes.
In addition, the response to my noble friend Lady Hodge’s review—handily, it came out today; timing is everything—confirms that the Government will accept or explore the recommendations. Arts Council England will play an important role in realising this ambition, and we will work with it to improve access to excellence in arts education and enrichment.
Picking up on the comments made by my noble friend Lady Keeley and the noble Lord, Lord Freyberg, philanthropy is an interesting subject. The arts in this country depend on philanthropy, so we have to make it work better and align with our priorities. The Hodge review aims to create a joint fund in this area; we are not yet clear on whether we will move down that road, but it is essential that we bring together the thinking on this from the National Centre for Arts and Music Education.
On the comments about the National Centre for Arts and Music Education, I can confirm that a budget of £13 million will be set aside for the first three years of a six-year programme. This will be commensurate with the establishment of other centres, supporting schools in the teaching of music, art and design, drama and dance through a programme of professional development, recognising just how important is that teacher training keeps up with the demands.
The noble Earl, Lord Clancarty, talked about the supply of music teachers. In art and design and in music, we have seen remarkable growth in the strength of our teaching workforce. Over the past two years alone, the number of new trainees entering art and design and music has risen sharply: between 2024-25 and 2025-56, postgraduate teacher training recruitment in art and design increased by an outstanding 117%, and, in music, by an impressive 54%. Bursaries for initial teacher training are reviewed annually to ensure that they continue to support recruitment where it is most needed.
There was a lot of interest in Progress 8. This is a key subject. I wish I had more time to go into it, but the review found that the uptake of EBacc subjects did not translate into increased study of them at 16 to 19, and EBacc measures have unnecessarily constrained subject choice. It is out for consultation. Please can everyone make sure that they engage in that process to get the richest possible response.
In answer to the noble Baroness, Lady Sater, physical education is a foundation subject in the national curriculum and compulsory at all four key stages. It is very important to make sure that the dance and swimming content, for example, is included.
The noble Baroness, Lady Garden, talked about V-levels, which were raised by a number of noble Lords including my noble friend Lady Ramsey and the noble Earl, Lord Clancarty. It is vital that we get this right. We need clearer level 2 routes through. I reassure noble Lords that we are working with the sector in the rollout.
Modern foreign languages are the subject of huge concern. We are determined to make sure that all pupils have access to high quality language education. We want to start this at primary, updating key stage 2 languages and exploring the development of a more flexible new qualification, making sure that pupils can have their achievements acknowledged earlier. On an advanced language premium based on the advanced maths premium, we think this would not be the most effective way of increasing the take-up of A-levels, but we want to learn from the Languages For All programme.
My noble friend Lady Caine spoke about media literacy. It is critical that, through our curriculum reviews, children will be better prepared. This needs to be included all the way through. I am happy to discuss this further with her.
In answer to the noble Baroness, Lady Burt, we will be shaped and guided by the sector and take further steps on moving forward with regard to religious education. We have debated this before, in the Chamber. The school consensus should include views from faith, non-faith and wider school stakeholders.
In answer to the noble Lord, Lord Clement-Jones, AI is critical, and we are working with experts to ensure that refreshing the computing curriculum equips pupils with essential digital literacy that will be critical going forward. I am afraid my time is up. I thank all noble Lords for a well informed and enjoyable debate.
Learning Disabilities: Health and Social Care Access
(1 day, 9 hours ago)
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Lord Scriven
To ask His Majesty’s Government what assessment they have made of (1) the use of reasonable adjustments for, and (2) the safety of, people living with learning disabilities when accessing health and social care.
Lord Scriven (LD)
My Lords, I thank all noble Lords who put their names down to speak in this important short debate, which for me is rather a raw one. This debate is not to ask for more of the same; to do so would be to sign death sentences for thousands more individuals with a learning disability. The system does more than fail. It facilitates what Professor Sara Ryan describes as “social murder”. As both a researcher and the mother of Connor Sparrowhawk, whose preventable death occurred a decade ago, she uses this term to describe a state-sanctioned erasure whereby those very institutions aware of the risks to life choose to maintain the status quo rather than dismantle it. People with a learning disability die, on average, 20 years earlier than the general population, and 40% of these deaths are preventable. At current trends, it will take 102 years to close this life expectancy gap. I therefore ask the Minister: does she accept that this century-long wait is a human rights failure?
Saying that tweaks will be made to a fundamentally broken system is an acceptance of the status quo that killed Connor a decade ago, and it is the same status quo that killed my nephew. My nephew, Myles Scriven, died in 2023 at the age of 31. The coroner delivered a devastating judgment of the evidential reality of today’s health and care system. He found a culture stuck in another era where clinicians had only a superficial grasp of regulations and communication was unsafe. Most tellingly, the reasonable adjustments were laid out in Myles’s medical notes: advocates required; mental capacity tests required; a hospital passport required; communication support required. Yet this was ignored by all healthcare staff, despite the trust telling us at the inquest that 98% of staff had been trained. Safeguards existed on paper only; they did not exist for Myles.
Since Myles’s death, hundreds of families have contacted me, confirming that his experience was not an isolated incident. They have shared identical accounts of systemic failure. Reasonable adjustments are being bypassed, parental expertise is being dismissed, and regulators are failing to enforce the very standards that they are sworn uphold. Despite repeated warnings, some providers continue to ignore the very changes necessary to prevent further avoidable tragedy. Myles’s case was no outlier, but a systemic norm.
We see the grim reality of this failure in the superb journalism of Daniel Hewitt of ITV News, whose investigations have exposed a trail of preventable deaths where life-saving laws are treated as optional. We also see it in the timeless reporting of Dr George Julian, who spent a decade at inquests documenting the fatal consequences of diagnostic overshadowing. Her work reveals an ingrained culture that refuses to see the person behind the disability and a culture that sometimes weaponises the Mental Capacity Act, while completely abandoning the legal duty to provide reasonable adjustments.
So why has the machinery of oversight failed so spectacularly? The CQC has become a regulator of process. It audits the existence of policy, not the efficacy of its application at the bedside. With only one prosecution in this area by the CQC, despite hundreds of preventable deaths, I ask the Minister: does she not agree that the regulatory framework is fundamentally broken and requires urgent statutory reform? Similarly, LeDeR is a toothless archive of tragedy. It is a system of learning without much doing. It produces a report with no legal powers to compel change. Can the Minister say what the Government’s plan is to transform LeDeR from an archive of tragedy into a tool for change? Specifically, will they commit to a statutory requirement that makes LeDeR’s findings legally binding on providers?
The system is obsessed with inputs. It measures how many staff attend training, not whether they have learned and changed. It measures the number of annual health checks, yet senior clinicians say that these are frequently tick-box exercises. The quality is dangerously variable, leaving serious underlying health needs entirely unaddressed. A tweak will not save lives. We need a systematic reform of the implementation, accountability and regulatory framework that moves beyond paper policy and puts the actual safety and survival of human beings at the very heart of the system.
First, we need a statutory review of all deaths, ensuring legal accountability for implementing recommendations. Can the Minister explain the Government’s ongoing refusal to support this call and why they believe the current voluntary arrangements are sufficient, when the death toll suggests otherwise?
Secondly, the Government must look to the Netherlands, where a dedicated medical specialty for learning disabilities has transformed outcomes and extended life expectancy. We need senior clinical leaders—consultants who can navigate multiple overlapping health issues with the same authority that we see from clinicians in paediatrics. This is about providing the expert clinical leadership required to break through systematic inertia. Will the Government commit to the establishment of these senior clinical leadership roles across the system? Will they provide the recurrent funding required to ensure that this model delivers the improvement and accountability that are so desperately missing?
Thirdly, we need real leadership accountability. The era of moving on from tragedy to tragedy must end. If a provider fails, the responsibility for reform must personally be held right at the top. Accountability must be triggered where a leader presides over safety breaches and fails to implement documented remedial actions—then they should face a lifetime ban from holding any senior management or board-level position in the health and social care sectors. Government responses to my Written Questions reveal a startling vacuum of oversight. They currently lack the basic data required to identify where the system is failing. How can the Government claim to enforce accountability when they do not even track which safety actions are being ignored?
The Minister cannot change the past, but the Government can be the architect of a new era of robust, safe services, accountability and regulatory action that works—or do we continue to defend a system that oversees social murder by another name? Systemic change is more than a tweak; it is a fundamental shift in how we value these human lives. It is the transition from viewing my nephew as a tragic case to seeing him as a citizen, with an inalienable right to safe care and an equal right to long life.
If we do not move to a legally binding new model of improvement, accountability and effective regulation, the Government are effectively saying that a 20-year life expectancy gap is the cost of doing business. Families deserve more than a sympathetic nod. They deserve more than a system that does not work in practice and they deserve a guarantee that “never again” starts today. I look forward to the Minister’s response, not just as a Member of your Lordships’ House, but as an uncle who will not allow his nephew’s preventable death and those of others to be in vain.
Baroness Ramsey of Wall Heath (Lab)
My Lords, I congratulate the noble Lord, Lord Scriven, and thank him for securing this important debate and for his deeply powerful and moving speech.
One day in 2018, I was walking down a south London street, trying desperately to get through on the phone to my older sister’s GP in the West Midlands. Patsy, my sister, who I have talked about in this House before, had profound learning disabilities. She never talked, she could not walk and was doubly incontinent. She had recently been diagnosed with lung cancer, despite having never smoked.
The consultant who gave us that diagnosis had advised that her cancer was not suitable for treatment and that he expected that she would receive palliative pain-relieving care at the end of her life, at some unpredictable time in the future. There would be future X-rays to establish the progress of the disease because, of course, Patsy could not tell anyone in the usual way how she was feeling. Her carers, and my other sister and me, could tell when she was in pain or happy, or cold or hot, but obviously with medical treatment it was important to have more information on the progress of the disease.
In our regular conversations with our carers and from what we observed with our regular visits, it seemed on that particular day important that she had a follow-up X-ray, as she seemed to be less comfortable. Our main worry was that she was in pain. I had had to telephone her GP practice countless times to remind them of Patsy’s needs, as well as on numerous occasions to speak to the hospital that was supposedly looking after her. She never did have that follow-up X-ray.
Noble Lords will see why this matters so deeply to me and my family, and why I care about the importance of the NHS providing reasonable adjustments to people with learning disabilities. But in case anyone listening—not knowledgeable and expert noble Lords, of course, but perhaps people reading Hansard—thinks that this is an extremely unfortunate one-off, I take them into a meeting of the children and young people steering group for transforming care, a body that the then NHS chief executive, my friend the noble Lord, Lord Stevens of Birmingham, asked me to chair, with the aim of improving outcomes for a particular group of young people with learning disabilities, autism or challenging behaviour.
One day, we were meeting with the then Minister for Children in the Department for Education and the Minister for Social Care in the Department of Health and Social Care under the previous Government. An important part of our work was to try to break down the considerable barriers to health and education for children and young people in these circumstances. But I had to interrupt the Ministers to leave the meeting—very unusually, of course—to take an urgent call on my mobile. I have done that only in particular circumstances.
The call was from Patsy’s carer, who explained that she had had to take Patsy into A&E that day, to a hospital in the Midlands, because she had developed an infection. Hours later, Patsy was still on a trolley waiting to be seen by a doctor, and the carer’s shift was about to come to an end. She was phoning me because she was anxious that she would have to leave Patsy alone as, once my sister had been in the care of the NHS for a certain period of time, the care provider could apparently hand over contractual responsibility for Patsy until she was back home after treatment. I was nearly 150 miles away and was acutely conscious that she was about to be left all alone, lying on a hospital trolley, with no one to give her a drink of water or any food or to change her incontinence pads. I had no idea when she would be seen or what would happen next. It was intolerable.
My elbows sharpened, as I am sure other relatives will understand, and I persuaded the inexperienced but kindly carer to take her phone, with me on it at the other end, and find somebody who looked like they were in a position of authority in the hospital. I asked her to find the nurse in charge, but she did not know what that meant, let alone who that person was. She managed to find the nurse in charge, who I spoke to in very clear terms, explaining the nature of my sister’s learning disabilities, that she had not eaten or had any water or pain relief the whole time she had been in A&E and that she would need a change of pad.
As a result, my sister was then swiftly seen by a doctor, treatment was prescribed and that distressing episode was over. But what a shame that this information had not been on the hospital system automatically, ensuring that she was prioritised accordingly rather than ignored for so long. I was haunted by the image of my sister lying alone, uncared for. Of course, this is the problem that the reasonable adjustments digital flag has been designed to address. Its introduction is too late for my sister, who sadly died some months later, but it could make such a difference to so many others, which is why I am keen to understand from my noble friend the Minister how implementation is going.
The latest deadline for full rollout is September 2026. I say “latest”, as the 2019 NHS Long Term Plan set a deadline of 2023-24. Of course, the NHS struggling with national IT systems is nothing new, but does my noble friend have some good news for me? What about healthcare for people with learning disabilities more generally? Will this now get the priority that it has not had before? I did not see anything specific for this group in the latest 10-year NHS plan, but I know that Ministers are ambitious for change, which is certainly needed.
One more story about Patsy, perhaps the saddest of all, brings this to life. Another day, another meeting of the transforming care steering group and another phone call about my sister, this time to tell me it was time to come up to the West Midlands straightaway, as lung cancer had done its worst and Patsy did not have long to live. When I arrived it was clear that she was in pain and needed morphine, so I phoned the district nursing service to be told that there were only two nurses working across the whole district and that, since morphine was a controlled substance that needed to be administered by the two of them together, Patsy would have to wait for a while in pain—on the last day of her life.
Noble Lords can imagine what I said to those poor district nurses, for whom I felt sorry, but I made sure that my sister was as high up the list as she reasonably could be, given their other commitments. My other sister and I sat all day and night either side of Patsy. The district nurses came when it was her turn. She became calm after the painkillers were administered and, in due course, some hours later, she died peacefully. Of course, many people with learning disabilities get much better care than this, but we all know that many still do not. What can my noble friend the Minister tell us today that will give us hope that action will be taken so that fewer people in future will suffer needlessly in the way that my sister did?
Baroness Hollins (CB)
My Lords, I am grateful to the noble Lord, Lord Scriven, for securing this important debate and acknowledge with deep respect the noble Lord’s personal connection to the death of his nephew Myles; and to the noble Baroness, Lady Ramsey, for her moving speech.
This issue is about real lives, real families and the profound consequences when health and social care systems fail to provide reasonable adjustments. I speak as the mother of an autistic son with learning disabilities as well as a doctor, and I spent much of my career working with people with learning disabilities. I want to speak today primarily about David Lodge, whose death was recorded in the most recent LeDeR report and brings this into sharp focus. David was a 40 year-old man with a learning disability and autism. His sister Dr Lodge is a psychiatrist who some years ago worked here in your Lordships’ House with me as a parliamentary researcher. Her brother David was unable to speak using words and used AAC to communicate. He lived at home with his elderly father Peter, who was still his primary carer. When Peter unexpectedly died at home while caring for David, David had no way of raising the alarm. There had been no anticipatory emergency plan. Despite his father explicitly asking David’s social worker what would happen if he died, he was not helped to make a carer’s contingency plan. David was found by his sister days later and taken to hospital, where he very sadly died 13 hours after admission.
David’s inquest identified serious failings in his hospital care: basic physical examinations were not carried out, staff did not recognise how unwell he was and, most distressingly, he was left in pain. His sister told staff that David was in pain, but they did not listen. She told them that he had a hospital passport explaining how he showed pain. No one looked at it. No one acted on it. Despite her repeated concerns, David was not given any pain relief. A prevention of future deaths report issued by the coroner following David’s inquest raised clear concerns about the lack of reasonable adjustments around assessing David’s pain.
As we have heard, David’s case is not an isolated one. My research, published in the early 1990s, found that people with a learning disability died 20 or more years earlier than the rest of the population and it helped to make the case for a confidential inquiry. However, in the most recent LeDeR report, 39% of deaths were considered avoidable and men still die 20 years earlier. A recurring factor is the failure to provide reasonable adjustments. This is not the first time this House has debated reasonable adjustments, nor the first time I have spoken about them, and it is deeply troubling that the gap between policy and practice persists. The question is no longer what needs to be done to ensure the safety of people with learning disabilities in health and social care settings, but why is it not being done? Does the Minister agree that perhaps a Select Committee or an inquiry should be established?
The reasonable adjustments digital flag, a national record of a person’s needs for reasonable adjustments across health and social care settings, is now live in England. The digital flag has the potential to ensure that reasonable adjustments are identified and recorded. However, implementation is slow and inconsistent, and recording alone is not enough if reasonable adjustments are then not provided. Tick box exercises are not enough. People with learning disabilities need trusted relationships. They need continuity in their relationships, not episodes of care after which a person is discharged, and not constantly changing healthcare professionals. David’s sister commented that his annual health checks were five-minute phone calls between a practice nurse who had never met David and his father.
My recent experience attending my son’s annual health check with him was incredibly disappointing. The health check was a tick box exercise delivered by a GP registrar who was about to qualify. He had not met her before, and she had not even heard of Oliver McGowan mandatory training. These are the same health checks at which reasonable adjustments should be agreed and recorded and a meaningful health action plan created. My son’s health plan was not discussed with us, but when it was sent to me it had three things on it and against each the action was “Mum to do”. That is me. Mum could not do.
I found this experience particularly painful as I was involved in the development of the Valuing People White Paper and subsequent work, including designing health checks; recommending health facilitators; helping to get the confidential inquiry agreed; and amending the Health and Care Act to include mandatory training and other initiatives, most of which have been implemented in patchy ways. If we are serious about safety, we must be serious about accountability. As the stories of Myles and David remind us, this is a matter of life and death. What mechanisms will the Government introduce to monitor compliance with recording and, vitally, to provide reasonable adjustments across health and social care?
Also, what accountability measures will apply when organisations fail to deliver? For example, what can be done to introduce standards for annual health checks? Would His Majesty’s Government require ICBs to commission learning disability liaison nurses to be available 24 hours a day in acute NHS trusts? What about committing to introduce David’s rule on the right for people with learning disabilities in NHS hospitals to be seen, heard and understood every day? This would include an obligation on healthcare staff to complete at least daily assessments of the person’s well-being, pain, hydration and nutrition, adapted to the individual’s communication needs—in other words, with reasonable adjustments—and at least daily communication with the individual’s carer, family or supporters to seek their views on the person’s well-being.
David’s sister is doing her own survey of local authorities and reviewing how many have included emergency care planning provisions, having done a carer’s assessment. I pick out one of her results. The City of York identified 298 carers’ assessments in the previous 12 months. Of those, only 32 had any details of emergency care plans, of which only four had alternative contact information. I wonder: does the Care Act need to be amended? If we are to honour the memories of Myles, David and the many others who die from avoidable causes each year, we must move beyond intention to delivery.
The Lord Bishop of Newcastle
My Lords, I am grateful to the noble Lord, Lord Scriven, for bringing forward this Question for Short Debate. I acknowledge his very personal connection to this topic and echo the words of the noble Baroness, Lady Ramsey of Wall Heath, in paying tribute to his powerful opening speech. I also express gratitude to the organisations that have written to me; I am particularly grateful for the extremely helpful briefing document from Mencap.
The topic of our debate has been on my mind since I sat on the Select Committee in your Lordships’ House as part of the Terminally Ill Adults (End of Life) Bill process. Persistent health inequalities for young people—well, for people generally—living with a learning disability and those with Down syndrome were raised on behalf of the National Down Syndrome Policy Group by Ken Ross, who gave evidence to the Select Committee describing
“a systemic direct and indirect bias shown within the health service, which could also be linked to a lack of understanding of the needs, wishes, health, learning and communication profiles of this particular group”.
The LeDeR report and others highlight that the rate of preventable deaths among those with learning disabilities is double that of the general population; the noble Lord, Lord Scriven, raised the critical matter of the lack of heft with LeDeR.
If we are going to make a real difference to health inequalities, we must focus on not only care delivery but preventive care such as accessible public health campaigns. The report noted that access to care is often missed for practical reasons such as a lack of accessible transport links, which, again, will only be compounded for rural communities. Preventive care that includes the practical must continue to be prioritised by ICBs in their strategies to reduce health inequalities.
As the Covid inquiry has continued, we have seen in close detail the impact of inappropriate application of DNACPRs, sometimes on those with learning disabilities. Fear and distrust of the health service for disabled people remains. In some places, that is worsened by geography. There are additional challenges of accessing care if living rurally—a particular feature of the area where I serve as Bishop, which includes Northumberland. This is about accessing the right care at the right time and with the appropriate reasonable adjustments in place.
On the availability of reasonable adjustments, the most recent LeDeR highlights that the involvement of a learning disability liaison nurse in someone’s interaction with the healthcare service is correlated with a higher likelihood of reasonable adjustments to care. It also says that access to learning disability liaison nurses is not straightforward in all parts of the country and they are less commonly available in the north-east.
We are living in an uncertain health and care landscape, and in the midst of significant reforms to the healthcare service and impending significant reforms to adult social care services. ICBs were asked to make 50% cuts to their running costs last year and, to meet this, many have made arrangements to merge and expand their geographical footprint. None of these agreements, to my knowledge, has been made in the north-east, but those ICBs will still have been required to make cuts. What then will the impact be of ICB cuts on the important measures to ensure patients have access to the reasonable adjustments they need? What support is being provided to ICBs to ensure that essential services like this are protected from cuts?
As we await the outcome of the Casey commission on adult social care, which promises significant reform, we know the huge pressure facing council budgets. Services such as Shared Lives, run by councils, are extremely beneficial, especially for those living with a learning disability. According to a survey carried out by the Association of Directors of Adult Social Services, 87% of its membership think that
“greater availability of Shared Lives would reduce or significantly reduce adult social care expenditure”.
Although this debate is not about the provision of social care per se, if care and support are the means by which we are all enabled to flourish, they are part of the discussion about ensuring reasonable adjustments to healthcare and good decision-making for patients.
In conclusion, overall, the problems are systemic, requiring stronger leadership, better designed services, collaborative thinking, improved training and consistent, proactive approaches to ensure equitable access to care.
Lord Crisp (CB)
My Lords, it is a privilege to follow four such powerful, knowledgeable and moving speeches. I will briefly discuss five areas.
First, following the powerful speech of the noble Lord, Lord Scriven, I congratulate him on getting this debate and focusing on reasonable adjustments—that kept coming up in all noble Lords’ speeches—and accountability. He discussed the learning disability physicians in Holland. One of their roles is, in a sense, cultural: it is not just what they do as people; it is what influence they have within the wider system. It is significant that there are physicians and doctors in that context and that they are playing a leadership role alongside their nursing and other colleagues. That is an important point, and I hope that the Minister will say something about discussing that at a later point—and not just whether she knows anything about it. Health is almost always about people. There may be other issues, but what happens inside the heads of the clinicians who look after us is really important. It is about how they see the world and how they want to behave.
Secondly, I will pick up on the Mencap briefing, which I am sure we all received. It makes the simple point that the NHS is not well designed to meet the needs of people with a learning disability—it is that simple. Mencap gives examples of that, and noble Lords have mentioned them already. I noticed one in particular that has a ring of truth about it: it seemed that, in many cases, one or two individuals in a practice were driving good practice, perhaps going above and beyond, and that care would fall apart when those people moved on. That is real. I not only see in that the importance of those people; I also bet they were good at beating the system and getting around the systemic obstacles that are in people’s way. That is the reality of what we have here. Accountability and the example of the learning disability physicians are part of that.
There is another issue here. What is good for people who have disabilities of different sorts is good for the rest of us as well. While we may not need the reasonable adjustments that some people need, we will need certain sorts of reasonable adjustments, particularly as we get older. This is about the focus on the individual patient in front of you and understanding that person as a person. All these stories are about not understanding the people that noble Lords have been talking about.
That takes me to the area of professional education. This is a much bigger question than this debate, but I would be interested to hear anything the Minister is prepared to say about it. Professional education has to change. For the people we are educating today—I am thinking about pre-service education—the world in which they will be working will be so different in 20 years’ time. AI is already affecting us in so many ways—but it is not just AI; it is all the other technologies that are around and impacting us.
Health is not just about smart technology; it is about people. When that develops, the leadership roles of professionals will involve picking up on some of the things that we are starting to talk about. I work with a group of young doctors who are trying to change some of this to get more emphasis on prevention and health creation—by which I mean creating the conditions for people to be healthy and helping them to be so.
The third area I have been reminded of is about reasonable adjustments and seeing the patient in front of you. I am not quite sure what the right language is here, but “reasonable adjustments” is what we use in this part of the world. I hope that we will return to professional educational change in the House and try to give it some push. There are lots of people out there who want to make that sort of change.
My two final points are about statistics. There was a wonderful description of the LeDeR results as a “toothless archive of tragedy”—we will remember that. The statistics are pretty awful. As the noble Lord, Lord Scriven, said, this is not about tinkering but about fundamental change. Where do we want to be in five years’ time?
Finally, I will share my personal story, which is not as tragic as those of others. I had a brother-in-law, Gareth, who had Down syndrome. At the end of his life, he suffered from dementia. He had some of the problems that people have talked about but to a much lesser degree than noble Lords have referred to. What we discovered about dementia as he became worse is that very little is known about dementia for people with Down syndrome. Yet there is a genetic connection that suggests that about 50% of people with Down syndrome will end up having some level of dementia by about the age of 60. There needs to be much more research in this area and more development of services. The simple answer is that people did not know how to handle it—it is just another service that did not know how to handle somebody with learning disabilities.
I will end with a point of praise for North Derbyshire. There is a community dementia team there—it is one of the few community dementia teams in the country—and it is first class. Its members were able to be those one or two people who sorted out and beat the system—they knew the back door and the ways to get things done. I have put this on the record before in the House, but I again praise that team. I hope that the Government are listening and will pick up on that in the future.
Lord Addington (LD)
My Lords, the most depressing thing about this debate is that it has been decades since I first spoke in a debate that pointed out that anybody with a learning disability or autism will have very bad health results and die early. That is an established fact. My noble friend said that you cannot change the past, but let us at least learn from it. We have been doing this for a long time with various Governments.
It turns out that our medical system is based on somebody telling a medical professional what the matter with them is by responding to certain, usually verbal, stimuli. Any group that has not been able to do that has always suffered badly. For example, it is an established fact that people using sign language have suffered badly. If we are going to do something about that, we will have to make some reasonable adjustments—that is the expression we are using here. If we do not do that, we will continue to get bad results because the medical profession will get involved only when something becomes obvious. We have all been told, again and again, “You should have seen a medical practitioner sooner”. We are guaranteeing that that will happen here if we do not find a way to assess those needs and get in earlier.
For anybody who has a communication problem or is communicating through one person that is going to be worse still. An example is the fear of an individual, usually a parent, who thinks, “What happens to my child with a disability when I’m not around?” The emphasis on that has been made very clear. It might be another relative who is doing the caring or somebody else. According to everything that we have heard today, they are quite right to be frightened when they are going through that.
We also have a system that has a series of flags coming up. As my noble friend pointed out to me, it is great having a flag, but what do we do when we see it? Until we get that ingrained in the training and structure—indeed, until somebody’s life is made more than a little unpleasant if they are not doing it—we will not get change. Every time we have a system that works in a certain way and we want to deviate slightly, what is required is to play the system and get around it.
I will repeat another bit of black humour. It is often said that the first thing a disabled child who wants to do well should do is to choose their parents carefully in order to give them that advantage. I am afraid that that still applies. What are we doing to make sure that when we have a system in place, action is taken? Then, if we have a system in place, are medical professionals told—even if they are not trained to do it themselves—how to communicate with somebody with autism who takes things very literally? How do we get that information out to them? If the patient has certain types of learning difficulties, how do they get in touch with somebody to receive health checks? Those checks normally depend on tick boxes, so how do we avoid that? How do medical professionals extract information from that person, given that we depend on their assessment of their health? If they cannot do it, a prolonged examination will be needed. All of that is clear. If you follow it through, there is an iron logic to it, and it has not changed. It is an accepted system.
I will ask the Minister a few questions. On the flagging system, what is the process to make sure that people react to flags? Where would a medical professional go to get help interpreting and extracting information from a person who has certain types of communication or perceptual difficulties? That is particularly the case if the parent or carer is not readily available. Is there a process? If not, there should be because we are guaranteeing more failure if we do not have one.
These are the things that we have come back to over and over again for years. They have been said with more eloquence and knowledge than I can manage today. Unless the Government can start to address this, we will come back to this subject again in a new form because nothing will have fundamentally changed. I hope this Government will at least move this project on because, let us face it, it is well overdue and needs to be given a good hard push, or even a kick.
The Earl of Effingham (Con)
My Lords, I thank all noble Lords for their valuable contributions, including the noble Lord, Lord Scriven, and the noble Baroness, Lady Ramsey, for their lived experience of this important issue. Ensuring that people who live with learning disabilities are able to access safe and effective health and social care is a fundamental test of the fairness of our system. Reasonable adjustments are essential to ensuring patient safety and equitable care. However, we know that, regrettably, people with learning disabilities continue to experience poorer health outcomes and face avoidable barriers when accessing services. This is a matter of both access and safety. Where reasonable adjustments are not properly understood or implemented, the consequences can be severe.
When in government, we took important steps to try to address these issues as best we could. The Health and Care Act 2022 placed a clear requirement on providers to ensure that staff receive training in learning disability and autism. The Oliver McGowan code of practice established a consistent standard for training across health and social care. The NHS Long Term Workforce Plan set out ambitious goals to increase learning disability nursing training places by 46% by 2029. The noble Baroness, Lady Hollins, made some constructive challenges of our proposals, and I of course respect the views of an acknowledged expert, as the noble Baroness is.
However, it is now the responsibility of this Government to make good on our previous commitments and push through the further social care reforms that are needed. The Government published guidance last year stating that any adult social care providers arranging staff training between April 2025 and March 2026 would be reimbursed. Will the Minister update the Committee on how many adult social care providers have participated in this scheme and what steps the Government took to ensure that social care providers were aware of the funding available?
Pressing workforce challenges also threaten effective access to social care. Faced with falling student numbers, some universities have been forced to close learning disability nursing courses. In the south-east of England, there is no learning disability nursing course available. Nursing in Practice reported that the domestic supply of learning disability nurse specialists could run out by 2028. While the Conservative’s workforce plan set ambitious targets, the most recent data shows a negligible increase in the number of learning disability nurses of 4% between 2024 and 2025. The Government have committed to publishing a revised NHS workforce plan by spring 2026, so can the Minister now provide a publication date? Are the Government confident that the existing targets remain achievable?
We also have concerns regarding accountability. The removal of the quality and outcomes framework indicator relating to learning disability registers raises important questions. If only a proportion of those with a learning disability are currently captured on the registers, how exactly will the department ensure that all patients are properly identified and supported as they should be?
Finally, I turn to the issue of safety. The insights of the learning from life and death programme are invaluable in understanding the causes of mortality and identifying areas for improvement. The most recent report’s issue with the integrity of its data and delays was most unfortunate. The noble Lords, Lord Scriven and Lord Crisp, mentioned LeDeR. His Majesty’s loyal Opposition suggest that it is fair and reasonable to ask why the Government have not placed the programme on a statutory footing. Through what process will the Government ensure that the report’s findings are consistently translated into improvements in care at a local level?
It appears that many noble Lords are in broad agreement on the importance of this issue. The framework for improvement exists; the challenge now lies in ensuring effective implementation. The noble Baroness, Lady Hollins, highlight this very clearly. We hope the Minister will provide clarity on how the Government intend to bridge the gap between policy and practice to ensure that those with learning disabilities receive the safe and equitable care they deserve.
The Parliamentary Under-Secretary of State, Department of Health and Social Care (Baroness Merron) (Lab)
My Lords, I am pleased to respond to this Question for Short Debate, and I congratulate the noble Lord, Lord Scriven, on securing what, as we have heard, is a very important debate. I also congratulate him on his commitment to improving outcomes for those who have a learning disability. Personally and publicly, I also want to acknowledge—I will use the noble Lord’s words—how raw this is for him. As well as giving my condolences on the death of his nephew Myles, I can only say that I genuinely believe that, as Myles’s uncle, he pays the greatest tribute to the memory of his nephew as he strives to improve services. It is a mission with which I fully associate myself and the Government.
I also want to acknowledge the other losses of the bereaved—not just those of noble Lords sitting here in the Room but those outside too. I have listened to the debate closely and if I am honest, what I am about to say can only in part meet some of the very real questions, and a number of the proposals too. I will do my best and I commit to raising the points made with my honourable friend Minister Zubir Ahmed, in whose portfolio this sits. I know he will welcome, as I have done, the contributions today.
I will pick up as many points as I can in the time that I have. All noble Lords, including the right reverend Prelate and the noble Lord, Lord Crisp, made the point that the health inequalities faced by people with a learning disability are totally unacceptable. I certainly align myself with that. We are committed to driving change. The 10-year health plan gives me hope in this regard because it outlines our ambitions to tackle health inequalities and speaks to the point the noble Lord, Lord Crisp—not exclusively but particularly—made about the need to see the whole person. That is what is missing generally, and it is what the 10-year health plan seeks to tackle, including driving that critical shift from treatment to prevention. The two issues that are presented by this debate are inseparable. I am grateful to the noble Lord for the way he has presented that.
I therefore say at the absolute outset to the noble Lords, Lord Scriven and Lord Addington, that a near 20-year life expectancy gap is not acceptable under any point. I also thank the noble Lord, Lord Addington, for saying that the shortcomings and concerns we are debating have been going on for many years, and what is important is that commitment to change. The noble Lord, Lord Crisp, who spoke of the experience of his brother-in-law Gareth, also spoke of good practice in Derbyshire. We should commend all those who do this and learn from it.
To the point about reasonable adjustments, there are clear legal requirements on health and care organisations and their staff. I hear what noble Lords say clearly: yes, that is all very well but it is not happening. But it is worth reminding ourselves that, under the Equality Act 2010, public sector organisations are required to adapt their approaches in a very practical sense, as the noble Lord, Lord Addington, called for, so that their services are accessible to disabled people as well as to everybody else.
I am grateful to my noble friend Lady Ramsey for bringing Patsy into the Room again. NHS England is rolling out a reasonable adjustment digital flag, as we have spoken about here. That will continue and it is to ensure that, in the way that she rightly demands, key information about a person and the reasonable adjustments needed for their care and treatment are to be recorded in care records. I say to my friend the noble Lord, Lord Addington, that a new information standard was published in December 2025, such that all publicly funded health and social care service providers must be able to share, read and write reasonable adjustment data by 30 September. Training on this digital flag is freely available.
Turning to the safety of people with a learning disability while accessing health and social care, the NHS learning disability improvement standards provide a framework to support NHS trusts and organisations in assessing the quality of their services, because we have to see consistency and improvement across the NHS. There is guidance available on the use of health and care passports to support personalised care for people with a learning disability, and for autistic people.
I say to the noble Baroness, Lady Hollins, that I am deeply saddened by the tragic circumstances of the death of David Lodge. I send my condolences to David’s friends and family. In response to the noble Baroness, who called for a way forward, and the noble Lord, Lord Scriven, who raised whether this can all be a tool for change, because it is not currently—I heard him say that—I know that the noble Lord recently met the Minister for Health Innovation and Safety, Zubir Ahmed MP, as I mentioned. I understand that my colleague the Minister has agreed to work with the noble Lord, Lord Scriven, to continue to hear insights from those with lived experience and wider stakeholders. The Minister is currently working with officials to explore options to improve the process, because we know there is a lot further to go to get ICBs to meet the expectations they have upon them. All these points have rightly been raised on ensuring accountability, reducing inequalities and preventing avoidable deaths. That work will absolutely continue, and I look forward to noble Lords taking part in it.
The noble Baroness, Lady Hollins, asked whether there are any plans to establish a specific inquiry or committee. Currently, there are no plans to do this; however, as I have said, the Minister is very much on the case. On wider action to improve health outcomes, I absolutely hear the points made by the noble Baroness not only in your Lordships’ House but to me personally before this debate, for which I am grateful. If we are talking about those with learning disabilities, we are talking about not just episodes of care but building relationships to enable the correct care for that person; I use the word “person” very definitely in this regard.
Reference was made to the Health and Care Act 2022 and the requirements that it contains. The Government have published a code of practice setting out their expectations on training delivery, and we continue to roll out the recommended Oliver McGowan mandatory training package. I can tell the noble Earl, Lord Effingham, that more than 3 million people have completed the first part of the training, and funding has been provided to support greater uptake this year.
On the point about health checks, the Secretary of State recently wrote to all GPs to emphasise the importance of identification, recording and the quality of the checks themselves.
A number of very pertinent points have been made. I assure noble Lords that they will all fed into the move towards improving the situation for those who have learning disabilities. We owe them nothing less.
Arrangement of Business
The Deputy Chairman of Committees (Baroness Watkins of Tavistock) (CB)
My Lords, if there is a Division in the Chamber while we are sitting—I must stress that one is expected—the Committee will adjourn as soon as the Division Bells are rung and resume, at the very latest, after 10 minutes. We are very tight for time if we are going to get the fourth debate in today. Last week, when we had votes, we asked people to return as soon as they had voted because, once everybody is back, we can proceed; that is quite helpful, but it takes collegiate behaviour. The time limit for the following debate is one hour.
Former Prime Minister Imran Khan
Baroness Alexander of Cleveden
To ask His Majesty’s Government what discussions they have had with the government of Pakistan regarding the protection of the rights and the welfare of former Prime Minister Imran Khan during his imprisonment, including access to medical care and family visits.
Baroness Alexander of Cleveden (Lab)
My Lords, I thank noble Lords for their participation in this debate. It is my first QSD debate so I will be looking to the Deputy Chairman of Committees—I assume that we do not make reference to the Woolsack—to correct me if I make a procedural faux pas. I can promise that there will be no cricketing analogies because they are definitely beyond me.
This debate is a serious matter. It follows a recent Question in the Chamber on which several noble Lords who are present here today contributed. Since then, Ministers have helpfully provided Written Answers confirming that His Majesty’s Government expect the Pakistani authorities to respect fundamental freedoms, including due process, humane detention and access to appropriate medical treatment for all detainees, including the former Prime Minister, Mr Imran Khan.
I am grateful to my noble friend Lady Chapman of Darlington for participating in this debate and sharing the Government’s current thinking on this issue. Our debate is timely in view of the deteriorating welfare of Mr Imran Khan. The concerns span his health, conditions of detention and access to medical care, the denial of family access and recurring questions concerning access to justice. In raising these matters, I recognise that noble Lords can range more widely in the breadth of their concerns than Ministers may. For example, Ministers have confirmed in recent Answers that they would not advocate for specific medical arrangements for an individual prisoner in another jurisdiction, however distinguished they might be.
However, this debate allows the airing of overlapping concerns that span health, welfare and access to justice and the relationship of those concerns with universal principles concerning human rights, due process and democratic concerns. Other more expert noble Lords may comment on the wider context, but I simply note that, in any country, the recurring incarceration of political opponents generally damages rather than advances the cause of democracy. This debate is not to endorse any one politician’s programme or past record. Mr Imran Khan, like every politician—past, present and future—has made mistakes. This is about making our voice heard around the concerns that have been raised.
In 2024, Amnesty International, reviewing Imran Khan’s conviction and sentencing, found several fair trial violations that resulted in arbitrary detention and denial of his right to liberty. Worryingly, it
“noted a pattern of weaponization of the legal system to keep Imran Khan under detention and away from all political activity”.
The former Prime Minister is not just any other prisoner: the issue before us is that countless people of good will who care about Pakistan and its future and democracy are deeply concerned about Imran Khan.
Let me turn to three troubling specifics. The first is family access. Despite previous assurances, some of Mr Khan’s immediate family remain effectively barred from seeing him. I understand that his sons, Sulaiman and Kasim Khan, who are British citizens, have not been permitted to visit their father since December. They should have the right to visit their father in a way that does not impact their right to British consular protection. Moreover, such humanitarian access becomes more acute when a detainee’s health is in question.
The second concern is medical care. There seems to be agreement that Mr Khan’s medical condition has reached a critical stage. I understand that the Islamabad high court recently formed a medical board to oversee his treatment but rejected the request to include his personal physicians. His family have also indicated that they feel kept in the dark regarding his treatment protocols.
The third concern is fair treatment. Mr Khan recently indicated that his wife, Bushra Bibi, is being kept in isolation except for a rarely granted 30-minute weekly meeting. These allegations concern the rule of law and fair treatment. The targeting of family members to pressure a detainee is a violation of international norms.
Each of these three challenges, around family access, medical care and fair treatment, concerns the conduct of authorities in Pakistan, so His Majesty’s Government properly tread very lightly. I therefore turn my remarks to the Minister. On 25 February, she helpfully confirmed to the noble Lord, Lord Goldsmith of Richmond Park, that the UK consistently advocates for family access. That is very welcome. However, given the continuing obstacles surrounding access and the ongoing concerns about the former PM’s welfare, will the Minister help secure a meeting with the relevant FCDO Minister, Hamish Falconer, for a small cross-party delegation of Peers to explore humanitarian access for Imran Khan’s sons, to help secure the visas that would allow for full diplomatic protection, so that they can visit their father without risking their safety?
The Minister will also be aware of the concerns surrounding the detention of other current and former politicians. We look forward to learning how His Majesty’s Government can best support demonstrable improvements in human rights, specifically the humane treatment of political detainees, their access to legal counsel and the importance of not pressurising family members.
Time does not permit me to dwell—at least, not for long—on Britain’s shared history with Pakistan, its geopolitical importance and the hopeful aspirations of its young people. I have observed all of these things in my own visits to the country to deepen educational links and through my work with the British Council. Pakistan is a valued member of the Commonwealth and an important trading and security partner. It is a nation that is navigating the rising aspirations of many alongside a recently rising poverty rate. It is a country that experiences the impact of climate change, alongside border conflicts, and wrestles with the balance between military power and control by civilian authorities in democratic systems. The consequences of all these forces resonate globally, and we have a shared interest in the country’s lasting stability, prosperity and co-operation.
Finally, every participant in this debate is aware that the United Kingdom has deep people-to-people ties with Pakistan. Britain is enriched by 1.5 million British Pakistanis, friends and neighbours, many of whom take a close interest in these matters. We all share an interest in Pakistan’s future, the welfare of its citizens and the upholding of democratic and judicial norms. So the ask today is simple: for the British Government to use their undoubted influence, where they can, to uphold the principles that this country holds dear—those of fairness, justice and compassion.
Lord Ahmad of Wimbledon (Con)
My Lords, I thank the noble Baroness, Lady Alexander, for introducing this debate and the manner in which she did so. The sentiments she has expressed and the calls she has made are things with which everyone participating in this debate will align.
In the words of the Quaid-I-Azam, Muhammed Ali Jinnah:
“My guiding principle will be justice and complete impartiality, and I am sure that with your support and co-operation, I can look forward to Pakistan becoming one of the greatest nations of the world”.
We take part in this debate with a deep sense of concern regarding the continued detention of former Prime Minister Imran Khan—a figure who, irrespective of political persuasion, remains entitled, like every citizen of Pakistan, to the protections of the law and the dignity afforded to every citizen under Pakistan’s constitutional framework. As has already been said, this is a matter not of politics but of principle. It is about whether the justice envisioned by the Quaid-I-Azam, Muhammed Ali Jinnah—rooted in fairness, compassion and the rule of law—should rightly be a factor that continues to guide the Republic of Pakistan.
Having served as the UK Foreign Minister of State with responsibility for our relationship with Pakistan, I dealt with all political parties. Indeed, I dealt directly with the former Prime Minister, Imran Khan, during his tenure as Prime Minister, as well as with the current Prime Minister of Pakistan, Shehbaz Sharif. They will both recall, as I do, that, whatever the issues—albeit ones of deep concern—and no matter how difficult they were, we would engage in a manner that was, despite differing views and positions, rooted in mutual respect. With these sentiments in mind, I wish to make three clear and what I regard as reasonable calls, grounded firmly in Pakistan’s constitution and legal traditions.
The first is the immediate provision of specialist medical attention. Article 9 of the constitution of Pakistan guarantees the right to life and liberty. As we heard from the noble Baroness, Lady Alexander, the courts of Pakistan have repeatedly interpreted this to include the rights to health and to access to medical care. Where a detainee’s health is in question, the responsibility of the state is not discretionary; it is absolute. Ensuring that Mr Khan receives an independent specialist medical assessment, including with a professional medical practitioner of his choice, is not an act of concession but a constitutional obligation.
Secondly, as I called for in our debate on a Question in the main Chamber, Mr Khan should be granted full and humane access to his family—specifically, the granting of visas to his sons, Kasim and Sulaiman, who are both British citizens. Article 14 of the constitution of Pakistan confirms the inviolability of the
“dignity of man and … the privacy of home”.
Family contact is not merely an emotional consideration; it is intrinsic to human dignity and recognised in both domestic jurisprudence and international rights, to which Pakistan is party. Denying access to close family members, particularly in times of vulnerability—as is the case now—risks undermining the very dignity that the constitution seeks to protect. Facilitating visas for his sons is, in my view, a simple, humane and lawful step.
Thirdly, I call for Mr Khan’s transfer, under the conditions, to house detention. Pakistan’s legal framework, including provisions in its criminal procedure, allows for alternatives to incarceration where the circumstances justify it—in particular, where health, security or broader public considerations are at play. House detention would ensure that the legal process is upheld while mitigating concerns around welfare, transparency and proportionality. It would be a measured and lawful course, consistent with both precedent and principle.
Alongside these calls, I turn directly to the role of His Majesty’s Government. Will the Minister take forward, in addition to the request made by the noble Baroness, Lady Alexander, a direct request to the Foreign Secretary to use her full weight of office to facilitate access, particularly in supporting the granting of visas and ensuring appropriate consular and diplomatic engagement on humanitarian grounds? I should add that this is not without precedent. The UK FCDO has, in numerous instances, advocated for medical access, family visitation rights and due process; indeed, I engaged directly and robustly where there were concerns about the welfare and rights of detainees overseas. Whether cases involve British nationals or broader human rights concerns, Ministers have rightly raised individual cases directly with foreign Governments, underscoring the fact that humanitarian considerations sit firmly within the remit of the Foreign Secretary. Indeed, successive Foreign Secretaries have intervened quietly but effectively—that is the British way—where questions of health, dignity and access arise.
These are not extraordinary demands. They do not seek to interfere with judicial processes; nor do they pre-empt outcomes. Rather, they are rather a rational call to uphold the very standards that Pakistan has set for itself—standards rooted in its constitution, its courts and the vision of its founder. At a time when the eyes of the world are on Pakistan, when it is providing a glimmer of hope in the dark clouds of war, it will also need to reflect on how it treats those in detention, especially figures of such prominence. If it does the right thing, I am sure that it will further speak volumes about its commitment to justice, compassion and human rights.
In invoking the words of Muhammed Ali Jinnah as I did, we are reminded that nations are judged not by the strength of their rhetoric but by the fairness of their actions. Pakistan must demonstrate, through these three simple steps and with the constructive engagement of a friend and partner such as the United Kingdom, that justice remains not only an aspiration but a living reality.
Lord Mohammed of Tinsley (LD)
My Lords, I also thank the noble Baroness, Lady Alexander, for securing this really important debate on the rights and welfare of the former Prime Minister of Pakistan, Imran Khan. I am grateful to the House of Lords Library for its recent briefing and to Mr Nasir Mir, a senior member of Imran Khan’s PTI party, for his briefing note; I see that he is here with some of his colleagues. Both these publications have helped inform my deliberations over the growing international concerns.
Mr Khan’s detention, following his arrest in 2023 on charges that he denies, has become more than a domestic legal matter. It raises fundamental questions around due process, the rule of law and the treatment of political figures in a democratic system. The United Kingdom has long stood for the principles of fair trial, judicial independence and the humane treatment of detainees. These are universal values, not contingent ones.
Although Pakistan’s legal proceedings are rightly a matter for its own courts, there remains a clear expectation that international human rights standards will be upheld in all circumstances. It is concerning, therefore, that emerging reports suggest restrictions on Mr Khan’s access to legal counsel, family contact and adequate medical care. These allegations of prolonged isolation and deteriorating health would, if accurate, fall short of the standards set out in the United Nations Standard Minimum Rules for the Treatment of Prisoners—or the Mandela rules, as they are often called—which guarantee access to healthcare, legal representation and regular contact with family.
In that context, I wish to raise a specific humanitarian issue that other noble Lords have raised: family access. The ability of Mr Khan’s two sons, Kasim and Sulaiman, to visit their father is not simply a personal matter but an important element of humane treatment. I therefore express my support for the granting of visas by the Government of Pakistan to enable these two young men to go and visit their father; that is what we would all want. I lost my father 30 years ago. Being able to go and visit your father, particularly when they are ill, is a basic human right that should not be denied to anyone. I support this Government impressing that upon the Government of Pakistan, because allowing this would demonstrate compassion and commitment to the basic international norms governing the treatment of prisoners.
This case does not stand alone. I express my concern regarding the continued detention of the former Foreign Minister, Shah Mahmood Qureshi, who is a senior political figure. His imprisonment, similar to that of Imran Khan, raises questions around transparency, due process and the consistent application of justice.
Beyond these high-profile cases, there are also troubling reports about what has been described as transnational repression. This includes allegations that relatives of overseas critics of the Government of Pakistan have been subject to detention, harassment or intimidation by the security forces of Pakistan. If substantiated, these practices would represent a deeply concerning extension of pressure beyond borders that undermines fundamental freedoms. These issues speak to not only individual cases but wider confidence in democratic institutions.
This debate is not about interference in the sovereign affairs of another state. Rather, it is about ensuring that our foreign policy reflects our enduring commitment to human rights and the rule of law. The United Kingdom has engaged with the Government of Pakistan on these matters, but it is right that we continue to do so clearly and consistently. The imprisonment of prominent political figures carries broader implications. Where there is a perception, rightly or wrongly, of political motivation or selective justice, public trust in democratic processes can be eroded. This makes it more important that legal proceedings are transparent and fair, and are seen to be so.
I suggest that His Majesty’s Government continue to pursue three key priorities: first, sustained diplomatic engagement with Pakistan on due process and detainee welfare; secondly, support for credible monitoring to ensure accurate information about conditions of detention; and, thirdly, the clear implementation of the United Kingdom’s commitment to democratic principles and human rights. I align myself with the remarks made by the noble Baroness, Lady Alexander, and support her call for further engagement at ministerial level, or Secretary of State level as the noble Lord, Lord Ahmad, suggested. In particular, I support the proposal for a small cross-party delegation of Peers to meet the relevant Foreign, Commonwealth and Development Office Minister.
This House has a long tradition of upholding fundamental standards, not by dictating outcomes but by advocating principles. The treatment of any detainee must meet these standards, regardless of status or circumstances. Let us therefore send a clear message that the United Kingdom will continue to support the protection of fundamental rights, the integrity of the legal process and the dignity of all individuals.
Lord Sikka (Lab)
My Lords, I thank my noble friend Lady Alexander of Cleveden for securing this important debate. I never had the honour of meeting Imran Khan but, like millions of other cricket fans, I am grateful for the pleasure that he has given us over so many years.
Ever since independence, Pakistan has sought to embrace democracy, but military chiefs have always lurked in the background. No Prime Minister has completed a full five-year term in office. This democratic deficit has had a negative effect on its economy, social stability, foreign investment, standard of living and security. Khan sought to turn the leaf and make a new start. He became Prime Minister in 2018 with support from the military chiefs. This was effectively a power-sharing agreement. The relationship with the military subsequently soured. In 2020, he was removed through a no-confidence vote in Parliament, which many say was orchestrated by the military chiefs.
In 2023, he was charged with corruption, treason and illegal marriage. He has denied all such charges. On several occasions, one of Pakistan’s high courts acquitted him. Each acquittal was followed by a barrage of new charges. The generals then installed new judges and, eventually, got the convictions they wanted. In 2024, his wife, Bushra Bibi, was also imprisoned.
Khan is seen now by many as a political prisoner. He has been incarcerated in a tiny cell in solitary confinement and denied access to newspapers and books. His family and friends have not always been able to visit him. His sons have been denied visas to see him. His sisters have occasionally seen him but under strict supervision. His health has deteriorated, and he has been denied appropriate and timely medical care. He has a loss of eyesight, which the authorities have allegedly ignored for years.
Taking a leaf from a recent open letter issued by former international cricket captains, I urge Pakistan’s Government to provide Khan with at least three things: first, immediate, adequate and ongoing medical attention from qualified specialists, of Khan’s choosing, to address his reported health issues; secondly, are humane and dignified conditions of detention in line with international standards, including regular visits by close family and friends; and, thirdly, fair and transparent access to legal processes without undue delay or hindrance.
One must now fear for Khan’s life. Four of his predecessors have died from unnatural causes, one executed by a military ruler. If Khan were to receive humane treatment, it could start a new chapter of reconciliation, peace, compassion and freedom in Pakistan. It could end the vicious cycle where one set of rulers seeks revenge on the previous ones and help facilitate economic and social development.
The UK Government pride themselves on being champions of democracy and human rights and have condemned political imprisonments in China, Iran, Russia, North Korea and elsewhere. However, their response to Khan’s imprisonment has been muted. They need to rise above the weight of arms and trade deals. Pakistan is a member of the Commonwealth and receives financial aid from the UK. It is a member of the United Nations and its Human Rights Council. The UK Government must use these and other platforms to urge the Pakistani authorities to treat Khan with dignity and compassion. He is now old, sick and frail, and he should be allowed to spend what is left of his life with his family and friends.
Lord Hussain (LD)
My Lords, I, too, thank the noble Baroness, Lady Alexander, for securing this debate.
As many noble Lords are aware, I was born in Pakistan. I have lived most of my life here in the UK, but I still have strong family connections in Pakistan. I like Pakistan, and I go back and forth very frequently to see my relatives. During my visits, I have the opportunity to meet politicians of all political persuasions in that country. When it comes to the internal politics of Pakistan, I always stay neutral. My aim has always been to do everything I can to strengthen the historical relations between Britain and Pakistan.
From the early days, Pakistan has faced enormous internal challenges, including large-scale migration, poverty, floods, earthquakes, terrorism and corruption. Externally, there have been three wars, and many battles and ongoing hostilities, on its eastern borders with India, and never-ending instability and wars on its western border with Afghanistan. Pakistan continues to bear the cost of Afghan’s problems, which, so far, have cost Pakistan more than 70,000 lives and billions of pounds in economic losses.
Despite this, Pakistan has been able to establish a powerful and respectful place on the world stage as a nuclear state. On the international front, Pakistan has successfully been able to balance its relationships with the US, Russia, China and Great Britain. Similarly, in the region, it has good relations with Saudi Arabia, Egypt, Iran, Türkiye, Bangladesh and Malaysia. Pakistan is one of the largest contributors to the United Nations peacekeeping missions around the world. More recently, Pakistan has shown its diplomatic abilities during the war between the US, Israel and Iran by offering mediation between the US and Iran in order to end the war by finding a peaceful solution. I sincerely hope that these efforts will bring an end to this deadly war in the Middle East, which is affecting the whole world.
However, at home, Pakistan faces challenges around weak economics, law and order, justice, corruption and political instability. Many reputable human rights organisations, including Amnesty International, have criticised the elections process of 2024 and the treatment of political workers, including former Prime Minister Imran Khan. It has been alleged that Imran Khan has been denied free access to his lawyers and family members and has been held in solitary confinement. It is also alleged that he has lost 85% of his sight in one of his eyes. In my personal capacity, I raised these concerns with the Pakistan High Commission in London; I was told that Mr Khan has received eye treatment from the Pakistan Institute of Medical Sciences in Islamabad and that his lost eyesight has been fully restored with glasses.
On the detentions of the PTI’s leadership, I am told that most of them are linked to the anti-state action of 9 May 2023 and are being dealt with according to the relevant sections of the law.
As I said at the beginning of my speech, I stay away from Pakistan’s internal politics, but justice, fairness and access to health facilities are universal rights. Hence, in the light of these claims and counterclaims, I urge the Minister to ask the Foreign Secretary to raise these issues with the Pakistani Government: a fair trial, justice and medical care for Mr Khan and other political leaders; and free access to lawyers and family members, including Mr Khan’s British-born sons.
Baroness Goudie (Lab)
My Lords, I am grateful to my noble friend Lady Alexander of Cleveden for securing this Question for Short Debate. The United Kingdom’s relationship with Pakistan matters profoundly because we share substantial history through both the Commonwealth and people. More than 1.5 million people in England and Wales identify as Pakistani. Many families here follow events in Pakistan closely, not because they are taking sides but because they care about justice, stability and the rule of law.
That takes me to the heart of today’s debate. The House of Lords is not the Court of Appeal, of course, so it is not for us to determine the merits of any international criminal charge. However, it is entirely proper for us to insist on some of the basic principles laid out in the ICCPR, which we all hold dear: due process; fair trials; and human treatment for everyone, whether they are prominent or powerless, including the former Prime Minister of Pakistan, Mr Imran Khan. Concerns have been raised around Mr Khan’s detention, with reports of solitary confinement and restricted access to family. Serious questions have also been asked about his medical care, including for an eye condition through which, as his lawyers have said, he has lost much of the range of his right eye; many of the noble Lords here know better than me the condition it is in now.
In December, the UN special rapporteur on torture urged Pakistan to address reports of inhumane detention conditions, warning that prolonged solitary confinement can breach international human rights law and pointing to reported restrictions on access to lawyers and families, as well as to concerns around adequate medical attention. I recognise that the Government have said both in Written Answers and from the Dispatch Box that, although, the Pakistani judicial process is a domestic matter,
“we are clear that the Pakistani authorities need to respect … the rights to a fair trial … humane detention and access to appropriate medical treatment”—[Official Report, 25/2/26; col. 607.]
for all of their detainees. I welcome that clarity, as well as the assurance that Ministers and officials have raised these principles with our Pakistani counterparts.
I press the point that humane treatment is not just a slogan. It has a real-world meaning that applies to all, including Mr Khan. In practice, it means prompt access to appropriate medical care, regular and meaningful access to legal counsel and family contact that must not arbitrarily be interrupted. These safeguards matter in every country because they reduce the risk of ill treatment and injustice, especially to older detainees and anyone with serious health needs.
It also matters because what happens in high profile cases is felt far beyond one prison cell. Independent reporting from the Justice Project Pakistan, drawing on Pakistan’s prison data, has described a prison system operating at around 152% of authorised capacity—can noble Lords imagine what it must be like?—with about three-quarters of prisoners under trial. These pressures fall disproportionately on the vulnerable. The same reporting highlights more than 1,580 juvenile prisoners and notes that only four prisons are designed for women, with many women held in separate sections in male prisons. In such an environment, transparency and due process should be treated as the protections that they are instead of as a luxury.
Will the Minister say what further representations the Government intend to make to ensure that international standards are met in full for Mr Khan and other detainees? The test of a justice system is not how it treats those with power but whether it protects the rights and dignity of everyone consistently and without fear or favour. That is what we stand for quietly, firmly and as a friend of Pakistan.
Lord Bruce of Bennachie (LD)
My Lord, I concur with everybody and congratulate the noble Baroness, Lady Alexander, on securing this debate, which is clearly timely. I want to address the specifics first. Regardless of the merits and demerits of the case against Imran Khan—I will come to that—his treatment is disgraceful and inhumane by any standards. Solitary confinement is never a good experience and rarely justified, and refusing family or legal humanitarian visits is, frankly, a disgrace. It is against fundamental principles. As I think everybody has mentioned, denying his sons the right to travel to visit him is a denial of fundamental human rights. They are British citizens, so we have some responsibility to support them.
I am afraid that all of that suggests that the regime is anxious to divert attention. I do not think that it will succeed in that. It does not want the situation to be highlighted, but this debate is proof that it will be highlighted. Imran Khan and his supporters have denied the charges, and it is quite difficult to get detail of exactly what they are and what the evidence has been, but that is really not the point. The question is whether there been a clear, transparent and fair judicial process. That matters to us as friends of Pakistan and as a member of the Commonwealth and of the United Nations.
I have visited Pakistan a few times over the years and throughout that time the state of democracy has always been fragile and, to be honest, very much at the behest of the military. Khan started out as the darling of the military. The Sharif family was discredited and put in prison. Now the Sharif family is back, Khan and his party are being harried out of existence, and he is being kept where he cannot rally a revival. It is difficult to avoid seeing politics behind that, regardless of the merits or demerits of the case. Over the years, we have seen a political leader executed, which was shocking to us at the time, we have seen another, of the same party, assassinated, others suspended, and military takeovers. None of this bears the hallmark of a lively and vibrant democracy, which is what we all want to see in Pakistan and indeed around the world.
I say to the Government of Pakistan that if they feel somewhat aggrieved by the criticism, they should listen to the specific requests that are being made, which are about common humanity and standards, and accede to the requests for humane treatment and access to friends, advisors and families, and to his wife, who is also being effectively drawn into this; they should be allowed time together. The suggestion of the noble Lord, Lord Ahmad, of domestic detention seems to me to commend itself as the right way forward.
This month, 47 members of Imran Khan’s party have been sentenced to 10 years’ imprisonment and substantial fines. You have to ask a very serious question about that. That is an awful lot of people for a lot of severe detention, regardless of what the terms are. I also see that Pakistan’s trade status within the EU is coming under question and the European Parliament is questioning the EU’s relationship with Pakistan over this specific case. As has been said by everybody, the UK has a particular relationship with Pakistan. We were, to some extent, instrumental in the creation of the country and I think—I hope—that we have a genuinely positive view of wishing the country to succeed and wishing it well.
The Minister has answered these questions. We are asking for a further escalation at Foreign Secretary level of strong representations to the Government to accede to these requests to allow his sons to visit, to bring him and his wife together, to allow him to have access to all the circumstances and civilised conditions he should have and not to be in solitary confinement, and I hope, perhaps to consider domestic detention. A test of democracy is a peaceful change of Government without recrimination. Pakistan has not met that test very often, and I say that with sadness, not with anger.
As a friend of Pakistan, it is important that Governments who have been on the other side of this argument understand the points that have been made and recognise that they have to raise their standards, show compassion, show tolerance and deal with justice. If there are things to be dealt with, they should do it openly, transparently and in accordance with the law that everybody can see and observe. That is not what is happening, and we have to express our sadness about it. We ask that the UK Government use all the good offices they can to persuade the Government of Pakistan to, at least, accede to these civilised and fair humanitarian requests, so that, regardless of the wider issues, not just Imran Khan but his followers are not treated in a way that most people would regard as inconsistent with good, democratic human rights. That is all we ask; it is not a lot to ask.
Lord Callanan (Con)
My Lords, I believe that we are about to start voting soon, but I will make a start. I, too, want to thank the noble Baroness, Lady Alexander of Cleveden, for securing this important debate on a vital matter. I think the whole Committee is clear—and we certainly agree—that Pakistan must uphold its constitutional and human rights responsibilities in all cases. I am sure that we will agree that this principle applies in the case of Imran Khan as well. We share the noble Baroness’s concern about Mr Khan’s health, and we welcome that the Government regularly raise the need to uphold Pakistan’s constitution and international human rights obligations, as the Minister confirmed in response to an Oral Question on 25 February this year.
The Deputy Chairman of Committees (Viscount Stansgate) (Lab)
My Lords, my apologies. That will teach me not to believe the Whips when they say there will be another vote straightaway. The debate continues.
Lord Callanan (Con)
As many noble Lords have observed in the debate, the reports on Imran Khan’s health are now extremely worrying. Can the Minister say what efforts Ministers have made to confirm these reports? Following those efforts, have Ministers changed their approach to this issue? In particular, it has been reported that Imran Khan has been denied proper medical treatment. Can the Minister update the Committee on the Government’s understanding of Imran Khan’s medical situation? On the specific point of how regularly Ministers are pressing their Pakistani counterparts on this point, can she please say when a Minister or official last raised the Imran Khan case with the Government of Pakistan and what action the Government of Pakistan have taken, if any, in response to that engagement?
Another important area of concern in this case, as my noble friend Lord Ahmad of Wimbledon pointed out, is the denial of family visits. The Minister helpfully confirmed last month that the Government would want to see access to family granted to anyone held in these circumstances, and we agree with the Government on that. As the Minister has previously said, one of the barriers to family access is that the Government of Pakistan control the visa and immigration decisions that would be required. Can the Minister please say what whether Ministers and officials have also raised that specific point with their Pakistani counterparts?
While the Government are completely correct that Imran Khan is not a British citizen, that said, I hope the Minister will recognise his long and deep connection with this country when raising that case. He was educated in the UK and, of course, he has many British family members. I know that she understands this, and it is important for us to reflect on it when discussing Imran Khan’s case. It is also important to reflect on the historic and ongoing relationship between the UK and Pakistan as a close and valued Commonwealth ally. We should encourage Pakistan to uphold the values of freedom and democracy that we all hold so dearly. I hope the Minister will take a moment in her reply to set out the Government’s views on that topic as well. I look forward to hearing what she has to say.
The Minister of State, Foreign, Commonwealth and Development Office (Baroness Chapman of Darlington) (Lab)
My Lords, I am grateful to my noble friend Lady Alexander of Cleveden for securing this debate, and I thank all noble Lords for their contributions. The welfare and rights of detainees in Pakistan are concerns for many in the United Kingdom, particularly the British Pakistani community, and I recognise the strong feelings that this subject evokes. I welcome the opportunity to set out the United Kingdom’s approach.
I begin by underlining that Pakistan’s judicial processes are, of course, a matter for Pakistan; this has been the consistent position of successive UK Governments. However, we are clear—and I restate this today—that the Pakistani authorities must respect fundamental freedoms, including the right to a fair trial, due process, humane detention and access to appropriate medical treatment. These principles apply to Imran Khan, just as they apply to every citizen of Pakistan.
The noble Lord, Lord Ahmad, raised concerns about Mr Khan’s health and his detention conditions. We note the findings of the Supreme Court-mandated medical team and reports of medical procedures, including during this month. We also note the Islamabad High Court’s decision not to order an immediate hospital transfer, instead directing a further clinical review. While we do not comment on specific judicial decisions, we are clear that detention must be humane and that credible allegations of mistreatment should be investigated promptly and impartially.
Family access has been highlighted by several noble Lords, including the noble Lord, Lord Mohammed of Tinsley. The Government recognise the importance of prisoner-family contact, particularly in cases involving long-term detention or significant medical treatment. Decisions on visits, though, visas and entry to Pakistan, rest solely with the Government of Pakistan. Our consular support applies to British nationals. I know noble Lords understand this and that Imran Khan is not a British national, which limits the role that we can play. It is important that I restate that distinction, but I am happy to agree to speak to my friend, Minister Falconer, with a view to arranging the meeting that noble Lords have requested.
In response to my noble friend Lady Goudie, I can confirm that Ministers and senior officials have raised with Pakistani counterparts the need to uphold civil and political rights, including due process and humane treatment of detainees. This includes engagement between the Minister for the Middle East, North Africa, Afghanistan and Pakistan, and Deputy Prime Minister Dar in August last year. There were also discussions with the then Foreign Secretary, now the Deputy Prime Minister, who specifically raised Imran Khan’s case during his visit to Pakistan in May last year.
The British high commissioner to Pakistan has also raised Imran Khan’s case at the highest levels, most recently with Pakistan’s Minister for Law and Human Rights last month. In our engagement, we raised wider concerns about democratic freedoms, the conduct of the 2024 elections, media freedoms and the use of military courts for civilians. We consistently urge the Pakistani authorities to examine concerns thoroughly and transparently to uphold democratic rights.
This is a short conclusion to a thoughtful, calm, well-informed and important debate. Let me finish by returning to the central point of today’s debate. The Government’s position is consistent and principled. Pakistan’s judicial processes are, of course, as many have said this afternoon, a matter for Pakistan. But like the noble Lord, Lord Hussain, we expect Pakistan’s authorities to uphold fundamental rights, fair trial standards, due process, humane detention and access to appropriate medical care for all detainees, including Imran Khan.
Where we have concerns, we raise them. Without interfering in Pakistan’s domestic matters or advocating for bespoke arrangements, we remain committed to supporting Pakistan’s democratic resilience, its human rights protections, and the stability and prosperity that will flow from strong and accountable institutions, as noble Lords have said. We do so as long-standing partners; we engage constructively and honestly, and this is in the UK’s national interest. I thank all noble Lords for their contributions and look forward to continuing to work with colleagues on these important issues.
The Deputy Chairman of Committees (Viscount Stansgate) (Lab)
My Lords, the debate we were due to hold on the UK’s civil preparedness for war has had to be postponed, because we have run out of time. I take this opportunity to wish all Members, clerks, doorkeepers and our Hansard writers a peaceful and restful Easter Recess.