Health Bill (Seventeenth sitting)

Debate between Caroline Johnson and Helen Morgan

Committee stage
Thursday 16th July 2026 Public Bill Committees

[Helen Morgan]

I am suddenly cast back to 31 years ago, when I was choosing my subjects for the final year of my history degree. One of the early modern history papers was provocatively entitled “Women and other deviants”. It was called that to draw attention to the fact that, despite making up 50% of the population, women are often treated as a minority group. I sincerely hope that we are not still in that situation, but women’s issues clearly still need addressing. I will take the Minister at her word, but I will keep pressing her on this issue as we go through the course of this Parliament. I beg to ask leave to withdraw the motion.

Clause, by leave, withdrawn.

New Clause 66

Puberty blockers

‘(1) Within three months of the passage of this Act the Secretary of State must make regulations which ensure that puberty blockers may not be prescribed, dispensed or supplied to persons under 18 years of age for the purposes of treatment related to gender dysphoria, gender incongruence or a combination of both, in the United Kingdom.

(2) These regulations must ensure that such drugs cannot be given out or used as part of clinical trials for the treatment of gender dysphoria, gender incongruence or a combination of both, unless that trial has specifically been approved by a resolution of both Houses of Parliament.

(3) For the purposes of this section, puberty blockers means—

(a) a “gonadotrophin-releasing hormone (‘GnRH’) analogue” which means a medicinal product that consists of or contains buserelin, gonadorelin, goserelin, leuprorelin acetate, nafarelin or triptorelin, and

(b) any other drug which has the effect of suppressing or delaying puberty that the Secretary of State may by regulation appoint.’—(Dr Caroline Johnson.)

This new clause would create a requirement for the Secretary of State to make regulations which prevent puberty blockers from being prescribed to persons under 18 years of age for the purposes of treatment related to gender incongruence, or clinical trials related to gender incongruence unless specifically approved by Parliament.

Brought up, and read the First time.

[Dr Johnson]

I beg to move, That the clause be read a Second time.

New clause 66 relates to the prescription of puberty blocker drugs, also known as GnRH agonists. A first rule of medicine is “Primum non nocere”—first do no harm. That is what this clause seeks: to make sure that harm does not come unnecessarily to children. It is required because the Government are sponsoring a £10.6 million trial to put 226 physically healthy children on puberty-blocking drugs. That is being done despite the fact that the Health Secretary claims he feels “uncomfortable and uneasy” at the prospect.

There are lots of questions that need to be answered. The minimum age for this trial is 11 years old for girls and 12 years old for boys, despite the Medicines and Healthcare products Regulatory Agency having recommended a much older group. When my hon. Friend the Member for Fylde (Mr Snowden) asked why in a written question, the Minister gave a holding answer. Is that because the Government do not know or because they do not want to say?

I am not convinced that the trial will produce the answers the Government want. Apparently, they are asking the question of whether puberty blockers benefit children who have questions over their gender and who will later go on to have a trans identity in adulthood. The challenge is that we do not know which of the children who have challenges with their gender during puberty will go on to have such an identity in adulthood, so we are essentially doing a trial on a large number of children to see whether puberty blockers are beneficial for a small group, or, as it was described by the Secretary of State,

“a very small subset of a very small group”.—[Official Report, 22 June 2026; Vol. 788, c. 56.]

The Government have data that they could use in a data linkage study to try to narrow that field down, but for some reason they are choosing to do this trial before that. I do not understand why; perhaps the Minister can explain.

I do not want to detain the Committee too long on this issue—I could talk for some time—because we have had Opposition day debates in the House on it, but we have seen unease from both sides of the House. The Minister will be aware that there was a vote on the trial at the end of the recent Opposition day debate, and there were a large number of abstentions, as well as three votes against, from her party, as well as many votes against from ours. Puberty blockers carry risks that may or may not be reversible: there are concerns about bone density, cognitive damage and fertility loss, all for children who should be enjoying their childhood.

The new clause would prevent a trial from taking place without votes in the Houses of Parliament. I appreciate that we would not normally seek to have votes in the Houses of Parliament on a clinical trial, because it would slow clinical trials down, but I think this topic in particular has unfortunately become so polarised that it is very difficult to see how it can be processed properly.

Ultimately, the Government have responsibility for what goes on in this country. If the Government want to pay for the trial, then it is the Government’s trial, and the Government should bring it before the House for us to decide as parliamentarians whether it is the right thing to do. I think it is absolutely not. I think we are putting children at risk of permanent harm. We do not know that these children are going to benefit. We do not even know if they are in the pool of children who would, in the long term, have a trans identity, and the Government are not even waiting to see whether they can find out using the data linkage study. It is wrong, and we need to do what we can to try to prevent it.

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[Helen Morgan]

I thank the Minister for her response. I think it is important that we keep an eye on the power of medical misinformation or disinformation, and expand that consideration to things such as therapy chatbots. It is not just an online problem, but an AI problem—it is not just malign influences that cause the problem. I beg to ask to leave to withdraw the motion.

Clause, by leave, withdrawn.

New Clause 81

Minimum service levels

“(1) Within six months beginning on the day on which this Act is passed, the Secretary of State must, by regulations, make provision for minimum service levels to operate in the NHS during periods of strike action.

(2) Regulations under subsection (1) may repeal or otherwise amend provisions in the Employment Rights Act 2025, insofar as is necessary for the purposes of this section.

(3) Regulations under subsection (1) must include provision for minimum levels of service by categories of NHS workforce staff, including all Agenda for Change staff but not doctors.

(4) Regulations under subsection (1) may not be made unless a draft of the instrument has been laid before and approved by a resolution of each House of Parliament.

(5) When minimum service levels are in operation under this section, the NHS must set minimum standards of acceptable service to be provided by the NHS during periods of strike action, including mitigating any effect on appointments, medical procedures, acute services, midwifery, surgical procedures, and any other matters that the Secretary of State deems appropriate.

(6) With one year beginning on the day on which regulations are made under subsection (1), and within each period of a year thereafter, the Secretary of State must lay before Parliament a report on compliance with minimum service levels, including reasons for any failure by operators to secure the required thresholds, and actions the NHS is taking to improve performance to meet the minimum service levels.”—(Dr Caroline Johnson.)

This new clause would require the Secretary of State to make regulations which create minimum service levels to operate in the NHS during periods of strike action.

Brought up, and read the First time.

[Dr Johnson]

I beg to move, That the clause be read a Second time.

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[Helen Morgan]

New clause 108, tabled by my hon. Friend the Member for Mid Sussex (Alison Bennett), will place a duty on ICBs to collect and publish data on the number of patients who died while waiting for end-of-life care. This is a fairly self-explanatory new clause, so I will keep my remarks brief.

We know anecdotally that palliative care provision is very patchy across the country and can be something of a postcode lottery, and that many people who die in hospital would have preferred to die at home with the support of hospice outreach services or in a hospice itself. The new clause would ensure that we understand how many of those people there are and where they are located, so that we can consider whether hospice provision is appropriately provided in the right places.

I hope the Minister will consider the importance of the new clause, which would allow us to have a much more comprehensive palliative care service across the country.

[Dr Johnson]

New clause 109, tabled in my name, is very simple, requiring hospice funding to be provided in three-year blocks. Hospices are struggling under the weight of the national insurance rise in the Government’s first Budget, so they would benefit greatly from having a bit more certainty over how much their funding will be from year to year. I am interested to hear the Minister’s response to the new clause.

Health Bill (Sixteenth sitting)

Debate between Caroline Johnson and Helen Morgan

Committee stage
Thursday 16th July 2026 Public Bill Committees

[Helen Morgan]

I thank the Minister for outlining the existing statutory framework. I agree that it ought to be sufficient, but there are high-profile instances where it has not been, so I look forward to hearing more from her on Report about how the cultural change will be implemented so that further legislation is not necessary. I beg to ask leave to withdraw the new clause.

Clause, by leave, withdrawn.

New Clause 38

Single sex facilities

“The Secretary of State is required to ensure that there are single sex—

(a) changing rooms for NHS staff

(b) toilets and washing facilities for NHS staff

(c) wards for NHS patients

(d) toilets and washing facilities for NHS patients.”—(Dr Caroline Johnson.)

This new clause creates a requirement for the Secretary of State to ensure certain single sex facilities are made available for NHS staff and patients.

Brought up, and read the First time.

[Dr Johnson]

I beg to move, That the clause be read a Second time.

This is a very straightforward new clause. The Secretary of State would be required to ensure that there are single-sex changing rooms, toilets and washing facilities for NHS staff and single-sex wards, toilets and washing facilities for NHS patients.

The UK Supreme Court unanimously ruled that a woman is defined by biological sex in 2025, and the Minister herself said:

“We are completely committed to single-sex spaces.”

However, it appears that the Minister for Women and Equalities did not get that memo. Despite having apparently been sat on her desk since September, the new draft code from the Equality and Human Rights Commission was not laid before Parliament until 21 May. One week before that guidance was published, a female NHS England employee in Leeds won her claims of indirect sex discrimination and harassment over a policy allowing transgender colleagues to use toilets and changing rooms that correspond to their gender identity rather than their biological sex. On 28 June, after the draft code was laid, it was reported that West London NHS trust had told patients that they could use single-sex facilities based on gender identity.

It has taken the current Health Secretary some time, but I understand that he has changed his mind on the issue and come to the same conclusion as others: that a woman is, in fact, a woman and that toilets and changing facilities must be protected. Will the Minister follow his lead and protect single-sex spaces in NHS trusts? The Supreme Court has ruled that a woman is defined by her biological sex. My party knows that. The Minister claims her party knows that too. It is time for her to show it by pulling the levers that only she can to ensure that patients and staff are protected right across our health service.

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[Dr Johnson]

New clause 48 would require the Secretary of State to

“publish and maintain a national framework for improving access to radiotherapy services in England.”

One in four people can expect to need radiotherapy in their lives. That is a lot of people who will need consultation, assessment, pre-treatment planning and treatment delivery. Data published a few years ago showed that Scotland, Wales and Northern Ireland have more linear accelerator machines per million people than in England. Can the Minister confirm whether that is still the case? Last year, Radiotherapy UK had research indicating that more than 60,000 cancer patients are not getting the radiotherapy they need and I know particular areas of the country are struggling. Can the Minister provide an update on the roll-out of the new LINAC machines at 28 hospitals, which she spoke about in May 2025?

We were also told that by March 2027, up to 27,500 additional treatments will be delivered. Can the Minister share some information on how that will be achieved? The Labour Government have now been in power for two years. They have raised taxes by more than £60 billion and they do not have much to show for it. They have not produced a workforce plan. They have said that one will be imminent; can the Minister confirm whether it will be published today before we break for the recess? Is the intention to publish it during the recess or will we have to wait until the autumn?

There is a 31% shortfall in clinical radiologists. New clause 48 essentially requires the publication and maintenance of

“a national framework for improving access to radiotherapy services”.

This Government have essentially shown that if a requirement is not in legislation, plans just get delayed, diminished and disowned, but patients cannot afford to wait any longer.

[Helen Morgan]

I rise to speak to new clauses 53 and 54, tabled in the name of my hon. Friend the Member for Epsom and Ewell (Helen Maguire), and new clause 65, tabled by my hon. Friend the Member for Westmorland and Lonsdale (Tim Farron).

New clause 53 would give patients a right to start cancer treatment within 62 days of referral and require the Secretary of State to establish a scheme to deliver that. It would also require the Secretary of State to update the House on progress against the target on or around the time of World Cancer Day. New clause 54 would require the Secretary of State to introduce regulations requiring the Government to co-ordinate research into cancers with the lowest survival rate.

Health Bill (Fourteenth sitting)

Debate between Caroline Johnson and Helen Morgan

Committee stage
Thursday 9th July 2026 Public Bill Committees

[Helen Morgan]

Hon. and right hon. Members on the Committee will understand that we are talking about a single patient record that we do not understand much about yet, because most of the detail will come later. This new clause is attempting to establish what guardrails we would like to see for the protection of patient data when the single patient record is brought into existence

There are very genuine concerns about people’s health conditions becoming individually identifiable. If there is an individual in a single postcode with a rare condition, anonymising the data can essentially never happen. That is a genuine concern that people have. I hope that, when we get to Report stage, the Government will be able to give us a little more detail on what safeguards they intend to put in place over the use of that data. To that end, I do not intend to press this new clause to a vote, but I hope that the Government will take into account the concerns we have expressed about building trust and protecting data privacy, and will give us further reassurance at a later stage. I beg to ask leave to withdraw the motion.

Clause, by leave, withdrawn.

New Clause 11

Directors of public health

“After section 7B of the National Health Service Act 2006 insert—

‘7BA Directors of public health

Each integrated care board must, for the purposes of exercising any public health functions directed by the Secretary of State, appoint a lead director of public health.’”—(Dr Caroline Johnson.)

Brought up, and read the First time.

[Dr Johnson]

I beg to move, That the clause be read a Second time.

--- Later in debate ---

[Dr Johnson]

I beg to ask leave to withdraw the motion.

Clause, by leave, withdrawn.

New Clause 12

Corridor Care Accountability

“(1) Six months after the passage of this Act, and every 12 months thereafter, the Secretary of State must produce and lay before Parliament a report on the prevalence of corridor care in NHS hospitals.

(2) A report under subsection (1) must include—

(a) an analysis of data on the number of corridor incidents at the national, integrated care board, trust, and hospital level,

(b) the steps the Secretary of State has taken that year to reduce the number of corridor care incidents,

(c) the Secretary of State’s plans to reduce the number of corridor care incidents in the coming year, and

(d) information regarding the amount of funding directed toward reducing the number of corridor care incidents that year and funding allocated for such efforts in the future.

(3) Following the publication of a report under subsection (1) the Secretary of State must give evidence in front of a panel (to be called the “Corridor Care Tribunal”) including—

(a) patients,

(b) bereaved or affected families, and

(c) frontline NHS staff who have been impacted by corridor care.

(4) Panel members for a Corridor Care Tribunal under subsection (3) shall be identified by local Healthwatch organisations and NHS Royal Colleges.”

This new clause requires the Secretary of State to publish an annual report about corridor care and give evidence before a panel of affected patients and staff.—(Helen Morgan.)

Brought up, and read the First time.

[Helen Morgan]

I beg to move, That the clause be read a Second time.

Health Bill (Thirteenth sitting)

Debate between Caroline Johnson and Helen Morgan

Tuesday 7th July 2026 Public Bill Committees

[Dr Johnson]

As I understand it, the objectives of the Bill are to replace the local healthwatch with a less independent, internalised gatherer of patient experience feedback. The objectives appear to be featuring feedback more centrally in strategic decision making, getting people into the room and simplifying the patient landscape.

There are things that I do not understand about that. If the problem is that those who commission or deliver the services are not listening adequately to the people who gather the patient experience information, why not invite the independent individual who has gathered that information into the room? Why ask someone in the room to gather the information and risk the independence? Why not compel more listening?

The Minister talked about who is accountable for action. My understanding is that it is the healthwatches’ job to gather the patient experience and present it to Healthwatch England and the decision makers. It is not their job, as I understand it, to make decisions on how care is delivered or to deliver that care differently. Does the Minister intend that to change?

The Minister also talked about strengthening the impact of Healthwatch, but I do not understand how this change will do that. We have heard how its independence allows Healthwatch to go on telly, talk to Members of Parliament, Select Committees, radio stations and others, and publicise its findings. If it is within the Department, will it be able to do so as freely? I suggest that it will not.

The other thing that I do not really understand—perhaps the Minister can help us with this—is the organisation. At the moment, it is done in local authority areas. It will now become the job of the local authority and the ICB to commission feedback, but we have already heard how the 50% cuts to ICB budgets have led to ICBs merging into larger conglomerates. Those do not necessarily overlap with the strategic mayoral authorities in the way the Minister eventually wants. What geography does the Minister want the feedback to be gathered over? How does she see that working? Will it require further restructuring? The hon. Member for Lichfield talked about the importance of localism and how different areas of his constituency have different health needs. How does the Minister think that that will work under her new plans?

The Minister said that one benefit of the new process is reaching vulnerable individuals, but what is to stop Healthwatch doing that? Ultimately, if we have Healthwatch doing things now that are independent and respected across the House—I am sure your local healthwatch is also excellent, Ms Lewell; Lincolnshire’s certainly is—why not strengthen that voice? Why not say to those who are providing that service, “We’re going to give you more resources,” or “We’re going to ask you to deliver it in a slightly different way,” or “We’re going to ask you to focus on particular populations,” or even, “We’re going to invite you into the room with the ICBs so that they can hear you and listen carefully”?

Why not compel those making the decisions and delivering the services to listen to Healthwatch, rather than replacing it? It was not Healthwatch’s job to listen to them, but to gather the information and present it, and that is what it has done. Can the Minister explain how removing its independence is going to help? I simply do not understand it.

[Helen Morgan]

I am very grateful to serve under your chairship, Ms Lewell. My hon. Friend the Member for Winchester has made some general points about Healthwatch and the importance of an independent patient voice; I will not reiterate them, because he made them very well, but I want to speak specifically about local healthwatches and the benefits that they bring.

I find it quite difficult to hear in this room, so I hope the hon. Member for Lichfield will correct me if I have misunderstood the gist of his speech, but I was frankly astonished by the suggestion that if local managers had heard about the problems at Mid Staffs or at Shrewsbury and Telford hospital NHS trust, the concerns raised in those extremely serious scandals would have been addressed. The reality is that the management of both providers knew exactly about the concerns in those trusts, and they did not address them. That is why we have Healthwatch.

The hon. Member for Lichfield may be aware that my parents live in Stone, which was in the Mid Staffordshire constituency at the time. My mum was a clerk to Staffordshire county council, and I recollect very strongly that the health scrutiny committee at that council questioned the trust about its appalling mortality rate and was constantly reassured that there was nothing to see here. It absolutely failed to mark its own homework. The suggestion that my constituents Kayleigh and Colin Griffiths, who fought for the Ockenden report on Shrewsbury and Telford, did not first try the local services is, I think, missing the point.

With the Ockenden report on Nottinghamshire a couple of weeks ago, we also saw that the hospital trust commissioned several reports into its own maternity services, which found that it was failing. Instead of acting on them, it brushed them under the carpet and commissioned another. The suggestion that providers are capable in the current culture of dealing with those issues does not, I am afraid, hold true in the way it should across every trust.

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[Dr Johnson]

Is there not a third issue: that the local authority and the ICB will no longer have congruent areas and will therefore look at different populations?

[Helen Morgan]

The hon. Lady raises a good point. I do not want to revisit an earlier part of the debate, but it is certainly relevant that where there is not a local authority representative on the ICB and there is not a mayor in place, and the ICB’s area is not coterminous with the local authority boundary, that adds another element to the issue of the separation out of Healthwatch. Does the Minister agree that the independent and locally rooted Healthwatch cannot be replaced by processes that sit within the NHS system? Will she please reconsider the change? There is concern on all sides of the House, given the value that Healthwatch brings to the service.

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[Helen Morgan]

New clause 1, which I tabled, would require the Secretary of State to appoint a maternity commissioner within the Department of Health and Social Care to oversee national maternity services. This person should be someone with experience and expertise in maternity services, and not a political appointment.

It is important to start by saying that I tabled the new clause before we had the report from Donna Ockenden on the Nottingham review, and last week’s report from Baroness Amos on her national review, both of which recommended the appointment of a maternity commissioner. Obviously, since then, the Secretary of State has announced that he will appoint a maternity commissioner. None the less, I will state the arguments for having one, and if the Minister can give us some assurances today, I will not press the new clause to a vote.

Just to set the scene, which I think we all know too well, maternity services in England have suffered a series of high-profile scandals. The cost of political neglect has been paid by families in terms of trauma, injury and lost lives. We have known for a long time that maternity services in this country have been failing. Numerous recommendations have been made over that period, but they have not been effectively acted on in a consistent way, and Baroness Amos’s inquiry finally confirms that.

It is important to say that the vast majority of births take place safely, successfully and happily. However, where things go wrong, having a baby safely has become a postcode lottery. Women are being routinely silenced, and staff who raise the alarm on unsafe care or systemic discrimination have been put off or crushed by a culture of fear. We therefore need to make England the safest country in the world to have a baby.

The Liberal Democrats have been campaigning on that for a long time, and following the Ockenden and Amos reviews it genuinely feels that there is now the will and focus to deal with the problem once and for all. This issue has been going on for far too long. We thank the Secretary of State for hearing our campaign and Baroness Amos’s calls for a national maternity commissioner to oversee national standards and drive change. We also pay tribute to campaigners such as Louise Thompson and the former MP for Stafford, Theo Clarke; without their advocacy, and without so many women sharing their stories, we would not be moving forward.

It is important to say that one individual—one maternity commissioner—will not solve all the issues in maternity by themselves, but they can help drive change and address recurrent issues, whether those are cultural or about safe staffing. They can hold Ministers to account, help restore public confidence in NHS maternity service and ensure that accountability exists. But I want to be clear that the buck should always stop with the Secretary of State; they hold the power and the purse strings, and this role cannot be used by Ministers as a way to shirk that responsibility.

I hope the Minister will clarify a few key points. First, can she reassure us that the commissioner will be independent and not a political appointee? It is essential that this individual feels confident to hold the Government to account and have those difficult conversations. That is far less likely if they are a political appointee.

Secondly, women have made it clear that for them to be reassured that this change will happen and happen meaningfully, they need a clear timetable for when the maternity commissioner will be in place and operating. Understandably, the Secretary of State has not been able to provide that yet, given the need for this Bill to pass through Parliament and for the statutory role to be on the books, and given the time it will take his maternity taskforce to define what it wants the role to look like and for the appropriate legislation to be written and put in place. However, we hope we can get a firm commitment to a timetable from the Minister today or, if not today, then on Report.

We think the commissioner should be involved in the establishment of the taskforce, because it is important that it does not develop a plan that they are required to implement, despite it being something they personally would not have approved. I therefore hope the commissioner will be in place very quickly, even if only on a temporary basis, so that they are working to get the taskforce plan into place.

We heard from the Secretary of State that the commissioner will co-chair the taskforce alongside him. That seems to be the right move, and I welcome it, but, as I said, it is important that they have some role in shaping its action plan, so that they can feel responsibility for it and be fully behind its implementation. Will the Minister commit to introducing a temporary maternity commissioner so that that can happen?

Finally, we have heard reports that the taskforce is not meeting very regularly. I hope the Minister can reassure me that it is now meeting much more regularly and getting that plan into place as quickly as possible, and that the Secretary of State is fully on board in driving forward the commissioner’s role as soon as possible.

New clause 13, which is also in my name, is about putting a duty on the Secretary of State to create a scheme to ensure that every maternity unit in the country achieves a good or outstanding rating from the CQC. I will not repeat some of the points I have just outlined about failing maternity services, but the first quarter of 2026 saw the worst ever recorded rate for maternity injuries. Four years ago, the Ockenden review into the Shrewsbury and Telford hospital NHS trust, which is in my area, found that over 200 babies had died unnecessarily in Shropshire. Yet, despite several immediate and essential actions being put in place, a subsequent CQC review found that the majority of maternity units in this country did not achieve a good rating for safety—they were inadequate in some way. That is just not acceptable.

Our package of measures includes the maternity commissioner, which the Government are obviously progressing with, and we are very pleased about that. However, we also need investment in the service to ensure that that maternity commissioner has the resources they need to make the changes required. We therefore call for one-to-one midwifery care for every woman in labour; a consultant on every labour ward 24 hours a day, seven days a week; a director of midwifery—a senior, experienced midwife—in every maternity service to ensure that more junior midwives on that ward are suitably supervised; the restoration of ringfenced service development funding; and a dedicated neonatal workforce plan.

New clause 13 also requires an annual report to be laid before the House on the “effectiveness of the scheme”. That would allow Parliament to track progress and hold the Government’s feet to the fire on it. Baroness Amos has also called for regular reporting to Parliament to maintain accountability, albeit through the maternity commissioner.

There seems to be consensus, here and across the NHS, on the need for meaningful and decisive action on maternity. There is a great deal of overlap between our plan and the recommendations Baroness Amos has made, and I hope the Minister will be able to take some of these points on board and incorporate them into the Bill.

[Dr Johnson]

As the hon. Lady said, new clause 1 seems somewhat redundant, because the Government appear to have decided to appoint a maternity commissioner.

New clause 13 asks for a report. Before I go any further, I should say that I am a member of the Royal College of Paediatrics and Child Health and have attended the delivery of many babies as a paediatrician at different levels of seniority. I should also say that I am a member of the British Medical Association, that I continue to work as an NHS consultant paediatrician and that I worked at Nottingham University hospitals NHS trust in late 2012 and 2013.

I have great sympathy with the reasoning behind what the hon. Member for North Shropshire is proposing. We have all been shocked by the many reports we have read, the circumstances we have heard about, the tragedies that have occurred over many years and the challenges that are faced by maternity care. I am not sure that writing more reports is going to help; I think we need more action rather than words.

The hon. Lady mentioned the taskforce. I was disappointed that it took the Government so many months to establish it, that it took so long for it to meet and that it has met only a few times. As we have talked about things such as Healthwatch and the HSSIB, the Minister has shown her enthusiasm to get on with things and ensure that the recommendations made in the varying reports are implemented. I would therefore be interested to understand how that will occur in maternity.

My understanding is that the Government are going to produce a plan on how to deliver the recommendations in the recent report, and that is going to be available by Christmas. However, that means that we will then be in a situation where the Government came into power in mid-2024 and then spent a year writing a plan—the 10-year “Fit for the Future” plan. Around the time that they published that, they decided that they needed an urgent maternity report; that was going to take a few months, but it ended up taking another year in of itself. Now we are going to take another six or seven months writing another plan on how to implement the plan we have written, based on the plan we wrote before, based on the plan we did not have at the general election.

I am interested to understand how the Government are going to convert the good intentions I am sure they have into action. In particular, their manifesto promised that thousands more additional midwives would be trained. I would be interested to know what progress they have made on that.

Health Bill (Twelfth sitting)

Debate between Caroline Johnson and Helen Morgan

Committee stage
Tuesday 7th July 2026 Public Bill Committees

[Helen Morgan]

The amendment was tabled by my hon. Friend the Member for Wells and Mendip Hills (Tessa Munt) on behalf of the approximately 1.2 million people in England who live with myalgic encephalomyelitis, because five years after the introduction of National Institute for Health and Care Excellence guideline NG206, little has changed. Service provision according to NG206 remains patchy and poor, with many patients having traumatic experiences. The amendment would require a period to be set in which integrated care boards and other health bodies must comply with the guideline, and the Secretary of State must publish an annual statement on compliance with NG206 across the NHS in England.

The introduction of the guideline after sustained campaigning represented a major reform after years in which ME was treated as a psychiatric condition and patients were pushed to follow graduated exercise therapy. Often, GET had disastrous consequences, precipitating serious deteriorations that patients never recovered from. Credit is due to the hon. Member for Washington and Gateshead South (Mrs Hodgson), the current Minister for Public Health and Prevention, for her determination when in opposition to bring about the change.

In a written answer published last week, the Minister for Public Health and Prevention confirmed that all ICBs have a statutory obligation to ensure sufficient care provision for their population, but the experience of those with ME is that that obligation is far from being fulfilled. In some ICBs, no services for ME are commissioned; in others, the provider has a history of providing services that reflect not NG206, but the old and condemned approach of GET. Some services are provided out of psychiatry departments, which is a huge red flag for those with ME, and information on the quality of services is patchy. Results from a big survey of more than 5,000 people with ME or long covid in late 2025 painted a bleak picture: more than half said that they had been disbelieved by an NHS healthcare official, one in three had been made to feel that their ME was their own fault, and almost two in five had had an encounter with a clinician that was traumatic or traumatising.

Five years after its introduction, NG206 is far from being complied with, and so members of the ME community—approximately 1.2 million people, as I said—are desperately asking that something be done to address the situation. The amendment represents a route that offers hope for many long-neglected and mistreated people. I do not intend to press the amendment to a vote, but I hope that the Minister will be able to reassure us about improving the consistency of provision for people with ME.

Moving to the clause generally, we broadly support the intention, but think that more safeguards need to be built into the principle, given the powers that are being handed to the Secretary of State. The clause makes provision for the period for compliance with a NICE recommendation, but gives no detail of how that will work in practice or how often the Secretary of State will change the standard three-month rule that NICE requires. No ceiling is put on the compliance period, no criteria govern when the period may be extended, and there is no duty to consult or set out reasoning.

What will the process be when the Secretary of State intervenes in the period of time for compliance with a NICE recommendation? We thought that there would be some mix of evidence requirements, consultation, statement of reasons, impact assessment and some kind of parliamentary scrutiny. The Secretary of State should at least have to set out their reasoning why the new power has been used. The value of the current requirement is almost entirely due to the compliance period being short and fixed. The three-month rule gives a positive NICE recommendation practical force. A power to lengthen or vary that period without constraint weakens the requirement in substance while leaving it formally intact. The right is not removed but its timing is made discretionary. For a patient awaiting treatment, that does not amount to the same thing.

A variation power is not new. Since the introduction of the budget impact test in 2017, NHS England has been able to apply to NICE to extend the funding period for medicines with a budget impact above a defined threshold, but, importantly, that period is criteria-based, triggered by a defined financial threshold, subject to a defined process and time-limited in effect. We are not overtly opposed to the power in principle, but more safeguards should be built into the criteria for its application. I would be grateful for some guidance from the Minister on that.

[Dr Caroline Johnson (Sleaford and North Hykeham) (Con)]

I have sympathy with the principle behind amendment 58, in the name of the hon. Member for Wells and Mendip Hills. The hon. Member for North Shropshire is right to say that individuals with ME have not always received the best quality care. In many cases, ME is a debilitating and incredibly frustrating condition, and around 10% to 25% of sufferers have severe ME, meaning that they are housebound or bedbound. We know that some patients are sadly not believed by medical professionals.

In 2021, NICE said that most medical students have little or no training on the condition. The Government have previously committed to increasing the uptake of ME modules among NHS professionals. What progress has been made on that in the last couple of years? The Government also committed in the ME/CFS action plan to develop and run a public awareness initiative, with implementation expected by May this year. Has the Department developed that initiative yet? If not, what is responsible for the delay? It is not marked as complete on the Government website.

The amendment would put guidance for medical professionals into legislation, though, and my concerns about that are twofold. First, it may slow down improvements in the future. If individuals have to legally follow that guidance, how can they innovate and improve treatment without having to come back to Parliament for more primary legislation? That will take time and may mean that people with ME get worse rather than better care in the short term.

The requirement would also limit clinical judgment. A patient may have a particular set of symptoms or conditions or be on a particular set of medications that mean that the doctor or clinician looking after them needs to vary from the guidance. NICE intends the guidance to be just that, guidance, not law, but if guidance becomes law, the doctor or clinician will not be able to vary from it. My concern is that the amendment would be overly restrictive. Although it is well-intentioned, and it is a good idea to ensure that guidance is followed where possible, it would be too rigid. I therefore do not support the amendment, while continuing to support the aim of better treatment.

Clause 58 amends the Health and Social Care Act 2012 by inserting a new section 237(8A), which states:

“Provision made under subsection (8)(b) may include provision about the period within which a recommendation is to be complied with (including provision for the period to be determined by NICE or the Secretary of State).”

At the moment, NICE technology appraisals check the value of a product, whether a drug or a technology, then NICE makes a recommendation. It is then supposed to be the case that within 90 days or three months, ICBs ensure that those technologies are available, but we know that in the real world it can take longer—sometimes 12 to 24 months—for some things to become available. That could be because technology needs to be bought or training needs to take place.

I understand why there could be variation and why the Government may want to consider varying the period, but it is not clear why they need to do so in legislation, because it is possible now to vary the period on an individual basis. For example, the Government imposed a five-year limit rather than a 90-day limit for the introduction of hybrid closed loop systems for diabetes, because that is a technology that requires proper training and they were never going to be rolled out in such a short period. The other product that notably has a longer time is tirzepatide, which is more commonly known as Mounjaro. I suspect that that is down to cost, but I am not certain.

Why do the Government want to change the 90 days? The patient’s right to treatment with a NICE-approved product within 90 days will become a right to getting the product when the Secretary of State says so. That is not really a right at all, because it does not give patients any comfort and may mean that products are received later. The Government have put this power into the Bill, so they clearly intend to use it. Given that they have the power to vary on an individual basis, why do they need the power to vary on a blanket basis? Do they intend to extend the 90-day limit across the board? If so, by how much? There is no ceiling. The Committee received written evidence from Henry Burkitt from Oxygen Strategy, who made the point that there is no ceiling, no maximum time, no duty to consult and no necessity for the Secretary of State or NICE to give reasons why a delay has occurred.

The life sciences industry talks about how it wants products to be rolled out. When it is investing and doing research in this country, it wants to see new products rolled out as quickly as possible once they have been approved, and the clause is a sign that roll-out might be delayed. I understand that the Government might want to be able to vary on certain products, but they already can; why do they want to vary on a more general basis? It is presumably to slow down roll-outs, but by how much?

Health Bill (Eleventh sitting)

Debate between Caroline Johnson and Helen Morgan

Committee stage
Thursday 2nd July 2026 Public Bill Committees

[Helen Morgan]

Amendment 70, tabled by my hon. Friend the Member for Epsom and Ewell, would require the Secretary of State to prepare and publish a risk assessment on the potential for digital exclusion under the establishment of a single patient record. I declare an interest as the current chair of the all-party parliamentary group on digital communities.

I hope that we Liberal Democrats have been clear that overall, we are supportive of the single patient record; it is important that every patient can access their own health records. Under the SPR, however there is a risk that people belonging to already vulnerable groups will be digitally excluded from accessing their health information. Research commissioned by Ofcom suggests that 2.8 million people—5% of the UK population—do not have access to the internet at all. Although age is a predictor for a person not having access to the internet at home, especially if they are over 85, more than half of such people are younger than 75.

Amendment 70 would ensure that the Secretary of State assesses the potential for digital exclusion with relevant stakeholders, including patient groups, and that the assessment is laid before Parliament. It would also ensure that the Secretary of State takes into consideration the risk of exclusion for those lacking access to a suitable electronic device or suitable broadband connectivity, including people who have disabilities, who belong to socially excluded groups or who lack digital skills.

[Dr Johnson]

Amendment 70, as the hon. Member for North Shropshire said, would require the Secretary of State to publish a risk assessment on the potential for digital exclusion in the single patient record. That is important because, as our lives become more electronic and online, there are people who are getting left behind. That could be because they have a disability that prevents or makes it more difficult for them to access online facilities, because they do not have the resources, because they live an area of the country that is less well served by digital or broadband provision, or because they are elderly and have decided that they will not get involved in the digital world.

In fact, according to the Good Things Foundation, 7.9 million people in the UK lack basic digital skills and 1.6 million adults do not have a smartphone, tablet or laptop. Of those with no basic digital skills, 77% are over 65. People need more healthcare as they get older, yet those individuals have fewer digital skills, so this issue needs to be addressed. The NHS Alliance published a report on digital inclusion in March 2026, which found that rural and coastal areas typically have higher levels of digital exclusion than urban areas.

Lincolnshire ICB, which covers the area that I represent, estimates that 21.3% of Lincolnshire’s population live in the most digitally deprived areas. The ICB has a digital inclusion strategy for 2025 to 2028, which includes efforts to try to reduce digital exclusion; I am interested in the Minister’s thoughts on how she might expand that sort of initiative across the country.

The Government’s equality impact assessment for the single patient record recognises that digital exclusion is a significant challenge in several groups with particular protected characteristics and other characteristics. I am interested in learning more from the Minister about how she intends to mitigate that challenge. In many ways, digital availability is a good thing, and it makes things much easier for many people—I am not knocking it in any way—but we need to ensure that people do not get left behind.

I understand that NHS England is supporting public libraries to signpost users to the NHS website and help them navigate it. What will happen to that support as NHS England gets abolished? Does the Minister intend the Department of Health and Social Care to provide something similar?

Amendment 49, tabled in my name, is basically about public awareness. Although we get immersed in what we are doing here, the public are not necessarily following every word that is said in Committee or in this House—or even necessarily every word that appears in the press—so when the single patient record is launched, it is important that they are aware of it, and in particular, aware of their rights.

We have talked about whether a person might want to let a carer see the single patient record or whether they might want to let someone see part but not all of the record. If the record goes live before people are aware of their rights and abilities in relation to it, they might find that things are available to people, or can be viewed by people, who they would not have wished to see them, which could lead to a number of problems. The amendment would allow people to be more aware of the single patient record for a period of time before it is brought in to try to make sure that that sort of problem is mitigated, and I am interested to understand the Minister’s view on it.

--- Later in debate ---

[Dr Johnson]

I have a couple of questions. In lots of ways the provisions derive from clause 1 and the abolition of NHS England. Schedule 7 refers to operating a system in the interests of the health service, which is not the same as operating it in the interests of the patients. Does the Minister have any comments on that? The Nuffield Trust has pointed out that schedule 7 would not pass over to the Secretary of State NHSE’s duty to report to Parliament. Is that because the Minister thinks that duty is duplicated elsewhere and is therefore not necessary?

Under the previous legislation, the Care Quality Commission was slightly stronger and could make a mandatory request that NHS England establish a system, and NHS England had to comply with that unless it related to an existing exception. Now if the CQC makes a request, it goes to the Secretary of State, and whether it is agreed to is then somewhat more optional. Will the Minister say why she needs to change that power?

[Helen Morgan]

I want to speak to amendment 6, which is tabled in my name, and amendment 7, which is consequential upon it. Amendment 6 would ensure that the CQC and NICE can

“continue to make mandatory requests to the Secretary of State to establish an information system”,

as they currently can with NHS England. At the moment, NHS England has a duty to co-operate with the CQC and NICE, and that is often enough for a collaborative approach that allows the CQC to access the data it needs.

But the duty that applies to NHS England is not being passed on to the Department of Health and Social Care. The CQC raised the issue in written evidence to the Committee, saying that the duty

“has been an important mechanism”

that has

“supported receipt of patient safety incident reports…information sharing between regional teams, and the development of central data sharing solutions.”

The CQC went on:

“Without an equivalent duty, we would be reliant on there being sufficient capacity and willingness within DHSC to share information, with no statutory backstop. This could inhibit our ability to receive the information”

needed

“to keep people who use services safe. Challenges in this area are often cultural and rely on the subjective judgment of individual data controllers as to whether particular data sets can be shared, how these should be used and what the timeliness of sharing should be, leading to protracted piecemeal conversations and delays.”

As we have harrowingly heard over the past week, there is often reluctance to share data, particularly when there is a defensive culture in certain NHS institutions. Our amendment seeks to address the gap. I hope that what I have outlined is an oversight from the Government, not a deliberate attempt to reduce transparency or reduce regulator access to key data. The wider changes in schedule 11 will omit section 288 of the Health and Social Care Act 2012. The Government are dropping this key wider duty in a schedule entitled “Minor and consequential amendments”. We do not think it is minor. It holds major implications for patient safety and transparency.

On a wider note, it seems counterintuitive that the CQC, as regulator, does not have easy access to the data collected nationally in the health service.

Health Bill (Eighth sitting)

Debate between Caroline Johnson and Helen Morgan

Committee stage
Tuesday 30th June 2026 Public Bill Committees

[Dr Johnson]

My hon. Friend is, as ever, correct. The mayors are also not all responsible for health and social care—the local authorities are, in most cases. There could therefore be a mayor directing proceedings with the ICB who is a political opponent of those actually democratically elected to look after social care. ICBs are supposed to be apolitical commissioners accountable to the Secretary of State, but now, instead of working with social care directors, they will work with an elected mayor instead.

I can see a positive to that in terms of democratic accountability, but what happens if they all disagree? There is some incoherence about who is in charge. We have the local authority tasked with delivering social care, which may be led by one political party; the mayor directing the ICB, who may be of a different political party; and the Secretary of State who can also direct the ICB, who may again be of a different political persuasion. How does it work if they disagree? Does the mayor actually have authority, given that the Secretary of State can override them anyway? How does the Minister see that working in practice? It feels like some people will be in power without responsibility and others will have responsibility without the power to exercise it.

[Helen Morgan (North Shropshire) (LD)]

I will raise some similar concerns about the abolition of integrated care partnerships and integrated care strategies, which clause 23 brings about. Before I do, I should declare my interest as a vice-president of the Local Government Association.

The removal of integrated care partnerships, as well as the extension of ICBs to cover multiple local authorities, raises unanswered questions about the future of social care planning, which is very important to the Liberal Democrats, as the Minister knows. We feel that it removes the voice of charities and others in the voluntary sector who are crucial to meeting the range of needs in health and social care.

Throughout the Bill there is a theme of separating social care and the NHS, at a time when greater integration and closer working are clearly needed. We heard Sir Andrew Dilnot say in evidence that we cannot deal with some of the challenges that arise in the NHS—particularly around flow through hospitals and long waits in corridor care in accident and emergency—without improving the discharge of patients into social care. Separating the organisations that deliver those things is clearly problematic. If we think about it, as the shadow Minister just outlined, we have lost the local authority representative on ICBs. The Bill also changes the way the better care fund is administered. With those changes, we are really concerned about the separation of these two responsibilities.

I want to draw the Minister’s attention to an example in Shropshire. Shropshire council spends almost 80% of its budget on social care. It is an extremely challenged council because of those funding pressures. Shropshire, Telford and Wrekin ICB has also been one of the most financially challenged ICBs. That is partly because of its small scale and its merging with Staffordshire—which, for the record, is unlikely to be the combined mayoral authority that Shropshire ends up in, as is my current understanding, although we are a long way off resolving that problem.

--- Later in debate ---

[Dr Johnson]

Will the hon. Lady give way?

[Helen Morgan]

I had finished speaking, but I will give way and think of something else to say.

[Dr Johnson]

The civil servants will be under the direction of the Minister, so how does the hon. Lady envisage it working? Presumably, civil servants are there to deliver for their Ministers or Secretary of State? Is she suggesting that makes the decision more impartial? Can she give us some detail on how that will work?

[Helen Morgan]

As I mentioned in my previous remarks, one imagines that a Secretary of State would set out criteria to ensure that the best people for the job are appointed. We are in a situation where a current Parliament cannot bind a future one, but we do need to set a precedent that political capture of these important leadership roles is not an unintentional consequence of this legislation. I accept that it is unintentional; I think the Secretary of State and the Minister have drafted this legislation with the best of intentions, but this is something we should guard against.

Health Bill (Seventh sitting)

Debate between Caroline Johnson and Helen Morgan

Committee stage
Thursday 25th June 2026 Public Bill Committees

[Dr Johnson]

The Government say they are firmly committed to cutting waiting times and meeting the NHS’ 18-week target. It seems odd that, despite that, it is necessary for me to table an amendment to prevent systems from forcing patients to wait artificially longer for their care through the imposition of minimum waiting times.

Last year, The Times reported that at least eight local ICBs had introduced policies to pay healthcare providers for treatments only once patients have waited 12 weeks or more. I cannot think of any clinical reason why someone should wait for 12 weeks before having any treatment. At the time, the Minister said that while there was

“no formal national policy supporting minimum waits”,

local areas may

“choose to include minimum waiting times in Activity Planning Assumptions to ensure delivery of targets within agreed financial allocations…to support commissioners in managing activity to ensure they can sustainably manage within their budgets”.

I do not understand why we would want to make people wait longer than necessary.

The Royal College of Surgeons has expressed concerns and made clear that minimum waits prolong “pain and anxiety” for those made to wait longer, saying that it is

“counterintuitive…to give commissioners the green light to impose 18-week waits, while simultaneously working to ensure patients begin treatment within 18 weeks.”

Age UK deemed it a “rationing approach” that is

“potentially harmful to the health and wellbeing of older people.”

NHS England has made it clear that ICBs cannot introduce minimum waits of more than 18 weeks—that is longer than the target, so that makes sense—but waits between 12 and 18 weeks are permissible. Will the Minister explain why that is a good idea?

Amendment 51 seeks to ban ICBs from introducing any operational policies requiring patients to wait a minimum number of weeks before they may access treatment. There are safety risks involved in introducing minimum waiting times. They distort clinical priorities and may make patients wait in unnecessary pain and anxiety. Treatment should be delivered when possible, based on clinical needs. If a patient has a high level of clinical need, they might need to be treated earlier than the minimum waiting time because of the suffering they are experiencing.

Minimum waits are not only detrimental to patient experience by forcing people to live in greater pain and discomfort; in some cases, the delay may make the patient’s condition worse, and the treatment they need may be more extensive and even more expensive. Their condition may even become life-limiting or life-threatening as a result of the delay. The introduction of arbitrary minimum waiting times that do not have any relevance to patient clinical need raises worrying issues, clinically, professionally and ethically.

Minimum waits will also hinder the NHS’ ability to cut waiting lists and get waits to within 18 weeks. Some providers will have a list of people who can be available at short notice for a procedure, who they can call on if there is a cancellation on the day. If that person has not waited the minimum, that may be left as a gap, and that operation or appointment may not happen. That is wasted NHS resource.

Each month that goes by, many people are added to the waiting list, and some are removed from it. We are aware that there seem to be a lot of unexplained removals from the waiting list, and that has spiked recently. Among the people treated by NHS providers in April, around 600,000 were treated within eight weeks of referral, versus 74,000 who were treated between 14 and 18 weeks. The introduction of a minimum waiting time will therefore push back many people’s treatment by as much as 10 weeks.

Minimum waits also worsen and entrench postcode lotteries, because patients who have differential waits, based on whether their ICB has decided to implement minimum waiting times, may experience differential levels of care because of where they live. They are also another way of undermining patient choice, because patients may want to be treated in one area or one hospital because of the waiting time. If they all have different minimum waiting times, that distorts patients’ ability to choose.

Minimum waits are also completely contrary to the 10-year plan for health, in which choice and productivity were considered central features, along with the Government’s wider commitment to keep people healthy. I hope the Minister will agree with amendment 51, which would ensure that minimum waiting times cannot be instituted.

Amendment 52 also concerns waiting times. You will no doubt have seen, Dr Huq, the many newspapers articles about the Government fiddling the figures on waiting times, and there has been a spike in removals from waiting lists. People have found themselves removed from lists or going back on lists, or have suddenly found out that their waiting time started more recently than they thought. Amendment 52 would require the Secretary of State to publish the number of patients who are taken off treatment waiting lists each month and why they were removed. It is important that we are able to explain to our constituents why the Government have decided to remove them.

[Helen Morgan]

I want to speak to amendment 63, tabled by my hon. Friend the Member for Westmorland and Lonsdale (Tim Farron). As hon. Members know, he has campaigned passionately and for a long time on the provision of radiotherapy. His amendment seeks to ensure that there is sufficient and equitable access to radiotherapy. Radiotherapy is required by half of all cancer patients, and it is incredibly cost-effective, but England has fewer radiotherapy machines than comparable European countries, and thousands of people have to travel long distances and over 45 minutes for their treatment, particularly in my hon. Friend’s Cumbria constituency, as he has noted on many occasions.

The Darzi review noted that radiotherapy services are on their knees. They have some of the longest waiting times for treatment and vast parts of the country are classed as radiotherapy deserts, because of lack of accessibility. Radiotherapy currently has the worst 62-day performance of all main cancer treatments, and if we are serious about ensuring that all cancer targets are met by 2029, then we need the infrastructure, people and equipment to deliver them.

Cancer cases are expected to rise 30% by 2040, meaning that radiotherapy centres must be able to keep pace. Importantly, radiotherapy can also be used at an earlier stage in treatment, potentially saving lives, saving money and meeting important waiting time targets. We really ought to be leading the way on this and keeping pace with our European counterparts so that no one is left without the treatment they so desperately need. I add my support to amendment 52, because we do need to build confidence in the reduction of waiting lists, and more transparency around reductions would be helpful.

[Gregory Stafford]

Amendment 35 has not been moved, but it is very similar to new clause 35, which may be moved and concerns equipment. I will address both together. I think all in this Committee would agree that ensuring timely access to community equipment and wheelchair services is vital for patient independence, dignity and recovery. I have a number of constituents who believe that they are not getting access to that equipment in the time they would expect.

We also need to ensure that we give proper consideration to the efficiency and management of resources. In particular, we should look more closely at what happens after that equipment has been distributed. Too often, items such as crutches, wheelchairs or Zimmer frames are not reviewed after issue or returned when they are no longer needed. We are already seeing a massive financial consequence of that. It was reported last year that the Royal Berkshire NHS foundation trust is losing around £70,000 a year due to patients retaining unused mobility equipment. That might seem like a drop in the ocean for the NHS, but £70,000 could fund another nurse, if we include the on-costs. These things do have consequences.

Despite distributing thousands of items, only 38% of crutches and just 15% of Zimmer frames were returned in 2024. That represents a significant loss of reusable equipment and considerable pressure on NHS resources. It also gets into the mindset of how patients use and value those pieces of equipment and how NHS users think about resources. While I think that we all agree in this Committee that the NHS should be free at the point of use, one of the downsides of that is that patients rarely think about what the cost of their care contributes. I personally think that if people understood how much crutches or medicines cost, they would use them much more usefully. Plenty of times I have spoken to pharmacists in my constituency who tell me that once a patient has unfortunately died, their family then comes to the pharmacy with a sackload of drugs that have never been used. I think that if people understood the cost of those things, they would use them more effectively and with more caution.

This is not an isolated issue but indicative of a wider problem across the system. If we were to introduce firm timelines for provision, we would need to ensure that there is a robust process for recovery, reuse and proper management of that equipment. Therefore, while I am not supportive of amendment 35 or new clause 35, I ask the Government to consider how those proposals could be strengthened by embedding clear expectations about the return and reuse of that equipment so that public funds are used as effectively as possible.

I will now turn to the two amendments in the name of my hon. Friend the Member for Sleaford and North Hykeham. Amendment 51 is important because, while I understand the Government’s intention in clause 16, as my hon. Friend has mentioned, her amendment will prevent any artificial delays in treatment by ensuring patients are seen as soon as clinically appropriate, rather than being required to wait a minimum period. It simply protects the principle that care should be based on medical need—which I think we would all agree on—rather than some administrative target. It helps avoid situations where waiting times are managed on paper rather than reduced in reality. That ultimately safeguards patient outcomes and timely access to care.

Moving on to amendment 52, I add my strong support to this amendment, because it goes to the heart of trust, transparency and patient safety in the health system. I have been speaking to constituents and individuals from across the country who have contacted me after a video I posted on my social media that contributed to the exposure of the removal of 351,000 patients from waiting lists in March of this year. The stories I have heard are deeply troubling. Those include patients who have waited years for potentially life-changing treatment only to receive notification late—or in some cases not at all—that they have been removed from the list. For many it came as a shock, while for some it came after months or years of uncertainty. This is not some trivial administrative matter. I would sum up the Minister, when responding to questions on this point, as: “Nothing to see here, this is what always happens.”

There has been such a significant jump over a period of two months that there has to be something going on here. The experiences of patients who have spoken to me about this suggest that that is happening. For those patients it is the difference between treatment and deterioration, between hope and abandonment. It is also undoubtedly affecting more vulnerable and less technologically savvy pockets of society, such as the elderly.

Health Bill (Sixth sitting)

Debate between Caroline Johnson and Helen Morgan

Committee stage
Thursday 25th June 2026 Public Bill Committees

[Helen Morgan (North Shropshire) (LD)]

It is a pleasure to serve with you in the Chair, Ms Lewell. In general, the Liberal Democrats support clauses 12 and 13. We think that local decision making and community empowerment in the NHS, including on commissioning decisions, is the right thing to be doing.

However, I echo some of the concerns of the shadow Minister, the hon. Member for Sleaford and North Hykeham, particularly on specialist commissioning. I declare an interest as vice-chair of the spinal cord injury all-party parliamentary group. We are concerned that expertise in low-volume, very specialist concerns will be lost if the commissioning is pushed out to multiple ICBs. My understanding is that specialist commissioning sat with NHS England in the first place because of concern that multiple commissioning groups would struggle to deal with low-volume, complex issues.

The president of the Royal College of Psychiatrists warned earlier this month that the new commissioning structure lacks mental health experts, with only one senior mental health lead across the seven new regional commissioning hubs taking specialised services from NHS England. Equally, the chief executive of the Derby and Derbyshire, Lincolnshire, and Nottingham and Nottinghamshire ICB cluster has said that it does not look like there will be a requirement for senior mental health expertise in reorganising ICBs. Will the Minister reassure us that when the Department designs which specialist services will be pushed back down to ICBs and which will be retained centrally, it will be minded to listen to representations from experts in the sector?

There are excellent services located geographically by accident—for example, the orthopaedic hospital in my constituency and the veterans service that goes with it. Both are highly valued, but they need specialist commissioning at national level to be utilised properly and to provide the best outcomes for patients. I would be grateful for the Minister’s reassurance on those points.

[Dr Johnson]

I agree with much of what the hon. Lady has said. Does she therefore support amendment 57, which would ensure that such a consultation takes place?

[Helen Morgan]

Yes, we would support the amendment, which is a reasonable way to get there, but an assurance from the Minister that the Department will consider specialist commissioning and really think that through properly before the powers are delegated to ICBs would be sufficient.

--- Later in debate ---

[Dr Johnson]

Of course, my hon. Friend is right. One challenge with the Bill is that although not all the measures are a problem individually, the way they are being brought in is a problem. The planning and organisation that has gone into it has not been coherent. A 50% cut has been made to the budgets of ICBs, which has required many of them to merge, but that has been done before the local government reorganisation has been finished, which means that ICBs have been melded together in a way that is not the same as the local government reorganisation.

Let me again give the example of Lincolnshire. Lincolnshire had an excellent ICB, run by chief executive John Turner. That has now merged with Nottinghamshire and Derbyshire. Nottinghamshire and Derbyshire form the East Midlands mayoralty, but Lincolnshire ICB, as was, forms part but not all of the Lincolnshire mayoralty—which, as I said, also includes part of what was the Yorkshire region. Because the cuts were done before the local authority reorganisation, and the left hand does not know what the right hand is doing, we have ended up with an incoherent pattern, which does not help, particularly for social care services that are delivered by local authorities. We will come back to that when we talk about who is on the ICB. The risk is that we end up spending money doing this twice—being forced to do it at short notice, because of the 50% cuts brought in overnight by Government, and then doing it again to try to sort out the mess and bring things back into line with the new local authorities as and when it is decided what they will be.

Going on to the pharmaceutical arrangements—I should probably declare at this point that my brother is a rural dispensing GP—I share the concerns raised by the hon. Member for Bury St Edmunds and Stowmarket in relation to rural dispensing GPs. Let me give the Minister an example from my constituency. The Cliff Villages medical practice was an excellent medical practice. However, there was a doctor retirement and the illness of a doctor, and as a result the service reduced in quality quite substantially.

The ICB was working alongside the surgery and the one remaining practice doctor—not swiftly enough, it must be said. What happened in the end was that the Care Quality Commission came in, found that the service was really not good enough and closed the surgery down overnight, in the middle of the week. It was closed with immediate effect and there were no appointments for any patients in my constituency. Then, because the surgery had been closed, the ICB worked very hard to get a new practice in straightaway, and it got that opened on the Monday, which was pretty quick in the circumstances; but people lost their dispensing GP.

Living in a rural area—I have a dispensing GP myself, living in a rural area—people can go to the doctor’s, see the doctor and, if the doctor perhaps says, “You need some antibiotics,” they can go back to the waiting room and sit there for 10 minutes, be given the antibiotics and then leave. That is significantly more helpful to a rural constituent than having to drive eight or nine miles into the centre of town, park the car, find somewhere to get the prescription and then go all the way home again, which would take much longer. People really value that service—I saw how much when I held a public meeting with the ICB and the new provider to talk about what had happened at the surgery, and 250 people turned up to an evening event in the village hall at short notice. It is hugely important to people.

Will the changes allow the Secretary of State to step in in such circumstances, where the medical contract has been lost due to that cut-off by the CQC? Will that sudden loss of service be able to be replaced with a new dispensing service? Could Ministers have therefore given dispensing rights to the new provider? At the moment, those rights are not transferable, and it means that the only way that my constituents who live in that area and attend that practice can maintain dispensing rights is either to move house—perhaps to next door and back again, but they have to move house—or to change practice immediately, that same day, to another dispensing practice. To be honest, that seems ridiculous. Could the Minister make any comment on how the provisions in the Bill will help that situation and what her views are?

I am confused by new clause 23 and new schedule 1; the Minister has introduced them later than the rest of the Bill, but they seem quite significant. They would move pharmacy appeals from the first-tier tribunal to an NHS body specified by regulations made by the Secretary of State. I presume the regulations are not yet written, so we do not know what form that would take, but the first-tier tribunal is part of an independent judicial system and the appeals will now be under political control, within the Department.

Could the Minister explain why they think that is fair? Why do the Government want to do that? Is it just about saving money? How will the judgments made by that new authority be properly enforceable and give people confidence, given the change from the first-tier tribunal in the judicial system to something more politically controlled?

I move on to new clause 2, which would require the Secretary of State to establish within six months a scheme to give patients the right to a GP appointment within seven days of seeking one, or 24 hours if urgent. I would be interested to hear the Minister’s comments on that and how she thinks it could be achieved.

Modelling by the Health Foundation suggests that 6,500 full-time equivalent GPs—37,800 in total—will be needed by 2030-31 to meet greater clinical need. We have already talked about the doubling of medical school places; I presume the Minister has sought correction since we last spoke on whether the Government have a plan to double those places or not, but the Government are not on track to have that number of GPs. Is it simply that they do not have the resources to deliver it? I would be interested to hear the Minister’s comments.

[Helen Morgan]

With permission, I will explain to the shadow Minister our votes on amendment 57, which she pressed to a vote. I was reassured by the commitment the Minister made to consult widely on those commissioning changes, so the Liberal Democrats switched our vote from support to abstain.

I move on to new clause 2, our amendment in this group, which the shadow Minister was just discussing. It would require the Secretary of State to introduce a scheme to ensure patients have the right to see a GP or another appropriate clinician within their GP practice within seven days.

The NHS constitution currently confers rights on patients when they are considered really important. There are, for example, rights within the NHS constitution around receiving cancer diagnoses and treatment. We felt that there was a gap on access to GPs. Given the Government’s stated aim of transferring more care into the community, which we fully support, and given the observation in the Darzi report that more and more money is being spent on secondary rather than primary care, we think it is really important to confer the right on patients to be able to access primary care when they need to.

As the hon. Member for Sleaford and North Hykeham pointed out, this measure would require a large number of additional GPs and would therefore not be achievable overnight, but over the course of a Parliament. The Liberal Democrat plan includes recruiting and retaining an extra 8,000 GPs, relieving pressure on the rest of the health service and enabling that shift into the community. When patients—

--- Later in debate ---

[Dr Johnson]

We Conservatives share the hon. Lady’s desire to ensure that patients get their appointments as soon as they need them to be had, but she is talking about a difference between urgent appointments, within 24 hours, and non-urgent appointments, within a week. Who is going to make the decision about whether the appointment is urgent? Will it be the clinician? Will it be the patient themselves? Has she thought about where that responsibility lies?

[Helen Morgan]

Yes, I have thought about where that responsibility lies. It clearly lies with the triaging process within the GP surgery. I do not think any of us envisage somebody phoning up about a child with a cold and saying, “I consider this to be urgent,” and getting an appointment within 24 hours, but I would imagine somebody from the surgery saying, “Please describe the symptoms to me,” and then, if they detected something more serious, saying, “That is urgent and you do need to come in within 24 hours.” The point of new clause 2 is to clarify in the NHS constitution that some services require parity with others. We have already established legal rights under the NHS constitution for certain types of treatment, and this puts GP access on the same level. We think that that is important.

I am conscious of time, so I will move on to new clause 52, which is about dental deserts. Everyone is horrified by dental deserts and by “DIY dentistry”, a phrase that means—let us face it—people using pliers to extract their teeth and super glue to reattach crowns, and cavities filled with household adhesives. More than 5 million children did not see a dentist at all in 2025. That is a stark failure. Dental care is as important as care for other parts of the body, in particular when most of what goes wrong in dentistry is preventable. We should absolutely focus on prevention, and that is in line with the Government’s aims to move from sickness to prevention.

New clause 52 is about our £750 million dental rescue plan to guarantee access to an NHS dentist for anyone needing an urgent or emergency appointment, which I hope would end that awful DIY dentistry. The plan needs to be achieved through bringing dentists back from the private sector, fixing the contract, using flexible commissioning wherever necessary and introducing an emergency scheme. For example, the emergency dental scheme in Shropshire, operated by the community dental practice, enables people who have urgent need and cannot register with an NHS dentist to get the care that they need when they need it. I urge the Minister to take our new clauses on board and to ensure that people get the care they need when they need it.

Health Bill (Fourth sitting)

Debate between Caroline Johnson and Helen Morgan

Committee stage
Tuesday 23rd June 2026 Public Bill Committees

[Dr Johnson]

The hon. Gentleman is right, but there are pressures and challenges for clinical academics, which he will be aware of. I am sure the Minister, in summing up, will tell us what she is doing about those.

We need to support innovation in all parts of the health service, not just in university hospitals. One of my concerns is that there has been a drive towards a hub and spoke model. There are good reasons for that, and there have been some good outcomes for patient care, but in some cases it restricts innovation in the peripheral parts of the model; it can disincentivise innovation and make it more difficult. We need to consider how we support innovation in all areas of the NHS.

[Helen Morgan]

One of the challenges of recruiting staff in Shropshire relates to exactly that point: some areas of the health service are perhaps less exciting to work in than others. Ensuring that innovation is driven across every NHS site and every region will help us understand the recruitment and retention problems that have plagued some of the country’s more rural areas.

[Dr Johnson]

The hon. Lady is absolutely right. When I was a very junior doctor, whether one wanted to work in a small hospital in the countryside or a large teaching hospital in a big city mostly related to whether one wanted to study a specialist, narrow field of medicine or a wider, broader field of medicine with a variety of different conditions. During my career, I have seen consultants make choices that meant they had to move from their district general hospital to a teaching hospital in order to make progress—in one case, a consultant was told he would not get a professorship unless he moved. The hon. Lady is right: we need to carefully consider how we support innovation.

I have concerns with the clause as it is drafted. Section 13K of the NHS Act 2006 gave NHS England the power to award prizes in support of innovation. Clause 6 ensures the Secretary of State has that power, but there is a big difference between an arm’s length body of technocrats awarding prizes and a political office holder awarding prizes, because then the prizes come out of taxpayers’ money and Governments are particularly short of that—not because they are not taking higher rates of tax, but because they are squeezing the economy.

There is a risk that those awards, and funding for innovation more broadly, become exposed to political cycles. When Governments face a fiscal straitjacket, Ministers are often quick to slash discretionary spending, even though it provides a long-term return on investment. There is also a risk that prizes will be awarded on the basis of who shouts loudest. Certain charities will want the Government to focus on awarding innovations in cancer care, for example; some unions will want the Government to focus on awarding innovators who achieve greater equity in service delivery. There is little doubt that Ministers will have a tough time batting away lobbyists calling for more funding to incentivise this or that type of innovation.

Clause 6 also gives the Secretary of State the power to set up a committee to provide advice on awarding prizes. It is right that the Health Secretary should solicit expert advice when determining which trusts, teams or individuals deserve incentive payments, but does that require the power to set up what is effectively a whole new quango? The Government created more than 25 arm’s length bodies and advisory councils in their first six months. Does the Secretary of State require the power to pay members of the advisory committee when there are many experts in their field who can give their time charitably? I notice there is no requirement for any prize committee to include the chief scientific officer or representatives from ICBs. It is ultimately an unchecked spending power.