NHS: Corridor Care

Earl of Effingham Excerpts

Wednesday 4th February 2026 Lords Chamber

[Baroness Merron (Lab)]

We very much appreciate the role that GPs play. Corridor care is related to a whole range of factors, not only the position of GPs. I have heard what the noble Baroness has said and will gladly relate it to my ministerial colleague.

[The Earl of Effingham (Con)]

My Lords, the Minister referenced data collection in her previous responses. In November, hospitals carried out 10% fewer operations than in October, but the Government claim the waiting list went down. Is that because the Government are paying hospitals £3 million per month in a process known as “validation”, and so it appears that the health service is treating more patients than it actually is? Is that the real reason that corridor care numbers are up?

[Baroness Merron (Lab)]

No. I hope that the noble Lord would welcome a greater level of activity in this area. The waiting lists are going down. We have delivered, for example, 5.2 million extra appointments since we came into government, when we had promised just 2 million. Waiting lists are going down, and I am very happy to provide the data again to the noble Lord so that he can investigate that.

Baby Milk Powder: Cereulide

Earl of Effingham Excerpts

Wednesday 4th February 2026 Lords Chamber

[Baroness Merron (Lab)]

In my preparation for this Question, which is an important one, I asked a similar question to officials, particularly those from the FSA, and they assured me that testing shows we are meeting the right standards. They also made the point that this is all covered by the Food Safety Act. In their opinion, they have the tools to do the job. I am not aware that there has been something wrong in the management of this live incident, but I am aware that the FSA and the UK Health Security Agency are liaising very closely with the manufacturers to establish the root cause of the possible presence of this toxin. But I can also reassure your Lordships’ House that it is confined to certain batches. That is the information that is going out.

[The Earl of Effingham (Con)]

My Lords, providing the best nutrition for children of all ages is surely a “must have”. So, why do the Government allow ultra-processed foods to constitute between two-thirds and three-quarters of calories in UK school meals? They are high in fat, sugar and salt. That is not a good combination.

[Baroness Merron (Lab)]

The noble Earl has moved from food safety to what is in food. Food standards applicable to school meals are both monitored and in place. As he knows, the general advice from the NHS on processed foods is that we would all benefit from eating less of the foods that are high-fat, high-salt and high-sugar. But those foods are not presenting the immediate safety concerns. I make that distinction as we are looking here at toxins in products.

Medical Training (Prioritisation) Bill

Earl of Effingham Excerpts

2nd reading & Committee stage
Wednesday 4th February 2026 Lords Chamber

[The Earl of Effingham (Con)]

My Lords, I thank all noble Lords who have made such valuable contributions to this debate. I greatly enjoyed hearing the maiden speech of the noble Lord, Lord Roe of West Wickham. He mentioned ham, egg and chips, and I can assure him that he will enjoy himself very much in your Lordships’ House, but it is the staff in this House who are amazing. I know they are going to look after him as well. They do an incredible job, and they are part of the package; they will do everything they can to make his experience an enjoyable one. He mentioned that he had served over half his life in the fire brigade, which is an incredible achievement, as well as his Army service. I think when he referenced boxing, it was incredibly appropriate, because fitness, discipline and mutual respect will greatly assist him in making a real difference in your Lordships’ House, and we are really looking forward to hearing his future contributions.

I must say the same for the noble Lord, Lord Duvall. It was most interesting to hear his background. The noble Lord is obviously an expert in local and regional politics. He was made in Woolwich. He then went on to lead Greenwich council, and I think the noble Baroness, Lady Thornton, was entirely correct when she said, back in the 1980s, that Len was going places. I think it is a huge testament to the NHS that the noble Lord, Lord Duvall, has had a double bypass and he is standing before us, fighting fit. He is going to enjoy constructively challenging His Majesty’s Government —and, I am sure, His Majesty’s loyal Opposition—and we are very much looking forward to hearing his contributions as well.

As many noble Lords have put it so well, there is a great deal to think about in this Bill, and there are a number of areas where His Majesty’s loyal Opposition and other noble Lords will wish to press the Government further. The Bill is intended to address a situation that is universally recognised as both serious and unsustainable, and precisely because there is such broad agreement on the problem, it is all the more important that your Lordships’ House scrutinises the Bill with a laser focus to ensure that the final proposals will be hallmarked as best market practice.

The interventions thus far have already highlighted the value of that scrutiny, with noble Lords identifying a number of areas that would benefit from further consideration. The noble Baroness, Lady Finlay—who is, of course, widely respected in this area of legislation—the noble Baroness, Lady Gerada, and the noble Lord, Lord Mohammed of Tinsley, all spoke about unintended consequences. In attempting to solve the problem, there may always be unintended consequences. Our desire is to stress-test the potential outcomes to resolve that the end result is indeed beneficial for those who need the help and does not formulate a situation where more harm is done than good.

The noble Baroness, Lady Coffey, referenced the fact that this is a pressing issue and time sensitive, but that is no excuse for poorly drafted legislation, which may have serious ramifications for both questions of fairness and trusted relationships with our international allies.

His Majesty’s loyal Opposition support the core principle and intended purpose of the Bill but are clear that there are areas that would benefit from constructive challenge and a moulded consensus as we progress. We have had the opportunity today to discuss some of the practical effects that the Bill will create. Certain groups will, for a variety of reasons, fall outside the mainstream. The noble Lord, Lord Clement-Jones, said that the situation Malta was a “manifest absurdity”. The noble Baroness, Lady Finlay, rightly recognised that routes for overseas doctors to train here have multiple ancillary benefits. The noble Lord, Lord Patel, likened this situation to being “thrown to the wolves”. So those studying on accredited programmes as part of agreements with third countries, and British citizens who have done the majority of their training abroad for legitimate reasons such as military service, are two examples where we need further scrutiny.

In light of the potential unintended consequences of the Bill, where Parliament has had a limited opportunity for detailed analysis both in your Lordships’ House and particularly in the other place, it is vital that it contains robust mechanisms for review and accountability. Clear duties to review and report on the operational and “lived experiences” impact of this legislation will provide a pivotal safeguard, ensuring that Parliament retains a meaningful and proactive role in holding the Government to account as this framework is implemented. This would seem an entirely proportionate and sensible approach, allowing the Bill to work effectively while minimising potential unforced errors. We are confident that noble Lords will be keen to embed such provisions in the Bill.

Workplace confidence and consistency were mentioned. The noble Lord, Lord Clement-Jones, said that the execution is “flawed”, and the noble Baroness, Lady Hollins, said that there is a great risk of undermining confidence. So we must address the question of confidence among individuals for whom this legislation contains far-reaching consequences and whom it directly affects. Doctors make long-term, often irreversible, decisions about their training, specialisation and careers. Those decisions are shaped not only by pay or conditions but by their confidence that the system is fair, predictable and stable. They need to know what the rules of engagement are and that their career paths will be, within reason, clear, coherent and consistently applied.

No one likes uncertainty and, whether for government, business or relationships, everyone needs stability. Doctors are no different. Knowing that the goalposts will not shift unexpectedly part way through training is a must-have. Where legislation is rushed or where its effects are uncertain, that very confidence can be undermined. Even reforms that are well intentioned can have negative knock-on consequences if doctors feel that eligibility criteria are opaque, that established pathways may suddenly be reclassified or that decisions affecting their future are taken without sufficient forethought or scrutiny.

That matters because confidence and morale are central to retention in every aspect of life. If talented doctors harbour doubts that the system they are held to may not treat them fairly, or doubts about whether their own significant investment in training, as mentioned by many noble Lords, will be recognised, they may choose to take their skill set elsewhere—not because they lack commitment to our National Health Service but because they lack confidence in the framework governing their progression. A lack of confidence in any system will lead to pitfalls.

This is precisely why the detail of the Bill matters so much. Getting it right is not simply a technical or procedural exercise; it goes right to the heart of whether doctors feel valued, supported and willing to commit their careers to the National Health Service. An open and transparent workflow of prioritisation will only strengthen confidence. A rushed or overly rigid one risks doing the opposite.

Many former Members of the other place would suggest that helping health and social care in some small way is critical because it provides a unique opportunity to do the right thing through debate and constructive challenge, which should result and positive outcomes for everyone living in the United Kingdom. Our National Health Service, while not perfect—indeed, nothing is—remains based on the founding principle of providing universal care that is free at the point of use, and our doctors are at the heart of that premise.

This Bill aims to make provision about the prioritisation of graduates from medical schools in the United Kingdom, and His Majesty’s loyal Opposition look forward to working constructively with the Government and all noble Lords in facilitating that desired outcome.

Emergency Adrenaline

Earl of Effingham Excerpts

Monday 15th December 2025 Lords Chamber

[Baroness Merron (Lab)]

I very much understand my noble friend’s personal involvement in this area. I congratulate her on her work in promoting the availability of needle-free delivery of adrenaline, and I too welcome its approval. It is down to local area prescribing committees to provide advice to integrated care systems on whether to include new products such as nasal adrenaline and whether they should be included in local formularies. This takes into account available evidence, as well as any relevant guidance. Following this Question from my noble friend, I will seek a view from NICE as to whether it is considering developing guidance in this area, as I know she would find that helpful.

[The Earl of Effingham (Con)]

My Lords, it has been four years since the Commission on Human Medicines first examined widening public access to adrenaline auto-injectors. It is an excellent initiative, but it requires national co-ordination. What progress have the Government made in establishing a national lead for allergy—which some refer to as an allergy tsar—given their previous support for the idea?

[Baroness Merron (Lab)]

We have been focusing our efforts, as I said, on whether changes to the law are required to allow wider access to, for example, adrenaline nasal sprays, which are a welcome development. Our focus is on that, rather than on the appointment of a tsar, to which the noble Earl referred. We will be establishing national clinical directors, and I am sure that this will be considered in that regard.

Breast Cancer

Earl of Effingham Excerpts

Monday 15th December 2025 Lords Chamber

[Baroness Merron (Lab)]

My noble friend makes a very powerful case; I am grateful to her for doing so. The UK National Screening Committee continuously monitors emerging evidence through horizon scanning and maintains active engagement with international peers. Should robust evidence regarding the extension of breast screening age thresholds become available, the committee will look at it right away. In the meantime, a suite of public-facing information communicates to women aged 71 and over that they can have screening every three years if they wish. I realise that does not quite meet my noble friend’s request, but I hope it indicates movement to support women aged 71 and over.

[The Earl of Effingham (Con)]

My Lords, women over the age of 70 are entitled to receive free breast screening every three years. However, for those who are digitally excluded, both awareness of this and the practical process of making an appointment can present real barriers. What steps is the NHS taking to ensure that women over 70 are aware of this right, and how is access to screening being made easier for those who struggle with digital access?

[Baroness Merron (Lab)]

Part of the 10-year plan, as we move from analogue to digital, will be ensuring that digital exclusion will not be a barrier. As I mentioned in response to my noble friend, it is indeed the case that women aged 71 and over can have screening every three years, and that can happen by women calling their local breast screening service to ask for an appointment. In other words, analogue is still possible, not just digital.

Alzheimer’s Disease

Earl of Effingham Excerpts

Monday 13th October 2025 Lords Chamber

[Baroness Merron (Lab)]

As the noble Baroness says, diagnosis is absolutely crucial. I feel our health system has struggled somewhat to support those with complex needs, including those with dementia. That is why I emphasise the role of the modern service framework in this area; it is the first time we have had one and it takes a whole view, which I think has been sorely lacking. It will be informed by the independent commission on social care next year—so we are looking at next year, not waiting for years. The final point I make is about the dementia diagnosis rate for patients aged 65-plus. The Government are committed to recovering that to the national ambition of 66.7%; at the end of August, it was 66.1%.

[The Earl of Effingham (Con)]

My Lords, the evidence is clear across the board: eating healthily and staying active helps brain health and the prevention of Alzheimer’s. Is it not a huge concern to the Government that more than half the calories the average person in the UK eats and drinks come from ultra-processed foods and fewer than 25% of adults in the age groups most prone to Alzheimer’s are not meeting the Chief Medical Officer’s guidelines for aerobic and muscle-strengthening exercise?

[Baroness Merron (Lab)]

I think the valid points that the noble Earl raises refer to a whole range of health conditions. I refer particularly to our health service’s struggle to support those with complex needs. Clearly, prevention of ill health—one of the pillars of the 10-year plan—is going to be crucial, and that will include good diet and a good exercise and movement programme. I cannot comment on the specific link with dementia. There is so much more work to be done, which is why we are investing so much in research and development.

NHS: Private Equity

Earl of Effingham Excerpts

Wednesday 25th June 2025 Lords Chamber

[Baroness Merron (Lab)]

The noble Lord raises an important point. I assure him that rent and service charges continue to be set in line with the original terms if there is a change of owner. Whatever the ownership, properties occupied by GPs are required to be professionally valued by the district valuer. The service advises commissioners on whether levels of rent are value for money and align with market rents in a particular area. The other thing I might add, which I mentioned in answer to an earlier question about the mixed model of the general practice estate, is that nearly half of them are in any case GP-owned and 26% are GP leasehold. We do not currently see a problem in the way the noble Lord describes, but if there are particular examples to follow up, I am very happy to do so.

[The Earl of Effingham (Con)]

My Lords, the private sector has a significant role to play in alleviating the pressures faced by the NHS. Please allow me to quote the Secretary of State for Health. He said the independent sector can “help us out” and:

“We would be mad not to”.


Can the Minister help us understand why a number of experts in your Lordships’ House are saying outside the Chamber that there is currently excess capacity in the private sector at benchmark NHS prices? There would be no extra cost to the taxpayer but huge incremental benefits to people on NHS waiting lists. However, the spare capacity is not being used.

[Baroness Merron (Lab)]

Again, if there is particular information I should have, I would be delighted to receive that. I can only wholeheartedly agree with my right honourable friend the Secretary of State about the need to use capacity in the private sector. It is one of the ways we are driving down waiting lists and offering more appointments. As I am sure the noble Lord knows, we committed to 2 million extra appointments in our first year of government; we have far exceeded that already with 3.6 million.

Preterm Birth Committee Report

Earl of Effingham Excerpts

Friday 6th June 2025 Lords Chamber

[The Earl of Effingham (Con)]

My Lords, it is always an honour and a privilege to participate in any debate in your Lordships’ House, but today that is particularly so for me as my children were born pre term. So please allow me to thank the noble Baronesses, Lady Blackstone and Lady Owen, my noble friends Lady Seccombe and Lady Wyld, and the noble Lords, Lord Winston and Lord Patel—who are all in their place—along with other noble Lords on the committee, for this compelling and measured report, and to thank all noble Lords who have made their valuable contributions today.

The evidence the report presents is sobering. There are clear challenges ahead, but with the help of this report, those challenges can be overcome. Preterm birth remains among the most pressing issues in perinatal healthcare. In 2022, nearly one in 12 babies in England was born pre term. These early births account for a disproportionate share of neonatal mortality and long-term health complications, placing considerable strain on families and the NHS alike. Despite repeated policy commitments to reduce this figure to 6% by 2025, the committee makes it clear that this target will not be met.

Preterm birth is not only a clinical issue, but one with profound implications for families and wider society. It is the leading cause of neonatal death and a major contributor to childhood mortality and long-term disability. Babies born too early face significantly higher risks of cerebral palsy, learning difficulties and developmental delay. They are more likely to struggle at school and more likely to require support throughout their life. Yet the impact does not end with the child. The report details evidence from parents whose lives were overturned in a matter of hours, whose babies were whisked into critical care, often in hospitals far from their home. Families are routinely separated, with little or no access to overnight accommodation. Many parents have highlighted that they were unable to stay near their critically ill child, as has been flagged by the noble Baronesses, Lady Blackstone and Lady Owen, and my noble friends Lady Sugg, Lady Penn, Lady Wyld and Lady Seccombe.

It is fair to say that childbirth itself is challenging for all concerned. Adding preterm birth into that mix and, further, not being able to stay near your just-born child is incredibly distressing. Further to the emotional havoc that this wreaks, there is also the financial strain: one in four families has to borrow money or take on additional debt to get through this period. Catriona Ogilvy, the founder of the charity the Smallest Things, summed it up perfectly when she said, “We know how hard it is to sit beside an incubator full of fear. We know how hard it is to bond with a baby covered with tubes and wires in intensive care and that parents still hear the hospital alarms when they close their eyes after coming home”.

There are also disparities amongst those affected. The preterm birth rate among black women is 8.5% and among Asian women it is 8.3%, which compares with 7.7% for white women. The committee rightly describes these inequalities as complex and interconnected, but we must be clear that they are unacceptable in a modern, equitable healthcare system. The Government have signalled their intention to refresh the maternity safety ambition, but this must be part of a co-ordinated intervention on all fronts. Alone, it will not suffice.

The report has given us a robust and compassionate road map, and His Majesty’s Official Opposition commends the report’s central message. While it is impossible to prevent all preterm births, it appears that far more can be done to reduce their number and mitigate their consequences. Key among the report’s recommendations is the call to revise national targets—not merely to lower the overall rate, but to tackle the specific inequalities that persist across ethnic and socioeconomic lines. This is not a partisan issue; it concerns the fundamental matters of equity and clinical necessity.

The report also highlights the inconsistent implementation of existing guidance. The Saving Babies’ Lives care bundle contains interventions proven to improve outcomes for preterm babies, yet access to these measures remains worryingly dependent on geography. My noble friend Lady Bertin flagged the postcode lottery. The noble Lord, Lord Weir, talked about a national rollout for best practice. We must ensure that provisions for such essential care are equitably distributed and maintained.

Staffing shortages in maternity and neonatal care continue to undermine even the best clinical intentions. The Government acknowledge this, as did the previous Government, and the long-term workforce plan aims to address these shortfalls, but training must include a specific focus on the care needs of preterm babies and their families. Health visitors, in particular, require dedicated support and protected time to deliver follow-up care effectively. Too often, follow-up assessments, especially at the ages of two and four, simply do not take place. This represents a clear breach of national guidance and a serious failure in our early years provision. The result is lost opportunities for intervention and avoidable suffering for families already under strain.

As highlighted by my noble friend Lady Wyld, investment is also required in the neonatal estate. The Government must publish the results of their maternity and neonatal estate survey without delay and ensure that phase two of the spending review includes funding to expand parental accommodation across the NHS.

Data collection and research was referred to by the noble Lords, Lord Winston and Lord Weir, the noble Baronesses, Lady Owen and Lady Blackstone, and my noble friend Lady Seccombe. We have to continue to strengthen our research effort. Many preterm births occur without any known risk factors. Understanding the biological processes of early labour and the social determinants that compound risk is vital to prevention.

Optimising women’s health prior to pregnancy was highlighted by the noble Lords, Lord Winston and Lord Weir, my noble friend Lady Sugg and the noble Baroness, Lady Blackstone. The Secretary of State for Health has rightly said that, holistically speaking, prevention is better than cure, and one of the key conclusions of the report is that optimising women’s health prior to pregnancy is a very important part of preterm birth prevention. In order to address risk factors such as obesity and mental health issues, we have to ask: when are the Government going to make a healthy diet and exercise a major priority in their programme of prevention, in both schools and the adult population at large? Currently, the statistics paint a frightening picture.

The committee’s findings have been welcomed by clinicians, researchers and advocates alike. In recent weeks, we have heard constructive challenges to the Government in your Lordships’ House regarding reviews and time delays, and in the same light we must challenge on any further reviews regarding preterm birth. We now have some of the answers. As the charity Bliss has rightly stated, this is a moment for action, not aspiration. We urge the Minister to provide clarity on how the Government will act on each of the report’s recommendations, so that families affected by preterm birth receive the care, compassion and clarity that they deserve.

Social Care Reform

Earl of Effingham Excerpts

Thursday 22nd May 2025 Lords Chamber

[Baroness Merron (Lab)]

I can say to my noble friend that the adult social care workforce is growing. Skills for Care data tells us that there has been an increase of 70,000 filled posts since 2022-23, that staff turnover is reducing and that the overall vacancy rate decreased to 8.3% in 2023-24 from 9.9% the previous year. While the direction is good, there is certainly more to do. As regards international care workers, it has indeed been factored in that we need a workforce, and that is one of the many reasons why the new measures that require care providers to prioritise recruiting international care workers are focused on those who are already in the UK, have visas and require new employment. I am sure we will talk about this as we discuss the Employment Rights Bill and all the directions it is taking to support professionalisation of the workforce and encourage those in the UK to take on adult social care roles.

[The Earl of Effingham (Con)]

My Lords, in July last year His Majesty’s Government scrapped the social care cap and curbed winter fuel payments. Sir Andrew Dilnot, author of the landmark Dilnot commission report on social care, said this was a “tragedy” and that

“we have failed another generation of families”.

With all due respect, the Government are doing a U-turn on the winter fuel payment; can the Minister rule out a U-turn on social care?

[Baroness Merron (Lab)]

Again, I do not recognise the characterisation of a U-turn on social care. The Prime Minister and the Secretary of State have been extremely clear, as I outlined earlier in response to the noble Lord, Lord Forsyth, about why this commission is in place. When it was brought to this House previously, I recall that many noble Lords, although not all, were positive about it because they saw the opportunity—which the previous Government did not, not least because they did not fund its suggestions. This Government are absolutely committed to having a lasting, practical answer that involves everybody concerned and will be supported in the right way. I would have hoped that the noble Earl would welcome that.

NHS and Care Volunteer Responders Service

Earl of Effingham Excerpts

Tuesday 20th May 2025 Lords Chamber

[The Earl of Effingham (Con)]

My Lords, the NHS and Care Volunteer Responders service has completed more than 2.7 million tasks and shifts, including more than 1.1 million telephone support calls, over the past five years. It provides volunteering support seven days a week, underpinned by wraparound support and assurance, as well as safeguarding, problem-solving teams and helplines running from 8 am to 8 pm. Volunteers are ID checked, have role guidance, hold DBS checks when required and have their expenses paid by the programme. How will the Government ensure that volunteering in the NHS and social care is encouraged and facilitated, given that the need for volunteers across the country remains acute? When will the new scheme begin operating and can the Government guarantee that existing patients will not be left in the lurch?

[The Parliamentary Under-Secretary of State, Department of Health and Social Care (Baroness Merron) (Lab)]

I start by saying, as I am sure the noble Earl agrees, how grateful we are for the generous contribution made by volunteers. They play a vital role in supporting patients, staff and services in many ways. The national NHS and Care Volunteer Responders programme was first established as part of the Covid response, and the noble Earl helpfully set out its contribution. The fact is that a model that worked well in a national crisis is no longer the most cost-effective option, so there will be a new recruitment portal for NHS volunteers to be fully launched this year. This is all about expanding voluntary opportunities and getting more volunteer hours to further support patients even better than volunteers do already.