Antisemitism and Other Forms of Racism in the NHS: Review

Karin Smyth Excerpts

Tuesday 27th October 2026 Written Statements

[The Minister for Secondary Care (Karin Smyth)]

When Lord Mann’s review of antisemitism and other forms of racism in the NHS was published in June this year, the Department of Health and Social Care committed to provide an initial update to Parliament in October on the progress made against his recommendations, followed by a detailed report within 12 months of publication. Today’s update to the House discharges the first of those commitments.

As we said in June, there is no place for antisemitism or any other form of racism in the NHS. The NHS was built on the premise of universal access to healthcare regardless of background, and it is therefore wholly unacceptable that anyone using that service, or any member of the dedicated workforce that provides it, should face discrimination, intimidation or abuse based on their race, religion, or ethnicity. The Government therefore welcomed Lord Mann’s important review, we accepted every one of his recommendations for DHSC and NHS England, and today we reiterate our commitment to implement each of those recommendations, and report on the progress already made in key areas.

In respect of Lord Mann’s recommendations in the area of openness, accountability and the restoration of confidence, a suite of NHS staff standards was published in July, including a standard setting out minimum expectations for employers to take sustained and meaningful action to prevent and root out racism in the NHS. The NHS leadership and management framework was also published in July 2026, setting consistent expectations on behaviours across all levels of NHS management.

In respect of Lord Mann’s recommendations on definitions, reporting and investigation of racist incidents, NHS England is delivering training for HR colleagues leading investigations into allegations of racism, and working to open up access to training to regulated health and care staff working outside of NHS settings. In addition, a large number of NHS trusts have now adopted both the IHRA definition of antisemitism and the Government definition of anti-Muslim hostility, but we recognise that significant progress is still required to see those definitions comprehensively adopted across the NHS as a whole.

In respect of Lord Mann’s recommendations on wider governance, regulation and oversight, the Professional Standards Authority is progressing work to develop new guidance for regulators on good practice in equality, diversity, and inclusion. The PSA will convene fitness to practise leaders from across the regulators on 24 November to examine current approaches, identify any opportunities for greater consistency and inform further guidance and/or shared action. The PSA is also co-ordinating updates from regulators and will formally report progress to the Health and Social Care Committee in December. NHS Employers has worked closely with regulators and NHS organisations to understand how existing materials and support relating to regulatory referrals are used, and where visibility of existing guidance can be improved. They will take forward further work to deliver on these findings by March 2027. The Secretary of State will also be holding a roundtable with the UK health systems and professional regulators in the coming weeks to discuss their ongoing work to tackle racism.

In respect of Lord Mann’s recommendations on protection and support for staff, NHS England will publish national safe working practices guidance and a violence prevention and reduction reporting framework in early 2027, supported by a national campaign to raise awareness of violence against NHS staff, promoting a culture of prevention and support across the NHS. On Lord Mann’s specific concern about the maintenance of a Jewish staff network within the DHSC and NHS England following the creation of the new Department, existing groups are being brought together bi-monthly as part of engagement activity on the transformation programme, and we are clear that those networking arrangements will continue after the merger.

In respect of Lord Mann’s recommendations on education, training and development, a new NHS training module on equality, diversity and human rights is being finalised for delivery across the NHS over the coming months. The training includes content on antisemitism and anti-Muslim hostility, alongside guidance on challenging prejudice and discrimination. NHS senior leaders will be invited to take part in further anti-racism training by the end of March 2027, developed by the NHS race and health observatory. In addition to the £1 million of Government funding provided for antisemitism training for university and student union staff, the Medical Schools Council has undertaken specific antisemitism awareness training and is drafting anti-racism guidance for the medical schools. Lord Mann will be meeting with the heads of the medical schools in December to discuss their progress in this area.

In respect of Lord Mann’s specific recommendations concerning the Care Quality Commission, the CQC has now strengthened its assessment of equality, diversity and inclusion through alignment with NHS workforce standards, the continued use of specialist EDI advisors, and enhanced learning for regulatory staff on anti-racism, antisemitism and the handling of racist incidents. It is also working with fellow health and care regulators to improve information sharing, support implementation of the joint regulators’ principles on advancing workforce race equity, and to promote consistent approaches to addressing discrimination and racist incidents across the sector.

There are other recommendations from Lord Mann’s report that we said in June would require further work prior to implementation, and that work remains in progress.

In particular, a supplier has now been appointed to lead the public consultation and engagement on the unified information standard on protected characteristics, and a public consultation is due to commence in early 2027 seeking views on equality monitoring, including on Lord Mann’s recommendation to include Jewish and Sikh as ethnicities in NHS data collection. Work is also ongoing to consider how to provide clearer guidance regarding the issues raised by Lord Mann on staff uniforms. New national guidance will be published in due course, and all trusts will be asked to review their current policies. In the interim, we have clarified guidance on the use of the NHS identity in “personal” social media accounts. Finally, a public consultation will be launched in the coming months, seeking stakeholder views on potential reforms to the General Medical Council’s regulatory framework, arising from Lord Mann’s recommendations regarding their decision-making and appeals processes.

In these and other areas, there is still a need for extensive further work to implement all of Lord Mann’s recommendations in full, and to produce the transformation in attitudes and action in respect of antisemitism and other forms of racism that his review was designed to achieve. That work remains a high priority both for the Government and for the NHS, and a comprehensive report on our progress against those objectives and recommendations will be provided to the House in June 2027.

[HCWS424]

NHS Maternity Services

Karin Smyth Excerpts

Thursday 22nd October 2026 Commons Chamber

[The Minister for Secondary Care (Karin Smyth)]

I thank the hon. and gallant Member for North Devon (Ian Roome) for raising this very important matter. He calls attention not just to his own constituency but, as we have heard from others, to a broader issue that we face, particularly in our rural and coastal communities. I want to stress that the Government are clear that all women have the right to receive the same high-quality, safe and compassionate care, wherever they have their babies. We need to ensure, and mums need to know, that services are there for them when they need them, including at the time they go into labour.

I thank the hon. Member for North East Fife (Wendy Chamberlain) for sharing the experiences of her constituents Kristie and Tammy today, and I agree that we need to bear such experiences in mind. That is why my right hon. Friend the Secretary of State has chosen to prioritise maternity, and why the work of the national maternity and neonatal taskforce is so important. In particular, the new modern service framework will define the standards needed to deliver care across the country, whether in large inner-city areas or small rural places.

I know the hon. Member for North Devon understands that the North Devon maternity unit was closed for a good reason: the trust could not provide a service that it knew was unsafe. It is really important that we all bear that in mind as we discuss this issue. We must support good, sound clinical assessment, particularly in this area. However, it is unacceptable that, as we have heard from the hon. Member for Honiton and Sidmouth (Richard Foord), expectant mothers are travelling all the way to Exeter or Bristol, and the current situation is not sustainable. I have given birth very healthily three times, and I am grateful for the care that I had. I had to travel only a short distance down the road and, frankly, that was enough, so I empathise deeply with women who have to endure long journeys.

I will not rehearse the recent history that led us to this point, because I know the House is well acquainted with that. As the hon. Member for North Devon knows, the responsible Minister is the noble Baroness Merron, but I will do everything I can to take this opportunity to update him and the House on where we are, and follow up in writing on any specific questions, if necessary.

The trust has set the following three tests before the unit can reopen: first, there must be 24/7 consultant and registrar cover in place through an on-call rota; secondly, three quarters of those staff must be employed full time; and thirdly, new staff must have gone through employment checks, onboarding and induction. Today I can update the House that the outlook on safe staffing was more positive last week, but unfortunately some recruitment has fallen through since then. The trust is still seeking the additional clinical staff that they must have to provide a safe service. As hon. Member for North Devon knows, the issue is not that the roles are not funded. They are generously funded, and the trust has even gone so far as to offer salary top-ups, but the roles remain unfilled. The question is how we attract the best talent to our rural and coastal communities, and show them that Barnstaple and other similar places are among the best in the country to build a life.

I want to thank partners that are working with the trust on recruitment, including the Royal College of Obstetricians and Gynaecologists. The trust is also exploring hiring international candidates, but ultimately we want the unit to have enough staff to provide a safe service that is sustainable—another point that has been well made today—even if a doctor is unwell or otherwise on leave. Every week, the chief medical officer at the trust conducts an assessment to see whether the unit is ready to reopen its doors. Every two weeks, the trust updates key stakeholders on the status of the unit. Once safe staffing is secure, there will be a short period of time to stand up rotas and put services in place. I have had assurances that, during that period, the trust will get in touch with every mother and give them the chance to change their birth plans to Barnstaple, should they want to do so.

[Richard Foord]

I accept that this is a point about recruitment, but it is also a point about retention. A constituent of mine who visited the maternity ward at Exeter hospital heard that the staff temporarily redeployed there from Barnstaple are having to pay the full car parking charge of £20 per day while they are doing the additional service of travelling to Exeter. Does the Minister think that retention also needs to be looked at?

[Karin Smyth]

Yes, of course, and that is what the trust does. I would gently urge all hon. Members to work very closely with the entire trust on these issues to solve these problems. It is absolutely right that the trust is working with MPs. It is reviewing its decision on a weekly basis, and it is important that it communicates openly and transparently with all its partners when those decisions happen. I am always very clear that Members of Parliament speak on behalf of their constituents and can be helpful in communicating those messages, because we want to make this work.

In the meantime, the trust continues to offer a range of maternity services, and it has taken steps to help the women covered by its duty of care. There is a dedicated helpline for women to discuss their birth plans, a maternity triage line for urgent help, special appointments to talk about travel costs and accommodation, free taxis for women who do not have their own transport and are advised by the triage line to go to hospital, and mental health support. These are good and sensible steps, but it is still unacceptable for women to have to travel for two hours while they are in labour.

Trusts in our rural and coastal communities do face systemic pressures, because they have fewer births and because it can be hard for the local NHS to recruit. Last year I visited North Devon district hospital, as part of my remit in overlooking the new hospitals programme, to see how it is using the £30 million the Government have made available to support the rebuild of the 50-year-old staff accommodation block and invest in MRI scanners. We are committed to those services in Barnstaple, and it is important for all hon. Members’ constituents to be clear about that.

Our 10-year health plan, produced last year, clearly set out the issues for rural and coastal communities, which the right hon. and learned Member for Torridge and Tavistock (Sir Geoffrey Cox) noted. We particularly highlighted those communities in the 10-year health plan because we recognise that they have specific needs and do not benefit from a one-size-fits-all approach. However, the broader systemic issues they face, particularly in staffing, must be addressed in our upcoming workforce plan, and I do agree that retention is a key part of that.

Ministers have made it clear to the NHS that we must do everything possible to help reopen North Devon maternity services. NHS England, the ICB and the regional team in the south-west are working with the trust to resolve these issues as soon as possible. As I have said, my right hon. Friend the Secretary of State has rightly made maternity a national priority for this Government. She is chairing the national maternity and neonatal taskforce to drive forward reforms, and to deliver systemic and sustained improvement across maternity and neonatal care, including in relation to the failings exposed in the south-west of England in recent months.

The Barnstaple maternity unit will reopen. I cannot give the hon. Member for North Devon a guarantee from this Dispatch Box of the date when that will happen, because it will depend on securing safe staffing. That is the problem that everybody needs to focus on, and this Government are focused on doing that with the local system. We will do everything we can to help the hon. and gallant Gentleman get those services back on track on behalf of his constituents.

Question put and agreed to.

Cosmetic Regulations Consultation

Karin Smyth Excerpts

Wednesday 21st October 2026 Written Statements

[The Minister for Secondary Care (Karin Smyth)]

This Government are determined to address long-standing concerns around the safety of cosmetic procedures.

Last year we pledged to introduce further regulation of the sector, and we have now launched a public consultation on much-needed safeguards to improve standards. Under our proposals, only qualified healthcare professionals will be able to perform the highest-risk procedures, such as the liquid Brazilian butt lift, and the Care Quality Commission will have powers to take enforcement action against rogue practitioners.

Cosmetic procedures can be very positive experiences, and this industry is growing to meet demand as more and more people seek to take advantage of the increasing availability and affordability of an expanding range of treatments. We recognise that many practitioners in this area are well trained and provide a good, safe service. We also value the contribution that this fast-growing industry makes to the economy, and the employment opportunities that it provides.

However, as has been widely acknowledged, regulation has not kept pace with this expansion. For too long, unsafe practices have been left unchecked, and ill-qualified, unscrupulous individuals have undertaken invasive procedures, at great risk to the public and sometimes with tragic consequences.

Our draft regulations, informed by extensive engagement with expert stakeholders, would restrict the performance of all cosmetic surgery to doctors who are regulated to strict standards set by the General Medical Council and who work for CQC-regulated providers. In addition, high-risk non-surgical cosmetic and wellbeing procedures would be restricted to specified groups of regulated healthcare professionals. To ensure the safety of young people, those under the age of 18 would be prohibited from receiving certain high-risk treatments when performed for cosmetic or wellbeing purposes.

These measures provide the public with reassurance that their chosen procedure meets robust regulatory standards.

This is part of a broader programme of reform in this area. We are also committed to introducing a local authority licensing scheme for lower-risk cosmetic procedures in the current Parliament, ensuring that practitioners are appropriately trained, insured, and working to safe standards.

[HCWS402]

Oral Answers to Questions

Karin Smyth Excerpts

Tuesday 20th October 2026 Commons Chamber

[Mrs Elsie Blundell (Heywood and Middleton North) (Lab)]

1. What recent discussions she has had with the interim leadership of the Northern Care Alliance NHS foundation trust.

[The Minister for Secondary Care (Karin Smyth)]

I absolutely endorse your comments about our colleague, Mr Speaker.

I know that my hon. Friend and many other colleagues are deeply concerned about the issues at Northern Care Alliance. As of June this year, the trust has been placed under the highest level of regional oversight and support from NHS England. It is imperative that rapid movements are made, governance systems are strengthened and that every patient receives the standard of care that they deserve.

[Mrs Blundell]

My constituents are very concerned about Northern Care Alliance hospitals. Across the trust, there were 10 serious incidents between 2025 and 2026 that were found to be wholly preventable, lengthy delays causing severe harm to patients and industrial action, culminating in a sustained decline in performance and national rankings on patient safety. What options are therefore on the table if the trust does not show urgent signs of improvement?

[Karin Smyth]

My hon. Friend rightly highlights on behalf of her constituents the number of issues that have led to this significant regulatory intervention and support. If necessary, further action is available to NHS England and the Care Quality Commission. We want to ensure that the focus now is on supporting and challenging the trust to make the rapid and sustained improvements necessary in those key areas. I know that my hon. Friend and our other colleagues will work closely with the trust on this; I always encourage MPs to work closely with their trust to ensure that that happens. If necessary, other measures will also be available.

[Rachael Maskell (York Central) (Lab/Co-op)]

2. What steps she is taking with Cabinet colleagues to regulate funeral services.

--- Later in debate ---

[Dr Sam Rushworth (Bishop Auckland) (Lab)]

7. What steps her Department is taking to increase the use of community hospitals and beds for step-down intermediate care.

[The Minister for Secondary Care (Karin Smyth)]

My hon. Friend makes an excellent point about the importance of intermediate care, which is a key component of supporting patients into discharge to recover outside of hospitals. Community beds play an important role, but we are clear that home-based intermediate care also needs support, particularly for frail people, through neighbourhood health. That should be the default pathway, and we will continue to work with the system to make that happen.

[Dr Rushworth]

Ward 7 at Bishop Auckland hospital is an example of the NHS working—physios, nurses, healthcare workers and some excellent facilities—so we were shocked to hear that our local NHS trust plans to close the ward, move it to Darlington and break up that team. Will the Minister meet me so I can represent my constituents and the workers at that hospital, and raise those concerns with her face to face?

[Karin Smyth]

I am, of course, happy to meet my hon. Friend to discuss that issue further. I am clear that all changes to services should be based on clear evidence that they deliver better outcomes for his constituents and people across the country. He is absolutely right that we want to extend care closer to home. As I said, the default is to get more care into people’s homes, and I am happy to discuss that further with him.

[Alex Brewer (North East Hampshire) (LD)]

Our community hospital in Fleet is doing a brilliant job, but it could be a much more established resource for local people, especially given the delays in rebuilding our local hospitals. Will the Minister meet me to discuss how we can make the best use of community hospitals in North East Hampshire while we wait another two decades for the rebuild of Basingstoke hospital?

[Karin Smyth]

The hon. Lady is right that we absolutely want to get more care closer to people’s homes and into people’s homes. We want to support frail people in their homes before they even get into hospital. I am working with the integrated care board to make sure that all that happens. I am happy to discuss that further with her.

[Mr Speaker]

I call the shadow Minister.

[Gregory Stafford (Farnham and Bordon) (Con)]

Step-down beds in community hospitals, such as the Chase community hospital and Haslemere hospital in my constituency, are vital. Unfortunately, neither of those two hospitals is being used for that purpose at the moment. At the same time, delayed discharges have hit an all-time high under this Government. More than 14,000 patients a day are stuck in hospital for two weeks or more after being declared fit to leave—that is up 12% since July last year. Behind every one of those numbers is someone who wants to be at home and an acute bed that another patient desperately needs. Why are the Government failing so abysmally at getting people out of hospital and into care at home?

[Karin Smyth]

As the hon. Gentleman knows, the situation deteriorated massively under the 14 years of Conservative government. He is well aware of the fragmentation of all our services. He knows how the system was fragmented and what happened under those reforms. He knows that is why we are trying to change it. He is absolutely right, though, that people being in beds in hospitals or in parts of the system where they should not be is not good for their health or their outcomes. That is why it is part of our three shifts, and that is fundamentally why the Prime Minister is very clear that we will raise social care up the agenda and ensure that people are treated more in their homes and in community services where they live. I welcome his support for our shift to neighbourhood care and to better care closer to home.

--- Later in debate ---

[Jonathan Davies (Mid Derbyshire) (Lab)]

T2. My constituent Audrina Hatton-Wright is a 12-year-old cancer survivor. She has spent a huge amount of her childhood in hospital, where she has found that the food is sometimes not of a nutritional quality to support people’s recovery. She is running a high-profile campaign on this issue, which has taken her on to the BBC and ITV’s “This Morning”. Will Ministers meet me and Audrina to see where we can work on this issue together?

[The Minister for Secondary Care (Karin Smyth)]

I thank Audrina for the great work that she is doing, supported by the campaign. Food in hospitals is really important, and we would be very happy to meet Audrina. Well done to her.

[Mr Speaker]

I call the shadow Secretary of State.

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[Jack Abbott (Ipswich) (Lab/Co-op)]

T4. East Suffolk and North Essex NHS foundation trust has made a £98 million application to the estates safety fund for a new maternity building. Our local services support the delivery of around 3,000 babies every year, but the existing building has not been fit for purpose for many years. Will the Secretary of State support our bid for a new maternity wing at Ipswich hospital, to make sure babies and families get the state-of-the-art services that they so desperately need?

[Karin Smyth]

My hon. Friend raises an excellent point about the state that these buildings were left in by the Conservative party, as Lord Darzi’s report made clear. We are investing unprecedented amounts in capital and giving greater certainty, and I would be happy to meet my hon. Friend to discuss the proposal from Ipswich. It is up to local systems to come forward with plans, but I would be happy to discuss that further with my hon. Friend.

[Mr Speaker]

I call the Liberal Democrat spokesperson.

--- Later in debate ---

[Mr Speaker]

Order. Can Members please help other colleagues to get in by shortening their questions?

[Karin Smyth]

My hon. Friend is absolutely right that it is the responsibility of the commissioners to look holistically at the provision of services. We want more services closer to home, using technology, care in people’s homes and so on, but she is quite right to highlight this issue. I know that she will continue campaigning on it, and I hope everyone has listened to her, so that people can come together to help her constituents.

[Mr Gregory Campbell (East Londonderry) (DUP)]

T5. Bowel cancer rates are increasing among the under-50s. What targeted interventions are taking place to try to reduce such incidences?

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[Ben Obese-Jecty (Huntingdon) (Con)]

I thank the Minister for her recent confirmation that the renal dialysis service would remain at Hinchingbrooke hospital in my constituency during the build under the new hospital programme, but I am conscious that it is not in the scope of the actual new hospital and may not be there in the longer term. Can she offer me some assurances that this vital service for constituents will remain at Hinchingbrooke? If not, is any provision being made to ensure that this local resource stays available?

[Karin Smyth]

I am glad the hon. Gentleman found that correspondence helpful. As he knows, I am keen to discuss the new hospital programme and its progress with all Members. I am sure that discussions about the renal service at Hinchingbrooke continue to take place locally, and that those involved will continue to work together. I know that the hon. Gentleman will keep in touch about the progress of the discussions on behalf of his constituents, and I am happy to talk to him about the issue.

[Lorraine Beavers (Blackpool North and Fleetwood) (Lab)]

Blackpool Victoria hospital desperately needs more money, because the ICB’s funding for hospital trusts does not account for the 20 million tourists or the complexity of care required. Will the Secretary of State ensure that the hospital receives its fair share of extra funding from the ICB?

[Karin Smyth]

I appreciate my hon. Friend’s concern on behalf of her constituents. We are moving the system governing hospitals such as Blackpool away from deficit funding so that it becomes well governed and managed, in line with fair shares allocation, and I shall be happy to discuss that further with my hon. Friend.

[Caroline Voaden (South Devon) (LD)]

Torbay hospital, which serves my constituency, is one of the oldest parts of the NHS estate, and the Devon and Cornwall fire services recently ruled that its tower block would now be unsafe in the event of a fire. A quarter of the beds in the hospital are in that tower block, so patients are now being moved. Staff are extremely worried about what will come next, and this is making the hospital much less viable. Will the Minister meet me, and other Devon Members, to discuss its future funding, and the need to make it safe and secure and ensure that it continues to operate?

[Karin Smyth]

I have met the hon. Member for Torbay (Steve Darling) to discuss this matter. Obviously, money has been allocated. We are well aware of the hospital’s position, and it is also part of the programme. I shall be happy to provide further information if the hon. Lady is not clear about the allocations that have been made.

[Tracy Gilbert (Edinburgh North and Leith) (Lab)]

Demand for surrogacy from the UK is leading to the exploitation of women in countries across the globe, including Ukraine, Nigeria and Mexico. Can my right hon. Friend give a commitment on when legislation will come to the Floor of the House, so that we can play our part in ending that exploitation as soon as possible?

[Mr Gagan Mohindra (South West Hertfordshire) (Con)]

Under the last Conservative Government, upwards of £300 million, which would have been lifesaving as well as life-changing for many of my constituents, was earmarked for the new Watford general hospital. The lack of those funds, combined with the closure of the urgent care centre at Mount Vernon hospital, means that many of my constituents are not now receiving the first-class healthcare that they would reasonably expect. What assurances can the Minister give local residents?

[Karin Smyth]

I pay tribute to my hon. Friend the Member for Watford (Matt Turmaine) and others for their campaigning in that part of north-west London and elsewhere. The movement of services is now firmly part of the programme, and the people of Watford will have the services that they deserve. Discussions are continuing, and I shall be happy to update the House on the final decision as soon as possible.

[Jayne Kirkham (Truro and Falmouth) (Lab/Co-op)]

Percy, a five-year-old constituent of mine, wrote to me ask whether gluten-free products would ever be provided on prescription for people with coeliac disease. What steps is the Minister taking to address postcode variations in the provision of gluten-free food by integrated care boards?

--- Later in debate ---

[Steve Darling (Torbay) (LD)]

The fire service and the Care Quality Commission have now served legal notice against the tower block at Torbay hospital, and more than 100 beds are under threat. With that new information, this is now a crisis at Torbay hospital. Will the Minister please meet me and other Devon MPs to help navigate this crisis?

[Karin Smyth]

I recently met the hon. Member, and as he knows, we are absolutely committed to working with the local system to do that. I absolutely commit to updating him as soon as possible if he is not aware of where we are on that. I will get something back to him very quickly.

[Markus Campbell-Savours (Penrith and Solway) (Lab)]

For those considering suicide, the message must be that there is always another way, but with new Office for National Statistics data showing that the rate of suicide in Cumberland has increased yet again, would Ministers meet me and Cumbrian Members to ensure that our health system is providing support to all when they need it?

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[Luke Myer (Middlesbrough South and East Cleveland) (Lab)]

Will Ministers meet me to discuss the future of East Cleveland hospital and what other services we can get closer to our community?

[Karin Smyth]

Yes.

[Shockat Adam (Leicester South) (Ind)]

I welcome the Government’s commitment to regulating funeral services, but for Jewish and Muslim families, burying a loved one quickly is a religious duty, not a preference. Will the Minister ensure that faith communities and burial societies, such as the Muslim Burial Council of Leicestershire in my constituency of Leicester South, are consulted directly, and that the new legislation does nothing to delay burials?

[Lloyd Hatton (South Dorset) (Lab)]

This month, we heard that Wareham’s chemotherapy clinic will reopen early next year, following two years of campaigning, meaning that patients across Purbeck will no longer have to travel long distances to access cancer care. Building on that success, will the Minister work with me to finally restore the rheumatology clinic at Swanage community hospital, so that many more patients can access care much closer to where they live?

[Karin Smyth]

I am always keen to discuss and visit places in Dorset with my hon. Friend. I am happy to look, with him, at the integrated care board’s overall plan for the provision of all those services.

[Saqib Bhatti (Meriden and Solihull East) (Con)]

I recently met pharmacists in my constituency, who expressed concern about the resilience of the supply chain, and specifically about wholesale suppliers spreading rumours, with the result that medicines are stockpiled, forcing up prices. In this case, it was Ramipril, but this is an issue across the board. It is the British taxpayer—our constituents—who suffer. Is the Secretary of State aware of this issue, and has she considered getting the Competition and Markets Authority involved?

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[James Wild (North West Norfolk) (Con)]

On Saturday, I joined hundreds of people in King’s Lynn in protesting against leaked plans for Norfolk and Waveney University Hospitals Group to downgrade accident and emergency and maternity services, and the intensive care unit, at the Queen Elizabeth hospital. Does the Health Secretary agree that services should be as local to people as possible, and will she reject any plans to remove services from the QEH?

[Karin Smyth]

I am aware of the issues around the hon. Gentleman’s local hospital; I have worked with him closely as part of the new hospital programme as well. It is up to local systems to decide on the clinical pathways across the whole patch. Those decisions must be clinically led, and there must be consultation with local people. I am very happy to keep an eye on that, and to talk with him in the future.

Health and Social Care

Karin Smyth Excerpts

Tuesday 20th October 2026 Written Corrections

The following extract is from the Westminster Hall debate on Underperforming NHS Trusts: Government Oversight on 14 October 2026.

[Karin Smyth]

The clinical strategy will make greater use of neighbourhood and community care in line with our 10-year plan and focus on maternity and planned care treatment. This is backed by £80 million for Southend hospital’s long-standing structural estate problems and support for a neighbourhood health centre in Maldon.

[Official Report, 14 October 2026; Vol. 791, c. 184WH.]

Written correction submitted by the Minister for Secondary Care, the hon. Member for Bristol South (Karin Smyth):

[Karin Smyth]

The clinical strategy will make greater use of neighbourhood and community care in line with our 10-year plan and focus on maternity and planned care treatment. This is backed by support to develop an estimated £80 million scheme to address Southend hospital’s long-standing structural estate problems and support for a neighbourhood health centre in Maldon.

Health and Social Care

Karin Smyth Excerpts

Friday 16th October 2026 Written Corrections

The following extract is from the fifteenth sitting of the Health Public Bill Committee on 9 July 2026.

[Karin Smyth]

We are also looking to support general practice in better identifying and recording which of their patients are unpaid carers, to help ensure that those carers can get the support they need in the community. NHS England recently published guidance to support that, and work is ongoing to ensure more consistent coding of unpaid carers by general practitioners.

––[Official Report, Health Public Bill Committee, 9 July 2026; c. 608.]

Written correction submitted by the Minister for Secondary Care, the hon. Member for Bristol South (Karin Smyth):

[Karin Smyth]

We are also looking to support general practice in better identifying and recording which of their patients are unpaid carers, to help ensure that those carers can get the support they need in the community. NHS England published guidance on supporting carers in general practice in 2019. A refreshed version has been developed with sector partners and will be published in due course. Work is ongoing to ensure more consistent coding of unpaid carers by general practitioners.

Integrated Care Board Boundary Changes

Karin Smyth Excerpts

Wednesday 14th October 2026 Written Statements

[The Minister for Secondary Care (Karin Smyth)]

On 22 September, the NHS England executive formally decided three changes to integrated care board boundaries. These have been approved by Ministers and will take place on 1 April 2027:

An area of Buckinghamshire, covering Newton Longville, will transfer from Central East ICB to Thames Valley ICB which covers the rest of Buckinghamshire country council;

An area of North Yorkshire adjacent to Lancashire, including Ingleton and Bentham, will transfer from Lancashire and South Cumbria ICB to Humber and North Yorkshire ICB;

The Craven area of North Yorkshire will transfer from West Yorkshire ICB to Humber and North Yorkshire ICB.

These changes will deliver alignment between those ICBs and local and strategic authorities, and progress delivery of our intention to align ICBs with strategic authorities by the end of the Parliament.

Further decisions on ICB boundary changes and mergers will be taken alongside other decisions regarding public service boundaries and strategic authorities, with any further changes expected on 1 April 2028. The Government and NHS England will continue working with local partners to ensure that all changes achieve the best outcomes for patients and citizens.

[HCWS379]

Underperforming NHS Trusts: Government Oversight

Karin Smyth Excerpts

Wednesday 14th October 2026 Westminster Hall

[The Minister for Secondary Care (Karin Smyth)]

That is very kind of you to encourage me, Mr Stuart. What are the timings now?

[Graham Stuart (in the Chair)]

We will finish at 4.15 pm, so ideally we will allow the wind-up at 4.13 pm.

[Karin Smyth]

Thank you. It is a pleasure to serve under your chairmanship, Mr Stuart.

I want to try to get back to most colleagues. I thank the hon. Member for Chelmsford (Marie Goldman) for securing this debate, and all Members who have spoken about the experiences of patients, because this is absolutely about the experiences of patients, families and the NHS staff in all our constituencies.

When an NHS trust underperforms, however we define it, the effects are very real. Patients wait longer, staff work without the stability and support they need, and public money is not used as effectively as it should be. Since becoming a Minister, I have made it clear that I think Members of Parliament should be part of conversations with local trusts. I commend my hon. Friend the Member for Ipswich (Jack Abbott) for hosting his trust in the way he has and seeing an improvement in his constituency, as he outlined, with mental health being considered as well as acute services. The Liberal Democrat spokesperson, the hon. Member for North Shropshire (Helen Morgan), spoke about her work in supporting her local trust and seeing those improvements. It can and does happen.

Many of the trusts that have been discussed today have faced problems built up over many years. In fact, I remember some of them from being a manager in the health service over the past 20 years or so. There is rarely one cause or a quick fix. There are varying problems, whether they be workforce shortages, poor estates, weak leadership, organisational change or rising demand, and some of those can reinforce one another. Let us be clear for patients and members of the public who are paying attention and for all our constituents: this Government will not accept poor performance, and we are determined to accelerate the recovery, particularly in the most challenged trusts.

I will just clarify some of the rules. Everyone knows that NHS England is an arm’s length body. That was a decision taken a number of years ago by my good friends the Liberal Democrats and the Conservatives when we were in opposition. The Health Bill, which is progressing through the House of Lords, changes that arrangement to put the NHS together with the Department of Health and Social Care. The Bill was not opposed in principle by any political party, because we all know that the arrangement has not worked.

As we bring the two bodies together, it is important to maintain the distinction between running large trusts and running the system as a whole, with operational performance oversight. It is a skilled job. It is hard to run a big trust. It requires good clinical and operational managers, and good leadership and knowledge. The complete separation of the Department and Ministers from NHS England meant that the oversight and what we could see in our constituencies as Members of Parliament was not linked up under the previous Government. That is one thing that will improve. As the hon. Member for Sleaford and North Hykeham (Dr Johnson) just said, of course Ministers will not be micromanaging. It is a skilled job. The complete separation that removed oversight from local trusts has been a dysfunction of the system over the last decade.

To be clear, I regularly meet teams and Members of Parliament in my role. I want to share how some of that operational oversight works. I will highlight two major areas. One is the oversight framework, which provides a clear and consistent assessment of every NHS organisation. In her expertise, the hon. Member for Sleaford and North Hykeham recognised that there are many ways to judge performance, but the new framework looks at what matters most to patients and taxpayers: waiting times, quality of care, use of staff and money, and leadership capability in order to have good-quality patient care. They cannot be separated in my view. I have made sure that it is transparent for the public and Members of Parliament. That is quite controversial; some people do not like what they call league tables, but I think it is important that people can see that.

[Dr Caroline Johnson]

Will the Minister give way?

[Karin Smyth]

I will move through some of these points for the moment. For providers with the most entrenched financial, operational, leadership and structural challenges that impact patient care—that is what these trusts are about—we are taking a more holistic approach to that enhanced support because, as the shadow Minister asked, how do we choose? They are the most challenged long-term systems.

At a national level, the intensive recovery programme is providing short-term, intensive support for organisations to help strengthen their immediate operational and financial stability while developing an organisation-owned plan for long-term sustainability. We cannot keep going round in this circle; at the end of the day, these organisations need to be well run and well led, and local systems need to own that problem. That is also part of our wider devolution agenda. I think I outlined that in my letter to the hon. Member for Chelmsford in September, but I am very happy to meet again and go through that in more detail if that is helpful.

The first IRP cohort includes Hull, Northern Lincolnshire and Goole, East Kent, North Cumbria and Mid and South Essex. Each faces very different circumstances, so there is not a one-size-fits-all response. I will touch on some of them, for hon. Members have raised their own issues with them.

There is interest in Hull and Northern Lincolnshire and Goole. Following an independent review, the decision has been taken to dissolve the Humber health partnership arrangements. In Hull, the focus is on strengthening core hospital services, making the best use of specialist services, improving productivity and reinforcing clinical leadership and accountability. For Northern Lincolnshire and Goole, the priority is to move more care into neighbourhood and community settings, reflecting the demands in those areas. There are good signs of progress.

The hon. Member for Chelmsford and others who intervened highlighted Mid and South Essex. The 2020 merger of those three trusts has not delivered the planned benefits for 1.2 million people. Staff culture and morale remain a serious concern, with little improvement, as was highlighted in those terrible survey results over the past five years. We have heard those. The trust has long-standing performance problems linked to how demand is managed across the wider health system in that part of Essex. Work is under way to improve the long waits, improve patient flow, strengthen governance and make better use of the estate. I shared the analysis in productivity packs with everybody earlier in the year, and I am sure that everybody looked at them in detail, but I am very happy to go through them again. It identified more than £122 million of productivity opportunities. It is not simply about saving money.

Better organisation across sites and stronger clinical integration should improve patient experience, reduce delays and raise quality for patients. The clinical strategy will make greater use of neighbourhood and community care in line with our 10-year plan and focus on maternity and planned care treatment. This is backed by £80 million for Southend hospital’s long-standing structural estate problems and support for a neighbourhood health centre in Maldon.

I will touch on North Cumbria because, for the hon. Members for Westmorland and Lonsdale (Tim Farron), for Honiton and Sidmouth (Richard Foord) and for Yeovil (Adam Dance), the work going on there really highlights what can and needs to be done in rural healthcare. I remind hon. Members that hospitals in some of those areas are additionally funded to cope with some of those rurality issues. We highlighted that in our 10-year health plan. We absolutely understand that across the country, there are different issues with regard to rurality. I will not talk about Kent, because it has not been raised, but again, it has very different issues. That is why those areas have been chosen. They have long-standing and deeply entrenched problems.

My hon. Friend the Member for Stoke-on-Trent South (Dr Gardner) raised ambulance handover delays. I did not know she was going to raise that today, but to assure her, the continued problem with the ambulances was raised with me in my oversight meeting with the team yesterday. Those issues are flagged by NHS England and its operational management across the country. They are long-standing issues, as she knows, but I gently disagree with her. She is absolutely right in her assessments of history, but this issue is not a failure of oversight and accountability. Good co-operation, collaboration and management are the responsibility of the services locally. The oversight has worked. We know that this is a problem. We and her constituents can see that. We very much want the services to work together to resolve that flow so that the ambulance handover works much better.

My hon. Friend the Member for Salford (Rebecca Long Bailey) highlights, sadly, her constituency’s downward improvement trajectory. She asked to meet me, and I am very happy to do that. My hon. Friend the Member for Darlington (Lola McEvoy) did the incredibly difficult job of raising the terrible distress for women in her constituency. She highlighted a terrible case, and I will make sure that she has a meeting with the Minister to go through how that can be supported on behalf of her constituents. I know that she will work closely to make sure that they are served better.

We are seeing early improvements through the IRP, but we need to demonstrate progress through safer care, better operation and financial performance. We have clear milestones and credible plans for stronger organisations. Support nationally is time-limited but proportionate, because trusts ultimately have to stand on their feet. Intensive oversight is not about naming and shaming. Staff in challenged trusts are working in exceptionally difficult circumstances. As we need to encourage people to work there, we must show them that it can be better. The purpose is to remove barriers to improvement, provide the right expertise and hold boards and NHS leaders to account for results.

The Government will continue to work with NHS England. I am committed to keeping Parliament informed of significant developments. We will judge our approach by its effect on patients and staff, not by the creation of more processes. The oversight framework and the intensive recovery programme provide a clear route from identifying the risk to taking targeted action. There is much more to do. It can only be done in local circumstances with co-operation and transparency, including working with Members of Parliament. Where we hear examples of trust chief executives not doing that, I am prepared to call it out. It is not acceptable.

There is more to do, but we want practical, safer and more timely care, and stronger organisations. I am pleased to have had the opportunity to debate this issue today. It is important for MPs to be part of the discussion. We want to improve all trusts, but we are focusing on those with long-term issues, sometimes having been affected for decades. The people in those areas deserve better, and we are determined to make sure they get it.

Health and Care Reviews, Improvement and Regulation

Karin Smyth Excerpts

Monday 12th October 2026 Written Statements

[The Minister for Secondary Care (Karin Smyth)]

I would like to inform the House of several updates from the Department of Health and Social Care, following developments and announcements over the conference recess.

Adult Social Care

The Government are delivering a package of reforms to fulfil the Prime Minister’s commitment to improve the strength and capability of those providing care. This includes plans to appoint the first unpaid carers champion to drive support for the millions of people who provide unpaid care for older or disabled people, and a new social care workforce action plan, to be published later this year, bringing together the steps the Government will take to support that workforce.

As part of the action plan, the Government will work with the care sector to expand sector-based work academy programmes, in order to help more young people and jobseekers access training, work experience and routes into care jobs; and to develop a national collective pension scheme, in order to improve care workers’ retirement outcomes. Alongside the first fair pay agreement, these measures will support recruitment, retention and career development, while laying the foundations for a national care service.

Healthy Babies Programme Expansion

The Healthy Babies programme will be rolled out nationally to every Best Start family hub, extending support based on Sure Start principles during pregnancy and the first two years of life to families in every part of England. Building on delivery in 75 local authorities, Healthy Babies will help parents and carers access joined-up support with infant feeding, parental mental health and forming strong attachments with their baby. The expansion will help all families give their baby the best start in life and lay the foundations for the healthiest generation of children ever.

Violence against Women and Girls

As part of the Government’s overall strategy to tackle violence against women and girls, the Department of Health and Social Care will adopt a public health approach to tackling VAWG, addressing the root causes, emphasising early intervention, and making sure no woman is turned away from the support she needs. A targeted consultation with stakeholders on the development of a national framework to support this approach will be launched. This will start with an investment of up to £34.4 million over three years to support 12 integrated care boards across England in delivering the first phase of a primary care referral pathway called Steps to Safety, which will make sure that women and girls experiencing violence and abuse can access specialist support through their GP. A further £15 million over three years will be invested in local victim support services through all integrated care boards in England.

A national clinical lead for violence against women and girls will also be appointed, combining clinical and public health expertise. They will cover prevention, early identification, partnership working and the health system’s response to victims, survivors and people at risk of harm, including NHS staff.

Independent Review into Mental Health Conditions, Autism and ADHD

The independent review into mental health conditions, autism and attention deficit hyperactivity disorder published its final report on 9 October. It can be viewed online at the link below, and copies will be placed in both Libraries: https://www.gov.uk/government/publications/independent-review-into-mental-health-conditions-adhd-and-autism-final-report

Chaired by Professors Peter Fonagy, Sir Simon Wessely and Gillian Baird, the review found that there has been a substantial rise in mental distress, particularly among children and young people, driven by a range of factors, such as financial pressures, social media and poorer sleep. For ADHD and autism, the review found diagnoses, referrals and waiting lists have risen dramatically. The report concludes that the balance of evidence suggests that underlying population prevalence has remained broadly stable, but it points to the need for more up-to-date population prevalence surveys. The review finds that the current system is overly focused on diagnosis as the gateway to support. The review recommends strengthening prevention, early help, wellbeing support and practical interventions for individuals facing mental distress, without waiting for a diagnosis, as well as improving access to high-quality specialist treatment and care for people with the most severe, complex and enduring needs.

The upcoming cross-Government mental health strategy will respond to the review’s longer-term recommendations, including increasing early intervention and shifting from a diagnosis-led system towards a needs-led system. We will require stronger partnerships with the voluntary and community sector, redesign commissioning arrangements, improve integrated mental health and neurodevelopmental support, and work across Government to address areas where diagnosis is currently the only gateway to support.

In the immediate term, the Government have also announced a comprehensive package of reforms to improve ADHD and autism assessments. We will work to bring all diagnostic assessments under Care Quality Commission regulation, helping to ensure that people receive high-quality, clinically robust assessments regardless of how they access care, and we are also acting on concerns about the advertising of ADHD and autism assessment services. In future, we will ensure that NHS funding is only used for assessments delivered by CQC-registered providers, and will require integrated care boards to improve oversight of commissioned services.

Independent Review into Maternity and Neonatal Services at Leeds Teaching Hospitals NHS Trust

Terms of reference for the independent review into maternity and neonatal services at the Leeds teaching hospitals NHS trust were published on 29 September. The Government worked closely with the review’s Chair, Donna Ockenden, and affected families to finalise the terms of reference, ensuring that families’ experiences and priorities shaped the scope of the review.

The review is due to be published in 2029, and will therefore consider maternity and neonatal care from 1 January 2011 up to and including 31 March 2028, where mothers and babies have suffered severe harm or death while under the care of the trust. Affected families will receive further information about the commencement of case reviews in due course.

Public Inquiry into Mental Health Care at Tees, Esk and Wear Valleys NHS Foundation Trust

His Honour Judge John Potter was appointed chair of the statutory public inquiry into Tees, Esk and Wear Valleys NHS foundation trust on 17 September. The inquiry formally commenced on 21 September 2026. This inquiry has been established to investigate the circumstances and issues surrounding patient deaths associated with Tees, Esk and Wear Valleys NHS foundation trust, and to ensure that lessons are learned to help protect patient safety.

The inquiry’s work will now be a matter for the judge. It is important that the voices of bereaved families, patients and carers are heard throughout the inquiry process, and that they are treated with compassion, dignity and respect.

Over the coming months, the chair will begin establishing the inquiry’s operating arrangements and consulting on its terms of reference. The terms of reference will be announced in due course.

National Cancer Board

Anita Charlesworth has been appointed the National Cancer Board’s independent co-chair, and Dr Robert Metcalf has been appointed national clinical lead for rare cancers. Ashley Ball-Gamble has also been announced as the representative for children and young people’s cancers on the board and Dr Dianne Addei as the representative for inequalities.

The National Cancer Board held its first meeting on 21 September. This meeting brought together senior leaders from the Department of Health and Social Care and NHS England, as well as external stakeholders and patient representatives, to discuss the progress that had been made on the commitments set out in the national cancer plan.

Government Response to the National Commission into the Regulation of Artificial Intelligence in Healthcare

Finally, the Government have issued their formal response to the recommendations made by the national commission into the regulation of AI in healthcare. Through its response, the Government welcome the national commission’s 44 recommendations, accept them in full, and will work with partners to implement them. This reflects the Government’s commitment to ensuring that the UK plays a leading role in using AI effectively and safely to improve health care systems and health research, ensuring that innovation also maintains public confidence.

The response has been prepared as an initial action plan setting out how the Government will take forward the national commission’s recommendations, and will provide stakeholders with certainty regarding direction of travel.

This publication is not the end of the process. It marks the next stage in an ongoing conversation that will support the work of the Medicines and Healthcare products Regulatory Agency and the wider Government, who will publish a more detailed implementation plan next spring.

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UK Medical Specialty Training Programmes: Prioritisation of Doctors

Karin Smyth Excerpts

Tuesday 15th September 2026 Written Statements

[The Minister for Secondary Care (Karin Smyth)]

We have now laid before Parliament the Medical Training (Prioritisation for Specialty Training Programmes) Regulations 2026. These regulations specify categories of person who will be prioritised for interviews and offers for UK medical specialty training programmes from 2027 onwards.

The Medical Training (Prioritisation) Act 2026 introduced a system of prioritisation for the allocation of postgraduate medical training places across the UK. It delivered the commitment in the Government’s “Fit for the future: 10 Year Health Plan for England” to prioritise UK medical graduates for foundation training and to prioritise UK medical graduates and other doctors with significant NHS experience for specialty training places.

The Act is designed to support a sustainable medical workforce that can meet population health needs, reducing the UK’s reliance on the international labour market, and ensuring we make best use of the substantial taxpayer investment in UK-based medical education and training. By creating a clear pathway from medical school to specialty training, we strengthen domestic talent and improve retention.

For specialty training, the Act prioritises graduates of medical schools in the UK or Ireland; international medical graduates who studied in Iceland, Norway, Liechtenstein and Switzerland, to reflect international agreements; and individuals who have completed or are completing the UK foundation programme or the relevant previous stage of a UK specialty training programme.

For specialty training offers made in 2026 only, the Act also prioritises individuals holding the following immigration statuses: British citizens; Irish citizens who do not require leave to enter or remain in the UK; Commonwealth citizens with the right of abode; individuals with indefinite leave to enter or remain in the UK; and those with EU settled and pre-settled status. These provisions were intended to act as a proxy to capture applicants most likely to have significant experience of working as a doctor in the NHS.

For specialty training places starting from 2027, the Act provides a power to specify by regulations groups to be prioritised, by reference to criteria indicating significant experience of working as a doctor in the NHS or health and social care in Northern Ireland, or described by reference to their immigration status, in a way that best delivers our policy intent.

During the Bill’s parliamentary passage, we committed to engaging with stakeholders on future regulations in this area. In spring 2026, NHS England undertook targeted stakeholder engagement on behalf of the four UK Governments. This included, among others, the medical royal colleges, bodies representing international medical graduates, trade unions including the BMA, NHS providers, the General Medical Council, think-tanks and medical schools. Most stakeholders favoured moving away from immigration status as the basis for prioritisation once NHS experience can be measured directly. Views on an appropriate minimum threshold for NHS experience were more mixed and based on limited evidence due to how recently prioritisation had been implemented, and we do not believe that we have a sufficiently robust evidence base to define alternative criteria setting a threshold for NHS experience in regulations at this stage.

The urgency of the Act meant that for 2026 it came into force after applications had closed and only introduced prioritisation for the offer of places. This meant that the evidence available from the 2026 recruitment round is necessarily limited, as prioritisation could have had little effect on applicants’ behaviour.

Having considered the available evidence, we have concluded that the immigration statuses that applied for specialty training offers made in 2026 remain the most appropriate basis for prioritisation at this stage. These statuses capture people with a permanent, unrestricted right to live and work in the UK and remain an effective proxy to capture doctors most likely to have significant experience working with the NHS. While we recognise this is not a direct measure of NHS experience, applicants with these immigration statuses are more likely to have worked in the NHS for a significant period of time or to remain working in the NHS for longer.

Using these immigration statuses from 2027 provides continuity with 2026 prioritisation arrangements while enabling evidence gathering from future recruitment rounds to support a fuller assessment of potential alternative approaches for future years.

These regulations do not amend the other categories of person already prioritised for specialty training places under the Act as set out above. These regulations also do not affect the prioritisation regime for foundation training under the Act.

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