Health Bill

Debate between Allison Gardner and David Chadwick

Report stage
Monday 7th September 2026 Commons Chamber

[David Chadwick (Brecon, Radnor and Cwm Tawe) (LD)]

I rise to speak in favour of new clauses 133 and 134, which stand in my name. The new clauses would require the Secretary of State to work with Welsh Ministers to update the England and Wales cross-border healthcare statement of values and principles, and to bring forward proposals to place those principles on a formal legal footing.

For many people living along the border, cross-border healthcare is simply a fact of life. In Powys, at least 40% of people depend on hospitals across the border in England. Yet the framework governing how our two healthcare systems work together is based on a voluntary statement of values and principles dating back to 2018. We do not need to look far to see why the current arrangements need reform. Since last July, Powys teaching health board has been asking English hospitals treating Powys residents to treat them more slowly than patients from England as part of cost-cutting measures, despite the fact that they had always previously been treated as equals. The impact of that decision has been devastating. Many patients have had their waiting times increased to up to two years—forced to wait longer in pain, all while their conditions deteriorate.

It is not just me and the Liberal Democrats who have been sounding the alarm; providers on the English side of the border have resisted the arrangements because of concerns about the impact on patients. However, there seems to be little will to resolve the issue from either the Welsh Government or the health boards responsible. Meanwhile, patients are falling through the cracks. My constituents should not have to navigate the administrative boundaries between the NHS in England and NHS Wales simply to get the arrangements and treatment they need. Eight years after the statement of values and principles was introduced, the limitations of relying on a voluntary statement with no formal legal footing are clear.

New clause 134 would require the Secretary of State to work with Welsh Ministers to update that statement, reflecting the problems that cross-border patients face today. Crucially, it would also require the Government to bring forward proposals within two years to place those principles on a statutory footing. The border should never be a barrier to receiving healthcare. It is time to update and strengthen these principles and give cross-border patients the statutory protections they deserve, because I fear that cross-border healthcare will continue to deteriorate over the next couple of years.

Over the summer recess, I held a series of public meetings in response to plans by Powys teaching health board to cut the number of community beds, which will just mean that more people end up stuck in community beds on the English side of the border.

[Dr Allison Gardner (Stoke-on-Trent South) (Lab)]

This Government aim to shift the focus from treatment to prevention, and it is in that spirit that I have tabled new clauses 90 and 91, which would strengthen the frameworks around health inequalities and address the wider determinants of health.

New data from Health Equals reveals a shocking reality: there is a gap of up to 18 years in life expectancy between different parts of the UK, and indeed between nearby neighbourhoods. Health Equal shows that in my constituency just a golf course separates two areas with an average life expectancy gap of eight years and 11 months. Reaching old age is somewhat of an aspiration in my more deprived areas. Indeed, in the most deprived communities people spend an average of just 52 years in good health. The stark inequalities are driven not only by healthcare, but by the wider determinants of health, including poverty, housing, education, employment and the environment.

Within Stoke-on-Trent, healthy life expectancy at birth has fallen by 6.6% for men in the last decade. For women, the picture is even worse, with a 9.6% fall in healthy life expectancy to just 53.5 years over the past 10 years. This Bill represents a real opportunity to enshrine in law a statutory duty for the Secretary of State to go beyond reducing inequalities in NHS access and outcomes, and to reflect wider cross-Government goals for health improvement.

Our health is shaped by the world around us—the food we eat, the money in our pockets, the air we breathe and the home we live in. In other words, every part of Government has an opportunity to influence people’s health. The purpose of new clause 90 is to ensure that the Government take greater responsibility for improving the nation’s health. That includes mitigating any increase in health inequalities, such as those seen in my constituency. The new clause would make improving health a duty, placing prevention on the same footing as treatment.

But a stronger duty alone is not enough. That is why new clause 91 would require the Government to publish a new health improvement and inequality strategy within six months. The strategy would include long-term targets for adults and children, public reporting on progress, a duty on Ministers across Government to have regard to the strategy, and independent accountability arrangements. The Minister, who has worked very hard on the Bill—I commend her for her engagement—has alluded to the fact that pre-existing guidance and processes are in place, and these are designed to tackle health inequalities, and she is right. However, I argue that they are clearly not working, because health inequality has increased. I ask again what the harm would be of embedding this duty in the Bill to tackle the most fundamental issue in health across England: health inequalities.

These amendments have cross-party support, and I note that they are also supported by the Health and Social Care Committee. I thank Health Equals for its work on these amendments. Again, I thank the Minister for her engagement and urge the Government to consider accepting these new clauses.

I will briefly mention new clause 109, which also stands in my name. It was written by myself and Haris Shuaib, with whom I worked on the standard BS 30440 and a validation framework for the use of AI within healthcare. I previously worked with the AI and digital regulations service for NHS England, working with NICE, the MHRA, the CQC and the Health Research Authority. In the interests of time, I will say that in that duty I identified a number of accountability and regulatory gaps that certainly need further addressing. I ask that the Minister responsible for health tech meets me so that we can discuss these further. They partner quite well with new clause 108, which I had not spotted, so I apologise for not signing the amendment of my hon. Friend the Member for Liverpool West Derby (Ian Byrne).

Cyber Security and Resilience (Network and Information Systems) Bill (Second sitting)

Debate between Allison Gardner and David Chadwick

Committee stage
Tuesday 3rd February 2026 Public Bill Committees

[David Chadwick]

Q Thank you for joining us. Reporting of several recent cyber-attacks has one thing in common: there were often insufficient security measures in place. British Airways in 2018 is just one example. Reportedly, the average tenure of a chief information security officer is 18 months. From your perspective, what do CISOs need from the Bill to help strengthen their hand when they are saying to a board, “This is what I need to do to keep our organisation secure”?

Richard Starnes: On what you say about the 18-month tenure, one of the problems is stress. A lot of CISOs are burning out and moving to companies that they consider to have boards that are more receptive to what they do for a living. Some companies get it. Some companies support the CISOs, and maybe have them reporting to a parallel to the CIO, or chief information officer. A big discussion among CISOs is that having a CISO reporting to a CIO is a conflict of interest. A CISO is essentially a governance position, so you wind up having to govern your boss, which I would submit is a bit of a challenge.

How do we help CISOs? First, with stringent application of regulatory instruments. We should also look at or discuss the idea of having C-level or board-level executives specifically liable for not doing proper risk governance of cyber-security—that is something that I think needs to be discussed. Section 172 of the Companies Act 2006 states that you must act in the best interests of your company. In this day and age, I would submit that not addressing cyber-risk is a direct attack on your bottom line.

[Dr Gardner]

Q You have answered the question I was about to ask. I may ask an addendum to that, but first I want to clarify something. If you put liability on an individual board member, that is going to cause problems. Do you think that there should be a statutory responsibility for the company to have a board member responsible for cyber-risk, and that the responsibility and accountability should sit at company level?

Richard Starnes: I think this should flow from the board to the C-level executives. Most boards have a risk committee of some sort, and I think the chair of the risk committee would be a natural place for that responsibility to sit, but there has to be somebody who is ultimately responsible. If the board does not take it seriously, the C-levels will not, and if the C-levels will not, the rest of the company will not.