Modern Service Framework for Dementia and Frailty

Baroness Wyld Excerpts

Thursday 9th July 2026 Grand Committee

[Baroness Wyld (Con)]

My Lords, I too thank the noble Lord, Lord Weir of Ballyholme, for securing this debate and for setting out the issues, as he did so comprehensively and with great expertise. We are very grateful to him.

Like so many people up and down the country—and, as I know, in your Lordships’ House—I too have experience of helping to care for relatives with dementia. The first time was over 20 years ago, and now our family joins many others in trying to navigate the challenge of a recent diagnosis. I have been reflecting on what has changed since I first tried to help a relative over 20 years ago, and I want to start on an optimistic note, because the medical landscape is different.

As we have heard, we have entered an era where the first disease-modifying therapies have been licensed. Innovation in diagnostics is enabling us to accurately identify disease earlier in the trajectory, and blood tests in NHS trials could make the diagnostic pathway easier. So, recent breakthroughs have at last delivered hope, if we build a healthcare and research system that is ready to adopt and deliver these innovations at scale as soon as they become available.

I am grateful for the briefings I have received. The joint letter from Dementia UK, Alzheimer’s Research UK and the Alzheimer’s Society in the very helpful Library briefing confirmed that there is

“a clear opportunity to change the trajectory of dementia—if the system is ready to act”.

However, it also stressed that

“we must recognise that the health and care system is failing to deliver the outcomes that people with dementia deserve today”.

The contrast between scientific progress and the daily reality faced by many patients can be jarring. Every dementia experience is of course unique to the individual, but the vast majority of families face similar hurdles: the emotional toll, the labyrinth of health and social care services and the struggle to access specialised support. It can be a very lonely journey, and I know that for many families, it takes a crisis for help to arrive, so I ask the Government to ensure that the framework is built on a true understanding of the experience of patients and carers.

In a debate on Alzheimer’s in October 2025, the Minister described the framework as taking “a whole view”. My hope is that this means it will take a whole view of the person and indeed of the system. The title of the report from Alzheimer’s Research UK, which the noble Lord, Lord Weir, rightly referred to, is Ready for the Cure. It also highlights that dementia is one of the most feared health conditions, as we have heard. Yet we may also have a once-in-a-generation chance to move to a more preventive treatment model. We must ensure that the UK’s scientific excellence is translated into impact for patients and their families. I would be most grateful if the noble Baroness could set out how she envisages the framework achieving this.

We have so many strengths in the UK: there has been political will from past Governments and from this Government and many global leaders in the field are based here. As part of the 2012 Prime Minister’s challenge on dementia, the UK established the UK Dementia Research Institute, a beacon of scientific innovation, and the last Government established the Dame Barbara Windsor Dementia Goals programme.

We are also gaining a better understanding of prevention. The Lancet commission suggested that 45% of cases of dementia are preventable, as the noble Lord, Lord Weir, referred to. We know that it is about managing risks where we can through lifestyle interventions—what is good for the heart is good for the head—and through better health system management, particularly of conditions such as diabetes. I also want to flag that recent successive studies have shown that people who have had the shingles vaccine have a low incidence of dementia. The shingles vaccine is one of a number of vaccines where studies have suggested some preventive cognitive benefit. Understanding the science behind this better will help shape future vaccine advice, and I wonder whether the Government have thought about this as part of the strategy and whether the Minister can comment.

Finally, but most importantly, let us remember the importance of kindness and empathy. I think about the number of people I have known who have sat in a room to hear a diagnosis and, indeed, the times when I have heard news about a family member. Each time, the reaction has been: where do we go next and who can help us? The Secretary of State has set out the importance of enabling patients to live well in their own neighbourhoods. This relies on a properly resourced workforce across health and social care, with the skills and kindness to help patients and their families manage a heartbreaking disease. Navigating post-diagnostic support is difficult, even with an advocate. I hope the Minister will be able to comment on the Government’s approach to care plans. This framework must move us away from a fragmented approach which too often let-down patients and families. We stand at an inflection point. I hope the Government recognise the urgency, because decisions taken now will shape how millions of people experience the hardest chapter of their lives. I look forward to the Minister’s response.

Preterm Birth Committee Report

Baroness Wyld Excerpts

Friday 6th June 2025 Lords Chamber

[Baroness Wyld (Con)]

My Lords, I add my thanks to the noble Lord, Lord Patel. The committee could not have wished for anybody better qualified to be our chair. He did it with his unique blend of professional brilliance and deep compassion, and we were very lucky to have him. I thank my noble friend Lady Bertin, who proposed the committee. As we have heard, she challenged your Lordships’ House to show ambition in its approach to this issue, and I know she made me even more determined to fight for better outcomes for women, their babies and families. She kept telling me to remember who we were doing this for.

On that note, it has been an absolute privilege for me to get to know some of the parents who gave evidence to us. I want to take a moment to acknowledge the strength it took for those parents to come and tell their stories to a public hearing of a Select Committee and to allow us to question them in order that we could find recommendations that would, we hope, improve the experience for others.

I have three general observations. First, given that, as we have heard, we still do not know enough about preterm labour, we owe it to women to do better research, as the noble Lord, Lord Winston, said. Secondly, where we do know a fair bit about ensuring the best possible quality care, women still cannot trust that this will be delivered consistently. Thirdly, as our recommendations show, it should be possible to reduce risk and improve outcomes.

It seems to me that there is a disappointing lack of pace and grip from the Government, despite very warm words in their response to our report. I emphasise that I am very grateful to the Minister for the time that she has given me to discuss these issues. I have said in the national media that I was convinced that the will is there to tackle this issue, and I am very happy to put that on the record here. I accept that the Government are making progress on preventive health care. I was very grateful for the smooth way in which they delivered the regulations to implement the Neonatal Care (Leave and Pay) Bill, which I took through this House in 2023. It is in that spirit that I come to this debate. I will never play politics on this, and I will be delighted if the Minister is able to contradict me in her summing up, because I will now be more critical on the response to our recommendations.

Our committee acknowledged the complexity of preterm birth. Witnesses expressed different views about the usefulness of just one overarching target of a reduction to 6% by 2025, which the Minister has acknowledged will be missed. None of this means that, from a policy perspective, preterm births should be put in the “too difficult” category. The Government have rightly accepted the principle that we need to address focus on tackling the stark and unacceptable inequalities, including the rate of preterm births, that exist for black and Asian women and babies, and women and babies from the most deprived backgrounds. The Government therefore need to set out how they intend to get there. Given that it is almost seven months since publication of the report, I would be surprised if the Minister was unable to say where the Government have landed on targets or whether they have come to a view.

I want to focus in the main on several recommendations from chapters 4 and 5 of the report, in which we examined how to improve the outcomes for preterm babies and the experiences of their families. As we have heard, many babies who are born early flourish, but during our committee sessions we heard from witnesses for whom that has not always been the case, including Francesca and Nadia, both mothers of preterm twins. I cannot do justice to that session in the time available today, but their campaigning call for all parents to be properly supported in the care of their babies born in hospital and on their return home must be acted on by the Government.

It seems to me astonishing that so many of us will stand up today in Parliament in 2025 and have to argue the case that all parents must be able to stay overnight with their tiny and unwell babies in neonatal units, including neonatal intensive care. They should be involved in their baby’s care as much as possible and should be able to hold them. They must be listened to when their instinct tells them that something is wrong. The charity Bliss outlined evidence showing that family integrated care leads to a range of benefits, including increased weight gain, improved breastfeeding, and reduced rates of mortality and morbidity.

If the Government and the NHS agree with this, why have they not yet published the review of the NHS maternity and neonatal estate survey, as requested by the committee and promised “early in 2025”? In answer to a Written Question I tabled in April, the DHSC said that NHS England would do this “shortly”, and we are now in June. Is the Minister able to give a definitive date for this to be published? Given that we await the NHS 10-year plan, can she say what consideration has been given to the need to extend and improve accommodation in neonatal units?

As we have heard, we made it clear that the impact of preterm birth does not end once families go home. Despite the fact that up to 40% of mothers experience symptoms of post-traumatic stress disorder six months after a preterm birth, witnesses told us that counselling after a preterm birth is either “not in place” or “not offered as standard.”

I raised the wider issue of perinatal mental health in the House last month. Can the Minister expand on the answers she gave then to address the committee’s recommendation that the Government and NHS England should detail the steps they are taking to ensure equitable access to neonatal outreach and perinatal mental health services for all families who experience preterm birth?

This ties closely to recommendation 8 on the need to develop specialist knowledge of the needs of preterm babies and their families into health visitor training and continuous professional development, with protected training time. As my noble friend Lady Bertin mentioned, it is people and relationships that can help others turn corners.

Finally, I turn to one of the most disappointing findings of the report, which is that the follow-up assessments for children born pre term that are recommended by NICE

“are not being consistently delivered, in particular at age four”,

as was outlined by the noble Lord, Lord Patel. I think I speak for the whole committee in saying that we were highly dismayed that neither NHS England nor the DHSC could explain why this was the case or who was going to grip it. I know that the Government are in the process of an NHS restructure; I am certainly looking not to open up that debate today but, rather, to emphasise the committee’s desire to see swift resolution here. I would be most grateful for a precise answer from the Minister.

To sum up, although there was a huge amount of specialist knowledge and experience in this report, at its core, it is very simple: we can and must do better for babies, mothers and families. The most powerful evidence comes from those parents who have campaigned with a quiet dignity to spare others the pain that they have experienced. I feel a huge responsibility to keep up the momentum to deliver change for them; I reiterate to the Minister my commitment that I will work cross-party to try to do just that.

Care Quality Commission: Mental Health Care Waiting Times

Baroness Wyld Excerpts

Thursday 8th May 2025 Lords Chamber

[Baroness Merron (Lab)]

As the noble Baroness says, we reduced the number of targets on the basis of the recommendation by the noble Lord, Lord Darzi, that having so many targets was not delivering the results that we want. We have had to think boldly and innovatively. Since July 2023, NHS England has included waiting time metrics for referrals to urgent and community-based mental health services. I am looking at how we can drive improvements in quality and in the data to help services, particularly those with the most lengthy waits. I will also review the 2021-22 clinical review of standards to consider what else can be done to put mental health on a more equal footing, which it absolutely deserves.

[Baroness Wyld (Con)]

My Lords, what are the Government doing to improve access to perinatal mental health services? The Minister will appreciate the urgency, given that suicide remains a leading cause of maternal death.

[Baroness Merron (Lab)]

It is particularly appropriate that the noble Baroness raises this issue, as it is Maternal Mental Health Awareness Week. Yesterday I was very glad to attend an event organised by the Maternal Mental Health Alliance, where I spoke to women about their experience and what has made—or not made—a difference to them. I know we are looking forward to a debate on this later in the year, but 41 maternal mental health services have already been set up to provide care for women with moderate, severe or complex mental health difficulties, and more than 62,000 women are reported to have accessed a specialist community perinatal mental health service or a maternal mental health service. Additionally, 165 beds have now been commissioned across England in 20 mother and baby units, providing in-patient care to women. But yes, we need to do more.

Vaginal Mesh Implants: Compensation

Baroness Wyld Excerpts

Thursday 5th September 2024 Lords Chamber

[Baroness Wyld (Con)]

My Lords, in preparing for this debate, I went back to First Do No Harm, the original report from my noble friend Lady Cumberlege. I had read it before and I pushed the previous Government to up the pace on the appointment of the Patient Safety Commissioner because that dragged, but we got there in the end. I found the report’s contents no less shocking than they had been on the first reading. If anything, I found the testimonies of those living with harm from mesh even more upsetting this time, because these women and their families have been in limbo. I give my strong support to the call for redress from my noble friend Lady Cumberlege, and pay tribute to her work and that of the excellent Patient Safety Commissioner, Henrietta Hughes.

This was systemic failure, and we have heard a pattern of women not being listened to when they go for help, of being dismissed. Someone who gave evidence to the Hughes report said:

“I am a woman of a certain age, I’m slightly overweight, I’m a mum, not working, so I’m not given credibility”.


Let us remember exactly what happened. First Do No Harm describes women reporting excruciating chronic pain that feels like razors inside their body, damage to organs, the loss of mobility and sex life, and depression and suicidal thoughts. The report found:

“Some clinicians’ reactions ranged from ‘it’s all in your head’ to ‘these are women’s issues’ or ‘it’s that time of life’”.


Despite all this—or because of it—First Do No Harm sets out the burden of guilt felt by many women affected by mesh; risks they did not know about at the time they consented to their procedures; procedures they did not always need to have, given the degree of their incontinence or prolapse condition. As the report so sensitively said to the women at the time,

“it was not your fault”.

We should say that over and again to all the women who bravely came forward and exposed this scandal and had to talk about their most intimate and painful experiences. We should thank them.

There are three main things I want the Minister to comment on today. I would like her to set out, as others have said, the timetable for a response to the redress recommendations. I have witnessed her excellent command of her brief in opposition and now as a Minister—I will get told off for being too nice—and I have no doubt that she will put patients at the heart of her own work. Naturally, there has been some light-hearted banter in her first few weeks about timelines, and I am sure we have all been guilty of being creative with seasons and deciding when autumn might start and end, but in this context none of us can fall into that trap. It is perfectly correct for the new ministerial team to take the time properly to review this, but it is my job to push on behalf of the victims. I will not play politics, but I will push the Minister in that spirit. I have read the redress report in full, and while it acknowledges a range of complexities, it also has a range of very well-developed options, so I hope she will be able to set out a timetable.

I also want to talk about future services. The previous Government are to be commended for progress on the specialist vaginal mesh centres, but the Minister will want to focus on continuous improvement and will note that satisfaction levels are not consistent. Can she comment on what steps she will take to ensure that patient experience is captured? More widely, will she ensure that she pushes for the highest standards of maternity care for women, which, specifically relevant to this issue, must include postnatal pelvic floor rehabilitation? My noble friend’s report recommended the French model and access to specialist pelvic floor physiotherapy as soon as required. These are not niche healthcare issues; they go to the heart of how we as a society allow women to be treated at one of the most major events in their lives.

Lastly, I would like the Minister’s reflections on the experience of so many women being dismissed and not listened to. One quote in particular stuck with me:

“They would tell you there is nothing wrong with you and that you are just a hysterical woman”.


I was not surprised by that and many similar comments. Like many millions of women up and down the country, I have had excellent care in the NHS, but these testimonies reminded me powerfully of my own experience of injury as a result of childbirth. Luckily for me, it was nowhere near the scale of those suffered by these women—I would not pretend it was—and I recovered, but I was told that I could not be in any pain when I had never felt any pain like it. I was a fit and healthy young woman but I asked my husband if he could speak to someone and explain that I really was in pain because I thought they might listen to a man. I am sorry to resort to anecdote, but one hears this over and again.

I have run out of time, but I push the Minister to respond on these issues.