Health Bill

Bernard Jenkin Excerpts

2nd reading
Monday 1st June 2026 Commons Chamber

[James Murray]

I am going to make some progress.

Following Dr Dash’s recommendations, the Bill will embed the mission and functions of the Health Services Safety Investigations Body into the Care Quality Commission to establish a clearer link between investigating safety concerns and increasing the quality of care. We will ensure that we protect the principle of a safe space for people to share their concerns. To ensure that patients are heard at every stage, from commissioning to delivery, we will make sure that patient feedback is embedded alongside decision makers at every level.

[Sir Bernard Jenkin (Harwich and North Essex) (Con)]

I am most grateful to the Secretary of State for giving way, and I congratulate him on his appointment. He has inherited this policy—it is not his own. I assure him that the abolition of the Health Services Safety Investigations Body is a dreadful mistake, because which other investigative function in the healthcare system is completely unconflicted in what it does? By abolishing HSSIB he is taking its functions into the CQC, which is a regulator and compliance enforcer, not an investigator, so that there is no longer any independent, unconflicted body conducting healthcare investigations. Has he consulted the royal colleges about this? I have not spoken to a single royal college that is in favour of the abolition of HSSIB.

[James Murray]

As I made clear, we will protect the principle of a safe space for people to share their concerns. The investigatory function will remain protected within the CQC. The benefit of embedding the HSSIB in the CQC will be to establish that clearer link between investigating safety concerns and increasing the quality of care. That is something on which we can all agree.

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[Sir Bernard Jenkin (Harwich and North Essex) (Con)]

I very much welcome the idealistic vision that the hon. Member for Dudley (Sonia Kumar) sets out for us, but I am afraid that it is far from what is in this Bill. Like my hon. Friend the Member for Runnymede and Weybridge (Dr Spencer), I shed no tears for the demise of NHS England; it was never an organisation independent of politics, but always looked upwards at the political leadership and did what Ministers wanted. It was created as an unnecessarily complex organisation. However, I ask myself whether reasserting the principle—unspoken in this debate—that somehow the man in Whitehall knows best is not reverting to the previous failures of the system, when we need to be looking for a much more organic and local system.

I speak in this debate to lament the demise of HSSIB, as proposed in this Bill. It is a profound mistake. It represents a downgrading of safety as a priority in this Government’s health policy, because HSSIB is the only organisation that can independently investigate safety incidents in the NHS and is not conflicted by any other function or role. It does not compromise any other functional role in the NHS, yet the Government have decided to get rid of it. It will not save any bureaucracy. This tiny organisation costs a few million pounds, yet it is pioneering a new system of safety management in the NHS that the NHS culturally barely understands.

We forget that NHS reform is really about people and leadership, not management structures and organisational structures. HSSIB was one of the catalysts that was beginning to transform attitudes towards safety. It was a safety valve for clinicians and patients and their families. It was the one place they could go to tell their story, without fear nor favour, in a safe space, and it was instructive.

[Saqib Bhatti]

My hon. Friend is delivering a passionate speech. Is he reassured in any way by the changes the Secretary of State alluded to that will help strengthen the patient voice?

[Sir Bernard Jenkin]

Well, no, and the abolition of HSSIB is an example of that. It was the one organisation that could independently hold any part of the system to account. If its functions are transferred to the CQC, those functions will be compromised in their independence —and they are explicitly intended to be compromised. The Government set great store by the Dash review, but it is a flawed and dishonest document that misleads the public by what it says. The Dash review is not about patient safety. It puts far more emphasis on quality. It elides quality and safety, which are not the same thing, even if many people believe them to be so.

That concern is reflected by the fact that there are too many recommendations flying around and too many resources being diverted to recommendations that the NHS does not want to implement. All those recommendations are coming from this plethora of public inquiries that Secretaries of State keep setting up. Surely we want to replace the public inquiry system with something much more effective, as we did for rail accidents. After the Ladbroke Grove rail crash, we replaced public inquiries with the rail accident investigation branch in the Department for Transport.

There has not been a public inquiry into a rail accident since the Ladbroke Grove inquiry, because we have the rail accident investigation branch. There has not been a public inquiry into an aviation accident since 1972, because we have the air accidents investigation branch. Why can we not have the same principle for safety in healthcare, instead of this ridiculous Dash review, which is full of falsehoods and misleading statements? I will give the House just one example of that. The review says:

“HSSIB was not able to retain the maternity programme because the Health and Care Act 2022 does not make provision for maternity investigations under HSSIB.”

That is wrong. It had to give them up, because it did not have the capacity to do them.

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[Andrew George (St Ives) (LD)]

It is an enormous pleasure to follow my hon. Friend the Member for Gloucester (Alex McIntyre)—I call him my hon. Friend as he is a fellow member of the Health Committee.

The 2012 Act was mentioned earlier, and I am one of the few Members who was in this House when it was passed. I was sitting on the coalition Benches at the time, but I eventually voted against the Second Reading and the Third Reading of the Bill because it broke the coalition agreement. We had agreed that there would be no top-down reorganisation, but it was the biggest reorganisation that the NHS had ever seen. Although the Liberal Democrats made the Bill significantly less bad—and I congratulate all those involved in that—there was still far too much that damaged the NHS. I welcome this Bill as it addresses some of those deficiencies.

On the points made by the hon. Member for Harwich and North Essex (Sir Bernard Jenkin), I strongly agree about the abolition or the merging of the Health Services Safety Investigations Body into the CQC.

[Sir Bernard Jenkin]

Clause 59 states:

“The Health Services Safety Investigations Body is abolished.”

It is going to be abolished.

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[Ian Sollom (St Neots and Mid Cambridgeshire) (LD)]

Reducing duplication, streamlining priorities, and getting resources close to frontline care—these are reasonable aims. My concern is that in pursuing simplification the Bill makes a series of choices on patient safety that it is not clear have been fully thought through and that risk repeating mistakes that this country has paid a very high price to learn from.

Through successive inquiries, including Mid Staffordshire, Morecambe Bay, Shrewsbury, Ian Paterson—I could name more—Parliament has repeatedly recognised that the NHS cannot be relied on to scrutinise itself. Each found the same pattern: concerns present within the system but not acted on, problems developing in isolated services, and a culture in which those who raised concerns were treated as the difficulty rather than as sources of vital information.

Yet the Bill’s general approach is to remove independent scrutiny rather than improve it. I am not arguing that all the bodies that have been created—Healthwatch, the National Guardian’s Office, which has been absorbed into NHS England, which will now be abolished, and HSSIB—have worked exactly as intended. In fact, I have been working with families and others affected by failings at Cambridge University Hospitals trust. It has been suggested that the trust has not published independent information, commissioned by the trust, that found 32 missed opportunities to identify and address concerns about a paediatric orthopaedic surgeon between 2012 and 2024, and children were harmed as a result.

[Sir Bernard Jenkin]

I am most grateful to the hon. Gentleman for raising the HSSIB question. The Dash review accused HSSIB of exceeding its remit. That is completely wrong in law, and it was always intended to look at systemic problems across the system. The new investigation function in the CQC will not be able to do that, because it will not be independent.

[Ian Sollom]

The CQC and HSSIB themselves have expressed concerns about how those two organisations might be brought together. The AAIB is separate from the Civil Aviation Authority, and that model was created for a good reason. The hon. Member made good points about the statistics on that earlier.

Returning to the case I was talking about, a clinician at the trust who did raise concerns formally in 2015 was simultaneously subjected to disciplinary proceedings and told by the trust that they did not want to hear any more complaints. I wish I could say that I had not heard similar stories from NHS staff several times in a little under two years as an MP.

Just because there are some flaws in those independent systems for the NHS, it is not a reason to remove the independence. That would represent a return to conditions that so many of the inquiries warned us about, and I think that patients would rightly question whether lessons have really been learned.

As the Bill proceeds to Committee stage, I urge the Government to ask a simple question about each body that it proposes to absorb or scrap: not just whether the function will still be performed somewhere but whether it will be performed with genuine independence from the organisations that it scrutinises. That independence has been hard-won, and I hope that Ministers will reflect on that carefully before legislating to remove it.

Health Bill

Bernard Jenkin Excerpts

Report stage & 3rd reading
Tuesday 8th September 2026 Commons Chamber

[Karin Smyth]

As the hon. and learned Gentleman knows—we have spent many long hours in this place discussing the arrangements with regard to our leaving the European Union—there are different regulations, as a result of Brexit, between Great Britain and Northern Ireland. As is currently the case, due to the Windsor framework, that results in Northern Ireland following the EU device regulations. This has been discussed with the Northern Ireland and Windsor framework taskforce in the Cabinet Office, and we are content that the provisions are right, given the framework’s application. I know and understand the point that the hon. and learned Gentleman makes, and I am sure that he will pursue it with the Government in other areas.

New clauses 95 and 98 update and clarify the Secretary of State’s information-sharing powers for medicines and medical devices. They provide a clearer legal framework for the Medicines and Healthcare products Regulatory Agency to share information with UK health systems, organisations and trusted international partners. The current legislative framework does not always provide the MHRA with the powers or clarity it needs to share information quickly and effectively, and this creates barriers to collaboration, including with the NHS. The new clauses will address these challenges, providing a clear statutory basis for information sharing.

There is currently no explicit statutory domestic information-sharing power for medicines, whereas there is for medical devices. The new clauses bring information-sharing powers about medicines in line with those for medical devices and updates the list of statutory purposes for which the MHRA may share information. Importantly, these reforms do not weaken existing safeguards. Patient information will not be shared internationally without consent, and domestic protections under the Data Protection Act 2018 and the UK General Data Protection Regulation remain unchanged. These new clauses and amendments will act in the interests of patients, and I commend them to the House.

[Sir Bernard Jenkin (Harwich and North Essex) (Con)]

Will the Minister give way?

[Madam Deputy Speaker (Judith Cummins)]

I think the Minister has finished her remarks.

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

As is now routine, I declare an interest as an NHS consultant paediatrician, a member of the British Medical Association and a member of the Royal College of Paediatrics and Child Health. Yesterday the Government voted not to introduce a backstop to decide on the Hughes report. I submitted a written question that also had a deadline of last night to ask when they were going to respond, and they have not answered that either. Taking their time about something is one thing, but for the Government to completely ignore victims, refusing to give an answer and refusing to provide a backstop or a deadline, is frankly shameful.

Patient safety is really important, and one key element to improving it is striking a good balance between accountability and blame. If we do not hold people accountable for their actions, they may not be as careful, but if they feel that their superiors are looking to find fault, they will be defensive and may cover things up. That makes it hard to get to the root cause and prevent mistakes from happening again. The Health Services Safety Investigations Body, or HSSIB, was set up with this problem in mind. Like the Air Accidents Investigation Branch, it has a safe space. This means that people are not held legally responsible for what they reveal to that team. They can then get to the bottom of why things are going wrong and find system errors. People come forward because they know and trust that HSSIB is independent, but this Labour Government want to change that.

The Health Bill will abolish HSSIB and transfer all its functions to the Care Quality Commission—the body responsible for regulating health and social care. This is the same CQC that, according to Ministers, is not fit for purpose. Why are the Government doing this? Ministers cite a review by Dr Penny Dash that said that the patient safety landscape was “cluttered” and “fragmented”, but too many different organisations are producing too many recommendations. That report was narrow in scope, and the clutter is not caused by HSSIB. In recent years, 30 public inquiries produced 1,400 recommendations, but HSSIB produced just 56.

The Government have suggested that moving HSSIB into the CQC can improve the quality of care and safety, but it is not clear how. People come forward to HSSIB precisely because it is a safe space, and this Government are removing the confidence in that safe space. For the new set-up to work, frontline workers will need to believe that the new unit in the CQC is independent, despite the law making it clear that it is not. The Government’s impact assessment says that the national quality board will provide clear direction to the new investigations unit, but the national quality board is tied to the NHS, so how does that square with the new unit staying independent? The impact assessment also says that the vast majority of investigations are expected to be directed by the Health Secretary. How can we be sure that the new unit will have the power and resources to look at things that might be politically difficult for the Government? How will the people in charge of the CQC balance the responsibility of investigating with the responsibility of maintaining that safe space?

[Sir Bernard Jenkin]

On the question of how the CQC leadership becomes conflicted, will my hon. Friend reflect on the fact that, in an Adjournment debate I held in July, the then Patient Safety Minister, the hon. Member for Birmingham Edgbaston (Preet Kaur Gill), made it clear that the person responsible for deciding what safe space information might be released would be the chief executive of the CQC? If the chief executive of the CQC is to see all that information, how would he or she not be able to use it, or be tempted to use it, when he or she inspects hospitals for the purposes of the CQC? Would the safe space not then be hopelessly conflicted, and therefore lose public confidence?

[Dr Johnson]

Absolutely; my hon. Friend has obviously read my speech. What would happen if the new unit identified the CQC itself as the problem? Ministers have not provided good answers to these questions. To be honest, they cannot, because the Government cannot have their cake and eat it. Either HSSIB remains independent or it is folded into the CQC and loses its independence. The Government are either decluttering the landscape by removing an organisation or simply hiding it inside another organisation, to the detriment of both. We have tabled amendment 1 to protect HSSIB, and I urge the Government to support it in the interests of patient safety.

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[Madam Deputy Speaker (Caroline Nokes)]

Order. I call Sir Bernard Jenkin.

[Sir Bernard Jenkin]

I would very much have liked to have discussed the medical devices questions arising from the Bill. The Minister made an incredibly short speech about that important matter. It is quite clear that these provisions are part of the covert dynamic alignment with the EU and the covert rejoin agenda being pursued by the Government. It raises all sorts of constitutional questions, but those are not for today.

I will concentrate on HSSIB. I rise to support amendments 1 to 4, which would remove the abolition of HSSIB from the Bill. The Government have singularly failed to make the case for removing this crucial safety investigation function. It did not exist until recently, and now they want to scrub it out. I suspect that is because too many people in the health system do not like being held to account by an independent investigative body.

[Karin Smyth]

indicated dissent.

[Sir Bernard Jenkin]

The Minister shakes her head, but she is yet to give a good reason as to why this measure is in the Bill.

When we had an Adjournment debate in July with the then Minister for patient safety, the hon. Member for Birmingham Edgbaston (Preet Kaur Gill), she could not answer the question of who would conduct independent safety investigations in the NHS after the abolition of HSSIB. She said that safety investigations would be conducted by the Care Quality Commission, but she could not actually claim that they would be independent; as my hon. Friend the Member for Sleaford and North Hykeham (Dr Johnson) demonstrated, they would not be.

If, as it seems, it is intended that safety investigations should be carried out by the CQC unaffected by the transfer, why make the transfer at all? How much is this transfer going to cost? I asked the Minister, in a letter I sent her after the debate in July, to give us the information on how much the transfer of all this would cost. Nothing has arrived. I never had a reply to the letter. Of course, the Government have changed the Minister and the new Minister for patient safety, the right hon. Member for Kingston upon Hull North and Cottingham (Dame Diana Johnson), is not in the House today. I rather suspect that she is more sympathetic to this argument than the Minister sitting on the Front Bench today.

In our earlier exchanges we discovered and once again exposed how the safe space will be brutally compromised by the fact that it will be housed in a regulator with, inevitably, other ulterior motives. The chief executive of the CQC is wantonly conflicted in terms of looking after the safe space, so he cannot be the one left in charge of that function.

The real point here is that we are missing the opportunity to save so much money. Governments keep having public inquiries. The EPUT—Essex Partnership University NHS Foundation Trust—public inquiry, affecting my constituency, cost in its first year £5 million, and in its second year it is costing another £5 million. The whole budget for HSSIB was only £6.3 million a year, yet it does scores of investigations, not just one inquiry. The Ockenden inquiry cost £14 million. If we could save just a fraction of the cost of medical negligence, which is £3.6 billion a year, HSSIB would pay for itself.

[Jeff Smith (Manchester Withington) (Lab)]

Clauses 5 and 6 place duties on the Secretary of State to promote patient involvement, patient choice and innovation. My new clauses 86 and 87 would apply those principles to psychedelic-assisted therapy treatments involving schedule 1 controlled substances.

I have been pleased to be a trustee of the charity Drug Science, which has allowed me to talk to researchers who are looking at therapeutic treatments using what are called psychedelic drugs. Around the world there is growing evidence of the successful treatment of post-traumatic stress disorder, trauma, mental health issues and end-of-life distress using these drugs. For some patients they are absolutely revelatory. They change lives for the better and can relieve the burden of those conditions on the wider health service.

Researchers tell me, however, that the barriers the current system puts in place really restrict research. Research involving schedule 1 controlled substances generally requires a Home Office licence, and the bureaucracy and inertia in the system adds delay, cost and an administrative burden to the extent that research grants are being lost because of delays.

The issue has already been considered. In 2023 the Home Affairs Committee recommended urgently moving psychedelic drugs to schedule 2 in order to facilitate research. Later that year, the Advisory Council on the Misuse of Drugs recommended that research using schedule 1 drugs in universities and hospitals should be exempt from the Home Office domestic licencing requirement and should instead operate under schedule 2 controls. In 2025 the Government accepted the ACMD recommendations in principle. There is supposed to be a pilot of a proposed extension to test operational feasibility, but that has not happened. The Government said the policy work was under way and that further plans would be published in due course, but without a timetable for implementation. My new clause 86 would make it happen. Other jurisdictions are ahead of us on this issue. The US Department of Defence and the US Department of Veterans Affairs are already funding clinical trials for military personnel and veterans.

New clause 87 concerns compassionate access to treatment. International research has identified potential in some treatment-resistant psychiatric conditions and end-of-life distress. There is international precedent. The 2022 Canadian special access programme has allowed clinicians to request restricted drugs, including psilocybin and MDMA, to treat those conditions. We can learn from those experiences.

Finally, I am grateful to the Minister for meeting me to discuss these issues, and for her agreement on the principle of enabling the clinical research of these drugs and her commitment to get back to me to outline how the Government will take them further.

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[Karin Smyth]

It will not be a surprise to the hon. Gentleman that I do not agree with his proposition, although I commend the work that many people have done in Healthwatch. We want to work with people in the other place to make sure that this is the right way forward.

I am sorry that we do not have more time to debate HSSIB, because it requires more discussion, although we had a good debate in Committee. We have heard many discussions today. I have met the hon. Member for Harwich and North Essex (Sir Bernard Jenkin), and I hear what he is saying; I will ensure that he gets a response to his letter from the new Minister for Patient Safety—asap, as they say.

It is an issue that we need to get absolutely right. We all know, from our experience with patients and families, about the importance of creating a culture in which concerns can be raised without fear and lessons are learned effectively. The Government fully agree with those objectives. Our view is that patient safety, in line with the Dash review, is best served by clear lines of accountability, effective independent scrutiny, and a relentless focus on learning and improvement. We are therefore transferring HSSIB’s functions to the CQC to ensure that learning from investigations can more readily inform improvement activity across the system.

We recognise the importance of ensuring that the investigation arm has the autonomy to investigate the qualifying incidents that it deems appropriate free from interference, and I can give the House the assurance that we will work with the executive of HSSIB and the CQC to ensure that their operating model upholds this operational independence.

In response to the Chair of the Health Committee, who is not in her place, let me say that there is obviously no one single metric by which to judge the suitability of the CQC. It is usual in the Department’s oversight of arm’s length bodies and independent regulators to look at things like stable leadership, IT capability, governance and operational effectiveness. This is something I am sure the Select Committee can help with.

[Sir Bernard Jenkin]

Will the Minister give way?

[Karin Smyth]

I apologise, but I am going to press on. There is a lot to get through.

We are committed to tackling health inequalities wherever they arise. There are strong duties on both ICBs and the Secretary of State to tackle these inequalities, and we remain firmly committed to doing so. We continue to drive forward improvement plans including the national cancer plan and the mental health strategy, which will transform mental health care into a system that responds and intervenes early, reduces waiting times for support, and ultimately supports people to participate fully in education. I note in particular that the Government are already making record investment in mental health. All ICBs are expected to meet the mental health investment standard over the next three years, and all are forecast to meet it for 2026-27.

We are also committed to delivering the national cancer plan and focused on driving improvements, including on diagnostic capacity, which is key to addressing waiting times and tackling variation in access to better treatment, as we have heard today from my hon. Friends the Members for Easington (Grahame Morris), whose work in this area I commend, and for Blaydon and Consett (Liz Twist).