Points of Order

Debate between Caroline Johnson and Judith Cummins

Monday 2nd February 2026 Commons Chamber

[Madam Deputy Speaker]

I thank the hon. Gentleman for giving notice of that point of order. As the leaflet on courtesies makes clear, Members should inform colleagues in advance if they intend to visit another Member’s constituency. It is deeply discourteous to fail to do so.

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

On a point of order, Madam Deputy Speaker. I listened to the last debate carefully, and I wondered whether you could help me with a procedural question. Would it be orderly for the Government to bring forward legislation, as soon as they wished to do so, to relieve Peter Mandelson of his peerage?

[Madam Deputy Speaker]

I thank the hon. Member for her point of order. The introduction of legislation is a matter for the Government.

Medical Training (Prioritisation) Bill

Debate between Caroline Johnson and Judith Cummins

Committee of the whole House
Tuesday 27th January 2026 Commons Chamber

[The First Deputy Chairman of Ways and Means (Judith Cummins)]

I call the shadow Minister.

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

I will speak to the amendments tabled by the Opposition. First, amendment 9 would require that from 2027, priority is given to British citizens on UK foundation programmes, and that they are prioritised for interviews and places on specialty training programmes. Clause 4 defines a UK medical graduate as a

“a person who holds a primary United Kingdom qualification within the meaning of the Medical Act 1983 (see section 4(3) of that Act)”.

However, it does not include

“a person who spent all or a majority of their time training for that qualification outside the British Islands.”

The Secretary of State has stated his intention to prioritise UK medical graduates, but he has failed to protect all British citizens in doing so. Our amendment would ensure that British citizens who study on an eligible medical course overseas were still prioritised in the Bill. There are many scenarios in which we may need to ensure that we protect British citizens. Consider, for example, a spouse, partner or child of a serving member of the UK armed forces who completes relevant training overseas while their relative is posted in Cyprus; a student at Queen Mary University of London who has completed the bachelor of medicine and bachelor of surgery course at its Malta campus but received a UK medical degree; a young British citizen who has studied in the US or France, owing to a family relocation; or, given that the largest bottleneck is not in training places but in getting a place in medical school at all in some cases, a British student who has gone to study overseas because of their fervent desire to become a doctor.

Those are all entirely possible and plausible scenarios in which British citizens have completed their relevant training, and wish to bring their skills back and to relocate in their homeland for the rest of their career, but may not be covered by the Government’s prioritisation model. The Government’s prioritisation model is based on where the degree was taken, rather than also considering who did it. The Secretary of State must ensure that we do not overlook our own citizens if we are to fairly address the competitive landscape for training posts. The Opposition therefore urge the Government to accept amendment 9.

Amendment 10 is a probing amendment to explore the effects of the Bill on military personnel. As a Member of Parliament representing an area with a large armed forces community, I know that medical trainees are an integral part of our serving community. The world is becoming an increasingly dangerous place, and junior trainees may be sent abroad earlier in their career than is currently the case. It is clearly wrong to penalise people who are doing brave work caring for our armed forces. They ought to be provided with optimal opportunities, and the Secretary of State has a duty to ensure that they are not overlooked. I would be grateful if the Minister covered that in her response.

New clause 3 would require the Government to make an annual report to Parliament about the Bill’s impact on the number of international students at UK medical schools, and the financial impact on UK medical schools. We talked about the bottleneck, and the balance between UK and international students training at UK medical schools; clearly, becoming a UK graduate will now come with a significant premium. What impact will that have on British children getting to make their choices and become doctors if they want to? What incentives does it provide to universities to increase the number of international students, and what effect will that have overall on UK medical schools?

New clause 2, tabled by my hon. Friend the Member for Runnymede and Weybridge (Dr Spencer), is about places for UK foundation and speciality training programmes, and the importance of allocation on merit, because we all want the very best doctors. When I became a doctor—believe it or not, it was 25 years ago this year, Madam Deputy Speaker—I applied for a job as a junior house officer, as it was called then. I applied for the jobs I wanted, I was interviewed by the consultants who would have been supervising my training, and then I was offered the jobs.

The experience of students today is very different. They are allowed to put in a preference and say which deanery or foundation area they would like to work in, but that is all. After that, the application goes into a computer system, which gives them a single rank that is not based not on anything they have done at university, or on whether they got good results or worked hard, or anything like that. The computer system will do a first pass, and if the first choice is available, it will give the student their first choice. If it is not available because by the time its gets to that student those places have gone, the computer system will miss the student and go on to the next one. When it has completed its full pass of the list, it will start again, and when it comes to that student next time, it will give them the highest preference that is still available.

Once the student has been allocated a foundation deanery, the process starts again within the locality, and I mean “locality” in the loosest possible sense. Take those applying for the Trent rotation; they could be posted in Lincoln, Boston, Nottingham, Derby or Burton. The doctor has no control over where they will go, and very little ability to express a preference. My hon. Friend the Member for Weald of Kent (Katie Lam) spoke about a student in her locality who had not been able to get a place, despite being at the top—third, I think—of their university class. It is clearly not fair to give people no opportunity to control their future. By the way, there is no right of appeal, so having been given their place, the choice for the student is: that place or no place.

The hon. Member for Sunderland Central (Lewis Atkinson) spoke about ordinary children from the north-east. Having once been an ordinary child from the north-east, I agree that it is important that people have opportunity, but it is equality of opportunity, not equality of outcome, that matters. I worry that the system creates equality of outcome. We therefore support new clause 2, tabled by my hon. Friend the Member for Runnymede and Weybridge.

Amendment 1 would require the Bill to take effect on the date of Royal Assent, as opposed to a date at the discretion of the Secretary of State for Health and Social Care. The Bill is deemed necessary emergency Government legislation to prioritise medical graduates in the United Kingdom for places on medical training programmes. When he announced the Bill in an attempt to avert industrial action by resident doctors in December, the Secretary of State told the House that he had been working intensively with his team to

“to see how quickly we could introduce legislation”—[Official Report, 10 December 2025; Vol. 777, c. 430.]

However, the Bill does not commit to a date when these measures will be enacted. Instead, the power lies in the hands of the Secretary of State, giving him a clear bargaining chip for future negotiations. It is clear that the Government intend to pass this legislation urgently, as they have said. However, without a commencement date, there are clear concerns that the Bill is just a negotiating tactic to prevent industrial action by resident doctors, and can be scrapped at a later date. There remains the prospect of further industrial action, despite the legislation being introduced. The Secretary of State should not be asking Parliament to pass a Bill that he has no intention of enacting if the British Medical Association plays ball and holds off on strikes. Either the Secretary of State thinks that this is emergency legislation that we need to get on with and enact, or he does not.

It is vital that the legislation is enacted straight away, because students are due to be given their training programme places now, and they need to decide where they are going to live. They cannot put their life on hold, and measures to prioritise UK doctors cannot be held off, until the Secretary of State has finished dangling a carrot in front of the British Medical Association. The Opposition are clear: while we are supportive of the principles of the Bill, it must be used for offers made this year.

Amendment 8 would clarify that under clause 5, a UK foundation programme is a programme where the majority of training takes place inside the United Kingdom. A foundation programme is defined as

“an acceptable programme for provisionally registered doctors”

in section 10A of the Medical Act 1983. It is vital to clarify that a UK foundation programme is a programme where a majority of training takes place inside the United Kingdom. That is because the General Medical Council can approve foundation programmes overseas. If it is not explicit that a foundation programme needs to be in the United Kingdom, a loophole is created whereby a foundation programme could be approved overseas, creating a back way into the system and circumventing the measures that the Government have tried to put in place. I encourage the Minister to look at that carefully as the Bill progresses.

In summary, we support the Bill, but we have concerns about some of the clauses, so we have tabled amendments that we hope the Government will look at carefully.

[The First Deputy Chairman]

I call the Liberal Democrat spokesperson.

Immigration

Debate between Caroline Johnson and Judith Cummins

Wednesday 21st May 2025 Commons Chamber

[Dr Caroline Johnson]

On a point of order, Madam Deputy Speaker. The history lesson of who was which Minister in which Government when is obviously all available on the internet, if people want to look. How does it relate to the matter we are discussing today, which is what the current Government are doing to tackle migration?

[Madam Deputy Speaker]

I thank the hon. Lady for her point of order, and I look forward to hearing her views in the debate later.

Tobacco and Vapes Bill

Debate between Caroline Johnson and Judith Cummins

Report stage
Wednesday 26th March 2025 Commons Chamber

[Madam Deputy Speaker (Judith Cummins)]

I call the Opposition spokesperson.

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

It is now a truth universally acknowledged that smoking is bad for one’s health. It is the leading cause of preventable death in this country, responsible for over 80,000 deaths every year. When we say that number, it is easy to allow it to trip off the tongue as another statistic without really realising just how many people it represents. For each of them—such as my Nana Burton, who was a smoker and who died of lung cancer—there is a personal story of damaged health and often an early and preventable death.

The Conservative party introduced a Bill based on a similar premise to this one in the last Parliament, although the Government have made significant changes since to the legislation, including taking a power that could be used to ban smoking and vaping in pub gardens, as well as a licensing scheme for tobacco products.

On amendment 85, while we have received repeated assurances that the Secretary of State intends to use the measures in the Bill only to improve public health, we must still examine whether the legislation is proportionate and reasonable. As far as I can see, it gives the Secretary of State enormous powers to extend the smokefree legislation to any place with minimal oversight and without needing to provide a reason. There were whispers last summer that the Government were considering banning smoking in pub gardens, before they hastily withdrew this provision in the face of public backlash. If only they would withdraw more of their policies in the face of public backlash, because perhaps then we would not be in the situation we are in now.

The Bill empowers the Secretary of State to extend smokefree and vape-free regulations to more places—essentially, to any place—with the aim of reducing exposure to second-hand smoke and promoting public health. However, on Second Reading the Government did not accept our amendment that it should apply only to places that have a provable significant risk to public health to justify such a ban. For that reason, I commend amendment 85 once again, which would restrict the Secretary of State to being able to designate only open or unenclosed spaces outside a hospital, a children’s playground, a nursery school, a college or a higher education premises as a smokefree area. Those are the areas the Secretary of State has said he wants to target, and the amendment would prevent any targeting of other areas, such as pub gardens, by the back door. While he claims that that is not his intention now, that may not remain the case for the rest of this Government’s time in office, nor indeed for any future Government. That is the risk in allowing these measures to stand, and for those reasons I encourage the House to support amendment 85.

3.15 pm

On new clause 18 and amendment 89, the new Bill also gives powers to the Secretary of State to introduce a new licensing scheme for retailers selling tobacco, vaping or nicotine products. However, we know that licensing schemes will come at a cost, to businesses and local authorities that will administer them, and in enforcement. That does not make it the wrong thing to do, but we would need to make sure that any licensing scheme is not excessively burdensome or expensive. New clause 18 and amendment 89 would therefore require the Government to consult on the new licensing scheme for tobacco sales before it came into force. That would mean that the views and impact on businesses including small businesses are heard, and ensure that councils and trading standards have the capacity to deliver such a scheme. Ultimately, there is a balance to strike between the requirements on business and public health, and a public consultation would ensure that the Government are more likely to get that balance right.

On new clause 19, another concern we have heard from those who oppose the Bill is about the impact that the legislation would have on the black market. His Majesty’s Revenue and Customs estimates that the illicit market in tobacco duty and related VAT was £2.8 billion in 2021-22, with the tobacco duty tax gap remaining broadly unchanged since 2015, while in 2023 the Chartered Trading Standards Institute estimated that a staggering one in three vape products were non-compliant. Given warnings that increasing the age requirement for tobacco products and prohibiting more vaping could expand the black market economy further, it is sensible to take precautions to tackle the issue.

Welfare Reform

Debate between Caroline Johnson and Judith Cummins

Tuesday 18th March 2025 Commons Chamber

[Madam Deputy Speaker]

Just to let Members know that about 100 Members have asked questions on the statement.

[Dr Caroline Johnson]

On a point of order, Madam Deputy Speaker. When I asked a question during the statement, the Secretary of State said, “It does not mean that.” I had raised the list on the Government’s website of the descriptors used to qualify somebody for a certain number of points in relation to the daily living component of PIP. Each of the descriptors I mentioned has two or three points associated with it:

“Needs supervision…or assistance to be able to manage therapy that takes…3.5 hours a week. 2 points… Needs assistance to be able to wash either their hair or body below the waist. 2 points… Needs assistance to be able to get in or out of a bath…3 points … Needs supervision…to be able to manage toilet needs. 2 points… Needs assistance to be able to dress or undress their lower body”—

needing the physical help of another person—also

“2 points.”

At the moment, someone with all of those needs would qualify for this component of PIP, but under her new rules they will not. How can I give the Secretary of State the opportunity to correct the record?

[Madam Deputy Speaker]

That is not a point of order, but the hon. Lady has got her point on the record.

Access to NHS Dentists

Debate between Caroline Johnson and Judith Cummins

Tuesday 12th September 2017 Commons Chamber

[Judith Cummins]

I absolutely do.

Dental practices in working-class areas, facing spiralling overheads and a decline in their income, are struggling to stay afloat. In better-off areas, dental practices have been able to cushion themselves through extra revenue from privately paying patients. That extra income makes a difference. In working-class areas, the realities of life are hugely different. After many families have paid their rent or mortgage, covered day-to-day essentials and put food on the table, a visit to the dentist has now become one of life’s luxuries.

Research by the BDA supports that idea. Figures reveal that four in 10 patients have delayed a dental check-up because of fears about the high cost of treatment. That is understandable when we realise that the patient charge for treatment in the highest band—such as crowns or bridges—is £244.30. Working-class people, such as those in Bradford, are being hit the hardest. They have been abandoned by the Government, and they suffer failing oral health and chronic pain day in, day out. Worst of all, they are powerless to do anything about it because they find it difficult to access an NHS dentist. There is a clear human cost of poor dental health, which affects every part of a person’s day-to-day life.

The BBC spoke to a Mr Oldroyd during their investigations. Mr Oldroyd, a middle-aged man, has been trying to find an NHS dentist for four long years, during which he had suffered from chronic pain caused by his terrible tooth decay. He told reporters:

“The state of my teeth has made me depressed and I’ve literally begged to be taken on by an NHS dentist, but every time I’ve been turned away.”

Mr Oldroyd told reporters that his pain became so unbearable that, in the end, he resorted to self-extraction. He pulled out his own teeth. This is simply unthinkable. Mr Oldroyd believes that his poor dental health has contributed to him being out of work. As he puts it:

“The tops of my teeth are gone. I’m on benefits and trying to get a job, and when someone sees my teeth they just think I’m another waster.”

This crisis has been a long time in the coming. It has not crept up on the Government; it has been visible and in plain sight. The Government were put on notice when they came to power in 2010. There have been repeated warnings from dental professionals working in the sector, from within Parliament, and from the British Dental Association. All have warned that inaction is not an option, but sadly that is what we have seen.

It was not long ago that I, and many other Members, spent the afternoon right here in the Chamber in a Back-Bench business debate about health inequalities. During my remarks I set out a number of simple, uncontroversial steps that promised to improve access to NHS dentistry. First among those steps was to expedite reform of the NHS dental contract. Time and again when challenged about the reform of this contract, the Government have done little more than lay the blame at the door of the previous Labour Government. With respect, if that excuse was ever persuasive, it is now threadbare following seven years of a Conservative Government, two Conservative Prime Ministers and three general elections.

Reform of the contract is critical, as it promises to spend taxpayers’ money more effectively. The current dysfunctional contract sets quotas on patient numbers, fails to incentivise preventive work, including effective public information campaigns, and implicitly places an ever-growing reliance on dental practices to pursue private charging as a means of staying afloat. This Government are forcing dentists to make a terrible decision: either to stop providing NHS services altogether and go private, disregarding those who have less ability to pay, or to provide overstretched NHS dental treatment to their patients—or a combination of the both. That is a toxic choice for the dental profession.

Since first being elected in 2015, I have campaigned for more funding for Bradford. The city has among the worst oral health outcomes in the country, despite the hard work of local public health officials. We have received additional funding, to the credit of the previous Minister, the right hon. Member for North East Bedfordshire (Alistair Burt), but frustratingly this was only temporary. Despite my efforts, the Government still have not announced whether any permanent funding will be put in place. That is simply unacceptable. Official figures reveal that a five-year-old in Bradford is four and a half times more likely to suffer from tooth decay than a child in the Health Secretary’s constituency of South West Surrey. According to figures, a third of children in Bradford have not seen a dentist for more than two years. Children should be given a check-up every six months.

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

Will the hon. Lady give way?

[Judith Cummins]

I am really sorry; I cannot give way because of the time.

One of the most shocking figures reveals that the number of children admitted to hospital for tooth extractions has risen by a quarter over the past four years. Some may think that tooth extraction is simply a part of growing up—a rite of passage for children. Some may recount their own personal memories of visiting the dentist. If anyone still holds that sentimental view, they should pause for a moment and rethink. The tooth extractions I am speaking of, which have gone up by a quarter in the last four years, mostly involve a general anaesthetic. A recent freedom of information request to Bradford hospitals sets out the scale of the crisis. In the short period from April to December 2016, 190 children were admitted to hospital to undergo a tooth extraction under general anaesthetic. What was also shocking about this request was the hospital’s admission that those figures were not available prior to April 2016. The hospital did not consider that the procedure warranted reporting.