Procurement, Slavery and Human Trafficking Regulations: NHS

Caroline Nokes Excerpts

Wednesday 22nd October 2025 Commons Chamber

[The Parliamentary Under-Secretary of State for Health and Social Care (Dr Zubir Ahmed)]

I beg to move,

That the draft National Health Service (Procurement, Slavery and Human Trafficking) Regulations 2025, which were laid before this House on 9 September, be approved.

I am here on behalf of the Minister for Secondary Care, my hon. Friend the Member for Bristol South (Karin Smyth). It is an honour to represent the Government as we bring forward this important secondary legislation, and it is right that it should be given the full scrutiny of the House today.

Slavery is one of the greatest evils in human history. This Government cannot and will not accept that we could be supporting forced labour or human trafficking through our supply chains, however inadvertently. Before I continue, I acknowledge the cross-party support on this issue, both in this House and in the other place. I pay tribute to all hon. and right hon. Members and peers of the realm, such as Lord Alton, who have worked tirelessly to put modern slavery at the forefront of our national conversation.

I begin by setting out why we need the regulations. Many people are taken aback when they are told that there are more enslaved people now, in absolute terms, than at any point in human history. It is estimated that around 50 million people worldwide are living in some form of modern slavery. Globalisation has provided near-limitless opportunities for trade in goods and services, but also, unfortunately, in human beings. Though we on these isles would like to think that we are insulated from the highways of human trafficking, we are not.

In late 2023, the previous Government published a review into NHS supply chains that covered 60% of medical consumables. It accounted for £7 billion of spend across 1,300 suppliers, representing 600,000 products, and a fifth of those suppliers were deemed to be high risk. Imagine my horror when I read that some of the tools of my trade—surgical instruments, facemasks—could be contaminated by modern slavery. As someone who still practises as a surgeon, I know that I share that revulsion with my colleagues across the national health service. I ask my colleagues in this place to keep all our NHS staff in mind over the course of our proceedings.

The review also recognised the wider benefits to the NHS of a better understanding of how our supply chains work, noting how we could improve the quality of products supplied and the resilience of supply. It gave us clear recommendations for us to act on and today I am proud to come to the House with landmark modern slavery legislation to put those policies into practice. This is a first on these isles and I sincerely hope that our colleagues across the devolved Governments can follow suit soon.

I now turn to what the regulations will do. The NHS is one of the largest public sector procurers in the world, with an annual spend of £35 billion, doing business with over 80,000 suppliers. We have a duty to ensure that no products we procure could be tainted by forced labour, and an opportunity to use our immense purchasing power for global good.

The regulations we bring forward today will require all public bodies to assess modern slavery risks in their supply chains when procuring goods and services for the health service in England. They give effect to a duty established by the Health and Care Act 2022, which requires the Secretary of State to eradicate modern slavery wherever it is found in NHS procurement processes. We are asking public bodies to take reasonable steps to address and eliminate modern slavery risks, especially when designing procurement procedures, awarding and managing contracts and setting up frameworks or dynamic markets.

Reasonable steps may include enforcing robust conditions of participation in our supply chains, with assessment criteria built into every stage of that process. They may include monitoring suppliers’ compliance and reassessing risk throughout the lifetime of a contract. They can also include writing terms that require immediate mitigation where instances of modern slavery are discovered. The regulations will also require public bodies to have regard to any relevant guidance issued by the Department of Health and Social Care or NHS England for consistency and accountability across the system. The updated version of the guidance has now been published by NHS England and is publicly available.

Colleagues might be worried about legislative overlap. They might ask themselves why we need new regulations when modern slavery is already illegal, but these regulations have been carefully drafted to fit with existing statute, and I can assure the House that contradictory duties have been avoided. We are building on existing measures, such as the Modern Slavery Act 2015 and the Procurement Act 2023, not replacing them. We are bringing all NHS England’s procurement into scope and creating a stronger legislative footing for enforcement. The point is to introduce a single, enforceable risk management approach to modern slavery across the NHS, and we will continue to review our arrangements to ensure that they remain effective for years to come.

I do not pretend that this will be easy. If there was a button somewhere in Whitehall or inside the national health service that could eliminate modern slavery at a stroke, I do not doubt that all of us would push it, but our supply chains are vast, making it difficult to fully assess the scale. Although the 2023 review was just a snapshot in time, it is likely that more than a fifth of our supply chains are still at high risk of modern slavery. Items include cotton-based products, surgical instruments and PPE gloves—all products that are vital for the day-to-day functioning of hospitals and clinics up and down the country. That is why we will back NHS organisations with clear guidance and support to root out the scourge of modern slavery wherever we find it.

There is an argument that we could procure these items on the cheap if we could just turn a blind eye, but that way of thinking is abhorrent and fundamentally un-British. We cannot simply weigh such things on the scale of a tradesman behind a counter, and we must remember our historical responsibility in eliminating slavery wherever we find it. But even if we could do that, ethical supply chains have been proven to be cost effective in the long term. There is a strong case that they help to avoid litigation and, more important, supplier collapse. Even if that were not the case, I know the will of the British people, and I have not a shred of doubt that decent people across our country will not think modern slavery a price tag worth paying. This place, the mother of Parliaments, is here to answer a call today and to send a message to all enslaved people across the world: what is happening to you is unjust, but we have not forgotten, and we will do our utmost to ensure that our money does not go to those that exploit you and keep you in chains.

[Madam Deputy Speaker (Caroline Nokes)]

I call the shadow Minister.

Baby Loss

Caroline Nokes Excerpts

Monday 13th October 2025 Commons Chamber

[Madam Deputy Speaker (Caroline Nokes)]

I call Andy MacNae, who will speak for about 15 minutes.

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[Several hon. Members rose—]

[Madam Deputy Speaker (Caroline Nokes)]

Order. I will now call the next co-sponsor of the debate. After she has spoken, there will be a five-minute time limit.

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[Mrs Sharon Hodgson (Washington and Gateshead South) (Lab)]

I am very glad to be able to take part in this very moving debate and to follow so many excellent speeches as we once again mark Baby Loss Awareness Week, not least on behalf of myself and my story, and that of my beautiful baby Lucy, who I tragically lost back in 1998, but also on behalf of all the MPs in this place, women and men, who are not yet ready or able to stand and tell their story, as indeed I was not for so many years.

For almost 20 years I never spoke of my loss, and I never told anyone who did not know me back when it had happened, until I helped to set up the all-party parliamentary group on baby loss back in 2016, 11 years after I was first elected. That was along with a cross-party group of MPs, all of whom are no longer in this House, although Baroness Prentis of Banbury is now in the other place. I told them my story in the Tea Room, and I could point to the table that we sat around to share our stories through floods of tears. It was the first time I had spoken about it in any detail since it had happened two decades earlier. Baby loss was, and I think it may still be to a certain extent, the last great taboo that a lot of parents have to navigate their way through.

Not long thereafter, I was approached by one of the officers of the new all-party group regarding the private Member’s Bill introduced by the former Member for East Worthing and Shoreham, Tim Loughton. As those Members who were around at the time will remember, part of that Bill covered baby loss and the lack of any recognition for stillborn babies born before 24 weeks—what are, in law, still called late-term miscarriages. His private Member’s Bill tried to address this through what would become known as baby loss certificates. He had been approached by his constituents Hayley and Frazer, who gave birth to their son Samuel at 19 weeks. Tragically, he was stillborn, and they had been horrified to receive no official recognition and—even worse—to learn that their child was entered in the official records as a miscarriage, as indeed my Lucy was at 23 weeks and four days, just a few days short of the legal definition for recognition.

Tim also cited another tragic case, that of twins born either side of that 24-week threshold. One thankfully survived and was given a birth certificate, but the other—born just a day or so earlier on the wrong side of 24 weeks—tragically did not survive, received no official recognition, and was entered in the official records as a miscarriage. This felt grossly wrong to all those parents and to Tim, as it did to me and my husband when it happened to us. Tim set about trying to change the law, hence approaching me to see whether I would be brave enough to stand here—on the Opposition Benches as I was then—and tell my story, as it was so relevant to the case he was trying to make. Somehow, I managed to do it—it is all down on record for anyone to read or watch, so I will not repeat it today—and it involved an awful lot of tears. Those who have spoken today have somehow managed not to be in floods of tears. I did it, as lots of Members have done today, and I commend them all for sharing their heartbreaking stories. We should remember, though, that for every Member who bears witness in this Chamber, there are no doubt many more who are not yet ready to do so.

I was very proud of myself back in February 2018 to give mine and Lucy’s story in detail in that private Member’s Bill debate, and for my experience and Lucy’s all-too-brief life to perhaps have made a difference in helping to change the law and bring about the baby loss certificates, which are now much treasured by so many parents. It is something I am still very proud of.

After that debate and all the publicity it garnered, the right hon. Member for Godalming and Ash (Sir Jeremy Hunt)—who was Health Secretary at the time, and who I pay tribute to for everything he did—set up an official Department of Health expert working group, which Tim and I sat on, to consult on what a change in the law would look like and how the baby loss certificates would work. I was very glad when in February 2024, just before the election, the last Government announced the roll-out of the first ever baby loss certificates.

As welcome as those certificates are, I worry that there are still some unintended consequences, as there often are when first enacting new policies. I have been contacted by Catherine, whose much-wanted baby died at 12 weeks. Through the grieving process, she found comfort in knowing that she would get a baby loss certificate for her son Matthew. However, when she applied for that certificate, she found that she was not able to add her partner’s name to it, as he was registered with a GP on the Scottish side of the border. While relationships across the English-Scottish border are not common, neither are they unheard of. Catherine asked me to ask the Secretary of State—I am very happy that he is in the Chamber in person tonight—what steps could be taken to enable both parents’ names to be included on baby loss certificates where those parents are registered with GPs in different countries in the UK. I am sure that what I have described is an anomaly, and I hope the Secretary of State will address it in his response.

Due to time, I will leave my remarks there, Madam Deputy Speaker. I thank you for your grace.

[Madam Deputy Speaker (Caroline Nokes)]

I appreciate the hon. Lady finishing her remarks. Members will have noticed that I indulged the hon. Lady, but unfortunately after the next speaker I will have to reduce the time limit to four minutes so that I can get all Members in.

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[Several hon. Members rose—]

[Madam Deputy Speaker (Caroline Nokes)]

Order. I ask hon. Members to take their lead from the hon. Member for Bassetlaw (Jo White) so that I can get everybody in. If they kept their speeches to three minutes, that would be very helpful.

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[Several hon. Members rose—]

[Madam Deputy Speaker (Caroline Nokes)]

Order. There is now a formal three-minute time limit.

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[Michael Payne (Gedling) (Lab)]

I rise, in Baby Loss Awareness Week, to pay tribute to the far too many families in Gedling and Nottinghamshire who have suffered the devastating loss of their babies in circumstances that were entirely avoidable. They placed their trust in a system that should have protected them, and that system failed them.

The Ockenden review of maternity services in Nottingham is now supporting 2,500 families who have been affected by neonatal deaths, injuries, stillbirths and maternity deaths. Many of them were failed by the NMC, failed by the GMC, failed by the CQC and failed by our NHS. Regulation must be overhauled, and accountability must improve.

The mothers and fathers who have come forward in Gedling and Nottinghamshire have shown extraordinary dignity, courage and perseverance in the face of heartbreak that most of us can barely begin to comprehend. Yet even in the face of unspeakable loss, each and every family I have met in Gedling and Nottinghamshire who have lost a child or suffered harm during birth have reminded me that light always shines brightest in the darkest places. In the depths of their grief, their pursuit of truth and change honours their children’s memory and stands as a beacon of tremendous humanity and hope.

I want to take a moment to pay a special tribute to the incredible charities, volunteers and support organisations who walk alongside bereaved families day in, day out. They bring comfort where it is needed most, and we all owe them a tremendous debt of gratitude.

In speaking of courage and compassion, I also want to take a moment to thank my friend and neighbour, the Member of Parliament for Sherwood Forest, Michelle Welsh. Long before she entered this place, Michelle walked side by side with Nottinghamshire families through years of anguish and struggle, standing shoulder to shoulder with them when few others would. Just 37 days ago, she suffered her own loss with the passing of her beloved dad, who taught her to fight always against injustice, wherever she found it. Just days after losing her dad, she was back in Parliament, meeting bereaved maternity families. In thanking Michelle for her leadership today—

[Madam Deputy Speaker (Caroline Nokes)]

Order. The hon. Gentleman will know that we do not refer to Members by name in this place. That is the third time he has referred to the hon. Member for Sherwood Forest by her name.

[Michael Payne]

My apologies, Madam Deputy Speaker.

In thanking my hon. Friend the Member for Sherwood Forest (Michelle Welsh) for her leadership today, I want to say that her dad would have been so incredibly proud to sit in the Gallery today to see his little girl in this Chamber using the privilege of her platform to fight for those who have been failed and suffered the most unimaginable loss.

I also pay tribute to the families who have campaigned for years for change and justice. We owe them far more than sympathy. We owe them justice, and we owe them truth.

[Madam Deputy Speaker]

Order. The hon. Gentleman has had more than three minutes, and I want the Front Benchers to have some time to respond. I call Dave Robertson.

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[Sean Woodcock (Banbury) (Lab)]

It is a real privilege to have the opportunity to speak in this debate, particularly after so many powerful and profound speeches and interventions from Members across the House. I want to share the testimony of a constituent who has endured an experience that affects many families, yet receives very little attention: hypoxic-ischemic encephalopathy, or HIE. Her son survived a HIE event during his birth. HIE is a brain injury caused by a lack of oxygen or blood flow, which can lead to developmental delays, intellectual and physical disabilities and—tragically—in one in five cases, death. Some of these complications can remain hidden until school age.

My constituent had never heard of HIE at the time, nor had I prior to her contacting me, but it is an all-too-common condition that affects three to four births out of every 1,000. In her son’s case, it resulted in mild cerebral palsy. She was supported by a wonderful charity called Peeps, which highlights that families affected by HIE often feel that they do not belong in a baby loss space. Many of those families experience birth trauma, PTSD and complicated grief. While charities such as Peeps offer support to anybody affected, NHS mental health support can often be restricted to just the mother. This leaves fathers and partners—who are also deeply affected—to cope alone. Support must and should be for the whole family.

Peeps also emphasises the significant gaps in long-term support, especially for families whose children survive but face lifelong, severe disabilities. They are left to navigate complex needs for years after the initial intensive care ends. The trauma is compounded for families whose event may have been avoidable. A study in Finland between 2005 and 2024 suggested that a fifth of all such cases could have been prevented, or at least could have benefited from preventive measures. This compounds the trauma of affected families and underscores the importance of absolute honesty and systemic learning in our NHS services.

Additionally, HIE is not always recorded consistently in NHS systems or statistics, making it harder to advocate for policy change and obscuring potential disparities in outcomes, which we know exist for stillbirths and neonatal deaths. We must listen to brave parents such as my constituent and fantastic charities such as Peeps and ensure that HIE is no longer misunderstood or unheard of in conversations about baby loss. We owe these families recognition, compassionate care, and a commitment to address the lack of consistent data that makes it so hard for them to advocate for change.

[Madam Deputy Speaker (Caroline Nokes)]

Order. That brings us to the Front-Bench contributions, which will perhaps be in the region of eight minutes each.

[Alison Bennett (Mid Sussex) (LD)]

The hon. Members for Rossendale and Darwen (Andy MacNae) and for Sherwood Forest (Michelle Welsh) and the right hon. Member for Godalming and Ash (Sir Jeremy Hunt) must be thanked, not just for securing this debate to mark Baby Loss Awareness Week, but for their tireless advocacy to improve maternity services across the United Kingdom—work that they have been carrying out for many years.

The pain of baby loss is multifaceted. It involves not only the unimaginable grief that accompanies losing a baby, but the emotional and psychological suffering that comes with facing the prospect of a life without your child—a future completely different from the one you had hoped for. Losing a baby can be loud, fast and chaotic, but it can also happen quietly—almost unnoticeably. Some parents arrive home from the hospital to a wardrobe full of baby clothes and piles of newborn toys, but an empty cot. Other expectant mothers may wake up in the morning excited to be another day closer to their baby’s arrival, only to find out that it was not meant to be.

Half of adults in the UK said that they or someone they know had experienced pregnancy or baby loss. According to Sands, every day in the UK 13 babies die shortly before, during or soon after birth. These families, as we have heard tonight, have to try to pick up the pieces, maintain their relationships, work and continue with daily commitments, all while tackling the emotional and often physical trauma of their experiences. They often walk that path alone, feeling like there is nobody they can speak to about their indescribable grief, or that they should not speak about it, as though they themselves have somehow failed. That is not the case, and no woman should have to suffer in silence.

In the case of my constituents, Hannah and Simon, not only did they have to come to terms with the fact that they would not be taking their baby boy, Austin, home from the hospital, but they had to face the reality that this tragedy was avoidable and that their baby would have survived, had the trust recognised and responded to concerns identified in the foetal and maternal monitoring. Hannah and Simon are not the only ones. Connecting with other parents in Sussex resulted in them hearing stories from other families whose experiences were concerningly similar to their own.

Between 2019 and 2023, the University Hospitals Sussex NHS Foundation Trust paid £58 million in compensation for 60 medical negligence claims related to maternity and obstetric care. That is the second-highest amount of compensation and the third-highest number of claims across all NHS trusts in England. That, and Hannah and Simon’s story, points to a larger systemic problem at the heart of maternity care. It was clear then, as it is now, that successive Governments have been asleep at the wheel on maternity care, and it is the families at the heart of it who pay the price—families such as Hannah and Simon’s. Their baby Austin would have been starting school next year if things had been different, and their daughter, just three when her little brother died,

“should not have to continually ask us why her friends got to bring their siblings home, and she had to say goodbye instead.”

That family, like too many across the country, deserved better. Now, they themselves are calling for change so that no one else misses out on a lifetime of memories with their child as a result of avoidable mistakes.

As part of her inquiry into maternity care, Donna Ockenden provided a blueprint—a starting point from which we could put an end to this scandal, make maternity care fit for purpose and put an end to these unnecessary deaths. However, not only have the nationally applicable, immediate and essential actions of the Ockenden report not all been implemented, but the Government have dropped the requirement for every ICB to have a women’s health hub, and they have announced cuts to the national service development funding for maternity services from £95 million in 2024-25 to just £2 million the following year.

Is it any wonder, therefore, that the UK is underperforming compared with other OECD countries on infant and newborn mortality, or that, according to a Care Quality Commission report in September 2024, 65% of units are not safe for women to give birth in? We want our country to become the safest place in the world to have a baby, but that can only be achieved if accountability is taken for these failings, lessons are learned, and concrete steps are taken by the Government to put an end to this national scandal.

We have heard from a number of Members this evening about the impacts of deprivation and ethnicity on outcomes for maternity and for babies. The colour of someone’s skin, their bank balance or where they live should not be deciding factors in whether they and their baby live or die. Quite simply, maternity care should not be a lottery.

I very much welcome the Secretary of State’s presence this evening, and I endorse the comments made by the right hon. Member for Melton and Syston (Edward Argar) and my hon. Friends the Members for Horsham (John Milne) and for Chichester (Jess Brown-Fuller), who said that families who have lost babies through medical negligence need to be taken with the Government on this journey towards reviews. I think that the Sussex families would be furious with me this evening if I did not say to the Secretary of State that they are not happy with the way in which the reviews announced in July are going so far, so I urge him to do everything in his power to listen to the families and take them on that journey together.

Let me pose a question to the Secretary of State on behalf of Hannah and Simon. These Sussex families have waited over a year for the Government to appoint Donna Ockenden, the one person with a proven record of exposing failings and driving improvement. Thus far, their patience has been repaid with delay, confusion and avoidance. When will the Government act to stop these preventable deaths by appointing Donna Ockenden to lead the Sussex review, and by confronting what has become a national shame for our country’s children with a full public inquiry?

My hon. Friend the Member for Carshalton and Wallington (Bobby Dean) spoke movingly about his and his wife’s experience of miscarriage, and I endorse his call for mental health support following every miscarriage, not just after three.

[Madam Deputy Speaker (Caroline Nokes)]

Order. I am sure that the hon. Lady will want to conclude her remarks very quickly.

[Alison Bennett]

The theme of this year’s Baby Loss Awareness Week is “Together, we care”, and we do care. We care about all kinds of baby loss, and we care about babies like Austin. Hannah told me:

“We lost an entire lifetime. Our son never had the chance to grow up, to take his first steps, to speak his first words, to make friends”—

[Madam Deputy Speaker]

Order. The hon. Lady must have misunderstood what I meant by “quickly”.

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[The Secretary of State for Health and Social Care (Wes Streeting)]

I thank all right hon. and hon. Members who have taken part in this extremely powerful debate. I thank my hon. Friend the Member for Rossendale and Darwen (Andy MacNae), the right hon. Member for Godalming and Ash (Sir Jeremy Hunt) and my hon. Friend the Member for Sherwood Forest (Michelle Welsh) for securing the debate, and the Backbench Business Committee for granting it.

Before I get into the substance of the debate, since this is Baby Loss Awareness Week, I want to put on record my thanks to the all-party parliamentary groups on baby loss, on maternity and on patient safety for their work in raising awareness; and charities such as Tommy’s, Sands, the Miscarriage Association and Bliss, which give bereaved families a voice and incredible support, and which deserve special recognition. I am extremely grateful to Members from across the House who have named local charities, run by those—often with lived experience—who play such a crucial role in improving services, so that others do not have to experience the torture that they have experienced.

It is such organisations that drove the adoption of baby loss certificates, introduced by the last Government and expanded by this one. I, too, thank Tim Loughton for his work, and my hon. Friend the Member for Washington and Gateshead South (Mrs Hodgson) for her leadership in this space. Not everyone will choose to have a certificate, but the option is now there for all parents who have experienced losing a pregnancy to have that loss recognised officially. I know that this has meant so much to those who have taken up that option, and to those who are providing the service, particularly staff in the NHS Business Services Authority, who have shared with Ministers their pride—many of them having that experience of loss themselves—of being part of the solution. I am of course delighted that the Government in Wales have also taken up this option.

Given the time available, there is simply no way of doing justice to the contributions that we have heard from Members across the House and the stories that they have shared with us. However, if there is one thing I have learned in my time as Secretary of State working on these issues it is that words will not do any justice to these families. What people want to see is action, and what they need to experience is justice.

I really do want to say a heartfelt thank you to Members across the House who have had the courage to share their personal stories. In particular, my hon. Friend the Member for Rossendale and Darwen, by talking about his daughter Mallorie, has given a voice to many fathers and partners who too often feel airbrushed from the conversation and absent from consideration. I think it is very poignant that he opened the debate for us this evening.

This is no exaggeration, but my hon. Friend the Member for Gedling (Michael Payne) talked about the leadership of my hon. Friend the Member for Sherwood Forest, and it is truly extraordinary that, in the aftermath of such an awful bereavement with the loss of her father, she was back to work in a matter of days, so that she could be there with families in Nottingham to support them in their ongoing campaign for justice.

Of course, my hon. Friends the Members for Sheffield Hallam (Olivia Blake) and for Clapham and Brixton Hill (Bell Ribeiro-Addy) and the hon. Member for Carshalton and Wallington (Bobby Dean) all shared their stories, because others who have spoken previously had the courage to share their own experience. I pay particular tribute to my hon. Friend the Member for Washington and Gateshead South. I have certainly never forgotten her speech about Lucy, and she really has blazed a trail for others to follow.

I can honestly say that, in the last year, the most difficult meetings have been those with victims of the NHS. I think we should pause for a moment just to reflect on how outrageous that sentence is—victims of the national health service. They are people who, in their moments of greatest vulnerability, placed themselves and their lives and the lives of their unborn children in the hands of others, but who instead of finding themselves supported and cared for, found themselves victims. It is truly shocking.

I have heard dozens of stories, each unique, each told with heartbreaking clarity and each with a common theme: that what should have been a moment of joy became a terrifying ordeal. I have had complete strangers describe to me, a Government Minister, their experience of injuries endured in childbirth. Women have had to share with me, a total stranger, what it has done to their sex lives and what it has done to their continence. I have had fathers share with me for the first time their attempts at suicide, and the impact that their loss and grief has had on their mental health. We also heard from my hon. Friend the Member for Erewash (Adam Thompson) of the harm done to young people, in this case young Ryan, who was with us in the Gallery today. I have seen photographs of parents’ children. I have seen the ashes of their children in the tiniest boxes. I have seen more courage than I could ever imagine mustering if I had to walk a day in their shoes.

Each time they have met me—each time they have met anyone—they have had to relive the trauma inflicted on them by the state. Perhaps what is most shocking of all is that if there is another theme that ties these families together, it is the fact that they have had to battle time and again for truth, for justice, for answers, for accountability and for change, so that other families do not have to experience what they are going through.

I cannot thank enough the Members on both sides of the House who have placed on record not just the stories, but the names of the children we have lost, so that they can stand on the record there for all time, a stain on the history of our national health service, but also a galvanising call to action. I hope there is some small comfort for families who have been with us in the Chamber this evening to hear the debate, or who have watched online, to know that Parliament is listening, that we are learning, and that, crucially, we are acting.

Many Members have remarked on my personal responsibility and the responsibility that weighs heavily on my shoulders to get this right. We have been joined by some of the Nottingham families this evening. When I have met them, they have arranged themselves around a horseshoe table in date order, with those whose experience goes back furthest sat to my left, and those most recently sat to my right. I go back to Nottingham regularly and honestly dread the prospect of going to another meeting with another family arriving on my right-hand side at that end of the table with another story to tell, but one that has happened on my watch.

We know how serious these situations and challenges are. We have an implicit message from the system that tells women not to have a miscarriage at the weekend. We have women who are classed as having a normal birth still leaving traumatised and scarred. We still use terms such as “normal” to describe a particular type of birth for ideological reasons. All these things need to change.

We heard from my hon. Friends the Members for Clapham and Brixton Hill, for North West Leicestershire (Amanda Hack) and for Wolverhampton North East (Mrs Brackenridge) the shockingly wide race and class inequalities. We should not kid ourselves that these are statistical anomalies or just institutional failures, because I have heard time and again direct first-hand experiences of overt racism: black women told that it was assumed that that they would be “a strong black woman” and so would not need so much pain relief; and examples of Asian mothers described as divas. Perhaps most shockingly of all, taking a step back and looking at the overall picture, we have had the normalisation of deaths of women and babies. We have levels of loss and death in this country that are simply not tolerated in others. We have a shocking culture of cover-up and backside covering, as we have heard across the Chamber this evening.

Recognising that I cannot respond to every individual point that has been made in the debate, I will undertake to write to Members across the House with detailed answers to the questions they posed. I want to conclude by making this point, which is about trust. We are setting out the rapid investigation led by Baroness Amos because I need to act urgently on the systemic challenges. I want to acknowledge openly and publicly that not all families are with me on this; many have concerns, and they wonder whether this will be just another review that sits on the shelf. I want to conclude by assuring those families and this House of my personal commitment to ensuring that that is not the case, and not just through leading the taskforce that will implement the recommendations myself, but by giving a promise to this House and to those families, in the spirit set out by my hon. Friend the Member for Sherwood Forest, that grief must be the engine of change. The stories I have heard from those families at first hand will be the steel in my spine to deliver the change they need.

[Madam Deputy Speaker (Caroline Nokes)]

I call Andy MacNae to wind up.

Suicide Prevention

Caroline Nokes Excerpts

Thursday 11th September 2025 Commons Chamber

[Madam Deputy Speaker (Caroline Nokes)]

I call Lee Pitcher, who will speak for around 15 minutes.

Resident Doctors: Industrial Action

Caroline Nokes Excerpts

Thursday 10th July 2025 Commons Chamber

[The Secretary of State for Health and Social Care (Wes Streeting)]

With your permission, Madam Deputy Speaker, I will make a statement on planned industrial action by resident doctors.

Today’s waiting list figures show that after 14 years of decline, the NHS is finally moving in the right direction. Since July, we have cut waiting lists by 260,000. We promised to deliver an extra 2 million appointments in our first year, and have more than doubled that figure, delivering 4.6 million more appointments. For the first time in 17 years, waiting lists fell in the month of May, and they now stand at their lowest level in more than two years. That is what can happen when NHS staff and a Labour Government work together. We have put the NHS on the road to recovery, but we all know that it is still hanging by a thread, and that the BMA is threatening to pull that thread.

On Tuesday this week, I met the co-chairs of the BMA’s resident doctors committee to discuss the results of its ballot for industrial action. In that meeting, and in a letter I sent yesterday, I offered to meet the BMA’s full resident doctors committee and work with it to improve its members’ working lives. Since the start of this year, I have offered repeatedly to meet the entire committee, but it still has not taken up my offer. Instead of agreeing to talk, the BMA responded by announcing five days of strike action. Its planned strike action will run from 7 am on Friday 25 July to 7 am on Wednesday 30 July. These strikes are unnecessary, given this Government’s willingness and eagerness to work together to improve resident doctors’ working conditions. Following a 28.9% pay rise thanks to the actions of this Government, the BMA’s threatened industrial action is entirely unreasonable. I am asking it again today to pause, call off the strikes, and instead work with the Government to rebuild its members’ working conditions and rebuild our NHS.

Before this Government came into office, a toxic combination of Conservative mismanagement and strikes was crippling the NHS. The cost to the NHS ran to £1.7 billion in just one year; patients saw 1.5 million operations and appointments cancelled, and people’s lives were ruined. Phoebe suffers from a genetic condition: neurofibromatosis, which causes non-cancerous tumours on the outside of her body. Her first operation at Great Ormond Street hospital was cancelled twice—at first due to strikes, and then because there was not the capacity to treat her. Phoebe loves going to school, and it is an absolute tragedy that her education was set back. She was prevented from doing what she loves because the NHS was not there for her when she needed it, but this year, when Phoebe’s family contacted Great Ormond Street in March, her surgery was scheduled less than two weeks later. Compared with what she went through two years ago, the difference was night and day.

That is the difference a Labour Government make, and it is why this Government were absolutely right to end the strikes when we came to office. I am so proud of what we have achieved together with NHS staff. In the words of one NHS leader I spoke to recently, there is light at the end of the tunnel and, for the first time, it is not an oncoming train. That has only been possible because of the deal this Government negotiated.

When we agreed that deal to end the strikes last year, resident doctors did not just receive a 22% pay rise; the Government also gave a genuine commitment to build a new partnership with those we now call resident doctors, based on mutual respect. I have personally ensured that that commitment was followed through. A new exception reporting process has been agreed with resident doctors in principle, so that doctors are paid for the work they are asked to do. A review of rotational training is under way and almost complete to reduce disruption to resident doctors’ lives. We promised to tackle GP unemployment, and we have delivered with an extra 1,900 GPs on the frontline who were otherwise facing unemployment. I am determined to go further to tackle doctor unemployment.

When I say to resident doctors that I want to tackle the bottlenecks they face, and the unfair competition for specialty training places, and to create more training places, they can judge me not just by my words, but by my actions. When the pay review body recommended a 5.4% average pay rise for resident doctors this year, we accepted that and funded it in full. Those are not grounds for industrial action. Indeed, in the history of British trade unions, it is completely unprecedented for a pay rise of 28.9% to be met with strikes. The BMA itself described this pay rise as “generous”.

Thanks to this Government, the average annual earnings per first year resident doctor last year were £43,275. That is significantly more, in a resident doctor’s first year, than the average full-time worker in this country, and it is set to increase further with this year’s pay award. For resident doctors in their second year out of medical school, their average annual earnings rose to £52,300 last year. In core training years, resident doctors earned an average of £67,000. Specialty registrars earned on average almost £75,000. There is no question but that these are highly trained, highly skilled medics who work hard for their money, but to threaten strikes in these circumstances is unreasonable and unnecessary, so it is no wonder that the BMA has lost the public’s support.

At the beginning of this dispute, resident doctors faced a Conservative Government cutting their pay and refusing to talk to them. A clear majority supported action as a result. In February 2023, 56% of the public backed junior doctor strikes. Today, that support has collapsed. Just one in five people believe that the BMA is doing the right thing. Patients are begging resident doctors not to walk out on them, and I hope the BMA is listening, because many resident doctors are.

For the first time since the BMA’s campaign began, a majority of BMA resident doctors did not vote for strike action. They can see that the Government have changed and our approach has changed, yet the BMA’s tactics have not. Resident doctors have received the highest pay award in the public sector, both this year and last year, so renegotiating this year’s pay award would be deeply unfair to all other public servants. Such a deal would be paid for by their future earnings, and with the greatest respect to resident doctors, there are people working in our public services who are feeling the pinch more than they are.

Even if it would not be unfair on public sector workers, it is unaffordable. It should be apparent to anyone that the public finances this Government inherited are not awash with cash, so I will not and cannot negotiate on this year’s pay award, and I am not going to lead resident doctors up the garden path by making promises unless I know I can keep them. As I have said in person, in writing, in private and in public, I am willing and ready to get around the table and work together to improve the working conditions of resident doctors. There is so much more that we can do together. I do not just hear the complaints that resident doctors have about their placements, rotations and bottlenecks— I agree with them. I know the NHS has been a bad employer, and I am determined to change it. My offer to talk comes with no preconditions attached. I will also say this to resident doctors directly: consider very carefully the consequences of your actions.

[Madam Deputy Speaker (Caroline Nokes)]

Order. May I suggest to the Secretary of State that his statement has already taken 10 minutes and he has not asked for additional time? Does he wish to consider whether his statement is to the House, or to those outside the House? He might like to make a few closing remarks.

[Wes Streeting]

Thank you, Madam Deputy Speaker. I will move to closing. I did share the statement in advance, including with Opposition parties and the Speaker’s Office. I just say to resident doctors, and it is important that the House knows what we are saying to them, that they should carefully consider the consequences of their actions. Five days of strike action mean patients and their families receiving the phone call they are currently dreading, being told that the operation or appointment they have been waiting for—often for far too long—is being cancelled and delayed. I know how I would feel if that happened to a member of my family, and I ask them to consider how they would feel if that happened to a member of theirs. While they are out on the picket line, protesting the 28.9% pay increase they have had, their friends and colleagues and other NHS staff—many of whom are paid less and receive less than them—will be inside, picking up the pieces and working in harder conditions to cover for the consequences of resident doctors’ actions.

In conclusion, the strikes are not only unnecessary and unreasonable, but unfair. They are unfair on patients, unfair on other NHS staff, and unfair to the future of the NHS, which is in jeopardy. The tragedy is that they will never have had a Secretary of State as sympathetic to their legitimate complaints as this one. If they want to know what the alternative is, its Members are not sat here. They have not even bothered to show up today, and that party does not even believe in the NHS. The grass is not greener on the other side. I ask them not to squander this opportunity. At this stage, we can still come out of this dispute with a win for the BMA’s members, a win for the NHS and a win for patients, but if the BMA continues down the path of strike action, it will lose its campaign, resident doctors will be worse off, and the heaviest price of all will be paid by patients. I commend this statement to the House.

[Madam Deputy Speaker (Caroline Nokes)]

I call the shadow Secretary of State.

--- Later in debate ---

[Wes Streeting]

I completely agree with my hon. Friend. I urge BMA members to consider not just the significant progress that they have already made by working with a Labour Government, but the wider context in which we are operating. It is not just resident doctors who have seen their pay eroded over more than a decade of Conservative Government; it is the entire public sector. It is not just resident doctors who are working in crumbling buildings with out-of-date equipment and technology; it is the same in our schools, our hospitals, our prisons and the entire public sector estate.

This Government are facing enormous challenges across our economy, and we cannot sort out every issue that we inherited overnight, or even in one year—it is going to take time. BMA members should be proud of the progress that we have made together, and reassured that we want to make further progress with them, but there has to be some give and take here, and there has to be some reasonableness. Given the potential consequences of their action for patients, for their fellow staff and for the future of the NHS, the strike action is unreasonable, unnecessary and deeply unfair.

[Madam Deputy Speaker (Caroline Nokes)]

I call the Liberal Democrat spokesperson.

[Alison Bennett (Mid Sussex) (LD)]

People across the country, and NHS patients in particular, will be disappointed to hear of yet more strike action by resident doctors this July, especially after the immense disruption of recent years. I and my Liberal Democrat colleagues fully recognise that this dispute does not come out of nowhere. The previous conservative Government left our NHS under unbearable strain, with doctors working under intense pressure in crumbling hospitals and often without the resources they needed. My constituents, and people across the country, need and deserve a well-functioning NHS.

Over the past three years, doctors have received a 28.9% pay rise following earlier strikes. The BMA is now calling for a further 29% increase, but we have to be honest: after years of economic mismanagement by the Conservatives, the public finances are in a dire state. That kind of increase does not feel affordable or realistic right now. That said, we cannot ignore the reality of working conditions in our NHS. Doctors are expected to save lives in collapsing wards and to deliver care in corridors, rather than in safe clinical settings. It is degrading and dangerous for both staff and patients. We need constructive dialogue, not escalation, to resolve this dispute swiftly and fairly, and most importantly, we need urgent action to rebuild our NHS and restore working conditions that our doctors and patients can be proud of.

First, will the Secretary of State improve staff morale by committing to end the dangerous and dehumanising practice of corridor care? Secondly, does he not see that by dragging out social care reform, delayed discharges and corridor care are only going to worsen doctors’ experiences of working in the NHS, weakening morale and lowering care standards?

--- Later in debate ---

[Several hon. Members rose—]

[Madam Deputy Speaker (Caroline Nokes)]

I remind hon. Members and the Secretary of State that we have an important statement to come, as well as two Backbench Business debates. May we have short questions and shorter answers?

[Robin Swann (South Antrim) (UUP)]

I agree with the Secretary of State when he tells the BMA resident doctors that they will never have another Secretary of State as sympathetic to their legitimate complaints— I recognise that, having worked with five of his predecessors. My experience tells me that what happens here with the BMA often filters through to the devolved nations. What engagement has he had with his counterparts on the proposed industrial action so that there can be a combined resolution and message to the BMA?

--- Later in debate ---

[Wes Streeting]

I entirely agree with my hon. Friend. Looking back at all the contributions this morning, I have been struck by the fact that, quite extraordinarily, the entire House, on both sides of the Chamber, has spoken with one voice. There has been total unanimity across this House during these exchanges that the proposed strikes are unreasonable, unnecessary and unfair. For the avoidance of doubt, let me tell the BMA and the resident doctors committee that this House has spoken with one voice to say: abandon this rush to strike, get around the table and work with us to rebuild resident doctors’ working conditions and to continue rebuilding our national health service. I thank the House for its support.

[Madam Deputy Speaker (Caroline Nokes)]

I thank the Secretary of State for his statement today.

Spending Review: Health and Social Care

Caroline Nokes Excerpts

Thursday 12th June 2025 Commons Chamber

[The Minister for Secondary Care (Karin Smyth)]

With permission, I would like to make a statement on the outcome of the spending review for the Department of Health and Social Care.

This Government were elected on a manifesto to fix our broken NHS and make it fit for the future. Our job is twofold: first, to get the NHS back on its feet and treating patients on time again; and secondly, to reform the service for the long-term so that it is fit for the future. That is why, in her autumn Budget, my right hon. Friend the Chancellor took the necessary decisions to give health and social care a record uplift in day-to-day spending at the conclusion of the first phase of the spending review. The Department for Health and Social Care received a cash injection of £26 billion covering day-to-day spending and capital investment in 2025-26, compared with the 2023-24 out-turn.

All Opposition parties have rejected that investment and those changes to repair the damage done to our NHS and move it forward. They have rejected two above-inflation pay increases for our NHS staff, the recruitment of 1,700 more GPs and the agreement of a GP contract for the first time since the pandemic, the biggest investment for hospices in a generation, the biggest expansion of carer’s allowance since the 1970s, a boost for older and disabled people through the disabled facilities grant, and the biggest real-terms increase to the public health grant in nearly a decade.

We have also given pharmacies the biggest funding uplift in years, ensured that women across the country can access the morning after pill free of charge, frozen prescription charges for the first time in three years, enabled an extra 3.5 million appointments for operations, consultations, diagnostic tests and treatments—reaching and surpassing our manifesto pledge seven months early. I can update the House on waiting lists, which, as of this morning, have fallen by over 30,000 compared with last month, amid a reduction of 232,000 since this Government took office.

I could go on, but I have only 10 minutes, Madam Deputy Speaker, and I would not like to try your patience, so I will make this point briefly. To govern is to choose, and anyone who opposed the decisions that the Chancellor took in her Budget must tell us what they would have subtracted from that list. We cannot spend money if we do not raise it.

As the Minister of State for Secondary Care, I regularly hear appalling anecdotes from colleagues across the House whose local hospitals, GP surgeries and community services are crumbling, with rusty equipment, leaky pipes and buckets catching rainwater. Phase 1 of the spending review has allowed us to arrest 14 years of shocking neglect and undercapitalisation in the NHS, with a record capital investment of £13.6 billion in 2025-26. [Interruption.] The Conservatives do not like it, but I will go on. That money has gone towards repairing our crumbling hospitals, supporting over 1,000 GP surgeries to modernise their buildings, and installing state-of-the-art scanners across the NHS estate, including the latest linear accelerator machines. However, as my right hon. Friend the Secretary of State has made clear, investment must come with reform. This year we have unveiled our plan for change, our elective reform plan, our urgent and emergency care plan and a crackdown on agency spend in order to reinvest £1 billion into the frontline.

Yesterday, my right hon. Friend the Chancellor set out the conclusion of phase 2 of the spending review, setting budgets that will enable us to make firm plans to deliver on the people’s priorities in the coming years, while going further and faster on reform. Our settlement increases day-to-day spending on health, bringing the budget for my Department and our NHS up to £232 billion by 2028-2029. That means £29 billion more day-to-day funding for the NHS in England, in real terms, than in 2023-24. We have also secured the largest-ever health capital budget, with a £2.3 billion real-terms increase in capital spending by 2029-30, compared with 2023-24, representing a more than 20% real-terms increase by the end of the spending review period.

Let me hammer this point home: investment must be matched by reform. This will be a critical year for the NHS as we achieve better value for taxpayers, who must see their money being spent well and delivering results. We would rather take those difficult decisions now, to save our NHS so that it is there for future generations. NHS England is a top-down organisation—the biggest quango in the world—with a less efficient system than the previous Government inherited in 2010 and twice the headcount at the centre. That is why my right hon. and learned Friend the Prime Minister announced in March that we will bring together NHS England and the Department of Health and Social Care to form a new joint centre. That will put an end to duplication and enable substantial efficiency savings, while bringing the management of our NHS back under democratic control. We will also unlock £17 billion of savings over the spending review period through 2% annual productivity growth in the NHS—money that will be either reinvested in the frontline or used to support radical transformation to make the health system more agile and efficient.

Our elective reform plan set out how we will ensure that by the end of this Parliament 92% of patients will not have to wait more than 18 weeks for elective care. This settlement will drive us further towards that goal, with over £6 billion of additional capital investment over five years across new diagnostic, elective and emergency and urgent care capacity, which could deliver more than 4 million additional tests and procedures.

We will build on the record capital investment from phase 1 to repair the NHS estate. That means continuing the delivery of 25 new hospitals; investing £30 billion in maintenance and repairs, with £5 billion of it to address the most critical building repairs; and reducing by half the number of hospitals containing RAAC—reinforced autoclaved aerated concrete—over this Parliament.

This spending review provides for an increase of over £4 billion for adult social care in 2028-29 compared with 2025-26, including an increase in the NHS contribution via the better care fund. Local authorities with responsibility for adult social care will also benefit from wider reforms to better align funding with need, multi-year settlements and simplification of the funding landscape that enables them to plan more effectively. Last but not least, we have taken steps to simplify targets and better monitor delivery, and we will continue to work with local systems to improve financial and operational performance, to get the most from every penny.

A key part of our 10-year plan is driving progress on the three shifts: from analogue to digital, hospital to community and treatment to prevention. On digital, we will invest up to £10 billion in technology and transformation, to start making the NHS app a digital front door and deliver a single patient record. We will work in partnership with the Wellcome Trust to launch the world’s first health data research service, backed by £600 million, to accelerate the discovery of lifesaving drugs.

On primary and community care, we will invest in training thousands more GPs, helping to bring back the family doctor through millions of extra appointments a year; in 700,000 additional dentist appointments annually; in at least 8,500 extra mental health staff by the end of this Parliament; and in mental health support teams for every school within five years. Finally, on prevention, our world-leading immunisation programmes will be supported by £2 billion, and we will invest £80 million in tobacco cessation programmes and our Tobacco and Vapes Bill.

I want to end by thanking the Chancellor for her unwavering commitment to getting our NHS back on its feet. Fixing broken Britain will not be easy, but nothing that is worth doing ever is. Today I have set out how every penny from the public purse will be matched by reform, to make our NHS fit for the future. We remember we were elected on a manifesto to end sticking-plaster politics and do the hard yards of fixing our country, and we will never betray that promise to the British people. The public have a right to know how public money will be spent, and this is something we take extremely seriously. They can put their trust in this Government, because we have fixed the NHS before, and with the help of this Chancellor, we will fix it again. I commend this statement to the House.

[Madam Deputy Speaker (Caroline Nokes)]

I call the shadow Secretary of State.

--- Later in debate ---

[Karin Smyth]

As my hon. Friend said, this is a health area that I know well, and he has been the most amazing campaigner for Gloucester and the health service there since he became the Member of Parliament. He is absolutely right: dentistry is a key worry. It is one of the key areas that the Conservative party neglected for 14 years. That is why it was a manifesto commitment, and why I was able to outline today that meeting the target of 700,000 is front and centre, and part of the plan as we go forward. I know that the Minister for Care, who is responsible for dentistry, is keen to meet many hon. Members, and I will make sure he has heard that request.

[Madam Deputy Speaker (Caroline Nokes)]

I call the Liberal Democrat spokesperson.

[Dr Danny Chambers (Winchester) (LD)]

To reiterate: after years of Conservative mismanagement, the NHS is in crisis, with patients left waiting hours for ambulances, women giving birth in unsafe maternity units, and children turning up at A&E with rotting teeth because an NHS dentist cannot be found. That is the Conservative legacy, and they must never be trusted with our health service ever again. So yes, we welcome this funding boost—we really do—and we agree that funding must come with reform, because unless this funding is targeted properly, it will not bring the change that patients urgently need.

When it comes to reform we need to talk about fixing social care, because putting more money into the NHS today will be like pouring money into a leaky bucket. Last year, the Secretary of State for Health and Social Care stated that £1.7 billion a year is wasted because patients who are medically fit for discharge cannot leave hospital, simply because no care is available to support them at home. The hospital in Winchester that supports both your constituency, Madam Deputy Speaker, and mine has up to 160 people waiting to be discharged at any given time, and they would be better cared for with social care packages.

We need urgent action and a higher minimum wage for care workers. We need proper respite and financial support for family carers, and a clear commitment to conclude the social care review, hold cross-party talks, and deliver the real reform that the Minister has been talking about. We also need to tackle the crisis in primary care, because that is where prevention happens and where pressure on hospitals is eased. Will the Minister confirm that the funding boost will deliver the extra 8,000 GPs that are needed to guarantee everyone an appointment within seven days, or within 24 hours for urgent cases? Can she also confirm that the funding will bring dentists back into the NHS, and bring an end to dental deserts? That will not happen without urgent reform of the NHS dental contract, which is outdated, unworkable and driving dentists out of the system.

Finally, we cannot ignore the shocking state of NHS buildings, including our hospital in Winchester. It is an outrage that overcrowded hospitals must close operating theatres due to unsafe ceilings and other health and safety issues. I urge the Minister to spend the money where it matters: on primary care, on social care, and on ensuring that our existing NHS buildings are fit for purpose.

--- Later in debate ---

[Karin Smyth]

I thank my hon. Friend for her question and for the work she does to support NHS dentistry as part of the all-party group. As I have said, this issue is of huge importance to our constituents, and the shocking state in which the Conservatives left dentistry is there for all to see—particularly the shocking state of children’s oral health. That is why we acted rapidly to introduce the toothbrushing campaign—which, if I remember rightly, was ridiculed by Conservative Members when we discussed it in opposition—and the arrangement with Colgate to ensure that we improve children’s oral health. We are absolutely committed to reform of the contract; the Minister for Care is working hard on that and he will continue to update the House regularly. It is our confirmed commitment, as I have reiterated today, to increase access to dental services.

[Madam Deputy Speaker (Caroline Nokes)]

I call the Father of the House.

[Sir Edward Leigh (Gainsborough) (Con)]

Our spending on the NHS is now as much as the entire GDP of Portugal. We used to be a country with an NHS attached to it, but we are almost becoming an NHS with a country attached to it. Of course we would welcome this spending if we got the same outcomes that people get in civilised countries, like the Netherlands or Australia, but every time I mention fundamental reform, I am dismissed as wanting to bring in privatisation, so it is hardly worth raising that issue. Australia has an extremely successful pharmaceutical benefits scheme; I know that the Secretary of State for Health and Social Care went out there, and I have talked to Australian doctors about it. Will the Minister at least look at the successful outcomes, including some of the highest life expectancies in the world, that are being delivered in countries like Australia and the Netherlands, to see how we can deliver better outcomes? There is no point spending more money if people’s only right is to join the back of a queue.

--- Later in debate ---

[Karin Smyth]

My hon. Friend is absolutely right that his constituents and constituents across this country will not forgive the Conservatives for the state in which they left the NHS. That is clear from Lord Darzi’s diagnosis. We have still had no comment from the Conservatives on whether they acknowledge that. We are determined to be about the future, and that is what this settlement and the Chancellor’s announcement yesterday are about. It is about putting that extra funding that we raised last year into services and into a reformed system that reaches all parts of this country. We will tackle health inequalities, making sure that people who have not had that access and people who suffer worse health than others are raised up. We must take the best of the NHS to the rest of the NHS.

[Madam Deputy Speaker (Caroline Nokes)]

After more than an hour of diligent bobbing, I call Chris Vince.

[Chris Vince (Harlow) (Lab/Co-op)]

Apologies for my premature bobbing earlier, Madam Deputy Speaker.

I thank the Minister for her statement today and for her ongoing commitment to the NHS. I welcome the growth in day-to-day spending on the NHS and this Government’s commitment to bringing down NHS waiting times. However, may I gently advocate for Harlow in respect of the future of the UK Health Security Agency? It has a business case, details, designs and a site ready to go, and the estimated timeframe has consistently been assessed as the best value for money and the quickest to deliver.

[Karin Smyth]

I like how my hon. Friend says “gently”, because honestly no day goes past without him talking about this issue or, indeed, his new hospital. He is right, and he is a fantastic campaigner for the people of Harlow. He has made his point again, and I cannot make any further comment today, but he will be hearing from the Secretary of State soon on that issue.

[Madam Deputy Speaker]

I thank the Minister for her answers this afternoon. I ask anyone who is leaving before the Select Committee statement to do so quickly and quietly.

Mental Health Bill [Lords]

Caroline Nokes Excerpts

2nd reading
Monday 19th May 2025 Commons Chamber

[Jim Dickson (Dartford) (Lab)]

I thank everyone who has taken part in the debate, from the Secretary of State onwards. It has been moving and inspiring to see the House united on the need for change. It has been particularly useful for me to benefit from the professional expertise and the personal experience of so many Members who have spoken. My hon. Friend the Member for Sittingbourne and Sheppey (Kevin McKenna), the hon. Member for Runnymede and Weybridge (Dr Spencer), my hon. Friends the Members for Ashford (Sojan Joseph) and for Thurrock (Jen Craft) and the hon. Member for St Neots and Mid Cambridgeshire (Ian Sollom) have all educated and moved me with their experience and knowledge.

It has long been known that the Mental Health Act 1983 is not fit for purpose, and I pay tribute to all the work that has been done so far, including the excellent review undertaken by Professor Sir Simon Wessely, commissioned by the former Member of Parliament for Maidenhead when she was Prime Minister. I know that the intent of the Bill both to strengthen the voice of patients and add statutory weight to their right to be involved in the planning for their care and to inform their choices about the treatment that they receive is strongly welcomed by Members on both sides of the House. Also welcome are the steps that the Government have taken since the election to start to transform mental health services with new funding—mentioned by the Secretary of State—and the plans to recruit 8,500 new mental health workers.

Before I deal with the substance of the Bill, may I ask the Minister whether, when he winds up the debate, he will be able to provide some reassurance about the future of the patient and carer race equality framework, which I believe is vital to the achievement of equality of outcome in mental health, and which I believe would be more effective as part of the Bill than simply as guidance? I know that that is the strongly held view of many of the experts by experience who have worked on PCREF.

One thing I know from my time in a previous role, when I helped to develop mental health services in Lambeth over two decades, is that a disproportionate number of people from African and Caribbean-heritage communities are detained under the Mental Health Act, as has been said by others. Figures highlighted by Mind show that rates of detention for black or black British groups are over three times those for the rest of the population. Similarly, black or black British groups are more than 10 times more likely than white groups to be subject to community treatment orders.

In Lambeth, working with organisations such as Black Thrive—set up by my great former colleague Dr Jacqui Dyer, among others, to radically change mental health services in south London and elsewhere—we showed that hearing people’s voices, early intervention, reducing stigma among African-Caribbean communities, and focusing on keeping people well via work and training provided by membership organisations, such as Mosaic Clubhouse, can prevent people from becoming ill and from tragically coming into the mental health system for the first time via the criminal justice system.

I welcome the changes in the Bill and the commitment from the Minister in the other place to improve data on outcomes and on patients’ experience of community treatment orders. Despite the passing of the Mental Health Units (Use of Force) Act 2018—otherwise known as Seni’s law—which was brought forward by my right hon. Friend the Member for Streatham and Croydon North (Steve Reed), the use of force in mental health settings remains too frequent, and that must be addressed as well.

Prevention work and intervention to address mental health needs at the earliest possible stage are critical, because if someone faces mental health problems when they are young, it can hold them back at school, damage their potential and leave them with lifelong consequences. That is why I warmly welcome the work that the Government are doing to bring vital services into schools so that they can intervene early, support pupils and help prevent conditions from becoming severe. It is really encouraging that mental health support teams should reach 100% coverage of pupils by 2029-30—the end of this Parliament.

Young people in Dartford, where I ran a well-supported engagement event last month, will absolutely welcome the introduction of Young Futures hubs in communities in England to deliver support for teenagers who are at risk of being drawn into crime or facing mental health challenges by providing open-access mental health support for children and young people in communities. I have seen that approach achieve excellent results at the Well Centre, a mental health centre run for young people in Herne Hill as part of Lambeth Together’s care partnership.

I very much look forward to seeing this legislation progress through the House and become law with the support of all Members. I will support it 100% as it does so.

[Madam Deputy Speaker (Caroline Nokes)]

I call the shadow Minister.

NHS Pensions

Caroline Nokes Excerpts

Tuesday 1st April 2025 Commons Chamber

[Karin Smyth]

My hon. Friend is absolutely right that we are on the road to recovery—and that, of course, is what the Opposition cannot stand. This is a complicated issue, as they well know. As I said, we inherited this complication in July, when we were made well aware of it. The Conservatives could have done more about it while they were in government, but it is yet another issue on which they have let people down—this time, it is staff.

We will ensure that we remedy that. The timelines are available in the written ministerial statement that I issued yesterday. We will continue to work with trade unions and employers to ensure that people understand. As my hon. Friend said, it is important that people do understand their own personal positions.

[Madam Deputy Speaker (Caroline Nokes)]

I call the Chair of the Health and Social Care Committee.

[Layla Moran (Oxford West and Abingdon) (LD)]

I have to say that I am none the wiser about what exactly has happened. If we are to ensure that this will not happen again—that these deadlines will be met—we need to know how we got into this position. It may well be the fault of the previous Government. Will this Government commit to a full review of exactly how we got here, so that we can ensure that the published deadlines are met this time?

--- Later in debate ---

[Karin Smyth]

One of our major priorities is ensuring that the entire NHS workforce are doing the work that they are trained and committed to do, so that they can get down those waiting lists and deliver an NHS that is fit for the future. The staff, as Lord Darzi has outlined, have felt very severely the detriment caused by the previous Government. They are working under really difficult conditions, and we want to make sure that, through the 10-year plan and the NHS Long Term Workforce Plan, we offer them hope, so that they are ready to deliver the services that they have been trained to deliver.

[Madam Deputy Speaker (Caroline Nokes)]

I thank the Minister for her responses this afternoon. I will allow a moment for the Front Benchers to swap over.

Down Syndrome Act 2022: Local Authority Guidance

Caroline Nokes Excerpts

Friday 28th March 2025 Commons Chamber

[The Parliamentary Under-Secretary of State for Health and Social Care (Ashley Dalton)]

I thank the hon. Member for Windsor (Jack Rankin) for securing this debate on such an important topic. I am also grateful to him for his work with the all-party parliamentary group on Down syndrome.

People with Down syndrome should have the same opportunities to participate fully in society like everyone else, but we know this does not always happen. There is a pressing need to raise awareness of the needs of people with Down syndrome and how they can be met. While every person with Down syndrome is a unique individual, they often face common health risks.

For example, we know that almost half of children with Down syndrome are born with a heart condition. We also know that people with Down syndrome may need additional support with their speech, hearing or vision. And as the average life expectancy of a person with Down syndrome continues to rise—an increase I am very pleased to see—this means that more people require additional support in later life. This may be additional support with new, age-related health needs, as well as increased demand for social care services.

This Government are committed to ensuring that all people with Down syndrome receive the care and support they need to lead the lives they want in their communities, and we are taking action to achieve that by implementing the Down Syndrome Act. The Act lays the foundations to ensure that every person with Down syndrome can live a full and fulfilling life through accessing the health and care services they need, receiving the right education, securing appropriate living arrangements that work for them, and being supported into employment. We recognise that there is still much to do to achieve that, but I can assure the hon. Gentleman and the House that the Government are working on the implementation of the Act as a priority.

The Down Syndrome Act requires the Secretary of State for Health and Social Care to give guidance to relevant authorities in health, social care—including local authorities—education and housing services on what they should be doing to meet the needs of people with Down syndrome. Earlier this month, Minister Kinnock wrote to sector partners and the all-party parliamentary group on Down syndrome with an update on the development of the guidance, including the Government’s plan to put the guidance out for consultation by the summer. That followed a roundtable on 26 November, which Minister Kinnock—

[Madam Deputy Speaker (Caroline Nokes)]

Order.

[Ashley Dalton]

Oh, sorry!

[Madam Deputy Speaker]

Twice!

[Ashley Dalton]

I’m so sorry!

That followed a roundtable on 26 November, which the Minister for Care, my hon. Friend the Member for Aberafan Maesteg (Stephen Kinnock) convened to discuss with partners how we can improve life outcomes for people with Down syndrome and the opportunities that the guidance presents in support of that.

We appreciate that many of the issues that have been raised are borne out of a desire to ensure the guidance is as effective as possible and published as soon as possible. We know just how important the guidance is. I can assure the hon. Gentleman that a huge amount of work has been, and continues to be, carried out to develop the guidance. And we, like others, want to make sure the guidance is fit for purpose and impactful.

It has been vital that people with lived experience, and the organisations that work to support them, are involved at every stage of the work to develop the guidance. A range of sector engagement has taken place. That includes a national call for evidence, partner working groups, and a review of evidence to gain a better understanding of the specific needs of people with Down syndrome. Throughout the process, there have been differences in opinion on the scope of the guidance and how it should be drafted. Officials have worked hard to build consensus on these issues, but, as I am sure Members can appreciate, it is not always possible to resolve differing opinions quickly, especially on a topic as important as this. While that means the development of the guidance has taken longer than we all had hoped, it is only right that the issues are given the due consideration they deserve. The Minister responsible set out his position on the issues at hand in his recent letter to sector partners.

Our position remains that the guidance will be Down syndrome-specific, in accordance with the Government’s statutory duty under the Act. It is our intention to include references to where the guidance could have wider benefit. That is in line with the commitment made during the Bill’s passage through Parliament. This is not about moving the focus away from Down syndrome. The guidance is about meeting the needs of people with Down syndrome. It is about taking the opportunity, through the guidance, to help as many people as possible. Officials will continue to work with partners to ensure the guidance has the maximum benefit for all communities involved.

I can confirm to the hon. Gentleman that I have today secured a commitment that the Minister will work with sector partners to ensure that people with Down syndrome have direct access to, and are supported in taking part in, the consultation.

I would like to thank the individuals and organisations across the country who have worked tirelessly to help us develop the guidance. Their contributions have been invaluable throughout, and we appreciate their continued patience while we work to finalise the guidance for consultation. We would also welcome their support to ensure that the communities they represent are aware of the consultation and can share their views.

We are grateful to members of the all-party parliamentary group on Down syndrome for their engagement and can assure them that their comments on the guidance have been considered throughout the development process. The Minister in charge wrote to the APPG on 18 March. Officials will share a second draft of the guidance with sector partners for feedback in the coming weeks. I can assure the hon. Gentleman that I will pass on his comments to the Minister responsible, as requested.

On specific training, under existing legislation, Care Quality Commission-registered providers must ensure that staff receive the appropriate professional development necessary for them to carry out their duties, and must receive specific training on learning disability and autism appropriate to their role. We expect that providers should be considering whether specific training on Down syndrome is required for their staff. Officials will work with stakeholders to signpost that effectively in the guidance we are developing under the Down Syndrome Act.

I thank again the hon. Gentleman for securing this important debate.

Question put and agreed to.

NHS England Update

Caroline Nokes Excerpts

Thursday 13th March 2025 Commons Chamber

[Madam Deputy Speaker (Caroline Nokes)]

I call the shadow Minister.

--- Later in debate ---

[Wes Streeting]

My hon. Friend is absolutely right about the need to improve procurement. One thing that Attlee and Bevan could not have predicted in 1948 is that the single-payer model of the national health service makes it ideally placed for this world of artificial intelligence, genomics, machine learning and big data. We must unlock that potential so that we have new treatments, new technology, productivity gains and efficiencies, but we also have to get the basics right on procurement. We have to change the culture of profligacy, routine deficits and routine over- spending. That is why, today, the leadership of NHS England has summoned to London chairs and chief executives from across the country to get an immediate grip on the £5 billion to £6 billion deficit that was already being baked in for the 2025-26 financial year. Those chairs and chief executives have just become so accustomed to the idea that Governments will just come in and bail them out.

I said before the election that there would be no release of money in winter, because winter is predictable. The NHS was given additional resources and it must learn to live within its means. Despite howls of outrage before and since the election, I have kept to my word. I said that there would be accountability for people who think that the Government are there to bail them out. Having come from local government, where that culture would never be tolerated, I and this Government are bringing that same financial discipline to the NHS. We will not tolerate deficits. It is important that we get better value for money, while also making sure that, nationally, we are providing support through the procurement platform. That is how we will help the system deliver better value, and we will liberate frontline leaders to focus on the things that really matter, which are services for patients.

[Madam Deputy Speaker (Caroline Nokes)]

I call the Liberal Democrat spokesperson.

[Alison Bennett (Mid Sussex) (LD)]

The Secretary of State’s NHS shake-up is well under way. Many Members would agree that the NHS used to be the envy of the world, but years of Conservative failure have left patients suffering and unable to get the care that they desperately need. I and my Liberal Democrat colleagues therefore welcome steps to reform the NHS.

The new leadership of the NHS has much to do, but can the Secretary of State advise the House whether new legislation will be needed to scrap NHS England given that he told the shadow Minister that it will take two years to complete this merger? When will that new legislation, if it is required, be brought forward?

Any attempt to fix the NHS will ultimately fail if we also do not address the crisis in social care. The Secretary of State must show the same urgency in reforming social care as is being shown on the NHS. Where is that urgency? Long-promised cross-party talks have now been postponed indefinitely with no new date in sight. Care providers are hanging by a thread due to the rising cost of national insurance contributions. Does the Secretary of State agree that any attempt to fix the NHS will prove futile if we ignore the elephant in the NHS waiting room that is the crisis in social care? We will clear our diaries for cross-party talks, so will the Secretary of State give us a date today?

--- Later in debate ---

[Wes Streeting]

I do think that is the case. I also think that this is not just about form and function but about the opportunities for productivity gains through modern technology and practices. One of my frustrations is that whenever we talk about the exciting frontiers of life sciences and medical technology—this country’s competitive advantage, and how we need to build on that position— I am greeted with a weary sigh from poor frontline NHS staff, and managers for that matter, who say, “That’s lovely, and we agree with you, but we’d just like a machine that turns on reliably, and it would be nice to use systems that do not require seven passwords to deal with a single patient.” I feel their pain. We will prioritise that investment in technology.

Finally, we do want to liberate the frontline, and I am grateful for the leadership that GPs have shown in agreeing a contract with the Government for the first time since the pandemic, which contains substantial reform to benefit them and, even more importantly, their patients. We also have to liberate management in the NHS. As Lord Darzi said, it is not the case that there are too many managers, but there are layers and layers of bureaucracy between me as the Secretary of State and frontline staff. We have to liberate frontline staff and managers to help them be more effective, to manage their resources more efficiently and, most importantly, to deliver better and safer care.

[Madam Deputy Speaker]

I call the Chair of the Health and Social Care Committee.

[Layla Moran (Oxford West and Abingdon) (LD)]

This is a bold change indeed. The job of my Committee is to help the Secretary of State to do it, so let me start by asking him to come in front of the Committee as quickly as possible—certainly before Easter—because there is a lot of detail that we need to drill down into.

On a more substantive point, the right hon. Member mentioned the financial reset that Sir Jim Mackey announced to integrated care boards just yesterday, which means that they need to cut their running costs by 50%. I am concerned that when my Buckinghamshire, Oxfordshire and Berkshire West ICB struggled with money, the first thing it cut were the place-based teams. If we are to deliver the neighbourhood NHS that the Secretary of State and I both want, those are not the teams to cut. Will he send a signal to ICBs that cost savings should not be at the expense of the broader shifts in the 10-year plan?

--- Later in debate ---

[Several hon. Members rose—]

[Madam Deputy Speaker (Caroline Nokes)]

Order. I gently ask right hon. and hon. Members, and indeed the Secretary of State, to keep their questions and answers short so that I can get everyone in.

[Amanda Hack (North West Leicestershire) (Lab)]

Two GP practices have told me that they are waiting for section 106 money to be released so that they can improve their facilities, but that it has been stuck between decision-makers. Will the Secretary of State outline how the changes will help to release those kinds of delays and finally allow North West Leicestershire residents to get the facilities that they deserve?

National Cancer Plan

Caroline Nokes Excerpts

Tuesday 4th February 2025 Commons Chamber

[The Parliamentary Under-Secretary of State for Health and Social Care (Andrew Gwynne)]

With permission, I wish to make a statement on the national cancer plan. Today is World Cancer Day. Almost everyone in our country has been affected by cancer, either themselves or through a friend or relative. Having lost both my parents to cancer, I am so grateful to the Prime Minister for giving me this job. He has given me the chance of a lifetime to do my parents proud by creating the kind of compassionate and humane healthcare that all our constituents deserve.

I am also pleased to be led by a survivor of kidney cancer, my right hon. Friend the Secretary of State for Health and Social Care. His experience as a patient will be invaluable to us in the months ahead. I pay tribute to the amazing cancer charities who do fantastic work to help people live with cancer, support bereaved families and drive vital research in this area—Macmillan, Cancer Research UK, Cancer52 and Marie Curie to name just a few.

Lord Darzi’s investigation set out the scale of the challenges that we face in fixing the NHS, and how desperately we need to improve cancer diagnosis rates, waits and outcomes. He found that

“the UK has substantially higher rates than our European neighbours, Nordic countries, and countries that predominantly speak English”.

There were close to 100,000 more cases of cancer in 2019 than in 2001. While survival rates at one year, five years and 10 years have all improved, the rate of improvement slowed substantially during the 2010s.

Lord Darzi also noted important inequalities in the provision of cancer care; people in the most underserved areas are more likely to present as an emergency. As Cancer Research UK pointed out in its submission to the investigation, the 62-day target for referral to treatment has not been met for almost 10 years. Last May, performance was at just under 66%, with more than 30% of patients waiting longer than 31 days to start radical radiotherapy.

For all those reasons and more, we do not have a second to waste. That is why the Prime Minister kicked off this year with our elective reform plan, setting out how we will cut the longest waiting times from 18 months to 18 weeks. From March next year, around 100,000 more people every year will be told if they have cancer or not within 28 days, and around 17,000 more people will begin treatment within two months of diagnosis. That is why this year, we will spend £70 million on replacing older radiotherapy machines with newer, more efficient models. That is why in the King’s Speech we put forward an improved Tobacco and Vapes Bill, helping to reduce around 80,000 preventable deaths and putting us on track to a smoke-free UK.

While around 40% of cancers are caused by avoidable factors such as smoking, the backdrop is one of an ageing society. Cancer Research UK has forecast half a million cancer cases each year by 2040. We are preparing for the future now, with our 10-year health plan for the NHS. The plan will set out the framework of reforms that we need to ensure better outcomes and to meet the growing challenges that we face in the fight against this dreadful disease. The plan will play to Britain’s strengths as a global leader in the development of advanced therapies, using our strong academic and life sciences industry.

We should remember that the NHS was the first health service in Europe to commission CAR-T cellular therapy for blood cancer patients. On this World Cancer Day, I can announce that we will build on that legacy by investing in a cutting-edge, world-leading trial to transform breast cancer care through artificial intelligence. Nearly 700,000 women will take part in this trial, testing how cutting-edge AI tools can be used to catch breast cancer cases earlier. Thirty testing sites across the country will be enhanced with the latest digital AI technologies, ready to invite women already booked in for routine screenings on the NHS to take part.

The technology will assist radiologists by screening patients to identify changes in breast tissue that show possible signs of cancer, with referral for further investigations if required. If the trial is successful, it has immense potential to free up hundreds of radiologists and other specialists across the country to see more patients, tackle rising cancer rates and save more lives. It is just one example of how British scientists are at the forefront of transforming cancer care, and of the promising potential of cutting-edge innovations to tackle one of the UK’s biggest killers.

This Government know that unless we do things differently, our NHS will remain in the dire state in which we inherited it. That means proper reform, from doing away with burdensome process that holds back frontline staff to handing more power to local leaders so that they can deliver for the communities they know best. It also means embracing new technologies, including AI, to transform the way we deliver care and to improve patient outcomes. Today’s trial is yet more evidence of this Government taking action to bring in the reform that is desperately needed. As the Prime Minister set out last month, our plan for change will put the UK on the front foot, unleashing AI to drive up health services and shift the NHS from analogue to digital, as part of our 10-year plan.

Our 10-year plan will ensure that the NHS is there for our grandchildren and future generations, but we believe that the increasing number of cancer cases and the complexity of cancer care mean that we need a specific approach to cancer. We are determined both to bring down the number of lives cut short by cancer and to ensure that many more people go on to lead a full life after their treatment. That is why I am today announcing a call for evidence for our new national cancer plan that we will publish following the 10-year plan in the second half of this year. We will look at the full range of factors and tools that will allow us to transform outcomes for cancer patients while improving their experiences of treatment and care. We will make the United Kingdom a world leader in cancer survival by fighting the disease on all fronts—through better research, diagnosis, screening, treatment and prevention. However, we cannot do this alone, and that is why we are launching this call for evidence from patients, doctors, nurses, scientists, our key partners and other members of the public on what should be included.

To support that work, we will relaunch the children and young people’s cancer taskforce, co-chaired by the hon. Member for Gosport (Dame Caroline Dinenage) and Professor Darren Hargrave, with Dr Sharna Shanmugavadivel as vice-chair. I’ve put my teeth in—apologies if I pronounced that wrong. The taskforce will bring together the country’s top experts to set out plans to improve treatment, detection and research for cancer in children, which will feed into the plan. At every stage, we will ensure that patient voices are heard. I look forward to updating the House on the progress of the plan, the taskforce and the trial throughout the year.

Many of us on the Government Benches remember with pride the previous Labour Government’s record in the fight against cancer. We introduced landmark legislation to ban smoking in public places, protecting a generation of children from the harms of second-hand smoke, while putting record sums into smoking cessation programmes. At the dawn of the millennium, we launched a national cancer plan, which led to faster cancer diagnosis and treatment times, increased funding for cancer services, equipped the national health service with radiotherapy machines—many of which are still there—and expanded cancer research funding, so that a new generation of scientists could answer the call. What did that plan lead to? Survival rates went up. The number of patients diagnosed and treated on time went up. The number of lives lived well after cancer went up. That was our record in government, and we will do it again. I commend this statement to the House.

[Madam Deputy Speaker (Caroline Nokes)]

I call the shadow Minister.

--- Later in debate ---

[Andrew Gwynne]

I am very grateful to my hon. Friend for her question. Those of us who knew Margaret miss her very much; she was such a towering figure in the Labour party for so many years, and we on the Labour Benches have a lot to thank her—and, indeed, my hon. Friend—for.

My hon. Friend is absolutely right on research. This is one area where, quite frankly, we have not done well enough. We have not made any progress. I know she will continue to champion more research. With our new national cancer plan, I hope that she will be pushing on an open door, because this is one area we absolutely have to do much better in.

[Madam Deputy Speaker (Caroline Nokes)]

I call the Liberal Democrat spokesperson.

[Jess Brown-Fuller (Chichester) (LD)]

Nearly every family has a cancer story, whether it is a personal fight or that of a loved one. A 10-year plan from the Government is a welcome step, as the previous Government broke their promise to implement a 10-year cancer strategy that would have made a real difference to patients. We on the Liberal Democrat Benches are very proud that our cancer campaigner, my hon. Friend the Member for Wokingham (Clive Jones), secured from the Government a commitment to introduce such a plan.

Testing for cancer, diagnosing and starting treatment quickly reduces stress and anxiety. Also, if the cancer is caught early, it is more likely to be treated successfully. Yet the target of 85% of people receiving their diagnosis and starting treatment within 62 days of an urgent referral has not been met since December 2015. In my constituency, one third of cases fall short of that target and 1,000 families lose a loved one every year to this cruel disease.

Lord Darzi’s review laid out very clearly that the UK has appreciably higher cancer mortality rates than other countries and that more than 30% of patients are waiting longer than 31 days for radical radiotherapy. A quarter of England’s 280 radiotherapy machines are now operating beyond their recommended 10-year lifespan, and in some areas, such as West Sussex, there is no access to radiotherapy at all. That is why we welcomed the £70 million investment announced in October to start to replace the older radiotherapy machines.

Will the Minister confirm whether there will be further rounds of funding to keep pace with available radiotherapy technology? Will he look to support those at the mercy of a postcode lottery by ensuring that radiotherapy is available in all areas? What is the expected timeline for reversing the damage done by the previous Government, and when can all patients expect to start their treatment within the 62-day urgent referral target?