National Maternity and Neonatal Investigation
Caroline Nokes Excerpts(3 days ago)
Commons ChamberRead Full debate Read Hansard Text Watch Debate Read Debate Ministerial Extracts
The Secretary of State for Health and Social Care (James Murray)
With permission, Madam Deputy Speaker, I shall make a statement on the national maternity and neonatal investigation.
Less than a week ago, I stood at this Dispatch Box to respond to the report by Donna Ockenden that exposed devastating failings over more than a decade in Nottingham. As many right hon. and hon. Members rightly made clear following my statement, the shocking report into what had happened was far from the first: in 2015 we learnt of the failures at Morecambe Bay; in 2022 we were appalled to hear about what had happened at Shrewsbury and Telford; and that same year the Kirkup inquiry exposed failings in East Kent. There were also other reviews and reports over the years on specific issues related to maternity care, and it is deeply upsetting to recognise that Donna Ockenden is preparing to undertake further reviews into failings in Leeds and Sussex. Despite all the warnings, the NHS is still failing women, babies and their families on a scale that shames our society.
Bereaved and harmed families are hearing once again the unbearably painful and distressing consequences of the opportunities that have been missed to put things right. As I stand here, I think of how they must be feeling. I know from meeting some of the Nottingham families that their unwavering determination is accompanied by a sense of exhaustion—a sense that however many times they have told their stories, however hard they have campaigned for justice and accountability, and however strongly they have fought to stop what happened to them from happening to others, hardly anything has changed. That feeling will be shared by mothers and their families up and down the country who have suffered so appallingly too, and there will be deep sadness and distress as they are forced to relive their trauma. The burden they bear must sit with us all.
That is why my right hon. Friend the Member for Ilford North (Wes Streeting) decided last year to announce a national investigation into maternity and neonatal services. That investigation has been carried out by Baroness Amos, whose report is published today. I put on record my thanks to her and her team for the comprehensive and compassionate way they have carried out their work.
The Amos investigation gathered evidence from more than 10,500 people, with Baroness Amos and her team personally meeting more than 450 affected families. They visited 12 NHS trusts and heard from over 9,000 staff through surveys, site visits and one-to-one discussions. Although they found that many women experience good and safe care, the report paints a bleak picture of failings at every stage for too many: from pregnancy, labour and delivery to the first hours, days and weeks after birth. When I read about those systemic failures, I found them not only shocking and upsetting but devastatingly familiar, because they are explicitly repeated in review after review. Baroness Amos found a system that is fragmented, overly complex and far too slow to learn. It needs to be radically overhauled.
Last week I spoke about the need to avoid having review recommendations accepted but then sitting on a shelf gathering dust. Other hon. Members agreed with the need to break that cycle, so that is what we will do. As I told the House last week, the national maternity and neonatal taskforce, which I chair, will create a comprehensive action plan by the end of this year.
Today’s recommendations from Baroness Amos include a proposal for a modern service framework in line with the 10-year health plan to support system change and drive consistent, quality care. Those recommendations, along with the national-level recommendations from Donna Ockenden, will feed into our plan, which will make sure that women and babies receive safe, compassionate care no matter where they live. But I do not want people to have to wait for the plan to be completed for us to start making progress, so I am also taking immediate measures in response to Baroness Amos’s investigation, which I shall now set out for the House.
In considering Baroness Amos’s recommendations, the words of a Nottingham mother I met ring loudly in my ears. She said that “accountability drives action”, so today I can confirm that, in response to these recommendations, the Government will appoint the first ever maternity and neonatal commissioner. The holder of this new statutory role will have responsibility for driving change across all parts of the NHS, including those who provide, regulate and investigate care. They will co-chair the national taskforce, along with me. They will hold the system to account, and their role will be to champion the voices of women, babies and families; to ensure that those voices are heard within Government when decisions are made and implemented.
Last week I announced that the Government would roll out Martha’s rule, so that women and their families can demand a second opinion if they feel their concerns are being ignored. That meets a key and familiar concern that the Amos investigation pointed to: women not being listened to as a common factor in maternity failings. Because those concerns are too often batted away before women even arrive at hospital, I can today confirm that we will this week publish new national standards for maternity triage, so that care is consistent across the NHS and women’s concerns are recognised, valued and acted upon at every turn. I expect every trust to prioritise the implementation of these standards and I have asked NHS England to make sure that this is the case and to report progress directly to me.
Some of the starkest examples of racism, discrimination and inequality happen in maternity and neonatal settings, as the Amos report laid bare. The result is that the risks are notably higher for some women and babies and, as Baroness Amos points out, this is a critical safety issue. Black babies are still more than twice as likely to be stillborn as white babies, and black women are almost three times more likely to die during pregnancy or shortly after birth than white women. While tackling inequalities will be a core component of the national action plan, we will make a start straightaway by rapidly expanding the roll-out of the perinatal equity and antidiscrimination programme to every trust. All teams will be mandated to receive hands-on support, to hear first-hand experience, and to undertake face-to-face learning and development programmes. Every trust will have completed the programme by the end of next year.
Births that are safe for mothers and babies depend on health services having skilled, trained midwives. As Baroness Amos rightly identified, staff shortages can have a dangerous impact, with examples of some services being forced to delay admissions when they get too busy. Since coming to office, we have recruited 2,000 more midwives, and last year our graduate guarantee gave 850 more newly qualified midwives an immediate route into the profession. I can tell the House today that we have now created a further 1,000 temporary roles to help newly qualified midwives join the NHS. These new posts will be accompanied by investment, too, and I can confirm that we are investing an extra £41 million, on top of the £145 million already invested, to upgrade outdated and rundown maternity and neonatal facilities.
Alongside these practical measures comes a far more profound challenge that we must face. It is clear from my conversations with affected families, with Donna Ockenden and with Baroness Amos, and from the findings of all the reports, that culture is where so much of the responsibility lies. That culture is the most deep-rooted cause of the failures we have seen, and the most fundamental thing we must change. We know that when families have been in distress and looking for answers, they were too often ignored, sneered at, disbelieved, blamed and lied to. We know from review after review that wrongdoing is covered up and that bullying towards staff who try to sound the alarm is rife, so we will dismantle toxic dynamics, boost staff morale and support better teamwork between midwives, doctors and other clinicians.
We need not only the right policies, procedures and processes to be in place, but a fundamental reset in the culture of a service that too often puts the desire to protect itself above its duty to protect women and babies. That culture change must come from the top. It is time for trust leaders, executives and senior clinicians to pay attention to what is happening on their watch, to put professional tribalism aside, to lose the bunker mentality when things go wrong and to ensure that the safety of women and babies always comes first.
This has to be a watershed moment. We must break the cycle of recommendations sitting on a shelf gathering dust. We cannot go on having review after review while women and babies, as well as their fathers and other family members, continue needlessly to suffer injury, death and lasting trauma. We should all feel a responsibility to ensure that this opportunity is not squandered. We owe nothing less to every family the NHS has failed in the past, and to every family who will rely on it in the future. I commend this statement to the House.
Several hon. Members rose—
Madam Deputy Speaker (Caroline Nokes)
Order. Before I call the next Member, I wish to say three things. First, the Secretary of State for Defence will commence his statement at 2.30, so time is limited; Members may help each other if they ask short questions. Until then, the Macmillan Room in Portcullis House and Committee Room 7 are available as reading rooms for the defence investment plan. The plan will be made available from the moment that the Secretary of State for Defence begins his statement at 2.30.
Wes Streeting (Ilford North) (Lab)
May I add my thanks to Baroness Amos? I join the Secretary of State in emphasising the importance of culture change, but culture change will not happen without accountability. In all the conversations I had with families who were suffering bereavement, harm to themselves or harm to their children, what shocked me most was the cover-up culture in the NHS, which persists to this day, and was exposed once again by Donna Ockenden in her report last week.
There is a legitimate debate to be had about whether we continue with place-based inquiries or have a national statutory public inquiry, and we must have that debate. But whatever the answer to that question, any report will be worth the paper it is written on only if all those involved in decision making and care are held to account through a duty of candour. Given that, where is the Hillsborough law? The law is important not just for justice for the 97, but for justice for these families and in preventing future harms. Will it at least go through this House before the summer recess? Until it is on the books, people will continue to duck the real questions.
James Murray
I thank my right hon. Friend for his comments, and again put on record my thanks and tribute to him for having initiated the investigation that Baroness Amos published today. He has been a committed champion of change in maternity services in this country.
I could not agree with my right hon. Friend more about the importance of accountability in culture change. Without accountability, we will not have culture change across maternity services, and the culture of cover-ups will continue. Senior clinicians will feel that they can continue to get away with any mistakes. They will feel that they can avoid scrutiny when investigations take place, and will continue, in too many cases, to be more concerned with protecting themselves than with protecting women and babies.
On what we can do to change that culture, culture is deep-rooted and requires us to take a number of different actions, but the duty of candour is the single most powerful change we can make clearly, loudly and publicly, because the message it will send to senior clinicians thinking about what to do in the future if they make a mistake, or if they are tempted to cover up things that go wrong, is that one day they will be held to account, and there is no avoiding that. With a duty of candour in place, there will no longer be an opportunity for clinicians, in particular senior clinicians, to refuse to engage in that process, to refuse to be held to account and be part of the justice process. People will face up to two years in prison if they refuse to co-operate, so it is a serious measure. I very much agree with him on the importance of ensuring that the Hillsborough law gets on the statute book so that this duty of candour can apply to future maternity investigations.
Helen Morgan (North Shropshire) (LD)
May I also add my thanks to the Secretary of State, to Baroness Amos and her team, and to the families that have relived the pain of their experiences to bring about this report? But the Amos report tells us little that we did not already know—indeed, it confirms our worst fears. Maternity services in England are fundamentally broken with the cost of political neglect being paid in trauma, injury and lost lives. Figures revealed by the Liberal Democrats in the last week show that the first quarter of 2026 saw the worst rate ever recorded for maternity injuries. In fact, while the number of reviews into NHS maternity services has steadily ticked up, we have also seen rising maternal mortality rates.
Four years ago, I spoke in this Chamber in response to the findings of the Shrewsbury and Telford review, which were devastating for my community. Last week, I stood here really distressed, actually, as we heard further traumatic reports from the Nottingham review. But anger is not enough. The Government must meet this moment now and implement Baroness Amos’s recommendations in full and without delay, or the families simply will not forgive them. To do this, we need genuine accountability through the NHS and the Department of Health and Social Care, accompanied with the investment needed to make Britain the safest country in the world to have a baby.
I welcome the Government’s commitment to a national maternity commissioner—a long-standing Liberal Democrat campaign—and the other urgent and immediate actions that the Secretary of State has outlined in the last week. They are all urgent and are signs that this is being taken seriously. But we need to recognise that a commissioner alone cannot fix the broken system. I urge the Secretary of State to work with us and look at our maternity rescue package for inspiration for his action plan—it has a great degree of overlap with Baroness Amos’s recommendations. Our package would ensure one-to-one midwifery care for every woman in labour, additional senior midwives, an obstetrician on every ward, and mandatory updated annual training. Will the Government commit here and now to implementing all those recommendations and working with us to deliver the change we need?
James Murray
I thank the hon. Lady for her comments, and she puts it well when she talks about Baroness Amos’s investigation confirming our worst fears. I was shocked but not surprised, sadly, to read the investigation report. It was devastatingly familiar to read what it set out as being the failings across the country. The report’s recommendations will now become part of the work of the taskforce, which I chair, to produce the comprehensive action plan by the end of this year. My intention is that the taskforce will take all the national recommendations from Baroness Amos’s report, as well as the national-level recommendations from Donna Ockenden’s report last week and recommendations from any other investigations and reports, and ensure that the action plan it produces comprehensively addresses all the issues raised. I think that we would all agree that there is not—one, two, three—a small number of actions that we need to take; this has to be a comprehensive plan to truly transform the service.
Ms Diane Abbott (Hackney North and Stoke Newington) (Ind)
The Secretary of State will know that many women are never more vulnerable than in childbirth. It is about not just the vulnerability, but the horror of what women and their babies are exposed to in childbirth. We see inquiry after inquiry, and nothing seems to improve. Very many of those who suffer during childbirth are black women and their babies. The Secretary of State said himself that
“Black babies are still more than twice as likely to be stillborn than white babies, and black women are almost three times more likely to die during pregnancy or shortly after birth than white women.”
The whole House wants to see progress, but it is not enough to have another inquiry or another report; what black women want is equity of treatment and fewer black women and their babies dying.
James Murray
My hon. Friend draws out an important point: a key part of developing the national action plan is to ensure we have the right metrics and mechanisms for monitoring its implementation and the right structures in place to make sure it is implemented across all trusts. In working with members of the taskforce, I will ensure that those accountability mechanisms for the delivery of the plan are in place, because I have spoken many times today about the importance of recommendations not sitting on shelves. We need to ensure we have the structures in place such that the actions in the national action plan are implemented, we can see they are being implemented, and we can give people confidence that that is the case.
Madam Deputy Speaker (Caroline Nokes)
I call the Chair of the Health and Social Care Committee.
Layla Moran (Oxford West and Abingdon) (LD)
I, too, thank Baroness Amos, her team and, most especially, the families who so bravely gave the evidence that has formed this report. Further to the conversation about accountability, the Secretary of State will have noticed that some families are concerned that the commissioner is just one person, and that there is too much for them to do. Can he make clear that the buck stops with him and, indeed, the PM, and that he will not let go of this? The commissioner will report every six months to the Health and Social Care Committee—we welcome that—and once a year to Parliament. Further to that, will he personally commit that the Secretary of State will seek permission from Mr Speaker to make a statement to the House once a year, so that they can be held personally accountable for the progress made too?
James Murray
I will take away the right hon. Gentleman’s suggestion and think on it, because it is critical that we have accountability. As I said in response to earlier questions, I find the decision of senior clinicians not to take part in the Nottingham inquiry utterly unacceptable, and incomprehensible on a personal level. We must ensure that that never happens again.
Ben Coleman (Chelsea and Fulham) (Lab)
I am not a doctor, but thank you so much, Madam Deputy Speaker. Perhaps I am a doctor from the university of life—who knows?
I pay tribute to Baroness Amos for this excellent report, and to my right hon. Friend the Member for Ilford North (Wes Streeting) for commissioning it. It is a remarkable piece of work. It follows on from Ockenden, and the report on black maternal health done by my Health and Social Care Committee—its Chair, the hon. Member for Oxford West and Abingdon (Layla Moran), sits on the Opposition Benches. We see the same problems again and again: misogyny, racism and a lack of accountability. I am therefore delighted that this plan will be developed in six months, through the taskforce, and that we will have a maternity commissioner. I know that my constituent Louise Thompson, who has been campaigning hard for this position to be created, will be delighted. However, like me, I think she will have a question about timing. Will it be possible for the commissioner, who will be introduced on a statutory basis, to be brought in quickly enough for them to have a full role in shaping and creating the plan that will be before us in six months? If not, why not?
Department of Health and Social Care
Caroline Nokes Excerpts(3 days ago)
Commons ChamberRead Full debate Read Hansard Text Read Debate Ministerial Extracts
Madam Deputy Speaker (Caroline Nokes)
The debate will be opened by the Chair of the Health and Social Care Committee. Before I call her, I wish to alert Members that the same time limit of three minutes will be imposed in this debate, and I am sure the Chair of the Select Committee will be cognisant of that during her opening remarks. I call Layla Moran.
Puberty Blockers
Caroline Nokes Excerpts(1 week, 3 days ago)
Commons ChamberRead Full debate Read Hansard Text Read Debate Ministerial Extracts
Madam Deputy Speaker (Caroline Nokes)
I inform the House that Mr Speaker has not selected the amendment. I call the Opposition spokesperson.
James Murray
The MHRA has introduced additional safeguards. As a result of its dialogue with the trial sponsors, the amended protocol published last week increases the level of safeguards. That means that if the regular monitoring, which will happen at least every three months—it can be more regular during the trial—shows any sign of increased risk of harm, that will lead to increased monitoring, clinical review and, when considered against objective criteria, automatic withdrawal from the trial.
It is a question of monitoring this trial, possibly more closely than any trial before—the level of scrutiny is very great indeed—to ensure that at the first sign of any increased risk of harm, action will be taken. That is the assurance that I have sought in interrogating this matter carefully in recent days, and that is the basis on which I am talking to the right hon. Gentleman and others in the House today.
We must come to a fair and settled conclusion on this matter to move forward as a country, and I believe that we should follow clinical advice and establish the clinical evidence gathered in a highly scrutinised trial with all the safeguards in place that I have described. Only that approach will give us the confidence about where we settle on this matter in the future. On that basis, the Government oppose this motion.
Alison Bennett
I will not.
We must never lose sight of the fact that at the core of the debate is young people’s wellbeing and health. It is not about ideology; it is about what is best for young people. The Government must always prioritise clinical evidence and put the interests of patients at the heart of care.
Pathways Study: Puberty Suppression
Caroline Nokes Excerpts(1 week, 4 days ago)
Commons ChamberRead Full debate Read Hansard Text Watch Debate Read Debate Ministerial Extracts
James Murray
As my hon. Friend will know, the recommendations in Dr Hilary Cass’s review set out how to establish better services for young people in the future. The focus of today’s statement, the clinical trial, is just one part of the wider work on how best to support young people who need extra support in this situation. It was welcome that there had been, at least until recently, a cross-party consensus that Dr Cass was finding the right way through this difficult matter.
Helen Morgan (North Shropshire) (LD)
I thank the Secretary of State for advance sight of his statement. The Liberal Democrats have long highlighted the need for better access to specialist healthcare for children and young people struggling with gender identity. The closure of the Tavistock clinic and its inadequate rating by the Care Quality Commission demonstrated that urgent change was needed. Young people struggling with gender identity face serious challenges. They have been badly let down for years by low care standards and extremely long waiting lists. On top of that, they have to contend with a toxic public debate, which comes at a huge cost to their wellbeing at a particularly vulnerable stage in their life. The average three-year wait for a young person to see a specialist can be extremely harmful at such a vulnerable age.
We agree that treatment should first be based on talking therapies, so that patients are given the space and support that they need, but it is crucial that young people can start those therapies as a matter of urgency, not after years of delay. Decisions about these young patients’ futures should be made in an informed way, with expert clinicians and based on the best possible evidence, which the NHS must build up safely and effectively. We support prioritising clinical evidence, so that patients’ interests are put at the heart of decision making in all areas of healthcare. Guidance and decisions around puberty blockers must be led by experts and clinical evidence, and not influenced by ideological opinion. That is why we supported the decision of the former Secretary of State, the right hon. Member for Ilford North (Wes Streeting), to pause the Pathways clinical trial while concerns raised by the MHRA were thoroughly addressed. Will the Secretary of State confirm whether the MHRA has confirmed that the concerns that led to the withdrawal of the trial have been substantially addressed, and how many children are expected to take part in the trial now that its parameters have been altered?
James Murray
I absolutely agree with my hon. Friend about the importance of following clinical evidence and taking a clinically led and evidence-based approach to this decision. As I said, I have felt uncomfortable and uneasy about some of the challenges raised by this matter, but for me, the right way to move forward is to follow the clinical advice, and to base future decisions on clinical evidence, given that I have received the most robust assurances about the safeguards that are in place to protect young people involved in this trial from harm.
Madam Deputy Speaker (Caroline Nokes)
I call the Chair of the Health and Social Care Committee.
Layla Moran (Oxford West and Abingdon) (LD)
I welcome the statement and this approach. I thank the MHRA for engaging with the Committee when we asked it specific questions about this. It told us that the role of the regulator is to ensure that participants in any clinical trial are kept safe and are exposed to medicine only if there is a reasonable expectation of a positive effect, and that is what was foremost in its mind. It also reassured us that if it had not felt 100% assured, it would have not allowed the trial to go forward.
There was a lot of disquiet about the iterative process that the trial has gone through—that it was stopped, paused and then started again. Could the Secretary of State outline for the House how usual or unusual that is? What support can the NHS offer those families who might have hoped to be part of the trail but now find themselves excluded from it?
Jonathan Hinder (Pendle and Clitheroe) (Lab)
The Secretary of State has repeatedly told us that he feels uncomfortable and uneasy. If I am totally honest, I do not think that he believes that this is right at all. I think that in his heart, he knows that this is wrong. Of course it is wrong: stopping an 11-year-old—a primary school child—from going through the natural process that we must all go through to become adults by injecting them with drugs is wrong. We must think about the title of the statement: puberty suppression. People do not need a medical or a science degree to know that the suppression of puberty is wrong. This is a moral question and I am afraid that as it stands the Secretary of State is on the wrong side of it. He says “let them be”—if only they had let Keira Bell be. When she had the treatment, Keira Bell was much older than these children will be when they are given it. She regrets it all and now campaigns to stop this. There is huge public opposition to this—
Madam Deputy Speaker (Caroline Nokes)
Order. I assume the hon. Gentleman is getting to a question.
Jonathan Hinder
There is huge opposition to this among people who vote Labour, including many of my constituents, so I implore—
Madam Deputy Speaker
Order. The hon. Gentleman’s question is far too long. I call the Secretary of State.
James Murray
Despite our different conclusions on this matter, I respect my hon. Friend. Part of taking decisions as Health Secretary involves sometimes approaching issues where one might feel uncomfortable on a personal level, but none the less being guided by the right principles in order to take decisions for other groups of people in the country and for the country as a whole. I am not in any way disputing how difficult a matter this is; it is one where I, as Health Secretary—and my predecessors—have had to carefully consider how we ensure that the clinical basis for any future decisions is robust and that we can point to it as a foundation for where this matter settles.
Before Dr Cass did her review, the situation at the Tavistock clinic was totally unacceptable, as the right hon. Member for South Holland and The Deepings (Sir John Hayes) recognised, and we must never go back to a position where the situation is out of control in the way that it was then. In working out how to move forward, I believe that, as uncomfortable as it may make myself and others on an individual basis, focusing on the principle of following clinical evidence, demanding the highest possible safeguards and protections for the children involved, and setting objective criteria for them to be withdrawn or for action to be taken if the risk of harm increases, is the balanced and correct way to proceed.
Health Bill
Caroline Nokes ExcerptsMonday 1st June 2026
(1 month ago)
Commons ChamberRead Full debate Health Bill 2026-27 View all Health Bill 2026-27 Debates Read Hansard Text Read Debate Ministerial Extracts
Madam Deputy Speaker (Caroline Nokes)
Mr Speaker has not selected the reasoned amendment.
Allied Health Professionals
Caroline Nokes Excerpts(2 months, 1 week ago)
Commons ChamberRead Full debate Read Hansard Text Watch Debate Read Debate Ministerial Extracts
Joy Morrissey (Beaconsfield) (Con)
On a point of order, Madam Deputy Speaker. The Government placed a written ministerial statement on today’s Order Paper to update the House on the much-troubled Ajax armoured fighting vehicle programme. However, the media have reported within the last two hours that, according to urgent briefing from the Ministry of Defence, the statement will now be delayed until later next week due to the need to seek further interdepartmental approval across Whitehall. Given that the strategic defence review was published months late, the defence investment plan, including vital new equipment programmes, is still unpublished nine months on, and now the MOD is putting out WMSs on the Order Paper and then refusing to publish them, the Department is clearly in a state of chaos. Can you advise me on how we can force the MOD to clarify this utterly confusing situation later today, or on Monday at the very latest?
Madam Deputy Speaker (Caroline Nokes)
I thank the hon. Member for giving notice of her point of order. This House is entitled to expect that when a written statement is to be delivered to the House, it will be done promptly on the day the Government have given notice that it will be made. Those on the Government Front Bench will have heard her point of order, and may wish to verify what is happening about the written statement. The hon. Member may wish to take advice from the Table Office on the steps that she can take to obtain clarity on the substance of the matter.
Women’s Health Strategy
Caroline Nokes Excerpts(2 months, 2 weeks ago)
Commons ChamberRead Full debate Read Hansard Text Watch Debate Read Debate Ministerial Extracts
The Minister for Secondary Care (Karin Smyth)
With permission, I will make a statement on the Government’s renewed women’s health strategy.
The NHS was founded on the principle of equality and the right care for everyone, whenever they need it, but there is no getting away from the fact that it has failed to live up to that founding promise. For too long, women have been left to navigate a confusing system, fighting to get the basic care they deserve, and under-represented in health research. Above all, women’s voices and choices have been dismissed, and it is truly shocking how often women have been ignored when telling medical professionals about their pain. From pelvic mesh to endometriosis, we are expected to put up with pain as our lot in life, as if it were normal. But it is not normal, and since coming into office this Government have taken a number of measures to improve women’s health.
We have taken action to bring down gynaecology waiting lists, introduced menopause questions into routine health checks, made the morning-after pill available for free at high street pharmacies, stood up a rapid and independent investigation into maternity services, and introduced Jess’s rule, so that GP teams have to “reflect, review and rethink” if a patient presents three times with the same or escalating symptoms.
The blunt reality is that the NHS is failing women and girls on even the most basic measures of healthcare. Indeed, we do not treat all women equally either. The wealthiest 10% of women live almost 10 years longer than the poorest 10%, while the most deprived spend over a third of their lives in bad health—something I see starkly in my constituency of Bristol South. Disabled women experience poorer outcomes, and we should recognise the additional disadvantage faced by black and Asian women, who face the double discrimination of racism and misogyny all at once.
Our renewed women’s health strategy will address those and other glaring injustices. It will give women and girls faster care from a health system that actually listens. It will make it simpler and faster for them to access the care they need the first time they ask for it, and it will make sure that the latest innovations work for women, ranging from reproductive and maternal health to menopause and chronic conditions. Of course, every day women are receiving outstanding, compassionate care from our dedicated NHS staff, but being ignored, gaslit, humiliated and disrespected are all-too-common experiences for far too many. More than eight women in 10 say there have been times when healthcare professionals did not listen to them. Our mission is to dismantle the culture and ingrained behaviours that allow that medical misogyny to fester and grow, and that starts by listening to women.
Women’s voices and choices are the golden thread that runs through this renewed strategy. Their voices will be heard, as we work to reduce variation in how GPs listen to and respond to women, using patient survey data in a quality improvement programme. Their voices will be heard as we capture whether women have been treated with respect, kept informed, and involved in decisions about their own care. Their voices will be heard, as we co-develop new standards of care for procedures such as hysteroscopy, so that every woman has informed consent and a real choice over her pain relief.
Yesterday, my right hon. Friend the Secretary of State announced that we will do the first trial of a scheme known as patient power payments, which will cover gynaecology services. Women will get a say on whether the NHS provider should get full payment for the services women receive, based on the quality of their experience. It means that if a woman is not happy with her experience, a portion of the tariff paid to that provider would be redirected to fund improvements in the same services instead. In other words, women will have the power to kick medical misogyny where it hurts: in the budget.
All this is building on the evidence and expertise that informed the original strategy. I wish to acknowledge the intended ambition of that work, not least because it was based on the contributions of thousands of women. However, the changes that were promised have not translated into consistent improvements in access, quality of care or outcomes. Take gynaecology services. The waiting list for gynae care was north of 600,000 when we took office. Today that figure is finally moving in the right direction, but we cannot make as much progress as we would like because the system simply was not designed with women in mind.
I pay tribute to Baroness Merron, who has led this work on behalf of the Government. As she made clear in her foreword, this system was not designed in such a way—to be fair to Nye Bevan, in 1948 he was largely thinking about working men who were dying early in their sixties from the awful consequences of poor work, with some support for maternity services. We need to change that. We will support integrated care boards to introduce a single point of access for all non-urgent referrals to gynaecology and women’s health services, to speed up access. We will redesign the most common clinical pathways for heavy periods, menopause and urogynaecology, to remove unnecessary delays. Women with fibroids and endometriosis will be listened to at first presentation. They will be seen faster, and offered clear information through our new virtual hospital, NHS Online.
Women’s health pathways are being prioritised in NHS Online, and menopause and menstrual health services will be among the first to go live when it becomes operational this year. There will be a relentless focus on reducing women’s pain, improving standards, and reducing variation in both procedural and chronic pain management, including for chronic pelvic pain. We will launch a new programme to help young girls grow up understanding their menstrual health and know when to seek help.
From gynaecology to pain relief, our renewed strategy takes forward the work of the previous Government, and goes further and faster to fill the holes they left. It has only been made possible by the record £26 billion in funding for the NHS that was secured by my right hon. Friend the Chancellor, the first woman to hold that office. All that will be underpinned by an NHS that finally listens with respect, dignity and compassion to the voices and choices of every woman and every girl, every time. That is not least with the creation of the women’s voices partnership, which is a new space for organisations representing women, giving them a direct line to Whitehall to inform national decision-making. The partnership will have a particular focus on those women who are most excluded from traditional services, and through it we will ensure that women’s voices help to shape the long-term direction of NHS reform.
Unlike the original strategy that was based on an outdated model of care, this renewed strategy maps across the three shifts in our 10-year plan for health. The shift from sickness to prevention will mean that women can better understand and act on their risk of conditions such as breast cancer and diabetes. The shift from hospital to community will mean services designed around women’s lives, with much faster access to diagnosis and treatment. The shift from analogue to digital will mean that women will avoid long waiting lists for painful conditions through NHS Online. Within two years we will launch a new challenge fund, backing the most promising women’s health technology start-ups, with a focus on tackling health inequalities in community settings. We are embedding new sex and gender policies into studies through the National Institute for Health and Care Research, so that findings are genuinely representative and no woman is left behind by science.
As every woman hearing this statement knows, to fully exercise power over our lives we need to be at the top of our game, both mentally and physically. We also know that women’s health has been neglected for too long. It therefore falls to this Government to restore the founding promise of our national health service, and to deliver the right care for everyone when they need it. From the classroom to the clinic, our renewed women’s health strategy promises a fairer, healthier future for women and girls everywhere, acting on women’s voices and choices, transforming NHS performance in services that matter most to women, supporting all women to live healthier lives, and creating an approach to research and development that works for and empowers women. We are designing the system to fit around women’s lives. This will not be a strategy that sits around gathering dust on a shelf, because women are counting on us, and we will not let them down.
Karin Smyth
My hon. Friend is a fantastic champion in this area. We are so pleased to have her clinical experience and no day goes past without her representing her own speciality of physiotherapy and AHPs more generally. She is absolutely right that those professionals have led the way in looking at women’s care and it is important that women feel confident with that physiotherapy advice. I think that she will be pleased to see the developments that will come from the women’s health strategy and those that will come when we bring forward our workforce plan, which will have AHPs front and centre working in women’s neighbourhood healthcare.
Dr Danny Chambers (Winchester) (LD)
The Liberal Democrats welcome the strategy, and its specific recognition of the socioeconomic and racial disparities in women’s healthcare, which it is important to put front and centre. We also appreciate the specific recognition of endometriosis and similar conditions. My partner, Emma, suffers from endometriosis, and on many occasions I have seen her unable to stand up or barely get off the sofa, having been told for years that her symptoms are completely normal and that there is nothing wrong with her. Given that at least one in 10 women suffer from endometriosis and there are over 500,000 people on gynaecology waiting lists, clearly her experience is not unique.
The picture around maternity safety is deeply troubling. Maternal mortality has increased by over 20% in the past 15 years, and there have recently been some high-profile media discussions about women and babies being let down, sometimes with devastating consequences. That is why the Liberal Democrats have been calling for one-to-one midwifery care and specialist doctors on every unit.
I welcome the Government’s specific commitment on treatments for morning sickness. My hon. Friend the Member for Lewes (James MacCleary) has campaigned on that issue for a long time, and it is right that we end the postcode lottery for these medicines. The condition can be debilitating for some people, and it is not fair that women have different experiences simply because of where they live.
Given that this is not the first women’s health strategy to be brought to this place—the previous Government brought one through in 2022—and the fact that many women we speak to do not feel that there has been any meaningful change, a lot of people are saying that we cannot just keep announcing strategies while women are waiting for basic care. Given the failure of the last Government to deliver meaningful change, can we have reassurances that this will not simply be another strategy announcement and that women will feel a difference in the care that they receive?
Resident Doctors: Industrial Action
Caroline Nokes Excerpts(3 months, 1 week ago)
Commons ChamberRead Full debate Read Hansard Text Watch Debate Read Debate Ministerial Extracts
The Secretary of State for Health and Social Care (Wes Streeting)
With permission, Madam Deputy Speaker, I will make a statement on the proposed industrial action by resident doctors.
Yesterday evening, the British Medical Association called its latest round of strikes for 7 to 13 April, immediately following the long Easter bank holiday weekend. The announcement came just hours after its resident doctors committee rejected an historic deal that would have boosted pay, created jobs, improved career prospects and put money back in the pockets of its members. This was deeply disappointing after months of highly constructive and good-natured talks between the Government and the leadership of the RDC. In that context, the fact that the BMA’s immediate response was to call such extensive strike action, rather than return to the table, speaks volumes about what we are up against.
I will set out how we have reached this regrettable position. Since the start of this year, the Government have been holding extensive and intensive discussions with the BMA resident doctors committee leadership, who engaged in good faith. I have spoken personally to or met with the chair several times, and those engagements were, of course, on top of the near-daily dialogue that his team held with officials from my Department.
Together, we got further than many thought possible. As a result of our discussions, a landmark deal was put formally to the full resident doctors committee on 22 March. Based on our engagement with the BMA officers, we were optimistic that it would be received positively, although I was aware of the officers’ preference that it should be a deal over two years rather than three years, and that they had expected the independent recommendation of the Review Body on Doctors’ and Dentists’ Remuneration—the DDRB—to come out slightly higher than it did. Regrettably, despite the deal having been designed with and supported by the BMA leadership, the committee itself rejected it yesterday.
I will run through what the RDC has unilaterally rejected on behalf of the 81,337 resident doctors in this country. The headlines of the deal are: reform of the pay structure, so resident doctors would benefit from more frequent pay rises at each stage of their training; pay rises over three years baked in, linked to the independent DDRB recommendations, as requested by the BMA; and reimbursement of Royal College exam fees from April this year, which resident doctors currently pay out of pocket. They can be as much as £2,200 for psychiatry, £2,300 for paediatrics and £3,700 for ophthalmology. Other headlines are: contract reform for locally employed doctors to ensure they also benefit from greater job security, equal opportunities for pay progression, and improved terms and conditions; and up to 4,500 more specialty training places created over the next three years, including 1,000 for this year’s applicants.
Alongside the deal, the Government have just passed the Medical Training (Prioritisation) Act 2026, so that domestically trained resident doctors no longer compete on equal terms with overseas graduates for specialist jobs. The Act will reduce the competition ratio for jobs from almost 4:1 to almost 2:1. The deal also follows the 28.9% pay rise already delivered by the Government.
As a result of the proposed package, resident doctors would have seen an average pay rise of 4.9% this year; starting pay for new graduates entering the profession this year would have been nearly £12,000 higher than four years ago; the lowest-paid foundation year ones and foundation year twos would have seen a pay boost of at least 6.2% and 7.1%, respectively, this year; and there would have been 1,000 more resident doctor jobs in a matter of days from this April.
Along with pay decisions that I have already taken, the package would have meant that, this year alone, resident doctors would have been, on average, 35.2% better off than four years ago. There are not many, if any, professions in our country for which that is true. The DDRB recommendation is 3.5%, which is significantly less than what is on offer as a result of pay structure reform.
The BMA has pointed to the war in Iran as reason to reject the deal. I will spell out the consequences of what this country is facing. The Government want to see de-escalation and a swift resolution to the conflict, with a negotiated agreement that puts tough conditions on Iran, specifically in relation to its nuclear ambitions. However, we are planning on the basis of a prolonged conflict, because that is the prudent thing to do. In that eventuality, there would be an impact on the economy and on the public finances. Were that to happen, a future offer to resident doctors would not look better than what is on offer today.
The Government’s tolerance for costly and disruptive action that undermines a critical public service is fast diminishing. In three years’ time, I do not want resident doctors to look back on this moment with regret as they turn down three years of guaranteed pay rises, more money in their pockets through reimbursement of exam fees, and more jobs. The BMA is choosing more strikes. As a direct result of its decision, and despite our best efforts, resident doctors will be worse off. Indeed, on the very day that 1,000 more specialty training places would have opened up for resident doctors with this deal, the BMA will be on strike, demanding more job opportunities.
Let me turn to the impact on patients and the NHS. Yesterday, the British social attitudes survey revealed that patient satisfaction has increased for the first time since before the covid pandemic. Dissatisfaction has seen the sharpest decline since 1998. Patient satisfaction with access to GPs has gone from 60% when this Government came to office to more than 75% today. Wating lists are the lowest they have been for three years, four-hour performance in A&E is the best for four years, and ambulances are arriving faster than they have for half a decade. All of this has been achieved despite the BMA’s strikes, so I want to reassure patients that the NHS’s recovery will continue.
In the most recent round of strikes, the NHS team pulled together and delivered 95% of planned elective activity. I am confident that we will see the same outstanding efforts if further action is taken. But to the BMA, I say: we can achieve so much more, and the improvements can be so much faster, if you take this deal and stop your strikes. Strikes have a significant financial cost. Every penny spent on keeping the show on the road during strikes is a penny that cannot be spent on improving staff pay and working conditions or better care for patients. The impact on the other staff working in the NHS, who are left to pick up the pieces, is severely felt.
So I am asking the BMA’s resident doctors committee to reconsider. I will meet again with its officers. I also repeat my offer to meet with the entire committee, who have thus far refused to meet me since I became Secretary of State. Indeed, they are the only group of people I have offered to meet who have declined, which I find extraordinary in these circumstances. The deal on the table shows what we can achieve when we work together. In contrast to my predecessors, I have shown good intent from the outset. I have listened to the complaints that resident doctors have about their working lives—I agree with them, and I want to work with them to improve their working conditions as we improve the NHS.
But when it comes to making a deal, the reality is that it takes two to tango. The BMA has until next Thursday to reconsider before we have to call time on the extra jobs, and the focus of the NHS and my Department turns to minimising the disruption from this unnecessary and unwarranted strike action, which would also consume the money set aside for this deal. But there will be a cost to the NHS, to staff and to patients. This was an historic opportunity, developed in tandem with the BMA leadership. I urge the committee to reconsider. I urge the BMA to call off its industrial action. I commend this statement to the House.
Wes Streeting
I thank my hon. Friend for his support in trying to influence a more constructive approach, for the advice that he has given me and members of the resident doctors committee, and for the experience that he brings to these exchanges. He is right to praise Jack Fletcher for the constructive approach that he and his officers have taken. It has not been easy, but I know that officials have enjoyed the constructive engagement, and I thank enormously the officials who have worked tirelessly on this. I think all those involved in the discussions, on both sides of the table, are disappointed by the outcome, and that is why I urge the BMA to seize the offer before it is too late.
My hon. Friend talks about other changes, such as to placements and rotations. I think that BMA officers recognise my desire to not only do this deal, but to create a new business as usual with the BMA, where we have people around the table on a regular basis looking at what we can do to improve the health service for patients and staff and to make real progress on those issues. We cannot do that if we are in conflict. That is the tragedy of the position we find ourselves in. I think we have built trust through engagement and dialogue with the BMA committee officers. It is only disappointing that members of the committee are not prepared to get around the same table as me, because if they did, they might realise the sincerity and the opportunity.
Helen Morgan (North Shropshire) (LD)
People across the country will be extremely concerned about the prospect of further strikes, having faced so much disruption already in recent years. It is important to recognise that the strike is a symptom of an NHS still coming to terms with the damage caused by the previous Conservative Government. Doctors are burnt out from working in high-pressure environments under poor conditions—often trying to save lives on corridors with no space or privacy. However, we all know how difficult public finances are, and that is now being compounded by Donald Trump’s reckless war in the middle east. Therefore, a further 26% pay rise is not affordable or realistic at the moment, and it is time the BMA recognised that.
There is much more the Government could be doing to support both staff and patients. The BMA has a mandate to strike until August, yet patients struggle to get GP appointments and suffer months of pain while stuck on waiting lists. How will the Secretary of State stop the situation dragging on throughout the year and causing yet more harm to patients?
We must also show staff and patients that things will get better. Lib Dem plans to recruit and retain more GPs, offer one-to-one midwife care and fix the social care crisis would offer the NHS the hope that is needed by easing pressure on staff and patients. Will the Secretary of State consider fixing crumbling hospitals as a priority, to give staff and patients the working conditions and dignity that they need and deserve?
At Shropshire’s major hospitals, it is common to see ambulances queuing up outside, unable to offload their patients, while staff inside are struggling to cope with patients in corridors. Will the Secretary of State commit to ending the misery of corridor care by the end of this Parliament? I welcome his intention to build additional training places, but will he outline a timetable for publication of the workforce plan, because that is critical for the future of our NHS?
Wes Streeting
It is frankly breathtaking hypocrisy. It rather looks like doctors in their ivory tower saying one thing, and lecturing us about what is and is not affordable, but when it comes to how their subs are spent and how their own union behaves towards its own staff, not being prepared to pay them. I have been very complimentary about the officers who have been engaged with Ministers and my officials in recent weeks to try to get this deal over the line; so have BMA staff. I am stunned by the BMA’s unwillingness to practise what it preaches. I will not be joining resident doctors on the picket line. I should have declared, Madam Deputy Speaker, that I am GMB member, so if there is one picket line that I will be visiting during the doctors’ strikes, it may well be that one.
Madam Deputy Speaker (Caroline Nokes)
I call the Chair of the Health and Social Care Committee.
Layla Moran (Oxford West and Abingdon) (LD)
This is clearly the wrong move again. It is really stark; we keep hearing from patients across the country about how much they want the NHS to improve, but this is another blow to them, and they may even wonder if it is safe to go into their local hospital during the strike period.
I am grateful to the Secretary of State for coming to the Committee and talking about corridor care. The really interesting thing about that session was that the hospitals that have turned things around did so because of leadership from the top. Their executives and board members were going into hospitals out of hours and on weekends to speak with resident doctors, nurses and patients, to see what things were like on the ground. When was the last time the Secretary of State did that? This is not a “gotcha” moment—I have not done that recently, but I want to. If we are to lead a change in culture in the NHS, we should all show how we would do it, and should urge board members and executives to do the same, in every hospital across the country.
Palliative Care
Caroline Nokes Excerpts(3 months, 4 weeks ago)
Commons ChamberRead Full debate Read Hansard Text Watch Debate Read Debate Ministerial Extracts
Madam Deputy Speaker (Caroline Nokes)
I call Rachael Maskell, who will speak for about 15 minutes.
Several hon. Members rose—
Madam Deputy Speaker (Caroline Nokes)
Order. If Members confine their remarks to five or six minutes, we will get everybody in, but I do not intend to introduce a formal time limit yet.
Peter Prinsley (Bury St Edmunds and Stowmarket) (Lab)
I thank my hon. Friend the Member for York Central (Rachael Maskell) for this important debate. I pay tribute to her political expertise in this area and for everything she has done.
Dame Cicely Saunders—much quoted in this debate—was the founder of the hospice movement in this country. She understood that medicine is not only about curing illnesses; it is about dignity and ensuring that people are supported compassionately at the most vulnerable moment of their lives. It was her work that transformed how we think about care at the end of life, and today hospices all over the country continue that legacy. In my own work as an ear, nose and throat surgeon dealing with patients with advanced cancers in the head and neck, I am well aware of the importance of hospices.
I also pay tribute to Dr Eric Wilkes, who was a brilliant general practitioner and founder of the hospice movement in Sheffield. He was one of my teachers and one of the first people to understand the importance of integrating end-of-life care into community and hospital settings at St Luke’s hospice. The term “palliative care” was invented only in 1990—some 20 years or so after I first met Dr Wilkes—and the Sheffield model has been completely crucial to this development.
I would like to talk about palliative care in my constituency of Bury St Edmunds and Stowmarket, and in particular the remarkable work of St Nicholas hospice, its wonderful chief executive Linda McEnhill and all her staff. The hospice provides essential support for those approaching end of life and for their families and loved ones. What makes that hospice a little unusual is that it sits right on the campus of West Suffolk hospital, an arrangement that facilitates help for the patients in the hospice from all the services within the hospital. If, for example, a patient falls and fractures a leg, or needs an ear surgeon, support is available rapidly and nearby. Most hospices simply do not have access to that level of clinical support, and that is a real advantage for the Bury St Edmunds hospice.
St Nicholas hospice also illustrates a wider challenge facing palliative care across the country. As we know, demand for hospice services is increasing. St Nicholas lately increased its capacity by about 33% to meet the needs of patients and families in the local community. To expand, more staff need to be recruited, so we must do something to increase training capacity across the hospice service, particularly because we must ensure that we have a seven-day service. If we need to increase the service from a five-day service to a seven-day service, we need two sevenths more people.
Palliative care is a crucial part of a healthcare system. The problem, as we have heard on many occasions, is that hospices rely on charity and legacies. That is obviously admirable, but it raises an important question—one that I think was first asked by Baroness Finlay in the other place. We do not expect a maternity service to require charitable funding. If we needed a new maternity service, we would expect the NHS to put it up. Yet for some reason, if we need a hospice, we expect a charity to raise the funds for it and to run it. Being born and coming to the end of life are just inevitable parts of life, so I think we need a paradigm shift—a philosophical change—in the way we think about palliative care, which must be regarded as a core part of our national health service. If we genuinely believe that dignity at the end of life matters, let us make palliative care core.
Madam Deputy Speaker (Caroline Nokes)
That brings us to the Front-Bench contributions. I call the Liberal Democrat spokesperson.
Brain Tumour Survival Rates
Caroline Nokes Excerpts(4 months, 3 weeks ago)
Commons ChamberRead Full debate Read Hansard Text Read Debate Ministerial Extracts
Helen Maguire
The hon. Lady brilliantly describes the real nub of the problem.
One of my constituents got in touch to tell me that in the space of a few months, four people that she knew received a brain tumour diagnosis. With symptoms ranging from seizures to changes in behaviour, the diagnosis process for brain tumours can be dramatic, lengthy and hard fought. That is why we urgently need improvements in diagnosis. The national cancer plan aims to make great strides in speeding up diagnosis, but I was disappointed that the Government did not take up the Liberal Democrats’ calls for 8,000 more GPs, to ensure that everyone can get seen quickly and be referred for treatment.
Once a referral is successful, the brain tumour should be treated. To see delays because of equipment shortages is a disgrace. The Government have pledged funding for 28 new radiotherapy machines, which is a step in the right direction, but the Liberal Democrats have long called for 200 new, fully staffed machines, so that we can end radiotherapy deserts and stop delays to vital treatment. Will the Minister set out when we can expect funding for more machines?
Brain cancer has a more complex element; it does not occur in stages like other cancers, but is defined by grades. The grading system can also differ, depending on the type of brain tumour that the patient has. The national cancer plan has looked to offer some relief to patients by giving a commitment that a clinical nurse specialist or other named lead will support them through diagnosis and treatment to hopefully make the path clearer. I look forward to seeing how the Government intend to support this ambition by providing enough staff through the 10-year workforce plan. While we are waiting for that plan, will the Minister give some clarity on how he plans to implement the commitment to providing 5,000 learning and training opportunities per year for the first three years of the plan for people in cancer-critical roles?
It is important that I mention benign brain tumours. Just because they are not cancerous, it does not mean that people do not experience a life-changing impact from being diagnosed with them. Those living with benign brain tumours must also receive the right treatment, care and lifelong support.
I really hope that we are at a turning point in cancer care, especially for brain tumours, which kill more children and adults under the age of 40 than any other cancer. I am pleased to see many organisations, including Brain Tumour Research, welcome the national cancer plan, especially the proposed access to clinical trials and increased research. There is a lot of ambition in the plan that must be accounted for, so will the Minister confirm that the annual summary of progress for the national cancer plan will be presented in the House every year for proper scrutiny?
Dr Ahmed
Sacking people is above my pay grade, so I will revert to the Secretary of State’s opinion on that, but my hon. Friend can certainly be reassured that we will hold them accountable, just as she will hold me accountable. She might give me the sack at this rate, so I had better be careful.
We are grateful for the continued campaigning on rare cancers. We look forward to working further with partners to deliver improvements in outcomes for brain cancer patients, and we know that the improvements promised through this plan rely on good research.
That research has already begun, with over £25 million invested in the NIHR brain tumour research consortium, which aims to transform outcomes for adults and children —and their families—who are living with brain tumours, ultimately reducing the number of lives lost to cancer. Furthermore, we are partnering with Cancer Research UK to provide £3 million to co-fund the CRUK brain tumour centres of excellence. This will ensure that we accelerate the move from foundational research to delivering innovative treatments for patients. These investments have the potential to shift the dial and the UK’s position as a leading location for brain tumour treatment research.
As reaffirmed in the national cancer plan, this Government are proud to support the Rare Cancers Bill, introduced by my hon. Friend the Member for Edinburgh South West, which passed its Second Reading in the other place last month. I thank my hon. Friend the Member for Mitcham and Morden and other hon. Members for their support and their moving contributions to the debates on the Bill. This important legislation will make it easier for researchers to connect with patients living with rare cancers, including brain tumours; streamline recruitment into clinical trials; and ensure that our regulatory system delivers for patients. As set out in our 10-year health plan, we will ensure that the UK is a global leader in clinical research. This Bill will accelerate the clinical trials needed to deliver the most effective cutting-edge treatments and the highest-quality care for patients facing a rare cancer diagnosis. I look forward to seeing it progress towards Royal Assent.
I once again thank hon. Members for giving me the chance to set out our plans on rare cancers. I hope I have reassured them that we are determined to improve survival rates for patients, and ensuring that everyone has access to the highest-quality care and the highest-quality research. The national cancer plan embodies these ambitions and sets out how we will achieve them. Through our significant research investments and our support of the private Member’s Bill on rare cancers, in 2026 we will begin to shift the dial on outcomes for brain tumour patients.