National Care Service

Caroline Nokes Excerpts

Thursday 15th October 2026 Commons Chamber

[The Minister for Social Care and Mental Health (Alison McGovern)]

With your permission, Madam Deputy Speaker, before I make a statement on the creation of the national care service, I want to pay my own tribute to Sir David Amess and his family. We are all thinking of them today, and I am reflecting in particular on how much Sir David gave to this House.

It is in the news this week that Audrey Joughlin is celebrating almost 80 years of service in the NHS. This remarkable lady has been working in the NHS since the day it was founded in 1948, and today she is volunteering at the Royal Liverpool hospital. I want to also wish a happy birthday to my constituent Vibeke Nicklin, who is turning 80, having spent 60 years as a nurse caring for patients.

When I read about these women, I feel nothing but pride; to know that they are from my home town in Merseyside just about makes my heart burst. These incredible women show what a wonderful thing it is that people are living longer—more grandparents are living to see their grandchildren as adults—but it also sets a test for our generation of politicians. When Audrey began her career, there were fewer than 6 million people aged over 65 in the UK; today, that figure is over 13 million. According to the Office for National Statistics, by 2050, 18 million people will be aged 65 and over; the number aged 75 and over will rise to more than 10 million; and the number aged 85 and over will have doubled. As the Prime Minister said yesterday, we cannot turn away from the question of social care. People who depend on care deserve better, and the dedicated staff deserve better, too.

This issue of social care has often been overlooked for two reasons. The first reason is who does most of the care. I can explain this simply in three words: working-class women. Working-class women never get a fair hearing in this country, but those in social care need to be heard right now. The second reason is what happens to people when they experience a failing care system. It is not that people do not like talking about getting old; too many people who go through our care system are traumatised by the experience, and it is too hard for them to talk about it. As the Prime Minister said at the Labour party conference, social care workers often feel invisible. Who can blame them, when 80% of care workers working for independent providers receive within 10% of the minimum wage?

We are all looking forward to the findings of Baroness Casey’s important review, but the truth is that we cannot afford to wait for her to finish that work before getting on with the job. Ask any family who have gone through the nightmare of trying to sort out care for their loved ones—the status quo cannot be accepted. Beyond the immediate impact on families, the NHS is paying the price of our failure to get a grip; hospitals are dealing with 999 calls from a failing care system, and we have the appalling spectacle of corridor care in hospitals across the country. If we carry on like this, our broken social care system will break the NHS, too. We cannot let that happen.

We on the Government Benches remember that we were elected on a manifesto that said that we would build a national care service, improve the lives of the people who draw on care, and build a system that puts people before profit, and we are already working hard to deliver Baroness Casey’s early recommendations, whether on motor neurone disease, dementia or safeguarding. That is why the Prime Minister has taken the decision to build a national care service, with free personal care, adjusting the triple lock to make it possible. Baroness Casey will report next summer; meanwhile, we will prepare the ground now for the new service.

I am sick of people looking down their nose at social care staff, who do a highly skilled job that could provide the young people of this country with a great career. Yesterday, I spoke to our partners at Skills for Care about our workforce action plan. At the heart of this is a commitment not just to older generations who need care, but to younger generations who just need their chance in life. Being unemployed for any period can damage someone’s confidence, but doing a skilled job like social care can give people a sense of pride, and a pay packet they earn themselves. That is why we will offer thousands more academy places to help young jobseekers into good jobs in care, and are bringing in the first national collective pension scheme dedicated to care workers; and it is why we have already passed the Employment Rights Act 2025, which gave more than a million people—many of them care workers—access to sick pay, and raised the minimum wage. We will introduce the first fair pay agreement in adult social care, backed by half a billion pounds. It will put care workers under the protective umbrella of collective bargaining and give them the power that they deserve—not just as a one-off, but forever.

For unpaid carers, we have announced the biggest expansion to the carer’s allowance since the 1970s. We will soon appoint the first unpaid carers’ champion to be a voice for people who provide unpaid care.

For too long, social care has been a Cinderella service, with care staff held back by not having the tools they need to look after people. Recently, however, we have been making good progress. Digital social care records are helping to reduce paperwork and improving the quality of information available to staff, which is vital for good care and saving precious time. Today, I can give the House the update that digital records are now used by 84% of care providers, compared with just 72% when this Government took office, and 92% of people who draw on care are now benefiting from that modernisation.

We are supporting the adoption of preventive technology that was the stuff of science fiction just 10 years ago—home monitoring kits to identify infections early, reminders to avoid missed medication, and specialised sensors to detect and prevent falls. If we can put the best technology in the hands of skilled and emotionally intelligent people, the result will be working-age adults with self-determination, choice and independence in life, and older people at home for longer, in better health, and with a much, much better chance of dying at home, in comfort and in dignity, when the time comes. As my right hon. Friend the Secretary of State for Work and Pensions said on Tuesday,

“A good retirement…is about more than income.”—[Official Report, 13 October 2026; Vol. 791, c. 198.]

There are those who say that we cannot afford the national care service; I say that they are asking the country to pay for the cost of failure. This issue is not going away. If our response to the test of an ageing population is simply to find an even larger bucket of sand to stick our heads in, the impact on the NHS—already plain for all to see—will only grow worse.

If the decade after 2010 taught me anything, it is that we do not save money by tearing chunks out of the fabric of our society and then making the NHS pick up the pieces. Most importantly, if we improve population health, people will have a much better quality of life. I do not pretend that it is easy, but our pensioners deserve security and peace of mind. Our national care service will be better for them, families and the NHS. It will ease the pressures we see today; failings in our social care system mean that many pensioners are kept in hospital for longer than they need or want to be, because social care beds are unavailable. The cost of inaction will only be more pressure on the NHS through more ambulance call-outs, more A&E admissions, more corridor care and more people stuck in hospital when they do not have to be there.

We are at a crossroads. Our choice is: either pay the financial and human cost of the failed system that we have now, or build the national care service, stabilise our public finances and enable people to live happier and healthier lives. I urge colleagues to think of not just the consequences of inaction, but what it means for our constituents if we get this right. In place of fear, the rising population of elderly people we represent can grow old in a good society. Instead of corridor care, we would have a thriving NHS, in which unnecessary admission was prevented and people who become unwell recovered quickly and enjoyed their life. Care workers would be recognised for their work, and all of us would gain peace of mind about what happens later in life.

When Audrey began her lifetime of service to our country, she was part of a generation that left the greatest legacy that anyone could hope to build. It meant that when a person falls ill, they never have to worry about the bill. Today we have the chance to carry her generation’s torch into the 21st century, and to leave to our children and grandchildren something as significant as the creation of the NHS. We are ripping off the plaster. I commend this statement to the House.

[Madam Deputy Speaker (Caroline Nokes)]

I call the shadow Secretary of State.

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[Alison McGovern]

My hon. Friend is right that at the heart of the problems we have in the social care system are the way in which the workforce are looked down upon by others and the problems with low and uncertain pay in too many areas. We are cracking on with the fair pay agreement for all the reasons that I mentioned and that she knows only too well. It is about time that social care was seen as the great and fantastic career that it is.

[Madam Deputy Speaker (Caroline Nokes)]

I call the Liberal Democrat spokesperson.

[Clive Jones (Wokingham) (LD)]

I welcome the Minister’s statement on the national care service and thank her for early sight of it.

My Liberal Democrat colleagues and I believe that everyone deserves to be able to live independently with dignity and to receive the care they need in their own home when possible. Hundreds of thousands of people are desperately waiting for the care they need and 13,000 people every day are left stranded in hospital beds, unable to leave because their care packages have not been put in place.

One in seven people over 65 now pay more than £100,000 for their care in their lifetime. Spiralling social care costs have left many councils, such as my own in Wokingham, struggling to fulfil other basic services that residents want to see. Social care services are in crisis and have been for too long. That has been recognised for many years by Ed Davey, the leader of the Liberal Democrats and a carer himself.

[Madam Deputy Speaker]

Order. The hon. Gentleman will know that he must refer to his party leader by his constituency, not his name.

[Clive Jones]

Apologies for that, Madam Deputy Speaker.

We are pleased that the Prime Minister has recognised from his own experience that social care needs fixing. The Liberal Democrats are keen to work on a cross-party basis to fix social care. Failure to act on social care would be a catastrophe for families, for the NHS and for local services.

The Liberal Democrats have set the Government three tests for the social care reforms. First, they must put family carers front and centre, with guaranteed rights for every carer, and replace the broken carer’s allowance system. Secondly, the reforms must include a universal safety net of care, including free personal care. Thirdly, the Government must protect people from catastrophic costs so that family finances are not decimated and people do not have to lose the family home.

I am pleased that the Prime Minister committed yesterday to arranging another round of cross-party talks to fix social care. The Liberal Democrats will engage in those discussions and we urge others in the House to do the same.

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[Alison McGovern]

I thank my hon. Friend for all she did as a Health Minister and for raising that extremely important question. It is an often overlooked fact that in end-of-life care, the members of staff who might see a person and their family the most will be social care staff. If we cannot get the NHS working together with social care for people when they are dying, we will not be able to do it at any time. That is a priority for the work that we can do before the Casey review, and I will happily meet my hon. Friend to discuss that further, if she would like.

[Madam Deputy Speaker]

I call the Father of the House.

[Sir Edward Leigh (Gainsborough) (Con)]

The average cost of a home in the Gainsborough constituency is just £204,000. Typically, someone spends three years in a care home in their lifetime, which will cost them £150,000. Everything over £23,000—the upper capital limit—is taken. All over the country that really upsets people who have contributed for a lifetime, and it is a real issue outside London and the south-east, which have much higher house prices. If the Minister is to abolish the triple lock and change it to a double lock, which most commentators think is now inevitable, will she look at this issue and either raise the upper capital limit so people keep more of their money or have a cap on lifetime contributions, which was the policy of the last Government?

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[Alison McGovern]

I thank my hon. Friend for that contribution. He is absolutely right: people feel as if the current system is a fog, at best. It is totally fractured, and it is too hard to navigate for people already dealing with some of life’s biggest challenges. Those Co-op values are an important factor in our thinking as we move forward with the national care service. He mentioned the Prime Minister’s comments yesterday; I am glad to confirm that those are exactly the values that we want to bring to this discussion. We are trying to ensure that people are empowered and have their voices heard, and that they work together for the good of those who need care.

[Madam Deputy Speaker (Caroline Nokes)]

I thank the Minister for her statement.

Baby Loss Awareness Week

Caroline Nokes Excerpts

Monday 12th October 2026 Commons Chamber

[Madam Deputy Speaker (Caroline Nokes)]

Order. Members will know that there is protected time, so we have until 11.02 pm, but it would be helpful if they could keep their remarks to seven or eight minutes.

Sepsis Awareness Month

Caroline Nokes Excerpts

Tuesday 15th September 2026 Commons Chamber

[Mike Wood]

Absolutely. Of course, some infections are almost unavoidable, but where infections such as UTIs can clearly be reduced with the right care and precautions, we must do everything we can to reduce those risks.

Every Member in this Chamber has constituents whose lives have been permanently transformed by sepsis. Some Members have been directly impacted or have watched as close family and friends have encountered sepsis. We know the speed with which it strikes, but we also know that with early detection, immediate treatment and high quality critical care, thousands of lives can be saved. We have the clinical evidence and we have the modern service framework. What we now need is clear delivery timelines, rigorous parliamentary accountability and the necessary financial backing to make this ambition a reality. If the Minister can deliver this and provide the resources and tools that the NHS needs to implement it, the modern service framework truly can be a turning point in the fight against this silent killer and the battle to save thousands of lives.

[Madam Deputy Speaker (Caroline Nokes)]

Before we move on, I want to pay tribute to the hon. Member for Kingswinford and South Staffordshire (Mike Wood) for his bravery in sharing his personal story and, of course, to the noble Lord Mackinlay in the other place, who has spoken on this subject so often and with such power.

--- Later in debate ---

[Madam Deputy Speaker (Caroline Nokes)]

That brings us to the Front-Bench contributions. I call the Liberal Democrat spokesperson.

[Dr Danny Chambers (Winchester) (LD)]

I pay tribute to the hon. Member for Kingswinford and South Staffordshire (Mike Wood) for so vividly highlighting his personal experience of sepsis. He gave a very emotional speech and it is good to see him in the Chamber looking so healthy.

Around one in five deaths worldwide are associated with sepsis—that is 11 million deaths a year. I recently met Ron Daniels, founder and chief medical officer of the UK Sepsis Trust, to discuss the new sepsis modern service framework. I very much welcome its ambition to reduce deaths, life-threatening complications and the long-term impact of sepsis by at least 25% over the next decade, but if we are serious about achieving that, we need to get much better at detecting infection early.

Sepsis is the body’s extreme response to infection, whether viral, bacterial or fungal. It can cause organ failure, permanent disability and death. Crucially, patients can deteriorate incredibly quickly. There is no single diagnostic test for sepsis; its symptoms overlap with many other conditions and clinicians are often having to make decisions with incomplete information. That is why rapid diagnostic tests are so important. I recently held a meeting at Winchester hospital for local GPs, the local authority, laboratories and manufacturers of various rapid diagnostic tests to look at the barriers to implementing rapid diagnostic tests, and at how people can have them in the community for earlier diagnosis and the prevention of hospital admissions.

Better diagnostics mean earlier treatment. They mean being able to use the right antibiotic for the right infection; they mean preventing patients deteriorating into sepsis; and they mean using fewer unnecessary antibiotics, which ultimately can result in antimicrobial resistance developing and is another huge growing public health concern.

Prevention matters too. We must reverse the falling vaccination rates that we have seen in recent years to prevent infections occurring in the first place, as well as ensuring that hospitals have the facilities to isolate and care properly for infectious patients. Crucially, it also means tackling corridor care and long waits in A&E, because when somebody is deteriorating in those conditions, every hour matters, as we know. In the case of corridor care and long waits, that means that diagnosis and treatment is more likely to be delayed.

I wish to talk specifically about one group of patients—cancer patients. We rightly focus on treating the cancer itself, but infection, often sepsis, is the second-biggest cause of death for people with cancer. That may seem surprising, but cancer can cause a reduction in people’s immunity. Chemotherapy and various treatments cause people to become immunocompromised, weakening their immune system and making them more prone to getting infections. That also means repeat infections, which means that they are more likely to have repeat uses of antibiotics and to have antibiotic-resistant infections.

The consequences of infection for people with cancer can be even more serious. That is why I find one omission from the Government’s national cancer plan quite striking. It is an 86-page strategy setting out how we are going to transform cancer care by 2035, yet infection is mentioned only once, and that is just in the foreword. That is not a minor oversight; it is a glaring omission that risks undermining the entire cancer strategy. We would never produce a cancer strategy that treated radiotherapy, chemotherapy or surgery as peripheral to cancer care, so we need to ensure that we are treating infection, which is the second-biggest killer of cancer patients, as integral to cancer care. Infection prevention, rapid diagnostics, antimicrobial stewardship and surveillance need to be absolutely central to cancer care, not an afterthought. If we fail to address infection properly, we are setting the entire new cancer strategy up to fail.

Sepsis contributes to tens of thousands of deaths in the UK each year, as well as leaving many survivors with life-changing physical and psychological consequences. I have one specific request of the Government. Will the Minister commit to updating the national cancer strategy to incorporate infection control, sepsis and rapid diagnostic tests as being absolutely integral to cancer management? We welcome the new sepsis modern service framework; we just need to deliver it.

[Madam Deputy Speaker (Caroline Nokes)]

I call the shadow Minister.

Summer Health and Resilience

Caroline Nokes Excerpts

Wednesday 9th September 2026 Commons Chamber

[Mr Adnan Hussain (Blackburn) (Ind)]

When I bumped into the Secretary of State yesterday, I made clear the urgent need for investment in the Royal Blackburn hospital. I have seen shocking and undignified scenes in the corridors throughout the year. Having spoken to the hospital’s executive team, it is abundantly clear that the hospital is serving a population far, far beyond the capacity for which it was originally built. I welcome the building of new homes across east Lancashire, but does the Secretary of State accept that, unless we extend the hospital’s estate and workforce, this crisis will get worse? Health inequalities across Blackburn are already among the worst in England—

[Madam Deputy Speaker (Caroline Nokes)]

Order. I am sure the Secretary of State has the gist of the hon. Gentleman’s question.

[Yvette Cooper]

I thank the hon. Member for raising this issue. We have invested an additional £29 billion in the national health service this year, and we have also recruited thousands more doctors, nurses, midwives and mental health workers. It is important that investment goes in. Alongside that, we also now have the major new hospitals programme. In addition, the £1.5 billion I announced today is part of a £6.75 billion fund to improve existing facilities where there are safety issues, in order to ensure that the NHS has the facilities it needs.

Health Bill

Caroline Nokes Excerpts

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

New clause 81 proposes a single named co-ordinator bringing together information on financial support, employment rights for parents and carers, and signposting to relevant charities and support as part of a written plan for the family. This would cut away repetitive bureaucracy and mean that parents are no longer left to their own devices in trying to figure out a way through the challenges their families face in these situations. It is a simple duty, but one that could make a massive difference. At one of the most difficult times imaginable in a family’s life, it would ensure that they are no longer simply left to navigate an overwhelming and unfamiliar system alone. Childhood illness is traumatic enough. We should do everything we can to stop it.

[Madam Deputy Speaker (Caroline Nokes)]

Order.

[Clive Jones (Wokingham) (LD)]

I would like to speak to new clause 137. Cancer Research UK estimates that, in the six months since the national cancer plan was published, over 168,000 people were diagnosed with cancer in England. The number of those diagnosed is at a record high and this is projected to continue. Almost one in two of us will get cancer in our lifetime, and no one in this country is untouched by the disease. I welcome the Government’s ambition to improve cancer outcomes in the national cancer plan. Alongside my amendment to the Health Bill, my current private Member’s Bill seeks to guarantee that the Government make progress towards delivering these targets and are held to account by Parliament on that.

Over the past five decades, cancer survival has more than doubled because of lifesaving research, earlier detection and cutting-edge treatments. However, in the last decade progress has slowed, and the 10-year cancer survival index was better in the early 2000s than in the 2010s, so we are in danger of going backwards. The national cancer plan commits to meeting cancer waiting times targets by the end of this Parliament. The previous Government failed to do that, and I really hope that this Government will manage it. It is also important that these targets are met, alongside a full range of commitments in the plan.

The Health and Care Act 2022 required the Secretary of State to include cancer outcome objectives in the annual mandate set by the Secretary of State for NHS England, and those outcome objectives explicitly took priority over other cancer objectives. I have tabled this amendment because the current Health Bill abolishes that mandate, including the previous statutory requirement for cancer outcome objectives to be prioritised over other cancer objectives, and a similar duty has not been replicated elsewhere in the Bill.

With the removal of the statutory requirement to prioritise cancer outcomes over other cancer objectives in the health system, there is a very real concern that progress on cancer outcomes risks being deprioritised amid the competing priorities of a Department facing many external pressures. I am therefore seeking assurances from the Minister that, despite the disruption of the ongoing merger and the removal of the cancer outcomes clause, progress on delivering the transformation laid out in the national cancer plan will be delivered, and that it remains a priority for the new Prime Minister and the new Secretary of State. I ask the Minister to guarantee that the capacity needed to drive forward this essential work on cancer is protected.

[Madam Deputy Speaker]

Order. I call Kate Osborne.

[Kate Osborne (Jarrow and Gateshead East) (Lab)]

If I may begin on a personal note, just three weeks ago I had a second operation on my back, and I wish to put on record my sincere thanks to the staff who cared for me, from the clinicians who treated me to everyone involved in my care and recovery. [Hon. Members: “Hear, hear.]

Too often our access to healthcare depends on our postcode. That postcode lottery is stark in a number of areas, but nowhere more so than with IVF. As chair of the APPG on fertility, I have raised this issue repeatedly with Ministers. I again invite Ministers to attend our fertility roundtable tomorrow and to commit to ensuring that every ICB follows, at the very least, the NICE guidelines on access to IVF and fertility treatment.

We must strengthen the role of voluntary, community and social enterprise organisations in neighbourhood health planning and NHS commissioning. Voluntary organisations understand the barriers to care for hard-to-reach communities and often have trusted relationships with communities that statutory services struggle to reach. We see that particularly clearly in HIV and AIDS provision. Voluntary organisations have been fundamental to the UK’s response for decades, through prevention, testing, peer support, tackling stigma and supporting people living with HIV. I am extremely grateful to the National AIDS Trust for working with me on the new clauses, and I thank Ministers for their constructive engagement. Members of the LGBT+ community must have trust in healthcare providers, and community groups bridge that gap when needed.

New clauses 142 and 143 would actively harm vitally needed healthcare. The provision in new clause 142 has already been rejected in Committee, and we see it for what it is: an opportunity to attack some of the most vulnerable in our society. Access to much-needed healthcare has already been paused in the UK, and if access to treatment for gender dysphoria is now to be dependent upon additional research, the pathways trial must go ahead without further delay.

The provisions in new clause 143 were also rejected in Committee and are another attempt to vilify. The amendment fails to recognise the framework already in place to ensure that single-sex services are provided where they meet the requirements of the Equality Act. Neither the code nor the Supreme Court judgment mandate the provision of single-sex facilities. Providers must still consider whether the service falls within an exception within the Equality Act, whether single-sex provision is proportionate, what the impact might be on trans people, and what mitigation might be necessary.

I welcome the 10-year health plan. We have made great strides in repairing the damage done to our NHS—

[Madam Deputy Speaker (Caroline Nokes)]

Order. I call Sir Bernard Jenkin.

[Sir Bernard Jenkin]

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

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

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I was fortunate to get NHS speech therapy this summer, but not everyone is. That is why new clause 117, backed by the Royal College of Speech and Language Therapists, calls on the Secretary of State to publish a strategy tackling waiting times and unequal access to speech and language therapy. To do this job, we all rely on our voices, so I urge the House to support new clause 117.

[Madam Deputy Speaker (Caroline Nokes)]

That brings us to the Front Bench. I call the Minister.

[Karin Smyth]

We have genuinely had a wide-ranging and thoughtful debate, and I want to try to address all the points that have been raised. I think there is broad agreement across the House on the goals that we are seeking to achieve with the Bill: safer care, better outcomes and a stronger voice for patients. Every patient deserves safe and high-quality care, every community deserves to have its voice heard, and everyone should be able to access the care they need, when they need it. The question before us is how best to deliver those ambitions.

In general, we do not believe that the current landscape works, and that better outcomes are always achieved through new reporting requirements, additional layers of statutory process or more bureaucracy. Instead, we are committed to devolving responsibility and to empowering leaders in the NHS, while also holding them directly accountable, so that the NHS is focused on delivery and improving care.

I will begin with Healthwatch. I think there is broad consensus that we want to see patient voices heard strongly at every level of the healthcare system—it is something that all MPs feel strongly about, dealing with constituents as we do. Hearing the patient and user voice results in better decisions in a system that is designed around them—a system that is better able to correct when things go wrong.

Our ambition is to ensure that insight and experience from patients, service users and communities is part of commissioning and service planning decisions, rather than being held at arm’s length and outsourced. Our ambition is that this is done effectively everywhere. It is about strengthening the power of patients’ voices inside the NHS, where decisions are taken, not silencing criticism of those decisions. Within our approach, integrated care boards and local authorities will be expected to engage with people in their areas and will have a statutory duty to obtain their views.

That is a core part of the new strategic role of ICBs, and it involves transparency about what people have told the system, what the system has done in response and how learning is shared across partners. ICBs will be held to account if they do not demonstrate those elements. However, we have heard the strength of feeling in this place and in Committee, and as the Bill moves to the other place, I can commit to working closely with colleagues across this House and in the other place in order to review these provisions and ensure that our approach sufficiently empowers and devolves to local populations. We all want to ensure that the changes deliver for patients and service users, building public trust and ensuring that their voice is embedded in the care they receive.

Health Bill

Caroline Nokes Excerpts

Report stage
Monday 7th September 2026 Commons Chamber

[Several hon. Members rose—]

[Madam Deputy Speaker (Caroline Nokes)]

Order. After the next speaker, there will be a four-minute time limit, but I will not reduce it further than that.

[Tom Gordon (Harrogate and Knaresborough) (LD)]

I would like to start by welcoming the commitment from the Minister at the Dispatch Box to bring forward a maternity commissioner, and by thanking my hon. Friend the Member for North Shropshire (Helen Morgan) for her tireless campaigning on this issue. When I worked for her many years ago, I was all too aware of the scandal at the Shrewsbury and Telford hospital NHS trust, after sitting in on surgeries with her. Indeed, in my own constituency of Harrogate and Knaresborough, I have ended up with tireless campaigners coming to me when they face maternity issues at Leeds hospital.

I turn to the amendments tabled in my name. The first is new clause 36, which would require the Government to bring forward a formal transition strategy and to report back to Parliament on what happens when NHS England is abolished. I have tabled the new clause out of concern for families who have lost loved ones at the hands of the Tees, Esk and Wear Valleys mental health trust. They have said time and again that they are concerned about the delayed appointment of a chair to the inquiry. They are really worried about that as we see the largest changes to the health service in a generation, and they do not want the inquiry to be lost. I press the Minister on whether she might be able to push that forward or get her colleagues to do so.

New clause 43 would reduce inequalities in access to clinical research funding and trials. I have been working closely with Yorkshire Cancer Research, based in Hornbeam Park in my constituency. We know that funding for clinical research and trials across Yorkshire is about a quarter of what is received in London. If areas outside London and the south-east are getting less research funding, the logic follows that we will struggle to close inequalities in those areas.

Infants, Parents and Carers Bill

Caroline Nokes Excerpts

2nd reading
Friday 4th September 2026 Commons Chamber

[David Davis]

claimed to move the closure (Standing Order No. 36).

[Madam Deputy Speaker (Caroline Nokes)]

I thank the right hon. Gentleman for his point of order. He will be conscious that there are in the region of 15 more Members wishing to speak in this debate, and we have not yet heard from the Minister, so I am not minded to accept a closure motion at this point.

Sudden Cardiac Death: Young People

Caroline Nokes Excerpts

Tuesday 1st September 2026 Commons Chamber

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

rose—

[Madam Deputy Speaker (Caroline Nokes)]

I am conscious that another Member has risen, but we have only 10 minutes left. The hon. Lady might prefer to confine her comments to an intervention on the Minister in the interests of time.

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[Mr Frith]

I thank my hon. Friend for her intervention; I hope I will cover and do justice to those important points.

NHS pathways also give providers call-level CPR data to support local reviews and improve quality, as well as reviewing data and emerging evidence to see where we must do better. They send quarterly reports to the national clinical assurance group, which is made up of senior clinicians drawn from royal colleges, professional bodies and urgent and emergency care services. These professionals can and often do submit constructive feedback on the way that pathways are run.

At present, NHS clinical staff are trained in CPR, but from April 2027, this will be extended to all NHS staff, including those in A&E. The roll-out of this training will take time, but it will hugely increase the number of people in the country with valuable lifesaving knowledge.

Finally, when it comes to recognising cardiac arrest, I can confirm that the Care Quality Commission does assess call handlers’ skill as part of its inspections. We know that no human system is perfect, and I am all too aware that a list or accounts like this can risk sounding defensive, so let me repeat my openness to sitting with the hon. Member for Mid Buckinghamshire, Adam’s parents and other colleagues to see how and where we can do better and go further.

Turning to the hon. Member’s points about genetics, I am hugely optimistic about the potential of genomics and life sciences over the next 10 years. The NHS clinical genetics services deliver a comprehensive clinical genetics and genetic counselling service for individuals with a family history of genetic conditions, including cardiac conditions. They provide a detailed review of family history that can direct the diagnosis, risk assessment and lifelong clinical management of patients of all ages and their families who have, or are at risk of having, a genomic condition.

The current specification for the clinical genetics services was published more than a decade go under the previous Government and is no longer fit for purpose, not least because this is one of the most innovative fields in healthcare. Today, specialist clinical services simply do not have the capacity or infrastructure to contact family members proactively, except where a particularly high risk has already been identified. For me and my work, it is a clear example of why innovation must help connect our public services.

NHS England’s genomics programme, working with the genomics clinical reference group, has done a review of the 17 regional NHS clinical genetics services. This has shone a light on the challenges to be addressed for this service to match the Government’s expectations.

I am unable to confirm a specific date for the hon. Member for Mid Buckinghamshire, but suffice to say, there is much more to be done before expectations are met by service. On his point about the UK National Screening Committee, it is true that the draft recommendations, which have been consulted on, did not find that the current scientific evidence—

[Madam Deputy Speaker (Caroline Nokes)]

Order.

National Maternity and Neonatal Investigation

Caroline Nokes Excerpts

Tuesday 30th June 2026 Commons Chamber

[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.

[Madam Deputy Speaker (Caroline Nokes)]

I call the shadow Secretary of State.

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[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.

[Madam Deputy Speaker]

I call the Liberal Democrat spokesperson.

[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.

[Madam Deputy Speaker]

I call the Mother of the House.

[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.

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[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?

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[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.

[Madam Deputy Speaker (Caroline Nokes)]

I call Dr Ben Coleman.

[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

Tuesday 30th June 2026 Commons Chamber

(3) a further sum, not exceeding £115,924,112,000, be granted to His Majesty to be issued by the Treasury out of the Consolidated Fund and applied for expenditure on the use of resources authorised by Parliament.—(Lilian Greenwood.)

[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.