Health Bill (Sixteenth sitting)

Debate between Danny Chambers and Karin Smyth

Committee stage
Thursday 16th July 2026 Public Bill Committees

[The Minister for Secondary Care (Karin Smyth)]

It is a pleasure to serve under your chairship, Dr Huq. The hon. Member for Winchester raises an important point. Cardiac issues are serious, and people too often lose their lives as a result of unidentified cardiac conditions. As we know, ECGs are used significantly across the whole of healthcare, from accident and emergency to new community diagnostic centres and beyond. They are important for investigating palpitations or unexpected syncope and for evaluating pacemaker function, and are an extremely useful diagnostic tool. However, as my hon. Friend the Member for Bury St Edmunds and Stowmarket suggested, there is no clear evidence that non-symptomatic population screening using standard ECGs would yield any useful health data or improve population outcomes.

Clearly, the loss of life—particularly a young life, as in the case of the constituent the hon. Member for Winchester mentioned, although we have all seen or, sadly, experienced such cases—is an awful tragedy for those concerned, but we need to rely on evidence. The UK National Screening Committee, which is an independent scientific advisory body, advises all four nations and is considering the issue. The committee launched a three-month public consultation on 8 June to look at the evidence on screening for sudden cardiac death. Its draft recommendation is against screening, because ECGs, as well as other tests, are an unreliable tool for identifying significant cardiac issues in asymptomatic individuals. ECGs are useful tools in the diagnosis of symptomatic patients, and the UK National Screening Committee is in the process of reviewing ECG use for asymptomatic individuals. For those reasons, I ask the hon. Member to withdraw the new clause.

[Dr Chambers]

I thank the Minister for her comments. I beg to ask leave to withdraw the motion.

Clause, by leave, withdrawn.

New Clause 32

Review on deaths related to antimicrobial resistant infection

“Within six months of the passage of this Act, the Secretary of State must conduct and publish a review into the number of yearly deaths in the UK which are related to antimicrobial resistant infection.”—(Dr Chambers.)

This new clause would require the Secretary of State to conduct and publish a review into the number of yearly deaths in the UK which are related to antimicrobial resistant infection.

Brought up, and read the First time.

[Dr Chambers]

I beg to move, That the clause be read a Second time.

The new clause would require the Secretary of State to conduct and publish a review into the yearly number of deaths in the UK related to antimicrobial-resistant infections. I declare an interest as the secretary of the all-party parliamentary group on antimicrobial resistance. AMR is a major threat to public health globally and domestically, and it is already contributing to an estimated 35,200 deaths every year in the UK.

AMR is a bit like a silent pandemic. It gets little media attention, but given the prediction that 39 million people worldwide will have died of AMR by 2040, it will eventually be pushed right up the political agenda. This is not simply a matter of people dying from infections that could not be treated; nearly all the advances in modern medicine over the last 50, 60 or 70 years would be null and void. It would be too risky for someone to have something like a hip replacement, because of the risk of getting an infection that could kill them; they would be better off living with a painful arthritic hip than taking the risk of dying from sepsis. It is the same with things like heart disease, while giving birth will once again become one of the most dangerous things a woman can do if we lose the impact and effectiveness of antibiotics.

The Government invested more than £560 million in AMR programmes between 2020 and 2024, so it is reasonable that Parliament should receive an annual assessment of AMR-related deaths to ensure that that significant public investment is delivering results, represents value for money and is targeted where it can have the greatest impact. We cannot effectively tackle what we do not measure, and an annual review of deaths linked to AMR would provide a clear, consistent picture of the scale of the problem and enable Parliament and the public to track whether policies are working.

Better data leads to better targeted interventions. We know that rapid diagnostic tests and different types of decontamination will be hugely important in tackling AMR, along with potential future technologies such as phage technology. Surveillance has already identified significant variations by age, deprivation and geography. Understanding where deaths are occurring, and in who, would help direct resources to the communities and services that are most affected.

AMR threatens the effectiveness of modern medicine, including surgery, cancer treatment and routine healthcare. An annual review of AMR-related deaths would ensure that this growing public health threat receives the attention and urgency it deserves. The reason I am determined to push it up the agenda is that the national cancer plan does not specifically mention AMR or infection, but it is the second biggest cause of death in cancer patients. At the moment, it is not pushed up the political agenda enough.

[Karin Smyth]

I commend the hon. Member for outlining this important issue before the Committee and for his work on the APPG.

AMR is recognised as a chronic risk in the Government’s national risk register. In 2022, it was estimated that 7,500 deaths per year can be directly attributed to AMR in the UK, with a further 35,000 deaths per year associated with AMR. It is a significant and growing issue that the Government take very seriously—I want to assure the hon. Member and the Committee of that. Through the delivery of the 2024 to 2029 UK AMR national action plan, the Government are already taking comprehensive action to tackle this threat and ultimately reduce the burden it places on individuals, families and the healthcare system. That is where that work is located.

I am not convinced that a review of the number of deaths at this point, while important, would add significantly to our understanding of the impact and burden of AMR or to the action being taken to address it, which we do take seriously. The Government will continue to work with APPGs and with information around this issue through the action plan. For that reason, I ask the hon. Member to withdraw the new clause.

Health Bill (Fifteenth sitting)

Debate between Danny Chambers and Karin Smyth

Committee stage
Thursday 9th July 2026 Public Bill Committees

[Karin Smyth]

The shadow Minister is tempting me to divert away from addressing the main point, but I will take her point on board. I am glad that the Conservatives do not oppose the principle of advice and guidance, because evidence suggests that it is a good route to patients having care closer to home and getting faster treatment. She knows this because it has been clarified, but if there is any doubt: there is no compulsion on GPs to do that.

The hon. Member for Winchester talked about his expertise and blowing his own trumpet with regard to antimicrobial resistance. He jests slightly about that expertise, but he raises a really important point about AMR that I am sure we will talk about more when we discuss new clause 32. He is absolutely right that it is an important public health issue that crosses many divides, and I look forward to discussing that later.

[Dr Chambers]

I thank all Members for their contributions to the discussion. The hon. Member for Lichfield made the good point that a committee of 70 people may not be that efficient. He should come to the Lib Dem parliamentary party meetings, which are incredibly efficient. We have incredibly insightful discussions, which is what makes us such an effective force, so I would not knock a committee of 70 people.

I appreciate the Minister’s acknowledgment of the important of cross-party work for public health. I beg to ask leave to withdraw the motion.

Clause, by leave, withdrawn.

New Clause 15

Impact of trade deals on the NHS

“(1) Any trade negotiation which would require NHS spending or funding to exceed £100 million must be laid before Parliament by the Secretary of State in the form of regulations subject to the affirmative procedure.

(2) Before laying regulations under subsection (1) the Secretary of State must publish an impact assessment about how the trade negotiation will affect NHS frontline services and patients.”—(Dr Chambers.)

This new clause would require any trade negotiation which would require NHS spending or funding to exceed £100 million to be laid before Parliament by the Secretary of State in the form of regulations subject to the affirmative procedure.

Brought up, and read the First time.

--- Later in debate ---

[Karin Smyth]

Again, this is an area of work that my hon. Friend has led on for many years, as I have seen, often when many others have not been around to support it. With so many organisations and charities lobbying on behalf of so many people who are desperate for rare diseases in particular to be highlighted—those diseases that affect a small number of people, many of them children—that work is crucial. Her work in leading in this place is exemplary. That is exactly where we aim to get by working with our partners in difficult circumstances. Trade deals and negotiations are necessarily difficult—otherwise, they would be easy—but the hard work yields results for people. As I have said, this Government have taken an outward approach to working with our partners and with industry.

We have already taken steps towards achieving our commitments, most notably increasing the NICE cost-effectiveness threshold. The Government previously updated Parliament in two ministerial statements, and of course MPs quite rightly have the option to continue to table parliamentary questions. Officials should be able to produce confidential advice for Ministers, to inform trade or other negotiations, and we must maintain that confidentiality in this case, as the impact assessment contains commercially sensitive assumptions. It is scenario-based and remains linked to live policy development. On that basis, I ask the hon. Member for Winchester to withdraw the new clause.

[Dr Chambers]

I thank the Minister for her comments. It is good to hear cross-party recognition of how important the life sciences sector is in the UK, to universities and businesses as knowledge transfer partnerships. This is a huge opportunity not only to improve the health of the nation and the treatments available, but to boost the economy.

We will withdraw new clause 15, but I thought the hon. Member for Isle of Wight East spoke extremely well about his concerns relating to the trade deal.

--- Later in debate ---

[Karin Smyth]

I thank my hon. Friend. I heard audible voices of approval for that point. I think that when any of us know or encounter children, whether it be in our own circle or when we visit schools in our constituency, we are very much struck by those who are at school and are themselves caring. I think most schools do a tremendous job where they recognise that. Often children, like adults, do not want to inform their school or local people that that is what they are doing—they are very proud—and perhaps the person they are caring for does not know how to do that. I have certainly seen in my constituency schools starting to recognise and support the needs of those children, in a way that is dignified and respecting of privacy.

I did allude to some of the work that we are doing across Government, including with the Department for Education, to recognise, and to find ways to support, those young people, many of whom want to support their loved ones. I think we have all seen great ways to support them. When we are addressing young children in classrooms, I am always conscious of the need to think about the circumstances in which we are talking to them. There are a lot of teenage carers as well. My hon. Friend the Member for Bury St Edmunds and Stowmarket is absolutely right to highlight that.

More broadly, apart from data sharing and addressing barriers, the My Carer section of the NHS app will allow people to securely prove that they are providing care. That will streamline the care responsibilities of carers significantly—again, that can be done without having to confront the situation in public, if that is what people want—while giving them a means to seek advice or reassurance directly from a range of professionals when they need it.

I am also not convinced that the challenge of providing effective support would be solved by an additional legal duty. The existing legal framework already requires the system to support carers, including through the provision of information and advice. As the Committee has discussed, practical steps are what is needed. Progress is being made locally through issuing practical toolkits to help hospitals implement their legal duties under the Health and Care Act 2022. This year, the Government will also commission the better care fund support programme, led by the Local Government Association, to work with the NHS and social care partners to strengthen their approach to involving unpaid carers in discharge planning.

New clause 18 would establish a national respite care scheme. The Government do not feel that that is necessary, as the legal framework already provides rights for carers to access support, including respite services. Under the Care Act 2014, where a carer appears to have support needs, whether those are current or in the future, local authorities are required to carry out a carer’s assessment. Where carers have eligible needs, local authorities have duties and powers to meet them. That establishes a framework where needs assessments and subsequent care planning focuses on the individual and their circumstances, rather than prescribing a particular service or solution. In other words, respite care is already one of the many forms of care and support that might be offered as part of the process, where it is appropriate to meet the needs of the individual carer.

Funding and mechanisms are in place to enable local areas to deliver support for carers. Under the better care fund framework, there is £9 billion for integrated care boards and local authorities to make joint plans and to pool budgets to deliver better, joined-up care. In developing their better care fund plans, ICBs and local authorities should consider how pooled funding can help the NHS and local authorities to meet duties on unpaid carers, including around short breaks and respite services.

The Government are also making available more than £4.6 billion of additional funding for adult social care in 2028-29, compared with 2025-26, to support the sector to make improvements. Local areas will determine how best to use the money to support carers, depending on local need and with reference to their statutory responsibilities.

For those reasons, I ask the hon. Member for Winchester to withdraw new clause 16, and hon. Members not to press new clauses 17, 18 and 89 to a vote.

[Dr Chambers]

I thank Committee members for their contributions. The hon. Member for Isle of Wight East spoke particularly well and emotively—I know that he worked for Dementia UK before entering Parliament. My mother was a carer for my father, who had dementia, and my sister and I gave her respite care, although probably not enough of it. I know that many Committee members will have been in a similar situation, as it is a common disease, and it is becoming increasingly common. I also thank the Minister for her comments and reassurance.

The hon. Member for Bury St Edmunds and Stowmarket made a point about children being carers. I sat on the Mental Health Bill Committee last year, and to give an example of how impactful such Committees can be, it is now a requirement, as a result of the Committee’s consideration, to identify whether mental health patients have children who are carers. That was not the case before, and we appreciated the Government engaging with us on that issue. It is often teenagers who care for adults with severe mental health issues, but they were not even identified before, so they could not be given the support they required. That has changed now, and it is fantastic to see that, through Committee scrutiny, we can make a tangible difference to people’s lives.

I will not press new clauses 16 and 17 to votes, but the Liberal Democrats do think that it would be sensible and impactful to establish a national respite care scheme, so I will press new clause 18 to a Division. On new clause 16, I beg to ask leave to withdraw the motion.

Clause, by leave, withdrawn.

New Clause 18

National Respite Care Scheme

“(1) Within six months of the passage of this Act, the Secretary of State must establish a National Respite Care Scheme.

(2) The scheme under subsection (1) must make provision for—

(a) a local authority carrying out a carer’s assessment under section 10 of the Care Act 2014 to be required to consider whether a carer is able to take sufficient breaks from their caring responsibilities.

(b) unpaid carers to receive support to take breaks from their caring responsibilities to—

(i) maintain their physical and mental health and emotional wellbeing,

(ii) participate in work, education, training or recreation, and

(iii) participate in family and community life.

(c) a carer to receive appropriate support if a local authority carrying out an assessment under subsection (2)(a) determines that a carer is unable to take sufficient breaks from caring.

(3) Under subsection (2), ‘support’ may include—

(a) replacement care for the cared-for person;

(b) respite services;

(c) any other steps a local authority considers appropriate as support.

(4) The Secretary of State must provide sufficient support to local authorities to ensure the scheme under subsection (1) is delivered in every local authority.

(5) For the purposes of this section ‘unpaid carer’ has the meaning given by section 10 of the Care Act 2014 and includes a young carer within the meaning of section 96 of the Children and Families Act 2014.”—(Dr Chambers.)

This new clause would require the Secretary of State to establish a National Respite Care Scheme.

Brought up, and read the First time.

Question put, That the clause be read a Second time.

--- Later in debate ---

[Karin Smyth]

I thank my hon. Friend for going to hear directly from her constituents. She is right: that message is fairly consistent. Last year, my hon. Friend the Member for Bristol East (Kerry McCarthy), my right hon. Friend the Member for Bristol North West (Darren Jones) and I played a pivotal role in bringing our ICB and local authorities together as local Members of Parliament. That was a result of our experience with parents and constituents. Members of Parliament from across the House—this is not a party political point—can bring parents together to highlight this issue and use parliamentary power to bring together organisations that sometimes do not listen or know the best way to communicate. Our role in that has been pivotal. The Secretary of State for Education has taken that learning forward across the country.

That is why we are taking the steps to deliver the programme. ICBs have been asked to work with local authorities to develop local SEND reform plans. Those plans will lay the foundation for long-term reform, enabling ongoing monitoring of progress, and draw on knowledge, skills and lived experience held locally. That builds on work that is under way to improve accountability and set expectations of joint working, which is what parents and families expected to happen, but was not happening. Each ICB is expected to have an executive lead on SEND. The NHS medium-term planning framework for the next three years made it clear that ICBs and providers must meet their statutory duties and support delivery of the reforms.

Ofsted and the Care Quality Commission will continue to check how local services, including health, work together for children and young people and hold them accountable. We will also update the SEND code of practice and publish new guidance so that local SEND partnerships have clearer expectations to work to. That is why we have not proposed changes to health and social care appeals to the SEND tribunal or made the decisions binding. This reflects the need for ICBs and NHS providers to retain the flexibility to plan services across their wider populations and prioritise support according to clinical and population need. This aligns with our commitment in the 10-year health plan to create a new NHS operating model where ICBs are the strategic commissioners of local healthcare services. It is worth noting that while tribunal decisions on health and care are non-binding, local authorities and ICBs are expected to follow them, and in most cases do. If they do not follow recommendations, they must send a response setting out the next steps they have decided to take and why.

There is no doubt that health and social care have crucial roles in SEND reforms, with shared ambitions across education, health and care for earlier intervention and support. I reassure the Committee that we are exploring further opportunities to strengthen accountability, as stated in the SEND consultation document. We are considering responses to the consultation, which closed on 18 May, and will set out our next steps in due course. For those reasons, I ask the hon. Member for Winchester to withdraw the new clause.

[Dr Chambers]

I thank everyone for their comments. I thank the Minister for her reassurances on the seriousness of this issue. Given that we are waiting for the response to the report, I beg to ask leave to withdraw the motion.

Clause, by leave, withdrawn.

Ordered, That further consideration be now adjourned.—(Emma Foody.)

Health Bill (Thirteenth sitting)

Debate between Danny Chambers and Karin Smyth

Tuesday 7th July 2026 Public Bill Committees

[Karin Smyth]

I am grateful to hon. Members for tabling these new clauses. I recognise the concerns behind them. Contracts involving NHS data, digital services and technology must be subject to proper scrutiny. Patients expect their medical information to be protected, and NHS staff expect the systems that they use to be safe and reliable. The Government agree that Parliament should be entitled to test how those protections work.

I also want to be clear that the Government want British businesses to win more public contracts and build stronger UK capability in digital and technology. The Government are already using procurement to support British businesses, jobs, skills and national security. More than 90% of UK public contracts are currently awarded to UK suppliers, and the Government have set out reforms to make procurement do more to support British industry and supply chain resilience.

I do not think that new clause 3 is the right way to achieve proper scrutiny. It would require the Secretary of State, within six months, to conduct and lay before Parliament a risk assessment of all contracts between NHS organisations and suppliers based outside the United Kingdom. That would include contracts regardless of the value—we heard a little about that from the Opposition—and of the services being provided, the type of data and whether there is evidence of any sort of concern. Risk is driven by the nature of the data involved, not just where the supplier is located. That is why the Government’s approach is based on targeted assessment and proportionate control.

We already have the tools we need in the Procurement Act 2023, which gives contracting authorities the powers to exclude suppliers and terminate contracts where the legal tests are met, including on national security grounds. They may also refer suppliers for a debarment investigation. The National Security Unit for Procurement supports Ministers in assessing suppliers on national security grounds, working closely with Departments and the intelligence community. In health and digital contracts, those procurement powers sit alongside data protection legislation and data protection impact assessments, in line with the digital, data and technology playbook. That is not an argument for complacency; we should continue to identify risks before procurement begins.

A broad duty of the kind in new clause 3 would risk becoming a reporting exercise and would not necessarily make the highest-risk contracts safer. It could, however, draw time and resource away from the assurance activities that matter most. The right approach is to strengthen the targeted controls, not to create a single statutory risk assessment covering every non-UK supplier.

Similarly, on new clause 4, a blanket “buy British” rule would not be the right test for NHS data contracts, although I hope that I have assured the hon. Member for Winchester that home-grown domestic products are absolutely what we are trying to focus on. The UK must treat suppliers from countries with reciprocal procurement access fairly. Our international obligations matter and are an important driver of the UK economy, including the World Trade Organisation agreement on Government procurement, which gives British businesses guaranteed access to £1.3 trillion in public procurement opportunities overseas annually.

As the hon. Member will understand, new clause 5 would require the Government to commit to a new programme of work to develop domestic capability, to reduce reliance on overseas suppliers of IT services and technology. The strategy would also require us to set out an approach to managing the risk associated with our current use of technology provided by overseas suppliers. I welcome the notion of encouraging domestic innovation to ensure the security and resilience of our IT infrastructure. However, ensuring the security of our data and the resilience of our systems is already embedded in everything we do. The new clause is therefore simply not necessary.

Hon. Members will accept that we want to see continued growth of digital and tech industries in this country; it is one of our real success stories. However, it will not be achieved by cutting across procurement law and not seeking the solutions that provide the best value for our money and the right service for the NHS. Our approach to securing the best IT and tech solutions should always be to seek the best on offer in a diverse, global market, not to prioritise based on location. Prioritising domestic providers means making a decision on grounds other than the quality, integrity or value for money of a solution.

I understand the concern behind new clause 43, which the hon. Member for Sleaford and North Hykeham spoke to. However, where public money is used to provide NHS services, there should be proper transparency about the contract, the service being delivered and the use of public funds. Patients and the public are entitled to expect that information is not placed beyond reach simply because a service is delivered through a contract. I do not think the new clause necessary, and I am concerned that it could create confusion about the operation of the Freedom of Information Act 2000. The Act already deals with information held by another person on behalf of the public authority. The key issue is not where the information physically sits. It does not matter whether it is held by the authority or by one of its commercial partners; what matters is whether it is held for the public authority’s purpose.

The Government agree with the principle of transparency, but new clause 5 would not improve the existing framework. It would risk duplicating duties that already exist, cutting across standard contract terms and creating uncertainty about patient information, which is rightly protected. For all those reasons, I ask hon. Members not to press the new clauses.

Finally, I say to the hon. Member for Winchester that we have already debated the single patient record. Public trust is key, and there will be multiple suppliers. We are bringing patients and the public with us and will continue to do so. The hon. Member asked about the FDP roll-out. I do not think it was about the supplier. I think it was about the money. It was about inertia in rolling out some good technology that provides good efficiency. It was also about capacity, capability and an attitude to productivity, which we absolutely need to drive more of.

[Dr Chambers]

I appreciate the Minister’s response and the comments of other Members, which were insightful as usual.

When we discussed whether carers could access parts of the single patient record, Members made very good points about privacy and historical health issues that a patient might not want a carer to know about. Those are very sensible concerns, but someone watching these proceedings or looking back over the record would think that there had been a lot more agonising over whether someone caring for a patient could access relevant information than over the potential systemic misuse of health information facilitated by private companies. A lot of people are worried about that when it comes to procurement, trust and sovereignty.

I thank the Minister for her comments on new clause 3. I beg to ask leave to withdraw the motion.

Clause, by leave, withdrawn.

New Clause 4

Duty on the Secretary of State to prioritise domestic suppliers

“In the National Health Service Act 2006, after section 1CC (inserted by section 6 of this Act) insert—

‘1CD Duty to prioritise domestic suppliers

(1) In exercising functions in relation to the health and care service, the Secretary of State must prioritise the awarding of any contract that will involve the handling of NHS patient data to suppliers based in the United Kingdom.

(2) The Secretary of State may only seek to procure technology and information systems which will handle NHS patient data from suppliers based outside of the United Kingdom where a viable domestic alternative does not exist.

(3) Before signing any contract for the procurement of technology and information systems which will handle NHS patient data with a supplier based outside of the United Kingdom, the Secretary of State must consult with—

(a) patient groups,

(b) national security experts, and

(c) staff unions,

on the proposed contract and lay a report on such a consultation before Parliament.

(4) Where it is proposed to sign a contract for the procurement of technology and information systems which will handle NHS patient data with a supplier based outside of the United Kingdom, the Secretary of State must arrange for a motion agreeing to the signing of such a contract to be tabled in each House of Parliament, and no such contract may be signed where a motion for its agreement is negatived by either House of Parliament.

(5) If a contract is awarded for the procurement of technology and information systems which will handle NHS patient data with a supplier based outside of the United Kingdom, the Secretary of State must place a statement before both Houses of Parliament setting out whether the Government is taking, or is planning to take, steps to develop or support long-term domestic alternatives to the systems provided by the contract.’”—(Dr Chambers.)

This new clause would place a duty on the Secretary of State to prioritise domestic, UK-based, suppliers for technology systems and contracts handling NHS patient data, and places restrictions on the signing of contracts for such systems with non-UK based suppliers.

Brought up, and read the First time.

Question put, That the clause be read a Second time.

Health Bill (Eleventh sitting)

Debate between Danny Chambers and Karin Smyth

Committee stage
Thursday 2nd July 2026 Public Bill Committees

[Karin Smyth]

I am afraid I do not know the answer to the hon. Lady’s question, but if it is relevant, I will try to get back to her on it.

People applying for a licence must now indicate whether they have seen a medical practitioner other than their GP. The Government also intend to make a statutory instrument to require licence holders to inform the police if they consult a third-party medical practitioner who is not their GP.

The single patient record will build on and connect with information from GP source records where appropriate; no new provision is needed for that to happen. That process should be agreed as part of operational arrangements with the profession, in line with the current approach to markers in the GP record. If it is agreed that it would be beneficial for health and care professionals to have wider access to the firearms marker, the single patient record could facilitate that, but we do not intend to fill the Bill with detailed operational requirements such as that.

We do not believe that the SPR is the appropriate vehicle for having a debate about regulations requiring a report on the merits of a mandatory marker. As the hon. Member for Farnham and Bordon said, we should not expand the clearly defined scope of the single patient record—the scope is limited to direct care—to include a debate about what is stored more generally in NHS records. For those reasons, I ask the hon. Member for Winchester to withdraw amendment 71.

On amendment 72, as I have already outlined, the single patient record will build on and connect with existing source records, such as GP or hospital records, wherever possible. Where a person’s status as a military veteran is recorded, it will be possible to make that information available in the single patient record. Therefore, the provisions already ensure that the information is made available, where veterans opt to have that status recorded—that addresses some of the other issues raised by the hon. Member for Farnham and Bordon. There is no need to make any statutory requirement to ensure that staff have that information and consider any necessary adjustments or potential treatment options that may be relevant to ensure safe and effective care.

In addition, the clause contains powers to make regulations to allow people involved in the provision of an individual’s direct care, including that of any veteran after they have left the military, to access their single patient record. We want the single patient record to improve the accessibility and effectiveness of care for everyone. That includes making sure that military veterans can access necessary support and that staff can provide them with appropriate care. Furthermore, duties in the Armed Forces Act 2006 require the NHS and local authorities to have due regard to the armed forces covenant, which, of course, I fully support. For those reasons, I ask the hon. Member for Winchester not to press amendment 72.

[Dr Chambers]

I thank all hon. Members for their input, and the Minister for her insights. I beg to ask leave to withdraw the amendment.

Amendment, by leave, withdrawn.

Health Bill (Tenth sitting)

Debate between Danny Chambers and Karin Smyth

Committee stage
Thursday 2nd July 2026 Public Bill Committees

[Karin Smyth]

My hon. Friend touches on what I will come to as I conclude my remarks on the next new clause. He is absolutely right. The wider determinants of mental health need to be part of developing these services, as with physical health.

On new clause 34, I reassure the Committee that the Government are taking significant steps to improve mental health services in this area. We have recruited over 8,500 extra mental health workers since July 2024, we are accelerating the roll-out of mental health support in schools and colleges, and we are investing a record £16 billion in NHS mental health services this year. Furthermore, there will remain a requirement, as introduced in the Health and Care Act 2022, for mental health expertise on local integrated care boards.

However, as my hon. Friend just said, we know that good mental health and wellbeing requires more than improving NHS services. It requires concerted action to promote positive mental health and tackle the causes of mental ill health. That is why we are developing a new cross-Government mental health strategy for England, to be published later this year. It will take a whole-system approach, recognising the role of schools, employers, the voluntary sector and local government, and representing all parts of the country in promoting positive mental health and preventing mental health ill. The strategy will also go further on reducing the stigma and discrimination associated with mental health conditions, with a focus on improving mental health literacy across the population.

Finally, the new clause risks imposing unnecessary burdens on local systems. For those reasons, I ask the hon. Member for Winchester not to press it. I hope he feels assured that the Government will take forward many of the Committee’s concerns in the mental health strategy.

[Dr Chambers]

I thank hon. Members for their insightful input to the discussion on mental health in general and for their thoughts on our amendments. It is reassuring to see the cross-party concern for mental health and the recognition that it seems to be an increasing problem.

The hon. Member for Bury St Edmunds and Stowmarket made a good point about the causes of mental health problems. We know that people in debt are three times more likely to have mental health issues than people on an average income, and that people who have served in the armed forces are at a higher risk. A whole combination of non-clinical things, such as insecure housing, zero-hours contracts and even social media for adults and children, are potentially adding to the mental health challenges that we are facing.

I appreciate the Minister talking about the new cross-Department mental health strategy. It sounds valuable and it seems to address a huge number of the multifactorial issues that have led us to this point. I will happily not press any of the amendments apart from amendment 9. The mental health investment standard is one of our absolute core priorities, and I would like to press that to a vote. I thank everybody for their contributions and insight into this.

Question put, That the amendment be made.

--- Later in debate ---

[Karin Smyth]

The hon. Lady knows that we are talking about an enabling power in the Bill. All the details will be brought forward in regulations, through discussions and consultation. We will discuss that more broadly as we talk about the wider clause.

One of the key issues I have been asked about is protecting vulnerable people. Patients will access a single patient record through the NHS app, and NHS England has published guidance on clinical safety, safeguarding and the NHS app, which provides advice on minimising the risk to those where there may be challenges or potential risks. We will adopt a similar approach to the single patient record. Clinicians will be able to redact information that is too sensitive to share, and we will agree a protocol with professional bodies on how that will be applied. I am sure that we will discuss that in more detail, because it is an important area to get right.

[Dr Chambers]

I thank everyone for that very useful discussion. I was pleased to see everyone broadly in agreement that we need to work out how we can provide the necessary information to provide better care, and to balance that with privacy. Everyone made really insightful points on that.

I just emphasise that, as we all know, there is a difference between treatment/prescription and compliance, and compliance is where many medical treatments fall down. It is once the medical staff are not involved on a day-to-day basis, when the patient is not under their direct care or in the facility of the medical treatment, that most of the care takes place, and that is when successful or unsuccessful treatment for the medical condition occurs. If the people providing the daily care are not empowered properly, it is—well, not a complete waste of time, but the efforts of the medical staff are in vain if the compliance day to day is not accurate.

I thank everyone for the discussion. I will not press the amendment to a vote, and I beg to ask leave to withdraw it.

Amendment, by leave, withdrawn.

Ordered, That further consideration be now adjourned.—(Emma Foody.)

Women’s Health Strategy

Debate between Danny Chambers and Karin Smyth

Thursday 16th April 2026 Commons Chamber

[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?

[Karin Smyth]

I thank the Liberal Democrat representative for his comments—frankly, that is the way it is done.

Let me turn to some of the issues that the hon. Gentleman raised. May I take the opportunity to mention endometriosis in particular? There have long been campaigns on that issue in this place from many women and men such as him talking not on behalf of their partners, but for them about the suffering. That is all very welcome.

I commend the work of Sir David Amess, a former Member of the House whose plaque is behind us, and of my right hon. Friend the Member for Redcar (Anna Turley) in chairing the all-party parliamentary group on endometriosis. When in opposition in 2017 or 2018, I had a member of staff—I hope she does not mind my saying so—who opened my eyes to this issue. Persistence works. We have got to where we are by supporting women’s voices across the country, and that is front and centre in this strategy.

On the hon. Gentleman’s wider point, I am sure that when he gets all the way through the strategy, he will see that there is a list of 102 actions—if I remember rightly—with dates aligned to them. I am sure that all hon. Members will look at that. I notice that my friend Baroness Merron is in the Gallery; she will be keeping everybody’s feet to the fire, including the Secretary of State’s, to deliver on this work. That list is in the strategy, and we wanted to set it out very clearly. We are waiting for the roll-out of NHS Online during the summer, and seeing how that works will be a litmus test for us, so I very much welcome the hon. Gentleman’s challenging us on that.

Oral Answers to Questions

Debate between Danny Chambers and Karin Smyth

Tuesday 22nd July 2025 Commons Chamber

[Karin Smyth]

Phlebotomists are paid on an “Agenda for Change” pay scale, which is underpinned by the job evaluation scheme. It is something the Secretary of State and I discussed with the trade union Unison last week; I should declare that I am a member of Unison. It is working closely with the trust in question, but I am happy to discuss the matter with my hon. Friend further.

[Dr Danny Chambers (Winchester) (LD)]

Many carers have told me how much they rely on respite care to protect their own physical and mental health so that they can continue to care for their loved ones day in, day out. The wonderful Chesil Lodge day centre in Winchester has recently been threatened with closure, and I have been fighting alongside constituents to keep it open. How will the Department ensure that respite services such as those at Chesil Lodge are consistently available and are not subject to a postcode lottery? Can I also—

Spending Review: Health and Social Care

Debate between Danny Chambers and Karin Smyth

Thursday 12th June 2025 Commons Chamber

[Dr Danny Chambers (Winchester) (LD)]

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

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

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

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

[Karin Smyth]

I thank the hon. Gentleman for welcoming, on behalf of his party, the commitment that the Chancellor has made and the extra funding that she has identified, but I think his party still opposes the way in which we have raised the funding to do just that. It is good to have your cake and eat it, but we are clear that the funding does come with reform. As I said in my statement, we are committed to improving the front door—primary care—as well as social care and discharge. That is why the NHS contribution, as part of the settlement to the better care fund, increases. He will be aware that we previously revised the better care fund to make it better and more targeted on discharge, which is important.

The urgent and emergency care plan that we published a couple of weeks ago also confirms our recognition that flow through the hospital system is important for patients and staff; we must ensure that we do not face that continued crisis of corridor care over many years. We are committed to the fair pay agreement, and our colleagues in the Ministry of Housing, Communities and Local Government will make more statements in the coming weeks about how that will work.

Women’s Health Strategy

Debate between Danny Chambers and Karin Smyth

Thursday 30th January 2025 Commons Chamber

[Dr Chambers]

Apologies, Madam Deputy Speaker. Yes, in one sentence: the Government’s manifesto rightly said that

“Never again will women’s health be neglected”.

Can we have assurances that we will not remove the ICB requirement to have women’s health hubs?

[Karin Smyth]

The hon. Gentleman is right to highlight those long waits. That is why we particularly highlighted gynaecology for attention in the elective reform plan. It is shocking that the last Government left 600,000 women on these lists, and moving back to making sure people wait no longer than 18 weeks will predominantly be helping those women.

The hon. Gentleman is also right to highlight the appalling maternity situation. The Secretary of State and my noble Friend Baroness Merron, who leads in this area, have met many families to discuss their experiences, and we know those experiences are unacceptable. We know there are big issues around staffing, and it is a priority to work with NHS England to make sure that we grow workforce capacity as quickly as possible so that we can be sure that those situations are safe. There are many debates in this place about the issue and we will continue to update the House.

Winter Preparedness

Debate between Danny Chambers and Karin Smyth

Wednesday 18th December 2024 Commons Chamber

[Karin Smyth]

I am working very closely with the UK Health Security Agency to make sure that, week on week, we are aware of the movement of different diseases and viruses through the system, and we will continue to publicise the campaign to get people vaccinated. Anything that hon. Members can do to support that campaign, and to make sure that people support themselves and their loved ones, will be gratefully received by the entire system. The campaign is something that everyone can get behind.

[Dr Danny Chambers (Winchester) (LD)]

While we all pay tribute to the NHS staff who work over Christmas, we should remember that they are not only missing Christmas with their families, but putting their own health at risk in caring for us.

On Monday, Winchester hospital declared a critical incident, saying that it could admit no more patients and asking people to seek treatment elsewhere. For years, the chief executive officer of the hospital has been requesting 160 extra social care packages, because the lack of social care is stopping the flow of patients through the hospital. She said that providing such packages is the single biggest thing that would help deal with the winter crisis. In September, Winchester hospital applied for winter crisis funding to put an urgent treatment centre on the front of its A&E department to help deal with the anticipated extra caseload. It is now December, and the hospital has still not heard whether it will get the funding. Given the number of critical incidents being declared, will the Minister meet me and the CEO to discuss how we can support the hospital through this situation, and how we can avoid having a planned crisis next winter?

[Karin Smyth]

As I said earlier, different systems have different issues. Funding has been allocated in advance to the NHS so that it understands which systems require funding, and that has now been baked in for this year. I cannot address the hon. Gentleman’s points directly from the Dispatch Box, but I am very happy for officials to take note of them and to check with the system on what is happening in his particular community. Obviously, it is important that Winchester hospital works closely with its local authority with regard to discharge. We want to improve the better care fund, and I am sure that he will work with the local authority and his hospital to make sure that it works better.

NHS Winter Readiness

Debate between Danny Chambers and Karin Smyth

Wednesday 30th October 2024 Westminster Hall

[Karin Smyth]

I will come on to staffing to address some of those points. The hon. Gentleman makes an excellent point about staff recruitment and retention, which is a key part of our future look at the system.

On winter planning, the Government should not be micromanaging people in local systems as they do their job. Rather, we need to focus our efforts on where they are needed the most. Notwithstanding the excellent work of individual staff, let me repeat: the NHS is broken. None of us should underestimate how difficult this winter could be, but we are taking immediate steps to cushion the blow. First, we have set out our national winter planning priorities to NHS systems, local authorities and social care providers to support operational resilience over the coming months. Secondly, we are standing up the winter operating function seven days a week to respond to pressures in real time.

Thirdly, we are expanding the operational pressures escalation levels framework to give us a clearer picture of what is happening on the ground in all our systems. The framework uses comprehensive data to keep track of hospital pressures, and this year we are expanding its scope to mental health, community care and 111. Fourthly, we are continuing to support systems that are struggling the most through the urgent and emergency care tiering programme. Those are direct interventions to help systems get back on their feet and make the necessary improvements in performance.

Fifthly, we are providing targeted, clinically-led support to 19 of the most pressured hospital sites across the country, to help long waits in A&E and avoidable admissions over winter. Those measures are in addition to the aforementioned meetings that I hold with NHS England and UKHSA every fortnight. I am chairing every one of those meetings to ensure that we identify risks as soon as they arise, while supporting NHS England to mitigate them.

The party of the hon. Member for North Shropshire has called on the Government to set up a winter taskforce to prepare for an NHS winter crisis. Some might describe what we are doing as a taskforce; I actually think that is my job and the Secretary of State’s job, which, as I have outlined, is why we meet regularly with NHSE. I know that the hon. Member and others are sincere in their efforts to be constructive. I am happy to take away any specific suggestions about what we are not doing to help the NHS, because we all want the system to work well.

[Dr Chambers]

There has been no mention of increasing social care packages. Today, I spoke to the CEO of Hampshire hospitals trust, which runs Winchester hospital, and she said the single biggest thing that would make a difference over winter for that hospital, and probably every other one in the country, would be increasing the number of social care packages and ensuring that those well enough to leave hospital can be treated and cared for elsewhere. Why is that not the main focus of the winter measures that the Minister is talking about?

[Karin Smyth]

I will come on to social care, but I will make the broader point that every system is different, and the pressures in every system are different. Some systems suffer worse from poorer levels of primary or community care. Others, particularly those across borders, struggle with discharges and packages of care. One thing I am keen to do, and we are doing it, is try to understand the different drivers of performance in different parts of the system. I think we all have a role to play in that.

I very much support constructive advice from local Members of Parliament, in consultation with their local trusts, about the real drivers in their systems, because we know that some systems are performing much better. We as a new Government want to address that issue, to ensure that taxpayers’ money is being directed to the best place to make the system work better. That is something for the hon. Member for Winchester to take back. The flow is affected for different reasons in different parts of the system.

Several hon. Members have mentioned vaccinations. A key part of winter planning is the annual vaccination campaign, which began on 3 October. I thank the hon. Member for North Norfolk (Steff Aquarone), the hon. Member for Winchester and the Opposition spokesperson, the hon. Member for Meriden and Solihull East, for mentioning their support for vaccination programmes, which is absolutely welcome.

People talk about verifying the figures, but my understanding—I am happy to be corrected—is that we cannot verify the actual figures now. We have started different vaccination rates at different times, so the figures are not directly comparable. We will not really know that until the year works through, which I think people understand. It is too early in the vaccination season to draw firm conclusions, but we all have a role to play in driving and encouraging people to uptake vaccinations across the piece. I recently visited a local hospital in my city of Bristol which has staff hubs and encourages staff to go into the clinics. All Members’ efforts to help with that is really helpful. Vaccination programmes play an essential role in protecting people, particularly the elderly, children and the clinically vulnerable from serious illness during the winter months and in relieving pressures on hospitals and the wider system.

Data from the UK Health Security Agency shows that last year people who received a covid vaccine were around 45% less likely to be admitted to hospital compared with those who did not receive one. That is why we are delivering our usual campaigns for covid and flu for the clinically vulnerable in addition to the RSV work that is going on.

With regard to elective activity, for patients who are referred to a hospital we want to do everything we can to bring down waiting lists, which stood at over 7.5 million in August. The NHS is prioritising patient safety, urgent and cancer care and will continue to do its best to maintain appointments and elective procedures by separating elective care facilities and diagnostics wherever possible. In the longer term, we are going to return to 92% of patients waiting no longer than 18 weeks from referral to treatment in our first term, a standard that has not been met consistently for patients for a decade.

Our hospitals do not operate in isolation. Improving resilience across the whole system, including social care, is essential to winter planning. On 17 September we wrote to all local authorities setting out our priorities for improving resilience across social care ahead of winter, emphasising the importance of close partnerships and joint planning between the NHS and local authorities. We want people to have fair access to locally delivered services that start at home and support them to live independently for as long as possible. That will include building bridges between the NHS and social care services, getting people home from hospital as soon as they are ready, and providing much-needed support to families and friends who are involved in a loved one’s care. We will also work to ensure that people are not stuck in hospital beds when they are well enough to go home.

We cannot forget that the backbone of social care is carers. We have made it clear to all local health and care systems that they must continue to support people providing care for their family and friends throughout the winter. I am sure all hon. Members will join me in supporting the Chancellor’s Budget announcement today to support our carers more widely. We want to make sure that carers can access the support they need to look after their own health and wellbeing, not just that of the people they care for. The better care fund includes funding that can be used for short breaks and respite services for carers. The Government are clear that people who draw on care and support, and their families and carers, should be closely involved in decisions about their care. However, in the long term we clearly need reform. That is why the Secretary of State has called for a new national consensus on social care.

The Government are committed to building a national care service. My hon. Friend the Minister for Care is introducing the first ever fair pay agreement for care workers. Again, we have seen today our commitment to further support carers with improvements to carer’s allowance. That is a start, but we know we have a long way to go.

We are working radically to reform the NHS through the 10-year plan, building a health service that is fit for the future and ready to face every winter confidently. Lord Darzi gave us the diagnosis; the cure can be found in shifting the NHS from treatment to prevention, hospital to home and analogue to digital. That is why last week we launched an extensive engagement exercise with the public, staff and stakeholders to inform that plan. Some right hon. and hon. Members might be keen to see some of the public’s wilder ideas, perhaps, but alongside some of those we have already had many considered and thoughtful responses, and we look forward to outlining our specific plans in the spring.

With regard to the point made by the hon. Member for Strangford (Jim Shannon) about individual training and bursaries and the large number of suggestions about the important issue of recruiting and retaining our staff, we will look closely at the long-term workforce plan—we are already doing that. We are open to suggestions. We need to build a workforce for the future that lines up with our three shifts. It will be a tough process to get right and to keep up with modern technology, but all those ideas will inform that.

I commend the hon. Member for North Shropshire for securing the debate today and colleagues for shining a spotlight on the difficulties that our constituents face. I hope colleagues are reassured. As someone who has worked on winter planning in the NHS, I am fully aware of the challenges that we face. That is why we have taken a strong grip of it from the get-go. I know we cannot go on as we have done for the past 14 years, limping from one winter crisis to the next, improvising and making do with sticking plasters. The Government are winter-proofing the NHS with long-term reform, but until that day we will put every hand on deck to tackle the problems as they arise this winter.