Sodium Valproate

Diana Johnson Excerpts

Thursday 29th October 2026 Commons Chamber

[The Minister for Public Health and Patient Safety (Dame Diana Johnson)]

May I too say how nice it is to see the Clerk of the House in his place? I pay tribute to him for his long service in this place, and wish him the very best for the next chapter.

I congratulate my hon. Friend the Member for Lancaster and Wyre (Cat Smith) on securing this important debate, and thank all hon. Members who have contributed on this sensitive and important topic. We have had important contributions from my hon. Friends the Members for Blaydon and Consett (Liz Twist), for Shipley (Anna Dixon) and for Washington and Gateshead South (Mrs Hodgson), and the hon. Member for Harrow East (Bob Blackman). You too, Madam Deputy Speaker, have been a long-standing supporter on this issue.

My hon. Friend the Member for Lancaster and Wyre has been working tirelessly for many years on behalf of her constituent Janet Williams and all the campaigners and the families, including Emma Murphy, to whom she referred. We need to ensure that the voices of women and families are heard, and that they are at the heart of our discussions and debates. I agree with my hon. Friend about the perseverance of women, and there is clear perseverance here. I have been very moved by the stories I have heard, including before coming into office, and the more I look into this matter, the more tragic it appears to be. I will watch that television programme on 9 November that my hon. Friend referred to.

As my hon. Friend would expect, since becoming the Minister for Public Health and Patient Safety, I have been briefed by officials on the Hughes report and the progress we have made so far. Of course, I am happy to meet my hon. Friend and the families affected. I am also determined to make progress on the Government’s response to the Hughes report, and I will of course work closely with devolved Governments in doing that because, as has been said, this affects all parts of the United Kingdom, so we need to work together. My predecessor, my hon. Friend the Member for Glasgow South West (Dr Ahmed), established a direct line with the Patient Safety Commissioner to start to drive this work forward. I think that was the right approach, and I look forward to meeting Professor Hughes shortly.

I am conscious that it has been more than two years since Professor Hughes published her report, and more than five years since the independent medicines and medical devices safety review was issued by Baroness Cumberlege. We know that the lives of women, children and their families have been profoundly changed. Their voices must be heard as we address these issues with the urgency demanded.

[James Naish (Rushcliffe) (Lab)]

My constituent Matthew Cox has foetal valproate syndrome. This time last year, he wrote to the Prime Minister. It took several months for him to get a response. He wrote again to No. 10 in March, and I wrote to the Health Secretary in July. There have been no responses, and the response that Matthew did receive was not an appropriate response for someone with learning difficulties. Will the Minister take Matthew’s case away specifically, and ensure that he gets the response he has been looking for? He and his mum welcome the hope that a new Labour Government brought on this; it is essential that we deliver for them.

[Dame Diana Johnson]

I will of course take that away. As a Minister, I have made it clear that we should respond in a timely way not only to Members of Parliament, but in other correspondence, and in a way in which people can understand what is being said to them. I absolutely take my hon. Friend’s point.

Moving on, we are determined to build a system that listens, that hears and that will act, and we need to do that with speed, compassion and proportionality. As someone who has fought hard for the compensation due to the victims of the infected blood scandal, I fully understand the strength of feeling on this matter, and I can also appreciate the frustrations of the families and the campaigners. This is a complex and sensitive issue that requires careful co-ordination across Government.

The support we offer to those who have suffered profound harm must be meaningful and responsive to their needs. The Government are clear that those affected have already waited far too long for answers. While a decision has not yet been taken to provide financial redress, my priority is to drive these discussions forward with greater urgency, while ensuring that any decisions we take are underpinned by a thorough assessment of the available options, with continued engagement across Government. Our discussions so far have considered the scope, affordability and practical challenges of a redress scheme, so I will say a few words about non-financial redress.

[Cat Smith]

I seek some clarity. The Minister says that the decision has not yet been made, yet a previous Secretary of State for Health and Social Care, the right hon. Member for Ilford North (Wes Streeting), told ITV that he was expecting financial redress by the end of this Parliament. Can the Minister just clarify that, because it seems inconsistent?

[Dame Diana Johnson]

My understanding of what the previous Secretary of State said is that he wanted to see progress within this Parliament. I am mindful of the Hughes report, which set out clear recommendations around redress, and I have just tried to set out that that is the avenue I am pursuing with some speed, looking at what the options are. I hope that that answers my hon. Friend.

[Liz Twist]

I know from the Minister’s previous work that she will be conscious of the issues, but we are two years on from the Hughes report, which made it clear that we need to act. This is an important issue, and it feels like a group—primarily of women—are being left to one side to wait their turn or bide their time. Can the Minister assure me that she will be in the Department, making sure that we get a real answer on financial and other redress? I am sure she will be doing that, but we need to see some action.

[Dame Diana Johnson]

I fully understand and appreciate the frustration, because it has been two years since the report was published. I will do my very best. I know that my predecessor, my hon. Friend the Member for Washington and Gateshead South, who is in her place, was also looking at what more we could do to speed up matters. I give an undertaking to this House that I will do my very best to make sure that we make progress on redress and all the recommendations in the Hughes report.

[Mrs Hodgson]

rose—

[Dame Diana Johnson]

I can see that my hon. Friend wants me to give way, and I am happy to.

[Mrs Hodgson]

I know that my right hon. Friend, with her experience of leading the infected blood campaign, is best placed to deliver for all these victims of mesh and valproate—maybe Primodos as well, although that was not covered in the Hughes report. I would like to add one other thing to her list, if I may, and that is payments from big pharma to the health sector. They really do have to be disclosed. At the moment, they are ambiguous and misleading, and lump sum payments can hide a multitude of payments. Does she agree that, to prevent future injustices, it is time for the Government to enact a statutory approach to payment transparency in the health sector?

[Dame Diana Johnson]

I am very happy to discuss that with my hon. Friend and see what we can do.

I want to deal with non-financial redress. It is important to recognise that people need support now. The Department is working with the NHS to put in place a range of measures to support the women and their families, alongside action to strengthen the safe prescribing of sodium valproate. In February, on the second anniversary of the Hughes report, the Minister for Secondary Care, my hon. Friend the Member for Bristol South (Karin Smyth), set out how the Department is addressing their needs by improving the clinical services and treatment that patients receive, commissioning further research and initiating long-term preventive measures. I would like to update colleagues on those initiatives.

First, on the improvements to services and treatment, the number of women who have been prescribed sodium valproate has gone down since 2018, although there is a cohort who have already been affected and require specific treatment. We must ensure that our healthcare system is shaped around their needs and experiences. Shortly after the Government came to office, NHS England began operating the foetal exposure to medicines pilot service in hospitals in Manchester and Newcastle, to which my hon. Friend the Member for Lancaster and Wyre referred. The project is providing multidisciplinary assessments, diagnosis and treatment planning, and its findings will inform the way we do this at a national level.

The proposed extension of the pilot project includes setting up a third site and an independent evaluation of the pilot, because we should not be marking our own homework. That should give us the evidence we need to determine whether a nationally commissioned service could be implemented across England. This approach balances the need to improve support for affected individuals and families with the requirement to ensure that any future national service is evidence-based, clinically effective and financially sustainable.

[Bob Blackman]

It is good news that the Minister is considering a national proposal. Will she undertake to have a meeting with the long-suffering victims of this scandal, who have been caring for their children for many years without support, in such desperate times, to show her commitment to doing what needs to be done for them? I think she will learn quite a lot from such a meeting.

[Dame Diana Johnson]

Of course I will. I would be very interested in doing that and learning more, and I am sure my office will be in touch with the hon. Gentleman about that.

Secondly, on research and development, we are working with clinicians from the pilot and other experts to see how we can improve the services available to affected patients.

Finally, on prevention, NHS England and the Medicines and Healthcare products Regulatory Agency have introduced strict measures to minimise valproate exposure during pregnancy, including pregnancy prevention programmes, and prescribing controls and specialist counselling for women who may become pregnant while taking the medication.

Let me close by again paying tribute to all the families whose lives have been changed forever by sodium valproate and the other issues that were set out in the Hughes report around pelvic mesh. I hope I have made clear how determined we are to respond to the Hughes report with the urgency and the compassion that those families absolutely deserve.

[Madam Deputy Speaker (Caroline Nokes)]

I was overseas when the tributes to the Clerk of the House were made last week, so I would just like to correct the Minister: the Clerk of the House cannot be very long serving, because he is clearly an incredibly young man and far too young to retire. I add my thanks to him for all the support and help he has given me in this role.

Question put and agreed to.

Major Trauma Centres: Helipads

Diana Johnson Excerpts

Thursday 29th October 2026 Westminster Hall

[The Minister for Public Health and Patient Safety (Dame Diana Johnson)]

As always, it is a pleasure to serve under your chairmanship, Sir Alec.

I am grateful to the hon. Member for Strangford (Jim Shannon) for securing the debate—he must contribute to more debates than any parliamentarian I have ever come across—and for giving us the opportunity to discuss the important role that hospital helipads play in supporting urgent and specialist care. My hon. Friend the Minister for Secondary Care, who has responsibility for this policy area, is always happy to meet Members, in particular the hon. Member for Strangford, and I know she will look at Hansard to read the contributions of other right hon. and hon. Members.

The hon. Member for Strangford is a long-standing supporter of air ambulance services. He has regularly talked about their importance, particularly for rural and coastal communities, where the geography can make it harder to reach patients quickly. In his excellent opening speech, he paid tribute to the important and vital work of the air ambulance service in Northern Ireland. I too recognise its invaluable work.

I also recognise the work of the air ambulance charities around and across the United Kingdom, which provide a vital service helping seriously ill or injured people. Across England, air ambulance charities carry out more than 50,000 missions each year. I am very grateful to everyone who works and volunteers in the sector, and to the communities that support them. As a Yorkshire MP, I have to give a shout-out to my local air ambulance—Yorkshire Air Ambulance—for its brilliant work.

I thank all Members who contributed to the debate. My hon. Friend the Member for Camborne and Redruth (Perran Moon) asked about the Royal Cornwall hospital. Although decisions on capital investment are a matter for local NHS systems, I understand that work is under way to look at options to improve the air ambulance access at the hospital. I also understand that the hospital is investigating alternative options so that coastguard helicopters can land safely.

My hon. Friend the Member for Truro and Falmouth (Jayne Kirkham) talked about the necessity of the service in rural and coastal areas. She and a number of other Members raised fuel resilience. We routinely engage with air ambulance charities on contingency planning, and as part of that we have addressed fuel resilience. The Government will continue to work with fuel suppliers to make sure that essential services are supported.

The hon. Member for North Cornwall (Ben Maguire) said that Cornwall Air Ambulance is based in his constituency. He brought the whole debate to life when he talked about 15-year-old Lewie, who suffered horrific injuries, and about how the service saved his life. He also talked about how important the service was when three-year-old Mia had a seizure. I send my best wishes to them both—I am sure all Members would like to do the same—and I hope they have made good recoveries.

My hon. Friend the Member for Cannock Chase (Josh Newbury) gave the example of a family member—I think it was his niece—who needed an air ambulance. I was pleased to hear that she is now 21, and hopefully she is in good health. There were some very good contributions to the debate. I heard what the hon. Member for Chelmsford (Marie Goldman) said about Essex & Herts Air Ambulance, and the issues with the local hospital. I will relay those points to the Minister for Secondary Care.

I recognise the concerns raised by hon. Members and the all-party parliamentary group for air ambulances. The points are well made. In June, the APPG published its report making the case for safeguarded 24/7 on-site hospital helipads at major trauma centres and specialist hospitals, which is a very good piece of work.

We all accept that getting seriously ill or injured patients to the hospital quickly matters. Air ambulance teams work alongside NHS ambulance service and hospitals to provide specialist care at the scene and help patients to reach specialist treatment quickly. We also need to think about what happens when the aircraft reaches the hospital. If direct landing is not available, a patient may need an onward transfer by road ambulance, which can add time to the journey and place additional demand on ambulance vehicles and crews.

Alternative landing sites are an important part of resilience when a hospital helipad is unavailable, so clear local arrangements are needed to minimise delays. Hospital helipads therefore have an important role to play, but the current picture is not the same everywhere. Helipad provision has developed locally, over many years. There has not been a single national approach setting out where helipads should be provided, what the provision should look like and how it should be funded.

Currently, responsibility for hospital helipads sits with local NHS organisations, working with planning, aviation and local authority partners. Decisions about investment, including improvements to allow night-time operation, are generally made locally, as part of a wider NHS estates and capital planning programme. But I recognise the arguments made today that we need to look again at whether those arrangements remain right for the future.

NHS England has identified challenges, including changing aircraft and aviation standards, secondary ambulance transfers, and differences in landing infrastructure. Work has also started to strengthen safety arrangements. Following the tragic incident at Derriford hospital, NHS England worked with His Majesty’s Coastguard, the Department for Transport and the Civil Aviation Authority to strengthen assurance. Sites are now required to have a named accountable manager, a site-specific risk assessment and a helipad operating manual. Chief executives have been asked to confirm that appropriate safety standards are being met.

NHS England continues to work with the air ambulance sector and regularly meets the DFT and Air Ambulances UK. It also takes part, when needed, in the onshore surface landing group, which brings together organisations including the Civil Aviation Authority, the DFT and the devolved nations.

I want to be clear about what we are doing next. I am pleased to announce that the Minister for Secondary Care has instructed the Department of Health and Social Care and NHS England to scope a strategic review of air ambulance resilience, including hospital helipads and landing sites. That work is starting, and I do not want to pre-empt what it may find or any recommendations that it may come up with. It will give us the opportunity to look at current landing facilities, onward transfers, future clinical and aircraft requirements, and the condition of existing infrastructure.

The hon. Member for Strangford rightly recognised that different hospitals have different clinical needs, geography, landing arrangements and planning constraints, and that the same solution will not be right for every site. I agree that any future approach needs to be proportionate and informed by clinical and operational need.

Let me turn to the concerns, raised by a number of hon. Members and the APPG, about the impact of the planning system—

[Jim Shannon]

I want to clarify one wee matter. First, I very much welcome the national review that the Minister has described. On some occasions, there are issues with planning. Will the national review be able to address specific issues and ensure that, where there may be planning objections, there can be an arrangement to ensure that helicopters can safely access helipads? We would not want to see planning holding that up.

[Dame Diana Johnson]

I will set out the position on planning. The Government share the concerns about the potential impact of new developments on the operation of hospital helipads. That is why our new national planning policy framework, published in August, makes it clear that existing public services should not face unreasonable restrictions on their operation because of development that takes place around them.

The framework is clear that where a new development could be affected by an existing activity nearby, the impacts should be identified and suitable steps taken to address them. It also gives substantial weight to the benefits of new or improved public service infrastructure, including healthcare facilities. Work is happening on that now, and I am sure that if the hon. Gentleman wants to discuss it further, we will be able to facilitate that.

Work is happening on aviation standards, too. The CAA’s civil aviation publication 1264 provides guidance on the design and operation of hospital helicopter landing sites. This matters, because safe access depends not just on having a landing site but on whether an aircraft can use it safely. The guidance is not currently mandatory, but the DFT and the Civil Aviation Authority are working towards the formal regulation of hospital landing sites, which is currently expected around 2028.

NHS England and the DFT are also working to build a clearer picture of which hospital landing sites comply with the existing guidance. Currently, helicopter operators make their own decisions about where they can safely land. That can depend on things such as the aircraft being used, the weather and the obstacles around a landing site. The DFT is working with NHS England, the CAA, the air ambulance sector and His Majesty’s Coastguard on those issues. There is obviously much more work to do, and I absolutely recognise the concerns raised in the debate and through the APPG report.

The Opposition spokesperson, the right hon. Member for East Hampshire (Damian Hinds), asked about capital spend in previous years, and I will have to write to him about that. On his comment about announcements in the Budget, our contribution to the defence investment plan, including at the extended level set out yesterday, will avoid impact on frontline NHS services, patient safety, investment in technology and the delivery of the new hospital programme.

[Ben Maguire]

I am pleased to hear about the review the Minister has announced. Can she give us any sense of a timeline for when that review might conclude?

[Dame Diana Johnson]

I am not the Minister for this policy area, but I will ask my hon. Friend the Minister for Secondary Care what information might be available about timescales. I understand Members’ interest as to when the review might conclude.

We have had a useful debate and I am very grateful to the hon. Member for Strangford for bringing the debate before the House. I again thank the APPG’s members and the air ambulance sector for all their continued excellent work.

Health and Social Care

Diana Johnson Excerpts

Wednesday 28th October 2026 Written Corrections

[Dame Diana Johnson]

Times in A&E are being speeded up. The hon. Lady speaks with experience because she is a clinician, and I am happy to go away and look at that issue and write to her if there is information we need to let her have. My understanding is that we are speeding things up in A&E, and getting people through and on to the ward as quickly as possible.

[Official Report, 20 October 2026; Vol. 791, c. 955.]

Written correction submitted by the Minister for Public Health and Patient Safety, the right hon. Member for Kingston upon Hull North and Cottingham (Dame Diana Johnson):

[Dame Diana Johnson]

The hon. Lady speaks with experience because she is a clinician, and I am happy to go away and look at that issue and write to her if there is information we need to let her have. My understanding is that we are getting people through A&E and on to the ward as quickly as possible.

Covid-19 Inquiry Module 4 Report: Government Response

Diana Johnson Excerpts

Tuesday 27th October 2026 Westminster Hall

[The Minister for Public Health and Patient Safety (Dame Diana Johnson)]

It is a pleasure to serve under your chairmanship this afternoon, Mr Stuart, as you are my constituency neighbour in East Yorkshire. I thank the hon. Member for Christchurch (Sir Christopher Chope) for securing this debate, and I pay tribute to him for his work on the APPG on pandemic response and recovery and all his campaigning work over so many years. It was interesting that he referenced his first speech on this topic in 2021—persistence is certainly one of his qualities. I am always willing to meet hon. and right hon. Members.

This has been a very good debate on an important topic. My hon. Friend the Member for Worthing West (Dr Cooper), who speaks with great authority as a public health consultant, set out some of the good work that happened during the pandemic as well as the international perspective that we need to be mindful of. The right hon. and learned Member for Kenilworth and Southam (Sir Jeremy Wright) is a doughty campaigner on behalf of his constituent Kate Scott. He made an eloquent speech—as he always does—and I agree with him about the issue of timeliness.

My hon. Friend the Member for Blackley and Middleton South (Graham Stringer) took us back to some of the key decisions that were made during the pandemic. The hon. Member for Great Yarmouth (Rupert Lowe), who delivered a speech that I sadly felt was anti-vaccination, did not recognise the public health benefits of vaccinations. The hon. Member for Bromsgrove (Bradley Thomas) spoke very movingly about John Cross and his family, as well as the fight that they had and the need for reform of the vaccine damage payment scheme. I will meet the right hon. Member for Tatton (Esther McVey) as soon as possible, as well as the family she spoke of.

During the pandemic, Members on my side of the House did our best to offer constructive opposition to the previous Government, and this Government are committed to learning every lesson from the covid inquiry. We are extremely grateful to the noble Baroness Hallett and her team for the thoughtful and thorough advice they have offered us so far. At the end of next week, we will mark 80 years since the National Health Service Act 1946, which paved the way for the introduction of the NHS two years later, became law. That will be a chance for us to remember and pay tribute to all those who served the public with such courage and professionalism during the pandemic, not least our social care workers, whose contribution has been overlooked for too long.

Turning to module 4, we are also grateful to the small army of researchers, clinicians and regulators who worked around the clock to ensure that vaccines were deployed at speed, having gone through the rigorous safeguards of a clinical trial. But while it recognised the success of the vaccine programme, the module 4 report also sets out a series of recommendations and areas for improvement. For example, future vaccination and therapeutics programmes must—of course—have people’s trust, be guided by the best available evidence and remain available to all who need them. The inquiry also notes that safety monitoring must continue to evolve, with improvements to health data infrastructure. The Government published our response to those recommendations earlier this month.

We are taking action across the board to improve vaccination uptake, pandemic preparedness and the strength of UK life sciences, especially through our pandemic preparedness strategy. If the last pandemic taught us anything, it was that UK life sciences not only are vital for UK growth but play a central and strategic role in how we respond to health threats. We propose to establish an advisory group with our partners in industry, building resilience across our supply chains.

Vaccination uptake is not where it needs to be, especially for children. That is why we need stronger engagement with communities, particularly those communities where uptake is lower than average. As the Minister for Public Health and Patient Safety, I am especially concerned by the re-emergence of measles and other diseases that we thought had been banished when I was a girl. I want to respond to my hon. Friend the Member for Worthing West on targets. We still have the World Health Organisation target of 95% coverage.

I am determined to ensure that the protection that vaccines afford remains available to the many, not the few. I have also been clear that there must be strong collaboration across our United Kingdom, because diseases do not stop at Offa’s Dyke or Hadrian’s Wall. We are strengthening the way we monitor outbreaks, while improving access to linked healthcare data across all four nations.

I now turn specifically to recommendation 5 of module 4 and the vaccine damage payment scheme. This is an important financial support for anyone who has become severely disabled following a vaccination. Fifty-three million people followed the example of Her late Majesty the Queen and took the jab to protect themselves, their loved ones and their communities. This country has a global reputation for an uncompromising approach to safety, and vaccines are authorised only once they have met robust standards of effectiveness, safety and quality. However, in rare and devastating circumstances, some people have gone through the nightmare of losing a loved one or suffered severe adverse outcomes following vaccination. Those people did as they were asked, in good faith, and through no fault of their own they have become disabled or worse. We can never turn a blind eye to the tragic instances in which things go wrong, and we must continue to be honest with the wider public that no vaccine is completely free of risk.

This afternoon, I have listened very carefully to the concerns raised about the current scheme, the support available to those affected, the experiences of those who have made claims and the time that it has taken to respond to these concerns. People who experience severe outcomes deserve appropriate support. This is not just about the welfare of those families, important though that is. As the right hon. and learned Member for Kenilworth and Southam said, it is about public trust in our wider vaccine programme, because people must be confident, when stepping into the clinic, that the state will be there for them if things go wrong.

The hon. Member for Christchurch asked me when we started to review the VDPS. I want to be very clear on this, because I know that previous Ministers have stood up and given answers on it. The Department has been considering options for reform and will now initiate a period of open engagement with those affected. We are going beyond the case for reform and turning now to the detail that must underpin any reforms.

The hon. Member for Bromsgrove and a number of other Members have asked me whether the Government accept that the 60% disability threshold is too high and whether we will consider changing it. The Government understand the concerns raised about the 60% disability threshold by the inquiry. The inquiry’s recommendations will be central to our ongoing work as the Government consider a range of options for potential reform, including introducing multiple levels of payment. Last week, I met injured people and bereaved families. I understand their frustrations about how long this is taking when successive Governments have kicked the can down the road.

[Sir Jeremy Wright]

On the Minister’s point about whether graded payments might be available under the scheme, will she be clear that she is considering linking that to the disablement requirement? Of course, an outcome we would not want is a simple reduction of the £120,000 for those who are 60% disabled or more. We are interested in perhaps giving some money to those who are below the 60% threshold; will she confirm that is what she is thinking about?

[Dame Diana Johnson]

Yes, I am happy to say that that is what I am thinking about because of the unfairness of that 60% barrier. I am certainly looking at that. It will be considered. I am not saying exactly what will be decided, but that is certainly an option that I have asked officials to look at.

I note that the scheme has not been reformed since I was a member of the Labour Government in 2007. Of course the scheme must be made fit for the future; I think we can all agree on that. That is why Ministers will again meet with families of the injured and bereaved families before the end of the year. In the coming weeks, before Christmas, my officials will meet with advisers put forward by the families of the injured and bereaved families to listen to their views on possible options for reform of the vaccine damage payment scheme. From now until spring, officials will meet and engage with our key partners, including those injured and bereaved, to discuss the reforms. I look forward to updating colleagues in the spring.

[Esther McVey]

My specific concern is about the MHRA, which is meant to highlight and give out warnings on what is going on. The MHRA has failed throughout this situation; when we meet, can we also discuss its failings?

[Dame Diana Johnson]

Yes, I am happy to meet with the right hon. Lady and to discuss all the points that she wishes to raise.

Nearly everyone in our country remembers when they walked into their local clinic or pharmacy, or even into their church hall, school sports hall or village hall, to get their jab. We remember with pride how a country rallied together as part of a national effort to save lives. For most of us the vaccine was a welcome relief, offering additional freedoms and safety, but for some families it brought devastating loss and hardship. As the new Minister responsible for this policy I am committed to working closely with those families, who I met just last week, and I want progress made quickly. We will report any interim progress through the UK covid-19 inquiry implementation updates.

The public have a right to know that we are learning from past mistakes and as the Minister for Public Health I will never take the public’s trust for granted. The Government’s response to module 4 will not be some exercise in box-ticking or window-dressing because we know that, when it comes to preparing for future public health emergencies, readiness is all and we need the trust of our communities.

Prostate Cancer Screening

Diana Johnson Excerpts

Monday 26th October 2026 Westminster Hall

[The Minister for Public Health and Patient Safety (Dame Diana Johnson)]

It is a pleasure to serve under your chairship, Dr Murrison. I am grateful to the hon. Member for Berwickshire, Roxburgh and Selkirk (John Lamont) for opening this important debate and setting out so clearly the questions he wants answered.

I want to begin by acknowledging the strength of feeling behind the petition. More than 100,000 people have signed it and a large number of right hon. and hon. Members in the Chamber have made very powerful speeches. I will reflect on the issues raised; I will try to address as many of the points in my contribution this afternoon, but if I do not answer every question, I will reflect on them and I will certainly write to the shadow Minister.

There is a very real desire for us to do more to diagnose prostate cancer effectively, treat it earlier and ultimately save more lives. I am grateful to Members from across the House who have spoken so openly about their own experiences and those of their constituents, friends and families. I too am thinking of all those individuals facing a prostate cancer diagnosis and undergoing treatment at this time, and I was very pleased to hear that our former colleague, Gary Streeter, is doing well. I am sure that the whole House sends him our best wishes.

As we have heard, prostate cancer is the most common cancer in men in the United Kingdom. Around 68,000 men are diagnosed in the UK each year, and although survival rates are high, tragically, around 12,000 men still die from prostate cancer every year. Every one of those deaths is a loss to their family, friends and community. The Government are determined to improve outcomes for men with prostate cancer.

The UK National Screening Committee advises all four nations. Scottish officials are present at committee meetings and officials in the Department of Health and Social Care work with their counterparts across the devolved Governments to share information and good practice. In June, we announced England’s first targeted prostate cancer screening programme. From 2027, eligible men aged 45 to 61 with a BRCA2 gene variant and a family history of prostate, breast, pancreatic or ovarian cancer will be offered a PSA test every two years. We are working with the UK Cancer Genetics Group to identify further men who will be eligible for screening. That is an important step forward, but I recognise that for many it does not go far enough.

The petition asks the Government to go further than the UK National Screening Committee’s recommendation and introduce screening for all men at higher risk. I understand that ambition and I share the determination behind it, but we have a responsibility to ensure that the evidence tells us that, when we introduce screening, it will do more good than harm. That balance is particularly difficult with prostate cancer, as we have heard from some of the medically qualified Members. Unlike many other cancers, prostate cancer is often slow growing, and many men who develop it will never experience symptoms or come to any harm from it.

At the same time, treatment can have profound consequences. More than half of those treated experience significant side effects, including bladder leakage, bowel incontinence and erectile dysfunction. When we talk about the harms of screening and overtreatment, we are not talking about something abstract; we are talking about potentially lasting consequences affecting a man’s health, dignity and quality of life.

[Dr Luke Evans]

Will the Minister give way on that point?

[Dame Diana Johnson]

I am going to make some progress, because I am keen to address the points that the hon. Member for Berwickshire, Roxburgh and Selkirk raised. If I have time at the end, I will take an intervention.

I want to turn to the issue of ethnic minority men. I have listened very carefully to the concerns about men at higher risk who are not included in the initial screening programme, particularly black men and men with a family history of cancer. We know that black men are twice as likely as white men to be diagnosed with prostate cancer, and that disparity rightly worries us all. What we do not yet know is whether screening black men would identify more aggressive cancers that need treatment, rather than slower growing cancers that may never cause harm. If screening leads to men being diagnosed and treated for cancers that would never have harmed them, we risk causing significant and lasting harm, and that cannot be right.

We should not accept the gaps in the evidence that prevent us from giving men the answers that they deserve. That is why the Government are investing and building on the Transform trial introduced by the previous Government by investing £34 million to identify better ways to screen for prostate cancer and enable all eligible black men to be invited to participate at stage 2. Prostate Cancer UK is working with charities and organisations experienced in working with black communities to encourage participation. That matters because we need stronger evidence built with the men most affected to inform future decisions about screening.

Family history is another important part of this picture. We know that it can increase a man’s risk, but the evidence does not yet tell us precisely which patterns of family history confer the greatest risk. Work is under way to refine the definition of family history and ensure that it is properly reflected in the UK National Screening Committee’s model. I totally accept that men need support now, which is why Cancer Research UK, the UK Cancer Genetics Group and the Royal College of General Practitioners are bringing together expertise to develop guidance to support GPs when advising men about familial risk.

[Sir Bernard Jenkin]

Will the Minister give way?

[Dame Diana Johnson]

I will carry on because I want to make these points.

The important point is that the evidence and clinical practice are evolving, and our approach must be able to evolve with them. That is why the Government are funding the prostate cancer screening model used by the UK National Screening Committee for a further three years. Work is already under way on family history, risk algorithms and biomarkers, including Stockholm3, and significant evidence from Transform can be considered as it emerges. The initial programme is therefore not the end of the process. Where robust new evidence supports screening additional high-risk groups, that evidence can be considered and screening recommendations revisited.

[John Glen (Salisbury) (Con)]

Will the Minister give way?

[Dame Diana Johnson]

I will carry on because I am conscious of time and I want to make these points.

I want to address directly the concern about the evidence underpinning the current screening recommendation. The committee considered the current NHS standard of care, which includes the use of MRI before biopsy. It did not include newer and innovative approaches for which the evidence is not yet sufficiently established. There are enormously encouraging advances taking place, including more targeted approaches, such as focal therapy. Better diagnosis and less harmful treatments could change the balance between the benefits and harms of screening, and as robust evidence develops, it will be considered.

I also want to deal with the point about GPs. I have heard the strength of feeling about PSA testing for men who are not eligible for the new screening programme. I want to reassure men that the policy has not changed. Any man who is concerned about prostate cancer, including a man without symptoms, can discuss PSA testing with his GP. Separate from the decision on national screening programmes, it is my view and the Secretary of State’s view that men who ask their GP or urologist about a PSA test should be able to make an informed choice, based on good-quality information, about the likelihood of being helped or being harmed. The Secretary of State worked on this issue as a Health Minister at the Department almost 25 years ago, and personally ensured that the guidance includes references to the importance of informed choice.

[Dr Luke Evans]

Is the Minister therefore saying that a 52-year-old patient who understands the risks on both sides and wants their PSA has the right to get it, or is it the GP’s decision? The GP could deny it on a clinical basis even if the patient wants it. That is the change that people are worried about. Could she explain that point?

[Dame Diana Johnson]

I recognise the hon. Gentleman’s experience as a GP. My understanding is that a man who requests a PSA test from a GP will have that test if he is given the information and the choice is there, but I will write to the hon. Gentleman if that is not correct. It has to be an informed choice, with the man knowing the risks and the harms but also the potential benefits.

Ultimately, everyone in this Chamber wants the same thing: we want fewer men to die from prostate cancer, cancers that need treatment to be found earlier, and every man to receive the care that is right for him; but we must achieve that while protecting men from unnecessary diagnosis and from receiving treatments that can have lifelong consequences for a cancer that might never have caused harm. The question is not whether we want to prevent more deaths from prostate cancer—of course we do. The question is how we can do so safely, effectively and fairly, using the best available evidence while continuing to build the evidence where it is not yet strong enough. As I have said, as that evidence develops, we must be prepared to act. I thank the hon. Member for Berwickshire, Roxburgh and Selkirk for raising this important issue, and all Members who have contributed to this thoughtful and powerful debate.

Oral Answers to Questions

Diana Johnson Excerpts

Tuesday 20th October 2026 Commons Chamber

[Fleur Anderson (Putney) (Lab)]

14. What steps she is taking to improve access to GPs.

[The Minister for Public Health and Patient Safety (Dame Diana Johnson)]

We now have the highest number of fully qualified GPs since 2015, and almost 16 million more GP appointments were delivered in the last year than in the 12 months before the election. As a result of that investment, 77% of people now say that they have a good local service. We know that there is more to do, especially in rural and remote areas, but there is clear progress against our 10-year plan.

[Alan Mak]

Vital NHS services, including scans and X-rays, have been removed from Oak Park clinic, which serves every resident in the Havant constituency. Will the Minister meet me and support my campaign to restore those vital services so that my constituents do not have to travel to Portsmouth or further afield?

[Dame Diana Johnson]

I am happy to meet the hon. Gentleman. I have looked at the issue around Oak Park community clinic and I know that he has met the integrated care board. I am told that all options are being considered to provide a sustainable and accessible solution for diagnostics at the Oak Park site, but I am happy to meet him.

[Fleur Anderson]

I am concerned about NHS England’s GP list cleaning programme and its impact on London specifically. Putney GPs have told me that in the last six months, 344,000 patients have been taken off GP lists, 44% of whom are in London. Some are taken off after not responding to a single letter. That means that they do not get cancer check-ups, vaccines or GP care. Something is going on with the London part of the GP lists. Will the Minister pause, review the programme, look into it and meet me and other London MPs to talk about it?

[Dame Diana Johnson]

I understand the concerns that my hon. Friend has raised, particularly with regard to vulnerable patients, but it is important that GP lists are as accurate as possible. We think that there are around 6 million more registrations than England’s population and most people flagged are confirmed to have moved abroad. Strong safeguards are in place, including no patient being removed on the basis of a single indicator or because they failed to respond to one piece of correspondence. Overall, it takes more than five months from identifying a patient who may no longer reside to deregistering them from a practice system. I am always happy to meet my hon. Friend.

[Dr Luke Evans (Hinckley and Bosworth) (Con)]

One thing that hinders access to and the effectiveness of primary care is Labour’s mandatory use of single point of access—so much so that a safety watchdog has linked it to deaths. After those on the Government Front Bench dismissed the concerns raised by Conservatives, it turns out that an investigation has been set forward, with the NHS Strategy Unit asked to look at the matter. Will the Minister set out the terms of reference that the Strategy Unit is using, the timeframe and when this House can expect to hear the answers to ensure this is done safely?

[Dame Diana Johnson]

I am grateful to the hon. Gentleman for raising this. He will appreciate that I am relatively new in post, but I am going to find out and I will write to him with the specific answers to the questions he has posed today.

[Dr Marie Tidball (Penistone and Stocksbridge) (Lab)]

Constituents in Stocksbridge, Deepcar, Wharncliffe Side and Oughtibridge regularly tell me how important it is for them to have access closer to home to routine blood tests, X-rays, special educational needs and disability support, mental health support, NHS dentistry and mammograms, because of the poor transport links and delays in accessing NHS diagnostic services in Sheffield. Therefore, I was delighted to welcome Stocksbridge towns fund board members, local health leaders and experts to visit the 519 community hub site in our town. Will the Minister meet me to discuss our proposal for a community diagnostic centre in the new 519 building, to maximise its benefit to our community—mirroring the excellent Glass Works and Alhambra centre facilities in Barnsley—and to bring health to our high streets locally?

[Dame Diana Johnson]

My hon. Friend is a doughty champion for her local area and for ensuring that we have services close to populations and close to where people live. I am very happy to meet her to discuss this.

[Dr Simon Opher (Stroud) (Lab)]

5. What steps she is taking to help improve the health of young people.

--- Later in debate ---

[Jessica Toale (Bournemouth West) (Lab)]

6. What steps her Department is taking to support women affected by diethylstilbesterol.

[The Minister for Public Health and Patient Safety (Dame Diana Johnson)]

I pay tribute to my hon. Friend for all her campaigning on diethylstilbesterol and to her constituent Jan Hall and her family. We recognise the serious intergenerational effects of exposure to DES, including increased cancer risks and reproductive complications, and we have asked NHS England and clinical networks to improve awareness of those issues and the people affected by them. We have commissioned an evidence review of the intergenerational effects of DES, which will inform our efforts to strengthen support in this area.

[Jessica Toale]

I thank the Minister for her answer and the constructive way in which the Department of Health and Social Care has engaged with me and campaigners from DES Justice UK, but I am still meeting women who are being denied breast cancer screening, colposcopies and other things that are essential for their care, despite the letter from the cancer alliance about DES exposure risk. How can we ensure that GPs and other health professionals are truly aware of the risks of DES, and that the women who need the support can get it when they need it?

[Dame Diana Johnson]

I recognise that some women exposed to DES still face difficulties accessing advice, monitoring and referral. Clinicians should consider individual medical histories, symptoms and risk factors. I had a look at the letter that was sent on 12 December explaining what more should be done by clinicians. I will again ask officials to look at whether we need to reissue that letter or whether we need to take any other action to ensure that the information about DES is spread as widely as possible among clinicians.

[Alison Bennett (Mid Sussex) (LD)]

I am pleased that the Minister is talking about ensuring that medical professionals are more aware of DES and the risks for those who were potentially exposed to it, but what is her assessment of the feasibility of tracking and informing those who were potentially exposed? My constituent Heather did not realise that she—or her mother—had been exposed until long after her mother’s death.

[Dame Diana Johnson]

As I just said, the Government are improving identification and support for people affected by DES by raising awareness among clinicians and strengthening the dissemination of existing NHS guidance. There are considerable challenges associated with recalling records from the 1940s to the 1970s, particularly because of the record-keeping practices of that era and the fact that the Medicines and Healthcare products Regulatory Agency had not yet been established at that time, but I am mindful of the point that the hon. Member makes.

[Dr Sam Rushworth (Bishop Auckland) (Lab)]

7. What steps her Department is taking to increase the use of community hospitals and beds for step-down intermediate care.

--- Later in debate ---

[The Minister for Public Health and Patient Safety (Dame Diana Johnson)]

One of the reasons the Government committed to bring back the family doctor was the importance of maintaining continuity of care for patients. I am pleased to say that the proportion of patients who say they are able to see their preferred clinician when they make a GP appointment has risen from 61% to 68% since the election, but we recognise that there is more to do, and this remains an important priority for the Government.

[Sir Jeremy Hunt]

Has the Minister read the Norwegian population study published in the British Journal of General Practice, which says that people who see the same doctor over many years are 30% less likely to need out-of-hours care, 28% less likely to need emergency care and 25% less likely to die? It has been two years since the Government made the pledge to bring back the family doctor, but the basic structure of general practice has not changed. Can we see some changes in the next GP contract negotiations to bring back the system we used to have, in which everyone has their own doctor?

[Dame Diana Johnson]

I recognise the enormous experience and knowledge of the former Secretary of State for Health and his work on this issue and patient safety more generally. The Department has started to look at expert advice, with a clinical working group, on how best to support continuity of care in modern general practice. I have not read the report that he referred to, but I am happy to go and have a look it. I am also happy to have a discussion with him, because it would be helpful to understand his thinking on what I know he considers to be a very important issue.

[Maya Ellis (Ribble Valley) (Lab)]

Continuity of care in maternity services is based on women building relationships with maternity practitioners who meet them where they are. I would like to echo the comments of the hon. Member for North Shropshire (Helen Morgan): many obstetricians and midwives have been truly disappointed at comments from an NHS leader yesterday, who argued that more maternity units should be shut and that only consolidation of services can make births safer. Women in this country will not accept the industrialisation of our bodies. This Labour Government have promised neighbourhood and preventive healthcare, which has to include allowing new mums to feel rooted in the communities where they will go through their biggest physical and psychological change. Can the Minister assure me that our bodies will not be treated like a manufacturing supply chain to be optimised as she develops the asks for maternity services in this country?

[Dame Diana Johnson]

Gosh, my hon. Friend made a very passionate statement there, and I absolutely agree with what she said. This work will be undertaken with the national maternity and neonatal taskforce, and we will look at all these issues. I hope my hon. Friend will feel able to contribute to that work if she wishes to.

[Mr Speaker]

I call the shadow Minister.

[Mr Speaker]

Order. It is a struggle to get from the original question to where we are, but the Minister is happy to answer.

[Dame Diana Johnson]

I will be mindful of your comment, Mr Speaker. What happened recently is totally unacceptable, and the Secretary of State has made that clear. My understanding is that those individuals who have accessed information about patients, and had no businesses to access it, have been suspended. Disciplinary action will follow, possibly with dismissals. Such actions are totally unacceptable.

[Dr Caroline Johnson]

Another issue that affects continuity of care is when patients remain in the emergency department for prolonged periods after a decision is made to admit them to a ward. That has gone up by over a third since the general election. Can the Government say why?

[Dame Diana Johnson]

Times in A&E are being speeded up. The hon. Lady speaks with experience because she is a clinician, and I am happy to go away and look at that issue and write to her if there is information we need to let her have. My understanding is that we are speeding things up in A&E, and getting people through and on to the ward as quickly as possible.

[Richard Baker (Glenrothes and Mid Fife) (Lab)]

11. What steps she is taking to improve cancer diagnosis and treatment.

--- Later in debate ---

[Chris Coghlan (Dorking and Horley) (LD)]

12. Whether she plans to implement a redress scheme for people harmed by pelvic mesh and sodium valproate.

[The Minister for Public Health and Patient Safety (Dame Diana Johnson)]

I am aware that a number of right hon. and hon. Members are very interested in this issue, and as the new Minister for Public Health and Patient Safety, I am driving the work and giving the report by the Patient Safety Commissioner the urgent and thorough consideration that it requires. As has been stated, the Government are committed to making meaningful progress in this Parliament, and we are advancing non-financial redress to improve health service support for those affected.

[Chris Coghlan]

In 2006 my constituent, Ruth, had pelvic mesh implanted. It has corroded and caused her severe pain. She has been desperate for me to raise this issue with the Government. Three years ago, she paid for surgery to remove it but that has left her tens of thousands of pounds out of pocket and she requires more surgery. What steps is the Minister taking to implement the recommendations of the 2024 Hughes report, particularly if we are to give justice to pelvic mesh patients and support to those who cannot access the NHS compensation scheme?

[Dame Diana Johnson]

I am very sorry to hear about Ruth’s experience and what she has gone through. Just last night, I watched the film that has been produced about the experience of a number of women—my hon. Friend the Member for Washington and Gateshead South (Mrs Hodgson) provided a screening of it in Parliament last week—and the stories in it are harrowing. As I have said, I am looking at the issue. I am conscious that right hon. and hon. Members are interested in what the Government are going to do. The previous Secretary of State had made it clear that progress would be made by the end of this Parliament. That is as far as I can go today, but I am personally looking at this issue.

[Dr Allison Gardner (Stoke-on-Trent South) (Lab)]

From pelvic mesh to diethylstilbestrol, women have been harmed by a health system that has not and still does not listen to them, as starkly illustrated in Mumsnet’s recent report, “Medical Misogyny: A Lifetime of Failure”. Does the Minister agree that tackling medical misogyny must be at the heart of how we rebuild the NHS?

[Dame Diana Johnson]

My hon. Friend makes a very important point. That is why we have revised the women’s health strategy. It makes it very clear that medical misogyny is not acceptable and that women’s voices must be heard.

[Ian Roome (North Devon) (LD)]

13. What steps her Department is taking to improve NHS maternity services in Devon.

--- Later in debate ---

[The Minister for Public Health and Patient Safety (Dame Diana Johnson)]

There is money available for GP surgeries; as my hon. Friend the Member for Bristol South (Karin Smyth) has already said, many of them were left in a terrible state under the previous Government. They were not invested in over many years. There is money available, and when I meet the hon. Gentleman, I will be happy to discuss that with him.

[Helena Dollimore (Hastings and Rye) (Lab/Co-op)]

T7. Many hospital specialisms are increasingly shared between Eastbourne hospital and Hastings Conquest hospital, which is in my constituency. That means that the people I represent who do not drive are required to travel a long way by public transport to get to Eastbourne hospital—between 90 minutes and two hours, and that involves a lot of walking. The hon. Member for Eastbourne (Josh Babarinde) shares my concerns about people travelling in the other direction. With so many services shared between the two hospitals, I am calling on the NHS integrated care board, the trust, and the Reform-run county council to look at providing a shuttle bus that would make it easier for people to travel between the two hospitals. Does the Minister agree that this is something health commissioners should look at when planning services?

--- Later in debate ---

[Tracy Gilbert (Edinburgh North and Leith) (Lab)]

Demand for surrogacy from the UK is leading to the exploitation of women in countries across the globe, including Ukraine, Nigeria and Mexico. Can my right hon. Friend give a commitment on when legislation will come to the Floor of the House, so that we can play our part in ending that exploitation as soon as possible?

[Dame Diana Johnson]

We are clear that no surrogacy arrangements should place any party at the risk of exploitation, and the Foreign, Commonwealth and Development Office provides guidance on the risks of overseas surrogacy and the steps that intended parents must take to return to the UK with their child. The Government have no current plans to legislate to prevent people domiciled in the UK from entering international surrogacy arrangements.

[Mr Gagan Mohindra (South West Hertfordshire) (Con)]

Under the last Conservative Government, upwards of £300 million, which would have been lifesaving as well as life-changing for many of my constituents, was earmarked for the new Watford general hospital. The lack of those funds, combined with the closure of the urgent care centre at Mount Vernon hospital, means that many of my constituents are not now receiving the first-class healthcare that they would reasonably expect. What assurances can the Minister give local residents?

[Jayne Kirkham (Truro and Falmouth) (Lab/Co-op)]

Percy, a five-year-old constituent of mine, wrote to me ask whether gluten-free products would ever be provided on prescription for people with coeliac disease. What steps is the Minister taking to address postcode variations in the provision of gluten-free food by integrated care boards?

[Dame Diana Johnson]

The national position in England remains that gluten-free bread and mixes can be prescribed on the national health service for eligible people diagnosed with coeliac disease. As my hon. Friend says, ICBs can restrict or end the prescribing of gluten-free food, but I am happy to discuss this matter with her.

[Seamus Logan (Aberdeenshire North and Moray East) (SNP)]

The Department has thus far refused to publish the impact assessment associated with the US-UK pharma deal. May I ask what the Government are trying to hide?

--- Later in debate ---

[Baggy Shanker (Derby South) (Lab/Co-op)]

Despite increasing demand, the previous Government scrapped plans for a new health centre in Sinfin, denying our community the care and capacity that it deserves. Will the Minister confirm that this Government are taking a different approach, providing the NHS services in local communities such as Sinfin and beyond?

[Dame Diana Johnson]

Absolutely. That is a core part of the neighbourhood health offer that this Government are making. We have already announced, in wave 1, a number of neighbourhood health centres; wave 2 will be announced shortly. This is absolutely key to keeping people out of hospital and providing healthcare in local communities.

[Helen Maguire (Epsom and Ewell) (LD)]

The unit of dental activity formula is broken, pushing dentists out of the NHS every single day. In Epsom and Ewell, there is a dentist who is restricted from providing NHS dentistry by the UDA quotas. Will the Minister reform the dental contract now, and incentivise NHS dentistry?

Smoke-free UK

Diana Johnson Excerpts

Thursday 15th October 2026 Westminster Hall

[The Minister for Public Health and Patient Safety (Dame Diana Johnson)]

It is a pleasure to serve under you this afternoon, Ms Vaz. I congratulate the hon. Member for Harrow East (Bob Blackman) and my hon. Friend the Member for City of Durham (Mary Kelly Foy) on securing this important debate, and on their steadfast advocacy in support of creating a smoke-free generation. I am grateful to all hon. Members who have contributed today.

I note that the two hon. Members who secured this debate co-chair the APPG on smoking and health and are obviously a formidable duo. I am not surprised that they were able to secure this debate, which I understand was granted by the Chair and members of the Backbench Business Committee. They obviously made a very powerful case.

Hon. Members raised a number of questions this afternoon, which I will try to address in my remarks, but I would also be very pleased to attend a session of the APPG to discuss the issues further. It is really important that we carry on with the cross-party nature of this debate and the work that has gone on by previous Governments. I pay tribute to the work of the previous Government and previous Prime Minister in this particular area, ably assisted by the hon. Member for Harrow East.

The hon. Member for Strangford (Jim Shannon) told us about the rather drastic action his grandfather took to ensure that he remained smoke-free throughout his life. My hon. Friend the Member for Newcastle upon Tyne East and Wallsend (Mary Glindon) spoke about the role of vapes in helping people quit smoking. Importantly, she also talked about the illicit products and traders, and the fact that organised crime is funded by those products.

My hon. Friend the Member for Newport West and Islwyn (Ruth Jones) talked about her professional experience as a physiotherapist and the challenges that are faced particularly in Wales. My hon. Friend the Member for Uxbridge and South Ruislip (Danny Beales) talked about growing up in a family of smokers; he is very anti-smoking. He set out really clearly the health benefits of giving up smoking and how quickly those benefits can materialise.

My hon. Friend the Member for Falkirk (Euan Stainbank) talked about vapes. He chairs the APPG for responsible vaping and also made the case for vapes in helping people cease smoking. Again, I would be very happy to attend and talk to the APPG if that would be helpful.

The hon. Member for Wokingham (Clive Jones), who speaks for the Liberal Democrats, made a very personal statement at the beginning of his speech about the role that smoking had played in his family, with his dad dying at a relatively young age. The Opposition spokesperson, the hon. Member for Farnham and Bordon (Gregory Stafford), set out the work of previous Governments and asked a series of questions, which I will try to address.

I think we are all agree that tobacco is a uniquely harmful product and smoking is the single most entirely preventable cause of ill health, disability and death in the UK. It is responsible for around 75,000 deaths each year. Smoking reduces life expectancy by an average of 10 years, and almost every minute of every day somebody is admitted to hospital because of smoking-related harm.

Smoking contributes to a range of serious long-term conditions, including stroke, heart disease, diabetes, dementia, asthma and complications during pregnancy. The cost of smoking is not just measured in lives lost and poor health. There are significant economic costs. Smoking is estimated to cost the NHS and social care system £3 billion annually, resources that could otherwise be used to fund millions more appointments, scans and operations.

In terms of health disparities, smoking remains one of the greatest drivers of health inequalities in this country, with the burden falling disproportionately on our most disadvantaged communities. The disparities are stark. For example, the number of women who smoke at the time of delivery varies drastically according to deprivation—from 12% in Havering, 8% in Kingston upon Hull, where my constituency is, compared with less than 1% in Richmond upon Thames. Those are not merely statistics; they represent real families, communities and children whose health and life chances are being diminished by tobacco addiction.

Turning to the smoke-free generation, it is a real privilege to have responsibility for implementing the landmark Tobacco and Vapes Act. As many Members will be aware, the Act will create a smoke-free generation by ending the sale of tobacco products to future generations across the UK. In practical terms, that means than anyone who has turned, or is turning, 17 this year will never legally be sold tobacco. Over the next 50 years, that will save tens of thousands of lives and could boost the economy by up to £48 billion pounds.

Since Royal Assent, the Department has made significant progress towards the implementation of the Tobacco and Vapes Act. We have laid enabling legislation in Parliament, engaged extensively with stakeholders across public health and the retail sector, and published detailed guidance. We are also in the process of developing a nationwide awareness campaign to inform the public. We are expecting that to be rolled out in November with a particular focus on areas with high smoking rates.

The hon. Member for Harrow East asked about what progress has been made on the manifesto pledge for opt-out smoking cessation interventions in all routine care. I want to address that, but first I will say that protecting future generations through our smoke-free generation must go hand in hand with helping current smokers to quit. Through the public health grant, we have ringfenced a record investment of £153 million each year for local stop-smoking services specifically, with funding targeted towards those areas with the highest smoking rates. As I said, the hon. Member for Harrow East and my hon. Friend the Member for City of Durham raised the question about services and opt-out. Those services are currently available in 99% of maternity services and 92% of inpatient services. On top of that, ICBs have access to funding for tobacco dependence treatment services in those particular settings.

Many comments were made about youth vaping, and we know that vapes can play an effective role in helping adult smokers to quit, as my hon. Friends the Members for Newcastle upon Tyne East and Wallsend and for Falkirk stated. However, young people, and adults who do not smoke, should never vape. That is because we know that they are not harm-free and the longer-term harms are still unknown.

We are taking firm action to protect future generations from the risk of nicotine addiction. That is important given that a million 11 to 17-year-olds have tried vaping this year. We have also banned single-use vapes, and a vaping product duty is now in force. From 29 October, we are introducing a ban on vape vending machines, banning free distribution and extending the age of sale to 18 for all nicotine and vaping products, including nicotine-free vapes.

The Tobacco and Vapes Act also introduces a comprehensive ban on the advertising and sponsorship of tobacco, vaping and nicotine products. We intend to bring that into force across the UK from 1 June 2027. My hon. Friend the Member for Falkirk asked how we will ensure that striving for a smoke-free generation does not mean banning key smoking cessation tools such as vapes. The measures consulted on have been carefully assessed to ensure the right balance between protecting children and ensuring that adult smokers can still access vapes to quit smoking.

In terms of upcoming policy changes, in May we concluded our consultation on extending smoke-free places to certain outdoor settings and introducing vape-free places. Our consultation on proposals to reduce the appeal of tobacco, vaping and nicotine products closed on 2 October. We are now carefully considering the responses as we develop effective and proportionate policies that continue to protect public health.

Turning to enforcement, to ensure that measures in the Tobacco and Vapes Act are effective, we are providing up to £30 million a year for enforcement agencies until 2028-29. That will support legitimate businesses and enable stronger enforcement against those who break the law. The Tobacco and Vapes Act also provides new powers for enforcers. New fixed penalty notices come into force on 29 October, supporting trading standards to crack down on retailers who break the rules. The Act also provides powers to introduce a licensing scheme for the retail sale of tobacco, vapes and nicotine products in England, Wales and Northern Ireland and to expand the retailer registration scheme in Scotland. To answer the question asked by my hon. Friend the Member for Newcastle upon Tyne East and Wallsend, we intend to consult on those issues next year.

Several hon. Members asked what comes next after the implementation of the smoke-free generation measures on 1 January and for a longer-term road map for tobacco control and the introduction of a “polluter pays” levy. We share the ambition to drive down smoking rates. Indeed, new figures published just last week show that smoking prevalence across the UK has fallen to 9.8%, which is the first time it has fallen below 10%. That is a significant milestone that demonstrates the progress we are making.

We must not mistake progress for completion, however. Around 4.9 million adults across the UK still smoke, and we remain determined to go further. Our immediate priority is delivering the Tobacco and Vapes Act successfully and ensuring that these landmark reforms achieve their full potential. The Act represents the most significant advance in tobacco control in a generation, and getting implementation right will deliver benefits for decades to come. I am very happy to look at all the issues and suggestions that have been made by hon. Members; perhaps we can discuss them at the APPG.

In supporting smokers to quit, protecting children from nicotine addiction, strengthening enforcement and creating a smoke-free generation, the Tobacco and Vapes Act represents one of the most significant public health reforms of our time. Future generations will look back on this moment as a defining milestone in public health. It is legislation that will save lives, reduce inequalities, improve health outcomes and create a healthier, fairer future for communities across the United Kingdom.

Infants, Parents and Carers Bill (First sitting)

Diana Johnson Excerpts

Committee stage
Wednesday 14th October 2026 Public Bill Committees

[Dr Caroline Johnson]

I think it is important that we have both women and men in politics, because fathers have an important role to play with babies too, and gentlemen can talk about their experiences of fatherhood. One of the challenges that some babies face is the lack of that male role model. It is a balance between the two. And, of course, women and men can talk about each or either topic if they wish to do so.

The other thing I want to talk about is interaction and play—the serve and return. Being played with and stimulated is very important for brain development, and a lack of it can lead to reduced attention span, reduced memory and weaker impulse control in the long run. People might believe that interaction and play come instinctively, and to some they do, but to others less so. Support and understanding of what they can do to help their baby is something that I think women and men value, because almost everyone loves their children intently, so they will want to do the best for their baby, and sometimes it is helpful to know what that is. I often get patients in clinic who come with one problem, but if they have a small infant, they will often say, “While I am here, doctor, can you just look at this? Can I just ask about that?” I am sure the hon. Member for Stroud, as a GP, will tell us the same. Parents ask because there are so many questions, and having the opportunity to have them answered is very important.

I also want to talk about inequalities, because we have talked a lot about them this morning. There is now inequality between the services provided in cities and those provided in rural areas. Does the Minister have any comments on how those services will be provided in rural environments? Very often the average income for a postcode may be good, but there will be hidden poverty within it, because of discrepancies within postcode averages that are seen less in cities. Transport can also be more difficult in rural areas. How will the Minister ensure that the services are accessible to those who need them?

I want to talk about the money, because if we invest £1 in a child’s life at this age, we can get £10 in return owing to better outcomes in the long run. Will the Minister confirm that the money for those services will be provided in full, and that there will be a workforce plan to ensure that there is a workforce to deliver them?

The hon. Member for Washington and Gateshead South, who I know has done a lot of work in this area over the years and cares about it very deeply, talks about outcomes. Outcomes are important, but so is value for money, because we must be careful with taxpayers’ money. What interventions are making the most difference, and how do we focus on achieving them? We need to think carefully about what we measure. Overall, however, this is a good Bill that will help infants and children to develop their full potential and have equality of opportunity, and therefore I will support it.

[The Minister for Public Health and Patient Safety (Dame Diana Johnson)]

It is a pleasure to serve under your chairwomanship this morning, Dame Siobhain. We have had a very thoughtful and well-informed debate on the Bill. I am grateful to all hon. Members who have contributed, but I pay particular tribute to the right hon. Member for New Forest West for introducing the Bill and for the care, determination and constructive spirit with which he has championed it. I will follow his lead and deal with both groupings in my remarks.

We can all agree that every baby should get the best possible start in life, and I am delighted that last month the Secretary of State for Health and Social Care announced the expansion of Healthy Babies to every local authority in England. Like Sure Start before it, Healthy Babies will make enhanced health support available in every part of England, giving all families access to trusted, practical help throughout the critical 1,001 days from conception to age two. The Bill will complement the Healthy Babies expansion by creating a clear and enduring framework for support from conception to age two, providing long-term visibility and accountability.

A number of important points have been raised in the debate today. First, the hon. Member for Chichester asked whether those undergoing IVF would be included as prospective parents. The Bill focuses on support from conception to age two, as we have heard, therefore parents who conceive through IVF will be covered from the point at which a pregnancy is established, in the same way as any other prospective parent.

The hon. Member for Chichester also asked about breastfeeding, and there were a number of contributions on that very important issue. She asked whether there would be support for it in the secondary legislation that would come forward. Our starting point for the secondary legislation will be the Healthy Babies offer, which includes maternity, health visiting, infant feeding support, perinatal mental health support and parent-infant relationship support, while remaining open to considering other services that evidence might show babies and families actually need—so the answer to that is absolutely yes.

We also heard from my hon. Friend the Member for Washington and Gateshead South. I pay tribute to her for all the work she did in her previous role to make sure that the Bill could come before us today and will move through its stages in the House. She made a thoughtful and well-informed contribution—as ever—in support of amendment 1. My hon. Friend the Member for Stoke-on-Trent South also supports amendment 1, and spoke so movingly about the very sad case of her constituent Chloe Wilshaw. I am glad that Ministers will be meeting my hon. Friend shortly.

My hon. Friend the Member for Newport West and Islwyn talked about her experience as a paediatric physiotherapist, and how important the support that families and mothers get from conception onwards is to ensuring that babies get the best start in life. My hon. Friend the Member for York Central made, as ever, a considered speech. She raised a number of points, including whether environmental issues would be considered. I was interested to hear the exchange between her and the right hon. Member for New Forest West on that point, and his belief that it is implicit in the Bill’s drafting that environmental issues would be considered, among others. The sharing of data among health and local authorities in respect of children at risk is absolutely a key issue that we need to work at.

The hon. Member for Sleaford and North Hykeham raised the workforce plan. I am told that we will not have to wait too much longer and that a workforce plan will be published shortly, but I take the point made by my hon. Friend the Member for York Central about the need for integrated workforce planning in respect of babies and children. I also recognise the need to include the voice and agency of families, mothers, fathers and carers in this whole issue.

Finally, pre-conception health is of course very important, but the Bill is deliberately focused on the clearly defined period from conception to age two, when support can be directly linked to pregnancy, childbirth and infant development. Extending the Bill further would significantly broaden its scope and duplicate wider public health policy.

Let me turn to the clauses. Clause 1 establishes the scope of the framework set out in the Bill. It requires the Secretary of State to make regulations specifying the publicly funded infant support services to which the Act will apply, together with the functions connected with their provision. Those services must support pregnancy or childbirth, an infant’s health and development, or the relationship between an infant and their parent or carer. Crucially, the clause allows services and functions to be updated as needs and provisions evolve, thereby helping support to remain relevant to babies and families. Any change will be made through regulations subject to parliamentary oversight. That approach allows the framework to evolve as evidence, services and families’ needs change. The regulations will be subject to the affirmative procedure, so both Houses will have an opportunity to scrutinise and approve them.

Clause 2 puts the needs and experience of infants, parents and carers at the heart of national decision making. It helps to ensure that babies, whose voices are too often unheard, are not overlooked. We all know that the period from conception to age two is a golden opportunity to shape life, health, learning and happiness. The clause therefore requires the Secretary of State to assess the expected level of need for infant support services specified in the Bill. This is a practical, evidence-informed approach. So that it can respond to the needs of babies and families as they change, the clause deliberately does not prescribe every detail of the assessment. It does, however, establish a clear expectation that need will be understood and kept under review, thereby helping to inform decisions about services and resources.

[Iqbal Mohamed (Dewsbury and Batley) (Ind)]

The Bill will monitor what services are available and where there are deficiencies. I welcome the Government’s commitment to expanding the Healthy Babies programme across England, but we know today that there is a 40% shortfall in the number of health visitors needed; some health visitors are covering up to 1,000 cases instead of 250. Will the Minister comment on the actions the Government are taking today to address known deficiencies in parallel with taking the Bill forward?

[Dame Diana Johnson]

I am grateful to the hon. Gentleman for raising that point. We all understand how important health visitors are, and I acknowledge the reduction in numbers over previous years; this Government are determined to do something about that. I take his point. Given my responsibility for children’s health, I am very conscious that in health visitors we have a service with great potential. I am thinking particularly about improving vaccination rates; work is going on with health visitors on that. I will write to the hon. Gentleman with more specific details, but I absolutely take his point.

I return to clause 2. The Secretary of State must “take reasonable steps” to include the views of parents and carers as well as prospective parents and carers when carrying out the assessment. Just as we encourage local areas to shape services for and with families, national decisions should begin with the experience of babies and those who care for them; that goes to the point raised by my hon. Friend the Member for York Central. Some babies and families, of course, face additional challenges due to issues such as poor mental health, isolation, financial pressure or housing insecurity, and a regular assessment will help bring those pressures into view and inform decisions about the appropriate levels of provision.

It might help at this point if I turn to the amendment tabled by my hon. Friend the Member for Lowestoft. She has long championed the rights of children and the need to address inequalities, and she made her points in this debate with her usual eloquence and passion. I understand and welcome the challenge that she has made. She is right to press the Government to ensure that the assessment looks beyond expressed demand, considering both wellbeing and inequalities, and pays particular attention to those experiencing the greatest disadvantage. The Government share that objective.

It was always intended that the clause 2 assessments would consider health inequalities, drawing on evidence of unmet need and differences between groups and places. We intended—and I think the right hon. Member for New Forest West did, too—that that would be implicit in the drafting of the Bill. We have heard reference to section 149 of the Equality Act 2010 and section 1C of the NHS Act 2006, the public sector equality duty and the duty to reduce inequalities in access to and outcomes from health services. Together, they require particular attention to those experiencing the greatest disadvantage.

However, I absolutely understand the importance of ensuring that the assessment considers wellbeing and inequalities. Families do not experience need equally, and the assessment must pay particular attention to those facing health inequalities so that unmet need is identified and services can respond fairly and effectively. I would therefore welcome the opportunity to work with my hon. Friend the Member for Lowestoft and the right hon. Member for New Forest West to further consider the amendment ahead of Report. On that basis, I ask my hon. Friend whether she would consider not pushing her amendment to a vote at this stage and returning to it on Report.

Clause 3 concerns action. It builds on the assessment required by clause 2 and ensures that evidence of the needs of babies and families informs the exercise of the Secretary of State’s functions. The clause requires the Secretary of State, when exercising functions specified in the Bill, to act with a view to ensuring appropriate levels of service provision for infants, parents and carers, and prospective parents and carers. In doing so, the Secretary of State must have regard to the most recent assessment of need carried out under clause 2. That creates a clear link between understanding need and considering appropriate levels of provision.

The Bill deliberately does not impose a rigid or uniform national requirement. Needs, existing services and local circumstances differ, and an equal distribution of resources will not always deliver an equitable response. Instead, clause 3 allows the Secretary of State to take account of assessed need, differences between areas and the services already available. The level and type of provision may therefore vary, while the needs of babies and families remain central to decision making. This approach strengthens visibility and accountability, while retaining the flexibility needed to respond to circumstances changing. The needs of babies and families can change rapidly, and an agile response is required. Those 1,001 days cannot wait.

Clause 4 provides the accountability mechanism at the heart of the Bill. It requires the Secretary of State to prepare a report for each reporting period, and to lay that report before both Houses of Parliament. The report must assess the level of provision of the specified infant support services during the period, which will give Parliament regular and transparent information about the support available in England to infants, parents, carers, and prospective parents and carers.

Importantly, the report must consider not only what provision exists but the contribution that those services have made to positive outcomes in relation to pregnancy and childbirth, infant health and development, and the relationship between parents or carers and the infant. That includes examining those outcomes in the light of the needs assessed under clause 2. Clause 4 therefore completes the link between understanding need, considering the appropriate level of provision and reporting openly on the contributions that services are making to positive outcomes. By making provision and outcomes more visible, the clause will support sustained focus on babies and their families, and it will provide a clear basis for parliamentary scrutiny.

Clause 5 defines the Bill’s key terms. It defines an infant as

“a child under two years of age”,

which reflects the Bill’s focus on the earliest period of life, when the foundations for health, wellbeing and development are laid. It defines a parent broadly, including anyone with parental responsibility for a child or an infant. It also recognises carers who look after an infant without having parental responsibility. That inclusive approach reflects the range of family circumstances in which infants are cared for, ensuring that the Bill is not limited to one particular family structure or legal relationship.

Clause 5 also covers prospective parents and carers, meaning that the Bill can take account of people preparing to become responsible for an infant, whether through a current pregnancy or in relation to a child who has already been born. Those definitions do not create any separate duties or entitlement to services; they provide the clarity needed for the duties in the Bill to be understood and applied consistently.

Clause 6 contains standard provisions needed to bring the Bill into effect. It deals with territorial extent, commencement, transitional or saving arrangements and the short title of the Act. The Bill extends to England and Wales, but its substantive provisions apply to England. Clause 6 will take effect on Royal Assent, with the remaining provisions commenced by regulation, which allows time to prepare for implementation. As I have said, regulations specifying or changing the services and functions within scope will be subject to the affirmative procedure, giving both Houses the opportunity to scrutinise and approve them.

This is a really important Bill. It will help ensure that babies and families remain visible in national decision making, and that support during the critical period from conception to age two is informed by need, focused on outcomes and accountable to Parliament. I thank all Members again for their thoughtful and constructive contributions today. I pay tribute to the right hon. Member for New Forest West for introducing the Bill, and for his continued commitment to giving every baby the best possible start in life. The Government are pleased to support the Bill, and I commend it to the Committee.

[Sir Desmond Swayne]

I thank members of the Committee for their attendance and their contributions. In particular, I thank the hon. Member for Lowestoft for tabling amendment 1, which not only enabled the debate we have had but allowed the Minister to make the commitment she has now given to work further on the issue it deals with. After all, achieving such debate and scrutiny of a Bill is one of the principal duties of a Bill Committee. We are all, as a Committee, of one objective, even if we may have detected some minor difference as to how it might best be achieved.

I also thank the Minister and her officials for the work that has gone into preparing the Bill and getting it to this stage today, particularly the recent discussions we have had. I also thank the support of staff in my own office who have carried the burden of that. I ask all members of the Committee to put into their diaries Friday 29 January, when we will deal with the Bill’s remaining stages—that is certainly my estimate of when we will do so. I hope that there will not be a Division, but if there were to be it is vital that the Committee should be quorate.

Question put and agreed to.

Clause 1 accordingly ordered to stand part of the Bill.

Clauses 2 to 6 ordered to stand part of the Bill.

Bill to be reported, without amendment.

Infants, Parents and Carers Bill

Diana Johnson Excerpts

Wednesday 14th October 2026 Public Bill Committees

[Dr Caroline Johnson]

I think it is important that we have both women and men in politics, because fathers have an important role to play with babies too, and gentlemen can talk about their experiences of fatherhood. One of the challenges that some babies face is the lack of that male role model. It is a balance between the two. And, of course, women and men can talk about each or either topic if they wish to do so.

The other thing I want to talk about is interaction and play—the serve and return. Being played with and stimulated is very important for brain development, and a lack of it can lead to reduced attention span, reduced memory and weaker impulse control in the long run. People might believe that interaction and play come instinctively, and to some they do, but to others less so. Support and understanding of what they can do to help their baby is something that I think women and men value, because almost everyone loves their children intently, so they will want to do the best for their baby, and sometimes it is helpful to know what that is. I often get patients in clinic who come with one problem, but if they have a small infant, they will often say, “While I am here, doctor, can you just look at this? Can I just ask about that?” I am sure the hon. Member for Stroud, as a GP, will tell us the same. Parents ask because there are so many questions, and having the opportunity to have them answered is very important.

I also want to talk about inequalities, because we have talked a lot about them this morning. There is now inequality between the services provided in cities and those provided in rural areas. Does the Minister have any comments on how those services will be provided in rural environments? Very often the average income for a postcode may be good, but there will be hidden poverty within it, because of discrepancies within postcode averages that are seen less in cities. Transport can also be more difficult in rural areas. How will the Minister ensure that the services are accessible to those who need them?

I want to talk about the money, because if we invest £1 in a child’s life at this age, we can get £10 in return owing to better outcomes in the long run. Will the Minister confirm that the money for those services will be provided in full, and that there will be a workforce plan to ensure that there is a workforce to deliver them?

The hon. Member for Washington and Gateshead South, who I know has done a lot of work in this area over the years and cares about it very deeply, talks about outcomes. Outcomes are important, but so is value for money, because we must be careful with taxpayers’ money. What interventions are making the most difference, and how do we focus on achieving them? We need to think carefully about what we measure. Overall, however, this is a good Bill that will help infants and children to develop their full potential and have equality of opportunity, and therefore I will support it.

[The Minister for Public Health and Patient Safety (Dame Diana Johnson)]

It is a pleasure to serve under your chairwomanship this morning, Dame Siobhain. We have had a very thoughtful and well-informed debate on the Bill. I am grateful to all hon. Members who have contributed, but I pay particular tribute to the right hon. Member for New Forest West for introducing the Bill and for the care, determination and constructive spirit with which he has championed it. I will follow his lead and deal with both groupings in my remarks.

We can all agree that every baby should get the best possible start in life, and I am delighted that last month the Secretary of State for Health and Social Care announced the expansion of Healthy Babies to every local authority in England. Like Sure Start before it, Healthy Babies will make enhanced health support available in every part of England, giving all families access to trusted, practical help throughout the critical 1,001 days from conception to age two. The Bill will complement the Healthy Babies expansion by creating a clear and enduring framework for support from conception to age two, providing long-term visibility and accountability.

A number of important points have been raised in the debate today. First, the hon. Member for Chichester asked whether those undergoing IVF would be included as prospective parents. The Bill focuses on support from conception to age two, as we have heard, therefore parents who conceive through IVF will be covered from the point at which a pregnancy is established, in the same way as any other prospective parent.

The hon. Member for Chichester also asked about breastfeeding, and there were a number of contributions on that very important issue. She asked whether there would be support for it in the secondary legislation that would come forward. Our starting point for the secondary legislation will be the Healthy Babies offer, which includes maternity, health visiting, infant feeding support, perinatal mental health support and parent-infant relationship support, while remaining open to considering other services that evidence might show babies and families actually need—so the answer to that is absolutely yes.

We also heard from my hon. Friend the Member for Washington and Gateshead South. I pay tribute to her for all the work she did in her previous role to make sure that the Bill could come before us today and will move through its stages in the House. She made a thoughtful and well-informed contribution—as ever—in support of amendment 1. My hon. Friend the Member for Stoke-on-Trent South also supports amendment 1, and spoke so movingly about the very sad case of her constituent Chloe Wilshaw. I am glad that Ministers will be meeting my hon. Friend shortly.

My hon. Friend the Member for Newport West and Islwyn talked about her experience as a paediatric physiotherapist, and how important the support that families and mothers get from conception onwards is to ensuring that babies get the best start in life. My hon. Friend the Member for York Central made, as ever, a considered speech. She raised a number of points, including whether environmental issues would be considered. I was interested to hear the exchange between her and the right hon. Member for New Forest West on that point, and his belief that it is implicit in the Bill’s drafting that environmental issues would be considered, among others. The sharing of data among health and local authorities in respect of children at risk is absolutely a key issue that we need to work at.

The hon. Member for Sleaford and North Hykeham raised the workforce plan. I am told that we will not have to wait too much longer and that a workforce plan will be published shortly, but I take the point made by my hon. Friend the Member for York Central about the need for integrated workforce planning in respect of babies and children. I also recognise the need to include the voice and agency of families, mothers, fathers and carers in this whole issue.

Finally, pre-conception health is of course very important, but the Bill is deliberately focused on the clearly defined period from conception to age two, when support can be directly linked to pregnancy, childbirth and infant development. Extending the Bill further would significantly broaden its scope and duplicate wider public health policy.

Let me turn to the clauses. Clause 1 establishes the scope of the framework set out in the Bill. It requires the Secretary of State to make regulations specifying the publicly funded infant support services to which the Act will apply, together with the functions connected with their provision. Those services must support pregnancy or childbirth, an infant’s health and development, or the relationship between an infant and their parent or carer. Crucially, the clause allows services and functions to be updated as needs and provisions evolve, thereby helping support to remain relevant to babies and families. Any change will be made through regulations subject to parliamentary oversight. That approach allows the framework to evolve as evidence, services and families’ needs change. The regulations will be subject to the affirmative procedure, so both Houses will have an opportunity to scrutinise and approve them.

Clause 2 puts the needs and experience of infants, parents and carers at the heart of national decision making. It helps to ensure that babies, whose voices are too often unheard, are not overlooked. We all know that the period from conception to age two is a golden opportunity to shape life, health, learning and happiness. The clause therefore requires the Secretary of State to assess the expected level of need for infant support services specified in the Bill. This is a practical, evidence-informed approach. So that it can respond to the needs of babies and families as they change, the clause deliberately does not prescribe every detail of the assessment. It does, however, establish a clear expectation that need will be understood and kept under review, thereby helping to inform decisions about services and resources.

[Iqbal Mohamed (Dewsbury and Batley) (Ind)]

The Bill will monitor what services are available and where there are deficiencies. I welcome the Government’s commitment to expanding the Healthy Babies programme across England, but we know today that there is a 40% shortfall in the number of health visitors needed; some health visitors are covering up to 1,000 cases instead of 250. Will the Minister comment on the actions the Government are taking today to address known deficiencies in parallel with taking the Bill forward?

[Dame Diana Johnson]

I am grateful to the hon. Gentleman for raising that point. We all understand how important health visitors are, and I acknowledge the reduction in numbers over previous years; this Government are determined to do something about that. I take his point. Given my responsibility for children’s health, I am very conscious that in health visitors we have a service with great potential. I am thinking particularly about improving vaccination rates; work is going on with health visitors on that. I will write to the hon. Gentleman with more specific details, but I absolutely take his point.

I return to clause 2. The Secretary of State must “take reasonable steps” to include the views of parents and carers as well as prospective parents and carers when carrying out the assessment. Just as we encourage local areas to shape services for and with families, national decisions should begin with the experience of babies and those who care for them; that goes to the point raised by my hon. Friend the Member for York Central. Some babies and families, of course, face additional challenges due to issues such as poor mental health, isolation, financial pressure or housing insecurity, and a regular assessment will help bring those pressures into view and inform decisions about the appropriate levels of provision.

It might help at this point if I turn to the amendment tabled by my hon. Friend the Member for Lowestoft. She has long championed the rights of children and the need to address inequalities, and she made her points in this debate with her usual eloquence and passion. I understand and welcome the challenge that she has made. She is right to press the Government to ensure that the assessment looks beyond expressed demand, considering both wellbeing and inequalities, and pays particular attention to those experiencing the greatest disadvantage. The Government share that objective.

It was always intended that the clause 2 assessments would consider health inequalities, drawing on evidence of unmet need and differences between groups and places. We intended—and I think the right hon. Member for New Forest West did, too—that that would be implicit in the drafting of the Bill. We have heard reference to section 149 of the Equality Act 2010 and section 1C of the NHS Act 2006, the public sector equality duty and the duty to reduce inequalities in access to and outcomes from health services. Together, they require particular attention to those experiencing the greatest disadvantage.

However, I absolutely understand the importance of ensuring that the assessment considers wellbeing and inequalities. Families do not experience need equally, and the assessment must pay particular attention to those facing health inequalities so that unmet need is identified and services can respond fairly and effectively. I would therefore welcome the opportunity to work with my hon. Friend the Member for Lowestoft and the right hon. Member for New Forest West to further consider the amendment ahead of Report. On that basis, I ask my hon. Friend whether she would consider not pushing her amendment to a vote at this stage and returning to it on Report.

Clause 3 concerns action. It builds on the assessment required by clause 2 and ensures that evidence of the needs of babies and families informs the exercise of the Secretary of State’s functions. The clause requires the Secretary of State, when exercising functions specified in the Bill, to act with a view to ensuring appropriate levels of service provision for infants, parents and carers, and prospective parents and carers. In doing so, the Secretary of State must have regard to the most recent assessment of need carried out under clause 2. That creates a clear link between understanding need and considering appropriate levels of provision.

The Bill deliberately does not impose a rigid or uniform national requirement. Needs, existing services and local circumstances differ, and an equal distribution of resources will not always deliver an equitable response. Instead, clause 3 allows the Secretary of State to take account of assessed need, differences between areas and the services already available. The level and type of provision may therefore vary, while the needs of babies and families remain central to decision making. This approach strengthens visibility and accountability, while retaining the flexibility needed to respond to circumstances changing. The needs of babies and families can change rapidly, and an agile response is required. Those 1,001 days cannot wait.

Clause 4 provides the accountability mechanism at the heart of the Bill. It requires the Secretary of State to prepare a report for each reporting period, and to lay that report before both Houses of Parliament. The report must assess the level of provision of the specified infant support services during the period, which will give Parliament regular and transparent information about the support available in England to infants, parents, carers, and prospective parents and carers.

Importantly, the report must consider not only what provision exists but the contribution that those services have made to positive outcomes in relation to pregnancy and childbirth, infant health and development, and the relationship between parents or carers and the infant. That includes examining those outcomes in the light of the needs assessed under clause 2. Clause 4 therefore completes the link between understanding need, considering the appropriate level of provision and reporting openly on the contributions that services are making to positive outcomes. By making provision and outcomes more visible, the clause will support sustained focus on babies and their families, and it will provide a clear basis for parliamentary scrutiny.

Clause 5 defines the Bill’s key terms. It defines an infant as

“a child under two years of age”,

which reflects the Bill’s focus on the earliest period of life, when the foundations for health, wellbeing and development are laid. It defines a parent broadly, including anyone with parental responsibility for a child or an infant. It also recognises carers who look after an infant without having parental responsibility. That inclusive approach reflects the range of family circumstances in which infants are cared for, ensuring that the Bill is not limited to one particular family structure or legal relationship.

Clause 5 also covers prospective parents and carers, meaning that the Bill can take account of people preparing to become responsible for an infant, whether through a current pregnancy or in relation to a child who has already been born. Those definitions do not create any separate duties or entitlement to services; they provide the clarity needed for the duties in the Bill to be understood and applied consistently.

Clause 6 contains standard provisions needed to bring the Bill into effect. It deals with territorial extent, commencement, transitional or saving arrangements and the short title of the Act. The Bill extends to England and Wales, but its substantive provisions apply to England. Clause 6 will take effect on Royal Assent, with the remaining provisions commenced by regulation, which allows time to prepare for implementation. As I have said, regulations specifying or changing the services and functions within scope will be subject to the affirmative procedure, giving both Houses the opportunity to scrutinise and approve them.

This is a really important Bill. It will help ensure that babies and families remain visible in national decision making, and that support during the critical period from conception to age two is informed by need, focused on outcomes and accountable to Parliament. I thank all Members again for their thoughtful and constructive contributions today. I pay tribute to the right hon. Member for New Forest West for introducing the Bill, and for his continued commitment to giving every baby the best possible start in life. The Government are pleased to support the Bill, and I commend it to the Committee.

[Sir Desmond Swayne]

I thank members of the Committee for their attendance and their contributions. In particular, I thank the hon. Member for Lowestoft for tabling amendment 1, which not only enabled the debate we have had but allowed the Minister to make the commitment she has now given to work further on the issue it deals with. After all, achieving such debate and scrutiny of a Bill is one of the principal duties of a Bill Committee. We are all, as a Committee, of one objective, even if we may have detected some minor difference as to how it might best be achieved.

I also thank the Minister and her officials for the work that has gone into preparing the Bill and getting it to this stage today, particularly the recent discussions we have had. I also thank the support of staff in my own office who have carried the burden of that. I ask all members of the Committee to put into their diaries Friday 29 January, when we will deal with the Bill’s remaining stages—that is certainly my estimate of when we will do so. I hope that there will not be a Division, but if there were to be it is vital that the Committee should be quorate.

Question put and agreed to.

Clause 1 accordingly ordered to stand part of the Bill.

Clauses 2 to 6 ordered to stand part of the Bill.

Bill to be reported, without amendment.

Sepsis Awareness Month

Diana Johnson Excerpts

Tuesday 15th September 2026 Commons Chamber

[The Minister for Public Health and Patient Safety (Dame Diana Johnson)]

I start by congratulating the hon. Member for Kingswinford and South Staffordshire (Mike Wood) on securing this important debate on the Floor of the House of Commons from the Backbench Business Committee during Sepsis Awareness Month. I also thank him for his tireless advocacy on sepsis as the co-chair of the APPG. In his excellent opening speech, he spoke very movingly about his own experience. He said that consultants gave him a 10% chance of survival when he was ill with sepsis, so the odds were that he would not be with us today, but I am very grateful that he is and that he is looking so well, and that he can be such a strong voice in this place on sepsis.

I also compliment Lord Mackinlay on the work that he carries on in the other place. Like the shadow Minister, I remember the standing ovation he received when he returned to the House of Commons after battling life-threatening sepsis in 2023, resulting in four limb amputations—what a brave and decent man! Many tributes have been paid to him across the Chamber this afternoon.

I will refer to some of the contributions that have been made. My hon. Friend the Member for Dartford (Jim Dickson) spoke powerfully on behalf of his constituent John, who fought sepsis and is a quadruple amputee. He talked very movingly about how the community had rallied around the family to provide support, but also spoke about how we need to do much more to support people like John in the post-recovery period.

My hon. Friend the Member for Carlisle (Ms Minns) spoke eloquently about her mum, who she lost to sepsis last year—I hope she will accept my condolences—and also her constituent, Kelly Pattison. She reminded us that sepsis affects people in different ways and how important it is to remember that. The hon. Member for Winchester (Dr Chambers), who speaks on behalf of the Liberal Democrats, highlighted the particular risks that people with cancer face from sepsis. I will certainly take back to the Department the concerns that he has raised today.

Sepsis is a devastating condition. It also costs the NHS significant sums of money—more than £1 billion between 2024 and 2025. During Sepsis Awareness Month, I pay tribute to the charities, such as the UK Sepsis Trust and Sepsis Research FEAT, that do so much to support families, raise awareness and fund research. Their contribution to the new sepsis modern service framework was invaluable, and they acted as a megaphone for so many people whose lives have been devastated by sepsis. My deepest condolences go out to everyone who has been affected, not least Merope Mills and other campaigners, but I know that people are not seeking my sympathy today; they want the Government to support the case they are making.

Turning to the sepsis modern service framework, we worked hand in hand with patient representatives, clinical experts, professional bodies, NHS organisations and charities to build the framework. It has entered the history books as the first-ever large-scale engagement process for improving sepsis care. The framework spells out this Government’s commitment to transform sepsis care by 2035. It sets out priority actions to improve prevention, recognition, treatment and recovery while accelerating innovation.

I completely understand that people will say, “Okay, you have now got the framework. What happens next?” We are going to make real progress, and by doing that, we are going to raise our game in a number of areas, including science, technology and data. The National Institute for Health and Care Research, working with academia, industry and other partners, will develop a national research and innovation action plan for sepsis by March next year. That will include research calls that cover sepsis improvement priorities, whether it is vaccination and screening, faster and more accurate diagnosis or innovative treatments.

It is true that the most recent data from the Office for National Statistics suggests that sepsis deaths went down in 2024. However, the data is incomplete and inconsistent. That is due to changes in awareness, diagnosis and recording, making it harder to understand variation and improve care. Without that data, we do not have a full picture, and that is why the framework commits to collecting better sepsis data and why NHS England is commissioning a national infection and sepsis audit. That should give us a clearer picture of mortality, underlying causes and which groups are most affected.

Turning to understanding, it is right to say that Members have highlighted that sepsis is a complex condition that is difficult to recognise because of the variation in symptoms. Many people are unaware that sepsis can develop from common infections, such as urinary tract infections, and few can recognise the full range of symptoms. That is precisely why raising awareness is so important. As we have heard from Members across the House today, the work of campaigners has had a huge impact across the NHS and wider society. The NHS now has a planned, targeted public communications campaign to improve awareness of sepsis symptoms and the actions to take.

[Greg Smith (Mid Buckinghamshire) (Con)]

As was mentioned earlier, the UK Sepsis Trust had a big bang in 2016 with the famous orange and red posters saying, “Just ask ‘Could it be sepsis?’”, which can be seen in many GP surgeries, hospital waiting rooms and so forth. However, those information campaigns dwindle; they become samey, and people get used to seeing them and then not thinking about them. How can the Government organise an almost permanent campaign that refreshes awareness of such a huge killer in our country in the minds of the clinicians and doctors who do such wonderful work, but are under such incredible pressure that they need a constant reminder of conditions such as sepsis?

[Dame Diana Johnson]

I entirely take the hon. Gentleman’s point. We are working all the time on maintaining good public campaigns on issues such as this, and we are reviewing what works and the best methods to use. A campaign of this kind should not be limited to one point in time; it must be ongoing.

The NHS has got better at recognising and responding to all causes of deterioration, including sepsis, since the introduction of the national early warning score. This system helps to identify patients who are seriously ill through clear, scored measurements that are routinely recorded by their bedsides. It is used by every ambulance trust and 99% of acute trusts in England, and the sepsis modern service framework will improve the consistency of its use. To further support the way in which we identify sepsis, the framework prioritises advances in faster, more accurate diagnosis to improve outcomes and the correct use of antibiotics. It will support better access to rapid tests in urgent and emergency care to tackle the problems that occur with the services that are often under the most pressure, where sepsis can slip through the cracks. In the longer term, the Government are promoting wearable health technologies as part of our 10-year plan. The framework will also explore new point of care tests that can determine exactly what kind of infection someone may have, alongside the use of those wearable technologies to support the monitoring of high-risk groups.

No one knows a child better than his or her parents or carers, which is why listening to patients, carers and families is vital to supporting sepsis recognition and escalation. Too many cases have shown the devastating consequences when deterioration concerns are not heard. The death of Martha Mills was an avoidable tragedy, but I hope that her parents take some consolation from knowing that Martha’s rule is saving lives and helping thousands of patients to benefit from changes in their care. I thank them for their tireless campaigning in Martha’ memory, and the real change that it has brought.

Let me remind the House that Martha’s rule means that patients, their families and staff can request a rapid review from a different team if deterioration concerns are not being recognised. Between September 2024 and June this year, nearly 17,500 Martha’s rule calls were made, 5,000 of which were made when a family feared that their loved one’s condition was deteriorating rapidly. Of those, 60% required changes in treatment, with 13% leading to transfers to intensive care and 47% leading to other care changes, including investigations and procedural interventions. Today, Martha’s rule is being rolled out in all acute hospitals in England.

As Members have pointed out this afternoon, it is important to note what happens to people who survive sepsis. They may experience a range of long-term physical, psychological and cognitive health consequences. As the Secretary of State has said, the NHS is cradle to grave, and that means everything in between. It is not acceptable that when someone has been through the worst experience of their life, they are just left to get on with it. That is why we are committed to improving access to post-discharge support and rehabilitation, with priority actions set out in the framework.

Of course, the best way in which to stop sepsis is to prevent infection. Vaccination and infection prevention and control are fundamental. As was mentioned earlier, the outbreaks of meningitis B in England this year demonstrated how quickly infection can lead to sepsis and death. Those outbreaks highlighted the importance of prompt treatment and the benefits of vaccination. The one-off NHS menB vaccination programme has successfully delivered nearly 250,000 first doses to eligible young people across England since its launch on 20 July 2026. I encourage everyone who has not yet come forward to do so, and to ensure that they obtain both doses of the vaccine for proper protection.

The framework commits to improving vaccine access. The shadow Minister put a number of questions to me. I will respond in writing, as I am conscious of the time. The framework also recognises the tension between prompt antimicrobial treatment for sepsis and the risks of unnecessary antibiotic use, and it complements initiatives within the antimicrobial resistance national action plan.

The hon. Member for Kingswinford and South Staffordshire raised a specific question about funding. I want to make it clear that the immediate and short-term actions will be delivered within existing funding under the current departmental allocation, following the 2025 spending review. Longer-term funding is subject to future spending reviews. The Department and NHS England are committed to prioritising funding for sepsis in future spending bids. The framework is a 10-year plan. I do not pretend that we will deliver everything overnight, but it sets clear targets to reduce deaths by a quarter over the next 10 years. That is a clear metric by which to judge our success and to hold Ministers to account. Implementation will be overseen by the National Quality Board.

In conclusion, it has become a bit of a cliché to say things like, “World Sepsis Day is marked once a year, but our work continues all year round.” However, I can assure hon. Members that the sepsis modern service framework is doing just that. For every single day over the next 10 years, the framework will keep pushing us to do better. Let me end by again thanking the hon. Member for Kingswinford and South Staffordshire for securing the debate and for his leadership of the APPG. I look forward to working with him constructively going forward.