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.

Pharmacies: Government Funding

Diana Johnson Excerpts

Wednesday 9th September 2026 Westminster Hall

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

As ever, it is a pleasure to serve under your chairmanship, Mr Betts. I congratulate the hon. Member for Leicester East (Shivani Raja) on securing this important debate and on her opening statement, which set out thoroughly the current situation of pharmacies and the challenges that they face.

We all agree that community pharmacies are at the heart of the NHS and of their local communities. We absolutely recognise the important role that pharmacies play in delivering health services in neighbourhoods across the country, and the opportunity for that role to keep growing. We also recognise that many community pharmacies face financial pressures and that ensuring financial sustainability for community pharmacies is essential to improve patients’ access to medicines and services.

That is why, since coming into office, the Government have delivered successive uplifts to pharmacy funding, following years of cuts or flat funding, and have invested in pharmacies to roll out NHS prescribing and to improve patient access to care in their communities. Of course, none of that would be possible without the dedication and professionalism of pharmacy teams supporting patients across the country. Over the years, like other Members, I have visited many pharmacies in my constituency to listen to what the teams have to say, and I have met with my local organisation Community Pharmacy Humber and its chief executive Paul McGorry.

The contributions to the debate have been excellent and very well-informed. My hon. Friend the Member for North Somerset (Sadik Al-Hassan) is the chair of the APPG on pharmacy and a community pharmacist. He talked about his vision of the integration of primary care by 2040, and how important pharmacy is in that. I very much look forward to discussing that with him outside of this debate.

We then heard from the right hon. Member for Richmond and Northallerton (Rishi Sunak). I think his mum would be very proud that he is banging the drum for pharmacy. He talked about pharmacies in his rural constituency and the important role that they play in rural areas, which was a common theme in the debate.

The hon. Member for Newbury (Mr Dillon), a vice-chair of the APPG on pharmacy, gave a very thoughtful speech outlining the challenges facing pharmacy. The hon. Member for West Dorset (Edward Morello) referenced the closure of the Jhoots stores and highlighted the potential weaknesses in the current regulatory frameworks around closures, which are the reason the Department has been reviewing whether changes are needed to strengthen the oversight of pharmacy businesses. We are actively considering a range of options, including whether legislative changes are required. My officials have been working closely with the General Pharmaceutical Council, NHS England and others to identify any gaps in the current framework. I am of course very happy to meet the hon. Gentleman to discuss that further.

We of course heard from the hon. Member for Strangford (Jim Shannon). He talked about pharmacies in Northern Ireland and the effect on pharmacists and their staff of the stress they are under. He also made the economic case for the use of pharmacies.

I was very impressed that the hon. Member for South West Hertfordshire (Mr Mohindra) did work experience in a pharmacy, but I was a little concerned that he seems to have forgotten all the cuts that occurred to pharmacy under previous Conservative Governments. I think it is fair to say that they made pharmacy payments practically a fixed contract. In essence, with inflation, that meant there were year-on-year cuts to pharmacy funding.

The Liberal Democrat spokesperson, the hon. Member for Mid Sussex (Alison Bennett), spoke about the role of pharmacies and the particular role that they played during covid. We must all remember how important pharmacy staff and pharmacists were during that period; I assure her that I have not forgotten that, and I do not think that the Government have either.

The shadow Minister, the hon. Member for Farnham and Bordon (Gregory Stafford), seems to be suffering from amnesia, which is a common problem among Opposition Members when it comes to the funding situation under the Conservative Government.

[Gregory Stafford]

You’re in charge now.

[Dame Diana Johnson]

Absolutely, we are. I will set out what we are doing about pharmacy, but I thought it would be useful to reflect on the comments and contributions.

First, I want to address the issue of funding. As I said at the outset, the Government recognise the challenges facing community pharmacies following years of underfunding and the difficult fiscal environment. That is why, last year, we took the necessary decisions to give the sector a record 19% funding uplift across ’24-25 and ’25-26. I stress that, at the time, it was the NHS’s largest uplift. However, we know many pharmacies continue to face financial pressures, which is why we have followed last year’s settlement with a further significant uplift of 10% for ’26-27, worth an additional £340 million for the sector.

That funding will help to ensure that patients can continue to access medicines and important clinical support from community pharmacists. The uplift will also support the national roll-out of NHS pharmacist prescribing. From autumn ’26, those services will enable pharmacists to prescribe within the existing Pharmacy First and contraception service pathways, and for up to five new pathways. This will deliver increased access to NHS care, relieve pressures on other parts of the NHS and strengthen support in communities across England, delivering on the commitment made in our manifesto.

This year’s uplift is almost three times the rate of growth in the overall NHS budget and it demonstrates the priority the Government place on community pharmacy, but I do not pretend that the challenges will disappear overnight. Many pharmacies continue to face financial pressures, but the settlements represent a clear change in direction and provide the foundations for longer-term reform. Numerous Members raised pharmacy closures, and I can tell them that, according to recent data, there were 19 net closures in ’25-26 compared with 112 in ’24-25. There has been some progress, but I recognise that there is a lot more to do.

The long-term sustainability of community pharmacy depends on making better use of pharmacists’ clinical skills, reducing unnecessary administrative burdens and enabling pharmacists to deliver more care closer to people’s homes. We will deliver this through the three shifts set out in our 10-year health plan: sickness to prevention, analogue to digital, and hospital to community.

Let me give a clear example of how community pharmacy can support the shift from sickness to prevention. As a new Minister, I have already been struck by the vital role community pharmacists play in bringing vaccination services closer to the communities they serve. The NHS vaccination strategy and our 10-year health plan set out a clear ambition to increase vaccine uptake through primary care. That means complementing the core offer from general practice with accessible vaccination services in settings including maternity and sexual health services, schools, health visiting teams and, crucially, community pharmacy. During the ’25-26 flu programme, community pharmacists vaccinated approximately 4.7 million people, around 600,000 more than in the previous year. This demonstrates the growing contribution that pharmacists can make to prevention as a central part of the NHS-commissioned vaccine programme.

The shift from analogue to digital is very important. I am well aware that outdated technologies prevent skilled staff across the health and care sector, including pharmacy teams, from working to their full potential, stifling innovation and efficiency. Of course, digital transformation is not just about technology for its own sake; it is about giving pharmacists the tools they need to spend less time on admin and more time on caring for patients, and about giving patients more control over the care and support they receive.

Last year, a new prescription tracking service was introduced on the NHS app across nearly 1,500 community pharmacies in England. It allows patients to receive real-time updates and to check when their prescriptions are ready. This year, we will go further by strengthening the digital links between pharmacies and general practice as we build neighbourhood health teams in every community. Digital technology also has an important role to play in strengthening medicine supply chains, which is another issue raised today.

We also want prescribers to have better information about medicine shortages. At present, GPs cannot routinely see live national shortage information when prescribing. We intend to make that information available in real time to help GPs to prescribe suitable alternatives where necessary, saving time for patients and neighbourhood health teams. That will mean fewer patients going from pharmacy to pharmacy in search of medicines.

Thirdly, if we are serious about shifting care out of hospitals and into communities, community pharmacies must be part of the answer. They are trusted, accessible and highly valuable to the communities they serve. They have enormous potential.

[Lee Pitcher]

Will the Minister give way?

[Dame Diana Johnson]

I am very conscious of time—I might get a dirty look from the Chair.

[Lee Pitcher]

I am glad the Minister did not get a dirty look. On moving from hospital to the community, pharmacists often tell me that people do not always know about the services they provide, and residents tell me that too. Does the Minister agree that every one of us has a part to play in promoting and raising awareness of the great services that pharmacies already provide, as well as those they will provide in the future?

[Dame Diana Johnson]

I absolutely agree.

I was going to say a few words about Pharmacy First, the importance of which has been recognised this afternoon. Recent data shows growing public awareness of the service, with the proportion of people who know that pharmacies can treat Pharmacy First conditions increasing from 71% to 79%. There is more we can do, however, so I acknowledge the point made by right hon. and hon. Members.

Pharmacy First has also demonstrated what pharmacists can achieve when empowered to deliver more care. The introduction of NHS pharmacist prescribing will take that a significant step further. Evidence from the independent prescribing pathfinder programme is really encouraging. Across 200 sites, pharmacists delivered more than 34,000 consultations. Around 60% resulted in a prescribing decision, and 97% were completed without a referral to a GP. That demonstrates the real-world potential of pharmacist prescribing to improve access to care and relieve pressures.

The ’26-27 community pharmacy contractual framework builds on these lessons, as NHS pharmacist prescribing is rolled out nationally from autumn this year. That delivers on our pledges in the 10-year plan. We want to unlock the full potential of community pharmacy. It is not just about pharmacists; we are also enabling pharmacy technicians to take greater responsibility within dispensing processes, including allowing checked and bagged medicines to be handed out when the pharmacist is not present.

[Edward Morello]

I thank the Minister for being willing to meet me and the hon. Member for North Somerset (Sadik Al-Hassan) to discuss some of the issues raised today. She mentioned that officials are looking at whether legislation is necessary; will she ask them to consider whether the amendments I tabled to the Health Bill would deliver the powers she needs? If so, will the Government support them in the Lords?

[Dame Diana Johnson]

I am very happy to have a look at the amendments tabled by the hon. Gentleman and to meet him and my hon. Friend the Member for North Somerset. I cannot promise anything else, but I am happy to have a look.

Community pharmacists are a vital part of the NHS and of the communities they serve. They already dispense hundreds of millions of prescriptions every year, but their role is growing: preventing illness, treating common conditions, prescribing where appropriate and improving access to care. Our investment, reforms and 10-year health plan all point in the same direction—a stronger, sustainable community pharmacy sector. This Government are committed to working with the sector to deliver that vision.

Surrogacy Law and Legal Parenthood

Diana Johnson Excerpts

Monday 7th September 2026 Westminster Hall

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

It is always a pleasure to serve under your chairmanship, Mr Pritchard. I thank my hon. Friend the Member for Lichfield (Dave Robertson) for his opening speech on behalf of the Petitions Committee. I am pleased to respond to this debate on the proposal, made by a petition signed by over 113,000 members of the public, to change surrogacy law to recognise intended parents from birth. I welcome the shadow Minister, the hon. Member for Solihull West and Shirley (Dr Shastri-Hurst), to his place and congratulate him on his appointment to that role.

This is a well-attended debate, and there have been many valuable contributions. The hon. Member for South West Devon (Rebecca Smith) and my hon. Friend the Member for Edinburgh North and Leith (Tracy Gilbert) both spoke with great passion about the welfare of women and children, including in the international dimension of surrogacy. I wanted to tell my hon. Friend the Member for Bolton West (Phil Brickell), who is no longer in his place, that I was concerned to hear his intervention about his constituents who had a very poor experience going to Mexico with a certain company. The Department is looking into the allegations about My Surrogacy Journey. As part of that assessment, the Department will consider whether it is appropriate for that company to remain on the gov.uk list of agencies.

The hon. Member for Leicester East (Shivani Raja) talked about the rights of the child coming first. My hon. Friend the Member for Mansfield (Steve Yemm) talked about the strength of motherhood and discussed the important issue of consent. The hon. Member for Strangford (Jim Shannon) raised concerns about the commercialisation of surrogacy. My hon. Friend the Member for Cannock Chase (Josh Newbury) talked about his personal experience of becoming a dad. My hon. Friend the Member for North Warwickshire and Bedworth (Rachel Taylor) spoke about the personal experience of Adam and Jamie. She made a strong speech for reform and also spoke about consent. My hon. Friend the Member for Pendle and Clitheroe (Jonathan Hinder) talked about the ethics of surrogacy and referred to the approach taken by other European countries. The hon. Member for Chichester (Jess Brown-Fuller), the spokesperson for the Liberal Democrats, made a typically thoughtful speech that set out the Law Commission’s report in some detail.

It is worth saying from the outset that the Government recognise that surrogacy is a complex and sensitive policy issue where detail matters to all those involved in a surrogacy arrangement. The Government always recommend that anyone considering surrogacy should have a clear understanding of what is required for parenthood to legally transfer to the intended parents and should seek specialist legal advice before beginning the process.

I am grateful for the opportunity to reflect on this area of law. The UK was, of course, one of the first countries to introduce a legislative framework for domestic surrogacy. The Government support surrogacy as part of a range of assisted conception options and recognise the important part it can play in supporting people seeking to start a family. In the Surrogacy Arrangements Act, Parliament decided that altruistic surrogacy arrangements would be legally allowed and that surrogates would be entitled to reasonable expenses. The Act was introduced to prevent surrogacy arrangements from taking place on a commercial basis.

I am grateful to my hon. Friend the Member for Lichfield for his informed contribution. He and my hon. Friend the Member for North Warwickshire and Bedworth set out the issues raised by the petitioners, Adam and Jamie, and shared their experience of starting a family through surrogacy and of the pathway to legal parenthood in the United Kingdom. The Government recognise the difficulties that intended parents may encounter when applying for a parental order. We are very grateful to those with lived experience of this matter who feel able to share their stories.

I will set out the current legal position on parental orders. Under the Human Fertilisation and Embryology Act 2008, the person who gives birth to the child—in this case, the surrogate—is the legal mother when the child is born and has parental responsibility until the courts put in place a parental order. A parental order makes the intended parents the legal parents and permanently removes the surrogate’s legal motherhood. We recognise that the application process for a parental order can be a difficult period for intended parents. Although the safeguarding assessments take time, they are necessary to support the court’s considerations of parental order applications. Each application is carefully considered by the family court on the facts of the individual case, although I note the issues raised about delays in the system.

The debate has highlighted broader questions about whether the current legal framework in the UK continues to reflect modern family formation and contemporary surrogacy practice. The Government acknowledge those concerns and recognise the arguments on both sides—that the law should provide greater clarity, better support and a more streamlined pathway to legal parenthood while maintaining robust safeguards for children, surrogates and intended parents.

There are many reasons why people pursue international surrogacy arrangements. It is a very complex area. The process to bring the child or children to the UK after birth can be long and complicated. Foreign Office guidance makes it clear that if people are considering surrogacy in a foreign country, they are strongly advised to seek specialist independent legal advice in the UK and the relevant country before making any arrangements.

I hear loud and clear the calls for legislative change this afternoon but, given the limited parliamentary time available, the Government are not in a position to bring forward legislation on surrogacy reform immediately. We will, however, continue to consider options for future reform, and we remain engaged with the issues raised by stakeholders, parliamentarians and families with lived experience of surrogacy.

[Rebecca Smith]

I thank the Minister for making a very thoughtful summing-up speech, as ever. Has she had any conversations with her colleagues in the Department for Work and Pensions about providing clarity on whether the expenses that surrogate mothers receive should count towards their benefits? Under legacy benefits, they did, but under the new version of universal credit, they do not count as unearned income. That thorny issue needs to be looked at, particularly given that £25,000 can be paid to women who may be on benefits, but it does not count as income. Has the Minister had that conversation, and can she look into that?

[Dame Diana Johnson]

I am very happy to take that point away and write to the hon. Lady.

Any future reforms need to protect the welfare of children and safeguard those involved in surrogacy arrangements, as well as to maintain public trust. As noted throughout the debate, the Department supported the joint project of the Law Commission for England and Wales and the Scottish Law Commission to review the current surrogacy regime. The Law Commissions consulted widely on this topic, generating a wide diversity of views. The previous Government welcomed the Law Commissions’ 2023 report on surrogacy reform, and this Government will respond in due course as time allows.

I am very grateful to all those who have contributed to both sides of the debate. The contributions made today have highlighted again both the strengths of the current surrogacy framework and the challenges that may be faced when navigating it. The Government are clear that the welfare of children born through surrogacy must remain paramount. We recognise the importance of ensuring that children are protected, intended parents are supported in having families, surrogate mothers are protected and surrogacy arrangements operate within a framework that commands public confidence. I am sure that the Minister in the Lords, who has responsibility for this area, would be happy to meet hon. Members to discuss this further. Once again, I thank my hon. Friend the Member for Lichfield for introducing this important debate and acknowledging the families impacted.

Social Care and Mental Health Services: Hornsey and Friern Barnet

Diana Johnson Excerpts

Friday 4th September 2026 Commons Chamber

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

I congratulate my hon. Friend the Member for Hornsey and Friern Barnet (Catherine West) on securing this important debate. I have spoken to the Minister for Social Care, who is happy to meet my hon. Friend to discuss her concerns, including her concerns around standards of care in particular. We can arrange for that to happen.

This debate is important because when we talk about social care and mental health services, it can be easy to talk in terms of systems, services, assessments and waiting lists, but behind every one of those words is a real person—someone who may be struggling to get through the day without the right support. It could be a family member who has reached breaking point in trying to care for someone that they love. Those are the people we must keep at the heart of the changes that we are making to our NHS and social care system.

My hon. Friend has taken a sustained interest in these issues in Hornsey and Friern Barnet, particularly the pressures facing adult social care and mental health services, the importance of community provision and the importance of ensuring that people can access the right support at the right time. Let me be clear: it is unacceptable that anyone is left without the mental health care that they need, particularly when they are in crisis.

Let me turn to the local picture in my hon. Friend’s constituency. There is clearly a variation in mental health need across north London. The prevalence of severe mental health illness is particularly high in Haringey, where an estimated 1.44% of residents are living with a severe mental illness—compared with 1.16% nationally—making it among the highest rates in England. Residents of Hornsey and Friern Barnet draw on mental health and social care services at some of the most difficult points in their lives. As my hon. Friend knows, the constituency is served by both Barnet and Haringey councils. There is a different picture in each area. Barnet was assessed by the Care Quality Commission as “good” in January ’25. Haringey was rated as “requires improvement” in February ’25, with the CQC highlighting concerns surrounding mental health discharge processes, communication and timeliness around hospital discharge, partnership working, and a shortage of move-on accommodation for people with mental health needs.

I appreciate how important these issues are for people who are already facing considerable challenges, and how frustrating it is when services do not work together effectively. The Department has therefore supported Haringey through its improvement offer, and I am pleased that the council has engaged constructively with that process. In May, Haringey requested to be de-escalated from the Department’s formal reporting process, which was accepted. The council provided a voluntary update on its progress in August, and expressed confidence in its improvement trajectory.

While that is encouraging, I want to be clear that de-escalation does not change the CQC rating, which remains at “requires improvement” until the CQC completes a further assessment. The CQC issued a notice of assessment on 3 August and we will now await the outcome. I hope that will provide a clear picture of the progress being made and, most importantly, help to ensure that people receive the safe, timely and joined-up support that they deserve.

I want to say a few words about the national picture for mental health. I think we all acknowledge that the challenge is significant, but our ambition is significant too. The 10-year health plan sets out our ambition to reform the NHS, and we are already taking important steps to improve mental health services, including reforming the Mental Health Act 1983 to support better and more personalised care, and recruiting thousands more mental health staff.

We are also making £473 million of capital funding available over the next four years, including community-based mental health centres and mental health emergency departments. That includes £343 million to establish 100 community-based mental health centres and 59 mental health emergency departments across England, building on the six centres already operating in Birmingham, York, Copeland, Tower Hamlets, Lewisham and Sheffield.

One community-based mental health centre will be established in most places in England. That typically coincides with a borough in London. Mental health emergency departments will cover approximately 50% of type-1 A&E departments by ’29-30, and I am pleased to report that there is already a unit at Highgate mental health centre on Dartmouth Park Hill, which has been operational since 2024, but of course we recognise that we must go further. That is why we are developing a new mental health strategy for England, which will set out how we can transform mental health care so that people receive support earlier, face shorter waits, and are helped to stay active and participate in education, work, family and community life.

On delayed discharge and in-patient capacity, my hon. Friend described how discharge delays can leave people with no choice but to remain in mental health in-patient settings for longer than is appropriate. The Government recognise the importance of ensuring that people can leave hospital as soon as they are ready, with the appropriate support in place, such as rehabilitation services. That provision requires effective joint working across health and social care services, which is why the better care fund has committed over £9 billion in ’26-27 to integrated care boards and local authorities. That pooled funding is intended to support services that help people to retain or recover their independence, and to prevent avoidable admissions. Funding recipients are expected to agree local goals for preventing avoidable admissions and reducing delayed discharge, and to work together to develop effective services.

Let me address the point about social care, housing and community support at discharge that my hon. Friend made so eloquently. For some people, particularly those with more complex needs, being clinically fit to leave hospital is not the only condition required for a safe and successful discharge; the right social care, housing and community support must also be available to enable them to live well in the place they call home. In particular, autistic people and people with a learning disability can lack suitable supported housing options in their community, which can contribute to people remaining in mental health hospitals past the point of need. The Government are taking action to increase the availability of appropriate housing and support, including through the £39 billion social and affordable homes programme that my hon. Friend referred to, through which we want new supported housing supply across a diverse range of housing types, including for people with learning disabilities and autistic people.

NHS England is also investing £13 million in 2026-27 through its housing capital programme, to support areas to develop housing for autistic people and people with learning disabilities outside mental health hospital settings, alongside additional funding to support the development of crisis accommodation. Supporting timely discharge incudes ensuring that suitable arrangements are in place. It is essential that people leave mental health in-patient settings safely, with appropriate support in the community and with their needs properly considered.

Revised statutory guidance on discharge from mental health in-patient settings was published in 2024 under the National Health Service Act 2006. The guidance sets out how health and care systems can work effectively together to support discharge from hospital and ensure that the right support is in place in the community. It also includes best practice on involving patients and carers in discharge planning, as well as providing clarity on how health and care partners should work together effectively, including in relation to shared responsibilities and arrangements for funding section 117 aftercare.

Section 117 of the Mental Health Act 1983 places a duty on the NHS and local authorities to provide aftercare once they have left hospital to certain patients who have been detained under the Act. That aftercare should provide people with the support they need to live successfully and safely in the community, while reducing the risk of deterioration in their mental health and the need for further hospital admissions. Depending on an individual’s needs, aftercare can include accommodation, day services and other health and social care support.

We know, however, that there can be a lack of clarity over which organisation is responsible for providing and funding aftercare and in which locality, which can lead to further delays in providing support to vulnerable people. The Government’s recent reforms to the Mental Health Act clarify which local authority is responsible for arranging an individual’s aftercare, by applying the existing social care rules on ordinary residents to people receiving aftercare under the Act. That should provide greater clarity and consistency for local authorities and ICBs, supporting more effective joint planning and better aligned aftercare services.

I now turn to longer term adult social care reform and the Casey commission, which my hon. Friend referred to. We need to think ambitiously about the future of social care. At its best, social care is transformational. It can give people the support they need to live independently, maintain relationships, contribute to their communities and live the lives that they want. That is at the heart of the Government’s vision for a national care service: a system that is more person-centred, integrated with health services and preventive. The Prime Minister has been clear that he wants rapid progress towards that vision, working in partnership with the adult care sector.

The Independent Commission on Adult Social Care, led by Baroness Casey, remains central to the Government’s ambitions to reform the sector. Baroness Casey’s Big Conversation on Care, launched on 29 July, gives people across England the opportunity to tell us what they want and expect from a future care service. This conversation will feed into the commission’s recommendations for the funding of adult social care, which will now be made in the summer of ’27. In the meantime, we will continue to put in place the building blocks of the national care service through improving support for the workforce and unpaid carers, and providing more than £4.6 billion of additional funding for adult social care in 2028-29, compared with 2025-26.

I thank my hon. Friend again for raising these important issues and for shining a light on the experience of people who rely on mental health and social care services in her constituency. They are encouraging signs of progress locally, particularly Haringey’s engagement with the improvement process, but clearly there is more to do. The Government are determined to support local partners to make these improvements, while addressing the long-term challenges facing social care. Ultimately, this is about making sure that no one is left waiting unnecessarily for care and giving every person confidence that the services around them will work together when they need them most.

Question put and agreed to.

Infants, Parents and Carers Bill

Diana Johnson Excerpts

2nd reading
Friday 4th September 2026 Commons Chamber

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

I am grateful for the opportunity to speak on behalf of the Government in support of the Bill. I congratulate the right hon. Member for New Forest West (Sir Desmond Swayne) on securing first place in the private Member’s Bill ballot, and on bringing this important Bill before the House. In the 21 years that I have been in this place, I have never even got close to getting a private Member’s Bill, but I heard from the right hon. Gentleman that he had had to wait 30 years to get his, so there is hope for us all. It has certainly been worth the wait. The Bill reflects both careful thought, and a determination to ensure that babies, parents and carers receive the sustained attention that they deserve.

I also recognise the valuable work of the 1001 Critical Days Foundation, and in particular Dame Andrea Leadsom’s long-standing commitment to that agenda. I served in Parliament with Dame Andrea, and I know that over many years she has helped to build understanding across Parliament, and beyond, of why pregnancy and the first two years of life matter so profoundly. Her leadership has kept babies and their families at the heart of the national conversation. I also commend the work of the CEO of the foundation, Will Quince, who previously served in this House and was a Health Minister, and of course I thank my distinguished colleague, the right hon. Lord Blunkett for all his work in this area. I want to refer to the late Baroness Tessa Jowell, who has been mentioned many times during this debate, and her pioneering work around Sure Start, which I will say a little more about later in my speech. I also thank Graham Allen, the former MP for Nottingham North, for all his work in this area. I am grateful to all the organisations, professionals, parents and carers whose advocacy and experience have shaped this debate.

I acknowledge the many excellent contributions we have heard today, but I will start with the outstanding speech made by my hon. Friend the Member for Washington and Gateshead South (Mrs Hodgson), who until this summer was an excellent Minister in the Department of Health and Social Care. In the 21 years that she has been a Member of Parliament, she has fought long and hard for the rights of babies and children, be that by promoting school food or free school meals or special educational needs, or in this case through all the work she has done to ensure Government support for the Bill. As she said, “Back our babies, back the Bill.” She has been campaigning on these issues for so long—indeed, as the right hon. Member for New Forest West said, “since God was a boy”. In my view it is “since God was a girl”, but I thank my hon. Friend for all the work she has done.

We have had important and wide-ranging contributions from Members across the House covering many issues, and I will highlight a few. My hon. Friend the Member for Dulwich and West Norwood (Helen Hayes), the Chair of the Education Committee, gave us the excellent phrase that is outside Sheringham nursery and children’s centre: “Building brains here”. I think that is very powerful. We heard from my hon. Friend the Member for Ribble Valley (Maya Ellis) that raising children is a public good and we all have an interest in it. The hon. Member for Twickenham (Munira Wilson) spoke about the important role of charities and the voluntary sector, of Home Start, and of the Extra Mile charity in her constituency. The hon. Member for North East Hampshire (Alex Brewer) talked about medical misogyny and domestic abuse, which are really important issues, and my hon. Friend the Member for Sherwood Forest (Michelle Welsh) talked passionately about her frontline experience of early intervention at Sure Start and, absolutely, the power of sitting down with a cup of tea and having someone to talk to. I also pay tribute to her role as the Government’s national maternity adviser, and her wise counsel in that role.

[David Smith (North Northumberland) (Lab)]

Will the Minister give way?

[Dame Diana Johnson]

I will carry on, because I want to say something about other hon. Members. My hon. Friend the Member for Glasgow East (John Grady) spoke as a recovering lawyer and talked about safeguarding issues. I found his scrutiny of the Bill’s clauses interesting and important, and we will obviously reflect on that. I wish the hon. Member for Carshalton and Wallington (Bobby Dean) well as a new parent—I think he is the newest parent in the House, so all the very best with that. He talked about maximising the potential of every child.

My hon. Friend the Member for Edinburgh North and Leith (Tracy Gilbert) talked about surrogacy and made passionate comments about the surrogacy laws, particularly in respect of international surrogacy. My hon. Friend the Member for Croydon East (Natasha Irons) gave her personal reflections and talked about her community. The hon. Member for Chichester (Jess Brown-Fuller) talked with great skill and knowledge drawn from experience in her role on the APPG, and talked about the importance of support for mums. I add my best wishes to those of my hon. Friend the Member for Aylesbury (Laura Kyrke-Smith) to Hallie on her first birthday.

We heard about health inequalities. My hon. Friend the Member for Altrincham and Sale West (Mr Rand) talked about how investing in babies will provide the fairer, stronger and more prosperous country that we all want to see. My hon. Friend the Member for Mansfield (Steve Yemm) talked from the perspective of being a grandfather. My hon. Friend the Member for Tipton and Wednesbury (Antonia Bance) talked about temporary accommodation. My hon. Friend the Member for Lowestoft (Jess Asato) quoted one of my favourite Larkin poems—Philip Larkin was the librarian at the University of Hull for many years, and as a Hull MP, I know that poem very well—and talked about the importance of getting safeguarding right.

My hon. Friend the Member for Stoke-on-Trent South (Dr Gardner) spoke passionately on behalf of her constituent, Ashley, and baby Chloe. I am very happy to meet my hon. Friend and Ashley, and I am pleased to hear about the improvements that have been made at the Royal Stoke hospital. My hon. Friend the Member for Newport West and Islwyn (Ruth Jones) brought her experience and knowledge as an NHS professional to the debate.

[Rachael Maskell (York Central) (Lab/Co-op)]

Many Members were unable to contribute to today’s debate but have much to say, so will the Minister meet those Members to discuss further issues that were not raised during the debate?

[Dame Diana Johnson]

I know that my hon. Friend has a great deal of experience in this area. My door is always open to Members of Parliament to discuss issues within my portfolio, so yes, of course I would be happy to meet those Members.

I want to say a little bit about the importance of the first 1,001 days. The Government have set out an ambition to raise the healthiest generation of children ever, and to give every child the best start in life. If we are to achieve that, we must begin at the very beginning. The 1,001 days from pregnancy to a child’s second birthday are a unique window of opportunity. During that short period, babies’ brains, bodies and relationships develop at extraordinary speed. The experiences they have and the care and support around them help to lay foundations for physical health, emotional wellbeing, communication and learning. I have seen that myself in recent weeks with the birth of my great-niece, Isabelle Diane.

A baby does not develop in isolation: their world is shaped by the adults who care for them. Supporting a baby therefore means supporting the whole family, helping parents and carers to build confidence, protecting their mental health, strengthening the parent-infant relationship and providing practical help with feeding and child development.

[Katrina Murray (Cumbernauld and Kirkintilloch) (Lab)]

On that point, will the Minister give way?

[Dame Diana Johnson]

I will carry on.

That support must be accessible and compassionate. Parenthood can be joyful, but it can also be exhausting and isolating. Some families face the additional pressure of poverty, insecure housing, poor mental health or limited support networks. Early help cannot remove every challenge, but it can prevent difficulties from escalating and reduce inequalities before they become entrenched. That is why the child poverty strategy is also so important, alongside all that this Government are doing. Early intervention is not only the right thing to do for babies and families now; it is an investment in the future. When parents and carers receive the right help at the right time, children have a strong platform from which to grow, learn and thrive, and there is less need for costly crisis intervention later on.

I want to say a few things about Sure Start. We all know that well-designed support can make a lasting difference. Sure Start, launched in 1998 under the previous Labour Government, brought health, early learning, childcare, parenting and wider family support together for families with children under five. At its best, it offered a trusted local front door, with professionals working around the needs of the child and the family, rather than expecting families to navigate a maze of separate services.

The long-term evidence of the success of Sure Start is compelling. Research by the Institute for Fiscal Studies found that children with greater access to it experienced fewer hospital admissions later in childhood and adolescence, better educational outcomes, improved mental health and lower levels of school absence. That was felt even more profoundly by children growing up in disadvantaged communities. Very importantly, there is also a strong economic case. The central estimate is that Sure Start’s long-term financial benefits were about twice its up-front cost. That matters, because it shows that early support is not simply a desirable addition to public services, but can improve lives, reduce pressure on health and education services, and provide value for the taxpayer.

The lesson is not that every aspect of the past should be reproduced unchanged. It is that trusted local provision, early help, joined-up services and a clear focus on families can make a measurable difference. Those principles run through the Government’s approach today. Through the Best Start family hubs and the healthy babies programme, we are building a more joined-up, prevention-focused system of support. As part of the wider best start in life agenda, Best Start family hubs are designed to give families a clear route to the help and support that they need, making it easier for them to find information, advice and practical help, from pregnancy through to childhood. They bring together health, early education and wider family services, and connect parents and carers with support with parenting, relationships, child development, special educational needs and disabilities and financial wellbeing, and with community support. Since April 2026, all 153 upper-tier local authorities in England have been delivering the programme.

The healthy babies programme sits at the heart of the Best Start family hubs, providing focused help from conception to the age of two, particularly with infant feeding, perinatal mental health and parent-infant relationships. Those services support parents and carers to nurture their babies and promote healthy physical, social and emotional development. The Government are investing £200 million in healthy babies over three years as part of our wider £900 million package for Best Start family hubs and healthy babies. The healthy babies funding is helping 75 local authorities with high levels of deprivation to strengthen those services. The support is practical and preventive, and includes one-to-one and peer support with infant feeding, help with mild to moderate perinatal mental health difficulties, and evidence-based work to strengthen the relationship between parent and baby. The support also helps local areas to publish clear information and involve parents and carers directly in designing and improving services. Importantly, this is not a one-size-fits-all model. Local areas are responding to the needs of their own communities.

Effective support is about not simply making services available, but ensuring that parents, carers and expectant families feel confident seeking help and can access it when they need it. It means building on the strengths already present in communities, creating opportunities for families to support one another, and developing trusting relationships so that no family feel that they must face challenges on their own. Through the 10-year health plan, we are committed to expanding healthy babies nationally over the coming decade. We want to create a visible local offer, rooted in neighbourhoods and designed around families.

So why is the Bill needed? The Government are taking action to support babies and their families, but history shows us that effective early years support can be vulnerable when it depends mainly on time-limited programmes, non-statutory guidance or broad general duties. Priorities and funding arrangements change, and services that families value can lose visibility or become fragmented. As one of those who was around during the time when we had to fight to try to keep Sure Start in place, and who heard the warnings about how short-sighted it was to cut and dismantle the service, I know that the battle is really hard, so the Bill is very welcome.

The Bill provides a focused and proportionate response. Its central purpose is to ensure that the needs of babies, parents and carers are systematically understood, reflected in relevant decisions and made visible to Parliament. Pregnancy and the first two years should not be treated as a passing policy priority; they should receive sustained attention over time. The Bill does not create a new individual entitlement to a fixed list of services, and it does not prescribe a single model of what these services should look like. Instead, it creates a durable national framework, so that decisions on infant support services are informed by evidence, assessed need and the lived experience of families.

As we have heard, the Bill establishes five linked duties. First, the Secretary of State must make regulations specifying the publicly funded infant support services and relevant functions to which the framework applies. Secondly, the Secretary of State must assess the expected level of need for those specified services. Thirdly, in preparing that assessment, the Secretary of State must take reasonable steps to seek the views of parents, carers and those expecting to become parents or carers and must take those views into account. Fourthly, the Secretary of State must exercise the specified functions with a view to ensuring appropriate provision. Finally, the Secretary of State must report annually to Parliament on the level of provision and the contribution that those services make to positive outcomes.

The Government support the Bill because it aligns with our priorities. It advances our ambition to raise the healthiest generation of children ever and reinforces the work that is under way through the healthy babies programme and Best Start family hubs. For those reasons, the Government are supporting the Bill this afternoon.

Vaccination Rates: England

Diana Johnson Excerpts

Thursday 3rd September 2026 Westminster Hall

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

It is a pleasure to serve under you today, Mrs Barker. I am grateful to the Chair of the Health and Social Care Committee, the hon. Member for Oxford West and Abingdon (Layla Moran), and its members for securing this important debate and am grateful to all hon. Members who have spoken this afternoon. I commend my hon. Friend the Member for Uxbridge and South Ruislip (Danny Beales) for his passionate opening statement. I also welcome the shadow Minister, the hon. Member for Sleaford and North Hykeham (Dr Johnson), back to her place after the reshuffle; I congratulate her on surviving for so long.

I know that Members across the House are very concerned about this issue. I have been struck by the knowledge and expertise around the Chamber this afternoon. Many questions have been posed. If I do not get to every question that Members have asked, I will write to them with an answer.

After clean water, vaccination is the most effective public health intervention for saving lives and promoting good health. It protects individuals, protects families and protects communities. One vaccination can change the whole course of a life for the better or, if it is missed, for the worse. I am very conscious of that as a Hull MP, because in October 1961 we were the first city to mass-vaccinate with the new oral vaccine. When we faced a polio outbreak that threatened the city, over 350,000 people were vaccinated in two weeks. That led to the national roll-out soon afterwards, helping to virtually eliminate the disease nationwide.

Over generations, vaccinations have made diseases that once killed or disabled thousands of children rare and have eradicated smallpox worldwide. Vaccination is central to this Government’s wider shift from sickness to prevention. In terms of the diseases we protect against, we deliver at the moment what I still believe is a world-class vaccination programme, backed by expert advice from the independent Joint Committee on Vaccination and Immunisation. But the benefits depend on high uptake, and childhood vaccination rates have moved in the wrong direction.

Falling vaccination rates are a very serious challenge. Despite our programme achieving more than 90% coverage for babies’ first doses against diseases such as polio and measles, we are not hitting our targets. There is no single cause and there is no quick fix. We know that some families struggle to get an appointment that works for them or have not received clear, trusted information in a way that works for them. Services also vary across the country. The pandemic put further pressures on the health system and misinformation can add to these problems.

[Sir Desmond Swayne in the Chair]

We are therefore acting on four fronts: clearer NHS organisation, more flexible services, better public information and joined-up digital records. I will deal with each in turn, but first I will address targets, as well as funding and delegation to ICBs. Let us be clear: the Government have not dropped vaccination targets. To summarise, our targets are 95% for routine pre-school immunisations and 90% for routine school-age immunisations. Our targets remain in force and are based on standards set by the World Health Organisation. We have simplified the NHS planning guidance to avoid duplication, but we did not lower our ambition. We are also backing targets with better accountability. Coverage of MMR vaccinations for young children will form part of how the performance of NHS ICBs will be assessed as they take on responsibility for vaccination services from April next year.

We have not cut funding for vaccination services. We have confirmed funding for the next three years, giving the NHS certainty as responsibility moves from the NHS regions to ICBs in April 2027. Excluding covid-19 vaccinations, that is a real-terms increase and will help ICBs and vaccination service providers to plan service improvements further ahead.

On delegation, ICBs are best placed to improve vaccination coverage because they understand the needs of their local communities. That matters because the reasons for low coverage vary from place to place. ICBs can shape these services around local needs and barriers, whether that means more convenient appointments or clearer information from trusted sources. This is devolution in action.

I reassure hon. Members that national bodies will continue to set standards, monitor performance and hold the system to account.

[Dr Chambers]

Will the Minister give way?

[Dame Diana Johnson]

I will carry on because I have very limited time, but I am happy to write to the hon. Gentleman or talk to him afterwards. I know there are concerns about the cuts that have been made to ICB running costs. These are planned reductions that relate just to administration, not the funding that will be used to provide frontline vaccination services.

Turning to pre-school access, flexible services are critical. Vaccination rates are lowest in the most deprived communities, so improving uptake means making services easier to use. Pre-school children will continue to receive their vaccinations through their GPs. We have increased the payment to GPs for each routine childhood vaccination from £10.06 to £12.06 and changed the GP incentives to reward improvements where uptake is lowest.

However, we recognise that GP services will not reach every family and are therefore testing vaccinations through health visiting teams, including through 12 pilots across England, four of which are in London. Health visitors have brought vaccines to family homes to ensure that the most vulnerable families are offered these lifesaving interventions. We have also been expanding the use of community pharmacies and are evaluating that. We are looking at supporting targeted local outreach as well. The aim is simple: to reach those who might otherwise miss out.

School-age vaccinations are also a priority. The joint school-aged vaccination programme of work with my Department and the Department for Education is now overseeing actions to improve coverage in schools by resolving local delivery problems. The NHS is also rolling-out new digital technology to make it easier for busy parents to provide consent. It has published revised guidance for schools and the NHS and there are regional support forums to tackle any problems that are present.

We also have the Mavis—manage vaccinations in schools—scheme. That is a new digital system that allows parents to give consent online and helps NHS teams to keep records up to date. By September 2026, it will be used by 72% of school vaccination teams, covering more than 13,800 schools, with further expansion planned for April ’27.

Turning next to awareness, most parents want to do the right thing for their children. Our job is to ensure that they can easily find the clear and trustworthy information that they need. That means stronger public campaigns and confident healthcare professionals giving that advice. We think that it could also be provided by schools and better start hubs, as well as trusted local organisations.

We all agree that false claims online can cause huge concern and worry. As a number of hon. Members have said, the actions of politicians have consequences. We all share the responsibility to base our comments on science and evidence. We have seen the damage that misinformation can cause. The entirely discredited and morally repugnant claims linking MMR and autism in the 1990s led to a substantial fall in coverage, so experts now monitor emerging misinformation and respond with accurate information. I hear the calls today for stronger action against social media companies, but we do not want to mistake misinformation for the whole problem. To improve coverage, many families simply need vaccinations to be easier to understand and to access.

I will conclude with the issue of digital and data. We are improving vaccination records. At the moment, information is held in different NHS systems and does not always follow a patient between services. Through new digital systems, we are joining those records together. That will help healthcare professionals to see which vaccinations someone has had, allow the NHS to identify communities where uptake is low and give families clearer records, reminders and information about where to get vaccinated. Over time, families will also be able to access more of this through the NHS app.

Vaccinations have protected generations from serious disease, and all of us have a vested interest in ensuring that they continue to do so. That means clear accountability, easier access, trusted information and better record keeping. As I have set out, we are acting on each of those fronts. Rebuilding coverage will take sustained effort, but we will monitor progress closely and take further action wherever it is needed.

I note that the House of Lords Childhood Vaccinations Committee is due to report shortly. As the new Minister in this post, I will be looking very closely at the recommendations that come out of that report. I have had the chance to look at the letters that the Health and Social Care Committee wrote to one of my predecessors, and I can assure all hon. Members in the room today that I will go back to the Department and redouble my efforts to ensure that we see the increase that we all want in the number of vaccinations, particularly for children. I thank all hon. Members for their contributions this afternoon.

NHS

Diana Johnson Excerpts

Thursday 23rd May 2024 Commons Chamber

[Victoria Atkins]

I thank my hon. Friend not just for his question, which was excellent as always, but for his long record in the House, particularly in the world of healthcare. He was a superb Minister in the Department of Health and has chaired the Select Committee with great skill. He has scrutinised many a Minister, which I promise him is not a relaxing experience. I really pay credit to him.

May I also thank my hon. Friend for highlighting the importance of prevention? We want to bend the demand curve on the NHS. We know that demand has risen in recent years—we are seeing more people in A&E, we are seeing more cancer referrals and we are seeing more people accessing scans, checks and diagnostics—and we need to help people to understand that we can take responsibility for our own health. Through work such as that on using the NHS app as a gateway to prevention, I genuinely think that we will be helping not only our generations but, importantly, younger people, who sometimes get forgotten in our conversations about healthcare.

[Dame Diana Johnson (Kingston upon Hull North) (Lab)]

I welcome the commitment from the Health Secretary to paying the £210,000 interim payment to those infected under the contaminated blood scandal. But can I say that there is no clarity at all from the Government about the payments that Sir Brian recommended in April 2023 to those who have received nothing so far—the parents who have lost children and the children who have lost parents?

Can I seek a guarantee from the Health Secretary that we will see psychological support services put in place in England immediately? They are in place in Northern Ireland, in Scotland and in Wales. Since 2020, Ministers in the Department have been saying that those services would be made available. That is four years ago; it is not acceptable. After the statements earlier this week by the Prime Minister and the Paymaster General, that is something that the NHS could do quickly and which would have enormous impact, especially because, with the general election having been called, people do not quite know what will happen to the Government’s promises.

[Victoria Atkins]

I thank the right hon. Lady for all her work. She may recall that, when the inquiry was announced by the then Prime Minister, my right hon. Friend the Member for Maidenhead (Mrs May), we had a debate on that matter where I spoke as a Back Bencher on behalf of a constituent; I very much hope that he and others gain some reassurance from the fact that I understand exactly the issues they have faced over many years. As Health Secretary, it is my responsibility, and indeed my privilege, to try to help them now.

In relation to the compensation schemes for those who have not yet received payments, I know that the right hon. Lady will have carefully pored through the responses of my right hon. Friend the Minister for the Cabinet Office and Paymaster General. We want to give the independent compensation authority—I underline independent because I am sympathetic to the sensitivities of families and victims around the role that the Department of Health and others played in their pain—and Sir Robert the chance to set up the scheme, assisted by the expert panel.

I promise the right hon. Lady that I have been discussing psychological support with the chief executive of NHS England for some time. We want to recruit the right people to conduct that incredibly sensitive work. It will take us a little more time, but I assure her that NHS England is acting quickly to bring in those services, we hope, by the end of the summer.